iii.3 end-to-end supply chain:
TRANSCRIPT
III.3 End-to-End Supply Chain: The Integration of People, Process,
Technology and Location
End-to-End Supply Chain: The Integration of People, Process, Technology
and Location
Jay M. Kirkpatrick, CMRPSupply Chain Officer
HCA MedAmerica Division Supply Chain
Nashville, Tennessee
Dave CatinoAssistant Vice President
Strategy & Planning – IT&S
HCA Corporate Supply Chain
Nashville, Tennessee
Vivien Conner, CMRPSupply Chain Director
Centennial Medical Center
Nashville, Tennessee
Integration
People
Process
TECHNOLOGY
Location
Why Shared Services?
Supply Cost Rising at 8%-15% Annually
Labor Cost Rising
Technology Costs RisingIntegration Issues with Technologies
Variability in Process
Supply Chain BackgroundSupply Chain Background
Launched in January 2000 to:Protect HCA’s “Core” Business: Patient Care
Reduce Supply Cost
Increase Productivity
Improve Service
Launched in January 2000 to:Protect HCA’s “Core” Business: Patient Care
Reduce Supply Cost
Increase Productivity
Improve Service
Supply Chain BackgroundSupply Chain Background
• Three distinct components:–Consolidate back office functions–Share supply cost reduction
opportunities throughout the company
–Work with the GPO in developing and optimizing division contracts for medical devices and standardization initiatives
• Three distinct components:–Consolidate back office functions–Share supply cost reduction
opportunities throughout the company
–Work with the GPO in developing and optimizing division contracts for medical devices and standardization initiatives
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HCA Supply Chain Strategy HCA Supply Chain Strategy
Supply Chain Operations
EffectivenessReduce Supply Expense
Efficiency Reduce Transaction Costs
Clinical Focused on:•OR•Cath Lab•Pharmacy
Manufacturer
Point of Use
Best Practices
Standardization
Utilization Contracting
Procurement
Substitution
Supply Standardization/Utilization
Supply Chain Operations• Consolidation of Procurement• Consolidation of Warehousing• Deploy Point of Use Technology
Supply Expense Management• Supply Improvement Program • Physician Preference Contract Model• Division Based Procurement• Freight Management
Warehousing
HCA Supply Chain Services
HCA Supply Chain Services
BSS
CDCs (Satellite Warehouses)
New Orleans
Kansas City
New Orleans
Atlanta
Jacksonville
NashvilleDenver
Salt Lake City
Dallas
Houston Tampa Miami
Richmond
El Paso
Las Vegas
Oklahoma City Charleston
Portsmouth
HCA’s Integrated Supply Chain
HCA’s Integrated Supply Chain
Clinical Operations
NationalRegional
Agreements
SystemOperations
FinancialOperations Procurement
Financial RolesFinancial RolesHealthTrust RolesHealthTrust Roles
GPO Operations
Supply Chain RolesSupply Chain Roles
AccountsPayable Logistics
ProductStandardization
Utilization
-Product Evaluations
-Testing
-Technology Screening
-Clinical Networking
-National & Regional Negotiating
-Sourcing
-Legal
-Sales
-Implementation
-Customer Service
-Communications
-Compliance
-Contract Management
-Standard Master Files
-UPN
-Classification
-Accounting
-Audits
-Analysis and Reporting
-Financial Support
-Systems Support
-Internal Controls
-Requisitioning
-Purchasing
-Matching
-Payment Processing
-Accruals
-Shipping
-Receiving
-Put Away
-Replenishment
-Distribution
-Storage
-SKU Standardization
-Waste Reduction
-SMAT
-Appropriate Utilization
HCA IT&S
- HCA IT&S
- SMART
- POU
- WMS
- EDW
- GHX
Our mission is to obtain the best price for clinically recommended products, ensure their timely delivery, and continuously evaluate and improve our services to the patients,
physicians and clinicians we serve.
Supply Chain Core Operating Systems
Supply Chain Core Operating Systems
SMART MeditechSelectedItem andVendor Data
POUWMS
GHX CatalystGHX Connect
Plus
Item, Par,ASN
Replenishment
Item, PO, ASN,RMA, Reqs, SO
Receipts, Ship Con, Inv. Adj.Inv. Stock Balance,
Some inv. moves
Reqs
Item and ParEDI
IMS
Host AP
DataWarehouse
Vouchersand Vendors
PaymentHistory
AllTransaction
History
Item/vendor, contract info,contract participation info
Item, Par,ASN
Replenishment
ADT
Charges
Remedy & Symposium
Intranet Supply Chain
Website
ImagingInvoices
Reports
In The Beginning… In The Beginning…
SMART
GEIS
EDI
Host APVouchers
and Vendors
Materials Management & Accounts Payable
Materials Management & Accounts Payable
SMART – homegrown MMIS. Heart of Supply Chain Processing
Order Management – Purchasing, Distribution, and AP
AIX platform
MicroFocus Cobol
SMART – homegrown MMIS. Heart of Supply Chain Processing
Order Management – Purchasing, Distribution, and AP
AIX platform
MicroFocus Cobol
Materials Management & Accounts Payable
Materials Management & Accounts Payable
Host Accounts Payable – homegrown system which receives vouchers from SMART AP and generates payments to vendors.
