Endüstri Mühendisliği - Yöneylem teknikleriyle Sağlık Tedarik Zinciri Modellemesidir. Maalesef dünya bu yöntemleri taşıyacak kadar deterministik değildir. Zaten sonraki aşamada fiili model denemesi planlanmış.
Strategic supply chain management and logisticsBhavi Bhatia
Thanks to all my readers. It gives boost when I get calls from my readers and am always happy to revert back to my followers and readers. I am sorry if I am unable to reply to all the e-mails due to my busy schedule.
Contact me for any type of assignments help(nominal charges).
Thanks and Regards,
Er. Bhavi Bhatia
e-mail: bhavi.bhatia.411@gmail.com
Phone: +91-7696003714, +91-9814614666
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.
Understand the relationship between supply chain management (SCM) and organisational business objectives
Explain the importance of effective supply chain management in achieving organisational objectives
Explain the link between supply chain management and business functions in an organisation
Discuss the key drivers for achieving an integrated supply chain strategy in an organisation
Be able to use information technology to optimize supplier relationships in an organisation
Evaluate the effectiveness of strategies used by an organisation to maintain supplier relationships
Task 2.2: Use information technology to create strategies to develop an organisation’s relationship with its suppliers
Develop systems to maintain an organisation’s relationship with its suppliers
Case Study of a maintaining organization’s relationship with suppliers:
Understand the role of information technology in supply chain management
Assess how information technology could assist integration of different parts of the supply chain of an organisation
Task 3.2: Evaluate how information technology has contributed to the management of the supply chain of an organisation
Assess the effectiveness of information technology in managing the supply chain of an organisation
Understand the role of logistics and procurement in supply chain management
Explain the role of logistics in supply chain management in an organisation
Strategic supply chain management and logisticsBhavi Bhatia
Thanks to all my readers. It gives boost when I get calls from my readers and am always happy to revert back to my followers and readers. I am sorry if I am unable to reply to all the e-mails due to my busy schedule.
Contact me for any type of assignments help(nominal charges).
Thanks and Regards,
Er. Bhavi Bhatia
e-mail: bhavi.bhatia.411@gmail.com
Phone: +91-7696003714, +91-9814614666
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.
Understand the relationship between supply chain management (SCM) and organisational business objectives
Explain the importance of effective supply chain management in achieving organisational objectives
Explain the link between supply chain management and business functions in an organisation
Discuss the key drivers for achieving an integrated supply chain strategy in an organisation
Be able to use information technology to optimize supplier relationships in an organisation
Evaluate the effectiveness of strategies used by an organisation to maintain supplier relationships
Task 2.2: Use information technology to create strategies to develop an organisation’s relationship with its suppliers
Develop systems to maintain an organisation’s relationship with its suppliers
Case Study of a maintaining organization’s relationship with suppliers:
Understand the role of information technology in supply chain management
Assess how information technology could assist integration of different parts of the supply chain of an organisation
Task 3.2: Evaluate how information technology has contributed to the management of the supply chain of an organisation
Assess the effectiveness of information technology in managing the supply chain of an organisation
Understand the role of logistics and procurement in supply chain management
Explain the role of logistics in supply chain management in an organisation
Health Care Facility Managers: How to maximize vendor relationships to reach ...BrennecoFireProtection
Over the past decade, we have seen the role of the facility manager change across multiple industries, but none so much as in health care. The facility managers working in hospitals, assisted living facilities and other health care venues who partner with Brenneco Fire Protection are playing more critical roles and are fulfilling more demanding responsibilities than they were just a few years ago.
“Health Care Facility Managers: How to maximize vendor relationships to reach goals” offers our perspective on the crucial partnerships between facility managers and the outside service providers they hire.
What's Inside:
-Quality and performance goals for facility managers
-8 Search tactics to find a trusted vendor
-How vendors can help you reach your goals including:
-Fire Protection Services
-Electrical
-Plumbing
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-Commercial Insurance
-Temp Labor Provider
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5 best practices for ongoing evaluation
When to look for a new vendor
- See more at: http://brennecofp.com/health-care-facility-managers-guide#sthash.vXsRHBUO.dpuf
1. Outline three different applications and explain the utilizatio.docxpaynetawnya
1. Outline three different applications and explain the utilization of information systems in the healthcare supply chain.
2. Discuss and give three examples of the different uses of information systems and technology of those systems in the operation of the supply chain.
3. Relate, discuss and provide two examples where information systems in the healthcare supply chain provide the availability of performance metrics and statistics to inform decision making for improved efficiency, effectiveness and efficacy of the supply operation in the healthcare organization.
4. Distinguish the functional areas two different aspects of information systems, such as sourcing, EDI, vendor management, warehousing/storage and dispensing to points of care with regard to the healthcare supply chain.
5. Relate one business operation such as warehousing or storing or dispensing to points of care, how work is accomplished, to the information systems, how information and data from operations flow, within the healthcare supply chain.
6. Evaluate three different benefits of improved information systems and utilization of at least three metrics for healthcare supply chain operations and management in terms of performance, health outcomes and stakeholders’ perceptions.
Chapter 5 – Informing: Information Systems in the Healthcare Supply Chain
Learning Objectives
Outline and explain the utilization of information systems in the healthcare supply chain.
Discuss and give examples of the different uses of information systems and technology of those systems in the operation of the supply chain.
Relate, discuss and provide examples where information systems in the healthcare supply chain provide the availability of performance metrics and statistics to inform decision making for improved efficiency, effectiveness and efficacy of the supply operation in the healthcare organization.
