Webinar for Physician Leaders

Webinar for Physician Leaders The Impact of Supply Chain Transformation in Health Systems April 13, 2018 11:00am-12:00pm EDT

1

Agenda Time

Discussion Topics

Presenter

Webinar for Physician Leaders: The Impact of Supply Chain Transformation in Health Systems

Dr. John Van Aerde, MD, MA, PhD, FRCPC 11:00 Welcome & Introduction

Clinical Professor of Pediatrics - UBC & UA Associate Faculty - Leadership Studies - Royal Roads Univ Past-President - Canadian Society of Physician Leaders

11:05

Presentation: Scaling Supply Chain Innovation in Canadian Health Systems

11:25 Commentary: The Mercy Experience

11:30 Commentary: The NHS England Experience

Dr. Anne Snowdon, RN, BScN, MSc, PhD, FAAN Chair, World Health Innovation Network Scientific Director & CEO, SCAN Health Dr. Joseph Drozda, MD, MACC Cardiologist, Director, Outcomes Research, Mercy Health U.S. Dr. Charles Alessi, MD, LRCP, MRCS General Practitioner, Senior Advisor, Public Health England

11:35 Facilitated Discussion & Next Steps

Dr. John Van Aerde

12:00 Thank You & Adjournment

Dr. John Van Aerde

2

World Health Innovation Network (WIN)

WIN partners with health system stakeholders to source innovation, create the evidence for value, and develops models for scalability to embed innovative technologies, products and models of care into health systems to achieve value for Canadians, and drive economic growth for innovators.

3

SCAN Health is funded by the Government of Canada, Networks of Centres of Excellence (NCE) and hosted by the University of Windsor’s Odette School of Business. Spanning five countries including Australia, the Netherlands, the United Kingdom, the United States and Canada – and with over one hundred partners from industry, healthcare, government and academia – SCAN Health’s International Knowledge Translation Platform will enable the exchange of expert knowledge and research evidence to accelerate the implementation of healthcare supply chain best practices around the world.

4

THE IMPACT OF SUPPLY CHAIN TRANSFORMATION IN GLOBAL HEALTH SYSTEMS

5

Framing the Research •

System Level Measurement of patient outcomes linked to product use and care procedures does not exist; system infrastructure to support safety is under developed in the health sector.

•

Medical Error is now the third leading cause of death in USA, Canada and UK1.

•

Empirical Evidence of the Impact of Supply Chain Implementation in Health Systems is very limited.

•

Goal: To Create Empirical Evidence of the Health System Level Impact of Implementing Supply Chain Infrastructure in Health Settings.

1M

Makary (2016) BMJ2016;353doi:https://doi.org/10.1136/bmj.i2139(Published 03 May 2016)Cite this as:BMJ2016;353:i2139

6

Supply Chain Transformation Globally Case study research examined supply chain transformation as a strategy to strengthen health system performance in three global health systems: •

Canada – Alberta Health Services

•

U.K. – National Health Service

•

U.S. – Mercy Health

Case studies released February 15, 2018

7

Supply Chain Strategy • •

• •

• • •

Alberta

Province wide integration of supply chain processes into clinical programs and teams – creates evidence of product utilization and safety outcomes Online adverse event reporting province wide

NHS – Scan4Safety

Digital Tracking of every patient, product, care process, clinician, and location of care in six Trusts Creates transparency to reduce variation and waste, enables accurate case costing, releases provider time to care for patients

Mercy

Scaling supply chain infrastructure across 45 hospitals, traceability of every product linked to patient outcomes –Cardiology, Perioperative to date Revenues $1 billion since 2002 from supply chain 29% decrease in labour costs/case, 33% reduction in supplies costs in Perioperative program 8

Emerging Findings Globally Integration of Supply Chain in Clinical Programs Creates System Transparency

• Transparency of what care patients receive, by who, using what products linked to outcomes – cost, safety, quality in “real time” • Offers accurate case costing for every case linked to clinician-surgeon, and product use • Transparency of variation: reduces variation in cost, care processes informed by patient outcomes • Significant labour savings: 16 FTE’s NHS, 30% reduction in labour cost/case at Mercy •

Significant supplies cost savings due to reduction of waste: 29% reduction supplies cost /case (Mercy) 9

Emerging Findings Globally Patient Safety is the Key Driver of Supply Chain Strategy in Health Systems

• Enables automated product recall and traceability, expired or recalled products removed from clinical setting automatically • 70% reduction in Never Events (Mercy) • Patient Safety savings are NOT measured to date, will likely increase the ROI over time.

Inventory Automation Yields Substantial Savings

• Ranges from 4:1 to 7:1 ROI on inventory savings alone, savings occur within first 18 months • Potential to “self fund” the strategy as savings are recurrent, annually from inventory waste reduction.

10

Return on Investment: Three Countries Country

Health System

ROI

Alberta Health 7:1 to date from inventory System savings only Return on Investment Summary: $301,438,786 in savings over 7 years England National Health 4:1 expected by year 3 from Service inventory savings, £1,034,000,000 savings projected by year 7 (£30M/mon. all Trusts) 16 FTE’s in labour savings/ Trust.

Canada

United States

Mercy Health $1 billion savings as a direct outcome of optimizing and transforming supply chain processes across Mercy.

