Wednesday, March 22, 2017

Fake news for April fools


There’s a fine line between alternative facts and real ones. As we pass through April 1, read these headline blurbs and decide.
  1. Springing from the trendy “The Internet of Things,” one Supply Chain manager starts a basement cult centered on “The Purchasing of Things.” Suppliers around the country rejoice and fill the offering plate at each weekly worship service.
  2. Clever purchasing director discovers that the CFO’s golf clubs can effectively work the kinks out of contract price matching with the GPO database if he whacks his own MMIS hard enough with a nine iron.
  3. One hospital increases Supply Chain staff efficiency by making employees wear Foley catheters and leg bags in lieu of bathroom breaks. Savings generated from the workflow (and waste flow) improvements more than offset the costs of Foleys and bags purchased. Infection preventionists launch immediate protest.
  4. After a cost-conscious hospital bans purchasing of EpiPens, an industrious infection preventionist develops a new way to deliver epinephrine through Nerf blasters you can buy in the dollar bins at your local pharmacy outlet.
  5. Hospital value analysis manager is praised for improving clinical and purchasing process collaboration based on recommendations learned from the Dr. Oz television show.
  6. In a new twist on the “wearables” fad, one company develops a special skin-tight “A.I.” suit that allows staffers to work 24 hours a day. Sterile Processing leaders express concern that the suits must be certified to function properly during that overnight 3rd shift.
  7. In the latest effort to boost interest in supply data standards for healthcare products, GS1 Healthcare decides to incorporate the use of emojis in GTINs. Guess what the smiling turd represents?
  8. To improve communications with Supply Chain, critical care nurses are flocking to the “Materials Management Magic Wand.” This insanely popular product is nothing more than a multicolored squeaky clown hammer that comes with easy-to-read instructions: An arrow pointing to a silhouetted forehead with the words, “Aim here.”
  9. Sterile Processing tech finds a creative use for older model sterilization containers as effective storage bins for staff sack lunches and for flashing frozen dinners.
  10. New Louisiana university study finds that the best time for a New Orleans hospital to run low on supplies is between 3 a.m. on Fat Tuesday and 3 a.m. on Ash Wednesday.
  11. Feeling threatened by growing interest in two-bin Kanban systems, the makers of automated supply cabinets up the ante by equipping each of their models with a built-in Keurig machine.
  12. Automated Press Ganey sensors for immediate-access patient satisfaction scores represent the latest premium option for bar-code scanners, RFID scanners, and RTLS.
  13. Cronuts become the newest incentive of choice given to doctors by the savviest and most sophisticated of product sales representatives.
  14. Repless “advisory” team caught watching Netflix and Hulu on their iPads during virtual surgical “consultations.”
  15. A band of Luddite logisticians are developing Meaningful Use guidelines for clipboards, pens and sticky notes.
  16. To promote adoption and implementation of electronic health records, former band members of ELO reunite and go on a national tour as EMR. They re-release “Don’t Bring Me Down,” with an emphasis on paper-based patient records and payer reimbursement.
  17. Disappointed Supply Chain pros regret learning that 340B is not part of their compensation package. Nor are employee discounts for private-label products.
  18. To boost interest and participation in UDI implementation, the FDA borrows from the Lean Six Sigma philosophy and blends it with the martial arts colored-belt ranking system, granting gilded Black Belts to the heaviest users. In a seemingly unrelated development, retail outlets around the nation experience a run on black spray paint.
  19. When just-in-time distribution slips and stockouts prevent just-in-case hoarding, empathetic Supply Chain departments employ the just-in-bieber method, singing “Sorry,” a capella.
  20. What did Supply Chain pros give up for Lent? Top five sacrifices include stockouts, user-defined fields, Report Writer, patient charges and HPN. Wait, what? Sorry. Typo. They mean HPN’s SKU’d column.

Rick Dana Barlow

Wednesday, February 22, 2017



With the AORN Congress starting on April Fool’s Day, and Healthcare Purchasing News celebrating its 40th anniversary, it seemed only fitting to share some bumper snickers and T-shirt “pundamentals” to recognize and revere the noble and paramount profession of nursing.

Some of these 40 may be public knowledge; others are modified or simply contrived, but satirized for your protection. Enjoy the laugh and be proud of what you do and how you contribute to high-quality healthcare delivery.