Distinguish the functional areas of information systems, such as sourcing, EDI, vendor management, warehousing/storage and dispensing to points of care with regard to the healthcare supply chain.
Relate the business operation, how work is accomplished, to the information systems, how information and data from operations flow, within the healthcare supply chain.
Evaluate the benefits of improved information systems and utilization of metrics for healthcare supply chain operations and management in terms of performance, health outcomes and stakeholders’ perceptions.
Introduction
Information systems are valuable assets to healthcare organizations.
Data in context, such as a healthcare supply chain context, is information; information that is ‘actionable’ or useable is knowledge.
Information systems foster knowledge for operators, managers, leaders and strategists.
Efficient, effective and most importantly, efficacious business practices are reinforced and complemented by well developed, built and deployed information systems for a trained team of professionals a ...
Case report writing in the healthcare sector of an integrated supply chain – ...Pubrica
Hospital information systems (HIS) have become one of the most critical infrastructures for hospital administration, and information technology (IT) is becoming more vital in the healthcare business in Medical Case Study Report Writing.
Reference: https://pubrica.com/services/research-services/case-report-writing/
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The Healthcare Supply Chain1. Outline and explai.docxoreo10
The Healthcare Supply Chain
1. Outline and explain the concept of a supply chain.
2. How is a healthcare supply chain different from many other types of supply chains?
3. Discuss and give examples of categories of items involved in and functions provided by the healthcare supply chain.
4. Relate discuss and provide an example where the value chain integrates with healthcare supply chain operations and management.
5. Distinguish the functional areas of the value chain in the healthcare supply chain.
6. Relate the processing of cotton into a medics surgical supply item with the functional areas of the healthcare supply chain
7. Evaluate the benefits of improved healthcare supply chain operations and management in terms of a healthcare organization, patient, a community, and from the health industry standpoints.
Chapter 1:
The Healthcare Supply Chain
Learning Objectives:
Outline and explain the concept of a supply chain and supply chain management.
Discuss and give examples of categories involved in the healthcare supply chain.
Explain the concept of the Value Chain.
Distinguish the functional areas of the Value Chain in the healthcare supply chain.
‘Follow the Cotton Ball’ – Relate the processing of cotton into a medical/surgical supply item to the functional areas of the healthcare supply chain.
Consider the benefits of improved healthcare supply chain management.
Introduction
The healthcare supply chain plays a large role in the production of healthcare services.
Providing the right item, at the right time, at the right place and with quality into healthcare providers’ able hands are the focus of the supply chain.
3
Supply Chain Management (SCM)
Supply chain management is the integration of the flows of products, information, services and finances from the point of origin to the final customer.
Supply chain management is an important area of growth for healthcare organizations for several reasons; the most obvious being the cost associated with mismanagement of the supply chain.
The Supply Chain
A supply chain is an interconnected network of people and organizations that are involved in the production of products and services.
Every organization is part of a supply chain, whether they produce a product or a service.
5
Logistics
Logistics management “ is that part of supply chain management that plans, implements, and controls the efficient, effective forward and reverse flow and storage of goods, services and related information between the point of origin and the point of consumption in order to meet customers' requirements."
In the healthcare sector logistics is often referred to by an older name for logistics: materials management.
Materials Management
Material management in healthcare is the procurement , storage, inventory control, quality control and operational management of supplies, pharmaceuticals, equipment and other items used in the delivery of patient care or the management of the pa ...
Healthcare Interoperability Solutions Market by Product Type, Distribution Ch...IMARC Group
The global healthcare interoperability solutions market size reached US$ 3.9 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 11.0 Billion by 2032, exhibiting a growth rate (CAGR) of 12.24% during 2024-2032.
More Info:- https://www.imarcgroup.com/healthcare-interoperability-solutions-market
McKinsey Sağlık Tedarik Zinciriyle, FMCG Tedarik Zinciri karşılaştırıyor. Sağlık Tedarik Zincirindeki iyileştirme fırsatına ve toplumsal boyutuna dikkat çekiyor.
Computerized Physician Order Entry Systems Market.pdfKumar Satyam
The realm of healthcare has undergone a significant transformation with the advent of digital technologies, and one such innovation making waves is the Computerized Physician Order Entry (CPOE) system. According to the latest report by TechSci Research titled "Computerized Physician Order Entry Systems Market – Global Industry Size, Share, Trends, Competition Forecast & Opportunities, 2028", the Global Computerized Physician Order Entry Systems Market witnessed a valuation of USD 1.65 billion in 2022, with a projected Compound Annual Growth Rate (CAGR) of 6.22% during the forecast period from 2024 to 2028. This comprehensive report provides valuable insights into market dynamics, drivers, trends, and key segments, offering a holistic view for stakeholders and industry participants.
Modernizing Legacy Systems in Healthcare: A Comprehensive GuideLucy Zeniffer
Modernizing Legacy Systems in Healthcare: A Comprehensive Guide" offers practical insights into upgrading outdated healthcare technology. Exploring strategies, challenges, and benefits, this guide empowers healthcare professionals with the knowledge to navigate the complexities of system modernization. From enhancing efficiency to improving patient care, it provides a roadmap for embracing innovation in healthcare IT infrastructure.
