Advanced tech may turn heads, not hearts

Feb. 23, 2023

Not every healthcare organization’s consolidated service center, warehouse or storeroom can be rigged to function as a teched-out assembly line, anchored with automated guided vehicles, conveyor belts, interoperative software, mobile robots and robotic arms moving stuff around as supply chain staffers, sporting eyewear with heads-up display capabilities, wielding smart phones and wearing swanky wrist computers, calmly traverse the floor.

Those who may be outfitted with some of the latest tools and toys can juggle multiple demands and emergency needs with aplomb, efficiency, and effectiveness because they already know about backorders and anticipated clinical procedure requests as they’re plugged into production schedules outside the organization and surgical schedules inside. They’re connected to artificial intelligence (AI), blockchain, crosslinked item master-to-charge data master systems, enterprise resource planning (ERP) modules, radiofrequency identification (RFID), real-time location systems (RTLS), robotic process automation (RPA) or other automation technologies.

Few may be more tech-decked than most, but many yearn to adopt and implement as much as possible, hinging on budgets and business cases provided, as well as the skills – latent and learned – that staffers possess, supply chain tech experts indicate.

Healthcare organizations, by and large, rely on RTLS and other supply chain automation tools to manage, track, and trace three primary areas within and without supply chain: Process and workflow, product and service usage and the safety of patients, staff and visitors on campus or within a facility.

Where some might be able to construct new or retrofit existing buildings fully equipped with the latest technology applications, others approach improvements on an incremental basis, adding technological capabilities under a longer-term plan as resources allow, according to supply chain tech experts.

Based on the diversity of circumstances and available resources, healthcare facilities appeared to be on a tech-adoption trajectory until the global COVID-19 pandemic emerged in early 2020 in the United States, and disrupted worldwide supply channels for much of the next three years.

Although some question the rate of operational recovery from the seemingly receding pandemic, others widely acknowledge that facilities are pumping the brakes on implementing much of the tech that tickled fancies and tempted eyes for the last decade or so. Instead, they’re returning to the fundamentals, dependent on facility size and location, limited resources and speed to results.

Basic package deal

At this point, slowing the momentum of technological implementation progress may be beneficial, experts tell Healthcare Purchasing News.

“As with any investment in technology, healthcare organizations must start with the business objective or challenge they are trying to solve and then pick the best technology to address that need,” said Keith Lohkamp, senior director, Industry Strategy, Workday. “I do believe, however, that most organizations need to start by laying a strong foundation by either investing in ERP technology or, at a minimum, MMIS technology, to create a unified view and set of processes for inventory and procurement. And frankly, almost every other technology [on the ‘supply chain automation technology’ list on page XX (which is Sidebar 1 with Chart)] is either dependent on or would benefit from having this foundation because of the underlying process or the need for data.”

Lohkamp further contends that many of these technologies may even be included in that foundational investment. Workday Supply Chain Management users, for example, already have the option to use mobile devices and barcode scanning, he explains. Further, built-in AI features for Natural Language processes allow for the use of company chatbot Workday Assistant to check on the status of requisitions, while other AI/ML functionalities automate transactions or make recommendations during requisition creation. Processes can be integrated into a WMS or a carousel to support additional options for managing inventory within and outside the hospital, he adds.

Nathan Wicks, vice president, Commercial Technologies and Engineering, Cardinal Health WaveMark Solutions, hesitates to categorize technology options according to demographics, development, and fiscal and operational processes. Instead, he argues that healthcare organizations embrace a broader approach that focuses on two areas:

1.    Recognizing the shared challenges across the healthcare landscape and spanning all types of institutions

2.     Focusing on where they are at along the technology-adoption journey and if they have the foundation – people, process, and foundational technologies – in place to support more advanced tech solutions.

“Building the foundation – ORIS, ERP, MMIS – is key before layering on other tech solutions to support supply chain automation,” Wicks noted. “In addition, when health systems are looking to invest in more advanced clinical supply chain technologies, focusing on partners that offer one platform with flexibility on integration capabilities, as well as usage of different data capture devices to support the institution’s different needs (e.g., barcode, RFID, Kanban, mobile, etc.), will provide institutions the necessary enterprise visibility across their institution to deliver on improved financial performance, improve staff efficiency, and ultimately, enhanced patient safety.”

