Data: the public health supply chain’s biggest challenge and opportunity
Public health supply chains face two big challenges. The first is the availability of complete, accurate, and timely data. The second is isolated silos of data, which disconnect global supply chains from in-country supply chains.
Without accurate, timely data available across the supply chain, it is extremely difficult for donors, organizations, and service providers that manage public health programs to make informed decisions based on facts and, ultimately, to reach their program goals.
PFSCM has invested in a next-generation Control Tower, which will enable public health supply chain stakeholders to connect to a single, digital cloud-based platform that will streamline stakeholders' data input capabilities and provide them access to previously idle and isolated data.
The combination of accurate, real-time, and all-encompassing data will provide donors, governments, countries, vendors, and all stakeholders with the tailored information they need to make data-driven decisions that ensure the optimal performance of the supply chain.
Public health supply chain perspective
Like many industries, public health supply chains generate an immense amount of structured and unstructured data.
In the competitive, private sector, commercial supply chains were early adopters of new data technologies and concepts such as Big Data. Owing to strong profit incentives, the aggressive investment into data capture and analysis made perfect business sense. Commercial supply chains have become highly integrated, with various stakeholders being able to tap into the system at suitable stages to take actions.
In the global public health space, integration and the uptake of automatic data capturing and analysis has been slow, especially in the developing world. The reasons for the slow uptake can be linked to the common challenges faced by low- and middle-income countries. Think about: conflict, war, a lack of general infrastructure, exorbitant bureaucracy, corruption, scarce human and financial resources, a lack of education, and unique cultural and socio-economic circumstances.
These challenges make public health supply chains especially complex and put them at increased risk of mismanagement.
It is not only country-specific challenges that have impacted the public health supply chain's ability to adapt, but also historic supply chain structures.
Public health supply chain structures
Most public health supply chains started out manual intensive, disconnected, and prone to the "bullwhip effect" (increasing swings in inventory). This fostered a reactive as opposed to proactive approach to public health supply chain management.
In low- and middle-income countries, public health supply chains were jointly developed by country governments and donors employing various service providers and partners. Over the years, these relationships have resulted in several different supply chain structures.
Where governments had no capacity to run in-country supply chains, the donor program managed the whole supply chain, both upstream and in-country. Where governments had more resources, they took charge of the in-country supply chain, leaving the global supply chain management to the program funders and its service providers. There are also scenarios where countries advanced to middle income and thus started taking responsibility for some of the supply chain tasks previously managed by the donor program. Other developing countries manage the complete supply chain of certain verticals but still use the support of donor programs for select treatment areas.
These multi-tiered, separated structures have resulted in data becoming isolated to certain parts of the system.
Today, donors are demanding increased visibility into the supply chains, which they fund at great expense to the developed world. Governments, public health programs and service providers are coming under increased pressure to find ways of bridging the gaps in isolated data.
Where is the data now?
PFSCM Chief Information Officer Chad Davenport provides further insight into data capturing and data usage issues.
He explains that methods of in-country data capturing differ widely among countries; the quality of the input can also vary and, depending on the systems implemented, the data can remain static and may only get pulled for the occasional report.
"Manual data capture methods are time consuming and carry a high risk of human error. Many countries implement electronic or automatic data capturing systems, but some still rely on manual or paper-based entries," adds Davenport.
By offering key stakeholders an easy-to-integrate digital platform for data collaboration, they benefit from data validation on input, which ensures accurate entries, as well as cloud functionality, which drives real-time availability.
"The data is out there, whether in a spreadsheet, a barcode, a purchase order, a signed proof of delivery, a warehouse management system, or a handwritten ledger. It is collected and to some extent analyzed, shared, and used," explained Davenport. "With our Control Tower, we can uplift the stakeholders to bring their data into one secure digital space, and connect them by sharing tailored data."
Further, the Control Tower enables PFSCM and its various clients, vendors, and partners to reduce the amount of manual data input between systems and shareholders, for example, between freight forwarders and the procurement agent, or suppliers and public recipients and the procurement agent.
Prompts for information and actions, as well as checks and alerts, accelerate the information flow to create accurate yet real-time data on, for example, order release, shipment transit milestones, shipment off-loading, and inventory levels.
In addition, with growing access to data networks, PFSCM believes the barriers to entry to partake in a digital platform are extremely low.
"Through our own projects and the work of our partner organizations, we can approach each stakeholder with a custom solution," Davenport notes. "Where a country should have a lack of ability or experience capturing digital information, we can support them through technical assistance and systems strengthening to easily on-board onto the digital platform. Where countries have advanced systems, we can connect and train them with minimal impact on their own operations."
