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| Researchers at the University of Arkansas, Fayetteville, in conjunction with the Association of Healthcare Resource & Materials Management conducted a survey of supply chain professionals on the progress of data standards adoption. Support for the the movement is increasing, but many agree that education is needed to increase awareness. Participants also concurred that there is no fast track to adoption and the collaboration of vendors, hospitals and organizations is needed to make it happen. |
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Numerous individuals are working tirelessly to move the health care industry toward data standardization. Workgroups and professional organizations have joined together to provide educational outreach to materials managers for the purpose of promoting the importance, requirements and benefits of data standardization through the health care supply chain. One of the fundamental questions frequently asked during these outreach activities is, “Are we ready for data standardization?” The “we” in this question typically refers to health care providers that are being touted as the necessary driving force behind the data standard movement. Heather Nachtmann and Edward Pohl, both associate professors and researchers from the Center for Innovation in Healthcare Logistics (CIHL) at the University of Arkansas, Fayetteville, in conjunction with the Association for Healthcare Resource & Materials Management (AHRMM) conducted an industrywide survey of health care supply chain professionals designed in part to assess their readiness and progress toward data standardization. There is a clear movement toward the adoption of data standards among the 1,381 health care providers who responded to the Cost and Quality in Healthcare Logistics survey.
We were encouraged to see that nearly a third (31 percent) of these providers are moving toward the adoption of a data standards system with an overwhelming majority of those (85 percnt) moving toward adoption of the GS1 Healthcare US system. GS1 is very active in educational outreach for data standards adoption, which appears to be reflected in these data. However, more than one half of providers surveyed (53 percent) indicate that they do not know if their organization is moving toward the adoption of data standards. This lack of knowledge is a clear indication that there remains a need for educational efforts to increase the awareness of data standards throughout the health care industry.
More than one quarter (27 percent) of the 328 health care provider respondents that are planned adopters of data standards believe that their organization is ready or very ready to adopt a data standards system. When asked about their timeline for adoption, a small percentage of these respondents (7 percent) have already adopted a location identification standard such as the global location number (GLN) in the GS1 system, while even fewer (4 percent) have already adopted a product location identification standard such as GS1’s global trade identification number (GTIN). However, an additional 23 percent of planned adopters expect to adopt both of these standards within one year.
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These results indicate some progress toward the 2010 GLN Sunrise goal to use standardized location identification by December 2010 and the 2012 GTIN Sunrise goal to use standardized product identification by December 2012.
Interestingly, these providers indicate only slightly more progress toward their adoption of location identification standards as compared with product identification standards as their timelines and current progress toward the adoption of both identification standards appear similar.
This may indicate that providers are moving toward the adoption of these standards simultaneously. There also is an indication of unreadiness among planned adopters where half of these respondents indicate that their organizations are only marginally ready or not ready at all to adopt data standards.
A look into the progress that the 328 planned adopters have made toward the adoption of data standards indicates that health care providers may not be as close to full adoption as indicated earlier.
When provided with a five-step generic process (as shown on the following page) for adopting data standards, the majority of planned adopters have either not started yet or are still in the project initiation phases of adopting standardized location (62 percent) and product (65 percent) identifiers. Only small percentages of planned adopters have achieved complete implementation of standardized location (3 percent) and product (2 percent) identification.
1. Project initiation
- Establish executive support
- Form a management advisory group
- Establish an operational team
- Develop and initiate project communication
2. Establish data and system readiness
- Assess information system issues and make necessary changes
- Identify/obtain data standard codes
3. Establish implementation strategy
4. Involve suppliers
- Engage suppliers
- Conduct testing with suppliers
5. Complete implementation
- Make adjustments to initial implementation plan
- Create standard operating procedures
When asked what the most significant barrier to data standards adoption in their organization, the most common response among health care provider respondents is limited resources (38 percent). All health care providers operate under tight time, and cost and personnel constraints. These constraints are perceived to be the greatest impediment to achieving data standards adoption.
The investment of resources necessary to adopt data standards is largely unknown and warrants investigation. Cultural barriers (14 percent), including resistance to change, lack of universal acceptance and low management buy-in, are also mentioned as the most significant barriers. Some providers (7 percent) indicate a lack of knowledge as the most significant barrier, which again reinforces a need for further educational efforts.
As mentioned earlier, industry experts believe that health care providers must be the driving force behind data standards adoption. More than half of the planned adopters (52 percent) formally encourage their supply chain partners to adhere to a data standards system. Given their early progress toward adoption, it is encouraging to see that providers already are taking responsibility for driving data standards adoption. We suspect this movement will increase as providers make additional progress toward data standards adoption within their own organizations.
To assess perceived and actual benefits of implementing a data standards system within their organization, all survey respondents were given a set of supply chain performance indicators and asked to indicate observed and/or potential impacts of data standardization on these indicators. The most frequently observed supply chain performance improvements attributed to data standardization are: improved product tracking through the supply chain (36 percent), increased collaboration/partnering with other members of their supply chain (33 percent), and decreased cost/increased efficiency of contract management and administration (31 percent).
The most common potential benefits of data standardization include: achieving higher quality metric targets for your organization’s supply chain (69 percent), defining more effective quality metrics for supply chain performance (65 percent), decreasing labor costs associated with purchasing including rework (64 percent), decreasing cost/increasing efficiency of contract management and administration (63 percent) and increasing patient safety (63 percent).
