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The past few months have created incredible challenges and changes in the healthcare supply chain. Since late January, unprecedented global demand and other factors have strained the supply of personal protective equipment (PPE) and other critical products. Many non-acute facilities have either stopped seeing patients because of government guidance to pause patient visits or surgeries due to COVID-19 or are leveraging technology, such as telehealth, to stay connected with patients.
Supply chain leaders, distributors and manufacturers have demonstrated new levels of collaboration and communication to build plans designed to best use available PPE supplies and get them where they are needed most. Overall, the entire supply chain has shown extraordinary flexibility and resiliency to meet the influx of COVID-19 patients.
Because of the challenges COVID-19 has presented, there is no longer a “normal” healthcare setting. Adapting requires different thinking, looking at new sources of supplies and a focus on building stronger, more collaborative connections between manufacturing, distribution, supply chain and clinicians. While much of the road forward is uncharted, there are three things to consider that may help alleviate stresses for the supply chain and clinicians.
PPE demand has increased as much as ten times over the historical demand. Additionally, physician offices, long-term care facilities and nursing homes, which have not traditionally used many masks and gowns, now need more PPE to keep their staff and patients safe as they serve vulnerable populations.
Project Airbridge, coordinated by the Federal Emergency Management Agency, demonstrated the agility of the supply chain as distributors came together to get PPE products, thermometers and masks into the
supply chain more quickly and to hot spots designated by the Centers for Disease Control and Prevention.
“I was so proud of the healthcare distribution industry when I saw the loading and unloading of the planes, transferring the medical supplies to our trucks and distributing all the way to front-line providers in a matter of days,” said Greg Colizzi, vice president of marketing for health systems at McKesson. “It was incredible to see supplies arriving in days versus the standard six to eight weeks by boat.”
These types of heroic efforts are intended to help the hardest-affected facilities get the supplies they need to care for patients and keep staff safe. Even with Project Airbridge, the reality is that not all providers can get the PPE they want right now because there are still supply chain constraints. However, using a trusted distributor helps to ensure supply chain integrity.
As healthcare systems scramble to acquire the products they need, they also need to be careful about where they source products, given the increase in counterfeit products and scams.
“Everybody is seeking any channel they can find to secure products to meet patient needs,” Colizzi said. “Unfortunately, we’ve heard of providers trying to do their own sourcing only to get a load of unusable supplies. Without the proper quality checks in place, this may open the door to liability risk when it comes to patient and staff safety.”
“We have dozens of teams all across the globe who understand the regulatory requirements and the quality of products required for healthcare settings,” Colizzi said. For example, he noted that McKesson vetted more than 85 mask companies and found that only a few had a quality standard high enough for healthcare.
Lab manufacturers have worked at unprecedented speed to break down the COVID-19 virus and develop testing capabilities that enable providers to screen for the virus. Early identification and treatment of patients can greatly improve outcomes and minimize the spread. The use of molecular and antigen testing can provide early screening options where serology can identify the presence of the antibody. The development of these tests and approval by FDA continues to make for a very fluid dynamic. Many of the tests are in the early stages of production but volumes are expected to ramp up quickly over the coming months.
“As the lab testing environment continues to evolve, it’s important to work closely with your distributor and manufacturer to understand product availability which can help inform your patient care planning,” Colizzi said. “The availability of testing and supplies will continue to be constrained, however, we do see a light at the end of the tunnel with new tests being approved and production volumes increasing.”
He also noted the testing environment can be challenging to follow because it requires marrying the approved tests with the appropriate readers or analyzers. Due to manufacturing constraints, some lab manufacturers are allocating products to those providers who already have the diagnostic machine that runs the tests. Health systems can work with their lab distributor to identify which analyzers or readers they have that can run the new COVID-19 tests.
“We’re getting more information daily,” Colizzi said. “We have a team of lab experts investigating opportunities and working with several lab manufacturers.”
Given the complexity of ensuring tests meet emergency use authorization (EUA) approval and that the facilities have the infrastructure to process the tests, Colizzi recommended providers work with a trusted source that can consult with them on their testing infrastructure before purchasing tests.
Even as cities and states emerge to a “new normal,” it is clear many aspects of healthcare will have changed, perhaps permanently. One health system estimated that to get back to business it would need more than 200,000 masks and more than 120,000 gowns per month. This is above and beyond pre-pandemic demand for its non-acute facilities.
“The experience of patients, the way workflows are set up, PPE requirements — all those things are changing,” said Scott McDade, general manager of health systems at McKesson. “In the interest of safety, we expect to see an increase in home health services so that patients can be comfortable and separated from other highly vulnerable patients. We’ve also seen an incredible increase in telemedicine. Many patients who need treatment are becoming more comfortable with virtual appointments.”
Because the situation is relatively new for most and changing rapidly for all, providers will need to map out what the product demand will be for the fall and winter. It could potentially be a bad respiratory season for flu and COVID-19 as well as usual wintertime illnesses, such as RSV and strep. Providers should also consider what might be required to treat patients with post- COVID-19 complications. As patients recover, they could have longer lasting side effects. “Providers should also be looking closely at post-patient care product needs like oxygen concentrators, nebulizers, pulse oximeters, home infusion pumps and PPE equipment,” McDade said.
“From a supply standpoint we are looking at the entire respiratory season. We are working with providers to help them build a comprehensive plan. We’re anticipating high demand for flu and pneumonia vaccines. It will be really important to have a flu vaccine program in place,” McDade said.
Still, even with good demand planning and demand budgeting, it is likely supply will remain tight. “I think people need to make sure they’re having realistic open dialogues with their distributor and wholesale partners,” Colizzi said. “Making sure they are strategically mapping out what the product demand will look like to thoughtfully and strategically increase projected product usage without hoarding.”
As the backbone of healthcare, the supply chain will always play a critical role delivering the products healthcare providers need to protect the safety and health of healthcare workers and patients. While this has been a challenging season for healthcare, it has been amazing to see the resiliency and innovation of supply chain personnel as they support the COVID-19 response.