The Department of Defense, Philadelphia, launched its Global Data Synchronization Network (GDSN) pilot for the health care industry in December 2006. Initial participants consisted of four vendors, two GPOs and one hospital, in addition to 1SYNC, a subsidiary of GS1 US. The program’s stated overall purpose was to prove that data synchronization within the health care supply chain is possible. More than a year has passed since the project’s inception and though standards have yet to be implemented, industry sources say they are coming soon.
Testimony to this fact is in the growing number of participants in the program, which have expanded to about two dozen. The increasing number also illustrates how important standards are to those entrenched in the health care supply chain. Find out from vendors that have participated in the project about their experiences with data synchronization, how it affected their companies as well as their place within the health care supply chain.
Q Overall, what key lessons did you learn from the data synchronization program that you didn’t know before engaging in the pilot?
Dennis Black, Director of E-Business, BD, Franklin Lakes, N.J.
We learned that if we stick to the basic data fields that most providers can use now, data synchronization in health care is achievable today. We also found it is possible to reduce much complexity and become more efficient if we can get mass adoption across the industry. Supplying product information for the DoD Healthcare GDSN Pilot is much simpler and more accurate than the status quo. Secondly, we learned that if we burden ourselves with data attributes that are not available or cannot be used by providers, we are going to struggle. Also, we need to get mass adoption throughout the industry and eliminate some of our existing processes. We can’t layer another process on top of the current system. We need to make process changes.
Keith Lohkamp, Products Strategist, Supply Chain Management, Lawson Software, St. Paul, MINN.
The biggest lesson learned was that many systems, including those from Lawson, have many of the needed fields, technology and processes to at least get started. For example, most of the core data elements cited for synchronization match with fields already in our system, allowing for easy loading of data that is clean, standardized and synchronized. The pilot program also helped begin the discussion of how new data elements, such as the global trade identification number (GTIN), should be used in day-to-day processes such as ordering and electronic data interchange, and how their use would need to be phased in as more suppliers participate. What we learned from this was that data synchronization requires participation from all parties within the industry and impacts both supply chain business processes and supply chain technologies.
Joe Pleasant, Senior Vice President and CIO, Premier, Charlotte, N.C.
We learned three things: 1) The importance of having specific data attribute standards that all supply chain participants agree to as provided by the GDSN; 2) The need to have MMIS vendors modify their software database scheme to provide for the required and agreed upon data attribute fields; and 3) The importance of a majority of supply chain partners to use the data synchronization to achieve the efficiencies of the process.
Q Based on the large number of technical and strategic issues that still need to be resolved and the complexity of these issues, are you optimistic or pessimistic about the GDSN as a platform for health care product data utility?
Black: We are optimistic about using GDSN as a platform. It has been proven to work quite well in other industries and based on the pilot, holds great promise for health care. BD did not face any real technical challenges in the pilot—participation was pretty straightforward. The only real strategic issue seems to be moving toward market adoption. Which data pools and on-boarding partners will emerge to serve health care? Because the system is open to any company that meets the standard, it seems logical that a competitive market will emerge to meet industry needs. We also need to see how GPOs, distributors and GHX would choose to participate in the model.
Lohkamp: Certainly, there are a number of issues that need to be worked through. However, the GDSN is a proven platform that is used successfully in other industries worldwide, such as retail. This gives the health care industry a model to follow and build upon. In addition, since groups like the Healthcare Supply Chain Standards Coalition (HSCSC), the Coalition for Healthcare eStandards (CHeS) and the Association for Healthcare Resource & Materials Management (AHRMM) have endorsed GS1 standards, I’m optimistic that we have the focus and the industry support to overcome any issues we will face.
Pleasant: I am optimistic since the process is operational in other industries and many of the same manufacturers operate in those industries. In addition, there is a growing need to provide accurate and traceable information on products for recalls, patient ID and safety. Manufacturers are being asked to provide many different data attributes and product IDs so they are beginning to ask for global standards and synchronization such as the global location number (GLN), GTIN and GDSN. Also, regulatory agencies in many countries have or are considering requirements around product ID and associated attributes.
Q What do you see as the most significant challenges that still must be resolved to achieve industry consensus on global standards?