Mainframe-Based, Cobol
GE Information Systems Value added network for trading EDI documents
Host Accounts Payable – homegrown system which receives vouchers from SMART AP and generates payments to vendors.
Mainframe-Based, Cobol
GE Information Systems Value added network for trading EDI documents
Operational Advantages and Opportunities
Operational Advantages and Opportunities
ProsGood Order Management System
EDI Connectivity
Mainframe AP Application
ConsVariability in Setup and Operation
First StepsFirst Steps
SMART MeditechSelectedItem andVendor Data
POU
GEIS
Item, Par,ASN
Replenishment
EDI
Host APVouchers
and Vendors
Item, Par,ASN
Replenishment
ADT
Charges
Point Of UsePoint Of Use
SupplyScan Partnered with McKesson in 1999
Installed in all acute care facilities
Integrated with Meditech clinicals application
ADT
Patient charging
Integrated with SMART MMIS
Item/PAR
Replenishment
Advance Ship Notice
SupplyScan Partnered with McKesson in 1999
Installed in all acute care facilities
Integrated with Meditech clinicals application
ADT
Patient charging
Integrated with SMART MMIS
Item/PAR
Replenishment
Advance Ship Notice
Operational AdvantagesOperational Advantages
Automated Charge Process
Cards, Stickers, Labor Hours Eliminated
Nursing Satisfier
FTE Reduction
Elimination of Count, Pull, Replace Process
Eliminate Keying Charges in MMIS
Min/Max and Critical Levels vs. Top Off
CSC Consolidation BeginsCSC Consolidation Begins
SMART MeditechSelectedItem andVendor Data
POU
GEIS
Item, Par,ASN
Replenishment
EDI
Host APVouchers
and Vendors
Item, Par,ASN
Replenishment
ADT
Charges
Remedy &Symposium
Supply Chain Call CentersSupply Chain Call Centers
Symposium – an automated call distribution system that appropriately tracks and routes calls to specialized areas of support.
Established multi-hospital customer service operation
Symposium – an automated call distribution system that appropriately tracks and routes calls to specialized areas of support.
Established multi-hospital customer service operation
Supply Chain Call CentersSupply Chain Call Centers
Remedy – Call tracking and loggingLog analysis - Enables root cause problem resolution
Data Captured for Key Performance Indicators
Hold times, Abandonment Rate, Logs Open > Week, % Rush Calls, % A/P Calls, % Purchasing Calls, % Warehouse Calls, Facility Call %, Vendor Call %, Call Logs, Open Call Logs Closed
Remedy – Call tracking and loggingLog analysis - Enables root cause problem resolution
Data Captured for Key Performance Indicators
Hold times, Abandonment Rate, Logs Open > Week, % Rush Calls, % A/P Calls, % Purchasing Calls, % Warehouse Calls, Facility Call %, Vendor Call %, Call Logs, Open Call Logs Closed
Operational AdvantagesOperational Advantages
HospitalOne Point of Contact
Faster Resolution Timeframes
Issue Tracking
DivisionPurchasing, A/P, and Warehouse Staff Process Without Constant Interruption
Defined Audit Trail of Issues and Resolutions
Expanding Requisitioning & Supplier Connectivity
Expanding Requisitioning & Supplier Connectivity
SMART MeditechSelectedItem andVendor Data
POU
GHX CatalystGHX Connect +
Item, Par,ASN
Replenishment
Reqs
Item and ParEDI
Host APVouchers
and Vendors
Item, Par,ASN
Replenishment
ADT
Charges
Remedy & Symposium
GHXGHXCatalyst Requisitioning Connect + Data Exchange
Hosted by GHX
Functionality•Special purchase requisitioning•Capital purchase requisitioning•Round trip w/ Dell•Stat Rec in development
Interfaced with SMART MMIS
Replaced GEIS
EDI Compliance – 88.5%
Statistics • 88 Supplier Divisions• $1.2 Billion in Volume• 535,000 annual POs• 2.9 Million PO Lines• 450,000 Invoices (2005)
Documents• PO (850)• PO Confirmation (855)• Invoice (810)• Sales Tracing (867)
Operational AdvantagesOperational Advantages
FacilityKey Enabler to Move Purchasing Offsite
Approval Workflow and Visibility
Supports Standard Vendor Order Calendar
DivisionSPR Interfaced in MMIS (SMART)
Reduction in Purchasing FTEs
Warehouse Automation…Warehouse Automation…
SMART MeditechSelectedItem andVendor Data
POUWMS
GHX CatalystGHX Connect +
Item, Par,ASN
Replenishment
Item, PO, ASN,RMA, Reqs, SO
Receipts, Ship Con, Inv. Adj.Inv. Stock Balance,
Some inv. moves
Reqs
Item and ParEDI
Host APVouchers
and Vendors
Item, Par,ASN
Replenishment
ADT
Charges
Remedy & Symposium
WarehousingWarehousingPartnered with SSA (EXE) in 2000.
