AHRMM Recommended Initiatives for the Health Care Supply Chain

The below ideas give the foundation for a global “control tower” approach to managing the U.S. health care supply chain, building resiliency, visibility and multi-directional transparency between raw materials suppliers, acute and non-acute care settings. This, coupled with technology and cloud-based inventory platforms, could provide us with the unprecedented ability to effective manage and move critical products, supplies, equipment and staff to those areas most in need. 

These recommendations help to avoid the inefficiencies, unnecessary product demand, cost and operational management associated with hospitals establishing their own surge inventories, or mandates for hospitals to maintain a specified number of days of on-hand inventory of critical products and supplies. 

• Current manufacturing production equalizes to meet market demand and in today’s Just-In-Time (JIT) environment, there is limited flexibility across supply chain continuum to meet spikes in product demand. Consideration should be given how to effectively create an artificial floor for personal protective equipment (PPE) demand from a manufacturing perspective where production of critical products and supplies exceeds current market demand, limiting/eliminating the current environment of chasing demand, or the bullwhip effect. Building this level of supply chain resiliency has the potential to increase supply chain flexibility and its ability to absorb spikes in product demand. 

• Allocating capital dollars for non-revenue, patient-centered initiatives continues to be a challenge. Consideration should be given to establishing a program similar to the electronic health record (EHR) subsidy program that will assist/allow health care organizations to acquire scanning technology. Such a program could accelerate adoption and implementation of scanning technology allowing the health care organization to electronically capture the Unique Device Identifier (UDI) at the point of consumption greatly improving visibility into product utilization. Accelerated adoption of the data standards, including the UDI, could provide much needed transparency to on-hand inventory levels across the supply chain continuum (acute and non-acute care settings, distributors and manufacturers). 

• Develop new surge inventory programs. Some of the short-term and longer-term strategies include:
  • Health care organizations could form regional coalitions to build surge inventories and develop allocation strategy guidelines to use during pandemic or disaster mitigation. Emergency management agencies could play a critical role in the development of an allocation template that could be used/modified by these regional coalitions.
  • Aggressive use the Defense Production Act to provide supplies that can be used during this current pandemic, and pre-position contracts and equipment assets within existing manufacturing facilities for future pandemics. This will create additional production capabilities that can be activated in future disasters and pandemics.
  • Establishing a percentage of on-shore PPE manufacturing capabilities for critical products, supplies and equipment brings tremendous benefits beyond supply availability and contributes to addressing the social determinants of health, including community employment, access to health care, education, food, and more. 

• Educating clinicians and physicians during the course of this pandemic has proven to be challenging. Therefore, we must develop post-pandemic education and training that includes; matching product use to the appropriate environment, understanding conservation and decontamination strategies and the development of clinically accepted products list at the health care field level, and share the science and the studies behind each of these elements. Educating clinicians and physicians in the above strategies post pandemic will improve acceptance of adopted strategies during future disasters and pandemics.