Health Business Services Future of Procurement for Improved Patient Safety in Ireland Healthcare User Group event Health Service Executive (HSE) Mr. John Swords, Head of Procurement
Health Business Services Guiding Principles The model is designed to comply with the requirements of the Government decision One Voice for Health. Compliance with national initiatives and Procurement is mandatory, not optional. Single integrated approach for health procurement. Sustain the efficiencies already achieved in the Health Sector. HBS Procurement represents Healthcare customers.
Health Business Services Strategy 2017-2019 HBS Procurement Sourcing 3 yr plan Logistics - NDC System - Single
Health Business Services Single Financial Management System Pricing & Assisted Sourcing System The Pricing & Assisted Sourcing System (PASS) is a centralized searchable database designed to inform HSE staff who are authorised to buy goods and services of items on contract. PASS provides details and information relating to products, suppliers on contract as well as the price per item. Procurement Programme Management System The Procurement Programme Management System (PPMS) was developed to manage the procurement workload and pipeline. Procurement Data Warehouse The Procurement Data Warehouse (PDW) provides procurement with visibility across the supply-chain and the heterogenous systems within HSE. National Distribution Centre The National Distribution Centre (NDC) was developed to implement part of the Shared Services model to increase efficiency and productivity.
Building a Single National Sourcing Plan for Health Key Customers Generating Sourcing & Contracts Projects 3 Year Plan 40/02 Logistics NDC Capital Plan TUSLA / Other Government Departments 7 Hospital Groups Health Sourcing Plan Pipeline Savings Initiatives 9 CHOs Visibility of Future Work HSE Corporate / Clinical Directorates Philanthropic Donations CAWT Voluntary Agencies
HSE Logistics & Inventory Management Service New model for Logistics & Inventory Management Comprehensive Review resulted in the following recommendations: Consolidation of fragmented stores infrastructure into a National Distribution Centre (NDC) distributing to 9 Hubs Increase level of management of stock at point of use (POU) Implementation of appropriate supply channels 4000 Customer Delivery Points: NDC & Regional Hubs
Point of Use Benefits There are many advantages to using the Point of Use system as a way to manage work, including: Flexibility Focus on continuous delivery Reduction of wasted work / wasted time Increased productivity Increased efficiency Clinical Team 7
What is driving the need for standardised coding? Too Many Codes Track & Trace difficult Current systems of product catalog numbers include duplicate identifiers for different products across manufacturers Manufacturer Product # 305905 Manufacturer Catalog # Description Medtronic 305905 Mosaic 305 Porcine Heart Valve. BD 305905 3mL BD SafetyGlide Syringe.. J & J 305905 Protectiv IV Catheter System.. Distributor Product # MT305905 Hospital or Healthcare Provider Product # M- 5905 8 Source, Jackie Elkin, Medtronic
Recalls in Healthcare what happens today? In the news http://mccarthy.ie/category/depuy-asr-recall/ Did You Know? Paper based Time Risk to patient From 2002 to 2013 there were 578 hip replacement recalls from six major manufacturers. These recalls came too late for tens of thousands of people who already received the problematic devices. https://www.drugwatch.com/hip-replacement/recalls/
Current Challenges Paper based processes Time consuming, manual Everyone using a different code for the same product Compliance issues Standardised Information captured via barcode Future Track and Trace is much easier, faster and more accurate when done electronically based on Global Standards ie: Using Standardised coding and data
Key Driver Patient Safety (Traceability) Ability to recall Patient level costing Inventory management
Key Driver Regulation Unique Device Identification, GS1 accredited as issuing agency by U.S. FDA Unique Identification required for: Medical Devices - 2014 in US, 2020 in EU (UDI) EU regulation will require healthcare providers to capture and store the UDI for Class III Implantable devices preferably electronically! Pharmaceuticals - 9 th Feb 2019 in Europe (FMD) UDI = Unique Device Identification (Unique Identifier, Barcode and Product Data) FMD = Falsified Medicines Directive (Unique ID, Barcode, Serial # Repository)
