1. Congress pushes for the federal government (the General Accounting Office) to assume more oversight of hospital procurement practices under the guise of Medicare and Medicaid reform after the healthcare industry’s "Voluntary Effort to Contain Costs" and the "prudent buyer concept" began to fade. Ironically, the GAO recommends shared services and group purchasing among its cost management techniques.

2. Executives from 30 major hospitals and healthcare systems gathered in Chicago in 1977 to form Voluntary Hospitals of America Inc., which inks a groundbreaking and lucrative prime vendor contract with American Hospital Supply Co. that set the stage for GPO contracting strategies in the future.

3. The purchasing function expands beyond the traditional transactional role into other areas, gaining acceptance as "materials management" of a multimillion-dollar enterprise. Among the key functions wedded to materials management: Sterile processing. All around the nation hospital central service departments were folded into materials management.

4. Materials managers feared the rise of group purchasing organizations and investor-owned hospital chains influencing market direction – and their jobs and roles. They also began to fear management companies and the potential for hospitals to outsource the materials management function.

5. Sterilizing products with ethylene oxide gas and the reuse of disposable products emerge as hotly debated and thorny issues, the former because of the potential effects from prolonged exposure to toxicity and the latter because the cost containment tactic potentially elevated device failure and patient safety risks.

6. GPOs funded largely by hospital membership dues give way to GPOs funded by supplier administrative fees, and issues such as cherry picking among multiple groups, contract commitments and prime vendor arrangements reach a fever pitch.

1. Diagnosis-related groups (DRGs) and the prospective payment system emerges as the backbone of the government’s reimbursement strategies, bringing materials management some much-needed attention.

2. Under the new "managed care" environment, predictions of vertically integrated healthcare organizations, blending hospitals, physician practices, HMOs, PPOs, etc., take root. These integrated delivery networks (IDNs) would emerge in the early 1990s.

3. The 1986 safe harbor exemption to the Medicare anti-kickback statute for group purchasing organizations reshaped GPO activities and redefined their roles for decades to come.

4. Typewriters, bin cards and rudimentary computers give way to more advanced automation technologies, such as software-based materials management information systems and proprietary electronic data interchange (EDI).

5. VHA’s controversial prime vendor contract with American Hospital Supply Co. endures considerable legal scrutiny but faces its most serious test when American considers merging with Hospital Corporation of America, opting instead for Baxter Travenol Laboratories.

6. The Prescription Drug Marketing Act of 1987 was enacted to promote drug safety and to prevent the "introduction and retail sale of substandard, ineffective or counterfeit drugs."

7. Just-in-time and stockless supply distribution gain in popularity.

8. HIV and AIDS usher in more detailed and stringent federal and industry guidelines and policies for infection control practices.

9. Minimally invasive surgical techniques take root in the operating room, ushering in a new realm of product purchasing responsibility for materials managers and a rampant wave of technological development that would accelerate in the decades to come.

10. The Common Category Database surfaces as a watershed exercise for a standard classification of medical/surgical supplies that would sink early on in the next decade.

1. Proprietary EDI makes way for open EDI via value-added networks (VANs) and other software programming. By decade’s end, healthcare organizations turn to enterprise resource planning systems and the Internet with hypertext markup language (HTML) code as the "next wave" of electronic procurement.

2. Latex allergies and sensitivities gain national prominence, influencing purchasing behavior for a variety of products – predominantly gloves.

3. The Clinton Administration’s failed healthcare reform plan spurred the industry to act, which led to the formation of IDNs, a massive consolidation wave among providers and suppliers and an expense-reduction movement that had many materials managers either fearing, losing or changing jobs.

4. GPO consolidation in the mid-to-late-1990s served not only as a response to the Clinton Administration-inspired healthcare reform movement but also to the meteoric rise of Columbia/HCA Healthcare Corp. that redeployed the meaning of the term "purchasing power." The industry witnessed the consolidation of distributors, too, as mergers and acquisitions transferred the lion’s share of the market predominantly to four national suppliers who blurred the lines between medical/surgical supplies and pharmaceuticals and pursued information technology as their margin buffer/cash cow.

5. Capitated supply agreements, risk-sharing contracts and strategic partnerships with suppliers dominate the lexicon of materials managers.

6. Accidental needlesticks and needle safety issues push latex concerns to page 2 of the industry zeitgeist, but passage of the Needlestick Safety and Prevention Act in 2000 forces permanent purchasing behavior changes in the next decade.

7. The Universal Product Number (UPN) represents the newest movement to promote bar coding and a standardized classification system for supplies.

8. After making headlines in the 1980s for merging, Baxter spins off what had been the old American Hospital Supply outfit as Allegiance Healthcare, which ultimately was absorbed by Cardinal Health Inc. within two years.

9. The Efficient Healthcare Consumer Response report and resulting initiative that began in 1997 with a bang by claiming billions in savings could be reaped if organizations operated more efficiently and fizzled by the next fad, which was…

1. Y2K and its effects on the supply chain generated big business for consultants and software companies but turned out to be just like Geraldo Rivera’s monumental television report on Al Capone’s vault. However, it did uncover clever hoarding activities, just in time for…

2. Pandemic pandemonium – from SARS to avian flu to antibiotic-resistant superbugs – never have healthcare supply chain management professionals felt so unprepared and yet so ambivalent at the same time about effectively managing supplies for these crises.

3. Using the Internet as the key tool for electronic commerce peaks in the "strike-it-rich" hype cycle in 2000. Within six years, Global Healthcare Exchange emerges as the clear market leader. Materials managers chuck their dot-com playcards and scorecards, focusing instead on using the Internet as a serious tool in their arsenal.

4. Congress makes noise about cracking down on GPO business activities, alleged to be anticompetitive, which turns out to be just noise – even as the GPO industry makes incremental changes to their practices.

5. A major implant manufacturer, Guidant Corp., sues a prominent consulting firm owned by a GPO (Aspen Healthcare Metrics and MedAssets Inc., respectively) over the firm’s access to and use of (what the vendor deemed confidential) pricing data to help hospitals manage their costs. They settle out of court.

6. Preventing medical errors – ranging from medication delivery mistakes to wrong-site surgery to hospital-acquired infections – set the stage for influencing purchasing practices.

7. Radiofrequency identification chips and tags capture materials managers’ hearts and imaginations as the next-generation equipment-, people- and product-tracking system, but many remain hesitant to put money behind the interest.

8. Threats of federal government intervention inspire the healthcare supply chain experts to strive for data synchronization between providers and suppliers, as well as a Product Data Utility (PDU) for universal information standardization purposes.