Supply Chain and OpenHIE

[Shivers, Jennifer Ellen]

To:  OHIE Supply Chain Community 

At out last meeting, it was determined that a small group would begin to sketch out how supply chain system actors might fit with the OpenHIE architecture.   As we being to frame this discussion for our next meeting on 20-April at 11:00 am EST, I wanted to share these sketches with you so that you have time to comment and provide input on possible alternative views.  Please keep in mind that the OpenHIE diagram is meant to represent a logical view of how the components interact at a high-level.  We find that logical and physical diagrams for projects may differ in placement of systems like HIMS.  (Note that placement of applications like DHIS2 (HMIS) may depicted both above and below the interoperability layer  - see diagram here.)

With that frame for the OpenHIE architecture diagram in mind, here are rough sketches of two possibilities for including the supply chain components:  

1)  See slide two

2) See slide three

The rest of the slides depict how the descriptions for the system actors were defined and possible data exchange needs.  

We look forward to discussing your views of how you see the system actors fitting into the OHIE architecture on the next call. 

Jennifer 

Jennifer Shivers  |  Senior Integration Architect  | Senior Business Analyst

Tel 317-797-1200 | Skype jennifer.shivers

1101 West Tenth Street

Indianapolis, IN 46202

Web and email addresses, and phone numbers will remain the same.

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Confidentiality Notice: The contents of this message and any files transmitted with it may contain confidential and/or privileged information and are intended solely for the use of the named addressee(s). Additionally, the information contained herein may have been disclosed to you from medical records with confidentiality protected by federal and state laws. Federal regulations and State laws prohibit you from making further disclosure of such information without the specific written consent of the person to whom the information pertains or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is not sufficient for this purpose.

 

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[Chris Wright]

I'm sorry to say that I'll miss this next meeting as I will be on leave and off line next week.

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chris wright Practice Lead, Data Visibility & Use CELL: +41.77.951.7144 | WWW.JSI.COM/SUPPLYCHAIN

[Nsaghurwe Alpha]

Hi Jeniffer,

This is great start, and thank you for sharing,

I will suggest we explore this further, especially if we're considering this framework to be as generic as possible, In most of the countries LMIS component  is supported by more than one system (eg. LMIS tools, WMS/IMS/ERP, Mobile Applications as early warning systems etc), for example in Tanzania we've multiple systems supporting LMIS process, which is the same to Zambia, Malawi, Mozambique, Kenya, Uganda, CI, Guinea etc.

Therefore we can have domain (depends on how we'll name it) where by the LMIS domain will be on external systems (in the OHIE architecture) and will comprise LMIS system, WMS/ERP/IMS etc, and Supply chain early warning system etc. 

I can share Tanzania suggested HIE conceptual framework if it will be of help. Or we can discuss this during our next call, will do my best to join.

Regards,

Alpha Nsaghurwe

On Thu, Apr 12, 2018 at 9:32 PM, Chris Wright <chris_...@jsi.com> wrote:

I'm sorry to say that I'll miss this next meeting as I will be on leave and off line next week.

On Thu, Apr 12, 2018 at 6:59 PM, Shivers, Jennifer Ellen <jesh...@regenstrief.org> wrote:

To:  OHIE Supply Chain Community 

At out last meeting, it was determined that a small group would begin to sketch out how supply chain system actors might fit with the OpenHIE architecture.   As we being to frame this discussion for our next meeting on 20-April at 11:00 am EST, I wanted to share these sketches with you so that you have time to comment and provide input on possible alternative views.  Please keep in mind that the OpenHIE diagram is meant to represent a logical view of how the components interact at a high-level.  We find that logical and physical diagrams for projects may differ in placement of systems like HIMS.  (Note that placement of applications like DHIS2 (HMIS) may depicted both above and below the interoperability layer  - see diagram here.)

With that frame for the OpenHIE architecture diagram in mind, here are rough sketches of two possibilities for including the supply chain components:  

1)  See slide two

2) See slide three

The rest of the slides depict how the descriptions for the system actors were defined and possible data exchange needs.  

We look forward to discussing your views of how you see the system actors fitting into the OHIE architecture on the next call. 

Jennifer 

Jennifer Shivers  |  Senior Integration Architect  | Senior Business Analyst

Tel 317-797-1200 | Skype jennifer.shivers

1101 West Tenth Street

Indianapolis, IN 46202

Web and email addresses, and phone numbers will remain the same.

