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We want to thank everyday warriors.
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S TR O N G T OG E T H E R TO DAY. . . S TR O N G E R T OG E T H ER TO MO R R O W The COVID-19 pandemic is our generation’s most severe healthcare challenge. We are so grateful to our healthcare professionals who selflessly put themselves out there every day to care for our citizens. You are truly heroes and we are here to support you in any way possible. Our employees are committed to maintaining business continuity and manufacturing during this time to continue to provide the diagnostic tools you need. Sekisui Diagnostics is here for you because we understand every result matters. We will get through this, together.
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CONTENTS »» SPECIAL ISSUE 2020 4 Publisher’s Letter: Providing support and hope during an unprecedented time 5 Unsung heroes
Why the work you are doing matters. And why we can’t go back to normal.
16 Do we finally have a tipping point for a better healthcare supply chain? 20 AHRMM Senior Director to supply chain leaders: Review and implement CDC strategies
An enormous force for good How the private/public sector collaboration will help guide us out of these troubled times
p8
21 UHS Quality and Chief Medical Officer: Providing the best possible care during unprecedented challenges
The challenge will not wait Why the supply chain is instrumental in helping to manage, and overcome, the current crisis
p12
2
Special Issue 2020 | The Journal of Healthcare Contracting
28 Leading IDNs are being judicious with supply orders “for the foreseeable future,” GPO executive says 36 Vizient: Focus on resiliency
While meeting the demands of an emergency, supply chain teams will also need to anticipate future needs
Come together Supply chain leaders met with the president at the White House as part of the COVID-19 Supply Chain Task Force
p24
40 Intalere’s Steve Kiewiet: Transparency is key 48 SMM thanks Owen & Minor and McKesson teams
Keeping healthcare facilities infection free Best practices and protocols from an infection preventionist
p44 The Journal of Healthcare Contracting is published bi-monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 Lawrenceville, GA 30043-8153 Phone: 770/263-5262 FAX: 770/236-8023 e-mail: info@jhconline.com www.jhconline.com
Editorial Staff
Editor Graham Garrison ggarrison@sharemovingmedia.com
Publisher John Pritchard jpritchard@sharemovingmedia.com
Managing Editor Daniel Beaird dbeaird@sharemovingmedia.com
Vice President of Sales Katie Educate keducate@sharemovingmedia.com
Art Director Brent Cashman bcashman@sharemovingmedia.com
Circulation Laura Gantert lgantert@sharemovingmedia.com
The Journal of Healthcare Contracting (ISSN 1548-4165) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2020 by Share Moving Media. All rights reserved. Subscriptions: $48 per year. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.
The Journal of Healthcare Contracting | Special Issue 2020
3
PUBLISHER’S LETTER
JOHN PRITCHARD
Providing support and hope during an unprecedented time Welcome to this first-ever special edition of The Journal of Healthcare Contracting. We have been publishing for over 15 years with a front row seat to the U.S. Healthcare Supply Chain. Our community is facing an unprecedented crisis and we simply cannot sit by, so we’ve created this publication to help in the looming COVID-19 crisis. We stand in solidarity and support of our nation’s medical suppliers in this great time of uncertainty. In an effort to inform our nation’s supply chain leaders, we have assembled this group of suppliers to communicate how they are assisting all of you supporting our hospitals and IDNs. In this magazine you will find contributions from many renowned experts who share their insights and observations to shed some light and hope during a challenging time. I’d like to thank the following people for their contributions:
ʯ ʯ ʯ ʯ
Dee Donatelli Jeromie Atkinson John Strong John Bardis
Communication is paramount to any crisis relief plan. During this COVID-19 crisis the number one request we hear from Supply Chain Leaders is that they are trying to understand when and where help is coming from. This publication shows them exactly how suppliers are answering the call. You will see direct responses on what suppliers are doing to
We stand in solidarity and support of our nation’s medical suppliers in this great time of uncertainty.
repair the nation’s supply chain and support our healthcare providers. The Journal of Healthcare Contracting is committed to helping Supply Chain professionals coast to coast. Keep an eye on regular updates via our website at www.jhconline.com or through our DaileNews. Please reach out to me if you have any questions or if I can be of service to you. Thank you for reading this special edition of The Journal of Healthcare Contracting.
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Special Issue 2020 | The Journal of Healthcare Contracting
SUPPLY CHAIN
Unsung heroes Why the work you are doing matters. And why we can’t go back to normal. BY DEE DONATELLI
Reading each day’s headlines about how COVID-19 pandemic is affecting our
It’s the supply chain – suppliers,
hospitals and health systems, two thoughts strike me. First, the frontline caregivers are
manufacturers, supply chain profession-
obviously and appropriately being commended for their work and sacrifices. There is
als – that will be the unsung heroes of
even an appreciation now for the environmental workers, testers, support staff – anyone
this fight.
who is out having contact or could be physically touching patients
We’ll get through this. But when we do, we shouldn’t go back to normal, because normal wasn’t working all that well.
But that leads me to my second
A good friend of mine who is a supply
thought about the coverage. There are a
chain executive said the painful truth is that
lot of heroes in our health organizations.
we’ve never managed supply chain well.
Many, though, aren’t wearing scrubs.
We go to conferences and attend meeting
Whether the lack of recognition is good
after meeting and talk about the problems.
or bad remains to be seen. I’m concerned
But when are we going to start solving
that when all of the dust settles that the
them? How do we find the solutions?
supply chain will be a scapegoat in the crisis
Now that the light is shining on our
rather than recognized for the Herculean
contributions to healthcare, I don’t think
efforts of individuals and organizations
we should go back to normal. If we go
to move product to where it’s needed at
back to the way things were, we wouldn’t
unprecedented speed and volume. Will sup-
have learned any lessons from this.
ply chain be blamed that we didn’t do more,
We have to rise up and do better.
that we were ill-prepared or equipped? I
How do we have greater visibility in the
would love to believe that won’t happen,
upstream supply chain? How do work
but you can already see finger pointing and
as true partners and not just give out lip
second guessing in the news. Pointing fin-
service? How do we better understand
gers now or really ever is not in my opinion
where a vendor sources products from,
the right thing to be doing.
and how do we have greater visibility
Instead, we should look to the heroes.
strain knowing their clinical staffs are having
Supply chain teams across the nation are
to do without critical supplies and equip-
into the overall supply chain? That’s what this is about. That’s what
working tirelessly to procure supplies from
ment. The burden and how that weighs on
sources they would never have thought
you when you are down in the basement
As unimaginable and awful as this situ-
imaginable, and didn’t even know existed
doing everything you possibly can is just
ation is, let’s not have it be for naught. Let’s
a month ago. They’re feeling unbelievable
almost unimaginable.
learn from this and let’s do better, together.
this could be about.
Dee Donatelli, RN, BSN, MBA, is vice president of professional services, TractManager, and principal of Dee Donatelli Consulting, LLC. She currently serves as chair of the Association for Healthcare Resource and Materials Management (AHRMM) board, is a 2015 Bellwether inductee and serves on the Bellwether Board. She is also past president of AHVAP.
The Journal of Healthcare Contracting | Special Issue 2020
5
We’re here for healthcare. Throughout the fight against COVID-19 and beyond, Owens & Minor is here to empower our healthcare customers and supply partners. Together, we’re making a difference.
Visit owens-minor.com/covid-19 to learn more.
Owens & Minor has been in the business of healthcare for over 135 years. We know that when times are hard, healthcare doesn’t stop—and neither do we. As the world battles the 2019 novel coronavirus (COVID-19) pandemic, our teammates are working around the clock to serve our mission to empower our customers to advance healthcare. Throughout the many challenges and unprecedented demand stemming from COVID-19, Owens & Minor’s goal remains the same: we’re here for healthcare. We’re here for the clinicians and the patients. We’re here for each other. The health and safety of our teammates, suppliers, and our customers and their patients are at the heart of everything that we do. Whether it’s implementing advanced safety protocols to protect our teammates and service providers, or taking significant action across our organization to make and deliver product as rapidly as possible, Owens & Minor is committed to protecting our healthcare customers and the patients they care for in the fight against COVID-19. In the earliest days of the COVID-19 impact on the United States, we enacted business continuity and expedited delivery plans to ensure our ongoing capability to supply critical products to the nation’s hospitals. The majority of Owens & Minor’s Personal Protective Equipment (PPE) manufacturing is located within the US and Americas, enabling a more rapid supply chain from point of manufacture into the United States. We’ve invested heavily to further expand manufacturing capacity to supply as much critical equipment as possible during this challenging time. We are also working closely with government agencies such as FEMA and HHS along with our supply chain partners to address the unprecedented demand for PPE so we can provide healthcare customers critical product needed to fight this crisis. COVID-19 has certainly challenged our industry and the supply chain, but Owens & Minor, leveraging our Americas manufacturing footprint, remains intensely focused on partnering with suppliers and customers to mitigate risk wherever possible. Our leadership team is in awe of the tireless efforts of the entire healthcare community, including our customers, teammates and suppliers, in the fight against COVID-19. We are extremely proud to be part of Owens & Minor as together we work to conquer this global challenge. These are uncertain times, but I am confident in our ability to empower healthcare today, tomorrow and for years beyond this crisis, just as we’ve done for the past century and more.
Ed Pesicka President & CEO
SUPPLY CHAIN
An enormous force for good How the private/public sector collaboration will help guide us out of these troubled times
founder and former CEO of MedAssets. “I think our eyes are being opened to some
The COVID-19 pandemic has created a different kind of supply chain activity
degree across the world about that now,” he said.
“I think the supply chain profession in
The greatest risk to the human race isn’t nuclear. It’s biologic, according to John Bardis, former assistant secretary of Health and Human Services (HHS), and the
Bardis discussed this topic and more in a recent National Accounts Today podcast
8
general has adopted over the last several
with John Pritchard, publisher of The Journal of Healthcare Contracting. The following
decades just-in-time practices as an ef-
are insights gleaned from the podcast.
ficiency focus for the management of raw
Special Issue 2020 | The Journal of Healthcare Contracting
materials, all the way to finished goods
nor does it have a program to do it that
to customer,” said Bardis. “Obviously,
would cover all.”
that type of supply chain activity didn’t
So it underscores the extraordinary
contemplate or really doesn’t contemplate
value and importance of the delivery
the impact of a pandemic, particularly in
system in the United States and the role
a country that imports as America does
that it plays, but also the tragically fragile
the vast majority of its PPE.”
nature of certain elements of the supply
The supply chain and the way that
chain, in this case, PPE. “And not just
it works and the lessons that we’ll learn
PPE, but this is also quite true as it relates
from this particular event will change
to our compound formulas for the major-
the way we think about strategic sup-
ity of our pharmaceuticals,” he said.
ply chain and healthcare, said Bardis. “Specifically, if we were outsourcing our munitions for our military and found ourselves in a conflict but short on the
John Bardis
Drawing from his experience as assistant
supply chain, we would rethink that, but obviously, we manufacture the vast majority of our own armament. “You could even take into the similar vein the food supply in America,” he continues. “If we were importing the vast majority of our food during a crisis like this, we would have a serious problem on our hands. For some reason, largely because of lower manufacturing costs, we outsourced some portion of the commodity supply chains, specifically PPE, to Asia, and mostly China. That has really come back to bite us. In the end, yes, we have effectively reduced the price of com-
“There’s going to be a lot of hindsight analysis of how we responded and whether or not the mechanisms of government responded quickly enough to the real danger of the pandemic.”
secretary of HHS, Bardis praised the people working at institutions such as the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH) and HHS. “There’s going to be a lot of hindsight analysis of how we responded and whether or not the mechanisms of government responded quickly enough to the real danger of the pandemic,” he said. “What I’ve learned was, these organizations, these scientists, these humanitarians are amazing. America shut down the Ebola crisis in Africa. America has stemmed the tide with the
modities within the American healthcare
AIDS and HIV crisis in Africa through
delivery system, but we continue to operate under a very expensive model called
Government can, and should, play a critical role
Should a pandemic hit again, it is not
the PEPFAR program, which was initi-
the federal government who is going to
ated under Bush 43. Essentially, it was a
be able to solve these crises by stockpil-
coordination between USAID, the state
ing, he said. “Now we do stockpile all
department, the CDC, and the NIH. Dr.
