Operations Planning Bringing Healthcare Supply Chain to Life: The National E-Health Supply Chain Reform Programme and the Australian Experience Manager Supply Chain (NEHTA)
Agenda 1. Australian Healthcare and NEHTA The Who 2. Supply Chain Past The Why 3. Supply Chain Present The What 4. Supply Chain Future The Wherewithal
NEHTA s Structure The (NEHTA) is a company established by the Australian, State and Territory governments in 2005 to develop better ways of electronically collecting and securely exchanging health information. Independent company state and federally government funded, including: Board of Directors (CEOs of Health Jurisdictions, an Independent Director and an Independent Chair) Board Committees The Chief Executive Officer The Company Secretary The NEHTA Organisation
Myths Busted Myth 1 The World is Flat Christopher Columbus (1492) Ferdinand Magellan (1505) Sir Francis Drake (1567) Orville and Wilbur Wright (1903) Myth Busted 4
Myths Busted Myth 2 Thomas J. Watson (CEO IBM) 1943: "I think there is a world market for maybe five computers" Steve Jobs, Apple (1976) Bill Gates, Microsoft (1981) Tim Berners-Lee, World Wide Web (1991) James Gosling, Java (1995) Myth Busted 5
Myths Busted Myth 3 Selling medical products into healthcare is complex 1.Tendering 2.Contracting 3.Ordering 4.Logistics 5.Procurement 6.Pricing 7.Clinical 8.Regulatory Myth True
ehealth Supply Chain Reform Supply Chain Reform needed because: 1. Lack of standardised product identification 2. Lack of standardised location identification 3. Multiple product data catalogues being maintained per hospital, per hospital network and per state Poor supply chain costs the health system money: Wrong product ordered/delivered Wrong quantity/poor forecasting and inventory management Automating processes enables supplier and buyer organisations to: Reduce redundant purchasing tasks Improve inefficient work practices Achieve greater accuracy in procurement and tendering
Myths Busted Product and Price Synchronisation Myth 3 Selling medical products into healthcare is complex Hospital Health Department GS1Net NPC Supplier 1 Manufacturer Supplier 2 Importer Supplier 3 Distributor Hospital 1.NPC 2.GTINs 3.GLNs 4.eProcurement 5.Recallnet Health Department Hospital Other Data Recipients Retail Pharmacy, Private Hospitals Supplier 5 Supplier 4 Wholesaler Myth Busted 8
Agenda 1. Australian Healthcare and NEHTA The Who 2. Supply Chain Past The Why 3. Supply Chain Present The What 4. Supply Chain Future The Wherewithal 9
ehealth Supply Chain Reform Information is the enemy of disease 70yr old woman goes to hospital for a hip replacement Wrong prosthesis turns up No surgery = 1. Cost to patient pain, increased iatrogenesis, stress, time, financial 2. Cost to health system theatre, staff, bed, medications, other patients
ehealth Supply Chain Reform Accurate Data is Critical ehealth Supply Chain Reform can deliver: The right products, at The right price, for The right person, in The right location, at The right time
Agenda 1. Australian Healthcare and NEHTA The Who 2. Supply Chain Past The Why 3. Supply Chain Present The What 4. Supply Chain Future The Wherewithal 12
The National Product Catalogue The Solution: The National Product Catalogue (NPC) is a way for suppliers to provide standardised and accurate product and price data electronically to the Australian health departments and private hospital providers. The NPC provides suppliers with a single mechanism to communicate structured catalogue data to many health customers and the health customers a single way to access this data from multiple suppliers. The NPC enables synchronisation of product and pricing data for accuracy in electronic procurement.