Running head: REPORT 1
REPORT 5
Consumption Behavior; Electronics
Student’s Name
Institutional Affiliation
Topic description
Consumption behavior is the manner in which an audience responds to product marketing. Consumption behavior is also referred to as buying behavior, and it revolves around the buying intentions and attitudes of individuals. It is important for producers to understand the consumption behavior of existing and prospective customers; this way, they can make goods and services that align to customer tastes and preferences (Friedman, 2018). In addition to that, understanding consumption behavior helps producers to manufacture or process goods that match the aggregate demand of customers. It is not advisable for a business to engage in mass production without considering rough estimates for demand as such may lead to excess inventory that never manages to get off the shelves. This project will give invaluable insights with respect to the behavior of buyers towards electrical appliances.
Significance of the Project
The project is significant because it will answer a multiplicity of pertinent questions regarding market equilibrium of electronic appliances, the influence of Adam Smith's invisible hand in the electronics market, determinants of aggregate demand, and drivers of supply among others. As such, consumers, suppliers, producers, and investors will find the study insightful with respect to answering market questions they may have (Roos & Hahn, 2017). The significance of the research questions offered by the study is that it will make audiences more rational in the choices they make. First, after reading the study, buyers may decide to commit to buying high-quality products as opposed to those of less quality which require replacement every six months. What's more, a majority of the producers that read the study may be influenced to produce high-quality products that make their brand unique in the eyes of customers; with a promise of high quality and longevity of the products involved to customers. Third, the research may influence suppliers to be more committed to excellence.
Historical Data for Key Parameters
The steady sale of electronics in The US does seemed to have followed a clear pattern over time. The frequency with which consumers buy electronics seems quite high. Most producers are looking strike a balance between quality and price get the most customers. Where some are just trying to cash in with cheap and flashy items. The graph below depicts the time line for The US computer/software store sales from 1992 to 2015. Currently, the US Electronics Store Sales is in excess of $25 Billion USD annually.
Source: https://www.statista.com/statistics/197603/annual-computer-and-software-store-sales-in-the-us-since-1992/
The necessity of electronics to us becomes evident when you look at how many US homes have them. The percentage of US house hold owning home computers has incr.
Serialization: Driving Business Value Beyond ComplianceCognizant
As serialization and track-and-trace capabilities go mainstream to meet regulatory compliance mandates, pharmaceuticals companies should simultaneously explore how these tools and techniques can improve supply chain planning and operations, elevate patient and doctor engagement, and increase sales and marketing effectiveness.
Serialization: Driving Business Value Beyond ComplianceCognizant
Serialization and track-and-trace capabilities are not just useful for meeting regulatory compliance mandates; pharmaceutical companies can also explore their use to improve supply chain planning and operations, elevate patient engagement, and increase sales and marketing effectiveness.
Ibm The Supply Chain Of The Future BilcareBilcareltd
In the course of our research for IBM’s inaugural Global Chief Supply Chain Officer Study, we conducted face-to-face interviews with nearly 400 senior supply chain executives from 25 countries and 29 different industries.
Here, we focus on the responses of the 23 supply chain executives from the Life Sciences industry (see sidebar, Survey sample).
Tahmin ve internet tabanlı kolaylaştırmaya dayalı bir çalışma. Haiti' de elektrik kesintileri, internet erişim kesintileri, İngilizce - Fransızca - yerel dil, düşük eğitim profili, ada olmaktan kaynaklanan lojistik zorluk, fakirlik, kolera salgını,... engellere rağmen iyileşme sağlanmış.
Tahran' daki 5 hastanenin Tedarik Zinciri incelenmiş ve temel sorunun ortamdaki belirsizlik olduğu ortaya çıkmış. Kısıtlar Teorisi tarzında bir çözümleme yapılmış.
DMO, diğer OECD ülkelerindeki gibi merkezi alım ve kamu için ortak tedarikçi olma eğilimindedir. Böylece stoklar paylaşılabilecek, aşırı alımlar bitecek, ölçek ekonomisi sağlanacaktır. İlaç ve Tıbbi Sarf Malzemesi DMO gündemindedir.
Cari Kakınma Planıdır, KOBİ - girişimci - inovasyon - yerli sermaye vurguludur, sağlık - lojistik öncelikli sektördür, kamu desteğiyle büyüme modelinden söz edilir. SCHAIN bu gruplamaya uygundur.
Sağlık Bakanlığı 2013/09 sayılı genelgeyle bağlı kurumlardaki ilaç, tıbbi sarf malzemesi yönetimini düzenlemek istiyor. Problemler tespit edilmiş, çözümler eski paradigmaya ait...
LODER ve MTSO tarafından düzenlenen IV. Ulusal Lojistik Proje Yarışması Bireysel Kategoride ödüle layık görülen projemdir. Perakendeciler için Lojistik firmaları tarafından işletilen "tamamlama-replenishment" servisidir.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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Managing healthcare supply chain
1. 1
MANAGING HEALTH CARE SUPPLY CHAIN: TRENDS, ISSUES, AND
SOLUTIONS FROM A LOGISTICS PERSPECTIVE
Charu Chandra
Swatantra K. Kachhal
Industrial and Manufacturing Systems Engineering Department
University of Michigan – Dearborn
4901 Evergreen Road
Dearborn, Michigan 48128-1491
Abstract
The U.S. healthcare industry is a large enterprise
accounting for over 14.1% of the national economic output
in 2001. It has been under pressure for cost containment
and providing quality health care services to consumers. Its
record of investing heavily on development of
sophisticated drugs and diagnostic systems does not match
that of technologies to manage its day-to-day operations.
In order to achieve improved performance, healthcare
supply chain must be efficient and integrated. The driver
for this integration is logistics and supply chain
management. This paper describes trends, issues and some
solutions for logistics management for Health Care Supply
Chain with concepts drawn from Industrial Engineering,
and Operations Research disciplines applied to specific
domains. A healthcare supply chain template utilizing E-
commerce strategy is presented. Use of simulation,
optimization, and information sharing techniques are
demonstrated to optimize purchasing and inventory
policies.