The U.S. supply chain will change as a result of this pandemic
over the United States for critical events
Deborah Birx, who was the ambassador
like biological warfare or a radiological
for South Africa and came back to lead
Some of the ways that the supply chain
event, potentially nuclear event, that kind
the President’s work here with COVID,
will change would be equally obvious to
of thing. But as it relates to the broad
led that effort. Today, there are 15 to 18
us all, said Bardis. “One, we cannot de-
general population, a pandemic that
million citizens in Sub-Saharan Africa
pend on a foreign nation for something as
could affect over 300 million people,
who get antivirals every day to prevent
critical to our delivery system as personal
the federal government doesn’t have the
the spread of HIV and ultimately AIDS.
protective equipment.”
capacity to stockpile enough product,
America does that.”
fee-for-service.”
The Journal of Healthcare Contracting | Special Issue 2020
9
SUPPLY CHAIN
However, America doesn’t get credit for that kind of thing, Bardis said. “It doesn’t make the headlines; it doesn’t make the news, but we do it every day. When the Ebola crisis hit, it was us who put the Commission Corps on the ground in Liberia and other African countries. We buried the dead, we built the hospitals, we had the handheld technology that unraveled the DNA of Ebola and sent that back to Dr. Anthony Fauci at the NIH, and within nine months we had a vaccine for Ebola.”
“I think that what will likely come out of this is good old American ingenuity backed by a government that’s willing to support private/ public sector partnerships to get it done.”
Bardis said that while we don’t always move as rapidly in some areas like the supply chain as we might hope, “this country is an enormous force for good, particularly in its health assets throughout the world. You won’t find India, Russia, or China on the ground in these hot zones. You’ll find America on the ground and officers of the Commissioned Corps, the CDC, and then the scientists behind the scenes who worked tirelessly to solve these kinds of problems.”
Collaboration between the private/public sectors will get us out of this crisis If you’re looking for quickness and speed, the government isn’t your dance partner, Bardis said, “but if you’re looking for power and getting it ultimately right with remarkable force, the government with industry combined is really rather remarkable. I suspect out of this lesson we’re going to get that.” Industry isn’t going to want to see the country return to this kind of problem again, where the economy gets shut down and people can’t work. “I think that what will likely come out of this is good old American ingenuity backed by a government that’s willing to support private/public sector partnerships to get it done. I think what will come out of it is remarkable, but it doesn’t mean that we’re out of the pain, if that makes any sense.” To listen to the full National Accounts Today podcast, visit www.nationalaccountexecutives.com/ category/podcast.
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Special Issue 2020 | The Journal of Healthcare Contracting
More than providing care. Making a difference.
Thank you. We know healthcare providers are working harder than ever to keep our communities safe. That’s why our dedicated teams, especially our delivery and distribution professionals, are working hard to support you with the products you need. From all of us at McKesson, thank you. ©2020 McKesson Medical-Surgical Inc.
SUPPLY CHAIN
BY JEROMIE ATKINSON
The challenge will not wait Why the supply chain is instrumental in helping to manage, and overcome, the current crisis
Novel approaches to fighting a novel virus In my conversations with my healthcare supply chain colleagues around the country over the past couple of weeks, the discussions are typically focused on the emergent need – personal protective equipment (PPE), ventilators, available beds – and the worry about our caregiver colleagues, those who are the last line of defense for the sickest patients. However, I have also been encouraged by the resilience of our healthcare supply chain leaders across the country. When faced “When we least expect it, life sets us a challenge to test our courage and
with this ‘novel’ virus, they are taking
willingness to change; at such a moment, there is no point in pretending that nothing has happened
novel approaches to responding to the
or in saying that we are not yet ready. The challenge will not wait. Life does not look back.”
immediate concerns, while not losing site
– Paulo Coelho
of our supply chain mantra, that we never become the weakest link in the overall healthcare value chain.
When faced with a crisis, we natu-
are becoming unemployed as industries at-
There are many lessons to be learned
solutions. Leaders are present in all forms
tempt to adjust to an uncertain future.
from this event, and we could likely fill an
around us; our workplace organization
While all that may feel overwhelming,
entire textbook of things that we should
leaders, our community or religious leaders,
the immediate crisis is the one faced by
do different going forward, but the below
and of course our leaders at the local, state
health systems across the country as they
are four high-level observations:
and federal levels. When leaders are at their
attempt to understand a virus that trans-
best, they are a steadying force during times
mits very efficiently, is much more severe
have been, and rightfully so, heavily
of uncertainty in taking charge of the im-
than the annual flu, and is often transmit-
tilted toward cost saving outcomes.
mediate crisis, while learning and planning
ted by those who are asymptomatic all
While driving cost out of the system
for the future so that the same kind of
while managing a patient load that is taxing
remains an element of high impor-
crisis will never catch us unaware again.
their resources beyond anything in recent
tance, what has been uncovered of
1. Supply chains around the country
memory. I don’t know when the time is
equal importance is the assurance of
foundations of life as we knew it. Millions
appropriate to look for a bright side, but
supply and the importance of having
across the country are in self quarantine in
when we do have some time to reflect, the
multiple avenues to diversify our
their homes, the retail, entertainment, hos-
supply chain of healthcare will have an op-
spend portfolio and minimize risk
pitality, and restaurant industries are reeling,
portunity to really look in the mirror and
on our critical care items. After all,
the stock market is reflecting the uncertainty
diagnose where we could have been better.
it doesn’t matter what the cost of an
COVID-19 has completely shaken the
12
of the global market, and millions of people
rally defer to looking to our leaders for
Special Issue 2020 | The Journal of Healthcare Contracting
item is if you cannot get the item in
information as there are companies
ended with the other parties’ eyes roll-
the first place.
in the healthcare supply chain. I read
ing back in their head as I explained. I
optimistic reports that we are close
love the profession of supply chain, but
silos. While our collaboration as an
to turning the corner and pessimistic
let’s be honest: It has never been a sexy
industry has never been higher, we
reports that we should prepare for
industry and I doubt 1 in 10 people had
often tackle challenges on a premise
the worst still to come and many
any idea how supply chains make their
that “this is my problem to solve”
sources that just present the data for
entire worlds work, from the technol-
vs. “this is something we can more
the reader to interpret and make de-
ogy that they use on a daily basis to the
effectively solve when we work with
cisions based on. Having a source of
clothes that they wear, to the foods they
an extended network of partners.”
truth is a challenge with the volume
eat. Today, I suspect nearly everyone
We often fail in the healthcare sup-
of content to sort through.
in the country knows what the sup-
ply chain to consider all sources of
4. The need for an industry utility
ply chain is and has an opinion on it
2. We are still solving many problems in
contribution. While there are pockets
focused on supply resilience and
formed over the last 60 days. Of course
of working across systems, inclusive
continuity might be more visible
we should be instrumental in helping
of our supplier partners, it is not
than ever before. While we have
to manage this crisis, and most of our
nearly as widespread as it could be in
resources like the Strategic National
supply chain colleagues are currently
the crowdsourcing of ideas and the
Stockpile, we do not have resources
working around the clock to help man-
sharing of capabilities. It is incum-
dedicated to coordinating supply
age this emergent needs.
bent upon us as an industry group
chain efforts across the industry
to process how we got here and how
that is led by healthcare supply chain
is to ensure we prepare our organizations
we might address these challenges
experts. Tremendous efforts are be-
and industry for the next time something
cohesively as a group for the next
ing exerted by the industry profes-
like this happens. This is our time as
event. It is only a matter of when
sional organizations, by GPOs, by
supply chain leaders to lead with strategy
before another event, not a matter
leading progressive health systems,
and insights, to create forward looking
of if, and using the lessons of CO-
and many others, but we are often
plans, to be agile and to create sustainable
VID-19 to inform our future should
building duplicative versions of the
operations supported by a strong supply
be a platform for us all.
same solutions. It might be time to
chain backbone and resilience.
However, the other half of leadership
3. Sorting through the ‘noise’ to find
consider a unified vision for supply
Our organizations, our colleagues –
clear and concise information is a
continuity of our most critical sup-
and most importantly our patients – need
challenge. While many organizations
plies, funded by our industry and
us to be the best versions of ourselves
are doing admirable work in trying
managed by our industry.
in the future. Now is our time to have
to collect content to put in an easily
the willingness and courage to adapt and
accessible online repository, there are almost as many repositories of
When telling someone what I did for a living a year ago, it inevitably
change, and show with our actions that we are ready.
Jeromie Atkinson, Supply Chain Leader and Essentialist, Supply Chain Sherpas. Leveraging more than two decades of strategic customerfocused experience and extensive knowledge of the healthcare supply chain, both as an internal transformation agent and external business partner, Jeromie is a passionate educator and advocate for helping organizations develop solutions tailored to their own internal DNA and to discover and unlock their own supply chain abilities. He earned his supply chain credentials in a variety of industries prior to joining some of the nation’s most progressive health systems where he applied his focus and passion to elevate supply chain discourse nationally. For more information, visit: www.supplychainsherpas.com.
The Journal of Healthcare Contracting | Special Issue 2020
13
SUPPLY CHAIN
BY JOHN STRONG
Do we finally have a tipping point for a better healthcare supply chain? This past Sunday afternoon, I was sheltering at home due to COVID-19 after
The second is the Food Safety and
walking our dogs about as far as either they or I could go and turned on the TV. ESPN8
Modernization Act of 2011, enacted after
was replaying the 2006 Johnsonville Brat Eating World Championship from Sheboygan,
the September 11 terrorist attacks on the
Wisconsin. It was an MLE (Major League Eating) event, with an $8,000 cash prize for
U. S. This Act applies to everyone in the
the winner with Sonja “the Black Widow” Thomas trying to best her previous record of
food supply chain, from farmers to large
eating 35 brats in just 10 minutes.
manufacturers, and it mandates that all facilities in the food supply chain have a proper food safety system that includes
How does protection of the U. S. food production system mirror healthcare’s current requirements?
