How medical device experts are confronting supply chain challenges
By Andy Lundin
Over the last several years, global supply chains experienced unprecedented levels of demand, which complicated healthcare equipment and device acquisition trends. And while the medical industry awaits the supply chain’s return to pre-pandemic stability—or at least arrives at a “new normal”—industry professionals have identified ways to persevere through the challenges.
“We are observing a few trends that are helping the industry including changes to inventory distribution, a higher focus on product availability, and the importance of accessing reliable information,” says Tim Mikac, vice president of business development and supplier solutions at Aurora, Ohio-based PartsSource.
It’s a point his colleagues in HTM echo.
Supply Chain Struggles and Solutions
Offshore manufacturing and just-in-time inventory management—along with increased demands during the pandemic—stretched the public health industrial base’s supply chains beyond capacities, according to a 2022 report of the Public Health Supply Chain and Industrial Base. Suffice it to say that this created frustrations for organizations looking to quickly acquire new medical equipment.
Conversely, well-organized medical organizations with a solid understanding of their inventory base—through the help of data—could rely less on an inconsistent supply chain.
“We have a comprehensive inventory that we maintain, which allows us to then have quality data for our clients,” says Kelley Jacobsen, senior vice president of supply chain and shared services at Indianapolis-based TRIMEDX. “We use our data and analytics to understand equipment utilization with clients and what’s happening from an ordering and stocking perspective. We then partner with our suppliers to make sure that we have materials available to our healthcare client providers.”
Indeed, being this thorough will also provide organizations with a better understanding of asset utilization.
“Many hospitals actually own more equipment than they need,” adds Brandon Anaya, senior director of upstream marketing and strategy at Eden Prairie, Minn.-based Agiliti. “On average, we see that hospitals only utilize around 40% of the equipment they own, which is often due to a lack of a dedicated management process or team. As a result, hospitals are often unaware of how much equipment they own and where it’s located within their facility.” Ignoring this inventory “blind spot” may ultimately result in unnecessary spending on capital equipment, Anaya maintains.
Additionally, a recent survey from research company Software Advice identified ways medical organizations may not be effectively engaging in inventory management.
“Most providers use passive methods to manage their supplies: 53% only reorder when supplies are low, 66% don’t have a supply chain specialist on staff to manage their inventory, and nearly half (42%) don’t even know if they use procurement software at their practice,” according to a survey takeaway.
Consider Partnerships for Equipment Sourcing
As evidenced by the abundance of new products that will be on display at November’s annual meeting of the Radiological Society of North America, the healthcare sector is launching medical devices at warp speed. And while this may represent a positive indication for the future of patient care, the increased demand compounds supply chain issues, which may result in organizations looking for alternative manufacturers and vendors to acquire goods.
“Generally speaking, people are looking at different technologies, sources, and materials to determine if there are other alternatives for specific component manufacturing,” Jacobsen says.
Unfortunately, identifying these alternate avenues of acquisition can get a bit muddled when manufacturers and vendors are pulling materials from the same supplier, a scenario that is detailed in a recent Medical Device Supply Chains Project Report.
“The situation can be more challenging because products require multiple components, all of which could be in short supply,” the report reads. “As a hypothetical example, consider a ventilator that requires both a regulator and a monitor. If one manufacturer were to buy up the entire supply of regulators in the market, while a different manufacturer bought up the entire supply of monitors, neither manufacturer would be able to produce any ventilators, because both would be lacking components that their competitor possessed.”
A way to remedy this is to establish solid industry partnerships and vendor relationships to help address potential supply chain issues before they materialize. To Jacobsen, this approach has been a game-changer. “We have a lot of analytics around what’s happening in the industry and what suppliers are available,” she says. “We work collectively with additional supplier partners that are qualified to have alternative sources available so we have alternate plans depending on what happens from a supply-disruption perspective.”
The Maintenance Factor
The condition of equipment housed at a medical site also plays a critical role in how much a healthcare organization may rely on the supply chain. “Comprehensive programs that are on regular preventive maintenance (PM) schedules and have onsite models that track usage and ensure equipment is being repaired in the most effective and efficient way allow for less usage of parts and our reliance on the disrupted supply chain,” says Jacobsen.
