Healthcare Supply Chain Research Articles

The necessity of healthcare supply chain resilience for crisis preparedness.

Prior to and during the COVID-19 pandemic, Canadian provincial health systems and governments did not sufficiently consider healthcare supply chain in their crisis preparedness plans, leading to an exposed and vulnerable healthcare system. There have been many opportunities to learn from past Canadian and global crises, which have emphasized the importance of healthcare supply chain resilience in providing essential care to patients; however, considerations of healthcare supply chain resilience remain a significant gap in preparedness planning. Illustrated through the Canadian response to COVID-19 pandemic, this article will explore how healthcare supply chain resilience should be a necessary consideration in any crisis preparedness plans. Further, without this consideration of healthcare supply chain resilience, it is the person (the patient and healthcare worker), and especially vulnerable populations, that are most put at risk in the event of a future crisis.

Supply chain risk management to achieve healthcare supply chain operational excellence: a fsQCA and PLS-SEM approach

PurposeHealthcare supply chains (HCSCs) face severe challenges when compared to regular chains. Besides avoiding bankruptcy, they must accomplish their goal which is to save lives. Since 2019 the COVID-19 pandemic evidenced that a HCSC disruption generates disruptions to other SCs. Therefore, the objective of this paper is threefold: conduct a systematic literature review to build a HCSC operational excellence (HSCOE) definition; build a conceptual framework by mapping the antecedents of HSCOE and formulate hypotheses; test the hypotheses using a fuzzy-Set Qualitative Comparative Analysis (fsQCA) combined with partial least squares structural equation modeling (PLS-SEM) techniques to obtain empirical validation.Design/methodology/approachGiven this context, this paper conducted a systematic literature review to build a HSCOE conceptual framework and used a fsQCA combined with PLS-SEM techniques to obtain empirical validation.FindingsThe paper revealed a relationship between important variables to achieve HSCOE, such as Supply chain 4.0, SC risk management, SC integration, SC resilience (antecedents) and HSCOE (consequent).Originality/valueThe literature contributions of this paper are as follows: validating a new scale for each of the constructs; finding evidence of the causal relationships between the latent variables; measuring how the constructs influence the HSCOE; in addition, the results address important literature gaps identified by researchers and serve as a guide to organizations that need to implement these practices. Furthermore, this study recommends that HCSC managers consider the implementation of robust initiatives concerning the latent variables presented in this work.

Case Study: Role of Supply Chain & Transportation in Food and Healthcare

This case study delves into the indispensable roles of supply chain and transportation networks in the pivotal sectors of food and healthcare. These domains are not only vital for our well-being but also profoundly impacted by dynamic market forces, evolving consumer preferences, and global events. In the food sector, the journey from field to fork is a complex web of growers, manufacturers, distributors, and retailers. It must strike a delicate balance between delivering a diverse range of products while ensuring safety, freshness, and sustainability. Conversely, the healthcare sector demands an entirely different level of precision. The timely availability of life-saving medicines, medical equipment, and personal protective gear is non-negotiable. The efficiency of healthcare supply chains can be a matter of life and death. Recent challenges, from pandemics to vaccine distribution, have illuminated the need for agile healthcare supply chains and robust transportation networks. This case study will explore the critical challenges faced by these sectors, innovative solutions that have been devised to address them, and the profound lessons learned in the pursuit of building more resilient, efficient, and responsive supply chain and transportation systems.

A Blockchain-Based Approach for Drug Traceability in Healthcare Supply Chain

Abstract: Healthcare supply chains are complex structures spanning across multiple organizational and geographical boundaries, providing critical backbone to services vital for everyday life. The inherent complexity of such systems can introduce impurities including inaccurate information, lack of transparency and limited data provenance. Counterfeit drugs is one consequence of such limitations within existing supply chains which not only has serious adverse impact on human health but also causes severe economic loss to the healthcare industry. Consequently, existing studies have emphasized the need for a robust, end-to-end track and trace system for pharmaceutical supply chains. Therein, an end-to-end product tracking system across the pharmaceutical supply chain is paramount to ensuring product safety and eliminating counterfeits. Most existing track and trace systems are centralized leading to data privacy, transparency and authenticity issues in healthcare supply chains. In this article, we present an Ethereum blockchain-based approach leveraging smart contracts and decentralized off-chain storage for efficient product traceability in the healthcare supply chain. The smart contract guarantees data provenance, eliminates the need for intermediaries and provides a secure, immutable history of transactions to all stakeholders. We present the system architecture and detailed algorithms that govern the working principles of our proposed solution. We perform testing and validation, and present cost and security analysis of the system to evaluate its effectiveness to enhance traceability within pharmaceutical supply chains.

