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Sameer Kumar, Ph.D. Professor of Operations and Supply Chain Management
Qwest Endowed Chair in Global Communications and
Technology Management
Opus College of Business
University of St. Thomas, Minneapolis
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Managing the Healthcare
Supply Chain
Trends Issues Applications
A Systems Perspective
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Systemic Intervention for Public Health
“Because of the complexity of many public health issues,
where numerous interacting variables need to be accounted
for; multiple agencies and groups bring different values and
concerns to bear, it is not uncommon for people to call for a
systems approach.
This should not be surprising, as the whole concept of
public health is founded on the insight that health and
illness have causes or conditions that go beyond the
biology and behavior of the individual human being.”
Gerald Midgley, PhD, (2006), “Systemic Intervention for Public Health,”
American Journal of Public Health, Vol. 96, No. 3, pp. 33-39. 2
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Presentation Outline
Research Approach / Interests
System and its Structure
Health Care Supply Chain Problem Definition
Health Care Supply Chain
Healthcare Initiatives (and Associated Issues) – Federal and
State / Local Levels
Health Care Questions / Applications
System Dynamics Modeling Illustration
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Research Approach
Systems Thinking
Interconnections (Collaboration), Synthesis (Integration) &
Behavior (Performance)
Analytical and Computer Competence, Mathematics,
Statistics, Risk Management, Reliability Engineering,
System Modeling and Optimization, System Simulation, . .
. System Dynamics, Problem Formulation
Interdisciplinary Leaning
Global Implications
Complexity of the Issues 4
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Research Interests in Healthcare Systems
Health decision and prevention systems
Healthcare supply chain informatics
Healthcare system design
Health communication
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System and its Structure
Assemblage of sub-systems
(components, modules, etc.), agents
(people, technology, equipment,
other resources) and mechanisms
designed to perform a set of tasks to
satisfy specified functional
requirements and constraints.
(e.g., healthcare supply chain)
Unity („consistent whole‟, „complex whole‟, „wholeness‟, „synergy‟, etc.).
Parts („elements‟, „constituents‟, „components‟, etc.).
Relationship („interrelationship‟, interactions‟, „structure‟, and „organization‟).
Unity
Relationship
Part
Environment
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Healthcare Supply Chain
Manufacturers
Medical
Equipment
Manufacturers
Pharmaceuticals
Companies
DistributorsG
Medical Equipment
- Prosthetic Devices
- Artificial Body Parts
- Wheel Chairs
- CT Scanners
- Laboratory Equipment
Pharmaceuticals
Healthcare
Providers
Healthcare Professionals - Doctors, Nurses,
Respiratory Therapists, Dietitians,
Medical Technologists,...
Healthcare Facilities - Hospitals
- Proprietary Clinics - Nursing Homes
- Hospices - Urgent Care
- Same-day-surgery Centers
G
Patients
Public and Private Payer
Systerms
G & S
Insurance
Companies$
$$
e-Commerce (using Internet/Intranet/Extranet)
$ $ $
Medicare
Medicaid
Employers
Government Regulatory
AgenciesEnforce Health Care Regulations On Manufacturers / Distributors / Health Care Providers
US Congress
Food & Drug Administration
National Institute of Health ...
Legend:
G – Goods
S – Services
I – Information and Directives
$ - Payments / Reimbursements
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Healthcare Supply Chain:
General Problem
Design a healthcare supply chain that effectively
responds to needs during a health related activity in a
specific patient scenario by optimizing allocation of
resources under constraints of health care professionals
size and capability, health provider environment, nature
of disease (ailment), and insurance coverage.
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Healthcare Initiatives and Issues
Federal / State / Local Levels
Global Healthcare Supply Chain Opportunities (Logistics related issues)
HIV / AIDS Prevention & Control
Bird Flu Pandemic Prevention & Control
Essentials (food, water, medicine) delivery for disaster events (drought, tsunami, earthquake)
Disease Free Crop Production and Distribution
Medical Tourism
Humanitarian Supply Chains
Global Medical Diplomacy
Cargo Container Security (biological/nuclear/chemical weapons)
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Policy Initiatives and Issues
Federal / State / Local Levels
National (US) and Community Health initiatives
Elder Care delivery systems
Affordable public housing
Child Care delivery systems
Prescription Drug delivery supply chain through Medicare / Medicaid
Health Management Organizations Supply Chain Management
Technology Impact
Cyber-infrastructure for Healthcare Enterprises
Role of e-management in Healthcare Enterprises
Expert Systems / Decision Support Systems in Healthcare Delivery
RFID in Healthcare Supply Chain
Electronic Health Records
Classification and Coding of Clinician Diagnostics Systems
Integration issues for ERP Systems in Healthcare Enterprises
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Healthcare Questions Examined
? How severe is the impact of potential Avian flu pandemic disruptions on
global supply chains and what are the continuity strategies for mitigation?