Indeed, if biomeds are actively maintaining healthcare equipment and devices located onsite, reliance on the supply chain will subsequently diminish.
Brandon Anaya agrees, stating that HTM can help extend the useful life of devices and reduce the need to procure new parts and equipment. “This can take stress off the supply chain and bring down capital outlay in the process,” he says.
Not that this is a panacea, some stress. PartsSource’s Tim Mikac, for instance, points out that ongoing biomed shortages can certainly complicate this strategy. “Staff shortages continue to impact service as HTM departments are beyond capacity due to a retiring workforce, resulting in increasing PM challenges,” says Mikac.
That’s why Anaya encourages HTM teams to evaluate where they are spending non-value-added time and develop plans to reduce or eliminate these activities.
Areas to evaluate include:
- Sourcing parts, negotiating pricing, and managing vendors.
- Management of large-scale projects (e.g., pump preventive maintenance projects).
- Equipment maintenance that requires significant logistics or storage space (e.g., beds and surfaces).
Evaluating vendors, like Agiliti, that can support these activities and operate as an extension of in-house teams can give HTM teams valuable time back to focus on more pressing issues, he says.
“COVID compounded the already significant labor shortages for HTM roles,” Anaya says. “Given all the unique challenges brought about by COVID, this group stepped up and stretched their responsibilities, giving them more exposure than ever before. The challenge is that this group is now being asked to manage a higher workload with existing or shrinking resources.”
Why Labor Challenges Are Important
Certainly, labor challenges played a major role in the disruption of the medical device supply chain. According to last year’s report from the Health Industry Distributors Association, increased demand for shipping and transportation services for medical supplies increased significantly over the last several years. The demand created backlogs and congestion and is producing significant delays, uncertainty, and cost increases.
Reasons for these challenges included a dramatic increase in e-commerce compounded by a shortage of commercial drivers, ships waiting longer to dock, as well as longer unloading times and other challenges. Fortunately, some of these disruptive trends are gradually relaxing.
“I believe we’re starting to see some of the supply disruptions from a component, raw material, shipping angle subside a bit, which may continue into the new year,” says Jacobsen.
Mikac concurs, saying he views the improvements in shipping times as a positive indication for the future of the medical device supply chain. “In 2022, we started observing a downward trend in average days to ship. This has continued through the year as the number of days for an ordered item to ship is approximately 75% lower now compared to January,” Mikac says.
Other Supply Chain Strategies to Consider
Because the future of the medical device supply chain is unpredictable, alternative approaches to better support device acquisition and utilization have become more essential, insiders say. The U.S. Department of Health and Human Services, for example, published a report urging hospitals to reprocess medical devices to encourage and facilitate better resource stewardship.
“Reliance on single-use disposable medical supplies and devices not only leaves health systems vulnerable to supply chain disruptions, as seen with the COVID-19 pandemic, but they are frequently cited as containing higher lifecycle emissions per use compared with equivalent application of reusable alternatives,” according to the report. “Healthcare organizations should strongly encourage and facilitate resource stewardship.”
Another avenue medical organizations may want to consider? Using rental equipment suppliers, according to Anaya.
“Many hospitals rely on partnerships with rental suppliers to help address their emergent needs without adding more cost and burden to the supply chain,” he says. “The key is to partner with ISO 13485:2016 certified suppliers who can provide visibility into the quality management system and full maintenance history of the rental equipment that will be used with patients. This avenue provides quality assurance and can be a viable option in cases where equipment is waiting to be repaired or on backorder.”
And, while technological innovations, such as 3D printing, are expected to help alleviate kinks in the global supply chain—particularly when it comes to parts replacements—one thing will always remain relevent, Jacobsen says: data.
“Using internal data and information will help us identify where we will be going and what we should be doing, and then partnering with the right qualified suppliers to make sure we’re ahead of the game,” Jacobsen says. And that, she says, is advice all clinical engineering departments should heed.
Andy Lundin is associate editor of 24×7 Magazine. Questions and comments can be directed to [email protected].