Friday, February 27, 2015

Some Health IT Supply Management Concerns in Middle-East


Healthcare technology supply concerns in middle East are numerous. Some are normal and natural, others are not common. Here, I will only focus on two examples from the EMR market in GCC.
Natural Evolution.An example of SCM issues which are encountered as part of natural evolution of the industry is the adoption of EMR's. In many cases, solution design happens without communicating with end user. Often, end user himself/herself doesn't want to get involved in the process. In such case, decision maker in the hospital (or health system) want to rely on the expertise of the solution provider and that's why they often contract only 'big name' firms. That situation is normal looking into the fact that this industry started only during the last decade in middle east. However, that leads to a situation where the user feels that the solution is enforced and; thus, lot's of resistance will be there to adopt the new solution. In fact, in many cases, user doesn't feel the ownership of this solution and I have seen some cases where users literally thrown away patient data to litter bins as part of a decision to change the solution provider. The solution to this odd situations will naturally come when when local management in GCC gains more expertise in both: field of Healthcare Technology and the field of Supply chain management and when the No. of Health IT experts grow up. Having such local expertise will shift trust from third parties to their own in-house experts. Those experts will naturally start getting more involved in the process of the solution design and thus will pretty much help in the change management and the adoption of the new systems.
Unique Situation.
On the other side, there are examples of some problems that are unique in middle east and the legal, political, financial systems in GCC play a big role in them. In fact, due to booming oil prices, GCC states have been allocating a good amount of their money for the development of their healthcare systems. Much of it goes to building new medical facilities and state of art medical technology. This is unique because almost every where in the world, economy was in hiccup except in emerging markets. GCC is still unique due to the high liquidity and due to the high GDP per capita. That will make buyer in GCC very hungry for consumption. Running a supply management system for a hungry market is not an easy task. In fact, majority of health systems in GCC are state owned which makes the procurement process very slow compared to privately owned facilities. So, high spending in a slow process, means that spending will only be in big-chunks. In such areas, supply chain management is not easy. If you push to speed up, you inject more money to corrupted practices, if you tighten the spending's; then you are slowing down the development process.
That shows up very clearly in EMR operation when; for example, EMR needs to be upgraded to a new version. That's is sometimes critical for the operations as new versions usually include fixes for previous bugs, or new feature that are necessary for the operation. In such cases, supply chain systems will not be able to finance those upgrades to new version immediately as the procurement process take long time. Thus, EMR management usually runs in trouble not because of shortage of money but rather running short in money on the right time. The solution to this problem lays; from my point of view, in the adoption of modern supply chain management techniques that will balance between spending and needs, by committing to evidence based purchasing and by decentralizing the supply management. In that case, the role of central management should be constrained to guidance, and motoring rather than direct control.
My final advice to GCC is to focus on the quality of spending on health technology rather than to focus on the amount of spending. Once we focus on quality this will automatically lead to an in depth perception and thus a sustainable solution to our problems in healthcare at GCC.

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