Member Profiles

Baxter Corporation’s manufacturing facility in Alliston, Ontario recently celebrated 50 years in operation, and with a long history comes experience. Due to its veteran position, the facility has continuously made improvements to its operations to stay in alignment with present-day needs. As a result, they have taken a big step forward in integrating GS1 standards to realize greater supply chain efficiency and enhance the safety of their products’ end-users.

With many of its medical devices from its Sherbrooke, Quebec plant and pharmaceutical products bar coded and encoded with the Global Trade Item Number (GTIN) in Alliston, Baxter’s manufacturing facilities are steadfast in recognizing the benefits of supply chain standards they can provide its sector.

"We have relatively complex supply chains in healthcare. We’ve got manufacturers involved that sometimes ship directly to hospitals; we’ve got distributors involved; we’ve got people who run Just in Time programs involved," explains Jacques Chaput, Co-Chair, Carenet Healthcare Sector Board, and Manager of eCommerce, Supply Chain, Baxter Corporation.

Mr. Chaput notes Baxter’s own complexity and uniqueness in shipping product directly to its hospital customers, as well as using distributors for the non-hospital marketplace to reach vets, dentists, cosmetic surgery centres, and many others. "As such, there are a lot of different folks that can touch product. And up until this point, there has been a lot of proprietary identification. To link that whole supply chain from the patient to the manufacturer with a common standard for identification is huge for our industry."

With the cost and effort of integrating GS1 standards and solutions top of mind for many healthcare organizations as the Canadian Healthcare Supply Chain Standards Project moves into its second phase of implementation, James Taaffe, Engineering Manager, Baxter Corporation understands the manufacturer’s predicament when making the move to bar coding and standards. Taaffe points out the success other sectors have had with implementing GS1 standards, such as the grocery industry, noting that the healthcare sector is "not going down a blind alley – we’re going down a road that has been travelled by many."

"[The successful history of GS1 standards] helps a lot with that initial leap of faith and investment. It is a fairly complex process to get a bar code enabled and printed on something...and manufacturers aren’t going to invest in the technology unless the customer wants it," Taaffe says, who has led the Alliston facility’s foray into bar coding and met with such challenges as printing bar codes directly on clear IV bags, which go through intense sterilization processes that would ruin a paper bar code. More than that, as this product is comprised of a clear bag and clear liquid, it has also been a challenge to find a universally readable bar code for Baxter’s IV bags due to the variety of scanners currently used.

To meet the needs of its customers and ensure that its clear IV bags are bar coded, Taaffe is currently investigating various methods to enable the bar code to be printed directly on the clear bag, while also ensuring that it can be identified with the GTIN and reliably scanned at a patient’s bedside.

Despite the potential challenges that need to be overcome to bar code healthcare products, Taaffe maintains the importance of identification and says that "one of the most compelling arguments for bar coding [is that] the GTIN goes to the 5 Rights [right person, medicine, dose, time and method]."

Both Taaffe and Chaput are confident that mass adoption of the GTIN is not far away, with the industry-driven sunrise date to integrate the GTIN in the healthcare sector set for December 2012.

"[With the GTIN], we are investing in patient safety," Chaput says. "This is not a purely financial exercise. At the end of the day, it could be someone’s life. And that has to make you feel good."

Canada’s healthcare Group Purchasing Organizations (GPOs) have a long standing commitment to the success of Carenet’s Canadian Healthcare Standards Project.

Of particular relevance to Canada’s GPOs is the adoption of the GS1 System of global standards for medical, surgical and pharmaceutical supplies, and the development of technical bar coding standards.

"We work with suppliers and providers and keenly understand the benefits of global standardized supply chain and eCommerce practices," explains Cynthia Valaitis, VP Business Development, HealthPRO Procurement Services (HealthPRO), a sponsor and participant in the Canadian Healthcare Supply Chain Standards Project ", HealthPRO is in an excellent position to advocate for and support those standards and practices."

Last Spring, the Institute for Safe Medication Practices (ISMP) Canada and the Canadian Patient Safety Institute (CPSI) jointly endorsed the adoption of the GS1 System of standards for automated identification of pharmaceutical products in Canada, signaling a major step forward in the Supply Chain Standards Project. Implementing global supply chain standards and practices will help reduce errors and lower production and supply chain costs, enhancing medication safety at the patient bedside and allowing more resources to be directed towards patient care.