A literature survey on healthcare supply chain management

Supply Chain Management (SCM) is a practice that has rapidly spread across industries. SCM may boost output while simultaneously satisfying customers. Despite SCM's recognition as a key factor in enhancing healthcare efficiency, widespread adoption remains in its infancy. Hospitals, a crucial element of the healthcare supply chain (HSC), have failed to fulfill the primary goals of lowering costs and providing high-quality treatment due to their inadequate knowledge of supply chain management (SCM). This research was conducted to fill in the blanks in the current HSC literature. Achieving the healthcare supply chain's goal of reducing costs will be greatly aided by the thorough literature study completed for this report. This review of healthcare supply chain management can quantify the benefits of supply chain initiatives and identify opportunities for improvement. Healthcare institutions can make informed decisions on optimizing their supply chains by understanding customer and supplier needs. This includes making strategic decisions on how to improve inventory management, streamline processes and reduce costs. The focus of this study is on the relationship between supply chain practices, the efficiency of supply chain performance, and the financial outcomes for healthcare organizations. By highlighting certain key research issues that are shared by supply chain management and healthcare management, this article contributes to the literature in both areas.

Relative bed allocation for COVID-19 patients, EHR investments, and COVID-19 mortality outcomes.

Managing flexibility in the relative bed allocation for COVID-19 and non-COVID-19 patients was a key challenge for hospitals during the COVID-19 pandemic. Based on organizational information processing theory (OIPT), we propose that the local electronic health record (EHR) systems could improve patient outcomes through improved bed allocation in the local area. In an empirical analysis of county-level weekly hospital data in the US, relative capacity of beds in hospitals with higher EHR was associated with lower 7-, 14-, and 21-day forward-looking COVID-19 death rate at the county-level. Testing for cross-state variation in non-pharmaceutical interventions along contiguous county border-pair analysis to control for spatial correlation varying between state variations in non-pharmaceutical intervention policies, 2SLS analysis using quality ratings, and using foot-traffic data at the US hospitals our findings are generally supported. The findings have implications for policymakers and stakeholders of the local healthcare supply chains and EHR systems.

The influence of artificial intelligence techniques on disruption management: Does supply chain dynamism matter?

Healthcare supply chains (HSCs) have been hard hit by disruptions such as COVID-19. Keeping pace during this interruption has been a significant challenge. HSCs' adaptability and collaboration using artificial intelligence techniques (AITs) have been recognized as key components of supply chain resilience for managing disruption. The current study aims to investigate how AITs might help improve HSC resilience (HSCR) by facilitating improved adoption and collaboration throughout its operation. Data was collected from the Indian healthcare sector and analyzed using the partial least squares structural equation modeling (PLS-SEM) technique. Additionally, an examination was conducted to determine the potential moderating role of supply chain dynamism (SCD) on the adoption and cooperation of HSCs with HSCR. The research shows that AITs encourage HSC adaptability and collaboration in their operations and that HSCR results from both factors. Moreover, SCD does not moderate the link between HSC adoption and HSCR but does moderate the link between HSC cooperation and HSCR. By enhancing HSC adaptability and effective collaboration with AI-enabled systems, AITs may help HSC stakeholders deal with disruptions in healthcare sector operations.

Environmental strategies for a healthcare system with green technology investment and pandemic effects

