Preparing for the next crisis: Why a clinically integrated supply chain is a must

A clinically integrated supply chain breaks down key barriers between supply chain and clinical teams to deliver better patient care. However, many health systems don’t have an approach or a solution to help them establish their clinical integration goals, explained Christina Tosto, Vice President of WaveMark™ Supply Management & Workflow Solutions at ‎Cardinal Health.

One such solution released in November of 2019 that helps guide providers in their journey to a clinically integrated supply chain is the HIMSS® CISOM (Clinically Integrated Supply Outcomes Model). The eight-stage maturity framework aims to provide health systems with a strategic road map to advance clinically integrated supply chain infrastructure to strengthen care quality and safety. 

In early 2021, Cardinal Health's WaveMark™ began offering its customers support for adopting the CISOM in collaboration with HIMSS®.

Here, Ms. Tosto discusses how WaveMark™ is helping health systems to achieve their goals for supply chain maturity. 

Editor's note: Responses have been edited for clarity and length. 

Question: WaveMark™ recently announced a collaboration with HIMSS® as a Certified Organization for the newly created Clinically Integrated Supply Outcomes Model. Can you tell us about the model, how WaveMark™ helps health systems achieve a clinically integrated supply chain and why a health system should focus on adopting this new maturity model's best practices?

Christina Tosto: CISOM is an eight-stage maturity model that helps guide health systems in creating a successful strategy to adopt best practices that integrate their supply chain and clinical practices, all in the spirit of delivering optimal patient care. Ultimately, at a very high level, CISOM will give clinicians the infrastructure to mobilize supply chain data, connecting it to patient care outcomes, which allows them to choose the best product that will have the best possible outcome for each unique patient population. 

The WaveMark™ Supply Chain Management and Workflow Solution is aligned to the industry-accepted best practices outlined in the CISOM. Our services and technology offerings support health systems by implementing some of the foundational steps that are required of a clinically integrated supply chain. Currently, WaveMark™ supports more than 50 percent of the CISOM maturity criteria. These include:

  • proactive risk management for recalled or expired products at the point of care,
  • linking patient care processes, products and care teams to every patient encounter via clinical system interfaces,
  • optimizing inventory management through product utilization tracking and ensuring availability of products, and 
  • supporting product standardization, helping to streamline associated workflows while maintaining optimal patient care.

The COVID-19 pandemic put a spotlight on healthcare supply chain and showcased the immense need for clinically integrated processes. Personal protective equipment shortages really reinforced the need to have our clinicians and supply chain teams’ processes integrated to best support one another and make sure they have the right product, at the right place, at the right time. According to Anne Snowdon, Director of Clinical Research at HIMSS® and the lead developer of CISOM, health systems that were further along on the clinical integration maturity curve were better prepared to manage supplies throughout the pandemic. That said, adopting integrated supply chain best practices can help health systems ensure they are better prepared for the next crisis.

Q: What steps should a health system take to ensure that their clinical and supply chain teams are integrated in their workflows to best deliver optimal patient care?

CT: The first step, which should happen any time you're talking about two teams that have historically not collaborated much, is to begin the conversation. Both supply chain and clinical teams need to work together and identify what their teams can do to support one another. 

A second step would be getting sponsorship from the top — identify a key leader in the organization that can support the ongoing journey it will take to reach supply chain maturity and be the strong voice it takes to bring other leaders along at the appropriate times.   

After you get some sponsorship at the top level, I would say you need to create a steering committee or a task force within your health system that's composed of several stakeholders, including supply chain leaders, clinicians, and health system administration. The goal of this steering committee would be to review the current state of processes and leverage the support of models like CISOM, to help identify opportunities and build a strategic path that will move the health system towards a path of clinical integration. 

After developing the strategy and business case, supported by Certified Organizations like WaveMark™, gain buy in from C-suite level leaders. Articulate the journey the health system needs to take, what’s involved, why it’s critical to prioritize this work, and what’s at stake if you don’t. Aim towards creating digital supply chain that provides you the automation and transparency that you need to gain the critical insights that ultimately support patient care. 

Lastly, I would say: Trust the process. With roughly about 60 percent of health systems still relying on some form of manual process within their supply chain, many of them have a long way to go when it comes to achieving what is considered true clinical integration.  With the help of the CISOM model and Certified Organizations like WaveMark™ following industry best practices, you can trust you are applying the right strategy that will support you along your journey. 

Q: Can you share a success story from a WaveMark™ customer who prioritized a clinically integrated supply chain?    

One customer, a large integrated health system in the Midwest, worked with us to implement the WaveMark™ solution across multiple hospitals within their system over the last few years. When it came to the pandemic, this health system was able to leverage supply chain usage data from our system, which gave them a leg up to tackle PPE shortages during the pandemic. They had great visibility into their PPE stock on hand and were able to map that against where there was demand in the system. This visibility allowed the system to make the right decisions on how to reallocate product and what to order to ensure patients and clinicians were protected, despite shortages. This customer, to me, is one of the shining examples of how having visibility into where your inventory is and being able to map it against demand, can ensure the best outcome for patients. 

In addition, customers overall who use WaveMark™ are seeing benefits in some of the basic tenants of the CISOM. As mentioned above, one key theme of the model is the proactive management of at-risk products, including identification of expired and recalled items.  WaveMark™ not only ensures identification of these types of products at the point of care, but also helps health systems have visibility to minimize the occurrence of product expiry. From an aggregate level, health systems that leverage WaveMark™ to manage their inventory fare much better in product expiration than the industry standard. In fact, the average health system department utilizing WaveMark™ to optimize their supply management processes sees an average of only 2.1 percent products expire on their shelves. Even further, WaveMark™ customers who fall in the top 25th percentile of optimization see a 1.5 percent expiration rate — representing an 85 percent improvement over the industry average.

Q: What can a health system do if it is interested in learning more and taking the next step to evaluate its supply chain on the CISOM?

CT: For anyone who is interested in learning more or taking the next step, you can visit our website here to request a CISOM evaluation. We will work with the health system or hospital to complete the evaluation and provide a Gap Assessment based on your responses. The assessment will help  give hospitals an idea of where they stand on the maturity scale and will provide recommendations on what efforts should be prioritized to achieve a truly clinically integrated supply chain, including walking you through all the stages, what you're doing well and where there are opportunities for improvement.

To learn more about Cardinal Health and how it is helping customers evaluate where their supply chain stands on the CISOM, click here

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