As the GS1 bar coding and e-commerce standards and practices are gradually implemented across all medical, surgical and pharmaceutical supply categories, HealthPRO is preparing to:

• Communicate the new standards among its membership and suppliers;
• Revise its contract awards criteria to reflect the new standards; and
• Modify its proprietary contract management software(HealthPROCONNECT) to accommodate the new standards and unique identification.

“We cannot solve the complex problems of today using the same level of thinking which created them.” - Albert Einstein.

Following Einstein’s advice, the province of British Columbia created Health Shared Services BC (HSSBC) this September, an update to its original brand, the BC Health Authority Shared Services Organization (SSO), which was initially created in December 2007.

HSSBC is now a division of the Provincial Health Services Authority, which means the organization has the governance, administrative and human resources infrastructure it requires to meet current needs, without having to create an entirely new organization. Despite the re-branding, the organization’s mandate to improve cost effectiveness and enhance service quality for BC health authorities remains unchanged.

HSSBC will also continue to assume the supply chain services function across all six BC health authorities, with a focus on enhancing the healthcare system through effective and efficient delivery of specified support services in order to have more resources available for frontline patient care.

With approximately 1,000 employees located across six health authorities, the supply chain services division of HSSBC manages over $1.4 billion in total annual spending. The initial estimated savings to be generated by a provincially integrated supply chain service model were thought to be as high as $150 million in the first five years.^[1]

The current projected total for HSSBC’s first five years of operation (February 2009 – March 2014)^[1], taking into account contracts negotiated to-date and the achievement of the 2010/11 contract plan is now $181 million – well surpassing the initial savings estimate, with more than three years left.

“While the opportunities for us here at HSSBC are tremendous with respect to improving all aspects of supply chain performance, the challenges are also quite daunting. Currently, we use seven different Enterprise Resource Planning systems. In order to make sense of the different types of data and to translate that to be able to speak the same business language with our suppliers in Canada and internationally, we need to use GS1 System of standards," said David Loukras, Provincial Director, Performance, Integration & Transformation for Health Shared Services BC, and co-chair of the GS1 Canada Carenet Healthcare Sector Board.

To combat these challenges, HSSBC has developed a supply chain standards implementation roadmap that will see the following standards implemented over the next few years:

• Consolidation of product data into a single provincial item master file, using the Global Trade Item Number (GTIN) as its sole product identifier and ultimately linking to the Canadian Healthcare Product Registry when it becomes available.
• Use of the Electronic Data Interchange (EDI) version 6020 transaction sets and Global Location Number (GLN) for purchasing, e-requisitions, accounts payable functions, and inventory management.

“Patient safety, through reduction of medical errors is paramount to providing good healthcare. Using GS1 standards in collaboration with our trading partners to consolidate information on a real-time basis, and into a single GS1 standardized, provincially accessible database like the Canadian Healthcare Product Registry will enable patient safety, supply chain efficiency, traceability and cost savings for the province,” says Loukras. “We are looking forward to the exciting and worthwhile changes, and innovation which will have a significant impact on healthcare delivery in British Columbia.”

^[1] Health Shared Services BC Website

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A profile of one of CareNET's founding members

In 1990, when CareNET was established as an association, its members consisted of 10 healthcare suppliers organizations that started their electronic data interchange (EDI) trading in the supplier category. One of those suppliers was Medical Mart Supplies (Medical Mart).

Since then, Medical Mart has continually been at the cutting edge of electronic commerce in Canadian healthcare and its leadership has helped the company achieve many accomplishments. For the past 13 years, Medical Mart has participated on the CareNET board of directors and Rob West, Executive Vice President, has served on the CareNET executive committee for the past eight years.

Rob West has clearly been a leader when it comes to the advancement of e-commerce in healthcare. He states, “Medical Mart has always focused on leading-edge technology with a vision of cost reductions for all supply chain stakeholders, including both the providers (hospitals) and the suppliers/distributors. We strongly believe that, by endorsing e-commerce in conjunction with global standards, the goal of a more efficient supply chain will be attained, for the betterment of patient safety.”

Fran Goddu, IT Director, described the level of integration that Medical Mart has achieved to date. “First and foremost, we are open to all initiatives that promote e-commerce. We have implemented connections to TELUS, GHX and ORMED X, depending on the specific requirements of our customer base. Our systems are designed for constant, rapid communication between our customers and ourselves.”

In addition to implementing many of the EDI transaction sets - purchase order (PO), PO acknowledgement, price & sales catalog, invoice, functional acknowledgement, payment order/remittance advice, application advice, Medical Mart is planning to implement the product transfer and resale report, motor carrier bill of lading, motor carrier pick-up manifest and motor carrier freight details and invoice. Medical Mart has also moved ahead with a program to extend several of these transactions beyond its customer base to its suppliers.