(Keywords: Health Care Supply Chain, Health Care
Logistics, e-Health Care)
1. Introduction
The US healthcare industry accounted for 14.1%
of the U.S. economic output in 2001 (URL:
(http://www.cdc.gov/nchs/data/hus/tables/2003/03hus112.
pdf). Various studies of this industry point to lack or
failure of basic quality-control procedures, and
misalignment among consumer needs, payers and provider
services, as primary causes for building waste into industry
management practices.
Pressures on the industry have fostered innovation in the
design of services and organizations. Most of the
innovations have targeted cost reductions in key functions,
including logistics. The industry must find a flexible
delivery enterprise that has substantial capital and is
capable of efficient operations. This means effective
management of a broad range of processes with diverse
measures, from medical outcomes to cost of tissue paper.
Healthcare sector of US economy faces several challenges,
such as cost containment, outdated information
management systems, and mergers and/or acquisitions.
The need to cut costs and compete has led to mergers and
acquisitions in healthcare industry. Such consolidations
have created new organizations made up of very different
entities which are not as integrated as they should be. Due
to competition, it has become imperative that enterprises
seamlessly and efficiently provide and manage services
(including purchase and delivery of supplies to the final
user) across entities and continuum of care, both now and
in the future.
The principal participants in the US healthcare supply
chain include: manufacturers (drugs, medical equipment,
and hospital medical supplies), distributors, medical
service providers, medical groups, insurance companies,
government agencies (such as, Health and Human
Services), employers, government regulators, and users of
healthcare services.
This paper describes trends, issues and some solutions for
logistics management in Health Care Supply Chain with
concepts drawn from Industrial Engineering (IE), and
Operations Research (OR) disciplines applied to specific
domains. A healthcare supply chain model utilizing E-
commerce strategy is presented. Use of simulation,
optimization, and information sharing techniques are
demonstrated to optimize purchasing and inventory
policies.
The rest of the paper is organized as follows. Section 2
lays the foundation of supply chain as a business strategy,
describing concepts, key issues and approaches to problem
solving in supply chain management. Section 3 makes the
case for a Health Care supply chain emphasizing the need
for it, strategic drivers, key issues and opportunities that
exist for it to be a viable alternative for businesses. An E-
Health Care supply chain model is presented in Section 4.
The rationale behind this model and its various
2. 2
components is described. Section 5 presents a
methodology for applying IE and OR techniques to
potential Health Care supply chain problems using the
proposed model. The paper concludes with suggestions of
possible problem areas where the proposed framework can
be suitably applied as a future task, described in Section 6.
2. Supply Chain Management: Concepts, Key
Issues, and Approaches to Problem –Solving
Supply chain has been defined as a system of
suppliers, manufacturers, distributors, retailers, and
customers where material typically flows downstream
from suppliers to customers (except for reverse logistics)
and information flow in both directions. Supply chain
management involves managing a connected series of
activities, which is concerned with planning, coordinating,
and controlling movement of material, parts, and finished
goods from supplier to customer. For this to occur,
material, financial, and information flows are managed as
decisions are made at strategic, tactical, and operational
levels throughout the supply chain. Supply Chain
Management issues span a large spectrum of a firm’s
activities, at these levels (Simchi-Levi et al., 2003). Table
1 summarizes decisions made at these levels.
Table 1. Decision-Making levels in Supply Chain.
Decision-
Making
Level
Timeline Type of Decision Made
Strategic 5 to 10 years Investment on plants and
capacities.
Introduction of new products.
Creation of a logistics network.
Tactical 3 months to 2
years
Inventory policies to use.
Procurement policies to be
implemented.
Transportation strategies to be
adopted.
Operational Day-to-Day Scheduling of resources.
Routing of raw materials and
finished products.
Solicitation of bids and quotations.
The above decisions are made in order to address some of
the following common issues facing the supply chain
management activity:
Distribution Network Configuration. This issue deals with
selection of warehouse locations and capacities,
determining production level for each product at each
plant, and finalizing transportation flows between plants
and warehouses so as to maximize production,
transportation and inventory costs. It is a complex
optimization problem dealing with network flows and
capacity utilizations. This issue relates to healthcare
related manufacturers and suppliers in a healthcare supply
chain.
Inventory Control. This issue deals with stocking levels at
various levels in the supply chain. Demands from level-to-
level are considered in making this decision. This is a
decision problem, solution to which involves using
forecasting, inventory management, and simulation and
optimization algorithms. Healthcare providers, suppliers as
well as manufacturers deal with this issue in a healthcare
supply chain.
Supply Contracts. This issue deals with setting up
relationships between suppliers and buyers in the supply
chain through establishments of supply contracts that
specify prices, discounts, rebates, delivery lead times,
quality, returns, etc. etc. This approach differs from
traditional approaches because its central focus is on
minimizing the impact of decision made at not just one
level in the supply chain, but on all its players. This is a
decision problem, solution to which could range from a
simple Linear Programming problem to a complex Game
Theory algorithm. A healthcare provider will be setting up
these contracts with a distributor or directly with a
manufacturer.
Distribution Strategies. This issue deals with decisions
pertaining to movement of goods in the supply chain.
Among the strategies available are direct shipment, cross-
docking involving transshipments and load consolidation.