Tel 317-274-9234 | Fax 317-274-9303

Twitter: @Regenstrief  |  Facebook.com/regenstriefinstitute

www.regenstrief.org

 

Confidentiality Notice: The contents of this message and any files transmitted with it may contain confidential and/or privileged information and are intended solely for the use of the named addressee(s). Additionally, the information contained herein may have been disclosed to you from medical records with confidentiality protected by federal and state laws. Federal regulations and State laws prohibit you from making further disclosure of such information without the specific written consent of the person to whom the information pertains or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is not sufficient for this purpose.

 

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chris wright Practice Lead, Data Visibility & Use CELL: +41.77.951.7144 | WWW.JSI.COM/SUPPLYCHAIN

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[Chris Wright]

I agree that the framework doesn't reflect the complexity within the SC domain. Perhaps for a generic term we need to expand label the domain SCIS for supply chain information systems, in which LMIS would serve as a the primary hub for the domain?

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[Nsaghurwe Alpha]

Exactly,

And this is applicable to many other external system setups. So we can use LMIS as reference group to inform other areas. 

My 2 cents.

Alpha

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chris wright Practice Lead, Data Visibility & Use CELL: +41.77.951.7144 | WWW.JSI.COM/SUPPLYCHAIN

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[Carl Leitner]

Hi Chris,

These look good.   One suggestion is that we combine the "registry of products” with the “registry of health terms” under the "terminology service.”   Note that there are already things within the terminology service that are not disease classifications (e.g. ICD-10 codes).  For example, it often includes the list of health worker cadres.   

Cheers,

-carl

On Apr 12, 2018, at 2:32 PM, Chris Wright <chris_...@jsi.com> wrote:

I'm sorry to say that I'll miss this next meeting as I will be on leave and off line next week.

On Thu, Apr 12, 2018 at 6:59 PM, Shivers, Jennifer Ellen <jesh...@regenstrief.org> wrote:

To:  OHIE Supply Chain Community 

At out last meeting, it was determined that a small group would begin to sketch out how supply chain system actors might fit with the OpenHIE architecture.   As we being to frame this discussion for our next meeting on 20-April at 11:00 am EST, I wanted to share these sketches with you so that you have time to comment and provide input on possible alternative views.  Please keep in mind that the OpenHIE diagram is meant to represent a logical view of how the components interact at a high-level.  We find that logical and physical diagrams for projects may differ in placement of systems like HIMS.  (Note that placement of applications like DHIS2 (HMIS) may depicted both above and below the interoperability layer  - see diagram here.)

With that frame for the OpenHIE architecture diagram in mind, here are rough sketches of two possibilities for including the supply chain components:  

1)  See slide two

2) See slide three

The rest of the slides depict how the descriptions for the system actors were defined and possible data exchange needs.  

We look forward to discussing your views of how you see the system actors fitting into the OHIE architecture on the next call. 

Jennifer 

Jennifer Shivers  |  Senior Integration Architect  | Senior Business Analyst

Tel 317-797-1200 | Skype jennifer.shivers

<image002.png>

1101 West Tenth Street

Indianapolis, IN 46202

Web and email addresses, and phone numbers will remain the same.

Tel 317-274-9234 | Fax 317-274-9303

Twitter: @Regenstrief  |  Facebook.com/regenstriefinstitute

www.regenstrief.org

 

Confidentiality Notice: The contents of this message and any files transmitted with it may contain confidential and/or privileged information and are intended solely for the use of the named addressee(s). Additionally, the information contained herein may have been disclosed to you from medical records with confidentiality protected by federal and state laws. Federal regulations and State laws prohibit you from making further disclosure of such information without the specific written consent of the person to whom the information pertains or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is not sufficient for this purpose.

 

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chris wright Practice Lead, Data Visibility & Use CELL: +41.77.951.7144 | WWW.JSI.COM/SUPPLYCHAIN

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[Chris Wright]

Hi Carl. 

Product registry may or may not be related to terminology; it is a list of products registered for use by the national drug regulatory authority. It might also include medical equipment. This serves as a single source of truth for warehouse management systems, procurement shstems, meidical asset inventory systems, EMR meds dispensing modules, and LMIS. It might be housed in an HIE terminology registry. 

On Fri, Apr 13, 2018 at 14:40 Carl Leitner <litl...@gmail.com> wrote:

Hi Chris

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[Carl Leitner]

Yep, and to clarify I wasn’t suggesting that the “Product Registry" and “Terminology Service” are the same pieces of the software (e.g. the Product Registry needs to support the relevant GS1 standards, for example) but they are perhaps more similar than different in their functionality. 

Cheers,

-carl

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[Derek Ritz]

Hi all.

