In this, we will read about the Supply Chain Management in Healthcare
The following contents will be described briefly:-
1. What is a supply chain?
2. The process of Views of Supply Chain
3. Objectives of Supply Chain Management
4. Supply Chain Decisions
5. Benefits of Supply Chain
6. Integrated Health Supply Chains
7. New Trends In Healthcare Supply Chain
8. Potential Risks to an Organization and Supply Chain
9. Strategies to Improve Healthcare Supply Chain Management
In this, we will read about the Supply Chain Management in Healthcare
The following contents will be described briefly:-
1. What is a supply chain?
2. The process of Views of Supply Chain
3. Objectives of Supply Chain Management
4. Supply Chain Decisions
5. Benefits of Supply Chain
6. Integrated Health Supply Chains
7. New Trends In Healthcare Supply Chain
8. Potential Risks to an Organization and Supply Chain
9. Strategies to Improve Healthcare Supply Chain Management
SIM Unit 4
Store management :
Materials handling,
Flow of goods/FIFO,
Computerization of inventory transactions
Security of stores,
Stocking and technical impacts-
shelf life,
wastage,
pilferage
This presentation deals with the basics of Supply Chain Management.It gives short notes on what is it that makes a complete supply chain network and industrial terminologies are explained here.
Endüstri Mühendisliği - Yöneylem teknikleriyle Sağlık Tedarik Zinciri Modellemesidir. Maalesef dünya bu yöntemleri taşıyacak kadar deterministik değildir. Zaten sonraki aşamada fiili model denemesi planlanmış.
Supply of health and medical care
Definition and Law of Supply.
The health care production function.
Cost production in health care.
Factors determine price and quantity of health care.
Factors affecting Supply.
Investment on healthcare.
Health insurance and supply in healthcare.
Market Equilibrium.
References
Questions
SIM Unit 4
Store management :
Materials handling,
Flow of goods/FIFO,
Computerization of inventory transactions
Security of stores,
Stocking and technical impacts-
shelf life,
wastage,
pilferage
This presentation deals with the basics of Supply Chain Management.It gives short notes on what is it that makes a complete supply chain network and industrial terminologies are explained here.
Endüstri Mühendisliği - Yöneylem teknikleriyle Sağlık Tedarik Zinciri Modellemesidir. Maalesef dünya bu yöntemleri taşıyacak kadar deterministik değildir. Zaten sonraki aşamada fiili model denemesi planlanmış.
Supply of health and medical care
Definition and Law of Supply.
The health care production function.
Cost production in health care.
Factors determine price and quantity of health care.
Factors affecting Supply.
Investment on healthcare.
Health insurance and supply in healthcare.
Market Equilibrium.
References
Questions
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Key strategic issues pharmaceutical industry of SCM: A systematic literature ...journalBEEI
In this global era, making the competition in the pharmaceutical industry is very treacly. Implementation Supply chain management is the process of planning and managing all sourcing, procurement, distribution activities to increase value to customers and interested companies. Pharmaceutical companies are one that has a very complex supply chain. In this article will discuss the main issues that can improve industry strategic. This research is done by the systematic approach of literature to find things related to research. This study used 64 articles from search results. The results of this search are key issues in the pharmaceutical industry such as product and process development, capacity planning, factory and network design, e-business and IT applications, inventory management, outsourcing and reverse logistics, lean manufacturing, performance measures, people, and information technology. All of these findings are issues that improve the performance of supply chain management in the pharmaceutical industry.
Study of Drug Expenditure at RMMCH 24 Hours Pharmacy - ABC VED AnalysisChathreian S R
This was our PowerPoint Presentation in 71st IPC, Chennai, during my 4th year of Pharm.D.
I thank my co-author, Dr P. Dhanalakshmi, for her contribution to this study.
The study mainly focuses on the availability of drugs in a pharmacy and auditing of stocks using ABC, VED Matrix Analysis.
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The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
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International Journal of Computational Engineering Research(IJCER) is an intentional online Journal in English monthly publishing journal. This Journal publish original research work that contributes significantly to further the scientific knowledge in engineering and Technology.