How does the barcode support traceability? 01108576740020171714112010NYFUL0121192837? 0110857674002017 17141120 10NYFUL01 21192837 10857674002017 20 Nov 2014 NYFUL01 192837 ERP Entries GTIN: 09012345670016 EXPIRATION: 21.Mai 2012 BATCH/LOT: 123456 SERIAL: 123456 Barcode Scanning allows the Product to be linked and traced back to the Patient Record
Examples of the HSE using GS1 Standards National product file 79% GTIN Haemophilia T&T Instrument T&T > 10m savings to date Other examples HSE National medical equipment asset registry Individual Health Identifier HSE Services Directory 90% HSE Trays use GS1 Aset ID GS1 Standards for interoperability in Healthcare
HSE wins awards at GS1 Global Healthcare Conference 2008 2011 2012 2013 2014 2015 FUTURE Phase 1 Project Kickoff GO LIVE 8 CDUs SJH first hospital to GoLive Phase 2 Business Case (including Endoscopy) Approval Procurement/ Finance Phase 2 GO LIVE 5 CDUs 10 ERUs Phase 2 GO LIVE 7 CDUs 9 ERUs Phase 2 GO LIVE 8 ERUs Completion of Phase 2 Phase 3 Business case Remaining CDUs and ERUs (10% volume) - Commercial loan set providers - Private Hospitals Pauline Biggane received the Healthcare Provider Advisory Council award for the excellent implementation of a national track and trace solution for Instrument Trays and Endoscopes Clinical requirement to have traceability for high risk procedures Full visibility of Instrument set and Endoscope tracking across HSE Hospitals Loan set providers now using GS1 standards for track and trace:
Adoption of GS1 identification standards in healthcare HSE NDC Audit Product Identifiers Key Facts 79% of All products have a GS1 Barcode/GTIN 45% of All products with a GS1 Barcode/GTIN also have expiry date information in the barcode 45% of All products with a GTIN have a GTIN on 2 packing levels (unit, box) GS1 is the chosen standard by the healthcare industry
Audit of HSE National Distribution Centre 79% GTIN Completed Next Steps 1. All products scanned in Warehouse using GS1 Scanning App 2. Report generated and Internal HSE code now linked to the unique product identifier/gtin 3. Conduct survey in other regional warehouses - Include GTIN in HSE SAP master data to build a National Product File - Include Unique ID in tender documents HBS Procurement communication sent to Suppliers March 2015 We need Suppliers to be GS1 compliant
The need for Unique product identification in the HSE HSE is adopting industry best practice for: Improved patient safety* Operational efficiency Regulatory compliance Enables: Increased traceability Shared services Efficient including Cost GS1 GTIN - Global Trade Item Number is the unique product identifier/barcode found on most medical device, pharmaceutical and retail packages April 2013 MOU signed between HSE and GS1 Ireland Scanning at patient bedside (patient level costing/recall management) *See McKinsey report Strength in Unity
Benefits to using GS1 GTINs as the Unique Identifier for HBS Reduction in duplicate products being setup in the material master Spend analytics >> Compliance management Single identifier enables mapping of data from legacy systems and onboarding of additional warehouse locations Supports the HSE data warehouse initiative (improved data accuracy) No confusion as to what is being ordered (pack size linked to GTIN) Enables a national product file for HSE products (single unique identifier) Patient Safety HBS Procurement communication sent to Suppliers March 2015 We need Suppliers to be GS1 compliant Will be included in Sourcing Documents
Next Steps for GS1 Adoption Opportunity for Patient Safety enabled and supported by Health Procurement (One voice for health) & the Marketplace HBS are working towards full adoption of GS1 We need support of Suppliers to be GS1 compliant Hospital CEO s need to understand the importance of GS1 for patient safety (Unique Identification Patient, Practitioner, Product, Place, Procedure) We need policy endorsement Clinical Leadership + Collaboration is Key
Queries: ohop@hse.ie Thank You
HBS Structure Procurement organisation structure One Voice for Health HBS Shared Services Procurement Office of the Head of Procurement Sourcing & Contracts Logistics & Inventory Management Systems
Health Procurement Structure Health Customers HBS Procurement Health Led Categories Medical Care & Pharma Equipment, Laboratory & Diagnostics Medical Professional Services Surgical Interventional Devices & Consumables OGP Led Categories Professional Services Facilities Management and Maintenance Utilities ICT and Office Equipment Marketing, Print and Stationery Travel and HR Services Fleet and Plant Managed Services Other Sector Led Categories Local Government Minor Building Works and Civils Plant Hire Defence Defence and Security Education Veterinary and Agriculture Laboratory Equipment 23