“We now generate EDI purchase orders to many of our suppliers and receive EDI acknowledgements and invoices in return,” stated Andrew Bugeja, System Analyst/Developer. “We contacted all of our major suppliers to request that they implement e-commerce as a basic way of doing business. In addition, we continue to follow up with suppliers who do not yet have EDI capabilities, with the intent to put in place effective e-commerce programs.”

“There have been strategic advancements in just the past year,” said Rob West. “We have seen the amalgamation of CareNET with GS1 Canada. This development positions the healthcare industry for the introduction of global standards that can be implemented by all stakeholders. Global standards will allow all participants to receive the benefit of future supply chain efficiencies. The best is yet to come.”

Learn more about Medical Mart.

Susan Smith, General Manager of Mohawk Supply Chain Services and new GS1 Canada Carenet Healthcare Sector Board member, recently invited GS1 Canada to its facilities to provide staff with updates on healthcare supply chain standards – such as Electronic Data Interchange (EDI) transaction sets, the Global Location Number (GLN) and the Global Trade Item Number (GTIN).

“The purpose of the meeting [with GS1 Canada] was to ensure that my staff is up-to-date and aware of present and future supply chain standards,” explains Ms. Smith. “Just as our member hospitals continue to generate electronic purchasing to achieve supply chain efficiencies, Mohawk [Supply Chain Services] must ensure that as we implement new systems and business processes in our day-to-day tasks, we always keep in mind that we must be thinking of ways to incorporate the GS1 [System of] standards.”

As one of the nine shared services organizations (SSOs) in Ontario, Mohawk Supply Chain Services covers the following provincial areas in addition to St. Michael’s Hospital in downtown Toronto:

• Hamilton and area;
• Niagara peninsula;
• Haldimand;
• Brantford;
• Kitchener-Waterloo; and
• Wellington.

The SSO is comprised of 15 hospital organizations at 28 locations and is responsible for sourcing and delivering products for 5,000 hospital beds. A recent move has consolidated Mohawk Supply Chain Services’ staff and operations into one location in Burlington, Ontario.

The following services are provided by the organization to their member hospitals:

• Sourcing, negotiations and contract management;
• Warehousing of the medical/surgical products (other than capital equipment) and laboratory and housekeeping supplies;
• Pandemic support; and
• Logistics providing Just in Time delivery of the products.

GS1 Canada will be continuing to meet with other SSOs to keep these organizations apprised of healthcare supply chain standards development in Canada. Along with Mohawk Supply Chain Services, presentations have been made to Central Ontario Healthcare Procurement Alliance (COHPA) and Champlain Local Health Integration Network.

Ormed Information Systems Ltd., which is celebrating 20 years of healthcare specialization this year, is proud to be partnered with Carenet. Ormed requires their Internet portal membership to be supportive members of Carenet and its efforts to standardize and promote Internet connectivity in Canada, which will ultimately reduce human error, increase efficiency, and save money.

Dale Gregg, Senior Vice President and Business Development Officer for Ormed, serves on the standards committee for GS1 Canada. "Ormed has been on the leading edge of creating new transactional standards. By serving on these committees, we can be sure that the standards contain the transactional information required to perform the efficient business processes we’ve helped create."

"Ormed is in a very strong position right now in terms of credibility for these initiatives - we’ve been through the trial and error process already, so we know what works. And, just as importantly, what doesn’t."

As members of GS1 Canada and supporters of GS1 US, Ormed is a solution provider member with Carenet and is helping bring those set standards to greater acceptance with more transaction sets and more capabilities. "Supporting Carenet is one of the easiest steps an organization can take to help move the supply chain marketplace to better cost-effectiveness and efficiency," says Gregg.

Naturally, all Ormed software complies with GS1 standards. Ormed’s current goal is to create standards around electronic invoicing, e-payments, e-receiving, and e-reconciliation.

With Carenet’s support, e-commerce awareness in the healthcare marketplace has been raised significantly, benefiting all organizations looking to automate their business practices and capture savings for the long term. As such, Gregg is optimistic about the future of the industry.

"Historically, healthcare has been slow to adopt new technology, but thanks to GS1 initiatives like Carenet, and the support of organizations like Ormed and many others, hospitals everywhere are realizing real benefits that go right to the bottom line. It’s a great time to be in healthcare."

Founded in 1892, St. Michael’s Hospital is a 500+ bed teaching and research hospital in the heart of downtown Toronto, Ontario. With several hundred thousand patients treated every year, streamlining operations to improve patient care delivery and service is vital to ensuring first-class patient care, an objective the St. Michael’s supply chain team is particularly conscious of.