 

I must admit that I’m worried about scope creep. I agree with Chris and Alpha that trying to embody the entirety of supply chain management into our HIE architecture might be biting off more (way more!) than we can chew. I think we’re better served to appropriately treat the entire supply chain domain as a full architecture and technology stack in its own right and, instead, look for where/how health transactions connect with and relate to supply chain transactions.

 

Doing such a mapping between health transactions and supply chain transactions will require that certain master data elements can be related to each other. The most obvious of these are “locations” and “items”. For the first – this will mean we’ll need to be able to get the GLN (or whatever ID# the SCM side is using) for each of our facilities in the ILR. And for the latter, we’ll need to be able to map the meds referenced in a “dispense” transaction to the GTINs for these products. Similarly, we can imply consumption of commodities in our labs based on the execution of certain lab tests and the consumption of med/surg commodities during surgeries (or the consumption of medical devices, if these were implanted)… and so on.

 

This gets more complicated the deeper we decide to go. Happily, however, the first basic maps we develop could yield significant benefits pretty much right away. In SCM, generally – and particularly in how SCM is applied in the manufacturing sector – there is a concept called backflushing. Backflushing is were we take a transaction that is relatively easy to track and measure and imply from it a whole family of transactions that also must have occurred. For example if we manufacture little red wagons, each one of these that rolls off the assembly line “backflushes” the consumption of 4 wheels, 2 axles, one red box and one handle.

 

I think it might be smart to look for the data maps we’d need to support in order to allow us to support backflushing; in order for us to imply inventory transactions from healthcare events we will have recorded in our SHR, for example. Doing this would focus us on one key piece of the SCM puzzle: the consumption transactions. There will have to be, of course, replenishment and physical stock keeping and logistic network planning and all sorts of other things… but this whole inventory ecosystem doesn’t all need to be in OpenHIE. Or not yet, at least.

 

I’m very interested to know what others think of such an approach (and the narrower scope it implies).

 

Warmest regards,

Derek

 

Derek Ritz, P.Eng, CPHIMS-CA

ecGroup Inc.

+1 (905) 515-0045

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[Shivers, Jennifer Ellen]

HI.  Thank you for great dialog last week.  I have a follow up question:  

Do LMIC countries implement LIMS systems that are focused on the health supply chain or are these systems more broadly focused?  

The answer to this may provide some insight into how we conceptually depict relationships.  

Thanks! 

Jennifer 

Jennifer Shivers  |  Senior Integration Architect  | Senior Business Analyst

Tel 317-797-1200 | Skype jennifer.shivers

1101 West Tenth Street

Indianapolis, IN 46202

Web and email addresses, and phone numbers will remain the same.

Tel 317-274-9234 | Fax 317-274-9303

Twitter: @Regenstrief  |  Facebook.com/regenstriefinstitute

www.regenstrief.org

 

Confidentiality Notice: The contents of this message and any files transmitted with it may contain confidential and/or privileged information and are intended solely for the use of the named addressee(s). Additionally, the information contained herein may have been disclosed to you from medical records with confidentiality protected by federal and state laws. Federal regulations and State laws prohibit you from making further disclosure of such information without the specific written consent of the person to whom the information pertains or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is not sufficient for this purpose.

 

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[Chris Wright]

LMIS are typically focused on health supply chains in LMICs, but other government service sectors may well have analogous systems for, say, primary school text books. The private sector has a variety of systems that link distribution with point of sale systems but they don’t refer to them as LMIS. 

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[Derek Ritz]

Hi all.

 

I’d advocate for us separately considering supply chain management vs. logistics network management (the former is a superset of the latter). Although the healthcare system will usually have its own sector-specific supply chain solution, the logistics network that replenishes demand may be made up of a mix of both common commercial carriers and dedicated logistics – some of which may be health-sector specific and others which may be operated on a whole-of-government basis.

 

Making these distinctions will help us be explicit about any assumptions we’re making as we do our modeling. There will be connections/relationships between OpenHIE and the healthcare supply chain’s supporting ICT systems and between these SCM solutions and the underlying logistics network that replenishes demand. My sense is that the OpenHIE-SCM connections will afford us ways to improve the effectiveness of demand management. Improving demand management opens opportunities to do a better job of supply management (replenishment) – and there are potentially significant health-related and economic benefits that can be associated with this. 😊

 

Warmest regards,

Derek

 

Derek Ritz, P.Eng, CPHIMS-CA

ecGroup Inc.

+1 (905) 515-0045

This communication is intended only for the party to whom it is addressed, and may contain information which is privileged or confidential. Any other delivery, distribution, copying or disclosure is strictly prohibited and is not a waiver of privilege or confidentiality.

 

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