  1. OR Nurse: Because “Miracle Worker” isn’t an official job title.
  2. RNs always give 100% … unless they’re donating blood.
  3. Floor nurses know that supply hoarding is a cache business.
  4. Nurses never have enough time to be so busy.
  5. Nurses always call the shots.
  6. Nursing is all fun and games … until the doctor tries to assist.
  7. Nurse Management: Keep calm … and use a sticky note.
  8. The nurse is the first person you see after saying, “Watch this!”
  9. No matter how serious, orthopedic nurses never ignore the humerus.
  10. I.V. nurses know how to pump you up.
  11. Nursing IT secret: When the surgeon loses his mind, know that his backup must be somewhere.
  12. RN power: Cute enough to stop your heart; skilled enough to restart it.
  13. Nurses wear scrubs. They don’t need capes.
  14. Anyone who thinks “the customer is always right” never worked in critical care nursing.
  15. Some surgical suite problems are caused by a loose nut gripping the surgical robot controls.
  16. Nurses know that surgeons screaming at them just need to be rebooted.
  17. Nurse engineering: If something’s not broken, mark the other side so the doctor gets it right.
  18. Be nice to nurses. They keep doctors from killing you.
  19. You can talk to the doctor in charge, or the nurse who knows what’s really going on.
  20. Nurses have the best jobs. They get to stab people with sharp, shiny objects!
  21. Nurse Managers aren’t control freaks, but they can show you the right way to do something.
  22. Nurse power: Walk softly but carry a large-bore 18-gauge needle.
  23. Some doctors swear by their supply chains. Some nurses swear at their supply chains.
  24. Infection preventionists know that bacteria may be the only culture some people have.
  25. Nursing veterans love the smell of anesthesia in the morning.
  26. According to nursing chemistry for sterility, alcohol is a solution.
  27. Nursing journal editors know the semicolon is not a medical condition.
  28. Nurses know that some days, it’s not even worth chewing through the red tape.
  29. Nurses know that even the best healthcare system in the world needs to be good enough for patients.
  30. Good nurses realize some doctors specialize in counter-intelligence as they can recognize stupidity.
  31. Smart nurses see UDI in an EHR world.
  32. Product Evaluation Committee Meetings: The ultimate whine and geez party.
  33. Nursing is the new black.
  34. Nursing signature of success: Be yourself. Everyone else is taken.
  35. Be the kind of circulating nurse that when you enter the sterile field, Dr. Satan says, “Oh crap, she’s here!”
  36. As a nurse I may not be perfect, but I’m so close it scares me!
  37. G.I. nurses know, when you neglect to irrigate, the patient moves to litigate.
  38. Nurses don’t give up. They know Moses was once a basket case.
  39. N.U.R.S.E.: Never Underestimate Registered Surgical Excellence.
  40. Nurses: Fixin’ cuts; stickin’ butts.

Rick Dana Barlow

Wednesday, February 1, 2017





       Animal Services & Welfare
       Assisted & Independent Living Services
       Boy Scout/Eagle Scout Projects
       Clinics – Dental, Medical, Mobile, Vision, Veteran
       Community Health Center
       Community Development Programs
       Community Preparedness
       Dental and Health Facilities
       Dental Services & Care
       Disability & Low Income Services
       Disaster Relief
       Educational Clinics & Programs – Dental, Nursing
       Emergency Preparedness & Response
       Fire Departments
       Food Banks & Hygiene Kits
       Health & Care Fairs
       Health Education Programs
       Homeless Support Services
       Hospitals – General, Children’s
       Hospital/Clinic Facility Upgrades
       Maternity Care & Programs
       Medical & Dental Vocations Training
       Medical Services & Care – General, Emergency, Geriatric, Pediatric, Pharmaceutical, Respiratory
       Missions – Dental, Medical, Pediatric, Vision
       Neuro Rehabilitation Center
       Refugee Care
       Schools – Dental Hygiene, Nursing
       School Nurse Supplies
       Special Education Programs
       Surgical Missions - Facial Reconstruction, Ophthalmic, Orthopedic, Pediatric, Urological
       Sustainability Programs
       Veteran Programs
       Youth Programs