NPC Data Synchronisation Product and Price Synchronisation Supplier 1 Manufacturer Supplier 2 Importer Hospital Health Department GS1Net NPC Supplier 3 Distributor Hospital Health Department Supplier 4 Wholesaler Supplier 5 Hospital Other Data Recipients Retail Pharmacy, Private Hospitals Product data is common to all - Price data is customer specific
NPC Data Usage National Product Catalogue 286,000+ items, 400+ suppliers All jurisdictions accessing data Clean, standardised data in all systems Private Sector Private Hospitals Community Pharmacies / pharmacy software providers Accurate reference of Prosthesis Rebate Code for billing benefits Clinical Outcomes Focus Clinical Terminologies Australian Medicines Terminology (AMT) Product tracking and recall Bedside scanning (incl. batch, exp., serialisation, etc) => patient record TGA approval of pharmaceuticals NEHTA anticipates that full implementation of the NPC will save the public healthcare sector at least $AUD200 million per annum by ensuring accurate, valid and up-to-date product data, and improved communications and supply chain operations (Deloittes, 2004. Recommendations for National IM & ICT Enablers in the Health Sector Supply Chain report).
Why implement eprocurement? For both suppliers and buyers a range of benefits result from eprocurement implementation Interoperability Increased transactional accuracy Reduced order errors Improved compliance Improved payment times Timely information for improved purchasing and inventory management
NEHTA eprocurement Solution NEHTA have chosen to use GS1 XML as the emessaging standard Six messages selected to cater to the needs of the supply chain Data sets used in these messages are based on the recommendations made in the AS 5023 2003 guidelines Multi Shipment Order (Purchase Order, Purchase Order Change) Order Response Despatch Advice Invoice Remittance Advice For NEHTA technical specifications (Message Implementation Guidelines) Click Our Work Supply Chain
eprocurement What is a MIG? The Message Implementation Guideline (MIG) is A document containing information about the way electronic procurement is implemented within an environment. This document is provided by buyer(s) to the marketplace to develop eprocurement capability to trade Details in a MIG include: Organisational set-up Business process/rules and messages used Technical, and on-boarding requirements Supporting EDI files with business scenarios Details on open connectivity for the B2B marketplace
Current MIGs available The ultimate goal: A national MIG State based MIGs have been developed for some jurisdictions ACT WA NSW SA VIC MIGs are planned for others The National MIG is the equivalent of the NPC data set a single document containing all requirements for all jurisdictions The National MIG was released in January 2013
eprocurement solution NPC PURCHASE ORDER eprocurement Central Purchasing ORDER REPONSE Manufacturers ORDER CHANGE NPC is key to standard data and a shared identifier across all parties GS1 Product Number (GTIN) Hospital Pharmacy Ward BUYERS DESPATCH ADVICE (ASN) INVOICE REMITTANCE ADVICE SUPPLIERS Wholesalers Distributors
Conclusion 1. Lack of standardised product identification = GTIN 2. Lack of standardised location identification = GLN 3. Multiple product data catalogues being maintained per hospital, per hospital network and per state = NPC 4. Inaccurate and inefficient procurement practice = eprocurement
Healthcare Recallnet Overview Project Need Product recalls have a large impact on all involved Product recalls are increasing Opportunities exist to improve the product recall process through new technologies, data standards and a more streamlined process Project Mission To deliver a single product recall notification system in the Australian healthcare sector, through a phased approach, to improve the speed and accuracy of the therapeutic goods recall process with the aim of improving patient safety. NPC is key to standard data and a shared identifier across all parties GS1 Product Number (GTIN) and Location Number (GLN)
Who is involved?