2002 which required processed food man-
All this sports action and the daily brief-
history of their products. That history
ing from the White House missing any
needs to include where the ingredients
Why can I find a can of Spam, but not N95 respirator masks?
details about what products were available
have been, where they are at the cur-
The Bioterrorism Act and the FSMA Act
in the healthcare manufacturing sup-
rent time and where they are consigned
have been used – and are instructive to
ply chain and where they were located
for delivery. The Act gives the Food and
healthcare. In May of 2018, the Hormel
reminded me that the federal government
Drug Administration the authority to
Company recalled more than 220,000
had put in place two important pieces of
recall food if they have evidence that it
pounds of their Spam meat product
legislation to protect America’s food sup-
poses serious health threats to humans
because they found metal contamination
ply some years ago.
and animals.
from batches produced in February. As
The first is the Bioterrorism Act of
traceability of all products.
ufacturers to show the entire movement
1
a result, no consumers were seriously harmed. Only the recalled batches came back, and the cost was lower than a general recall would have been. Despite more than 50 years of trying, the healthcare industry has never been able to accomplish this feat, even though the barcodes and technology already exist for this purpose. For example, GS1 has already set standards for healthcare products2. For years both manufacturers of healthcare products and healthcare providers have pointed to each other and said “you need to go first” with the adoption of these standards. As a result,
16
Special Issue 2020 | The Journal of Healthcare Contracting
there has been a stalemate of epic pro-
that can help ‘balance’ the healthcare
downsides but not overpowering ones –
portions for tracking many commoditized
supply chain and avoid factors such
either for healthcare providers or health-
healthcare items where absolutely noth-
as the “Bullwhip Effect”4.
care product manufacturers. Yes, there
ing has happened. (Think N95 masks, disposable gowns, and gloves.)
is a higher maintenance cost than simply
ʯ Real time location(s) of products. Nice to have – right now.
doing nothing5 and it does involve more government regulation. It also requires staff to manage the process and more
Advantages and disadvantages of a medical product tracking system
ʯ Proper documentation of products.
difficult data analysis. Facilities must pay
This will put the so-called grey
a $500 annual registration fee to the FDA
market at rest and ensure that
… which in the scope of this health crisis
Now that we are coping with supply
products will perform as specified
seems like a modest amount.
shortages of key medical products due to
and not endanger providers on the
the COVID-19 health crisis, the advantag-
front lines of healthcare.
Conclusion
es cited by both those advocating for the use of these barcodes, and those in the food supply chain seem almost prophetic.
ʯ Access and manage inventory more
ʯ Response preparedness. The
The United States is blessed to have the
healthcare supply chain is still
most innovative and productive develop-
largely reactive, and more needs
ment capacity for new medical devices
effectively across various storage
to be considered to help it become
and pharmaceuticals of anyone around
locations . Many folks are flying blind,
more proactive during events
the globe. At the same time, we still
and just know they need more product
like COVID-19.
haven’t engaged the technology neces-
3
to get them through the next few weeks.
sary to make the healthcare supply chain
ʯ Transparency and honesty. Been ʯ Make products more available
far more transparent and useful in times
approached by folks with high cost
of crisis. This pandemic should be a
when needed and avoid and
supplies? One of my contacts reported
reminder to everyone working along the
mitigate out-of-stock scenarios by
more than 50 calls from folks hawking
supply chain that we can and need to do
identifying an alternative source.
hard to find medical products.
better before the next pandemic.
FEMA is moving their stockpiled goods to so-called “hot spots”
Let’s use this lesson to better pre-
ʯ Ease of corrective action. Having
pare the healthcare supply chain for the
around the country. Wouldn’t it be
more information about the location
next pandemic. Even professional eaters
nice for large healthcare systems to
and types of medical supplies will
prepare by stretching their stomachs
have the same capability?
allow healthcare providers without
for weeks. Unfortunately, though, the
federal intervention to allocate their
“Black Widow” was upended in her
ʯ Undertake more effective hospital
supplies in a more efficient fashion,
bid to eat more than 35 brats in the
inventory planning projections.
and share with others, if necessary.
2006 World Championship by Takeru
While impossible to project the demand for something like the COVID-19 crisis, this is a key feature
Kobayashi, who was able to consume Lessons from food traceability indicate that there are some significant
58 sausages in just 10 minutes. That’s roughly 10 pounds.
www.getsweet.com/blog/posts/importance-of-effective-food-traceability-system See GS1.org/healthcare 3 GS1.org/healthcare 4 The bullwhip effect on the supply chain occurs when changes in consumer demand causes the companies in a supply chain to order more goods to meet the new demand. The bullwhip effect usually flows up the supply chain, starting with the retailer, wholesaler, distributor, manufacturer and then the raw materials supplier. This effect can be observed through most supply chains across several industries; it occurs because the demand for goods is based on demand forecasts from companies, rather than actual consumer demand. (www.cbpp.uaa.alaska.edu/afefbullwhip_effect_in_supply_ch.htm) 5 Op.Cit., www.getsweet.com. 1 2
The Journal of Healthcare Contracting | Special Issue 2020
17
There are a lot of unknowns in the world right now. But one thing is certain‌ we are here for you. Now more than ever, we can all appreciate the importance of coming together during times of crisis. As we are all altering our lives to limit the advancement of COVID-19 to keep our families, teammates and customers safe, we also recognize that Midmark has a vital role to play in our country’s response. Midmark provides essential equipment, technology and services that our customers need to diagnose and treat patients. To manage this safely, Midmark created a dedicated COVID-19 task force to monitor developments of facilities, supply chains and required guidelines. In supporting these guidelines Midmark has developed a plan that allows a high percentage of teammates to work remotely. This is something new for most of our teammates, but we are staying connected and supporting one another every day. With this, Midmark is considered an essential business for the medical, dental and animal health industries and will have an operational presence in mission-critical locations that provide the products needed in healthcare facilities. Our priorities revolve around the well-being of our teammates and to safely serve our customers during this time of need. Within our offices and production areas that remain operational, we are taking the necessary precautions to practice social distancing, disinfection practices, the monitoring of teammate temperatures and providing clinical education to minimize the risk of COVID-19 exposure. Today, our healthcare customers are strained and Midmark is here for them. As we follow state and national guidelines, we will provide support for essential products and services in emergency situations. Please understand that we could have limited availability for nonessential services during this time. Midmark is dedicated to maintaining production in this fight and we will do our very best to serve our customers and channel partners through this difficult time. I have never been prouder to be a part of Midmark as our teammates are working tirelessly to take care of each other and our customers. We are in this together. Designing better care.TM
John Baumann President and CEO Midmark Corporation Learn more at: midmark.com/cometogether
There are a lot of unknowns in the world right now. But one thing is certain... we are here for you. As we find ourselves in the midst of unprecedented circumstances in healthcare, we’d like to take the time to make sure you know just how much we appreciate what you do. We see the sacrifices you’re making as you work tirelessly to help keep our communities safe and healthy. From the bottom of our hearts, thank you. See what we’re doing to help at: midmark.com/cometogether
© 2020 Midmark Corporation, Miamisburg, Ohio USA
INDUSTRY RESPONSE
AHRMM Senior Director to supply chain leaders:
Review and implement CDC strategies To help answer questions on how the COVID-19 pandemic is affecting the U.S.
associations, suppliers, and distributors
healthcare supply chain, The Journal of Healthcare Contracting reached out to Michael Schil-
from across the health care field, sharing
ler, CMRP, senior director, Association for Health Care Resource & Materials Manage-
information and solutions around resource
ment (AHRMM), a professional membership group of the American Hospital Associa-
allocation conservation, supply continuity
tion (AHA). The following were his responses from the early spring.
and availability. JHC: What do supply chain leaders need
Healthcare organizations are encour-
The Journal of Healthcare Contracting:
to know about the supply and distri-
Can you provide us with some insights
aged to work with their suppliers, under-
bution of the coronavirus test kits?
into what is going on at a national level
stand product shortages and allocations
Schiller: Supply chain leaders should
in the U.S. healthcare supply chain?
they may be facing or expect to face, and
work closely with their laboratory depart-
Michael Schiller: The FDA issued an
identifying and implementing conservation
ment and staff on the procurement and
Emergency Use Authorization for use of
measures, as well as work with their State
inventory levels, and management of the
NIOSH approved N95 masks to supplement
and Local emergency management agencies.
COVID-19 test kits.
the CDC has issued strategies for optimizing
JHC: How is the government
JHC: How are you advising hospitals
the supply of N95 respirators. A checklist
coordinating with providers, GPOs,
and health systems to navigate any
for healthcare facilities and utilization
associations, etc.? What are the
supply disruptions?
of N95 masks beyond the manufacturer
conversations like?
Schiller: First and foremost we recom-
designated shelf life can be found at
Schiller: AHA has coordinated a number
mend healthcare organizations visit the
www.cdc.gov/coronavirus/2019-ncov/hcp/
of calls with healthcare executives, regula-
CDC COVID-19 website (www.cdc.gov/
respirators-strategy/index.html.
tory agencies, State, Local and Metropoli-
coronavirus/2019-nCoV/index.html) to ac-
healthcare organizations’ mask inventory, and
The CDC has also
tan Hospital Associations.
cess the resources and information they
stated that based on local
All conversations have been
have compiled. We are encouraging supply
and regional situational
extremely collaborative,
chain professionals to review and imple-
analysis of PPE supplies,
focused and engaging.
ment the CDC strategies for the extended
facemasks are an accept-
use and limited reuse of N95 filtering face
able alternative when the
JHC: What product
piece respirators in the healthcare setting
supply chain of respirators
categories are most
and, review the surgical N95 masks that
cannot meet the demand.
affected by COVID-19?
have been approved for use. For a com-
More information regard-
Schiller: Personal protective
prehensive listing of the NIOSH approved
equipment (PPE) including
masks visit www.cdc.gov/niosh/npptl/topics/
gowns, gloves, and respirator
respirators/disp_part/respsource3surgi-
gov/coronavirus/2019-
masks, and blood supplies
caln95.html. Lastly we encourage reviewing
ncov/infection-control/
are the most affected catego-
the CDC’s strategies for optimizing the
ing these recommendations can be found at www.cdc.
20
Michael Schiller
control-recommendations.html?CDC_
ries. It has been projected that there are over
supply of N95 respirators; crisis and alter-
AA_refVal=https%3A%2F%2Fwww.
1,900 medical/surgical items and pharma-
nate strategies by visiting www.cdc.gov/
cdc.gov%2Fcoronavirus%2F2019-
ceutical items on allocation. AHRMM is
coronavirus/2019-ncov/hcp/respirators-
ncov%2Fhcp%2Finfection-control.html.
actively working with healthcare leaders,
strategy/crisis-alternate-strategies.html.
Special Issue 2020 | The Journal of Healthcare Contracting
UHS Quality and Chief Medical Officer:
Providing the best possible care during unprecedented challenges Editor’s note: In the following letter, Paul Stefanacci, MD, FACS, MBA, vice president, quality and chief medical officer, acute care division, Universal Health Services, Inc., shared with The Journal of Healthcare Contracting what UHS was doing at press time to leverage its resources and collaborate with federal, state and local health authorities.
