Transforming ARV Supply Chain In India

Transforming ARV Supply Chain In India

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Description: The solution developed and deployed on an open source LAMP Stack. Dedicated reporting database –provides the capability to generate reports without affecting transactions. The modular design of solution – can easily be updated to include other features/modules.

Implements a role based access control system – helps configure access to features without code change. Open source & Licence free – interoperability - integration with other systems.

 
Author: Prateek Gupta, Nisha Subramanian, Aude Wilhelm  | Visits: 233 | Page Views: 369
Domain:  Business Category: Management 
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Contents:
Thanks to our generous
sponsors

Global health Supply Chains. Dar es Salaam Tanzania
2016

Inventory Management System (IMS):
Transforming ARV Supply Chain In India

• Prateek Gupta
• Nisha Subramanian
• Aude Wilhelm

Clinton Health Access Initiative
Access and Supply Chain Team

Global health Supply Chains. Dar es Salaam Tanzania
2016

Fast Facts

NACO Supply Chain – Overview

79 Centrally Procured
Items

39 State Warehouses
(SACS)

~930K patients on
ARV Drugs

~20,000 Point of Care
Facilities

524 ART Centres

> 10M patients
served (annual)

Fixed Demand – Low Supply Chain Complexity
3

Supply Chain Challenges

Symptoms
Relocations

To balance demand & availability of
drugs/kits

Expiries &
Shrinkage

Significant % of inventory procured
not utilised

Stock Outs

Non-finalisation of tender or
imbalance in demand

Productivity

Considerable time spent in manual
registers & reports, manual errors

Issues & Challenges
• Demand Planning & Forecasting
• Supply Planning & Scheduling
• Inventory Management & Replenishment
• Storage Space Planning & Optimization
• Logistics Optimization

• Supply Chain Performance Monitoring
• National Standard Operating Procedures

Impact: Patient Treatment, Budget Utilization, Productivity

The missing link…

Network
Optimization
Demand
Planning
(Forecasting)

Storage
Space
Planning

IMS
Logistics &
Distribution
Planning

Supply
Planning
Inventory &
Replenishment
Policies

“The goal is to turn data into information, and information into insight.”.. Carly Fiorina

Precursors to Technology-led
Interventions

Asset Light, Scalable and
Low TCO

Standardized
processes with
Exception Handling

Benefits All
Stakeholders in the
Value Chain

Without right Processes and People in place,
Technology solution will not be sustainable

Project Phases (2013- 2016)

Alignment with
MoHFW on solution
scope

Documentation of
SRS

Product
Development and
testing

Set up and train
support team

Solution Design

Solution Development

Implementation

NACO provided timely sign off on
the scope of the solution

NACO helped the CHAI team to
understand all the inventory
processes

NACO ensured
availability of
infrastructure at all levels

Milestone 10

Milestone 9

Government of India
Security Certification
and migration to NIC

Milestone 8

National Scale up
through T-o-T model

Milestone 7

Milestone 6

Milestone 5

Milestone 4

Milestone 3

Milestone 2

Milestone 1

Pilot, UAT and
feedback

Preparation of Solution
Design

Supply Chain
Assessment

Completion of
transition

Transition
NACO provided
sign off & NIC
infrastructure

IMS: Features & Functionalities

Advanced

Basic
Contract &
Supplier
Management

Stock Reports
& Management

Stock Receipt
& Dispatch

Automated
Patient Status
Tracking

CD4 &
Adherence
Monitoring

Digitally Signed
Invoices for
Supply
Payments

Product &
Facility
Management

Patient
Registration &
Dispensation

Event
Notifications –
email + SMS

Independent
Reporting
Engine

Role-based
Access
Privileges

GIT Inventory
Tracking

Dispensation
Reports
(National, State &
Facility)

Barcode
Enabled

Role based
Dashboards

Patient
Bio-Metrics
(Fingerprint)

National
Patient
Portability

Offline
Dispensation
(Windows +
Android)

Configurable Open Source Modular

Customizable

National Stats: ARTC Usage
31
(since 1-Jan2016)

493

Dispensation Counter

https://ims.naco.gov.in/dcount

Screenshot taken as on 13th Nov 2016- 0326 hrs

Dashboards & Report Generation

Dashboard

Reports





Improved Reporting Engine
Faster report generation
More comprehensive reports
Customizable reporting