Recallnet Why? Comply Identify Communicate Monitor Minimise Audit Comply with mandatory TGA requirements Quickly identify the trading partners required for notification Confirm your trading partners have received the information they need to action the recall or withdrawal on your behalf Monitor the ongoing status of your recall or withdrawal Minimise the time to close out and return to business as usual Review the outcomes to ensure you are adhering to best practice
Recallnet Why? Move from the current manual, processes To a standards based, secure, auditable web based portal
Recallnet Why? Australia Wide Direct Notification Structured Feedback Support for Medicines, Medical Devices and Biologicals B2B and B2G not B2C Continuous Improvement based on metrics
Recallnet When? March User Acceptance Testing April Final Industry Pilots Pre- Production Testing September 2013 Launch and Go Live
Supply Chain Nirvana 1 2 Patient Identification Medication Identification EMR Integration 5 Medical Device Identification 3 Instrument Identification 4
Agenda 1. Australian Healthcare and NEHTA The Who 2. Supply Chain Past The Why 3. Supply Chain Present The What 4. Supply Chain Future The Wherewithal
NPC Public Health Usage by Region VIC understanding use patterns; not having to ask suppliers what the State has bought from them (e.g. 83 different product catalogues) NSW data maintenance work effort/invoices on hold and delayed payment time (> 90 days and no discount) WA want to get to eprocurement (too much paper); can t do this without accurate data SA warehousing and dimensions; process change for overall supply chain reform TAS/ACT/QLD data maintenance work effort and data accuracy; scan the bar code at the pharmacy, but have no record in internal systems NT standardising a single catalogue (multiple product identifiers) and moving to eprocurement in next phase
NPC Private Health Key Drivers Prosthesis rebate codes linkage reimbursement from the insurers (also now identified as an issue for public hospitals as well) = 1 hour/hospital/day on phone Reduce effort and cost in collection and maintenance of catalogue information (not just health data also food service, medical grade PCs and hand held devices + hotel services sectors) Increase savings through removal of inefficiencies, e.g. payment variations and ordering errors due to inaccurate and/or insufficient data Accurate Data to reduce Supply Chain costs and maximise efficiency in the automation of Purchase to Pay processes using B2B electronic procurement messaging
NPC Product Supplier Key Drivers 1. National approach to product data set for medicines, medical devices and consumables for public and private healthcare buyers 2. Reduced effort in product data maintenance and provision 3. Reducing order errors and the supply costs associated with invoice reconciliations, credit claims, returns and refused deliveries Current costs of bad product data: a) One supplier estimates that 47% of all pricing errors in purchase orders result from public hospital data errors, at a cost to supplier of AUD$40,000 per annum b) Estimates of the time required to reconcile purchase order discrepancies is between 10 to 30 minutes per order c) A typical tender submission can take as many as 30 days
NPC Product Supplier Experiences Is it now easier to communicate product and price data to trading partners since being on the NPC? Absolutely it s much easier! Dianne Prince, Customer Supply Chain Manager, Abbott Australia. A significant benefit is having all the data logically and securely stored within the NPC assisting staff in accessing the information required in the preparation of contracts, and allowing us to provide a more efficient service to our customers. Karen O Donnell, National Quality Office, ArjoHuntleigh. We have already reduced the time taken up in providing information to certain trading partners, and have been able to re-deploy staff to other value adding tasks internally. Robert Webb, Director of Healthcare Business Solutions, Cook Medical. It is now much easier to communicate product and price data to trading partners, as we only have one set of data instead of five different sets. Yvonne Bell, National Business Support Manager, Terumo.
Lessons Learned Why does is it work: 1. National Data Set (NPC) for medicines, medical devices and consumables considering non-medical items 2. Data validation processes: NPC (GS1net) Ready 3. Governance Supply Chain Reform Group (SCRG) and Healthcare User Groups (HUG) 4. Buy-in from public and private healthcare organisations buyers using common data 5. Supplier engagement/tenders and for off-contract purchasing 6. eprocurement National Messaging Implementation Guidelines Buyers and suppliers exchange the same eprocurement messaging content, i.e. exchanging common data 7. Alignment with Australian Standard for Heath Supply Chain Messaging (AS 5023) 8. Partnership with and support from GS1 Australia this is key
Summary 1. Australian Healthcare and NEHTA The Who 2. Supply Chain Past The Why 3. Supply Chain Present The What 4. Supply Chain Future The Wherewithal
Contact and Questions Supply Chain www.nehtasupplychain.com.au NEHTA specific information Manager Supply Chain e-mail: mark.brommeyer@nehta.gov.au The latest in ehealth including registering for an ehealth record www.ehealth.gov.au