A dispensary is a place, a career, and in some cases, a company's business. A dispensary is a place, where the licensed pharmacists of medicines, based on a prescription issued by a legitimate doctor. A pharmacy is a pharmacy. Some of the companies do not have pharmacies, but they will sell medicines bought without a prescription. In a pharmacy, it can be a stand-alone building, or it can be to be found in other locations as well, such as a pharmacy, a medical office or a hospital. Pharmacists are registered with the Pharmaceutical Council and have been designated as registered pharmacists. However, this is a title that is only awarded after the passing of a truly national and practical and legal studies. Pharmacists must always be vigilant against fake prescriptions ordered due to the addicts who are trying to illegally obtain drugs and other controlled substances. The pharmacy also means that it is in the practice of pharmacy as a profession. Pharmacy has a rich appeal. With the availability of computers and the development of the advances in information technology have led to the fact that we have the ability to quickly and efficiently, to receive or collect to analyze, transfer, and storage of large amounts of information related to patient care.
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This person is none other than Oprah Winfrey, a highly influential figure whose impact extends beyond television. This article will delve into the remarkable life and lasting legacy of Oprah. Her story serves as a reminder of the importance of perseverance, compassion, and firm determination.
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wise drug selection underlies all other improvements; that effective management saves
money and improves performance; that rational drug use requires more than drug
information; and that systematic assessment and monitoring are essential.
What works best in drug supply has no simple answer. It will never be possible to state that
one particular system is “the best”. Each country brings unique political, economic and
geographical factors to the equation and to weigh the pros and cons of one drug supply
system against another cannot be properly done from a global perspective without detailed
study. Clear goals, sound plans, effective implementation and monitoring of performance are
essential ingredients in pharmaceutical sector development. Therefore “e-Aushadhi”,
introduced in this paper is following the same guidelines aiming at improving equity, quality
and efficiency in the health sector through changes in the organization and financing of health
services. [2]
This paper describes the functionality and analysis done in ‘e-Aushadhi’ to proficiently
manage the Drug warehouse. The paper is summarized into following sections: Section 2
emphasizes on the problem in earlier traditional system of Drug warehouse management
system. Section 3 discusses the methodology and the structure behind in ‘e-Aushadhi’.
Section 4 sums up the result which came out after evaluating all the data and finally Section 5
ends the paper with all the discussions about the earlier warehouse management approaches
and their methodology.
II. PROBLEM IN OTHER TRADITIONAL DRUG WARE HOUSE MANAGEMENT
SYSTEM
Different countries are using different drug warehouse management systems based on
their requirements. However many of them lack in essential features like drug locator, system
alertness for expired items, status of pending purchase order, proper inward/outward records,
QC management on drugs, no control on Quarantine drugs etc. Another vital feature missing
in traditional systems is the maintenance of current stock position at main stores and sub
stores. [2]
III. e-AUSHADHI AND ITS METHODOLOGY
‘e-Aushadhi’ overcomes the entire above mentioned shortcomings by further
introducing many specialized features that not only helps in improving the drug warehouse
management system but also makes it more efficient in handling the medical and health
services at larger scale with more ease. This spic-and-span approach came out with
provocative highlightslike ‘Drug Locator’, Codification, Drug Safety Alert, Drug
Contradictor, Drug Dosage Indicator, Grouping and Sub Grouping, Improvement in
ApprovalSystem by applying validationat both Raising end and Receiving end and many
more.
This software has been already implemented in Rajasthan Medical Services
Corporation (RMSC) and is used for managing drug supply and inventory among various
district centers and sub centers. Therefore in this paper, for better understanding of the
software, RMSC data will be takeninto consideration for further explanation and analysis.
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THE STRUCTURE BEHIND
Fig I. Process Flow of Drug Warehouse Management System [1]
1. Budget processing
The state government has made sufficient fund provisions with RMSC for purchase of
equipments and consumables. Considering present scenario, RMSC has been allotted the total
budget of 25 crores in minutes of meeting with chief minister on 03.01.2013 (Refer Table I).