As healthcare providers, we fulfill a
ʯ Alternate, external
of patients, as we
critical mission in society. And as the
screening locations
mitigate the risks of
novel coronavirus creates unprecedented
for the Coronavirus
community spread.
challenges nationwide, we are continuing
have been set up away
to provide the best possible healthcare
from the main EDs
Our Supply Chain
across our served communities. Our
to ensure the safety
team is continuing to
hospitals are collaborating with each other
of patients, staff and
source for necessary
for best-practice sharing and leveraging
visitors and allow for
the resources we share as an organization.
patient access for other
supplies and equipment, Paul Stefanacci
emergency conditions. We are working closely with the Centers
including actively seeking alternate supplier channels. UHS Supply Chain is
ʯ We have suspended visitation,
working daily with customers, distribu-
and with local health authorities. We are
with limited exceptions. We
tors, and manufacturers to manage our
actively taking precautions to protect the
are screening all individuals
supply needs across the organization.
health and safety of our patients and staff
upon entering the facility. We
We have established tracking, reporting
members, and to help reduce the spread of
are monitoring patients for any
and have daily calls with our internal
the virus in our regions. Specifically:
symptoms and implementing
customers to ensure their needs are be-
isolation protocols, if needed.
ing met. We are redeploying supplies to
for Disease Control and Prevention (CDC)
ʯ We are in daily communication with all clinical workers to share updated guidelines/protocols. Providing updated training to ensure we can
facilities who are experiencing unusually
ʯ We are scaling telehealth to continue to provide care.
ramp up quickly.
ing our hospitals of the importance of conservation of supplies, especially
ʯ All volunteers have been asked ʯ Taking temperatures daily; reporting
high spikes in volumes. We are remind-
PPE. We are utilizing corporate re-
to temporarily suspend their
sources across the enterprise to manage
symptoms, as appropriate. Using
scheduled times at the hospital,
consistency and information flow dur-
isolation, when warranted.
for their own safety as well as that
ing this evolving situation.
Paul Stefanacci, MD, FACS, MBA is Vice President, Quality and Chief Medical Officer for the Acute Care Division of Universal Health Services, Inc. Dr. Stefanacci provides UHS with the clinical leadership to face the challenges of the rapidly evolving healthcare environment and advance an ambitious quality and performance improvement agenda.
The Journal of Healthcare Contracting | Special Issue 2020
21
To those on the front lines, As the COVID-19 pandemic continues to affect people and communities around the world, I appreciate the unimaginable minute-by-minute demands placed upon you and your teams. BD fully understands the sacrifice and commitment from all of the frontline healthcare workers who are risking their own health to help others. It is nothing short of heroic. I want you to know that helping our longstanding partners respond to the COVID-19 crisis is BD’s sole focus right now. Because patients depend on you, BD teams around the world are working to fulfill our shared obligation to serve patients and society during this unprecedented time. BD has deployed our capabilities, expertise and scale to address critical health needs related to coronavirus – from our diagnostic offerings to identify COVID-19, to real-time informatics and electronic surveillance technology, to essential medical devices to support patient care. We are committed to doing our part, and we’ve ramped up production and activated our business continuity plans, so we can make every effort to ensure you have the medical technologies you need to respond. With the first reports of COVID-19 in January, BD took immediate action to prepare by activating our global crisis management team, and we wanted to provide you with an update on our efforts to ensure BD products and solutions are there to support you – and your patients. Prioritizing the access to BD products – BD manufactures and sources products from multiple locations around the world. Each of our manufacturing and distribution centers that are critical to responding to COVID-19 are operational and have enacted business continuity plans to minimize the risk of disruption to you. In response to very high demand for our critical medical devices, we have ramped up production to the highest degree possible under the current circumstances, and we are closely monitoring inventory and customer ordering to ensure supply continuity. We are continuing to update the list of products on manual inventory allocation on a new website at bd.com/allocation. Collaborating with government and industry – Consistent with BD’s long tradition of public-private partnerships, we’re proud to be working with government and industry partners to expand access to testing and bring new innovations to the market to aid in the identification, diagnosis and treatment of COVID-19. In addition to working with the FDA on new diagnostic tests that will increase the potential capacity to test for COVID-19 using the BD Max™ platform, we’re also exploring the development of a rapid point-of-care test for coronavirus by leveraging the BD Veritor™ system. At the same time, we are collaborating with peers from across the industry, HHS, FDA and private partners to identify and validate additional swab types as well as transport medium options in order to expand capacity and alternative collection methods. Ensuring we’re there when you need us – Our sales and clinical associates have tools to support you remotely, including FaceTime and Microsoft Teams among others. Where our on-site support is needed to ensure immediate patient care, such as technology installation/service and clinical support, we will be there at your request. We are taking precautions to protect our associates, customers and patients by following guidance from the World Health Organization, U.S. Centers for Disease Control, and each of our customers’ guidelines on access to their facilities. Protecting our employees – As part of our preventative actions, we have taken a number of steps to ensure the health and safety of our team. In our manufacturing facilities and distribution centers, we have increased our deep cleaning protocols, implemented temperature screening for on-site employees, and are changing work practices where possible to facilitate social distancing. Around the world, we are regularly educating employees about good hygiene and health practices, including social distancing, self-quarantining and handwashing. Supporting response efforts – BD is deploying more than $1 million in cash and product donations to seven non-profit organizations – Direct Relief, the International Medical Corps, Americares, the World Health Organization-United Nations Foundation COVID-19 Solidarity Response Fund, Project HOPE, the CDC Foundation and the Wuhan Red Cross – to advance their work to contain COVID-19, support healthcare workers and treat patients in countries throughout the world. We will continue to communicate regularly on our website — bd.com/COVID-19 — to keep you informed as we move forward. On behalf of the 65,000 employees at BD, I want to express our deep appreciation to you and the hundreds of thousands of healthcare providers across the country who have answered the call to respond to this truly unprecedented situation. We consider it a privilege to support you as a trusted partner. Sincerely, Tom Polen, CEO and President BD
For the tireless, the selfless, the brave
You mean the world Whether you are working on the frontlines or are the last line of defense in the fight against COVID-19, you are making a world of difference for so many. Thank you.
bd.com/COVID-19 BD and the BD Logo are trademarks of Becton, Dickinson and Company. All other trademarks are the property of their respective owners. Š 2020 BD. All rights reserved. 4644
INDUSTRY RESPONSE
Come together Supply chain leaders met with the president at the White House as part of the COVID-19 Supply Chain Task Force
President Trump held a meeting at the White House on Sunday, March 29,
Schein on a number of collaborative
with the leaders of several supply chain distributors and shipping companies as part of
fronts. “No. 1, we’ve all talked about PPE
the COVID-19 Supply Chain Task Force.
products – that’s critical, and it’s not just to the hospitals,” Connett said. “It’s a
Med/surg supply chain leaders who participated were:
ʯ ʯ ʯ ʯ ʯ
must to the hospitals, but it’s really to all
Brad Connett, president, U.S. Medical Group, Henry Schein
healthcare providers that are working on
Mike Kaufmann, CEO of Cardinal Health
the front line. Our commitment is to get
Charlie Mills, CEO of Medline Industries Inc.
it to the hot spots, and get it to the care
Ed Pesicka, president and CEO of Owens & Minor
providers who are taking care of those
Brian Tyler, CEO of McKesson
patients. It’s absolutely key.” Second, Connett said the task force talked about the importance of buying
“We’re waging a war against an invisible enemy,” said Trump. “We are grateful
American-made products, and getting
med/surg leaders at the press conference.
manufacturing and resources back in
for your tremendous partnership – it’s
America. “It’s a lesson to be learned from
been incredible – and the work you’ve
where we are.”
done so far.” Each supply chain representative was given an opportunity to provide an update.
24
The following were comments made by the
Henry Schein
Connett also spoke about the im-
Connett thanked President Trump and his
portance of more rapid tests to detect
administration for working with Henry
COVID-19. As of press time, Henry
Special Issue 2020 | The Journal of Healthcare Contracting
Schein helped bring two products into
The 51 flights the president referenced,
masks a week is now using 200,000 to
the market. The first is an antibody
we’re excited about. We look to build
300,000 masks a week. So you multiply
rapid blood test, known as Standard
upon that. So, I would echo my thanks for
that times the entire U.S., let alone the
Q COVID-19 IgM/IgG Rapid Test,
your leadership, and certainly to the staffs
same demand outside of the U.S., and
intended to be administered at the point
for the terrific partnership and the com-
that’s part of the issue we are running
of care. According to the healthcare
mitment to protect the people we think
into. Even with a significant ramp up
company, the test delivers results within
about most often, which are the people
in supply, there is still a demand that is
15 minutes from a pinprick with no
on the front lines providing care.”
much greater.”
instrumentation required. Henry Schein will also serve as the exclusive distributor in the United States of a second point-of-care rapid test kit that can detect antibodies associated with COVID-19 in as few as 15 minutes.
“ The supply chain is working, it’s resilient, and though supply is a challenge, we’re tackling that.” – Brian Tyler, CEO of McKesson
Working with BD (Becton, Dickinson and Company) and BioMedomics, a North Carolina-based clinical diagnostics company, Henry Schein will make the test kits
Tyler also offered a word of thanks
Cardinal Health
available to health care professionals as
on behalf of all the CEOs present at the
Kaufmann thanked the president for his
part of the company’s broad offering of
task force meeting to the teams of each
leadership. “Because of that leadership,
point-of-care rapid tests.
organization “that continue to show up in
we’ve seen the government agencies
warehouses across the country, in pharma-
working with industry like no time be-
cies across the country, and do their jobs
fore,” Kaufmann said. “We’ve seen HHS,
McKesson
to keep the supply chain going. The supply
FEMA, and the CDC work effectively
Tyler said collaboration between the
chain is working, it’s resilient, and though
with all of the distributors. And all of the
government agencies and medical sup-
supply is a challenge, we’re tackling that.”
distributors are working together for the
pliers has been key. “I’d certainly like to
good of the people. All of us have been
echo my colleagues’ comments that the
so focused on making sure we take care
collaboration amongst many of the gov-
Owens & Minor
of our customers because our customers
ernment agencies and the private market,
Pesicka said Owens & Minor is leveraging
are the ones taking care of the patients
including the distributors represented
its manufacturing capabilities in America,
every day. We need to do everything we
here today, has been incredible, and has
specifically in North Carolina, to ramp up
can to make things good for them.”
been increasing and ramping up over the
production. “We did hear the challenge,
past few weeks.”
and starting in January we’ve ramped up our production in the Americas, including
Medline Industries
an innovative public-private partnership
our facility in North Carolina where we
In his remarks at the press conference,
called Project Airbridge, where FEMA
are now manufacturing an additional 40
Mills said the demand for supplies has
and other government agencies will
to 50 million masks per month to get into
skyrocketed. “We’re doing a lot of things
coordinate 50-plus air cargo flights in a
the U.S. healthcare system.”
to bring in more masks and other protec-
During his remarks, Tyler referenced
span of two to three weeks. Each flight
Pesicka said the task force talked
tive apparel,” he said. “We are involved in
will bring tons of medical supplies to the
about the massive demand increase in
reprocessing masks. We’ve already started
U.S., directly to the cities where it is most
PPE supplies. “I used an anecdotal ex-
reprocessing about 100,000 masks per
needed. “Today the first delivery of Proj-
ample of one hospital in New York that
day. We hope to expand from there, so
ect Airbridge is evidence that it’s working.
traditional uses roughly 10,000 to 20,000
we’re quite optimistic about it.”
The Journal of Healthcare Contracting | Special Issue 2020
25
A Message from MedPro Associates: To Our Distributor and Manufacturer Partners, The past several weeks have certainly tested us all. As we continue to monitor ongoing developments related to the coronavirus (COVID-19), please know that MedPro will not compromise our commitment to you and the customers we collectively serve. We will always be here when you need us most, and you can count on us to continue providing the same high level of service you have come to expect.