The objective is to minimize warehousing (storage) and
transportation costs. Solutions to this problem involve
Network Algorithm utilizing Linear, and Non-Linear
programming techniques in deterministic and stochastic
environments. A healthcare provider will have to make
decisions about warehousing or direct shipment to point of
usages of various supplies.
Supply Chain Integration and Strategic Partnering. One of
the key issues in managing supply chain is its integration.
Information sharing and joint (or collaborative) operational
planning are basic ingredients to solve this issue.
Implementation of Collaborative Planning, Forecasting
and Replenishment (CPFR) as carried out by Wal-Mart
retail stores in their supply chain, aided by information
sharing through common software platforms such as the
Enterprise Resource Planning (ERP) are viable strategies.
In a healthcare supply chain, it would mean CPFR among
the healthcare provider, supplier and the manufacturer of
healthcare related items.
Outsourcing and Procurement Strategies. An important
issue to consider is what to manufacture internally and
what to buy from outside sources. One of the problems to
be dealt in making these decisions is identifying risks
associated with these decisions and minimizing them.
3. 3
Another issue to consider is the impact of Internet on
procurement strategies and what channels to utilize (public
or private portals) when dealing with trading partners. In
arriving at the decision whether to outsource or buy,
various optimization models may be utilized to balance
risk and payoffs. Once this decision has been made, use of
appropriate information technology component such as,
Internet portals, and procurement software plays a key role
in these decisions. An example of this issue in healthcare
supply chain may be the decision to prepare the meals for
inpatients in house versus delivering meals already
prepared in the centralized kitchen of a catering company.
Information Technology and Decision Support Systems.
One of the major issues in supply chain management is the
lack of information for decision-making. Information
technology plays the vital role in enabling decision-making
throughout the supply chain. Some of the key ingredients
of information technology in supply chain are – use of
Internet and Web-based service portals, integrated
information / knowledge within ERP software, and
decision-support systems that utilize proven algorithms for
various strategic, tactical and planning problems in
specific industry domains.
Customer Value. Supply chain must be measured by its
ability to deliver value to the end customer, the patient.
This may be in the form of price, quality, service levels,
and perceived value. Solutions based on Statistics and OR
can be employed to – measure quality of product, and
reduction of lead time to enhance service rates.
3. Health Care Supply Chain: The Need,
Drivers, Issues, and Opportunities
Why supply chain management for Health Care
Industry? There are a number of reasons why Health Care
industry needs to look at how they manage their supply
chain. The main ones -- cost and risk. According to
Bradley (2000), “how well or badly the health care supply
chain is managed is a major factor in health care costs”.
During the mid 1990’s, the Efficient Healthcare Consumer
Response (EHCR) (EHCR, 2000) performed its own major
supply chain study. They found out that the health care
supply chain inefficiencies contributed $11 billion (or
48%) out of the total annual costs of $23 billion. Their
report described that the health care supply chain was
centered around distributors, resulting in little contact
between manufacturers and hospital materials managers.
Contract negotiations tended to be adversarial. Providers
achieved lower costs, but these costs were not driven out
of the system, just pushed lower in the supply chain. They
encouraged the health care industry to adopt the concept of
“collaborative planning, forecasting and replenishment
(CPFR)”, used by retail chains such as, Wal-Mart. The
main idea is to avoid excess inventory through accurate
forecasting, utilizing one commonly agreed to demand
data among various supply chain partners (Anonymous,
2000).
Health Care Supply Chain Drivers. The factors that are
driving the call for efficiency in health care supply chain
are based on common business sense realizing that
considering the size of the industry, even small-scale
efficiencies can have potentially large dollar impact. Some
of the key drivers are described below (URL:
http://www.cisco.com/warp/public/779/ibs/solutions/suppl
y/vertical/).
• Fragmented supplier base. With 26,000 medical
suppliers, managing vendor relationship costs
significant time and money for the buyer. The goal
should be to consolidate purchases so as to buy
majority of products from one source.
• Reduced government subsidies have created the
necessity to control costs. In addition, the Health
Insurance Portability and Accountability Act of 1996
(HIPAA) regulations have created the urgency for
providers to address security and electronic
transactions issues, resulting in additional cost of
doing business.
• Supply chain inefficiencies. As mentioned earlier,
according to the Efficient Health Care Consumer
Response (EHCR) study, approximately $23 billion is
spent on the U.S. health care supply chain annually.
Streamlining the ordering process and reducing
number of supplier relationships can eliminate
approximately $11 billion in costs.
• Managing core competencies. An efficient supply
chain frees up time for health care professionals to
focus on their core competency of delivering quality
patient care.
• Internet based purchasing. This enables supplier
consolidation, reduced ordering costs, and a common
purchasing platform for hospital networks.
• Common data standards. Adopt and promote uniform
industry data standards for supply chain transactions
over the Internet. The formation of "E-Standards
Work Group" is an industry wide initiative for this
purpose (URL:
http://www.neoforma.com/corp/news_and_events/pres
s_room/2000/estandards.html).
• Standardization of product purchases in the supply
chain. Standardization of hospital supplies for their
impact on (a) purchase volume, (b) ordering and
tracking, (c) storage space, (d) resource allocation, and
(e) economies of scale through group purchasing
power (Vermond, 2000).
4. 4
Integrated Supply Chain Process: Key Issues and
Opportunities. There is now a greater awareness in the
Health Care industry that there are significant payoffs
through efficient management of the health care supply
chain, whose processes incur avoidable costs in following
areas (URL:
http://www.oha.com/oha/perspec.nsf/0/3d488bb0d512a8ea
85256abf005cce2e?OpenDocument):
• Transportation from a production plant to a regional
distribution center;
• Distribution center operations;
• Outbound freight;
• Wholesale distributor’s receiving and warehousing
operations;
• Wholesaler distributor’s mark-up for information
processing and customer service;
• Transportation to the care provider; and
• Inventory.