Today the healthcare industries struggle to cope with the ecological and social challenges for their customer services even while we are entering into a post-pandemic economy. Hospitals are quickly running out of essential medical supplies and firms are fraught to keep up with the rise in pent-up demand due to ongoing supply chain issues caused by the troubles from the pandemic. Therefore, we must design a sustainable inventory strategy for managing the healthcare supply chain (HSC) to ensure customer service and net-zero economy. This study explores sustainable inventory policies in a pandemic situation while considering the transport cost as proportional to COVID-19 intensity. We assume that the pharmaceuticals items have a predictable shelf-life and demand rate directly relates to the effectiveness of the investment in service facilities. The model incorporates the carbon emissions during the activities of transport, production, and storage, which are intended to be cut by green investment. The proposed scenario is modeled as an optimization problem and a solution approach has been designed for finding the sustainable inventory strategies such as order lot-size, delivery lead time, amount of green and service investment with the objective of reducing CO2 and overall cost. Key managerial insights into the influence of pandemic are extracted through the study of numerical and sensitivity. The suggested model is validated in the healthcare sector. The novelty of this research is examining the effect of green investment and COVID-19 pandemic on HSC. This work also reveals how green technology can play a vital role in managing the HSC issues caused by the pandemic in the post-COVID-19 environment.

The promulgation of group purchasing organizations into the healthcare sector in India

PurposeThe promulgation of group purchasing organizations (GPOs) into the healthcare (HC) sector is an invaluable procurement strategy to manage the suppliers effectively. This study aims to identify and prioritize the factors of integrating GPOs into the HC sector on the perspectives of the developing countries such as India.Design/methodology/approachThe factors are identified from current literature exploration, experts’ support and experience surveys. The factors are scrutinized and shortlisted using the Delphi technique and analysed further using the best-worst model method.FindingsThe findings of the study highlight the cost reduction, fair distribution of savings and healthcare supply chain (HCSC) data standardization among others to be the most prioritized drivers. The consulting services provided by GPOs including training and development as a result of high competitiveness in the HC market has been prioritized the least.Practical implicationsThe study bears some important implications for decision and policymakers. The managers should consider factors, namely, cost reduction, fair distribution of savings and HCSC data standardization on a priority basis that acts as motivation for the HC providers to join the GPOs.Originality/valueThe study provides valuable insights for HC providers to participate in the GPOs for cost savings and enhance the performances.

Predictors of medicine redistribution at public healthcare facilities in King Cetshwayo District, KwaZulu-Natal, South Africa

BackgroundEffective pharmaceutical inventory management is essential for optimizing healthcare outcomes and supply chain performance. However, challenges such as stockouts, overstocking, and wastage can hinder this process. This study examines the interrelationships between overstocking, stockouts, and wastage in eight healthcare facilities in Northern KwaZulu-Natal, South Africa. It also explores the extent of these challenges and investigates the use of medicine redistribution as a strategy to address inventory management issues.MethodsA retrospective quantitative analysis was conducted using pharmacy inventory records from public healthcare facilities. Eight facilities, including hospitals and a community healthcare center in King Cetshwayo District, were purposively sampled. Linear regression analysis was used to examine the association between medicine redistribution as the outcome and the predictors - stockouts, overstocking, and wastage. Pearson’s correlation was utilized to evaluate associations between the predictors. Descriptive statistics were employed to quantify the levels and extent of overstocking, stockouts, and wastage related to expiry.ResultsThe study included eight healthcare facilities with pharmacy warehouses managed by pharmacists. A total of 392 medicines were analyzed (49 per facility). Stockouts affected 85.6% of medicines, while overstocking and expiry-related wastage impacted 50.6% and 15.2% of medicines, respectively. The most common stock-out medicines were salbutamol 200mcg inhalant (4.0%), paracetamol 500 mg tablets (3.5%), and azithromycin 500 mg tablets (3.3%). Overstocking, stock with short-dated expiry, and expired medicines explained 68% of redistribution transactions to other facilities (r² = 0.68). A moderate, statistically significant correlation was observed between overstocking and expiry-related wastage (r² = 0.47, p-value = 0.020). Stockouts had a weak correlation with redistribution, accounting for only 4.5% (p-value < 0.01). A weak correlation was found between stockouts and overstocking (r = 0.10), as well as between stockouts and expired medicines (r = -0.20).ConclusionThis study highlights significant challenges in inventory management, particularly regarding stockouts, overstocking, and expiry-related wastage in the evaluated healthcare facilities. Medicine redistribution emerged as a viable strategy to address these challenges. Improving inventory management practices and implementing targeted interventions are crucial for optimizing pharmaceutical supply chain performance and enhancing healthcare delivery outcomes in this setting.