Further these funds have been sub allotted to medical colleges, district centers and sub
centers, etc based on their previous year consumption. There are total of 33 districts under
which many sub stores and hospitals falls. [3]
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The entries of budget allocation are being made in this software at the commencement of
financial year for all the districts. Further these districts have the responsibility to divide the
available funds in such a manner so that it can allocate the funds to its sub centers which can
be either medical colleges, stores or sub stores. This process of budget allocation is carried
out till it reaches the leaf node.
Table I. District wise budget allocation [3]
2. Demand Process
Demand management activities in any global supply chain consist of threeactivities:
demand management, demand planning, and sales forecastingmanagement.
• Supply chain relationship management, which is the management of relationships
with supply chain partners to match performance with measurements and rewards so
that all companies in the supply chain are fairly rewarded for overall supply success.
• Demand planning is concerned with the coordination across the global supply chain of
derived and dependent demand.
• Sales forecasting management is concerned with the independent demand that occurs
in any global supply chain. [9]
Time Series is the model used in ‘e-Aushadhi’ for forecasting. The model is one of the
fastest and cheapest ways to conduct a demand forecast. The basic idea behind this model is
that past demand process will continue similarly and therefore it can be projected to the
feature with the fact that time is always an independent variable. Dependent variable changes
according to the issues that are being forecasted. Therefore, in this case demand is:
ࡰ ൌ ࢌሺ࢚ሻ
Where:
D is the variable to be forecasted,
f(t) is a function whose exact form can be estimated from the past data available on the
variable.
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The value of the variable for the future is expressed as a function of its values in the past.
ࡰ࢚ ൌ ࢌሺࡰ࢚, ࡰ࢚ െ , ࡰ࢚ െ , . . . . ሻ[8]
As soon as the stores, sub stores and other medical colleges receive their budget, they
try to figure out their requirements based on previous year consumption and then place a
demand to their above levels. This process is called demand process. Placement of this
demand is again carried out with the help of this software makes this process easier by
ensuring that no sub store can demand more than its budget but also assure the demand in the
form of report.
However there are chances that the turnout of patients increases beyond the
anticipated numbers. Therefore the hospital administration is expected to enlist the available
resources and assess if there is any shortfall. These issues are again handled by ‘e-Aushadhi’
by adding a new feature called ‘Reorder level’ which states that the software will alert the
user that this resource is running short and is need to be reordered again.
As soon as the stores, sub stores and other medical colleges receive their budget, they
try to figure out their requirements based on previous year consumption and then place a
demand to their above levels. This process is called demand process. Placement of this
demand is again carried out with the help of this software makes this process easier by
ensuring that no sub store can demand more than its budget but also assure the demand in the
form of report.
However there are chances that the turnout of patients increases beyond the
anticipated numbers. Therefore the hospital administration is expected to enlist the available
resources and assess if there is any shortfall. These issues are again handled by ‘e-Aushadhi’
by adding a new feature called ‘Reorder level’ which states that the software will alert the
user that this resource is running short and is need to be reordered again.
Moreover demand process deals with two more innovative features called approval at
both raising and receiving end. These features propound that when the demand is generated,
then it cannot be passed to its higher level until it is approved by the authority at raising end.
Similarly, when the demand is being received at district level, it will not be finalized till it is
approved by the authority at receiving level (Refer Fig II).
Fig II. Snapshot of Approval Desk in e-Aushadhi
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3. Rate Contract Desk
This desk basically deals with compiling the demand from every sub center and store
and then placing the tender to the suppliers. The process of tender placement and quotation
filing is handled by NIEC as per the government norms. Based on the best quotation and
grade of supplier, this desk displays the list of suppliers to which order can be
placed (Refer Fig III).
Fig III. Snapshot Rate Contract Details in e-Aushadhi
4. Indent Generation
Indent is a type of purchase order (placed often through a local or foreignagent of a
foreign supplier) under specified conditions of sale. This indent or purchase orders (PO) can
only be generated by Head Quarter by compiling the request from all the sub centers and
selecting the appropriate supplier from the list. The purchase order is then send to the
supplier using ‘e-Aushadhi’. The supplier will receive the PO and send the order as per his
schedule. ‘e-Aushadhi’ will also let the user know the pending PO by displaying the note on
the screen each time a new PO is generated.