Integrated supply chain processes would transform this
disjoint string of activities into streamlined, cost effective
processes characterized by substantial standardization,
integration, and optimal service placement (Brennan,
1998). In order to successfully integrate the supply chain
processes, five supply chain management areas need to be
met or exceeded, as per the results of study published by
Pricewaterhouse Coopers (URL: www.eMarketer.com),
and summarized in Table 2.
Table 2. Supply Chain Management Applications and
Potential Savings for Health Care in the US, 2000 (as a %
of procurement costs)
Supply Chain
Management
Area
Potential Benefits Percent of
Procurement
Cost
Demand
management
Minimized duplication,
planning system, demand-
driven ordering (clinical
guidelines, etc.)
2% to 4%
Order
management
Consolidated purchasing,
paperless order management
(EDI, Internet)
2.5% to 4%
Supplier
management
Supplier consolidation,
optimal direct-from-
manufacturer implementation,
compliance with GPO
agreements
0.5% to 2%
Logistics
management
Consolidated service center,
integrated transport network,
capacity utilization
0.5% to 2%
Inventory
management
Automated point-of-service
distribution, replenishment,
non-stock items, reduction in
SKUs
0.5% to 1.5%
Overall cost-savings from Supply Chain Management 6% to 13.5%
Source: Pricewaterhouse Coopers, 2000
(URL: http://www.emarketer.com/images/chart_pdfs/020001-
021000/020410.pdf)
For the Health Care Supply Chain, these supply chain
management areas are elaborated below:
Demand Management. Managing consumption of clinical
resources is key to controlling demand and reducing the
number of supplies that move through the supply chain
process. Three practices need to be implemented in this
regard: 1) demand needs to be forecast and a plan
implemented to facilitate fulfillment of supplies on a
periodic basis, 2) standardization of supplies so as to
deliver them as a single unit of inventory, and 3)
development of clinical guidelines to define supply
requirements for key patient groupings.
Order Management. Initiating effective order management
practices:
• Establishing standard order management processes.
• E-procurement through Web or electronic data
interchange.
• Implementation of electronic product numbering and
tracking process.
Supplier Management. Some of the key ingredients of an
effective supplier management process are as follows:
• Reducing the number of suppliers that provide product
to the healthcare system.
• Establishing and participating in group purchasing
contracts to take advantage of discounts and rebates.
Logistics Management. Integrated logistics management
that exploits efficiencies offered by consolidation of
shipments, utilization of service centers and transportation
network, and cross-docking in transportation of goods.
Inventory Management. Reducing the storage space,
minimizing stock keeping units and their stocking levels,
and maximizing inventory turnover rates can achieve
integrated management savings. One of the key enabler of
this policy is reducing variability among common products
through standardization initiatives.
4. E-Health Care Supply Chain: Business
Trends, Initiatives, and Model
E-Healthcare can be described as the transition of
healthcare business and patient-related processes and
transactions into the Internet-delivered electronic
information superhighway. The concept of e-health as it
evolves, refers to the use of Web-enabled systems and
processes to accomplish some combination of following
objectives: cut costs or increase revenues, streamline
operations, improve patient or member satisfaction, and
5. 5
contribute to the enhancement of medical care (Bose,
2003).
According to a study published by Forrester Research, the
Internet healthcare industry in the U.S. will become a $370
billion business by 2004. Firms will organize around a
healthcare e-business network that will serve consumers,
providers, distribution chains and payers (Dembeck, 2000).
According to this study, “Eight percent of retail health
sales will move online.” Health e-tailers such as Rx.com
and Vitamins.com will experience retail growth to $22
billion in 2004.” The real growth in e-healthcare, however,
will be in the business-to-business segment, which the
study predicts will soar to $348 billion in 2004. As online
business trade gains momentum, 17 percent healthcare
business transactions will move online by 2004.”
Forrester’s analysis of the consumer e-Commerce
healthcare market projects healthy growth in on-line trade
for -- non-medication health and beauty aids, over-the-
counter non-prescription drugs, natural health cures, and
prescription drugs.
According to this study, both large institutions and small
medical practices will turn to Net players, such as
Embion.com, Medicalbuyer.com and Medibuy.com to
simplify procurement of medical supplies, thereby driving
Internet efficiencies into the distribution chain. As a result,
the study predicts that cost-conscious hospitals will move
24 percent of their purchasing online by 2004. Meanwhile,
as more doctors get connected to healthcare networks, 12
percent of private practices will conduct their procurement
online by 2004.
E-Health Care initiatives. In the healthcare industry, web-
enabled applications under development include products
for: claims handling; physician practice management
systems; online prescriptions; and electronic clinical and
financial data interchange for hospitals, physicians,
pharmacies, managed care organizations and commercial
and hospital laboratories. Other applications include:
patient-centered systems; solutions for chronically ill
patients; finance and accounting programs for hospitals
and other health agencies; medical supply purchasing;
health and medical web portals; managed care organization
provider directories; health promotion and disease
prevention; provider credentialing; risk management; case
management; and practice management.
The move to Internet-based programs and services should
result in savings for employers, insurers, managed care
organizations and government-sponsored programs
because of the significant cost-saving opportunities, such
as better price comparisons, lower inventory costs, and
more efficient health system-wide communications, patient
information management and billing and claims handling
(Nugent 2000).