Examining the influence of industry 4.0 in healthcare supply chain performance: Moderating role of environmental dynamism

Healthcare supply chain management (HCSCM) is a network of different systems, tools, and processes. This system works in a seamless manner to ensure healthcare related materials such as medicines, hospital supplies, and so on. These materials are manufactured in the firms, distributed through agents, and eventually reach patients on time. During COVID-19, HCSCM was severely impacted in many countries. Many patients had to face severe difficulties during the pandemic. But post pandemic and after the adoption of several modern technologies like Industry 4.0, the performance of HCSCM was more reliable. Not many studies are available which have examined the influence of Industry 4.0 in HCSCM during such a crisis. In such context, the study aims at examining the influence of Industry 4.0 in HCSCM with moderating role of environmental dynamism. A conceptual model is proposed with the support of theories and literature. This was later validated by PLS-SEM approach considering 312 respondents from people of HCSCM system. The study ascertained that Industry 4.0 has greatly improved the performance of HCSCM system after COVID-19 crisis. In addition, this study highlighted that environmental dynamism has a significant moderating role on the linkage between adoption of industry 4.0 technology with HCSCM.

The effects of COVID-19 on domestic and international security in democratic and authoritarian regimes.

While numerous studies have examined how the COVID-19 pandemic has affected health care systems, supply chains, and economies, we do not understand how the pandemic has impacted the security of democratic and authoritarian states from a global standpoint. Thus, this study examines how COVID-19 has affected the security of democratic and authoritarian regimes. In conducting a historical, qualitative review of the security effects of the pandemic, we find that COVID-19 significantly affected domestic and international security for democratic and authoritarian states in both similar and varied ways. Additionally, the manner in which states responded to the pandemic was often conditioned by their regime type and by the nature of the governing leadership during the pandemic. These findings have important implications in considering how COVID-19 affected the security of democratic and authoritarian states, how regime type shapes government responses to infectious disease outbreaks, and how democratic and authoritarian states may respond to future pandemics.

Optimizing Hospital Services: Implementing Healthcare Supply Chain Management through MERN Stack Web Application

This paper offers a new approach to hospital service optimization that seamlessly incorporates concepts from healthcare supply chain management. Using the advantages of MERN stack technology, we are developing a dynamic web service that connects hospitals in real time and expedites patient transfers. By addressing the pressing need for efficient supply chain management in the healthcare sector and by offering features like virtual consultations and organ transplant search capabilities, this system enhances patient care and accessibility. By putting this into practice, we intend to improve and elevate the standard for hospital treatment. This paper offers a new approach to hospital service optimization that seamlessly incorporates concepts from healthcare supply chain management. Keywords- Supply Chain Management, Healthcare Service Delivery, MERN stack, Real-time data processing, Patient Transfers, Predictive Analytics, Patient-Centric Care, Efficiency, Seamless Coordination, Fast Connectivity

A Review on the Healthcare Supply Chain Management in Transforming Hospital Services

The aim of this paper is to present a novel idea to revolutionize hospital services by integrating healthcare supply chain management principles. By using a web application which enables hospitals to establish a real-time connection and streamline patient transfers. Many sectors focus on supply chain management optimization and qualifications to construct a better network of suppliers for their end consumers. Especially in healthcare sector, not only for pharmaceutical products but also for hospital materials, supply chain management gets importance for service quality and patient satisfaction. Thus, there are many studies about supply chain management in healthcare to emphasize its importance. In this study it is aim to put forward more review of existing solution on healthcare management system and patient transfer. Keywords- Supply Chain Management, Healthcare Service Delivery, MERN stack web application, Real-time data processing, Patient Transfers, Predictive Analytics, Patient-Centric Care, Efficiency, Seamless Coordination, Fast Connectivity

