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

2. 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

3. 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 …

4. 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

5. 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

6. 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

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

8. 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

9. 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

10. 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)

11. 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

12. Changing the Way Healthcare CONNECTS