5. Challan Process
This process is used to keep tracking of the Challan sent by the supplier. Challan
basically has the delivery details so that hospital can verify the received items as per Challan.
The Challan will be received by the Head Quarter on the basis of unique PO number. The
user can either receive the Challan if it matches with his/her requirements or can cancel the
same accordingly. The same information will be updated by e-Aushadhi and an automated
report will be generated signifying that the materials are being received by headquarter.
The same stock will be distributed among sub stores based on their demand. As soon as the
medical colleges and sub stores receive their requested items, a new process came into view
called ‘Quality Check’.
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6. Quality Check
This Quality Check center is at headquarters and is responsible for reviewing the
quality of all factors involved in production. It examines the sample received from all the sub
centers and then a report is framed for all the items specifying whether the sample status will
be approved or will be marked as quarantine (Refer Fig IV).
Fig IV. Process Flow in Quality Check Department [4]
7. Payment to supplier and penalty check
The payment will be done to the supplier based on the items delivered in good
condition. e-Aushadhi enable the user to categorize the received items into following
categories like ‘expired items’, ‘broken items’, ‘received items’, ‘ordered items’ etc based on
which automatic amount will be calculated which will be paid to the customer as per his/her
quotation. Further penalty will be charged if the ordered quantity is greater than the
maximum quantity that can be ordered.
8. Inventory Management
Inventory management is the process of efficiently overseeing the constant flow of
units into and out of an existing inventory. Balancing the various tasks of inventory
management means paying attention to three key aspects of any inventory.
The first aspect has to do with time. In terms of materials acquired for inclusion in the total
inventory, this means understanding how long it takes for a supplier to process an order and
execute a delivery. Inventory management also demands that a solid understanding of how
long it will take for those materials to transfer out of the inventory be established. Knowing
these two important lead times makes it possible to know when to place an order and how
many units must be ordered to keep production running smoothly. [6]
These challenges are easily managed by ‘e-Aushadhi’ by introducing various features like
‘Physical stock verification’, easy transfer of drugs between stores, Grouping and sub
grouping of drugs for easy and efficient drug searching and reporting.
Commonly used inventory analyses in ‘e-Aushadhi is:
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a. FSN Analysis
Classification based on frequency of issues and uses
F, S & N stand for fast moving, slow moving and Non moving items.
Fast Moving (F) = Items that are frequently issued/used.
Slow Moving (S) = Items that are issued/used less for certain period of time.
Non-Moving (N) = Items that are not issued/used for more than certain duration.
This type of classification helps to establish and organize proper warehouse layout by
locating all the fast moving itemsnear the dispensing window to reduce the handling efforts.
Also, attention of the management is focused on the Non-Moving items to enable decision as
to whether they are in needs in the future or they can be salvaged or disposed. This will help
to improve organization’s capital utilization and cash flow.
b. ABC Analysis
This principle is applied to classify inventories based on consumption value.
Pareto principle: The significant items in a given group normally constitute a small portion
of the total items in a group and the majority of the items in the total will, in aggregate, be of
minor significance.
This way of classification is known as ABC classification.
CLASS A: 10% of total inventories contributing towards 70% of total consumption value.
CLASS B: 20% of total inventories which account for about 20% of total consumption value.
CLASS C: 70% of total inventories which account for only 10% of total consumption value.
Fig V. Consumption analysis of A B and C item type
A ratio showing how many times anorganization inventory is sold and replaced over a period:
Periodic Review
To make the most effective use of ABC classifications, the analysis should be
completed at leaston an annual basis, and more often as necessary. [7]
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Fig VI. Re-order point for Uniform condition and weighted condition
4. Other special features in ‘e-Aushadhi’
Generic drug code is the technique in which a code and name is provided to the
drugs so that it can include both branded and non-branded items for better searching and
reporting.
Drug dosage indication is used to define Dosage and Indication parameter for a drug as per
CIMS Guidelines. This parameter can be useful while generating the Drug Profile that can be
useful for doctor/pharmacist.