A Smarter Way to Procure: Exploring the Use of Smart Contracts

Purpose:This article delves into the transformative potential of smart contracts in revolutionizing procurement within supply chain management, with a special focus on the healthcare industry. In line with the challenges posed by complex procurement processes, the study explores how self-executing digital contracts can enhance efficiency, security, and transparency. Theoretical framework:The article is grounded in the concept of smart contracts and their applications in procurement, serving as a bridge between emerging technology and supply chain management innovation. It draws upon an extensive body of literature and research related to smart contracts, supply chain management, and technology adoption. The study is designed to build upon this theoretical foundation, using two comprehensive case studies to provide real-world insights and practical applications. These case studies, situated within the healthcare industry, serve as tangible examples of how the theoretical concepts surrounding smart contracts manifest in actual procurement processes. Design/methodology/approach:To investigate the application of smart contracts in healthcare procurement, we employed a qualitative research approach. This encompassed an extensive literature review of academic papers, industry reports, and relevant articles, uncovering the unique advantages and challenges in procurement &amp; supply chain management. Building upon these findings, we developed a groundbreaking smart contract-based procurement system, presented through sequence diagrams. To validate our solution, we implemented and rigorously tested it within a real-world Ethereum environment. Findings:Our research reveals that integrating smart contracts into procurement processes results in streamlined operations, diminished reliance on intermediaries, and heightened transparency and traceability. Moreover, the proposed solution showcases significant potential for enhancing procurement efficiency in the healthcare sector. Research, Practical &amp; Social Implications: These findings present valuable insights with far-reaching implications and hold substantial implications for stakeholders. Healthcare organizations can harness smart contracts to optimize their procurement procedures, yielding improved efficiency, transparency, and security. In a rapidly digitalizing landscape, our research empowers companies to maintain their competitive edge while delivering enhanced value to partners and customers. Originality/value:This article contributes significantly to the existing literature by offering a comprehensive examination of smart contract integration within procurement function, set within the broader context of supply chain management. It introduces a pioneering solution and provides a validated methodology, paving the way for in-depth exploration of smart contracts' impact on diverse stakeholders across healthcare supply chains

Role of Supply Chain Management in Quality of Healthcare Services

Healthcare organizations in Haryana (Kurukshetra) face many supply chain management challenges that can be addressed through effective operational and management decisions. The aim of this paper is to examine the supply chain management of healthcare quality in developing countries, particularly in rural healthcare in Haryana (Kurukshetra), and to consider demographic variables such as gender, age, education level and healthcare experience. Design and Hypothesis Testing Approach Distributed 500 questionnaires to determine the impact of aspects of supply chain management on the quality of health services. 27 of his seven procurement officers and administrative staff in Kurukshetra Haryana. The primary method was to collect data from 73 rural health managers and procurement managers to identify the quality and size of health services. The results of our study show that a combination of timely delivery of health products, specifications, level of health product providers and safety in the rural health sector of Haryana (Kurukshetra) is related to the quality of health services. The scope of this article focuses on employing appropriate human resources and highly trained professionals in supply chain departments to improve the quality of health services in the supply chain. As a practical contribution, this article can help healthcare supply chain managers and organizations do their jobs better or create a competitive advantage by addressing the issues and challenges facing individual healthcare managers, organizations and their partners.

Strategizing the online healthcare supply chain management in rural areas: A study of critical success factors

AbstractOnline healthcare supply chain management (OHCSCM) in rural areas is a matter of concern and is susceptible to policy changes, especially after the alarms raised by the COVID‐19 pandemic. This study aims to develop an approach towards examining the state and building a framework for examining the OHCSCM in rural areas. The study develops a framework by integrating various theories and methodologies like stakeholders' theory, critical success factor (CSF) theory, triple bottom line theory, fuzzy set theory, evidential reasoning approach, and scenario analysis for identifying the dynamism among the CSFs. The developed framework helps prioritize the CSFs based on environmental, economic, and social perspectives. Further, the model helps create scenarios for decision‐makers to improve the understanding of the CSFs influencing OHCSCM and achieve sustainability. The study reveals that infrastructure development, security and privacy of data, and use of predictive tools are the top factors that need immediate attention. By recognizing the interdependencies and interactions between these factors, managers can develop a more comprehensive and integrated approach to OHCSCM in rural areas. This understanding enables them to identify potential bottlenecks, streamline processes, and optimize resource allocation, ultimately saving valuable time and resources for achieving sustainability in the online healthcare supply chain in rural areas.

Drivers and Barriers to Implementing the Internet of Things in the Health Care Supply Chain: Mixed Methods Multicase Study.

