Question

• Describe the concepts and models of planning and decision making in the context of the healthcare supply chain.

Answer 1

In order to increase systems performances in the healthcare process (i.e. the Drug Distribution
Process) and improve patient safety, the areas of intervention for information technologies are
human errors and human violations. To minimize the impact of human fallibility in the safety
critical environment of the healthcare system, it is important to design process that addresses the
positive control of patient safety critical data (CEN, 2000). The procedures of identification of
patient and Patient Related Objectives is the unique intervention point with the highest potential for
minimizing the risk of human errors and for maximizing the performance of the health informatics
systems (CEN, 2000).

A technology in healthcare has to get the right trade-off among patient safety, quality of care and financial constraints ( very different, especially in Europe, from a conventional firm). Actually in pilot projects and in earlier applications of RFID in healthcare, five functional areas are involved (Ingeholm et al., 2006):

1) Asset management: active RFID can be used linked to an asset such as a wheelchair or a
defibrillator. The advantages of this application are: cost reduction by increasing asset
visibility, reduction of losses and thefts, improvement of inventory control.
2) Patient safety at point of care: bar-coding technology has been widely used to reduce human
error in drugs administration and in blood transfusion management (Roark, 2004).
Nowadays this activities are done with the support of passive RFID, which does not require
line of sight, but a passive tag and handheld reader. The technological support to drugs
administration and blood transfusion management will improve using active tags.
3) Workflow optimization: active RFID systems can be used to retrieve identification and
location information about tagged entities in real time. Then it is possible, monitoring
tagged staff, equipment and patients, to map the entire workflow of processes of a healthcare
organization.
4) Increased security: another relevant application is the possibility to control the access to
dangerous zones inside a structure. For example if for a person an exposure to x-radiation is
not allowed, with RFID technology, it is possible to create a system of alert in proximity to
critical boundaries.
5) Electronic pedigree for pharmaceuticals. As The Food and Drug Administration (FDA)
(2004) sustains, endorsing the concept of Electronic Product Code(EPC)/RFID solution, this
type of technology permits to “increase the safety of medications consumers receive by creating the capacity to track and trace a drug from the manufacturer all the way to the
pharmacy”.

Obviously the first pilot projects have met also obstacles in the application of this technology in
healthcare area. In particular, (Ingeholm et al., 2006) they are:
Cost: this is the most relevant problem for the application of RFID technology in healthcare
industry. This problem can be discussed along two dimensions: The cost of the tags and the
investment for implementation ( e.g.: changing processes, training people) are very relevant, It’s
difficult to quantify benefits. In facts it is not easy evaluating efficiencies in a care workflow and
process and it is hard measuring cost reduction such as decreased medical errors. Furthermore the
problem of cost is emphasized by the comparison with the bar-coding technology. This
complementary technology present costs much lower: for example if a passive tag cost 0.4 $ ( 20 $
for an active tag), the cost of a bar-coding label is 0.001$ per unit.
Standardization: from a technological point of view the most import obstacle for the application of
RFID technology is standardization. The standardization process has been complicated by the
emergence of competing standards from International Standardization Organisation (ISO) and
EPCglobal/GS1 which are driven by divergent interests. Nowadays, in the earlier projects, this
obstacle is not very dangerous because RFID applications operate in a closed-loop environment. In
the future the need for interoperability of RFID system across an enterprise will make the challenge
for standardization essential.
Data processing and integration: one of the most advantage of RFID than competing technologies
is the possibility to create a large amount of data. In this sense the management of the data becomes
critical and, because of RFID is not a stand-alone technology, it will be critical the choice of
supporting technology.

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