Blog: The state of the health care supply chain during the COVID-19 pandemic

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Blog: The state of the health care supply chain during the COVID-19 pandemic
tjordan_drupal
Apr 23, 2021

A year into the COVID-19 pandemic and certain health care supply chain pressures which were present during the initial period of the pandemic remain, though there are marked improvements, particularly in the area of collaboration. 

In September 2020, Mike Schiller, senior director of supply chains for the Association for Health Care Resource and Materials Management (AHRMM), discussed the past, present and future state of the health care supply chain during the COVID-19 pandemic. In this blog post, Mike Schiller returns to discuss the current state of the health care supply chain a year into the COVID-19 pandemic.  

Where are the current pressure points in the health care supply chain, if any? Are there certain articles of PPE which are still proving difficult to source? Or has the situation leveled out somewhat?
Mike: The existing pain points are what they’ve been for the last few months. And those are the nitrile gloves, syringes, sharps containers, and more recently, sterilization wrapping, which really ties back to more of a raw material issue. The same product that goes into the sterilization wrap is the same raw material that goes into making masks and gowns.

And with three approved COVID-19 vaccines now available domestically, has this created any new concerns with supply chain consistency? 
Mike: I think syringes can be tied to a vaccination program, the sharps container. I think there’s two situations at play here. One, global vaccination programs, and two, back in January, there was a fire at a resin production facility in Texas. And they make the resin that is used to manufacture sharps containers. So that’s a bit of a hit on the ability to produce sharps containers.

On the topic of domestic manufacturing, early in the pandemic there was much political discourse and scrutiny over the need to move our reliance away from foreign manufacturers to domestic ones when appropriate. Do you think the supply chain has been successful in that endeavor? Or is there still a heavy reliance on foreign manufacturers?
Mike: Yeah, anecdotally, the reliance on what I’ll call the nontraditional manufacturers, nontraditional suppliers, is not as high as it was back in December, January and November. During December through January, we saw a resurgence in the use of the nontraditional supplier for sourcing channels. 
At this point, what we’re seeing is more of the traditional sourcing channels being able to provide PPE but we’re seeing PPE security, or the ability to have a sufficient inventory of PPE. That seems to reside more with the larger health systems, health systems that might be more resource-rich, resources being staff, finances, just the sheer size of the organization itself. But what we are seeing is in some of the non-acute care spaces, and in the rural spaces, we’re hearing of challenges still, within those communities to acquire PPE.

During our last discussion, we focused on the phenomenon of bad actors infiltrating the health care supply chain, taking advantage of what was a desperate situation for many hospitals, health systems and their supply chain managers. While this must always be a concern, is this as much of a concern as it was in those early months of the pandemic? Are you hearing from members anywhere experiencing faulty orders of product or missing orders entirely? 
Mike: I’m not hearing the same level of concern. We’re not concerned at the same level of occurrence with issues of counterfeit products, or some of the bad actors, but we always have to be on our guard and that’s why these vendor-vetting programs and the vendors that AHRMM has vetted are always a good first choice for hospitals to begin to focus on and then to follow their own formal vendor approach. Simple processes. There’s always going to be those actors out there, but I’m not hearing quite the level of occurrence with counterfeit product or bogus product, product that doesn’t meet quality standards, etc., that we heard earlier on.

Last time, we had discussed the work that AHRMM and Vendormate did to ease the burden of identifying legitimate manufacturers, and the reviews of those efforts were very positive from the field. Are you happy with the direction that collaboration has taken? Do you think the field has embraced it or do you think its prominence has died off? 
Mike: The field absolutely embraced it, we saw a tremendous uptake of the vendor-vetting program back when the pandemic first began in March, April and May of last year. When we hit the summer months, we saw a decline in the number of visits to the page and the duration that folks were on the page. We saw another big uptick in November, December and January, with folks going back out to the vendor-vetting page to identify the approved vendors that we have, and utilize those vendors. 

I haven’t seen the latest statistics, my guess is that we’re going to begin to see a bit of a flattening perhaps in the amount of visitors again, and then the duration of their time on the webpage. One thing that we have done those we’ve revamped the webpage to make it much more user friendly. We’ve added a couple of search features where you can search by PPE category, year, and there’s also a free text field if a user just wants to type what they’re looking for, as opposed to more of a linear list that you just had to scroll through for the 400 plus members. We’re hopeful that by adding this user functionality, we’re making it easier to search on the site and make it easier to identify the vendors and the supplies that they need.

Looking at the months and even years ahead, do you see a place for the vendor-vetting program in a world after the pandemic? 
Mike: As long as the emergency use authorizations remain in effect, then I think you’ll see the vendor-vetting program and the approved vendors remain. This includes the work that we’ve done with other groups as well, such as Project N-95 and HealthEquip. I think there will be a need, but again, that’s tied to the FDA’s emergency use authorizations.