We look back on 2016 with gratitude and amazement – at the generosity of our donors, the dedication of our partners, and the diligence of our employees. Because of the efforts of these and many others, we were able to fulfill our mission to improve the delivery of healthcare worldwide. In particular, in 2016 Globus Relief:

       Partnered with over 220 charity partners worldwide
       Provided aid in 59 countries, from Afghanistan to Zimbabwe
       Shipped the equivalent of 64 containers to hundreds of destinations
       Filled more than 1,230 requests for medical & dental humanitarian aid
       Distributed over $30 million in supplies, instruments & equipment

Donations were employed to back a full array of humanitarian programs (see list at right), from suppling clinics in Kosovo, to treating war-weary refugees in Syria and Turkey, to medical missions across South America, to vision treatment in Ghana. Domestic and local programs also benefitted – nursing schools, veteran programs, maternity care, community clinics, charitable dental care, homeless support services. And the list continues. Truly we are engaged in a tremendous work.

As we now look forward to 2017, we are enlivened by the opportunities to expand this work even further – to help more people, in more places, more efficiently. To accomplish this, we hope in 2017 to: (1) increase the dating on donated supplies to comply with international shipping guidance constraints (minimum of 12 month dating), (2) identify and obtain funding sources to ffset inbound donation and product acquisition costs, (3) heighten internal efficiencies through process consolidation and the eventual move into a permanent, non-leased building and (4) enhance our current IT resources to decrease labor costs while elevating product accessibility and transparency.

We cannot say enough about what the support of you, our donors, partners and other stakeholders, has meant to the good Globus Relief provided in 2016 and will yet mean to accomplishing our aim of increasing that impact in the future. We look forward to collaborating with you in this great effort in 2017 and beyond.

Globus Relief is Your Humanitarian Non-Profit Inventory Solution. Please contact us if you have medical or dental equipment, instruments, and supplies or other resources available for donation.

Monday, January 23, 2017

Supply Fi


Many people recognize the honorable and indelible motto of the United States Marine Corps. as “semper fidelis” or the abbreviated “semper fi.” This Latin phrase, means “always faithful” or “always loyal.”

For four decades, Healthcare Purchasing News (including its previous names) has been always faithful and always loyal to covering, exploring, reporting on and writing about supply chain events and issues — including purchasing and materials management, sterile processing, surgical services and infection control — as important, as tantamount to healthcare organization success and patient care quality. We didn’t want you to surmise that the “Fi” in the headline somehow signified “fiction” as in sci-fi.

In fact, one of the overriding themes woven into HPN’s industry coverage involves the critical importance of supply chain to the clinical, financial and operational blueprint of day-to-day activities. Individual and organizational development hinges on it.

During the last decade, HPN implicitly and tacitly promoted the idea that Supply Chain belongs in the C-suite — either directly with a seat at the table or indirectly as the immediate go-to executive tapped by the CEO, CFO, COO, CMO and CNO (not necessarily in that order all of the time) to handle big picture issues with a firm grasp on all the snapshot issues feeding into them.

Deep down, that underlying philosophy continues and remains unchanged.

But for this decade, the next decade, HPN more overtly will reinforce the notion that for Supply Chain to justify its executive-level position and status it must fortify itself with data science and solid clinical connections. This means that whether right or wrong, Supply Chain needs to be armed with information and backed up by physician and surgeon “manpower” to influence, if not drive, decision-making authority.

Supply Chain will accomplish this through their inherent negotiating expertise, which involves a degree of persuasion, fueled by data. What’s that mean? Healthcare reform has placed clinically driven and motivated physicians and surgeons under fire for the last two decades. What these clinicians lack, by and large, is business intelligence as another dimension under consideration for thorough diagnoses.

This doesn’t mean the doctors must partner with the CIO and the IT department to succeed any more than a consumer will lean on his or her car dealership salesperson or mechanic to advise him or her how to drive. No disrespect intended for the IT folks but in simplest and most idealistic form, they make sure the communication and computer equipment works, integrated into the medical/surgical, imaging and laboratory infrastructure. Supply Chain, meanwhile, should be sourcing and acquiring that equipment, with clinician input and oversight, of course, but also delving into the data science elements of analysis and analytics (read about the difference between these concepts deeper inside this edition) to help clinicians make optimal decisions that impact the quality of care they deliver and how the patients who receive that care respond in kind.