Laying and fortifying the technology foundation is key, according to Melissa Amell, senior director, Healthcare Strategy, Supply Chain, Infor.

“Most organizations' lowest-hanging fruit is ongoing metadata management required to gather meaningful insights,” Amell said. “Those insights would inform what areas have the largest opportunities, and then would warrant investigation of the proposed technologies.

“I personally think there is a natural progression of improvement and growth when it comes to buying and utilizing technology,” she continued. “Organizations, regardless of size or scope of service, need to understand their current state and put those foundational technologies in place like an MMIS, ERP or WMS. Some of these technologies are in such early adopter phases that until they are successfully used in industry over a period of time they are likely not worth the investment to the majority of organizations.” Amell points to augmented reality/virtual reality (AR/VR) products as examples, especially if organizations are not using current technologies with proven results like mobile technology, barcoding and RFID/RTLS, she added.

Ashok Muttin, founder and CEO, SupplyCopia, laments that the healthcare supply chain “has consistently under-invested in data, technology and analytics.

"There needs to be a solid foundation from which complicated services can be launched,” he observed. “They will need to invest in building this foundation first. Once the foundation is built and tested properly, the sky is the limit in deploying cutting-edge technology solutions.

Assuming that a health system already has an ERP and EHR/EMR system in place, then Muttin urges an organization to invest in MMIS and RFID, as well as demand-management/predictive-analytics software. “This demand management should go beyond the traditional use case for demand management and include the integration of preference card/bill of material information to predict the demand and hence, inventory management,” he added.

But Muttin recognizes the looming storm clouds this year.

“Health systems are facing significant headwinds, and this situation will likely continue for the rest of 2023,” he forecasted. “Supply chain leadership will be required to find cost savings in the next six-to-nine months. Hence, they will need to concentrate more on ‘blocking and tackling.’ This requires investing in solutions that will deliver the results.”

While technologies such as blockchain, AI, wearables, augmented reality, etc., likely will have a huge role to play in transforming the supply chain landscape, according to Muttin, implementing them will require significant new resources, such as dollars and talent. “CFOs are unwilling to sign off on such investments at the current time, [so] it’s prudent for supply chain to invest in technologies that are guaranteed to generate results in a six-to-nine-month period,” he added.

Resource limitations

One of the major impediments to investigating, investing in, and implementing supply chain automation technology hinges on available resources – whether that amounts to budgets, cash-on-hand, credit for financing or labor, talent, and training.

Cardinal WaveMark’s Wicks offers a panoramic picture of future operations that technology will impact.

“All healthcare providers, regardless of their size, are facing similar challenges: Labor challenges with shortages expecting to continue through 2025, supply chain disruptions leading to lower-than-average fill rates into the 80%-90% [range], and increased revenue and cost pressures,” he told HPN. “Therefore, it’s more important to assess where you are along the technology-adoption journey to ensure you’ve invested first in foundational elements to support the layering of more advanced technology solutions.”

Foundationally, healthcare organizations should pursue ERP, MMIS and ORIS implementation first and foremost to ensure maximum utilization, according to Wicks. “These systems are core to capturing the key data elements of the health system related to patient information and resource planning,” he said. “These are often necessary integration components for other advanced automated supply chain technologies.

“Once these components are in place and functioning, more advanced solutions can be layered in to offer enhanced product visibility across the enterprise, and provide the data and insights to support strategic decision-making and bring together the clinical and supply- chain teams,” Wicks continued. “Even for an organization with limited resources, selecting a technology partner that offers flexibility in integration with multiple data capture technologies – barcode, RFID, Kanban, automated cabinets, etc. – as well as integration capability with your foundational tech systems – ERPs and EMRs – will offer the ability to support your organization’s needs today and adapt to more advanced solutions as your needs change.”

Wicks recommends that any technology partner should offer three elements:

1.     Flexibility with the type of data capture technologies to meet your different clinical supply chain needs now, as well as in the future

2.     Proven integration with existing technologies

3.     Roadmap to grow into the new technologies

Healthcare organizations first must understand the scope and size of their supply chain needs and challenges before investing in any technology, according to Marlin Doner, vice president, Data Analytics and Product Strategy, Prodigo Solutions.

