Healthcare Product Supply Interoperability Cross-domain discussion Presented by Jose Costa Teixeira

Healthcare Product Supply Diagnosis or therapy usually requires products: Medication, devices, consumables, nutrition products… These products are explicitly requested or implicitly expected. But a lot has to happen in the background for this to happen Clinical workflows are not isolated from the management of these products and their supply and lifecycle (availability, traceability…) We propose to handle the interoperability concerns of supply of health products

Example Use Cases Management of inventory, expired products… Traceability What items/batches have been given to patient X? Which patients have been given batch ABC? When ordering a product, physician considers availability …

Opportunity Increasing awareness – traceability for patient safety, counterfeit drugs, operational efficiency There are norms and guidance (e.g. GS1, HL7…) Supply seems a side concern for most profiles Pharmacy has an intrinsic concern – Usually pharmacies handle most materials, not only medication. Other domains have their workflow – This diversity should be respected IHE Pharmacy is outlining a vision, and does not want to go alone Only by bridging to other domains can improvement be optimal: For the patient For the institutions

Goal Define an interoperability framework for supply, enabling: Better patient safety by better information Better management of operations Close the gap between supplier and patient Enable healthcare processes to be compatible with supply solutions and best practices Integrate supply of medical products with the rest of enterprise interoperability

Integration with a clinical process (example) Clinical path Order Processing / validation Preparation Administration Transport, inventory mgmt, product identification Besides supporting the procurement, purchase, labelling, distribution and preparation… We can also integrate these concerns into the “clinical” process. Purchasing… Purchasing… Materials path

Inside / outside logistics For IHE, focus on the enterprise (institution, or group of institutions). Articulate with – not redo – the supply mechanisms outside the institution

Scope Supply (e.g. of medication) Supply of Healthcare products Supporting all expected distribution rules Nominal/bulk dispense, consignment, ordered or ad-hoc Supply of Healthcare products Medication (obvious need) Supporting / Extendable to all expected product types Medical devices Nutrition products Other consumables Non-traceable, batch- or serial-traceable. Support other products and flows beyond “order” or “prescription” Articulate with formulary / catalog; articulate with billing Analyse (keeping flexibility) product coding, barcoding, RFID… Enable best practices, not depend on them Gather much existing knowledge into applicable guidance

Scope exclusions Should not define rules like “How to calculate ideal stock levels” => concepts like “refill when stock reaches minimum” are use cases, not design constraints. Assuming them as universal would harm the model Should not hardcode other business rules that may change with Location Regulation Product type Defining a business model is out of scope. We should provide support for communication. “Anchor” or limit any freedom from supply chain or data is not good for interoperability - innovative models or views will exist and should be supported. Should not replace formulary or catalog of items/services. Must not enforce or block any billing options

Use Cases “Simple” order – supply (e.g. medication) Forward and reverse traceability Extra: support product recall Internal redistribution (inventory balancing) Product replacement In daily operations due to shortage After new purchase contract Give the prescriber visibility about supply Determine whether supply is limited (easy for medication, more complex for long lead time products, or perishable items)

Business Vision Full bidirectional traceability Identify shortage before ordering Predict shortages before they happen Review purchasing based on actual consumption Allowing finer-grained forecasts? Easy and safer identification of the right product

Changing the Way Healthcare CONNECTS http://www.ihe.net