That’s why we’re amping up and ramping up our exploration of Supply Chain’s clinical and IT connections.

No, I’m not referring to Supply Chain issues in a clinical and IT world. I’m referring to clinical and IT issues in a Supply Chain world. Big difference. Don’t believe me or agree? Stick with us and you’ll see what we mean. By our 50th anniversary in 2027, we think Supply Chain will be right where it’s supposed to be perched.

Rick Dana Barlow

Thursday, December 22, 2016

Ten in 10 ahead


Last month, we highlighted 10 milestones from the last decade as Healthcare Purchasing News marked 40 years of service. This month we fast forward with 10 predictions about the next decade as HPN races toward its 50th year.
  • The group purchasing industry, which surfed a considerable consolidation wave during the last decade, hits some breakwaters in the coming decade, as the largest GPOs foresee greater valuation — in revenue, efficiencies and cost savings — by splintering into key specialties to foster and foment competition. With the market shifting to clinically motivated provider-driven shared services operations, these smaller specialty service organizations cater to data science, labor/workflow and supply/service demands.
  • Armed with legal protection, manufacturers will sign “immediate-use manufacturing” license agreements with providers that allow healthcare facilities to 3-D print a growing array of products on site. Clinicians will be able to produce a variety of implants on demand as a countermeasure to consignment and loaner programs. Bolstered by this progress, manufacturers cautiously expand the 3-D printscape to a variety of commodity items as a strategic solution to disaster-related shortages, and demand-driven backorders.
  • As reports of improperly reprocessed devices multiply, single-use device manufacturing enjoys growth extensions into higher-tech minimally invasive product categories, including single-use-only rigid and flexible endoscopes. Reprocessing SUDs for limited additional use generates heavy debate and discussion.
  • Because a majority of states will require SPD certification over the next decade, a nationwide accreditation and certification requirement surfaces, which is endorsed by a number of clinical and professional organizations. Further, the federal government will require certification of all reprocessing techniques for reusable products as part of granting marketing clearance for all new products and retroactively will phase in the same for previously cleared products over a five-year period.
  • Frustrated (and rightly so) by the slower pace of adoption and implementation of healthcare supply data standards for medical/surgical products versus pharmaceuticals, standards proponents make one last push. Noteworthy organizations succeeding with the federal Unique Device Identification requirements, along with links to electronic health records, push through the operational resistance just ahead of an anticipated CMS penalty for non-compliance. With universal data standards for healthcare products and services in place by the late 2020s, healthcare organizations undercover rafts of data inaccuracies and operational inefficiencies that will reshape education and training in the 2030s.
  • With automation, digital and electronic capabilities woven like fibrous tapestry throughout a number of the largest healthcare trade shows in the U.S., a horizontal integration movement emerges to create a confederated exhibition of clinical and medical science and technologies. This North American Healthcare OmniExhibition for diagnostic imaging, IT, med/surg, laboratory/pathology and oncology includes marketing and sales incentives to encourage cross-attendance and cross-exhibiting/sponsoring growth with an eye on patterning itself after Europe’s ginormous Medica show.
  • Supply Chain finally will be acknowledged and accepted as the largest expense category in a healthcare organization, encompassing both labor and non-labor costs, products and purchased services. Supply & Service Management enjoys departmental and professional title popularity for a while. Consequently, a data science-driven Supply & Service Management department (encompassing collection, analytics, visualization and virtualization) will propel its key executive leaders to C-suite importance, prominence and relevance.
  • Data science gains momentum in Infection Control and Prevention as clinical experts can become certified in surveillance techniques and clinical data analytics. This will motivate epigenetic modeling to reinforce patient and population health-based behavior modification, a controversial but more proactive and less reactive approach to infectious outbreaks.
  • Look for technology advances in air quality to reach new heights as breakthrough developments for filters, scrubbers and pulsed-light stationary and mobile devices emerge that are safe for human exposure even as they render bacteria, dust particles and other microorganisms inert and easy to remove via vacuum suction or blowers.
  • The plethora of personal and remote healthcare devices, including smart phone apps and wearables, hits a fever pitch as manufacturers take a cue from Hollywood’s sensor-bedecked motion/performance capture suits and release healthcare-specific models that can monitor vital signs, chronic conditions and physical therapy progress that can be uploaded to the EHR.

