Episode 11 of What's Up Dock? Podcast

In this episode, we sat down with Randy Subramany, Director of Supply Chain at NewYork-Presbyterian Hospital, to discuss his work ensuring materials are readily available so physicians are capable of administering the best care for patients.

Navigating Tech Challenges in Healthcare Logistics

When thinking of a hospital or healthcare facility, the first aspect that often comes to mind is the staff members — doctors, nurses, CNAs and more. Yet, there are so many things these professionals require to provide quality, specialized care. 

Randy Subramany, Director of Supply Chain at NewYork-Presbyterian Hospital, manages the supply chain logistics for eleven hospitals and health organizations in the New York City and upper New York area. With over a hundred people in his supply chain department and over forty thousand SKUs, his work ensures materials are readily available so physicians are capable of administering the best care for patients. 

The healthcare supply chain’s uniqueness

In retail, many stores aim to keep their SKU count low. Additionally, consumers are able to make substitutions when shopping. If a store does not offer green onions or they are out of stock, a customer can concede and purchase white onions instead with little to no hesitation or concern. 

In healthcare, this could not be further from the truth. Extraordinary amounts of materials must be procured and remain stocked. If not, patients could suffer from inadequate care or worse, death. One specific SKU may only be used once every three months, but when it is used, it saves a life. This means the supply chain department absolutely must keep this material on hand. 

“In one specific case, we had a pediatric dialysis patient that required a specialized catheter size,” Randy says. “Typically, we use a thirty-centimeter-sized catheter, but this patient required a thirty-one-centimeter size. If we provide only the thirty, this patient's quality of care would be at risk.”

Compassionate care behind-the-scenes

Back to the initial thought that comes to mind when thinking about hospitals, supply chain teams work extremely behind the scenes to help provide care to patients. Often, the work begins to feel like a thankless role, only garnering attention when something is wrong or unavailable. 

“If everything is going right, you will typically hear nothing,” Randy says. “But the second something goes awry, all sirens go off in the hospital.” 

Yet, the value of the role is undeniable. Knowing they play a role in ensuring people are properly and comfortably cared for is gratification enough for the supply chain team. 

While healthcare’s supply chain differs immensely from the supply chain functions of other industries, they are still faced with the same fundamental duties, with added responsibility and importance. “The added lens of our work meaning life or death for patients really drives and motivates what we do,” Randy says. 

Procuring specialized materials

With forty thousand SKUs to maintain, it does not come as a surprise that there are countless vendors to work alongside in the healthcare supply chain space as well. This means that much of what Randy does in a day is centered around logistics.

“Because healthcare is so specialized, this means there could be thirty vendors in one specific space,” Randy says. “The vendors' priority is producing and manufacturing goods. It then becomes our responsibility to find a way to get these items from their warehouses, wherever they may be, to a three-block-sized space in the middle of New York City.” 

For instance, one of the vendors Randy works with weaves cardiovascular graphs — in Scotland. 

With such a strong reliance on vendors, healthcare supply chain team members must navigate unfavorable conditions, such as labor shortages and strikes, distribution breakdowns and more. This makes the number one quality in a strong supply chain team adaptability

Backed by a team of experts

In this space, it is crucial to have a supply chain team that is full of individual professional strengths and expertise. Supply chain success relies on having an expert on ERP systems for reorders, one for EDI transaction complexities, another for shipping, and many others. Especially in a globalized world, being supported by several, specialized team members is key.

Advancing technology and market moves

“Healthcare always lags behind the market when it comes to market shifts and technological advancements,” Randy says. 

This is for good cause. Reliability is the number one expectation in healthcare. When people go to a hospital, they expect a secure, tried-and-true system to support them. While the rest of the market is making a massive, rapid shift to automation and AI, some hospitals are still utilizing the same ERP system today as they were when some of their doctors were learning how to crawl. 

Yet, they continue to do this because the systems in play are proven to be reliable and trustworthy. Making system changes takes years to accomplish in healthcare due to the pace of the work, the importance of the work and the confidentiality of the data that would need to be moved. 

For this reason, healthcare will likely never be on the cutting edge of the newest available tech in the market, but once new tech has proved its abilities in other markets of reduced risk, healthcare facilities can choose to make that change with strong amounts of research and data to support their decision. 

There is a gap in talent in healthcare leadership. Most leaders are either on the cusp of retirement or just beginning their careers. Those veteran leaders are accustomed to on-site data storage, and the ideology of changing systems and operations may be offputting to many. Those new to the field are pushing to make substantial changes to the technology on hand, which is an eventuality, after all. 

While the healthcare industry naturally lags behind other markets, there is evidence that the industry is growing in the right direction toward adopting new automation and AI technology. Many academic medical centers and academic teaching hospitals are beginning to adopt newer technology, and they are thriving with many patients flocking to their facilities for their cutting-edge capabilities and new, tech-enabled care capabilities. 

As these technological advances continue to be enacted in care facilities, many hospitals will be forced to adapt or they will lose relevance. 

Innovation under regulation

Rightfully so, hospitals are highly regulated entities, with rules coming from several angles — government, healthcare authorities and insurers being the most prominent. 

Innovation moves slowly in fields that are under heavy regulation. Yet, in the coming years, automation's impact on the market will likely push regulating bodies to encourage hospitals (and their supply chains) to adopt new technology. After all, the promise that is offered could bring reduced burnout, increased quality and customization of care, better physician and patient experiences and more. 

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