For almost 20 years, St. Michael’s has been a Carenet/GS1 Canada member. In order to drive supply chain efficiencies through standards and automation, St. Michael’s collaborated with Medbuy, its Group Purchasing Organization (GPO), and Mohawk Shared Services to enhance its logistics, warehousing, sourcing and procurement processes.

Today, under the leadership of Joan McLaughlin, Chief Supply Chain Officer & Director of Support Services at St. Michael’s and a GS1 Canada Carenet Healthcare Board member, the hospital continues to demonstrate its commitment to healthcare supply chain standards implementation.

“Our goal as a hospital is to ensure the highest quality of patient care while maximizing value across the healthcare chain,” says Ms. McLaughlin. “With the implementation of global standards, we have seen first-hand, the supply chain efficiencies - leading to improved patient safety, decreasing costs and enhanced productivity. We are committed to implementing global GS1 standards that will modernize and advance Canada’s healthcare system.”

Using the Smartstream software for its Materials Management System, St. Michael’s has been an active participant in Electronic Data Interchange (EDI), trading with more than 45 vendors and sending approximately 800 EDI Purchase Orders (POs) per month.

Leading the Way – EDI Version 6020 Pilot Testing Completed
As part of Phase 2 of the Canadian Healthcare Supply Chain Standards Project, St. Michael’s has successfully completed testing of the first EDI implementation pilot with the assistance of Rogue Data Corporation, its third-party facilitator, as well as vendors/distributors such as Cardinal Health and Medical Mart Supplies Ltd.

The pilot, which began in the fall of 2010, set out to accomplish the following objectives:

• Introduce Global Location Numbers (GLN) via EDI
• Introduce Global Trade Item Numbers (GTIN) via EDI
• Pilot the new EDI transaction sets version (6020)

While results are currently being aggregated, the initial outcomes are encouraging - GLNs and GTINs were successfully tested in the version 6020 transactions and the invoice transaction was implemented during the pilot project.

For more information on how you can participate in the Canadian Healthcare Supply Chain Standards Project as an EDI pilot site, contact Herb Martin, Director, Healthcare, GS1 Canada at carenet@gs1ca.org.

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TELUS Health Solutions (TELUS) and its predecessor companies (TDSi, SNS Assure, BCE Emergis and Emergis) has been a network gateway serving Carenet members since 1990. TELUS began providing e-commerce services (electronic mailbox, transaction delivery, document translation, etc.) from Carenet’s inception and has consistently increased its transaction growth as Carenet boosted its number of provider and supplier members.

TELUS’ core healthcare business – traditionally in the claims management, electronic health records and pharmacy management areas – has expanded to include solutions that are helping to transform the way information is used in healthcare across its continuum. The company provides technology solutions for hospitals and large healthcare providers, as well as solutions for community and home care that enable the effective sharing of health information between healthcare teams and their patients to improve outcomes including:

• The Oacis Unified Health Record – Designed for use in large hospital environments and provides a 360 degree view of a patient’s status enabling better decisions at the point of care.
• TELUS Personal Health Record (PHR) solution – Enables patients undergoing long-term treatment for conditions such as breast cancer to take control of the management of their health status. Integrated with a hospital’s electronic health record, the PHR enables patients to view lab results, schedule appointments, find and consult with additional physicians, and keep track of their daily regimens (i.e. medication, weight, exercise and more).
• Utilizing Remote Patient Monitoring systems – Part of an integrated PHR solution linked to the patient’s hospital both empowers the patient in terms of managing their health situation and streamlines efficiencies for care providers. Patients no longer have to go into their doctor’s office for assessments and treatment. Using PHR they can provide their doctor (or an entire healthcare team) with hourly and daily updates on their vital signs, fluid levels and other metrics in real-time and the healthcare team can respond accordingly.
• TELUS iScheduler – Enhances efficiencies for both the patient and the clinician, empowering patients to schedule appointments, tests, home care visits and more online.

"Adoption of global standards across the healthcare supply chain will result in significant improvements for the Canadian healthcare system," said Francois Côté, President, TELUS. "Global standards facilitate a common framework for technology-based processes, enabling healthcare facilities to speed up order and payment processes, lower inventory carrying costs, and upgrade record-keeping functions. This enables healthcare workers to focus on providing outstanding patient care and service."

TELUS was one of the first companies to become a sponsor for the Canadian Healthcare Standards Project when it was launched in 2008.