Inventory Reports






Dashboard with Key Information highlighted
Key patient data - Expected patients, etc.
Key stock levels – low stock, expiry stock
Alerts & Notifications

Consolidated Reports

Patient Reports










Daily Inventory Report
Near Expiry Report
Patient Dispensation Report
Expected Patients Report
Missed Appointment Report
Stock Ledger Report
Dispatch Report







Stock Summary Report
Stock Out Report
Expiry Report
National Inventory Report
State Dispensation Report

Patient Status Reporting (On
ART, Mis, LFU, Transferred etc)






Patient Profiles
Link ART Reporting
Regimen based Reporting
Dispensation summary with
Stock Requirements

In addition, more in-depth analyses and reports can be generated from the database

Role Based Dashboards

Impact

Short Term (Operational)

Long Term (Strategic)



Productivity: Automated notifications and on
demand reports have increased productivity of
IMS users by ~28%



Forecasting: Increased accuracy of Forecasting
and Demand leading to improve budget
utilization



Inventory Rationalization: Analysis of supply,
consumption and stock data led to procurement
rationalization saving 17M USD in first 6 months



Increased Accountability and Transparency –
Positively impact expiry, drug availability.

Unlocking Efficiencies: Has enabled increased
ART eligibility, introduction of 3rd Line drugs and
other resource intensive initiatives.



Advanced Patient Insights: Real-time data
from IMS can be leveraged to get insights into
patient treatment data like
• Retention cascade analysis
• Adherence analysis
• CD4 / Viral Load trend analysis
• Reducing LFUs and SMS based monitoring





Reduced Relocations: Relocations have
reduced from couple of thousand to less than 500
in a month



Supplier performance : Enabled real time
monitoring of supplier performance

Laid the foundation for programmatic transformation

Conclusions

For Inventory to flow down, information needs to flow up
Manual system of record keeping, detrimental to SCM and performance
Digital recording of inventory transactions- Necessity and not Luxury,
for large, complex and optimized supply chains
Essential QRs- Robust, Scalable, Configurable and Customizable
Implementation, Adoption, Change ManagementKey to SCM transformation
Payoffs are exponential compared to TCO of Inventory Management System
Global health Supply Chains. Dar es Salaam Tanzania
2016

Thank You

Clinton Health Access Initiative
Access and Supply Chain Team

15

Additional Slides

16

Critical Success Factors

Solution Design
• Focus on user transactions; discourage “EOD
reporting”
• Design solution to add new features and requests
without compromising data integrity
• User interface must be intuitive enough for novice
users

• Continual engagement with the
development team
• Prevent loss of data; team uploaded
validated data of suppliers, locations,
inventory, patients etc.

Implementation
• Have right team members for managing
stakeholders, designing solution, change mgmt. and
training
• Identify the Project Champion from MoH
• Frequent communication to create awareness within
the organization

• Conduct field studies to understand and
document all the processes with exceptions
• Record user feedback; team documented and
studied 500+ user suggestions received
during UAT

Sustained Usage
• Plan and conduct a “Deep Implementation”; team
conducted 130 hands-on workshop to train 1400
users
• Present a strong value proposition to all users –
“What’s in it for me?”; reports generated from IMS
improve productivity across user base

• Ensure the organization is on board; NACO conducts
monthly reviews with project directors of all states to
ensure 100% adoption of IMS
• Plan and build capacity for a successful transition

Architecture Overview

Offline
Module

Email & SMS
Notification engine

• Solution developed and deployed on an
open source LAMP Stack

Data Analytics & Visualization

Digital
Signature

• Dedicated reporting database –provides
capability to generate reports without
affecting transactions

Biometrics

Web Browser

PHP
(Code Igniter)

Transaction
DB (OLTP)

Apache Web Server

Ubuntu Linux OS

Reporting
DB (OLAP)

MySQL

• Modular design of solution – can easily
be updated to include other features/
modules
• Implements a role based access control
system – helps configure access to
features without code change
• Open source & Licence free –
interoperability - integration with other
systems

Android Tablet Version- Offline

Dispensation to Patients

Role Based Access Control

Sample Reports: Stock Summary Report

Consolidated Stock
Summary (State wise)

Consolidated Stock
Summary (Product wise)

Sample Reports: National Inventory
Summary