As COVID-19 continues to impact our customers and supply chain needs, we are committed to doing A Message from MedPro Associates: what is best for our customers, our reps and the public. We have been closely monitoring the situation and making changes along the way. Based on customer requests and CDC recommendations, we have To Our Distributor and Manufacturer Partners, implemented social distancing sales protocols, but continue to actively communicate via phone, webinar The past several weeks have certainly tested us all. As we continue to monitor ongoin and Zoom technology, both with our distribution channel and healthcare providers to support your related to the coronavirus (COVID-19), please know that MedPro will not compromise customers for product in-services, demos, and other needs. Furthermore, we have heightened our sales to you and the customers we collectively serve. We will always be here when you nee and product training to stay sharp and be prepared to be stronger than ever when the crisis is under you can count on us to continue providing the same high level of service you have com control, while keeping active and prospective sales moving forward. We take our responsibility very seriously and will continue to do our part as representatives of our distributor and manufacturer As COVID-19 continues to impact our customers and supply chain needs, we are comm partners, as well as the customers we serve. what is best for our customers, our reps and the public. We have been closely monito and making changes along the way. Based on customer requests and CDC recommend MedPro has not taken a pass during this healthcare fight against COVID 19. We are operational and implemented social distancing sales protocols, but continue to actively communicate v available. Please do not hesitate to reach out to our management team and your local reps. There can and Zoom technology, both with our distribution channel and healthcare providers to never be enough communication during this time when our customers need us most. customers for product in-services, demos, and other needs. Furthermore, we have he and product training to stay sharp and be prepared to be stronger than ever when the As always, we appreciate our business partnership and your confidence in MedPro. control, while keeping active and prospective sales moving forward. We take our resp seriously and will continue to do our part as representatives of our distributor and ma Sincerely, partners, as well as the customers we serve. Bill Sparks, CEO Manny Losada, President MedPro has not taken a pass during this healthcare fight against COVID 19. We are op & our entire Executive Management Team available. Please do not hesitate to reach out to our management team and your loca never be enough communication during this time when our customers need us most. As always, we appreciate our business partnership and your confidence in MedPro. Sincerely, Bill Sparks, CEO Manny Losada, President & our entire Executive Management Team
WE’RE HERE FOR YOU. Committed to the well-being of our customers, reps, and the public, through our continued support of distribution.
CALL AND LET US HELP.
800-778-4718 ext. 114 info@mproassociates.com www.mproassociates.com
GPO RESPONSE
Leading IDNs are being judicious with supply orders “for the foreseeable future,” GPO executive says Editor’s note: As the coronavirus pandemic has evolved, JHC has reached out to several healthcare supply chain organizations to help assess the situation for our readers to try and make sense of what is going on. The following are responses from Chaun Powell, MBA, group vice president, strategic supplier engagement, Premier, originally posted on JHC’s blog in late March.
The Journal of Healthcare Contract-
caregivers at these facilities are working
Over the next five weeks we tracked the
ing (JHC): How are you working with
around the clock to promote the safety of
progress of the virus and the impact to
member organizations to identify
their patients and clinicians, and we must
the global supply chain, yet the impact on
and mitigate potential impacts or
do all we can as a country to support
the U.S. was minimal. Less than a month
supply disruptions?
them. Above all, we would
ago, there were still only three states with
Chaun Powell: This is an
like to thank our caregivers
fewer than 10 confirmed patients do-
incredibly challenging and
for everything they’re doing
mestically. Now we are serving providers
fluid situation with variables
to provide critical care to
across 49 states dealing with more than
that are in constant flux. As
our communities.
3,500 confirmed cases. In order to be ef-
a member-driven organiza-
fective, we have had to pivot our internal
insight on the speed at
processes significantly to make sure that
behalf of nearly 4,000
which this is escalating, the
our clinicians are able to deliver uninter-
acute care hospitals and
Premier Disaster Prepared-
rupted care. In addition to the work that
health systems and 175,000
ness and Response Team
we are doing with members, we are also
activated on January 24.
partnering with government agencies, the
non-acute providers. The
28
To provide some
tion, we are working on
Chaun Powell
Special Issue 2020 | The Journal of Healthcare Contracting
Administration, suppliers and distributors
joined India, Taiwan, Thailand, South
COVID-19 patients. However, a respira-
in the private sector to create both short-
Korea and China in halting exports of
tor, ex N95, is only required during high-
term and long-term solutions grounded
personal protective equipment (PPE).
risk procedures. Industrial N95 masks
in data created as a result of our primary
We recently released results of a sur-
research with the ultimate goal of inform-
vey of non-acute care providers, who
ing public understanding.
are experiencing supply chain strain
We collaborated with the White
that are NIOSH-approved and certain expired N95s are also allowed. To go along with the CDC’s revised
in accessing PPE. This follows up our
stance, CMS has temporarily waived
House Administration’s COVID-19 sup-
survey released at the end of February,
annual fit testing for respirators, which
ply chain task force to share our data-
which asked acute care providers about
will avoid wasting masks used in the
driven perspective about the current state
their inventory levels related to PPE.
annual validation.
of health system preparedness and potential actions that could be taken to ensure a more reliable supply chain. Premier presented unique insights and data on the 2,000 unique items that are currently on national allocation and in shortage, and key recommendations to protect the integrity of our acute, non-acute and pharmaceutical supply chain. Since activating over seven weeks ago, we’ve been sending daily updates to our
Coronavirus illuminates a critical message that we’ve been communicating for a very long time. We, as a nation, need to be more intentional with our supply chain.
field team and members, and maintaining near real-time updates on our internal Disaster Preparedness Response Com-
JHC: What are some best practices of
munity. There, we’ve been equipping our
leading IDNs, health systems and hos-
with supply orders for the foreseeable
members with updates including links to
pitals that have disaster and disruption
future. This is true for both the PPE
the CDC’s latest guidance, appropriate
plans in place? How are they trying to
supply chain as well as the pharmaceutical
use guidelines for PPE and response to
stay ahead of any potential issues?
supply chain. By avoiding panicked order-
many of the questions we’ve gotten from
Powell: We continue to advise all
ing, providers prevent straining the supply
our members. We also have the Premier
members to follow CDC-recommended
chain at large.
Safety Institute, a public-facing site where
conservation protocols for PPE.
Obviously, we all need to follow the
we provide the most up-to-date scientific
Currently, there are roughly 2,000
CDC’s general health guidelines here, par-
documents, resources and tools primarily
unique stock keeping units (SKUs)
ticularly healthcare workers: wash hands
focused on clinical information.
that have been placed on allocation
regularly; cover a cough or sneeze, avoid
from distributors. This means that in
touching our eyes, nose and mouth; avoid
JHC: What product categories
most cases, supply ordering is limited
close contact with people who are sick;
are seeing the most strain?
to historic levels. This underscores the
and stay home when sick.
Powell: Currently, the categories where
importance of all providers following
members are experiencing the most difficul-
rigorous conservation protocols.
ty accessing supplies include N95 masks, ear
As of March 11, the CDC has
Leading IDNs are being judicious
One additional area of interest for many industry stakeholders should be the increase in gray market activity. We’re
loops, hand sanitizers, COVID-19 testing
revised its guidance on masks and res-
cautioning our members to be careful
swabs and reagents, PAPRs and gowns.
pirators. Personnel should continue to
about anyone approaching them outside
wear facemasks and eye protection while
of their normal supply chain chan-
providing care to known or suspected
nels purporting to have access to PPE,
Further compounding this issue is the fact that Russia and the entire EU have
The Journal of Healthcare Contracting | Special Issue 2020
29
THANK YOU FOR YOUR DEDICATED COURAGE AND LEADERSHIP We’re proud to support the front lines of health care. To Our Health Care Leaders and Providers:
More information on Henry Schein’s key efforts:
First, we would like to thank all of the health care providers across the country for your dedicated courage and leadership as we combat the coronavirus disease, which continues to take its toll on our communities. We salute all health care workers and first responders for your bravery, compassion, and diligence.
COVID-19 TESTING
Henry Schein takes seriously the promise we make to our customers – Rely on Us – and that promise is especially meaningful in challenging times. Among our many efforts, we’ve announced our distribution of two point-of-care antibody rapid tests, shared information on the benefits of virtual care with Medpod, our Telemedicine Solution for health care professionals, and developed a Coronavirus (COVID-19) Resource Center. Additionally, Henry Schein is a participant in the White House’s COVID-19 Supply Chain Task Force, and has worked with the U.S. government to ship personal protective equipment (PPE) from the Strategic National Stockpile to testing sites in support of front-line health care professionals. The Company is also working with the Federal Emergency Management Agency (FEMA) to source and deliver critical supplies quickly, in accordance with directions from the U.S. government. We thank you for your service, and we applaud your personal sacrifice to stop the spread of the coronavirus and to keep our local communities healthy under these extraordinary circumstances. Sincerely,
Bradford C. Connett President, U.S. Medical Group Henry Schein Medical Group
Bradford C. Connett
In collaboration with our diagnostic partners, we introduced a wide array of diagnostics specific to COVID-19. Our new point-of-care antibody tests can deliver test results within 15 minutes from a pinprick with no instrumentation required. Our portfolio allows health care professionals to use the results with a patient’s medical history, symptoms, and results of other relevant testing, to make informed decisions about patient treatment and care. Our ultimate goal is to help get Americans back to work.
MEDPOD FOR TELEMEDICINE Medpod, Henry Schein’s telemedicine platform, comes in highly versatile configurations including a cloudbased version without devices and complete units deployed in a suitcase, stand-alone cart, or a mobile facility. To learn more about the benefits of virtual health care, please visit www.henryschein.com/medpod.
RESOURCE AND EDUCATION CENTER Henry Schein’s Coronavirus (COVID-19) Resource Center and Coronavirus (COVID-19) Education Center on our website delivers frequently updated information and offers educational resources to help customers with the wide range of issues presented by the outbreak.
THE CATALYST ADVANCING HEALTH CARE Henry Schein has partnered with Medpod, a software solution that transforms health care delivery.
By transforming telemedicine with the most comprehensive scalable telediagnostics platform, Medpod connects groundbreaking software and medical devices, optimizes health care delivery and maximizes patient management throughout the continuum of care. Medpod elevates the medical standard for higher quality care between remote provider and patient, regardless of their physical location — maximizing flexibility and opportunity for your practice. Are you ready to navigate the future of telemedicine? Let Henry Schein Medical and Medpod lead the way.
1.800.P.SCHEIN HenrySchein.com/Medpod DISCLAIMER: All product and company names are trademarks™ or registered® trademarks of their respective holders. The Medpod logo may not be reproduced by any means or in any form whatsoever without Medpod Inc.’s written permission. The Henry Schein logo is a registered trademark of HS TM, LLC, a Henry Schein subsidiary. The Henry Schein logo may not be reproduced by any means or in any form whatsoever without HS TM, LLC ‘s written permission. All rights reserved 2016-2019. © 2019 Medpod Inc. All Rights Reserved.
GPO RESPONSE
pharmaceuticals and other healthcare
This becomes problematic as suppliers,
are not made aware of a shortage until it
supplies, and to work with their GPO to
in an effort to remain cost-competitive,
has already been declared. The late notice
identify the authenticity of these goods.
have moved more manufacturing offshore.
leads to hoarding, as healthcare systems
We now find ourselves relying on Asian
react to protect their patient populations.
