I grew up hearing so many tales about the Bermuda Triangle that I wonder why I never had nightmares about it. For those of you who haven't heard its siren song, the Bermuda Triangle is an area of the Atlantic Ocean roughly defined by the apexes of Miami, Puerto Rico, and—you guessed it—Bermuda.
Inside its borders, hundreds of boats and planes have reported sudden instrument failure and freakish weather phenomena. Many have simply vanished without a trace. Incidents have been documented as recently as 2001, but perhaps the most well-known one occurred nearly two hundred years ago. On December 30, 1812, Theodosia Burr Alston, daughter of Aaron Burr—the man who was Thomas Jefferson's vice president and who shot Alexander Hamilton dead in a duel with pistols—set sail from Charleston, South Carolina, aboard the Patriot, bound for New York City. The Patriot was never heard from again. Nor was poor Theodosia.
The healthcare supply chain has created its own environment of mystery and peril. I call it the Bermuda Quadrangle, because it has four sides instead of three. The axis points are not places on a map but institutions in our midst: 1) the Provider, 2) the GPO, 3) the Manufacturer, and 4) the Distributor. Each bears some responsibility for the creation and perpetuation of this perilous—and in many ways dysfunctional—environment.
The Providers, hospitals, are more victim than perpetrator, but as I said in my previous post (What Happens When You Spend a Semester on the 6th Floor?), they act as an enabler if they accept the existing supply chain system as immutable. It is time to banish that thinking, and you have the power to do so for one simple reason: you are the CUSTOMER! A customer that is fair, welcoming of reciprocal transparency and trust, empathetic to financial realities, and understanding that the path from product to patient to P&L is very complex.
But even though each has an important core competency, your partners in the supply chain aren't playing well together. In fact, some are competing with one another for your attention and dollars, often with new "value-adds" that diminish their core competencies. As a result, you, the customer are being ill-served. And you, the customer, must say "unacceptable."
So, what to do? Well, first recognize that even with some divine intervention (probably in the guise of the federal government) it will be years before the healthcare supply chain becomes a well-oiled machine. And since "the industry" is unable or unwilling to treat you as the customer by providing the highest quality product at the lowest possible price, then resolve to do what is necessary to take control.
Pick a key set of partners based upon what they do best. And to keep your properly focused partners on task, take ownership of the analysis of your data, integrate the results of your analysis with your daily operations to effect improvement, and measure your effectiveness. If you can do that, the advent of improvements like GS1 and clinical comparative guidelines will make your good system even better.
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