Black: The newly established product data standards were developed by the GS1 Global Data Synchronization and Classification Team. The standard was based on input received from many manufacturers and providers worldwide. These global standards also were validated by the hands-on experience of participants in the DoD Healthcare GDSN Pilot (Phase IIA).
Input also has been provided by HSCSC, CHeS and members of the Strategic Marketing Initiative (SMI). We have discussed, debated and refined the data standards for years, and now the industry needs to begin using the global standards. It will require a significant effort for full adoption and the standards will certainly evolve as more participants begin to use them, but we need to get started.
Lohkamp: First, the industry needs to bring the critical mass of providers, manufacturers, distributors and GPOs to industry initiatives and pilots to gain experience with the standards and a common sense of commitment.
In the past year, we’ve seen this building as each of the health care supply chain groups (such as HSCSC and SMI) has devoted significant time to this topic. In addition, data synchronization requirements in countries such as Australia, as well as the FDA’s UDI initiative, have helped drive a sense of urgency that is fueling interest and helping to build this critical mass. This critical mass will help with the next step—the “how-to.” Achieving standards and data synchronization can be quite confusing and difficult to learn. A practical guide that explains standards, their benefits and implementation steps will give providers and suppliers the blueprint to take the first small steps. These two steps will help drive significant consensus within the industry.
Pleasant: The most significant challenge will be educating the industry as to what is required and major organizations (i.e., first adopters) within each segment of the health care industry (e.g., providers, distributors, manufacturers and GPOs) adopting and beginning to use the standards. Everyone has been waiting for others to do it and we need early adopters to take the lead along with the FDA to push.
Q Are there interim steps that can be achieved en route to employing the GDSN or some other platform that can help hospitals, manufacturers and distributors reap gains?
Black: The process of implementing true product data synchronization will require several steps and system changes to implement. Providers have indicated that there is great value in using some of the product data immediately. Interim steps can provide a positive ROI during this migration period. We could all benefit by migrating toward the use of the GLN, GTIN and GDSN product data standards. Even though it will require time and system changes, we should see benefits as we migrate. Organizations, including HSCSC, CHeS, SMI, AHRMM and GS1, are developing tools to help support their members in this journey.
Lohkamp: One important outcome of the pilots that we’re seeing is a better understanding of the interim steps that organizations can take.
For example, hospitals can perform a current state analysis to understand data sources, analyze the breadth of product data, determine how product data is managed and evaluate how to improve that process.
In addition, hospitals can begin documenting the capabilities of both their materials management system and the readiness of their suppliers. Manufacturers and distributors also can conduct a similar current-state analysis and begin developing their internal master data management strategy.
Pleasant: Adopting the standards is a big start. This would include endorsement and use of the GLN (locator) and GTIN (product) standards. This would make adoption of the GDSN and beginning to use it for synchronization much easier.
Q In the manufacturer summary, it was noted that fewer data fields should be necessary for the health care industry to realize meaningful benefits. Who will drive this effort? To what degree do IT vendors need to perhaps initiate this?
Black: The initial list of desired data fields included almost 300 unique product data attributes. This wish list included every conceivable product fact that you could dream of and would be virtually impossible to implement. Experience gained from the DoD Healthcare GDSN pilot, the HSCSC Product Data Synchronization workgroup and the GS1 Product Data Survey has proven that health care providers can only use a very limited set of product data fields in their systems today. We also learned that manufacturers are quite capable of providing basic product data fields today. We need to start off with the basic data fields that manufacturers actually have available and that providers actually can use. We can add fields as we evolve. Look at the retail model. The retail industry kept it very simple in the beginning. GS1 is well prepared to facilitate the process of managing the data definitions and data fields. Their members and users of the data actually drive the data requirements. As far as driving adoption, HSCSC has been leading the efforts to drive the adoption of GTINs, GLN and product data synchronization. IT vendors need to be in the center of this initiative.
Lawson and McKesson have been instrumental to the success of the DoD Healthcare GDSN Pilot and have demonstrated great leadership and supported their customers. Hospital systems need to be capable of accepting, storing and using the data fields that are being shared. Both Lawson and McKesson have helped their customers begin using the product data they are receiving through the pilot. Additional steps still need to take place over time, so that the product data received can be further integrated to reach clinical systems and be used in transactions.