Drug contradiction is used to map the contradicted drugs for a drug that can be useful while
ordering the drugs by the doctor to the patient, the system would generate alert if there is any
contradicted drugs in the prescription.
5. Report generation
This process takes into consideration the types of reports which are generated at
different levels. The reports are generally used for certification, record maintenance,
confirmation etc. The main types of reports in e-Aushadhi are Supplier Performance Report,
Material Inward/Outward Register Report, Indent for Issue, Issue Details (to patients, to staff,
to medical colleges), and Return Details etc (Refer Fig V).
Fig VII. Snapshot of Mater Inward Register Report
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IV. RESULTS
‘e-Aushadhi’ is totally committed in building healthy society, not only by making
available quality Medicare facilities at the door step of every citizen in the remotest corner of
the state, but also by providing medical facilities
of the highest order, keeping pace with rapid technological developments in the field of
medicine.
• Comparative analysis of traditional and newly proposed web application ‘e-Aushadhi’
has revealed major changes between them which are quoted in the following Table:
Table II. Difference between Traditional System and e-Aushadhi
Shortcomings in Traditional System e-Aushadhi and its overcoming features
Mismanagement of drugs and their
codifications.
Ability to define the drugs into groups, sub
groups, categories, Codification.
At a glance notice to expired drugs or near
to expire drugs main stores & sub stores.
Readily report available to track expiry
date/shelf life for the drugs.
No status report of the Purchase Order
dispatched by the HQ for main stores.
Issued PO for main stores are shown at
their desk.
No status report of the pending Purchase
Order.
PO is shown in the desk in pending status
till items are not completely received.
Rely on manual register or self alertness for
expired or near to expired drugs.
Alert with different colour for to be expired
items generated well before its expiry date.
Being a sensitive issue handling of QC is
always a great concern.
QC management is handled in a very strong
manner.
No report on Supplier performance. Activity of supplier is tracked with the issue
of PO.
Annual Auditing is poor. All saturatory reports are available in the
system with 100% reliability.
No Proper Inward/Outward Records
availability.
Voucher preparation is available with
budget management to sub store.
• Benefits and main objectives of ‘e-Aushadhi’ (Refer Fig VI) :
To implement a transparent system for procurement, storage and distribution of
quality drugs, supplies, equipments etc. required for the hospitals at reasonable
competitive price.
To ensure adequate savings in the drug budget by scientific forecasting system based
on the preparation of essential drug list and its actual consumption.
Monitoring the budget and drug consumption pattern by introducing pass book
system.
To improve infrastructure of the existing drug warehouse in district.
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Fig VIII. Varieties of task accomplished by e-Aushadhi [5]
V. DISCUSSIONS
The pharmaceuticals distribution process is a cycle of complex actions that require
highest security standards and constant information sharing. Keeping full control over the
system and having insight into even the smallest components determines the quality and
efficiency of warehouse management.
“Legislation requires drug distributors to use state-of-the-art packaging and transportation
technologies to eliminate human errors from the logistics processes. Unfortunately, the
human factor is in fact the weakest link in the entire process," – says Janusz Budek, CIO at
Prosper SA, a large Polish drug distributor. [6]
• Distribution:
"Some drugs cannot be stored next to each other, in a low or high temperature, in humidity,
etc.," says Marcin Figlarek, Logistics Consultant at Consafe Logistics. [6]
Since RMSC has a very robust mechanism of distribution using ‘e-Aushadhi’. Distribution up
to PHC is done by the district central drug warehouses. Vehicles from the respective facilities
take the scheduled quantity of drugs from the ware house, which also provides for the
transportation costs. Drug reaches to the facilities from where it is made available to the
beneficiaries through prescriptions. In cases where there is a need for drugswhich are not
available in the list, patients are referred tohigher centers. The district compliance to
prescribe only from the list of drugs available in a particular facility on the one hand lowers
the out of pocket expenditure on drugs but
on the other hand leads to increased referrals to higher centers.
• Accountability:
Keeping the account of inventory levels of items is of paramount importance in any stock
system. Similarly in the case of drug delivery system, accountability is extremely important.