In this early stage of adoption, there appears to be some discrepancies between the expected and actual benefits of data standards adoption. As more providers implement data standard systems, it will be important to track the true benefits of data standardization.
This article focused on a portion of our study that relates to progress toward data standardization. This is a first look into our survey findings, which also describe collaboration among supply chain partners, implementation and benefits of strategic initiatives, supply chain-related expenditures, inventory and order management and supply chain performance.
The authors would like to thank those who completed the survey and assisted in survey development, and CIHL and AHRMM for their generous support of this research.
Additional information can be found at cihl.uark.edu.
| Survey results confirm progress on data standards |
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Previous attempts to get hospitals and suppliers to support a common set of data standards to improve efficiency and patient safety produced few lasting victories. But now, after recent intense educational and coalition-building efforts, measurable progress is being made. The survey conducted by the Center for Innovation in Healthcare Logistics (CIHL) at the University of Arkansas, Fayetteville, and the Association for Healthcare Resource & Materials Management (AHRMM), Chicago shows that health care is achieving a critical mass of support for a common set of data standards. The survey of health care providers found that more than 26 percent of the 1,000-plus respondents plan to adopt the GS1 Healthcare US global data standards. In addition, more than 78 percent said their organizations are at various stages of readiness to adopt data standards. “This is great news because we think that we’ve now exceeded the tipping point in the industry with more than 20 percent moving forward [with GS1 US data standards adoption],” says Dennis Harrison, president of GS1 Healthcare US. Jean Sargent, director of supply chain management at the University of Kentucky Health Care system, Lexington, and past president of AHRMM, says there has been a groundswell of support among key supply chain players to adopt the GS1 standards. She notes that large group purchasing organizations such as Premier and Amerinet have already adopted the GS1 Healthcare US standards and that others such as Novation and MedAssets are enumerating to their customers Global Location Numbers (GLNs) for products they distribute. Consorta, Broadlane, HPG and other GPOs are also getting involved, she adds. Just last month, the Strategic Marketplace Initiative, announced that 32 of its industry provider members will adopt GS1 Healthcare US data standards by the sunrise dates set forth by the standards body. Some of the largest integrated delivery networks in the country are on that list. “It is our experience that the larger organizations are the early adopters,” Harrison says. “The IDNs are leading this initiative and are very involved at this time.” Yet even with the significant successful groundwork that has been laid in seeking support of data standards adoption, much work remains. Bill Zimmerman, director of enterprise data governance for Cardinal Health, which is actively involved in developing an adoption strategy for GS1 standards, points out that more than half the survey respondents don’t know if their organization is moving toward adopting data standards for the supply chain. And while some argue this indicates more educational efforts are needed to convince hospitals and suppliers of the value of implementing data standards, Zimmerman believes it shows that a strong business case needs to be made before supply chain leaders will commit to employing data standards. Corwin Hee, director of e-commerce at Covidien, Mansfield, Mass., which supports and is working to refine and implement GS1 Healthcare US standards, agrees that making a strong business case for standards adoption will trigger greater participation. However, he believes all stakeholders need to work to more precisely define the scope and purpose of the standards movement. “There’s wide adoption by many stakeholders in health care for the GS1 standards ... but by the same token, there’s no clear, concise definition of how those standards will be used,” Hee says. The ramifications of implementing standards impacts everything from the types of bar-code systems that will be used to bedside scanners hospitals may need to use. “What we need to decide as an industry is do we [intend the standards] for supply chain use ... or are we tying it to patient records? And this is not a quick-and-easy implementation,” Hee says. As these broader issues are discussed, standards adopters will focus on implementing components of GS1 Healthcare US standards. This includes implementing location and product identification standards. Mary Beth Lang, senior vice president of Business Intelligence and president of Diagnostix for Amerinet, was encouraged to see that 70 percent of the respondents reported they could adopt Global Trade Identification Numbers by December 2012—the target date set by GS1 Healthcare US. She adds that providers will need to be encouraged “in a more comprehensive way” to accelerate their adoption of standardized location identification. “Perhaps the coming FDA standard around unique device identification could be used to catapult health care providers to implement the strategies that have been identified,” Lang says. Sargent also says the FDA’s planned mandate of unique device identification will help drive overall standards compliance. |
| Adoption target dates |
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For hospitals and supply chain participants that plan to adopt GS1 standards for health care, below are the industry goals: Global Location Numbers (GLNs): The goal is to use standardized location identification by December 2010, which means:
Global Trade Item Numbers (GTINs): The goal is to use standardized GTINs by December 2012. They will be:
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| About the study |
| In November 2008, the Center for Innovation in Healthcare Logistics at the University of Arkansas, Fayetteville, and the Association for Healthcare Resource & Materials Management, Chicago, partnered to conduct an online survey of health care supply chain professionals to assess the current state of the health care supply chain from a cost and quality perspective. Survey responses received were 1,381 for a response rate of approximately 12 percent. The vast majority of respondents (77 percent) are health care providers with the balance made up of manufacturers (6 percent), group purchasing organizations (5 percent), distributors (4 percent) and other health care supply chain organizations (8 percent). Hospitals employ the majority of our health care provider respondents (76 percent). These providers range in size from less than 100 beds (17.5 percent) to more than 1,500 beds (8 percent). The majority of health care provider respondents are supply chain directors (40 percent) or managers (29 percent). Also represented in the health care provider respondents are executives (4 percent), vice presidents (7 percent) and clinicians (3 percent). |
This article first appeared in the March 2009 issue of Materials Management in Health Care.
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