JHC: How do we as an industry pre-
manufacturing for large portions of our
The downstream impact is amplified
vent shortages that may occur due
supply chain. This became apparent dur-
when the supply chain is overseas and
to hoarding and panic buying?
ing the Ebola crises, but our memories
not easily within our control. In sum-
Powell: Coronavirus illuminates a critical
faded about the risks of reliance on other
mary, increasing visibility to the upstream
message that we’ve been communicat-
countries to support our product needs
supply chain, increasing regulation around
ing for a very long time. We, as a nation,
until January.
notification periods for disruptions, and
need to be more intentional with our
In order to regain a competitive edge
bringing product manufacturing back
supply chain. Over the past several years
in the healthcare supply chain, we must
to the U.S. will allow us, as a healthcare
of a bull economy, there has been much
collaborate across private and public
ecosystem, to be more proactive and less
focus on profitability as most healthcare
sectors to improve visibility to upstream
relegated to reactivity.
systems only materialize a 2% profit. With
stakeholders including the locations of
decreasing reimbursements, in order to
raw materials, contract manufacturers and
JHC: Are you seeing lessons learned
maintain their ability to offer patient care
distributors. We must also increase the
from previous disasters being imple-
and other community benefits, healthcare
regulatory obligation of suppliers to pro-
mented? If so, how have we gotten
providers have tasked their supply chain
vide advanced notice of disruptions. In
better at handling situations like this?
professionals to help reduce expenses, and
today’s supply chain environment for de-
Powell: Given Premier’s unique posi-
they in turn typically turn to commodities.
vices and medical consumables, we often
tion in the supply chain as an extension of America’s healthcare providers, we understand firsthand the impact to patient care when hospitals and health systems do not have access to the drugs and medical supplies needed to treat patients. We also know that during shortages, prices tend to skyrocket and clinicians are removed from patient care as they are called on to help source alternative therapies. During outbreaks such as H1N1, Ebola and COVID-19, access to these drugs and medical supplies can determine whether our ability to practice modern medicine is threatened. Therefore, it’s critical that we proactively address these known supply chain vulnerabilities now. In order to truly address these supply chain vulnerabilities, we need additional transparency to understand true risk. We also need to create incentives to encourage domestic manufacturing of drugs and medical supplies. These are
32
Special Issue 2020 | The Journal of Healthcare Contracting
common-sense, market-based, holistic and sustainable solutions that Congress can act on. Congressional action is imperative to ensure the United States healthcare supply chain in prepared for the next COVID-19. For drugs, Premier supports S. 2723 – The Mitigating Emergency Drug Shortages (MEDS) Act introduced by Senators Susan Collins (R-ME) and Tina Smith (D-MN). Supported by over 75 provider organizations and health
In order to regain a competitive edge in the healthcare supply chain, we must collaborate across private and public sectors to improve visibility to upstream stakeholders including the locations of raw materials, contract manufacturers and distributors.
systems, the MEDS Act builds upon the prior work of Congress to provide ad-
regarding where critical drugs are
API manufacturers do not have
ditional authority to the Food and Drug
manufactured, the source of API,
to report supply disruptions to
Administration (FDA) to help mitigate
and redundancy plans. To overcome
the FDA. The MEDS Act would
drug shortages and develop market-
these lessons learned, the MEDS
expand FDASIA Title X reporting
based incentives to help ensure a stable
Act requires manufacturers to report
requirements to API manufacturers
supply of medications critical for patient
to the FDA the exact location of
and require reporting of potential
care. Specifically, the following scenarios
manufacturing for these critical
supply disruptions to the FDA,
exemplify the need for enactment of the
drugs, the exact source of all raw
creating an early warning system
MEDS Act:
materials, and redundancy and
that would allow the FDA upstream
ʯ A major concern with the
contingency plans to ensure a stable
visibility to appropriately assess
COVID-19 outbreak in China is the
supply. In the case of COVID-19,
risk and rapidly work to identify
overreliance on a single nation for
this type of information would be
alternative sources of supply.
a significant portion of the United
critical to understand exactly what
States’ drug supply. The MEDS Act
is being manufactured in China,
helps address this overreliance by
exactly what proportion of API and
we need to arm the FDA with similar
requiring the Secretary of Health
raw materials are manufactured in
authority to act for supply disruptions
and Human Services (HHS) to
China, and what a manufacturers’
and shortages as they do in the drug
develop a report to Congress with
contingency plans are should
space. As FDA articulated in their FY
recommendations to incentivize
manufacturing in China no longer
2020 budget request, no law requires
the domestic manufacturing of
be feasible. This is all critical
medical device manufacturers to notify
finished dose formulations and active
information to understand the true
FDA when they become aware of a
pharmaceutical ingredients (API).
risk to the supply chain and potential
circumstance that could lead to a device
The MEDS Act also examines the
drug shortages due to pandemics
shortage. By creating such a requirement,
risk to national security.
such as COVID-19.
as currently exists for drug manufactur-
ʯ We also support the Preventing Drug Shortages
For devices and medical supplies,
ers, it would ensure FDA has timely and
ʯ Another major unknown currently
accurate information about likely or
Act, a similar bill in the House
is the downstream impact of any
confirmed national shortages of essen-
of Representatives.
potential API shortages as a large
tial devices to enable FDA to take steps
portion of the world’s API is
to promote the continued availability of
manufactured in China. Currently,
devices of public health importance.
ʯ A lesson learned from Hurricane Maria is the lack of transparency
The Journal of Healthcare Contracting | Special Issue 2020
33
To our valued partners, It is difficult to fathom all of the change that the globe has experienced since we first heard the word “coronavirus.� At the OraSure family of companies, we see the enormous impact the COVID-19 pandemic is having on our customers, our communities and our families. At this time it is critical for organizations to rally and innovate to bring new solutions to a common challenge that is impacting everyone on the planet. We want to thank all of the frontline health workers, our trusted partners, and everyone in the healthcare community who is working tirelessly day in and day out to combat the COVID-19 pandemic. During these challenging times we offer our support and pledge our continued commitment to providing innovative, easy-to-use and scalable point-of-care diagnostic tools to help detect infectious diseases including HIV and HCV. We are working closely with public health to uncover new modalities to safely bring in-home HIV testing to those who are at extra risk during this time. And we are proud to bring our expertise to the fight against COVID-19 with the development of diagnostic solutions squarely aimed at improving access to reliable testing. We recently announced a contract from the U.S. Department of Health and Human Services’ Biomedical Advanced Research and Development Authority (BARDA), to develop a pan-SARS-coronavirus antigen rapid self-test that uses oral fluid samples to enable in-home testing. We are also developing an ELISA-based antibody test for Laboratory use. As a life-sustaining business, we remain engaged, ready, and committed to supporting our customers and partners. We wish you all safety and health, and sincerely thank you for your ongoing support of OraSure Technologies.
Sincerely, Stephen Tang, CEO And our entire OraSure family of companies
We want to thank all the frontline health workers, our partners, and everyone in the healthcare community working tirelessly day in and day out to combat the COVID-19 pandemic. During these challenging times we offer our support and pledge our continued commitment to providing innovative, easy-to-use and scalable point-of-care diagnostic tools to help detect infectious diseases including HIV and HCV. We are proud to bring our expertise to the fight against COVID-19 with the development of a Rapid Oral Fluid Antigen Self-Test for In-Home use and the development of an ELISA-based antibody test for Laboratory use.
We’re here to help – reach out to us at
orasure.com/smm for more information.
OraQuick® and OraQuick ADVANCE® are registered trademarks of OraSure Technologies, Inc. © 2020 OraSure Technologies, Inc. OQA0568 rev. 04/20
GPO RESPONSE
Vizient: Focus on resiliency While meeting the demands of an emergency, supply chain teams will also need to anticipate future needs
The Journal of Healthcare Contracting asked Vizient for insights into how the
Steve Downey: Most of the conversa-
organization and its members are responding to the COVID-19 pandemic. Respond-
tions are centered on supplies, especially
ing to JHC ’s questions were Steve Downey, group senior vice president, supply chain
critical ones – how many days on hand
operations, Vizient, Inc.; and Julie Cerese, group senior vice president, performance
do they have for masks, gowns, ventila-
management and national networks, Vizient, Inc.
tor parts, etc. Supply chain teams are trying to get ahead of what materials they need as their hospitals ramp up to
The Journal of Healthcare
provide care and how they’ll get those
Contracting: Can you pro-
in these times of short supply. They are
vide us with some insights
reviewing what practices clinicians are
of what is going on at hos-
implementing to conserve supply and
pitals and health systems
vetting suppliers that seemingly come
as it relates to their supply
out of the woodwork. They’re working
chain teams? What con-
to confirm deliveries, as some locations are right on the edge of stock outs and
versations are they having right now?
36
Steve Downey
Julie Cerese
arrival times matter. We are also seeing
Special Issue 2020 | The Journal of Healthcare Contracting
members and local sites setting up
JHC: How should supply chain teams
to convert those areas to needed patient
emergency operations and increasing bed
be planning long-term?
care areas. Hospitals have also worked
capacity quickly. Those emergency sites
Downey: Supply chain teams should
with local, state and federal health au-
need supplies, logistics and labor and
make their plans with a focus on resiliency
thorities to develop regional approaches
their unique requirements put pressure
because it ensures supply continuity for
to care that can support patient surges.
on the supply chain.
the long term. Vizient will soon roll out a
Some Vizient members have repurposed
new platform to members that will create
their ambulatory practices to serve as
JHC: How are you advising hospitals
a “two-sided� marketplace for healthcare
COVID-19 testing and treatment sites,
and health systems to navigate any
organizations and suppliers to map supply
helping to preserve hospital capacity for
supply disruptions?
sources, risk points and create transparency
the sickest patients.
Downey: We are advising supply chain teams at member hospitals to conserve where they can and to check our Disaster Preparedness page regularly for the latest updates and information. Vizient continues to explore alternative supply resources and make that information available to members as soon as possible. In addition, we are encouraging members to keep
Working with clinical teams, they should set up conservation practices on scarce supplies. When they have challenges, they can rely on Vizient contacts and resources such as webinars and newsletters, for key information.
forward-looking in order to project what stock they will have and what stock they will need so that suppliers can react to
through the supplier and provider chain.
their best abilities.
The platform will help supply chain leaders
ed to this crisis, they have made major
As healthcare providers have respond-
at hospitals recognize areas where supply
progress in improving access to health-
JHC: What are a few things that ev-
may be constrained, at risk because of
care for patients. When restrictions were
ery supply chain team should being
single geographic origination or with a ven-
lifted to make telehealth more available,
doing today as a result of COVID-19?
dor having fill-rate challenges, so they can
many providers made it the first stop of
Downey: Clear communication with
make the necessary adjustments for supply
the triage process, stopping patients from
key stakeholders is a major factor in
chain resiliency within their organization.
arriving and overwhelming the emergency
successfully working through a disaster.
department. This has helped providers
Every supply chain team should know
JHC: In what ways do you think
and patients to become more familiar
what supplies are critical to the care of
COVID-19 is transforming how
with telehealth as a future option for their
their hospital’s COVID patients and
healthcare is provided?
health care needs.
stay on top of the days-on-hand of
Julie Cerese: To prepare for COVID-19
those materials. Working with clinical
patients, healthcare providers quickly can-
ages of PPE, healthcare providers have
teams, they should set up conservation
celled elective surgeries and procedures to
quickly stood up new and innovative
practices on scarce supplies. When they
marshal resources for the coming surge.
processes to ensure PPE is available for
have challenges, they can rely on Vizient
They quickly began to assess, train and re-
front-line caregivers. This has included
contacts and resources such as webinars
deploy staff to support critical areas such
developing new sanitation processes, or
and newsletters, for key information.
as emergency departments and ICUs.
cohorting patients in a way that enables
Most importantly, they should take
Organizations quickly moved to
In addition because of critical short-
PPE to be used longer by staff. Vizient has
every step possible to keep their clinical
assess the facilities they own, such as
held weekly webinars and has been collect-
teams safe and healthy, as these are
closed inpatient areas, operating rooms
ing practices from its members in order to
difficult times.
and conference rooms and develop plans
improve knowledge transfer in this area.