Rick Dana Barlow

Tuesday, November 22, 2016

Ten in 10

Fast  Foreward

Next year marks the 40th anniversary of Healthcare Purchasing News. Technically, HPN reaches the four-decade milestone in April as the bimonthly Purchasing Administration sported a March/April 1977 cover date.

Each successive decade since that auspicious time offered up a wealth of healthcare industry milestones that impacted its growing readership base, spanning supply chain operations, sterile processing, surgical services and infection prevention.

Over the course of 2017, HPN will reminisce about healthcare industry milestones that directly impacted our four key readership segments.

Until then, here are 10 milestones HPN readers have endured during the last decade.

  • The last decade began with the stock market crash of 2008 and the ensuing “Great Recession” that not only impacted pricing and supply flow but made passage and enactment of the Accountable Care Act within two years more palatable and accepting — even as it served as a prelude to America’s ultimate conversion to a single-payer system, which has yet to reveal itself.
  • President George Bush may have tossed out his moonshot policy item of universal electronic health record availability, access, adoption and implementation, but it didn’t seem to go into overdrive until President Barack Obama’s terms and as a companion to ACA. Unfortunately, adoption and implementation has been outpaced by debates, discussions, doubts and pushbacks about the convenience and reliability of the technology as well as the validity of claimed benefits.
  • As the healthcare industry became more dedicated to and reliant on automation, computers and the internet as well as wireless communication and operations to make processes more efficient, the development also opened the floodgates to hackers as security breaches leapt to all-time highs with millions of patient records exposed.
  • On the bright side, the cause for adoption and implementation of supply data standards for medical/surgical devices and other healthcare products enjoyed a boost of awareness and need recognition with the entrance of GS1 into the mix. Of course, the awareness and excitement far outpaced adoption and implementation for the same reasons cited two paragraphs earlier for EHRs.
  • Futuristic, science-fiction-teeming technology debuted — not just the iPhone and iPad, but also speech-to-speech and speech-to-text translation software, Google Glass (short-lived), smart watches and “wearable” sensors that showed promise for monitoring vital signs as well as managing inventory. Even real-time location systems using radiofrequency identification, infrared, ultraviolet and ultrasound, among other “modalities,” experienced a surge in interest to which adoption and implementation continues to chase and play catch-up. But workable applications in healthcare operations continue in development and far from widespread use, along with 3-D scanning and printing of products, organs and tissue for a variety of legal reasons, and augmented and virtual reality capabilities.
  • Online “portals,” remote monitoring devices, self-service kiosks and telemedicine capabilities experienced a surge in interest and applications as the ACA payer aftershocks forced patient engagement in the care they receive, virtually eliminating the convenience of paying someone else — or having them pay — to make decisions.
  • The medical concept of “never events” saw an unprecedented definition expansion to 29 events grouped into six categories: surgical, product or device, patient protection, care management, environmental, radiologic and criminal. Yet now they also were conjoined to government/public and private reimbursement. “Accountability” quickly grew teeth under “accountable care.”
  • Implants and prosthetic limbs with motorized components or linked to neurological cues brought patients closer to “The Six Million Dollar Man” than your living room analog television set could in the 1970s.
  • Diagnostic imaging capabilities grew by going smaller and faster — from molecular capabilities to holographic and motion-capture 3-D/4-D photographic slices to the measurement of tissue elasticity as a disease marker. We may be a long way off from the magic pill or silver bullet but it seems like that distance is getting shorter. 
  • Finally, the last decade saw the largest consolidation wave in the group purchasing industry since the mid-to-late 1990s under President Bill Clinton’s healthcare reform initiative.

Next month, we’ll highlight some predictions as HPN progresses toward its 50th year.

