مقاله سال ۲۰۱۶

As early as 2008, the Pricewaterhouse Health Research Institute reports more than $1.2 trillion out of $2.2 trillion spends on healthcare each year is a waste of money (Kavilanz, 2009). Failure of using standardized process costs the healthcare industry unnecessary waste (Dooner, 2014). A lack of cooperation from health care supply chain partners is cited as a major barrier in implementing cost effective standardized process in the healthcare industry (Nachtmann and Pohl, 2009). Lack of cooperation may stem from either a lack of or absence of collaborative framework among trading partners. As a matter of fact, Nachtmann and Pohl (2009) points out that 60% of survey respondents mentioned a lack of trust is a major barrier in achieving an acceptable level of collaboration among healthcare supply chain organizations. In spite of many studies claiming that use of supply chain tools reduce organizational costs, reduce cycle time and lead to higher performance without compromising quality (Elmuti, et al., 2013), the healthcare industry consistently lags commercial industry in implementing supply chain tools. For example, the healthcare industry still uses heavily less than truck load (LTL) transportation mode (60% of their transportation) which is more expensive and increase damages as it touches more frequently than truck load (TL) mode. The warehouse utilization rate in healthcare is 60–۷۰% of the capacity and inventory turns in healthcare is 2 whereas it is 44 for consumer electronic, 10 for automotive industry and 6 for consumer packaging goods (Dooner, 2014). Such an inefficient utilization of capital investment in inventory management only adds to the operating costs in the healthcare industry. According to one study, the logistics cost in healthcare is 38% of the total expense while the same is 5% for the retail industry and 2% for the electronic industry (Johnson, 2015). A possible reason for such a wide gap may include unique distribution networks that healthcare supply chain is employing due to group purchasing organizations (GPOs) and independent delivery networks (IDN) practices (Kwon and Hong, 2011). A recent study reveals that healthcare cost in this country is the biggest barrier to entrepreneurship investment (O’Marah, 2015).

Another area that healthcare supply chain is struggling with is a misunderstanding of the fundamentals of supply chain concepts. Healthcare supply chain has been mistakenly identified as purchasing and contract management as group purchasing organizations such as Novation and Premier dominate purchasing and contract management for providers. Recent information indicates that over 70% of healthcare spends is managed by GPOs. Their major role is to negotiate the best prices for healthcare providers and pay less or no attention to logistics related cost of the total package. Supply chain is more than purchasing and contract management. Nevertheless, the term “supply chain management” is often used by healthcare professionals without having a firm concept of this management tool. Often cited excuse is that “the hospital stands for humanitarian delivery of health care than cost containment” (Schneller and Smeltzer, 2006). It has become a function, not an end-to-end process (Cecere, 2014). A failure of understanding of supply chain principles may have led decision makers to narrowly defined supply chain concept (e.g. purchasing) leaving many other areas in supply chain unexplored or neglected resulting in suboptimal solutions. We submit that it is time to integrate commercial supply chain concepts with healthcare supply chain practices to reap potentials from supply chain operations.

The purpose of this paper is to explore and discuss strategic areas of supply chain in healthcare organizations in an effort to reduce spending (efficiency) and improve quality of care (effectiveness) within a supply chain management framework. This paper argues that efficiency and effectiveness coexist in supply chain as it creates supply chain surplus where extra resources so created will be diverted/reinvested into areas which benefits customers (patients). Strategic areas proposed in this paper will be divided into three broad fields; deeper understanding of supply chain concepts in healthcare, organizational process improvement and utilization of relevant supply chain functional tools.