There are a number of companies engaged in e-healthcare
efforts - AmericasDoctor.com, Health-Central.com, The
Health Network, MedicalRecord.com, PlanetRx.com,
Shared Medical Systems, etc. Hospital-sponsored Web
sites, e-mail and discussion groups are becoming part of
health care organizations’ Information Technology (IT)
functions.
E-Health Care Supply Chain Model. The emergence of
digital business value chains in the healthcare industry will
lead to a trend for its supply chain management. The
technology that is already available to integrate Web front-
end interactions with back-office systems include,
packaged Web modules, “middleware” and tools to build
customized transaction systems, Web-based EDI, Web-
based electronic marketplaces, and many electronic
catalogs. This type of network connection allows the
consumer to go directly to the system of choice to design,
configure, and arrange for shipment or availability of the
final product or service of choice. This ability is the result
of an Extranet, linking partners in supply chain to
necessary information on-line. An Intranet is used to link
technologies, business processes, and organizational
constituencies into a network that can display its offerings
to consumers over the Internet.
Figure 1 depicts a representative model of US e-Healthcare
Supply Chain proposed in Kumar and Chandra (2001),
showing linkages and flow (material and information)
between various business entities. The principal
participants in the US healthcare supply chain include:
manufacturers (drugs, medical equipment, and hospital
medical supplies), distributors, medical service providers,
medical groups, insurance companies, government
agencies (such as, Health and Human Services),
employers, government regulators, and users of healthcare
services.
5. Implementing the E-Health Care Model:
An IE/OR Perspective
For improving supply chain effectiveness, a decision
support system that integrates information technology with
Industrial Engineering and Operations Research techniques
is described below. It is built upon a generic methodology
proposed by Chandra and Grabis (2002), which
emphasizes commonality of general structure of problems
(such as identified in Table 2) across various industry
domains. The unique differences that are, however, found
in specific problem for a particular industry (for example
Health Care supply chain) can be represented by
parameters that uniquely set it apart from other problems
(in other industry domains).
6. 6
Manufacturers
Medical Equipment
Manufacturers
Pharmaceuticals
Companies
Distributors
G
Medical Equipment
- Prosthetic Devices
- Artificial Body Parts
- Wheel Chairs
- CT Scanners
- Laboratory Equipment
- ...
Pharmaceuticals
Health Care
Providers
Health Care
Professionals
- Doctors, Nurses,
Respiratory Thera-
pists, Dietitians,
Medical
Technologists,...
Health Care Facilities
- Hospitals
- Proprietary Clinics
- Nursing Homes
- Hospices
-Same-day-surgery
Centers
- Urgent Care Centers
G
Patients
Public and
Private
Payer
Systerms
G & S
Insurance
Companies
$
$
$
e-Commerce (using Internet/Intranet/Extranet)
$ $ $
Medicare
Medicaid
Employers
Government
Regulatory
Agencies
Legend:
G - Goods
S - Services
I - Information &
Directives
$ - Payments/
Reimbursements
Enforce Health Care Regulations
On Manufacturers / Distributors /
Health Care Providers
US Congress
Food & Drug
Administration
National Institute of
Health ...
Figure 1: A Representative U.S. e-Health Care Supply Chain Model (Source: Kumar and Chandra, 2001)
General approach. The decision support system consists
of two integral parts – information support system and
decision modeling system. The methodology consists of a
number of consecutive tasks including definition of the
supply chain management problem, generation of
alternative supply chain configurations, decision modeling
and final decision making as depicted in Figure 2. The
main tools utilized in order to accomplish these tasks are
supply chain process model, modeling database, decision
modeling system and supply chain knowledge library. The
modeling methodology is built around a unified
representation of the supply chain modeling problem. This
representation can be transformed in a number of different
formats suitable for accomplishing different modeling
tasks. An implementation of the decision support system is
developed on the basis of standard specialized software
tools. An Enterprise Resource Planning software (SAP/R3,
developed by SAP Inc., Germany) provides data storage
support. ARIS (developed by IDS-Scheer Inc., Germany)
is used in process modeling. MS Excel (developed by
Microsoft Inc., USA) is used as a core component of the
decision model. It invokes packages such as LINGO
(developed by LINDO Systems, USA) and ProMODEL
(developed by Pro Model Inc., USA) for solving of
specific Linear Programming and Simulation modeling
tasks, respectively.
7. 7
For the Health Care industry, a supply chain management
problem may pertain to supplier selection, demand
management, order management, inventory control issues
etc., as described in an earlier Section. Alternative supply
chain configurations may identify a supply chain
representation that recognizes availability of alternative
health care suppliers, based on criteria such as lower cost,
quality, material specifications, etc. A decision model will
comprise of a problem representation, problem-solving
algorithm(s) and parameters associated with the specific
problem under study. A process model for a selected
health care supply chain configuration will explicitly
define processes (or activities) for all business entities such
as, manufacturers of medical supplies, component
manufacturers, wholesalers/distributors, health care
providers, and patients (along with their characteristics
captured as attributes and associated variables and
parameters), from supply to demand stages. A health care
supply chain knowledge library will represent the
knowledge captured for supply chain configurations
specific to a problem domain. This knowledge can be
reused when problems with similar features are
encountered in the future.
The unified representation of the supply chain problem
assures data integrity. Modeling results are stored in the
supply chain modeling database and are available to aid
solving supply chain modeling problems with similar
poperties. Sharing of the modeling database over the
Internet provides supply chain members with access to
data. Utilization of generic decision models reduces
modeling resource requirements and allows direct
comparison of multiple configurations.