Lohkamp: Although it might be nice for a hospital to know about the dozens of attributes associated with a single product, only a subset of these attributes are truly required to support commerce and thus achieve meaningful benefits. Because the DoD Healthcare GDSN pilot involved suppliers, providers and a GPO as well as IT solution providers, the group was able to review potential data elements and agree upon a minimum set of data fields to implement. Ultimately, GS1 Healthcare will provide a mechanism for determining both the required and optional data fields in the GDSN. However, initiatives such as the DoD pilot, the CHeS product data utility committee and the HSCSC data synchronization subcommittee will be key inputs into GS1. IT vendors need to have an active role in the process to provide technical input and advice. More importantly, IT vendors need to be involved since the industry will look to us as key enablers of the large-scale adoption of standards and data synchronization.
Pleasant: All segments need to agree upon the data attributes needed for product identification. The GDSN already has 26 required attributes that should be the starting point. The health care industry can add to these as we begin the use of the GDSN. In addition, there is a Global GS1 data synchronization team that has reviewed the global requirement for health care product attributes and has identified these as approximately 220. Most of these are supported by the GDSN.
Q The report seemed to make clear hospitals’ present business systems would need many more fields for data than exist today. Is this a significant challenge? What are the top two or three other key challenges?
Lohkamp: Hospitals that use Lawson and participated in the pilot reported available fields for the most critical data elements. Thus, while additional required fields may become apparent as the GDSN evolves, these challenges are manageable. The more significant challenge is agreeing on some of the practical aspects of phasing in data synchronization and standards with suppliers. Decisions regarding business practices (e.g., Will the GTIN be used in EDI to order a product? What solution provider will a hospital use to connect to the GDSN?), as well as timing, will have additional impacts on business systems that may require additional software development.
Thus, we need to be realistic and accept that full adoption of data synchronization will occur in phases and take time. The good news is that data synchronization and the use of GS1 data standards can benefit the health care supply chain at each step in the adoption process. For example, many members of the supply chain can benefit from a manufacturer who provides product data in a standard format with standard data elements through a single process.
Q From a manufacturer perspective, what did this pilot teach you? It was noted that BD recommends an incremental approach to implementing a product data utility. What’s the significance of this?
Black: We learned that participation in GDSN was not difficult. We also found that having perfectly synchronized product data will be essential to enabling providers to successfully implement the FDA’s UDI initiative. Although the FDA has not finalized the regulation, providers benefited from having synchronized GTINs, GLNs and unit of measure information when making use of the bar code. It certainly is less work to provide and maintain one precise data feed than it is to maintain countless data submissions we make to our trading partners.
Product data needs will change and evolve over time. We need to start off with the basic information that uniquely identifies each device (e.g., GTIN, GLN, descriptions, catalog numbers, brand name, classification system, etc.) and supply chain information (e.g., unit of measure, shippable unit, product dimensions, product weight, etc.). The entire supply chain can benefit from the use of this information. Many customers are extremely interested in obtaining product safety or clinical data (e.g., latex, sterility, reusability, expiration dates, etc.) through a product data synchronization solution.
We need to carefully define and prioritize these fields first. Until we begin using information that uniquely identifies each device and the basic supply chain information, the clinical attributes will be useless.We also need to consider the possible impact of the FDA’s UDI initiative. The FDA seems to be interested in product data as part of their UDI initiative. Using the same database could be an ideal and efficient solution.
Q From a GPO perspective, what was the most significant lesson Premier learned from this pilot? What specific issues do GPOs face that are different from manufacturers or hospitals?
Pleasant: Premier learned that we can consume GDSN data with minor changes to our current system. There will be minor enhancements required to deliver GDSN data using our existing delivery system. Premier is positioned to provide standards-based integration approaches beyond the current delivery mechanism. We determined that the coordination among parties within the supply chain requires adherence to standards and consistent processes. GPOs must integrate with all other segments of the industry, and this will require a considerable amount of communications and agreement on key processes.
This article first appeared in the March 2008 issue of Materials Management in Health Care.
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