Thesystems in this regard are appropriately in place in Rajasthan.
The central drug warehouse has a computerized inventory management system i.e. ‘e-
Aushadhi’. There is an On-line HIS system at facilities in 33 main districts. A system of
collection of slips from the patients to counter check the amount of drug distributed from the
pharmacies of the facilities is also in place. [4]
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ACKNOWLEDGMENT
We express our deep thanks to Mr. B.K. Murthy, Executive Director; CDAC Noida
(India) with the help of his vast experience, efforts, valuable suggestion, support and
motivation helped us to great extent for the design and development of this utility.
REFERENCES
1. http://www.rmsc.nic.in/Software.html
2. http://apps.who.int/medicinedocs/pdf/whozip10e/whozip10e.pdf
3. http://www.rmsc.nic.in/knowledge/Book%20MNJY.pdf
4. http://mohfw.nic.in/NRHM/District/Districts_Tour_Report/Final%20versionREPORT
%20TN&KERALA-21.7.11.pdf
5. http://www.barcodesinc.com/articles/what-is-inventory-management.htm
6. http://www.consafelogistics.se/knowledgecenter/articles/wms-for-the-pharmaceutical-
companies
7. http://homes.ieu.edu.tr/~ykazancoglu/BA437/ABC%20analysis%20YK.pdf
8. http://www.slideshare.net/AbhishekKumar159/demand-forecast-process-and-
inventory-management.
9. http://www.sagepub.com/upm-data/11204_Chapter_5.pdf.
AUTHORS
HIMANI GOEL
She is working as Project Engineer in CDAC Noida since December,
2012. She is having 9 months of IT experience, in ERP, Japanese and
Health Informatics Projects. She has completed her B.Tech (Computer
Science and Engineering) from Inderprastha Engineering College,
GautamBudh Technical University in 2012. She was among the
University toppers and secured second position in her college in
academics and overall performance. She has been praised in many
seminars and project presentations for her presentation and technical
skills. Her interest lies in designing database, SRS and other design documents. E-mail:
himanigoel@cdac.in
PRAVEEN KUMAR SRIVASTAVA
He has done his Masters in Computer Application from Madan Mohan
Malviya Engineering College Gorakhpur. Currently he is working as
Joint Director and Group Coordinator for Design Group in CDAC
Noida. He is having around 15 Years of Experience His achievements
include: He was the Topper of M.Sc (Maths) from Allahabad University
in the Development and implementation of Health Care Solutions at
Different Hospitals. He has deep interest in standardizing the Electronic
Medical Recordin Hospitals. Email: pksrivastava@cdac.in
13. International Journal of Management Research and Development (IJMRD) ISSN 2248-
938X (Print), ISSN 2248-9398 (Online) Volume 3, Number 2, April - May (2013)
30
AJAY GUPTA
Mr. AjayKumar Gupta, He has done his Masters in
ComputerApplicationfrom Institute of Engineering &Technology,
Lucknow (U.P).He is currently working as Senior TechnicalOfficer at
C-DAC. His major achievementsinclude: implementation of Patient
Billing,ADT and Online Inventoryand Procurement module at Post
Graduate Institute Medical Education&Research (PGIMER)
Chandigarh, Successful implementation of Various Modules at MGIMS
Nagpur, GeneralHospital Chandigarh, SMS Jaipur, RIMS Imphal and IGMC Shimla, Design
and Development of Various Modules of HIS for PGIMERChandigarh and GNCTD Delhi,
Design of Drug Warehouse Applicationfor NRMH Rajashtan.He has expertise in System
Study, Analysis and Design of Software Development Life Cycle which are his key interest
areas.Email:ajaygupta@cdac.in
CHINMAY GARG
He is working as technical officer in CDAC and received his B. Tech in
Electronics & Communication from UP Technical University, in 2005.
With knack towards learning further he completed Post Graduate
Diploma in GIS & RS from C-DAC Noida in 2006. He has done his
MBA from IMT-CDL, Ghaziabad in 2010. His areas of interests are
Geographical Information Systems, Web Application UI Design, and
Database Structure Design.E-mail: chinmaygarg@cdac.in