“Too often, technology is implemented as a ‘silver bullet’ without a clear understanding of the problem it’s being asked to solve or a clear set of success metrics,” Doner noted. “As a result, the impact from the latest technology rarely aligns to the return-on-investment goals or the end users’ expectations. Taking a data-first approach both informs your decisions about technology investment, as well as lays a strong foundation for building an agnostic technology ecosystem.”

Doner acknowledges the factors that influence technology investment decisions, including size, geography, and supply chain strategy.

“Every technology has its purpose,” he said. “However, that does not mean every technology is the right fit for every health system. Your supply chain strategy will determine how you need to predict and capture demand signals, manage inventory, service your customers, and control costs to deliver the right clinical, operational, and financial outcomes.”

Ceasing milk runs

Scott Hondros, MHA, SCPM, vice president, Professional Services, CenTrak Inc.,recognizes the challenges, too.

“Due to the pandemic, the last few years have caused significant disruption and constraint of budgets, manpower, and resources all throughout healthcare facilities, from the bedside to the back office,” he observed. “As such, healthcare professionals and administrative employees are asked to do more with less. Providing the necessary support is key to achieving high-quality patient care, staff satisfaction, and overall retention, along with increasing an organization’s bottom line.”

As a result, Hondros firmly recommends RTLS, RFID and RPA as providing the “support, visibility, and return on investment (ROI)” for a “near-immediate positive impact” for professionals and their organizations.

“Through enterprise visibility, healthcare professionals can gain better insights into the needs and safety of their patients and coworkers, the location of required mobile medical equipment, and the status of supplies,” he said. “By being able to remotely visualize what assets are in a given location, staff members can be saved from making a ‘milk run’ to check on items, and can reallocate that time back to patient care.”

The absence of technology can generate a deleterious outcome, according to Hondros.

“Manual documentation is often ineffective, time-consuming, and can be inaccurate due to human error,” he said. “In real-time, RTLS shows what is in each location, the status of those items, and if the medical equipment is soiled, in-use, being repaired or available. Predictive analytics then informs staff members of what equipment is or will be needed in specific areas, allowing teams to look ahead and properly prepare based on the anticipated demand to meet patient needs. Alternatively, instead of waiting for an order to be put in, automated offerings can create an order to replenish necessary items once an asset or item has been removed from its current location. This ensures that clinical staff can have what they need before they need it.

“Monitoring expensive, mobile medical equipment is best achieved with RTLS, while RFID is best for consumable goods,” Hondros added.

Managing critical inventory with a measured approach to process investment can be complex, particularly if organizations seek the right balance to satisfy their mission and want to design relevant solutions, according to David Lefkowitz, director of Market Strategy, Terso Solutions.

“This is not a ‘one-size-fits-all’ approach, and it’s imperative that individual solutions can be designed and implemented to exceed the needs of the hospital and fit within budgetary constraints of the organization,” he said. “It’s always a balancing act, but we utilize a sound approach that ultimately yields great things for our customers.”

Organizations should start with their end game in mind, Lefkowitz says. “For example, are you looking to better manage orthopedic implants, cardiac catheters and stents, tissue and biologics, or do you want visibility and automation for your med/surg inventory? Once this is understood, then there are multiple RAIN RFID hardware – open and closed systems – in conjunction with our partners’ cloud-based software options – that can be utilized and tailored to meet specific budgetary constraints.

“When evaluating RTLS technologies, it’s important to understand the organizational goals and then balance it with cost, reliability, accuracy and timeline of getting the solution up and running,” Lefkowitz continued. “As RTLS continues to evolve, it makes sense to evaluate newer technologies, such as WiFi, UWB, BLE, and others. Once your supply chain challenges are fully understood, then you can move forward with the right technology and develop the right solution for your organization.”

Leftkowitz advocates more of a deliberate approach.

“We’ve found that it works well to start small and then expand into adjacent areas as we prove our value to the hospital system,” he said. “So, if you start by managing tissue and biologics, and clinicians and Materials Management staff are happy with the outcome, then expanding into managing other clinical inventory like the Cath Lab space is fairly easy and welcomed by the hospital staff. In combination with great channel partners, we like to prove ourselves along the way and this type of approach allows hospitals to recognize our value and expand our technology as they see fit.”

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