The Journal of Healthcare Contracting | Special Issue 2020
37
DUKAL Strong This year – 2020 – started out as any other year. I spent a week in Shanghai, China, in mid-January to celebrate the Chinese New Year with DUKAL’s China team when we heard there was a virus in Wuhan, China, but thought nothing of it. However, Wuhan is an economic development city and billions of dollars have been invested there by foreign countries in manufacturing, led by the U.S. With visitors from all over the world traveling in and out of Wuhan daily, coupled with a virus that is a killer, it wasn’t long before we had the beginnings of a global mess on our hands.
Healthcare suppliers in the U.S. have handled pandemics before, but never one that hit so close to home and disrupted our supply chain while immobilizing our citizens. Wuhan and its surrounding cities were all quarantined before the end of the Chinese New Year holiday, and unable to resume their normal production. With a high concentration of PPE production coming out of Wuhan, and COVID-19 spreading in Europe and the U.S., the dramatically increased demand exceeded the production capacity of the region. By early March, COVID-19 had come into the New York region and broadened our focus beyond just the need to maintain our supply chain. The continued well-being of our employees and their families became an urgent concern as well. The continuity of the business hinges on our essential employees and for them to be able to complete their jobs efficiently. As an essential supplier, and one very involved in PPE, we knew DUKAL had to remain fully functional. Our Disaster Recovery Plan was enhanced to address both the pandemic and our employees’ well-being. The DUKAL main office in Ronkonkoma, New York, went fully remote on Monday, March 16 with over 50 people able to work at home. Phones rang, emails flowed, and the office become fully functional from 50 locations! That day the reality of the severity of what was happening
from buyers around the world and demand drives up pricing. Additionally, raw material shortages and hoarding also contributes to rapid and continued increases. Look at the Raw Material Pricing Index from January to April 13 to get an idea of the magnitude of the jump:
set in. As a person who believes in “New York Strong” I had not felt so empowered since the region started to recover from the tragedy of 9/11.
• Polypropylene the raw
As we work through the realities of meeting our customers’ increased demand, coupled with China still trying to normalize production post-virus, the industry is faced with rapidly increasing prices, especially for the PPE products. DUKAL is now competing for scarce products
• Spunbonded Polypropylene
material to make the SPP fabric: January RMB: 5,000 ton; April 13: 50,000 ton
fabric (SPP): January RMB: 8,000 ton; April 13: 120,000 ton
• Labor in China has increased five times since the beginning of the year
• China factories now require a 30-40% deposit upon order and full payment on shipping The current normal in the industry is that prices increase weekly and as of mid-April there is no timetable for stabilizing. It is very difficult to run a business during uncertain times and that is where the quality of a company’s management team is critical.
Gerard LoDuca president and founder
For the past 30 years, DUKAL has been able to drive redundant costs out of healthcare through smarter manufacturing practices. This past month, it has been disheartening to see 30 years of work be erased as these pandemic-related price increases wipe away a lifetime of work. However, in customary fashion we will move forward, continue to find innovative ways to bring healthcare products to market and put our customers first. Wherever that journey takes us, our team remains dedicated to being the best we can be and DUKAL STRONG!
We want to thank you, everyday warriors. As DUKAL employees work to ensure essential medical and PPE products are reaching healthcare workers on the frontlines of COVID-19, we want to take a moment to recognize and thank the essential workers who are committing tireless hours to keep our nation going. While it can feel like the world is standing still, everyone at DUKAL would like to acknowledge the postal workers - the grocery and restaurant workers - the farmers - the service worker - the not for profit staff - the truckers - the pharmacists - the police officers - the firefighters - the nurses, doctors, therapists and patient care aides from the medical industry, know your selflessness and dedication is so appreciated. Follow @dukalcorp to hear DUKAL employees share their thanks.
www.dukal.com
GPO RESPONSE
Intalere’s Steve Kiewiet: Transparency is key To help answer questions on how the COVID-19 pandemic is affecting the U.S.
JHC: Are you seeing lessons learned
healthcare supply chain, The Journal of Healthcare Contracting reached out to Steve Kiewiet,
from previous disasters being imple-
Chief Commercial Officer, Intalere. He offered the following comments.
mented? If so, how have we gotten better at handling situations like this? Kiewiet: I think individual systems have
JHC: What are some best practices of
chain visibility and transparency. We
gotten better and individual manufactur-
leading IDNs, health systems and hos-
should be able to track and trace every
ers have gotten better. I don’t believe the
pitals that have disaster and disruption
product necessary for the delivery of
industry has improved at all. Every dis-
plans in place? How are they trying to
care from raw materials to the use in
ruption becomes a case study in the same
stay ahead of any potential issues?
delivery of care. Inventory levels should
lessons learned from the last disruption.
Steve Kiewiet: I think some systems do a great job in communicating with everyone in their system about the impacts when disruptions occur. They manage their inventory and utilization effectively and engage their clinical community in ways to maintain care
Steve Kiewiet
Transparency can help prevent overstock and understock issues. It can ensure all necessary products for care are in the right place at the right time for the right patient.
while reducing the use of impacted products or finding alternative products for the
be transparent to every link in the
Yet, as an industry we don’t take those
delivery of care. Emergency operations
chain. Each stakeholder should be held
learnings beyond the local or individual
and crisis management are executed
accountable to use that transparency
stakeholder level. We don’t come together
well by many systems. The shortfall is
to ensure the complete supply chain is
as an industry and make the changes
we don’t work together to make this
optimized versus the optimization of
necessary to remove the risks and bring
best practices, common practice for
one link over another. Transparency
end-to-end resiliency to the supply chain.
everyone in the industry.
40
can help prevent overstock and under-
Healthcare isn’t consumer goods; we can’t
stock issues. It can ensure all necessary
keep living in reaction mode and playing
JHC: How do we as an industry pre-
products for care are in the right place
the role of hero firefighter. We need to
vent shortages that may occur due
at the right time for the right patient. We
be fanatic about fire prevention. It would
to hoarding and panic buying?
need to take all of the “lessons learned”
be great if I never had to watch another
Kiewiet: Transparency is the key. We
from every previous supply disruption
presentation, read a case study or attend a
must, as an industry, commit to enabling
and implement the change necessary for
seminar on the lessons learned from the
and participating in end-to-end supply
every link in the chain.
latest disruption.
Special Issue 2020 | The Journal of Healthcare Contracting
Whatever is takes and however long it takes Optimal is fully operational The team at Optimal is committed to working the necessary hours to get med-surg products out to people on the front lines.
www.optimalmax.com
Dear Healthcare Colleagues,
During this unprecedented, challenging time of the COVID-19 pandemic, it is more important than ever to honor and support the healthcare workers that are making a difference every day. It is the first responders, doctors and nurses, and all of those behind the scenes in hospitals, including cleaning and maintenance staff, who deserve our utmost thanks and appreciation for their unrelenting strength and resilience. With the number of COVID-19 cases continuing to rise, the focus on infection prevention and enhanced safety within hospitals is crucial. As my colleague, Caitlin Stowe, clinical research manager at PDI Healthcare, explains in this informative piece, there are key company-wide best practices to follow to ensure hospitals are properly protected. This includes establishing comprehensive cleaning and disinfecting protocols, utilizing proper equipment and products, and maintaining adequate supplies. As we have all witnessed, the most critical and valuable ingredient in infection prevention is the human element. Hospitals and healthcare facilities need to support their entire healthcare team. This crisis is not going away quickly, and we need to sustain these frontline heroes. Make sure they are physically and mentally healthy, and above all, keep them protected and safe. Now is the time for hospitals and healthcare facilities to focus on a layered approach to infection prevention, including hand hygiene and personal protection equipment, as well as implementing rigorous surface and equipment disinfecting processes. Managing the supply chain and having honest discussions with distribution partners is also a key element to ensure adequate supply of critical products, such as masks, cleaning supplies and life-saving equipment, during this time of heightened demand. We are all in this together. With a focus on best practices for infection prevention to protect patients and our healthcare professionals, we can safeguard our communities. Our thoughts and gratitude remain with all of those on the frontlines as we all forge ahead.
Stay safe and healthy, Sean Gallimore Senior Vice President and General Manager PDI Healthcare
Infection risks are everywhere. So are we. Innovation against infection. Sani-Cloth® Prime Wipes, Sani-Prime® Spray, Sani-24® Spray, Sani-HyPerCide™ Spray, Super Sani-Cloth® Wipes, Sani-Cloth® Bleach Wipes, and Sani-Cloth® AF3 Wipes are on EPA's List N1 for the emerging viral pathogen claim and are recommended by the CDC for surface disinfection to help prevent the spread of COVID-19. Powered By
For more info go to pdihc.com/tracking-2019-novel-coronavirus-2019-ncov/ 1 https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 ©2020 PDI PDI03202074
BE THE DIFFERENCE®
RESOURCES
Keeping healthcare facilities infection free Best practices and protocols from an infection preventionist
Introduction
as safe and healthy as possible so they can
at a cancer center, and worked her way up
The response to the COVID-19 pan-
be on the front lines saving as many lives
through various care settings. Stowe was
demic from medical caregivers has been
as possible.”
a system director for a couple of years
heroic, said Caitlin Stowe, clinical affairs
before she made the jump to industry
The Journal of Healthcare Contracting and
back in 2016. She has a master’s degree
highlighted the everyday work that nurses
Repertoire Magazine, asked Stowe for her
in public health and global communi-
and physicians do. Everybody in the hos-
insights into how best to keep those
cable disease and a certificate in infection
pital plays a key role in the prevention of
healthcare workers safe amid the risks
control. Stowe is currently working on her
infections, and I think it just goes to show
associated with the coronavirus.
PhD in health science and she is certified
that healthcare workers are the heroes right now. We have to keep our caregivers
44
Share Moving Media, publisher of
research manager at PDI Healthcare. “It’s
Stowe has been an infection preventionist since 2009. She started her career
in infection control, health care quality, public health and vascular access.
Special Issue 2020 | The Journal of Healthcare Contracting
In the following article, Stowe high-
protective equipment to help our team
Stowe said supply chain teams must
lighted the infection prevention products
members and staff care for patients,
work with their infection prevention team
that will be key to healthcare facilities’
but also making sure we have enough
and their nursing leadership to estimate
efforts, short-term challenges providers
disinfectant to appropriately wipe down
usage. “And with the situation so fluid it’s
will need to navigate, and the long-term
the surfaces, because we don’t want that
obviously subject to change,” she said.
planning that will be needed to maintain
to perpetuate the spread of this in the
“But in a worst case scenario, what’s the
an adequate supply.
healthcare setting. We need to ensure
par level or what’s the daily supply that
that we’re also doing really good surface
you’re going to need in order to take care
and equipment disinfection.”
of your patients safely?”