29.5% decline in labour costs and 33% decline in supply costs.

Example: Impact of Supply Chain on Perioperative Program - Total Knee Arthroplasty (Mercy Health)

Total CPI Adjusted Intraoperative Supply Cost Per Case, May 2012 Jan 2016 (n=11,834)

12 Vance Moore (2017). Scan Health Annual Networking Event, St. Louis, Missouri

Opportunity for Tracking and Traceability Infrastructure that Measures Value to Inform System Optimization Pathology “Supply Chain�

Infrastructure (Banerjee, Ottawa Hospital)

Traceability creates transparency of pathology processes and outcomes Barcode scanning at each step of every process is automated, offers greater efficiency and productivity 13

Personalization of Care to Population Need

THE SUPPLY CHAIN PATHWAY TO QUALITY AND SAFETY Traceability across the patient’s Journey of Care – what works, for who and under what conditions for accurate measure of value

Product Traceability enables automated recall, accurate case costing, safety surveillance

Global Standards Adoption: products, patients, location

Future= System Value Predictive Analytics, Proactive risk management Innovation of Products and Care Processes

Integration of supply chain tools into patient care to inform clinical decisions - Quality and Safety (reduced Never Events, med. errors

Inventory Optimization: (4:1---- 8:1) Cost savings = self funding potential

Supply Chain Infrastructure as a Strategic Asset for Health Systems

DISCUSSION AND NEXT STEPS

15

Thank You Dr. Anne Snowdon, Academic Chair, WIN Anne.Snowdon@uwindsor.ca Ms. Lori Turik, Executive Director, WIN Lori.Turik@uwindsor.ca

Find us online at: www.worldhealthinnovationnetwork.com Follow us on Twitter: @WIN_Health Like us on Facebook: World Health Innovation Network Follow us on LinkedIn: World Health Innovation Network Subscribe to us on YouTube: WIN Health 16

ADDITIONAL INFORMATION

17

Our Focus on Supply Chain Innovation

Improving Quality through Supply Chain Innovation

‌because 70,000 Canadians experience preventable serious injury while hospitalized and 23,000 experience death

WIN’s researches and develops evidence-based models for scalable supply chain innovation to track and trace products from manufacturer to end users based on global standards.

Our work aims to improve product safety and addressing the challenges of product diversion, to ensure that the health products are available to the patients who need them, and away from where they can cause harm to Canadians.

18

Current State of Supply Chain Infrastructure • Health organizations do not have the digital tools and infrastructure required to enable clinicians with automated “double-checks” and alerts to proactively manage risks and protect patients from harm • Providers do not have access to reports or searchable data to analyze patterns and root causes of adverse events in real time, or outcomes and trends across organizations and health systems that could prevent error or redesign processes to mitigate risk • Health systems do not track product performance, or undertake post- market evaluation linked to patient outcomes, that can reveal problems early enough to prevent population-level impact and inform product design

19

Benefits for Clinical Care •

Patient care data that captures every detail of a patient’s journey of care is visible to provider teams.

•

Automated tracking of all products used in clinical care processes ensures only the best and safest products are used in patient care.

•

Patient outcomes are tracked and aggregated within and across health systems to enable early and automated notification of unsafe, expired, or recalled products.

•

Adverse events are automatically tracked in real-time to ensure outcomes are captured in electronic medical records, to inform clinician decisions to support the safest care.

•

Automatic inventory tracking of products reduces waste and streamlines labour to achieve cost savings and ensure products are available when and where needed for patient care.

20

Value of Supply Chain Innovation and Traceability • Products are tracked automatically, ensuring that the right products are available. Clinical outcomes of products are tracked, aggregated and made visible, to notify clinicians of possible product risks • Patient’s medical record becomes visible across the continuum of care, profiling the patient’s unique journey, history and needs • Adverse events are automatically reported to ensure incident disclosures and reporting outcomes are embedded into the clinical environment • Up to 8:1 ROI on inventory savings alone, not including the cost savings from improved patient safety, as well as reduced liability

21

Opportunity for Tracking and Traceability Infrastructure that Measures Value to Inform System Optimization Pathology “Supply Chain�

Infrastructure (Banerjee, Ottawa Hospital)

Traceability creates transparency of pathology processes and outcomes Barcode scanning at each step of every process is automated, offers greater efficiency and productivity 22

Real Time “Live� remote pathology diagnostics Vision Tek digital microscope allows a surgeon to plan the extent of the procedure, A technologist prepares the frozen section slide on site and loads the microscope, pathologist can control the microscope from anywhere in the world.

One pathologist can provide remote interpretation for multiple surgeons in different locations. Immediate confirmation with other pathologists is used difficult cases.

Central Data base for all information, searchable, metadata use

Stream & Share Viewer

23

Real Time Dashboard: Pathology Dept. Performance

Next Steps (integrated automated scheduling systems) Ottawa Hospital (Drs. Banerjee, Halwani) • Workload Prediction analytics, automated workload monitoring with complexity adjustments • More effective impact analysis of new hires in clinical programs • Better alignment of vacation and CME leaves • Currently testing real-time system for immediate frozen section interpretation and immediate cytology assessment • Whole slide imaging of batches of slides overnight can be used for access to pathologists anywhere in the world

Pathology Schedules

Radiology and Endoscopy Schedules

OR Schedules