Davenport adds that the historical public health supply chain practices have resulted in a well-traced global supply chain from manufacturer up until in-country storage, but have left the remainder of the in-country supply chain, from central medical stores to regional distribution centers or points of care, lagging behind, with data dispersion practices even more obscured further downstream.
"Isolated silos of data within the public health supply chain has manifested into the perfect storm of disconnected information, incompatible applications, and room for duplicity."
The challenge is bridging the silos to connect the information, making a "single version of the truth" (SVOT) available to stakeholders.
"By connecting the whole supply chain, the stakeholders can see a single product on its journey from the factory to the central medical store and further to the patient. Serialization, authentication, and blockchain technologies are employed to ensure the product integrity is maintained throughout the supply chain."
PFSCM's Control Tower solution will enable the in-country and global supply chains to connect to the same platform, thus eliminating the data silos that create the breeding ground for discrepancies.
"One Network allows various legacy applications to connect. This will bring benefits to both upstream and downstream operations and will provide a holistic picture of performance from product producer to patient," states Davenport.
Bridging this gap will be a major success for global public health in general. An overall view from patient consumption and point of care all the way to the active ingredient producer's stock and manufacturing pipelines will reveal patterns that can help service providers and decision makers act proactively.
Using the data - knowing the facts
Data can be used to measure the success of a public health program, whether it is in patients treated, lives saved, infections prevented, level of patient adherence, or new infections identified.
Regardless if program goals are achieved or not, the data should reveal all performance metrics of the supply chain, from order placement and raw materials, to pending importation documents and offloading progress at warehouses.
Davenport adds that it is also important that stakeholders can understand and use data effectively.
"Millions of lines of data can be overwhelming, and it is not of any use to a decision maker or stakeholder. We use our Control Tower, IT, and supply chain experience to help stakeholders make sense of the data and use it appropriately. A stakeholder may have some metrics that they wish to be measured and analyzed, but they may also rely on us to guide them in the best practices."
Further, he notes that when data is presented in a user-friendly dashboard, a data-driven decision could be as fast paced as selecting an option or addressing an alert raised within the platform dashboard. Other decisions may be more involved, such as detailed reviews aimed at making strategic long-term commitments or program changes.
Meanwhile, Davenport also stresses the importance of using the data for proper forecasting and demand planning.
"Planning is a notoriously difficult task. It is challenging because it requires accurate, up-to-date consumption data. Through our partnerships, we have access to custom-developed forecasting software. However, the absorption of consumption and demand data into our Control Tower will streamline planning by leaps and bounds."
Collaboration is key
The more vendors and stakeholders join the digital network and share information, the stronger the potential for extracting knowledge from the data becomes.
For a public health supply chain, the participation of the in-country supply chain ̶ for which data is known to be sparsely collected ̶ is important in revealing backlogs, discrepancies, and bottlenecks.
Because of limited resources, problems are most likely to arise at the in-country level. As the input from in-country entities becomes more collective, the remainder of the supply chain will be able to better understand and act on downstream events to support the in-country supply chain. This creates a win-win for all. Downstream operations can leverage the expertise of the upstream infrastructure, and the global supply chain can assist the in-country supply chain in averting risk, reducing pressure, and maintaining performance.
"Participation across the whole of the public health supply chain will benefit all parties, but most importantly the patients will receive more efficient, uninterrupted treatment and care. Donor funds will go further and overall supply chain efficiency will improve," concludes Davenport.
The future of data in the public health supply chain
The possibilities of data in the public health supply chain are endless. As the Control Tower develops, with data increasing and feature engineering maturing, it will become more autonomous through its predictive and prescriptive analytics, as well as its cognitive learning abilities.
PFSCM's short- to medium-term vision with our Control Tower is to connect stakeholders on one digital platform and improve overall supply chain performance.
However, the potential in the long-term is plentiful. Read more about how Control Towers are being used to secure the supply chain and how our subcontractor Imperial Logistics is implementing Control Tower and blockchain technology in the commercial pharmaceutical supply chain.
Scenario: The Growing Control Tower
- In its infancy, the Control Tower starts addressing logistics management information system issues, such as inventory record keeping at individual facilities.
- As it develops, it connects all the facilities in the cloud, enabling better order management and stock allocation.
- Growing further, it links stakeholders - such as donors, freight forwarders, suppliers, and governments - for SVOT data sharing that forces transparent decision making.
- Running optimally, it automates manual processes and allows humans to work on intellectual projects.
- In its maturity, it leverages modern prediction tools, machine learning, artificial intelligence, and the internet of things to autonomously manage the supply chain.
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