Infection prevention products hardest hit There are a lot of hard decisions that healthcare facilities are having to make in regards to supplies, Stowe said. The biggest one is the use of personal protective equipment (PPE). How much protective equipment does each provider have for its staff to adequately protect the healthcare workers and patients? “The supply chain has a really hard job right now working with their distributor partners and having open communication with their
Once teams have an adequate supply for the organization’s day-today needs, Stowe said the focus should turn to proper maintenance of that supply.
leadership in infection prevention to ensure that they are maintaining adequate supply levels.”
Indeed, cleaning personnel play an
To help with this, the Centers for
Another supply category that supply
important role when it comes to prevent-
Disease Control & Prevention (CDC) has
chain teams need to be concerned about
ing any kind of infection. “The No. 1 way
issued some guidelines for reuse of PPE,
is surface and equipment disinfectants.
to prevent infection is hand hygiene,” she
for alternative PPE to ensure that people
“Do healthcare facilities have an EPA-
said. “The No. 2 way, in my opinion, is
are still being protected. (Visit www.cdc.gov/
registered disinfectant on list N, which
adequate surface and equipment disinfec-
coronavirus/2019-ncov/index.html)
means that it has an emerging pathogens
tion, because 80% of infectious diseases
claim? This way we can feel comfort-
are spread by touch.”
the coronavirus.” The coronavirus is an
fied, if healthcare facilities don’t have
Short-term challenges and long-term planning
enveloped virus, on the lowest level of
adequate supply levels, or supplies are
Staffing will be a major short-term chal-
the hierarchy of pathogens, so it’s fairly
back ordered, is there a contingency plan
lenge for providers, which makes keeping
easy to kill.
in place? “Providers need to work with
caregivers safe and their work environ-
able in knowing the disinfectant is killing
Once the needed supplies are identi-
their infection prevention leadership,
ment infection free critical. “We have to
I’ve been reading says it lasts in aerosol
their nursing leadership, and the C suite
make sure that we’re protecting our staff,
form for a couple of hours, and can
in general to ensure that there’s not going
because if they are exposed they have to
last on a surface for two to three days.
to be a delay or a gap in care because they
self-quarantine – usually a minimum of
So it’s really important that not only are
don’t have the equipment and/or supplies
14 days if they have high risk exposure.
we making sure that we have enough
needed to do their job safely.”
The CDC has changed their guidance on
“Some of the latest research that
The Journal of Healthcare Contracting | Special Issue 2020
45
this a few times, but right now if you have a high risk exposure, meaning you were not wearing the right PPE when you were caring for a confirmed patient, you cannot work for 14 days minimum,” Stowe said. Once supply in teams have an adequate supply for the organization’s day-to-day needs, Stowe said the focus should turn to proper maintenance of that supply. “Not a stockpile of that supply, because that’s not going to do anybody any good, but building up a day or two extra worth of their supplies to ensure that there’s not going to be a break,” she said. Also, there is the human element to
“ Have really frank discussions with your distributor partners and say ‘This is what we need. Do you think you’ll be able to fulfill it? If not, help me find somewhere that can give me the supplies that I need.’”
think about. Supply chain teams should check in with their staff. Is their staff
46
mentally and physically doing okay? “Ev-
all those other public health measures
Visitor restrictions. The visitor
erybody’s stressed,” Stowe said. “Ensuring
we’re trying to implement now, it may go
restrictions that a lot of facilities have
that you’re supporting your team mem-
through 2021.”
been implementing are necessary, Stowe
bers through this long-term marathon
said. To that end, hospitals and health
is important. It’s not a sprint. This is a
systems can check that policies and
pandemic that’s going to go on at least for
Protocols to follow
procedures related to the appropriate
the next few months at a high level. And
Stowe recommended the following proto-
use of PPE are in place, that they are
I’ve seen forecasts from the CDC where
cols as they relate to infection prevention
being educated to and communicated,
if we don’t do the social distancing and
for healthcare facilities:
and that there are spot checks to ensure
Special Issue 2020 | The Journal of Healthcare Contracting
that their staff are doing the right thing.
supplies, or building stockpiles because
health services for years so from a public
“Everybody must know when they
that doesn’t benefit anybody. One rea-
health standpoint, we’re so strapped for
need to wear a mask, when they need to
son is because the expiration dates of
resources that maybe they weren’t as
wear a N95, and when equipment and
disinfectants are fairly short. So if you
effective as they could have been in the
surfaces need to be cleaned.”
stockpile hundreds and hundreds of cases
initial stages because we really just, we
and then you don’t use them, that’s just
didn’t have the staff or the resources.”
Cleaning. Every multi-care patient use
product that’s going to expire.” Stowe
Stowe said like a lot of infection
equipment should be cleaned in between
likens the situation to a Seesaw, “a little
prevention suppliers, PDI Healthcare is
each patient, Stowe said. The equipment
give and take on what’s the appropriate
working hand in hand with its infec-
should also be cleaned at regular intervals.
amount to use and extra to keep in stock.
tion preventionists and hospital supply
“How often is a patient room getting
But also we don’t want to hoard because
chain departments. “We’d never want
cleaned, or the high touch surfaces getting
other providers will need these supplies.
care to be delayed or not given because
wiped down on a regular basis?” Doing
We don’t want them to expire before you
of a failure or a lack of supplies when
those enhanced cleaning procedures will
can use them.”
it comes to PDI, and like I said, surface
definitely help reduce the bioburden of
disinfection of equipment and areas
this virus in the environment.
are some of the most important things
What we can learn from the COVID-19 response?
you can do after hand hygiene. We are
A supply chain team checklist
As a public health professional, Stowe
to ensure that we’re addressing all their
First and foremost, Stowe recommended
said the COVID-19 pandemic highlights
questions and concerns and making sure
that supply chain teams maintain an open
the need for more public health funding.
that they feel as comfortable as they can
dialogue and good relationship with their
“We’ve been cutting funding to public
with the current situation.”
working hand in hand with our partners
organization’s infection prevention team. “The infection prevention team has the most up-to-date guidance from the CDC, the WHO, their local health departments and they really are the subject matter experts that can help the supply chain prioritize what they need,” she said. Stowe said open lines of communication – and “frank” discussions – will be needed with their industry and distributor partners. “Have really frank discussions with your distributor partners and say ‘This is what we need. Do you think you’ll be able to fulfill it? If not, help me find somewhere that can give me the supplies that I need.’” Providers and suppliers alike are working day and night to ensure that we have adequate supply for the facilities so that the supply chain isn’t disrupted. “However, it works both ways,” Stowe said. “Facilities should not be hoarding
The Journal of Healthcare Contracting | Special Issue 2020
47
DISTRIBUTION
To the Owens & Minor Team from all of us at Share Moving Media and the industry, thank you for taking care of America's healthcare providers. The work you’re doing is more important now than ever before.
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Special Issue 2020 | The Journal of Healthcare Contracting
To the McKesson Team from all of us at Share Moving Media and the industry, thank you for taking care of America's healthcare providers. The work you’re doing is more important now than ever before.
The Journal of Healthcare Contracting | Special Issue 2020
49
NEWS
CDC: Here’s how to keep you, your staff and your patients safe Editor’s note: The Centers for Disease Control and Prevention issued Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Though some of the recommendations are pointed toward the inpatient setting, physician practices should adhere to others. Here are CDC’s PPE recommendations for the care of patients with known or suspected COVID-19.
ʯ Based on local and regional situational
ʯ Eye protection, gown, and gloves
analysis of PPE supplies, facemasks
continue to be recommended.
are an acceptable alternative when the
Rooms (AIIRs) should be reserved for patients undergoing aerosolgenerating procedures.
supply chain of respirators cannot meet
ʯ If there are shortages of gowns,
the demand. During this time, available
they should be prioritized for
respirators should be prioritized for
aerosol-generating procedures,
background is based on currently
procedures that are likely to generate
care activities where splashes and
available information about
respiratory aerosols, which would
sprays are anticipated, and high-
COVID-19 and the current situation
pose the highest exposure risk to
contact patient care activities that
in the United States, which includes
healthcare personnel (HCP).
provide opportunities for transfer of
reports of cases of community
pathogens to the hands and clothing
transmission, infections identified
of HCP.
in healthcare personnel (HCP),
ʯ Facemasks protect the wearer from splashes and sprays.
and shortages of facemasks, N95
ʯ Included are considerations for ʯ Respirators, which filter inspired air, offer respiratory protection.
ʯ Updated information in the
filtering facepiece respirators
designating entire units within the
(FFRs) (commonly known as N95
facility, with dedicated HCP, to care
respirators), and gowns.
for known or suspected COVID-19
ʯ When the supply chain is restored,
patients and options for extended
ʯ Increased emphasis on early
facilities with a respiratory protection
use of respirators, facemasks,
identification and implementation
program should return to use
and eye protection on such units.
of source control (i.e., putting a
of respirators for patients with
Updated recommendations regarding
facemask on patients presenting with
known or suspected COVID-19.
need for an airborne infection
symptoms of respiratory infection).
Facilities that do not currently have
isolation room (AIIR).
a respiratory protection program, but care for patients infected with
50
ʯ Patients with known or suspected
pathogens for which a respirator is
COVID-19 should be cared for in
recommended, should implement a
a single-person room with the door
respiratory protection program.
closed. Airborne Infection Isolation
Special Issue 2020 | The Journal of Healthcare Contracting
Consortium aims to bring scalable solutions to the pandemic
A consortium of life sciences companies announced on March 25 a collaboration
Companies participating in the collabora-
to accelerate the development, manufacture, and delivery of vaccines, diagnostics, and treat-
tion include:
ments for COVID-19, according to a release from the Bill & Melinda Gates Foundation.
“The life sciences industry brings a
three continents, Vas Narasimhan, chief
range of assets, resources, and expertise
executive officer of Novartis, said, “We
needed to identify effective and scal-
feel a deep shared responsibility to see if
able solutions to the pandemic, which is
there are specific areas where collaboration
affecting billions worldwide,” the release
across the life sciences industry and the Bill
said. “The impact on health systems,
& Melinda Gates Foundation can acceler-
economies, and livelihoods is profound,
ate solutions to this pandemic. In addition
and an effective response requires an un-
to the individual contributions companies
precedented collaboration across govern-
are already making, collective action is criti-
ments, academia, the private sector, and
cal to ensure any promising studies into
the philanthropic community.”
vaccines, drugs, and diagnostics are quickly
As co-chair of a consortium life science companies headquartered across
scaled to people around the world who are affected by this pandemic.”
ʯ ʯ ʯ ʯ ʯ ʯ ʯ ʯ ʯ ʯ
BD bioMérieux Boehringer Ingelheim Bristol-Myers Squibb Eisai Eli Lilly Gilead GSK Johnson & Johnson Merck (known as MSD outside the U.S. and Canada),
ʯ ʯ ʯ ʯ
Merck KGaA Novartis Pfizer Sanofi
From the care givers to the medical distribution employees, the team here at Share Moving Media would like to say thank you to every frontline human being that has done their part to take care of America. We are forever in your debt!