Those EUAs opened up the non-traditional sourcing channels to the US health care supply chain, and once those EUAs are no longer active, those sourcing channels are no longer viable because their products are no longer approved for use in the U.S. health care supply chain. 
It really will all depend on the FDA. What direction they take this, but for right now, while all of the EUAs are so in effect, the vendor-vetting program will continue to be a benefit to the field.

Are there any new strategic partnerships that have formed since the last discussion that you’re particularly enthusiastic about? Are there any general developments in the field that make you optimistic? Another way of asking this: when the next pandemic or natural disaster occurs, are there any developments that make you optimistic that the field is going to be better prepared than it was at the beginning of the COVID-19 pandemic?
Mike: I can tell you I’m really encouraged by the public-private activity that is taking place. That’s very encouraging. In fact, Nancy Foster, myself and Mark Howell are all on a weekly call, the COVID-19 Response Coordination Workgroup. And it’s part of HPHSCC, the Healthcare and Public Health Sector Coordinating Council. The three of us are on a supply chain task force that meets every Friday. I’m very excited to see the merging of the public and private sectors, because at the end of the day, no one sector is going to be able to solve this, we’re going to need both sectors to come together to really work towards making the changes that need to be made to build a resilient health care supply chain. 

I’m really excited by that and by the number of conversations that I’ve been involved in where everybody’s talking about what we need to do. With human nature, we have very short memories, and once things settle down, we just tend to kind of slip back into that comfort zone. But right now, all indications are that everybody still is very focused on a post-COVID-19 efforts to build a more much more resilient health care supply chain, and there’s a number of different areas that are being discussed. 

During the last conversation, you mentioned that you are encouraged to see the field come together with a “We’re all in this together” mindset.  Do you think that collaborative spirit is still there? 
Mike: The optimist in me certainly hopes that it does last. I’ve been involved in a number of roundtable discussions where we’ve had a number of different organizations around the table talk about COVID-19 health care supply chain resiliency. Again, the optimist in me hopes such discussions continues and we don’t get slowed down by human nature, human behaviors where we begin to kind of settle back into our own competitive environments.

I hope the lessons we’ve learned and the partnerships that have been forged over the course of the last year remain in effect. And one of the things that encourages me going back to your previous question is the focus on health equity, the focus on working with community businesses, including hospitals working with businesses in their immediate community. That’s very encouraging and very exciting, because I think that there’s a lot of opportunity there. From a health equity perspective, from a social determinants of health perspective, we can perhaps partner and move more business to some of these communities and employ a greater number of people in each of these communities.

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Blog

Blog: The state of the health care supply chain during the COVID-19 pandemic
tjordan_drupal
Apr 23, 2021

A year into the COVID-19 pandemic and certain health care supply chain pressures which were present during the initial period of the pandemic remain, though there are marked improvements, particularly in the area of collaboration. 
In September 2020, Mike Schiller, senior director of supply chains for the Association for Health Care Resource and Materials Management (AHRMM), discussed the past, present and future state of the health care supply chain during the COVID-19 pandemic. In this blog post, Mike Schiller returns to discuss the current state of the health care supply chain a year into the COVID-19 pandemic.  Where are the current pressure points in the health care supply chain, if any? Are there certain articles of PPE which are still proving difficult to source? Or has the situation leveled out somewhat?Mike: The existing pain points are what they’ve been for the last few months. And those are the nitrile gloves, syringes, sharps containers, and more recently, sterilization wrapping, which really ties back to more of a raw material issue. The same product that goes into the sterilization wrap is the same raw material that goes into making masks and gowns.And with three approved COVID-19 vaccines now available domestically, has this created any new concerns with supply chain consistency? Mike: I think syringes can be tied to a vaccination program, the sharps container. I think there’s two situations at play here. One, global vaccination programs, and two, back in January, there was a fire at a resin production facility in Texas. And they make the resin that is used to manufacture sharps containers. So that’s a bit of a hit on the ability to produce sharps containers.On the topic of domestic manufacturing, early in the pandemic there was much political discourse and scrutiny over the need to move our reliance away from foreign manufacturers to domestic ones when appropriate. Do you think the supply chain has been successful in that endeavor? Or is there still a heavy reliance on foreign manufacturers?Mike: Yeah, anecdotally, the reliance on what I’ll call the nontraditional manufacturers, nontraditional suppliers, is not as high as it was back in December, January and November. During December through January, we saw a resurgence in the use of the nontraditional supplier for sourcing channels. 
At this point, what we’re seeing is more of the traditional sourcing channels being able to provide PPE but we’re seeing PPE security, or the ability to have a sufficient inventory of PPE. That seems to reside more with the larger health systems, health systems that might be more resource-rich, resources being staff, finances, just the sheer size of the organization itself. But what we are seeing is in some of the non-acute care spaces, and in the rural spaces, we’re hearing of challenges still, within those communities to acquire PPE.During our last discussion, we focused on the phenomenon of bad actors infiltrating the health care supply chain, taking advantage of what was a desperate situation for many hospitals, health systems and their supply chain managers. While this must always be a concern, is this as much of a concern as it was in those early months of the pandemic? Are you hearing from members anywhere experiencing faulty orders of product or missing orders entirely? Mike: I’m not hearing the same level of concern. We’re not concerned at the same level of occurrence with issues of counterfeit products, or some of the bad actors, but we always have to be on our guard and that’s why these vendor-vetting programs and the vendors that AHRMM has vetted are always a good first choice for hospitals to begin to focus on and then to follow their own formal vendor approach. Simple processes. There’s always going to be those actors out there, but I’m not hearing quite the level of occurrence with counterfeit product or bogus product, product that doesn’t meet quality standards, etc., that we heard earlier on.