? How can the role of nurses can be expanded for long-term care during and
post hospitalization?
? What effects medical tourism has had both on the U.S. and the global
healthcare supply chains including managerial and cost implications that
various surgical procedures will have on the global healthcare system?
? How to improve the insufficient health communication efforts to inform
uninsured or under insured medical tourists about the benefits and risks?
? How medical diplomacy can be used to curb extremism?
? What should a modern day hospital design look like? 12
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Healthcare Questions Examined
? How can RFID technology improve efficiency and mitigate medical errors in
hospitals?
? How can increased emphasis on preventive measures reduce national
healthcare expenditures?
? How can we improve the functionality and uses of the Electronic Medical
Record?
? What can be done to facilitate early diagnosis of childhood strokes and how
to reduce variability of diagnosis and treatment?
? Can we quantify the difference between the current process flow model for a
typical patient workup for chest pain and development of a new process flow
model that incorporates DMAIC Six Sigma and EBM in a best practices
model for diagnosis and treatment?
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Health Care Systems Applications
The Role of Leveraging Nurses for Long-Term Care During and Post
Hospitalization. (Journal of Home Health Care Management and Practice, 2011)
Decision Support Tool To Streamline Patient Diagnosis For Chest Pain Utilizing
Six Sigma DMAIC and Evidence Based Medicine. (Quality Management in Health
Care, 2010)
Supply Chain Disruption By Avian Flu Pandemic For U.S. Companies – A Case
Study. (Transportation Journal, 2010)
A modified Delphi methodology to conduct an FMEA: a patient-centric effort in a
clinical medical laboratory. (Quality Management in Health Care, 2011)
Revenue and Cost Economics of Partnering with Health and Wellness Services.
(Journal of Revenue and Pricing Management, 2011)
Service delivery of care in children who have had strokes: review of the initial
diagnosis and ongoing treatments. (Journal of Pediatric Neurology, 2009)
Medical errors elimination in U.S. hospitals. (International Journal of Health Care
Quality Assurance, 2008)
Technical efficiency measurement of specialty hospitals versus community
hospitals. (Journal of Revenue and Pricing Management, 2008) 14
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Health Care Systems Applications
Electronic health records economic justification and technical implementation.
(Health Informatics, 2010)
Rx for smart hospital purchasing decisions to influence product packaging.
(International Journal of Physical Distribution and Logistics Management, 2008)
Product recalls and counterfeit drugs control measures and mitigation in
pharmaceutical supply chain. (International Journal of Productivity and
Performance Management, 2009)
E-healthcare. (IIE Solutions, 2001)
RFID in healthcare supply chain. (International Journal of Health Care Quality
Assurance, 2009)
Medical diplomacy supply chain to curb extremism. (Journal of Health
Communication, 2009)
Managing risks in a relief supply chain in the wake of an adverse event. (OR
Insight, 2011)
Modeling Patient Flow Operation of a U.S. Urban County Hospital. (Technology
and Health Care, 2011) 15
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Health Care Systems Applications
The Hospital Cost Structure in the U.S.: What‟s behind the Costs? (International
Journal of Health Care Quality Assurance, 2011)
Stage Implementation of RFID in Hospitals. (Technology and Health Care,
2010)
Specialty hospitals emulating as focused factories – models for improved
efficiency. (International Journal of Health Care Quality Assurance, 2010)
An Ounce of Prevention: Revenue and Cost Economics of Partnering with
Health and Wellness Services. (Journal of Revenue and Pricing Management,
2011)
Examining Quality and Efficiency of the U.S. Healthcare System. (International
Journal of Health Care Quality Assurance, 2011)
Modeling hospital surgical delivery process design using system simulation:
Optimizing patient flow and bed capacity. (Technology and Health Care, 2011)
HIPAA impact on U.S. healthcare systems. (International Journal of Health
Care Quality Assurance, 2009)
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Health Care Systems Applications
Examining Potential Avian Flu Pandemic Disruptions on Global Business
Operations and Strategies for Corporate Preparedness – A DMAIC Case Study.
(International Journal of Health Care Quality Assurance, 2011)
Globalization of Health Care Delivery in the U.S. Through Medical Tourism.
(Journal of Health Communication, 2012)
RFID in Healthcare: A Six Sigma DMAIC and Simulation Case Study.
(International Journal of Health Care Quality Assurance, 2012)
Six Sigma Tools in the Health Care Supply Chain: A U.S. Retail Pharmaceutical
Service Application. (Technology and Health Care, 2011)
Exploring the Impact of Management of Chronic Illnesses through Prevention
on the U.S. Healthcare Delivery System – a System Dynamics approach.
(Information Knowledge Systems Management, 2011)
Development of a hospital based menu driven clinician coding tool to implement
quality reimbursement process. (Technology and Health Care, 2011)
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System Dynamics Modeling Illustration
• Supply Chain Disruption by Avian Flu Pandemic paper