Over the past 2 years, the COVID-19 pandemic has placed enormous pressure on the health care industry. There has been an increase in demand and, at the same time, a shortage of supplies. This has shown that supply chain management in the health care industry cannot be taken for granted. Furthermore, the health care industry is also facing other major challenges, such as the current labor market shortage. In the literature, the Internet of Things (IoT) is highlighted as an effective tool to build a more resilient and efficient supply chain that can manage these challenges. Although using IoT in supply chain management has been extensively examined in other types of supply chains, its use in the health care supply chain has largely been overlooked. Given that the health care supply chain, compared to others, is more complex and is under growing pressure, a more in-depth understanding of the opportunities brought by IoT is necessary. This study aims to address this research gap by identifying and ranking the drivers of and barriers to implementing IoT in the health care supply chain. We conducted a 2-stage study. In the first, exploratory stage, a total of 12 semistructured interviews were conducted to identify drivers and barriers. In the second, confirmatory stage, a total of 26 health care supply chain professionals were asked in a survey to rank the drivers and barriers. The results show that there are multiple financial, operational, strategy-related, and supply chain-related drivers for implementing IoT. Similarly, there are various financial, strategy-related, supply chain-related, technology-related, and user-related barriers. The findings also show that supply chain-related drivers (eg, increased transparency, traceability, and collaboration with suppliers) are the strongest drivers, while financial barriers (eg, high implementation costs and difficulties in building a business case) are the biggest barriers to overcome. The findings of this study add to the limited literature regarding IoT in the health care supply chain by empirically identifying the most important drivers and barriers to IoT implementation. The ranking of drivers and barriers provides guidance for practitioners and health care provider leaders intending to implement IoT in the health care supply chain.

Vaccinating Health Care Supply Chains Against Market Failure: The Case of Civica Rx

Summary This article focuses on the value of introducing novel business models into health care to address market failures that are hurting people — delving deeply into learning from real-world examples within the generic drug supply chain and its failure to supply critical medicines reliably at a low cost. Some problems in health care are so complex that traditional private-sector or governmental interventions alone have not been able to solve the problems. In an original response to ongoing generic drug shortages, in 2018, seven U.S. health systems and three philanthropic organizations founded a novel not-for-profit drug manufacturer, Civica Rx, to address the issue. Civica is a new entrant in this supply chain and utilizes a new business model called a health care utility that prioritizes access over profit. The company has been scaled rapidly and now provides more than 75 critical medications that are most at risk for shortages to more than 55 health systems across the United States. This article provides the first empirical evidence of Civica’s effect on security and cost of supply for one of its member health systems by utilizing internal supply chain, pharmacy, and external market data between 2016 and 2022. Results show that Civica was able to improve generic drug access above the wholesaler model. Using data related to 55 Civica orders of 20 distinct products between 2020 and 2022, the authors estimate Civica’s fulfillment of its contractually guaranteed volume at 96% (95% confidence interval [CI] = 92%–100%), whereas data on 302 wholesale orders for the same products over the same period estimate the wholesaler order fulfillment rate at 86% (95% CI = 82%–90%); the difference between these rates is statistically significant (P = 0.03). In addition, through its reserve supply of product, Civica offered a product access benefit of a further 43% above the Civica-guaranteed minimum viable volume floor. Wholesaler prices, at the order level, were estimated to be on average 46% above the Civica price for the same product in the same year (95% CI = 27%–64%, N = 302), with a P value of the difference of less than 0.001. However, through optimizing its wholesaler orders by buying more volume when prices were low from the 62 different non-Civica manufacturers, this closed the actual achieved cost-savings gap between the wholesalers and Civica to 2.7% in aggregate, with Civica still being the lower-cost option.

Cyber-susiliency index: A comprehensive resiliency-sustainability-cybersecurity index for healthcare supply chain networks

Resilience, sustainability, and cyber-security are three measures in supply chains that define how robustly supply chains perform without disruption. Although these three measures can each be assessed separately and give us some idea of a supply chain’s capability, a combined measure of all three can provide a more holistic picture and comprehensive understanding of the system. To our knowledge, no attempt has been undertaken to formulate a combined measure. We utilized a data fusion technique called the Dempster Shafer (D–S) theory and developed a comprehensive assessment framework considering all three dimensions of resilience, sustainability, and cyber-security. Further, we combine these three measures into a single measure called the cyber-susiliency index. The proposed framework is applied to a healthcare supply chain and shows reasonable results. Yager’s recursive rule of combination further validates the D–S theory application. An index value is developed on a scale from 0 to 1, representing a numerical measure of the organization’s cyber-susiliency. The cyber-susiliency index for the healthcare supply case was calculated at 0.62 on a 1 to 0 scale.