1st place submission in the SCAN Health Virtual Business Case Competition 2021 by Zaryab Ahmed, Abhinav Bhatnagar & Tyler Boulanger from McMaster University (Canada)

Executive Summary

The Canadian healthcare system involves an intricate network of key stakeholders that provide funding and support at various levels of the healthcare value chain. On average, Canada spends more than 11.5% (CIHI, 2020) of its GDP on healthcare related expenses, with costs for healthcare supplies and procurement making up a significant portion of healthcare budgets (Schneller, 2017). The COVID-19 pandemic has revealed some serious weaknesses in the Canadian healthcare supply chain. HealthcareHub Consulting has chosen three key objectives to focus on for the discussion of this implementation plan:

I. Improving Canada’s healthcare supply chain capacity to meet unexpected surges in demand.

II. Equipping the healthcare supply chain with better digital infrastructure and data enablement to
improve operational efficiencies and crisis response.

III. Balancing regional and national priorities to ensure local differences are accounted for, while
implementing a standardized solution that promotes collaboration and improved cost-efficiencies
(Snowdon et al., 2021).

An ideal recommendation needs to be adaptable to future changes in demand, scalable across Canada, feasible, collaborative between different levels of government and geographic regions, provide a cost benefit, and contribute to Canada’s long-term sustainability in addressing internal supply chain demands. HealthcareHub Consulting recommends MedChain, a cloud-based platform for supply chain management that will enhance data tracking and supply transparency. National structures which provide clear guidelines for implementing MedChain into current state processes, like Canada Health Infoway, will ensure consistency and coordination in the long run. As well, MedChain looks to capitalize on hospital networks and LHINs, which have enhanced local-level communication.

A recent study led by Deloitte’s Healthcare Practice emphasized the importance of adopting GS1 global standards across the healthcare supply chain to enable fast, efficient, and safe distribution of COVID-19 vaccines (Deloitte, 2020). Implementing GS1 barcodes will result in optimized traceability of supplies from manufacturer to patient (GS1, 2021a), providing more robust data points to elicit effective procurement and uncover new cost savings (GS1, 2021b). With this, procurement teams can monitor inventory, supply availability information from suppliers can be made available to all regions, and government analysts can facilitate knowledge translation regarding current needs. MedChain software will emphasize data-driven decision making and give users the tools they need to monitor KPIs with clearly outlined best practices and intuitive data visualization dashboards.

MedChain’s project timeline has been divided into four phases expected to last approximately four years (See Appendix 1 for timeline overview). Three months prior to Phase One, the communication plan will commence. This plan is based on Kotter’s Change Management Model from Harvard Business School (Kotter, 1996) to coordinate the federal government, the provincial and regional health authorities, and MedChain analysts. Initial communications with the federal government will emphasize the urgency of improving Canada’s supply chain capacity and an ongoing relationship will be developed with the Minister of Public Services and Procurement to conduct a Current State Analysis of Canada’s healthcare supply chain. This will reveal Canada’s key inefficiencies and present actionable information on MedChain’s potential value. Communications with Canada Health Infoway or other independent non-profit institutions will commence to work with legal and technical teams to build national MedChain guidelines. Finally, independent consulting firm Deloitte Canada will also be contacted to gain more insights on digital supply chain integration and GS1 best practices, building on the firm’s current work with the National Vaccine Management IT Platform (Ellis, 2021).

In Phase One, a full development team will be hired to carry out the project and retained for maintenance, using the Agile Methodology to reduce the length of future testing periods. Using insights from the Current State Analysis , the value of MedChain will be shared with healthcare representatives from every province and territory. These communications will be mindful of the regional differences in healthcare needs and utilize any feedback provided to enhance the program. Phase One is expected to last 12 months.

Over the six months of Phase Two, a pilot program will gauge MedChain’s effectiveness across two distinct healthcare systems. Toronto Central LHIN will model high-density regions while Saskatchewan Health Authority represents a larger, low-density area. CAN Health Network, a nationwide innovation piloting network, will provide crucial support in implementing MedChain. Each hospital within the pilot regions will have analysts assigned to draw insights throughout the process and implement GS1 barcode systems.

Phase Three initiates a federal expansion over approximately 24 months. This will involve coordination with multiple levels of the government. Communicating successful pilot results to healthcare leaders will enable an efficient onboarding process. Phase Three components include a comprehensive training program, clear process expectations, and dedicated support for users.

Staff will be trained to work with suppliers to upload GS1 barcode data onto MedChain. An analyst from each healthcare organization will be appointed as ‘MedChain Lead’ and would oversee the internal implementation of the platform, conduct bi-annual audits of data collection practices, and provide feedback to the larger MedChain network. MedChain analysts and the larger MedChain network will then liaise with provincial health authorities and a federal team of analysts to ensure advocacy from all regions.

Phase Four is the long-term evaluation of the program. The goal of MedChain is to remain useful and constantly adapt to future supply shortages. Data extracted from MedChain will allow for better tracking of Key Performance Indicators (KPIs). A KPI framework has strategically been identified based on Chorfi’s Integrated Framework (Chorfi et al., 2018) and a literature study by Moons et al. (2019). The system’s detailed KPIs can be seen in Appendix 2. KPIs will be compiled quarterly for each institution to produce a balanced Scorecard. Scorecards can then be used as a management tool to set goals for organizations and measure progress towards them in the long run. An estimate of MedChain’s implementation costs and ROI can be found in Appendix 3.

Healthcare Hub Consulting believes MedChain will evolve the Canadian healthcare supply chain with regards to efficiency, collaboration, and feasibility. We look forward to exploring this technology’s wide range of applications in the future, and we thank you for taking the time to consider our proposal.