Dr. Anne Snowdon, RN, PhD Professor of Strategy & Entrepreneurship Chair of the World Health Innovation Network Odette School of Business University of Windsor
Dr. Charles Alessi, LRCP, MRC Senior Advisor - Public Health England Lead for Dementia - Public Health England Director, Antibiotic Prescribing, Antimicrobial Resistance - Public Health England Visiting Scholar, World Health Innovation Network
Introduction One of the greatest challenges facing global healthcare systems is patient safety: medical errors are now the third leading cause of death in North America. This paper proposes a new direction to improve patient safety and performance. By transforming the healthcare supply chain we can achieve visibility and attain greater value for patients, health system leaders, industries and governments.
Value of a Highly Visible Healthcare System Traceability in healthcare supply chain enables: Patients to better manage their care, track health outcomes, report adverse events, respond to recalls and retain confidence in health systems. Providers to have access to product performance linked to patient outcomes and readily determine the attributes of products to ensure safe care. Health organizations to strengthen procurement to best meet patient needs in a cost-effective manner that offers the greatest value. Industry to gain information important for product design based on direct evidence of patient outcomes and to meet regulatory requirements. . Governments to have access to evidence across the continuum of care regionally, provincially and nationally, to make the best investments to improve heath system performance. Health system leaders to examine patient populations prospectively, across healthcare organizations and jurisdictions, to identify processes or products that place patients at risk, and inform the design and implementation of approaches to improve performance and care.
Characteristics of Health Sector Environments Health sector environments have an impact on our ability to address the growing rates of adverse health events. Patients do not have access to product information used during clinical care processes, impeding their ability to track outcomes linked to product use, report adverse events and respond to recalls; Providers do not have access to reports or searchable data to analyze patterns and root causes of adverse events in real time, or outcomes and trends across organizations and health systems that could prevent error or redesign processes to mitigate risk; Health organizations do not have the digital tools and infrastructure required to enable clinicians with automated “double-checks” and alerts to proactively manage risks and protect patients from harm; Health systems do not track product performance, or undertake postmarket evaluation linked to patient outcomes, that can reveal problems early enough to prevent population-level impact and inform product design; Health system leaders do not have expertise in supply chain logistics and management, and this aspect of health management curricula is not well developed; Governments do not have policy frameworks in Canada that require traceability of products from the manufacturer to patients across health systems to ensure safety.
Key Elements These elements will enable high-performing, high-visibility clinical environments that address these gaps: 1. Adoption of GS1 barcoding standards as the global language of supply chain in healthcare systems to accurately identify patients, the products used in patient care and the location of care provided 2. e-Commerce processes that automate supply chains in healthcare systems based on patient needs 3. Automated tracking, tracing and reporting of product performance across health systems linked to patient outcomes
Solutions 1. Create provincial policy and regulatory frameworks to require adoption of GS1 global standards in Canada to guide supply chain transformation across healthcare systems. 2. Invest in infrastructure integrating automated, digital tracking tools and devices in clinical settings to transform healthcare environments. 3. Establish a national product registry that holds accurate and up-to-date data on all healthcare products. 4. Build health system supply chain leadership capacity by leveraging the expertise and experience from other sectors. 5. Design and implement a supply chain visibility scorecard that measures progress towards achieving visibility for healthcare systems. 6. Develop a national, legislative supply chain framework to align with other global jurisdictions to maintain Canada’s viability as an international market and partner.
Conclusion Fundamentally, adverse events and error in healthcare are an outcome of an underdeveloped supply chain infrastructure. Supply chain innovation transforms healthcare environments making it nearly impossible for error to occur. Visibility within and across healthcare systems enables all stakeholders to deliver safe and effective care that contributes to health, wellness and quality of life for Canadians. Requiring, enabling and scaling supply chain traceability, based on GS1 global standards, achieves better value and builds confidence in the healthcare system. Supply chain infrastructure in healthcare can and must be transformed.
Address for Correspondence Dr. Anne Snowdon Chair, World Health Innovation Network Odette School of Business University of Windsor 401 Sunset Avenue Windsor, Ontario, Canada N9B 3P4 Email: anne.snowdon@uwindsor.ca
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