Software manages 4-walls of warehouse
12 – 15 Hospitals Per Warehouse
Receiving, Put-Away, Picking, Shipping, Replenishment
Daily deliveries
RF technology (hand-held and wearable)
Hardware Located in Regional Data Centers
SMART MMIS integration
Internal ASN via scanning at POU
Partnered with SSA (EXE) in 2000.
Software manages 4-walls of warehouse
12 – 15 Hospitals Per Warehouse
Receiving, Put-Away, Picking, Shipping, Replenishment
Daily deliveries
RF technology (hand-held and wearable)
Hardware Located in Regional Data Centers
SMART MMIS integration
Internal ASN via scanning at POU
Operational AdvantagesOperational Advantages
Integration to POU Min/MAX to Increase Picking Efficiency in Warehouse
Reduction in Picking Errors
Electronic Pre-adjusted Picking List
Advanced Ship Notice
Elimination of Hospital Storerooms
Disintermediation
Optimization!Optimization!
SMART MeditechSelectedItem andVendor Data
POUWMS
GHX CatalystGHX Connect+
Item, Par,ASN
Replenishment
Item, PO, ASN,RMA, Reqs, SO
Receipts, Ship Con, Inv. Adj.Inv. Stock Balance,
Some inv. moves
Reqs
Item and ParEDI
IMS
Host AP
DataWarehouse
Vouchersand Vendors
PaymentHistory
AllTransaction
History
Item/vendor, contract info,contract participation info
Item, Par,ASN
Replenishment
ADT
Charges
Remedy & Symposium
Intranet Supply Chain
Website
ImagingInvoices
Reports
Standardization and ImagingStandardization and Imaging
Item Management System• Collapsed 3 systems into 1• Houses standard Item and Vendor numbers as well as Contract Pricing
Imaging
• Hyland On Base Imaging solution which is used for storage and retrieval of Purchase Order, Invoice, and Voucher information. Eliminates routing of paper throughout the division.
Data WarehousingData Warehousing
Supply Chain Data WarehouseTeradata platform
2.1 billion rows
Data mined and reported via Business Objects, VISTA, AdHoc
250,000 individual reports run against the EDW in 2005 shared between 11,000 distinct users
Supply Chain Data WarehouseTeradata platform
2.1 billion rows
Data mined and reported via Business Objects, VISTA, AdHoc
250,000 individual reports run against the EDW in 2005 shared between 11,000 distinct users
Supply Chain WebsiteSupply Chain Website
SC Website (292,000 hits in 2005)2000+ pages of P&P, Business Flows, Forms (Business Standardization)
Supply Cost Management – Data and Information
SC Communications and Education (SCU)
SC Website (292,000 hits in 2005)2000+ pages of P&P, Business Flows, Forms (Business Standardization)
Supply Cost Management – Data and Information
SC Communications and Education (SCU)
Operational AdvantagesOperational Advantages
StandardizationProduct and Process Standardization
Enabler to Warehouse Consolidation
200 to 12 to 1
Cross Hospital Reporting Consistency
ImagingEnabler to Accounts Payable Consolidation
Nashville RDC
D
weE e3
Communication Server
D
weE e3
SQL DB Server
D
weE e3
Citrix Server
D
weE e3
Application Server
D
weE e3
EC Server
WMS
PC Workstation
Laser Printer
RDC
Warehouse
RF Scanner
RF Access Points
HCA Cloverleaf
Meditech
SMART
Application Server
Interface PC
POU
FacilityMaterials Management PC
NurseStationPOU Scanner
Laser Printer
Application/Web
Servers
Database Servers
GHX Cloverlea
f
Vendor Site
GHX
PC Workstation
Zebra Label Printer
Sato Printer
EDW Server
Host (AP, GL) Mainframe
RCS Mainframe
Application Servers (2)
Web Server
IMS
Database Server
WMS
SMART
Master Tower
Reports Servers
Session Server
Supply Chain Core Operating Systems Location SchematicSupply Chain Core Operating Systems Location Schematic
What’s Next?What’s Next?
Optimization, Optimization, Optimization
Pharmacy
Cath Lab
Operating Room
Questions?Questions?