Rick Dana Barlow

Thursday, November 3, 2016

Getting my goat

by Rick Dana Barlow 

It’s never a good sign when you drive up to your local Dick’s Sporting Goods store early in the morning before traditional business hours and notice a full parking lot with two squad cars near the front entrance. It’s like the Chicago Cubs won the World Series or something. Oh wait…

So I skedaddle into the building hoping to score a few Cubs T-shirts before the pesky crowds arrive (which I expected to happen around lunch hour). Too late. The panoramic scene before me resembled a cross between the Bridal Gown sale at Filene’s Basement in Boston and Billy meandering home through the neighborhood for supper after playing just two houses down in the cartoon “Family Circus.” Underneath the red, white and blue balloon arch commemorating the Cubs’ historic, milestone achievement were two 30-foot-long rows of tables piled high with stacks of different styles of T-shirts, shirts and hats as hordes of suburban fans – obviously taking early lunches from work – nosed, nudged and shouldered their way around each other like locusts. They clawed and pawed for the proper sizes at what had been neatly arranged stacks of linen, leaving rumpled piles in their wake like your teenaged son’s bedroom floor with the empty laundry hamper in the corner.

A police officer, standing stoically off to the side, eyes darting back and forth, his hands gripping his belt of weapons, hardly cracked a smile until I broke him of his beefeater pose with a few innocent comments and questions. It turns out he’d been on duty since 1 a.m. ahead of the store opening at 3 a.m. when the lines started.

With my merchandise in hand, I embarked on a winding tour through all of the nooks and crannies of the store, treading on carpet in spots that probably hadn’t felt shoe soles in a long time and retained that “fresh-floor smell.” (Sadly, I’m referring to the Bears and White Sox merchandise sections, but I digress.) I finally found the back of the line that was growing faster than you could spread the flu virus from coughing with an open mouth. Yes, right next to women’s socks way in the back.

As our queue of about 300 people – and growing by the minute – slowly slithered through the store, my new line-mates and I (who created our own impromptu “live” social network to pass the time) could only chortle as we noticed three or four store “managers” scurrying around the racks of ignored non-Cubs merchandise, trying not to make eye contact with any of the customers winding throughout the building. (We surmised they were managers because their lanyards read “Coach” on them, and they were pointing and talking as if trying to look busy doing nothing while their employees were overheating the few working cash registers at the front of the store.) Most amusing: The FedEx semi-trailer pulled up alongside the other entrance to the store, which was closed off to better manage foot traffic. (By the way, another “Coach” stood by those doors to direct people to the other doors on the other side of the building.)

We joked about storming the truck and offering cash for the Cubs merchandise as there was so little looting, pillaging and rioting in Wrigleyville last night. Some suburb just had to pick up the publicity baton and run with it, you know? We schemed about grabbing all the discarded merchandise along the way by impatient customers, paying for what we could gather and then scalping it on the street outside the store for a 10 percent or 20 percent markup. But alas, we retained our self-control. We already had invested 60 minutes of our morning for a few commemorative T-shirts, so what’s another 30 or so of inching along for another 200 meters to enter the Promised Land of Purchasing? Besides, we were just happy to be ahead of all those people still waiting by women’s socks.

When we finally arrived at the checkout counters – several of which were folding tables sagging at the center – we high-fived one another and stepped up to check out. This is where it turned interesting from a supply chain perspective. None of the merchandise carried a bar code or any kind of radiofrequency identification chip or tag. Instead, the cashier had to visually inspect each item and then thumb through a stapled packet of paper, each sheet sporting an image of a product with a bar code printed next to it. When he matched the item in his hand with the corresponding image in the packet, he scanned the bar code. Time-consuming, indeed. When I asked him why each item didn’t have a bar-code label affixed to it he replied that the merchandise had arrived this morning and was expected to move too quickly to justify marking each item. Of course, had the Cubs lost to the Indians, all this pre-printed merchandise would have been shipped to Africa and remote parts of Asia for distribution anyway, so I partially understood the oversight. I still thought this retail outlet could have configured a better, more efficient system for point-of-sale progress because they had at least a week to plan for it. This wouldn’t happen in hospitals, I reasoned. In most the merch doesn’t move that fast anyway unless you’re hording a treasure trove above the ceiling tiles.

Nonetheless, I exited the store after my 90-plus minute social and retail experiment drenched in euphoria and steeped in history, noticing the long line of people behind stanchions that curved around the building. I briefly entertained a thought to tell them about the wait they faced, but stopped myself. Maybe they were shopping for women’s socks.