Czarist rushing

June 25, 2020

Within a month of highly publicized and emotionally frenzied reports of hospitals running out of medical supplies, thanks to the explosive demands ignited by the COVID-19 coronavirus, the government decided to take charge in its own inimitable – and predictable – ways. 

Twin bills – one in the House and one in the Senate – call for the establishment of a centralized Medical Supply Czar to make things right and solve the problems that the private sector apparently cannot.

Quickly now, all of you must recall one of the climatic scenes in “The Sound of Music” when the contest-winning Von Trapp family sang their final number, “So Long, Farewell,” before their daring escape to the West.

“So long, farewell…

“Auf wiedersehen, goodnight!”

Now change the lyrics a bit to celebrate the newest nationalized czarist fad.

“A czar! A czar! A czar is what we need!

“He’ll stock…“Our shelves…“With stuff at rapid speed!”

Huzzah!

The last time the federal government created a “czar” and a bureaucracy around the office, it had wanted to promote the adoption and implementation of national health/medical records within the healthcare industry, integrating providers, patients, insurers and suppliers. That agency was created more than 16 years ago in late April 2004. How many of the 5,000+ hospitals have fully implemented electronic health records (EHRs) since then?

Before many healthcare organizations were willing to give supply data standards a try (largely via the globally accepted GS1), they demanded case studies, and then more case studies and then even more case studies, to the point that it seemed as if the demand for case studies was a stalling tactic to keep advocates busy so healthcare facilities could continue delaying and procrastinating from taking their medicine to cure inefficiency, risk and waste. Not unlike trying to parent teenagers.

I’m willing to argue more hospitals use group purchasing organizations (GPOs) today than use EHRs. Granted, GPOs began 110 years ago in 1910, but then the government never created a GPO czar.

Intrigued by the premise, I reached out to the media reps for both the representative and two senators for comment on their respective bills. Alas, my repeated requests for comment and my submitted questions (for authenticity, earnestness and legitimacy) went nowhere.

While I appreciate the heart and intent of these Congressional leaders, I feel their legislative plans haven’t been fully explored. Any Medical Supply Czar at least should possess some awareness of, if not experience in, healthcare supply chain or supply chain in general. Further, he or she needs to understand how private sector logistics works – including the use of GPOs, distributors and other third-party organizations supplying purchased services to healthcare facilities.

None of this should be foreign to the domestic government. Back in the 1990s, the Departments of Defense and Veterans Affairs converted to a private sector distribution model that succeeded the storied depot system. For these revolutionary efforts, Healthcare Purchasing News awarded the DoD’s Sara “Sally” Bird with its 1996 Materials Management Leadership Award back when HPN honored and recognized individuals versus departments (See July 1996 HPN). Bellwether League inducted the long-since-retired Bird into its Hall of Fame for Healthcare Supply Chain Leadership in 2017, followed by her late military colleague and compatriot, Capt. Terry R. Irgens (USN-Ret.) in 2019.

The examples and leadership set by Bird and Irgens raise a better idea: The government should show us how to do it right – mastering supply by managing unpredictable demand during a pandemic – within its own confines.

Set up a Medical Supply Chain Czar that oversees such operations for the DoD, VA and any other agencies involved with healthcare facilities. Based on my latest GPO Headliners (See November 2019 HPN), the VA (No. 4) and DoD (No. 8) represent two of the top 10 largest parent GPOs based on annual purchasing volume alone at $17.4 billion and $7.1 billion, respectively. That’s nearly $25 billion in an estimated $260 billion industry. Because these governmental agencies represent roughly 10 percent of the estimated total dollar volume of product funneled through GPOs, they would make optimal first movers and case studies in federal efforts show the private sector how to achieve mastery of demand planning.

Just don’t misconstrue it as a stalling tactic.

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