Informal description
of supply chain
modeling problem
Supply chain
kernel
Development of
supply chain
process model
Process
model
Conversion
process model
into data base
format
Supply chain
modeling data
base
Generation of
tentative supply
chain
configurations
Suppliers’ data
base
Tentative supply
chain
configurations
Supply chain
decision modeling
Supply chain modeling
problem definition
Final decision
making
Final decision
Supply chain
modeling data
base
Modeling
results
Supply chain
knowledge
library
Figure 2. The proposed modeling methodology (Source:
Chandra and Grabis, 2002).
5.1. Modeling methodology
The proposed methodology systematically
evaluates a specific problem by designing, modeling, and
analyzing it according to its context in relation to the total
enterprise represented by a supply chain entity. The step-
by-step problem evaluation adopted in this methodology is
described below.
Process model & modeling database. An initial state of
modeling is either a current supply chain, which should be
reconfigured, or a product or service specification, for
which a supply chain is needed. The initial state generally
is described in an informal manner. A supply chain kernel
provides the template describing data requirements for the
formal supply chain problem definition. Supply chain
models are developed using the kernel data. Development
of a supply chain process model is the next step of supply
chain modeling. The process model provides an exhaustive
representation of the general supply chain management
problem. It provides input data for other supply chain
models. Therefore, construction of the process model
follows a set of rules elaborated to provide a consistent and
generalized representation of the supply chain (Chandra
and Marukyan 2002), which can be transformed in other
required data processing formats. The process model
describes the initial supply chain management problem
referred to as the base configuration. The process model
development is accompanied by creation of a supply chain
modeling database. This database is used to store and
disseminate the definition of the supply chain modeling
problem and modeling results. The database is created
using a template of the standardized supply chain
modeling database model (Chandra and Chilov 2001). The
database is created using data extracted from the process
model.
Tentative configurations. The proposed supply chain
modeling methodology is primarily aimed at dealing with
a class of problems involving supply chain
reconfiguration. This includes evaluation of alternative
supply chain configurations generated using information
from the suppliers’ database. Tentative configurations are
stored in the supply chain modeling database, where they
are identified as alternative configurations to the base
configuration.
Decision modeling. Selected tentative supply chain
configurations are evaluated using the decision modeling
system. The decision modeling system emulates
consequences of adoption of particular supply chain
configuration and management policies. Each tentative
configuration representing the supply chain modeling
problem is retrieved from the decision modeling database.
The relational representation of the supply chain modeling
problem is transformed into a format readable by decision
8. 8
model components. This format uses incidence matrices to
represent the supply chain modeling problem. A
simulation model is a major part of the decision modeling
system. The simulation model is designed using the
generic modeling approach (Chandra et al. 2000, and
Chandra and Grabis 2001), which is particularly well
suited to deal with modeling of variety of supply chain
configurations. Each configuration is evaluated under a
number of different scenarios. A scenario describes
different supply chain management policies,
environmental and system parameters. Obtained results are
stored in the database.
Decision making & knowledge accumulation. After the
decision modeling process is completed with all tentative
supply chain configurations, the modeling database stores
a large number of alternative solutions to the initial supply
chain management problem. A management problem is to
find a decision to be implemented. The problem is
exacerbated by the fact that not all factors can be
adequately represented in models and several solutions
may yield similar performances. This decision making can
be assisted by utilization of an enterprise knowledge
library.
If the decision modeling process is repeated routinely, then
enterprise level supply chain modeling knowledge is
accumulated in the modeling database. This accumulated
knowledge is used to create the knowledge library, which
stores information about management problems solved,
alternative configurations considered, obtained modeling
results, implemented decisions and implementation
appraisal. The decision implementation appraisal is the
crucial step to assure usability of accumulated knowledge.
New decisions can be matched to stored decisions and
those which are likely to yield unsatisfactory
implementation results, can be filtered out using the
appraisal criterion. The knowledge library is built utilizing
the concept of supply chain ontology described in Chandra
and Tumanyan (2002).
6. Conclusions
This paper has provided a comprehensive
discussion on various aspects surrounding the need,
efficacy, design, modeling, and implementation of a
Health Care Supply Chain. It has been proposed that the
Health Care industry can achieve efficiency in their
operations through adoption of technologies, standards and
practices, and proven models and methodologies
developed in the IE/OR fields which have been
successfully applied in many diverse industries for
managing supply chain logistics. The model and
methodology proposed in this paper should be validated
with specific problems encountered in the Health Care
industry in managing supply chain logistics. It is the next
logical step planned to extend this research.
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Health Care's Leading Group Purchasing Organizations,
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Biographical Sketch
Charu Chandra is an Associate Professor in Industrial and
Manufacturing Systems Engineering at the University of
Michigan-Dearborn. He is involved in research in Supply
Chain Management, and Enterprise Integration issues in
large complex systems. His Ph. D. degree is in Industrial
Engineering and Operations Research from the Arizona
State University. He is a Senior Member of Institute of
Industrial Engineers.
Swatantra K. Kachhal is Professor and Chair in Industrial
and Manufacturing Systems Engineering at the University
of Michigan-Dearborn. He is involved in research in
Operational issues in healthcare systems. His Ph. D degree
is in Industrial Engineering and Operations Research from
the University of Minnesota. He is the current President of
Society for Health Systems, a Fellow of Institute of
Industrial Engineers, and a Senior Member of HIMSS. He
has been a frequent presenter at SHS and HIMSS.