Last time, we had discussed the work that AHRMM and Vendormate did to ease the burden of identifying legitimate manufacturers, and the reviews of those efforts were very positive from the field. Are you happy with the direction that collaboration has taken? Do you think the field has embraced it or do you think its prominence has died off? Mike: The field absolutely embraced it, we saw a tremendous uptake of the vendor-vetting program back when the pandemic first began in March, April and May of last year. When we hit the summer months, we saw a decline in the number of visits to the page and the duration that folks were on the page. We saw another big uptick in November, December and January, with folks going back out to the vendor-vetting page to identify the approved vendors that we have, and utilize those vendors. 
I haven’t seen the latest statistics, my guess is that we’re going to begin to see a bit of a flattening perhaps in the amount of visitors again, and then the duration of their time on the webpage. One thing that we have done those we’ve revamped the webpage to make it much more user friendly. We’ve added a couple of search features where you can search by PPE category, year, and there’s also a free text field if a user just wants to type what they’re looking for, as opposed to more of a linear list that you just had to scroll through for the 400 plus members. We’re hopeful that by adding this user functionality, we’re making it easier to search on the site and make it easier to identify the vendors and the supplies that they need.Looking at the months and even years ahead, do you see a place for the vendor-vetting program in a world after the pandemic? Mike: As long as the emergency use authorizations remain in effect, then I think you’ll see the vendor-vetting program and the approved vendors remain. This includes the work that we’ve done with other groups as well, such as Project N-95 and HealthEquip. I think there will be a need, but again, that’s tied to the FDA’s emergency use authorizations.
Those EUAs opened up the non-traditional sourcing channels to the US health care supply chain, and once those EUAs are no longer active, those sourcing channels are no longer viable because their products are no longer approved for use in the U.S. health care supply chain. 
It really will all depend on the FDA. What direction they take this, but for right now, while all of the EUAs are so in effect, the vendor-vetting program will continue to be a benefit to the field.Are there any new strategic partnerships that have formed since the last discussion that you’re particularly enthusiastic about? Are there any general developments in the field that make you optimistic? Another way of asking this: when the next pandemic or natural disaster occurs, are there any developments that make you optimistic that the field is going to be better prepared than it was at the beginning of the COVID-19 pandemic?Mike: I can tell you I’m really encouraged by the public-private activity that is taking place. That’s very encouraging. In fact, Nancy Foster, myself and Mark Howell are all on a weekly call, the COVID-19 Response Coordination Workgroup. And it’s part of HPHSCC, the Healthcare and Public Health Sector Coordinating Council. The three of us are on a supply chain task force that meets every Friday. I’m very excited to see the merging of the public and private sectors, because at the end of the day, no one sector is going to be able to solve this, we’re going to need both sectors to come together to really work towards making the changes that need to be made to build a resilient health care supply chain. 
I’m really excited by that and by the number of conversations that I’ve been involved in where everybody’s talking about what we need to do. With human nature, we have very short memories, and once things settle down, we just tend to kind of slip back into that comfort zone. But right now, all indications are that everybody still is very focused on a post-COVID-19 efforts to build a more much more resilient health care supply chain, and there’s a number of different areas that are being discussed. During the last conversation, you mentioned that you are encouraged to see the field come together with a “We’re all in this together” mindset.  Do you think that collaborative spirit is still there? Mike: The optimist in me certainly hopes that it does last. I’ve been involved in a number of roundtable discussions where we’ve had a number of different organizations around the table talk about COVID-19 health care supply chain resiliency. Again, the optimist in me hopes such discussions continues and we don’t get slowed down by human nature, human behaviors where we begin to kind of settle back into our own competitive environments.
I hope the lessons we’ve learned and the partnerships that have been forged over the course of the last year remain in effect. And one of the things that encourages me going back to your previous question is the focus on health equity, the focus on working with community businesses, including hospitals working with businesses in their immediate community. That’s very encouraging and very exciting, because I think that there’s a lot of opportunity there. From a health equity perspective, from a social determinants of health perspective, we can perhaps partner and move more business to some of these communities and employ a greater number of people in each of these communities.

###
 

Novel Coronavirus (SARS-CoV-2/COVID-19)
COVID-19: Supplies and Personal Protective Equipment (PPE)
Supply chain management

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