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Crisis-Proofing Healthcare Supply Chains: Insights with Steve Downey and Leanne Hester · Taking The Supply Chain Pulse

• 0:10
  Speaker 1: Hello again, everybody.
• 0:11
  Speaker 1: This is Fred Kranz from St Onge with another episode of our podcast, taking the Supply Chain Pulse.
• 0:17
  Speaker 1: Today, we are going to be talking about a topic that is fresh in everyone's mind, and that is what I would call contingency planning, or disaster mitigation planning, or whatever you want to call it.
• 0:31
  Speaker 1: When something bad happens, what are you going to do about it?
• 0:33
  Speaker 1: That's what we're going to be talking about, and we have scheduled three guests.
• 0:38
  Speaker 1: So far, only two of them are here, so if our third one makes it in, we'll add him.
• 0:44
  Speaker 1: If not, we'll proceed with two.
• 0:46
  Speaker 1: The second thing about today that is really interesting, leanne, is that the first person to appear on our posted podcast was Steve Downey of the Cleveland Clinic, and he did a wonderful job, and so he is our first official second-time guest, and I hope to have many more on here, because you know you guys are such vast repositories of knowledge and experience that it's a shame not to bring you back and, steve, you're so gracious to be here.
• 1:23
  Speaker 1: Leanne, the same with you, so let's get started.
• 1:28
  Speaker 1: Beginning in 2017, there have been several cataclysmic disruption to the day-to-day operations of the healthcare industry.
• 1:35
  Speaker 1: In 2017, there was Hurricane Maria that hit Puerto Rico and caused all kinds of disruption 2020 to 2021, the worldwide coronavirus pandemic.
• 1:47
  Speaker 1: Most recently, hurricanes hitting Asheville, north Carolina, which disrupted the IV supply.
• 1:53
  Speaker 1: In addition, there have been many regional and local events, near misses and fears, including cybersecurity and system hacking, tankers striking a bridge in Baltimore, disrupting the ports of the East Coast, dock workers strike, which could have been really disastrous but was averted relatively quickly, and wildfires, hurricanes, floods and things that happen regularly.
• 2:20
  Speaker 1: Today's guests will bring their unique backgrounds to a discussion related to preparing for the known, unknown disruptive events that are coming but are not known in advance and often have little to no time to prepare a response.
• 2:35
  Speaker 1: My guests today are Leanne Hester, the Chief Product and Marketing Officer for Resolink.
• 2:41
  Speaker 1: Officer for Resolink, steve Downey, the CEO of Accelerate, which is a physician preference item, collaborative GPO if I messed that up, steve correct me and chief supply chain and patient services officer for the Cleveland Clinic, and hopefully, at some point we'll be joined by Ken Jensen, the vice president of supplyly Chain and Chief Supply Chain Officer at the University of Vermont Health Network.
• 3:06
  Speaker 1: So let's get started.
• 3:08
  Speaker 1: First, starting with Leanne, tell us a little bit about yourself, the organization you work for in the case of Steve, the organizations that you're associated with and what your roles are.
• 3:22
  Speaker 1: Please, leanne.
• 3:24
  Speaker 2: Great Thanks, fred, thanks Steve.
• 3:26
  Speaker 2: It's really nice to be with both of you this afternoon.
• 3:28
  Speaker 2: As Fred said, my name is Leanne Hester.
• 3:31
  Speaker 2: I work for ResnLink and ResnLink.
• 3:34
  Speaker 2: We work with organizations particularly in the healthcare field not only healthcare providers but life sciences, pharmaceuticals and medical device manufacturers to really enable the organization to map their supply chain so be able to have visibility into where they're finding their supplies but also where their suppliers are getting their supplies, monitoring those sites for disruptions.
• 3:59
  Speaker 2: And so, fred, as you pointed out, natural disasters are trending up, but so are other things and we can talk about a little bit of the data that we see there.
• 4:08
  Speaker 2: But to monitor those sites and then proactively identify risk and, importantly, create mitigation strategies for, if a disruption occurs, what we can do to move fast, and particularly in health care providers, to ensure the continuity of patient care.
• 4:24
  Speaker 2: To move fast and particularly in healthcare providers, to ensure the continuity of patient care.
• 4:27
  Speaker 2: My background I actually started my career in healthcare at a health system here in Indianapolis, community Health Network, and have spent the last 25 years working within technology and professional services to serve organizations that really take care of patients and our families or organizations that really take care of patients and our families.
• 4:48
  Speaker 3: Very good, steve.
• 4:48
  Speaker 3: Thanks Fred and thanks Leanne.
• 4:49
  Speaker 3: It's an honor to join you.
• 4:50
  Speaker 3: I'm Steve Downey, chief of Supply Chain and Support Services for the clinic, been here about three years now.
• 4:56
  Speaker 3: In that scope I have supply chain and all the function, sourcing, resiliency, key parts of that, operations.
• 5:05
  Speaker 3: We have laundry and linen, food services and now sterile processing.
• 5:11
  Speaker 3: And prior to that I've been in healthcare my whole career, from medical device to third-party logistics to GPO.
• 5:21
  Speaker 3: I've seen the spectrum of the healthcare ecosystem and, yes, it's absolutely an important topic for us making sure you can actually get the products, take care of the patients.
• 5:35
  Speaker 3: It's what it's really about is making sure you have what you need to provide the care, and it doesn't do any good if I work really hard to source, find and then can't get a product.
• 5:47
  Speaker 3: So we take resiliency very seriously and we've been working for many years on resiliency programs, strategies to try to make sure we have product available for the caregivers when they need it.
• 6:00
  Speaker 3: And when disaster strikes, then how do we mitigate and rally the teams we have a culture of team, of teams here and get all of those teams active in solving the problem together.
• 6:16
  Speaker 3: Try to mitigate the situation we're up against.
• 6:21
  Speaker 1: Well, that's, and you guys are spread.
• 6:22
  Speaker 1: Well, that's, and you guys are spread out.
• 6:25
  Speaker 1: Give us a little idea of the size of the Cleveland Clinic Foundation and the geography that it entails 25 hospitals and hundreds of non-acute.
• 6:34
  Speaker 3: We're in Ohio, northeast Ohio in particular, with 13 of those.
• 6:56
  Speaker 3: Then we're in Florida and we have a concentration on the east coast of Florida, the West Palm Beach area, with a number of hospitals.
• 7:00
  Speaker 3: And then we're in London with our operation there and we're in Abu Dhabi.
• 7:05
  Speaker 3: We also have operations in Canada and Nevada and others.
• 7:10
  Speaker 3: So we're really a global health system.
• 7:13
  Speaker 1: You sure are Along that line.
• 7:17
  Speaker 1: How have your organizations been hit by unexpected supply chain disruptions over the last five to seven years, and how did you deal with them immediately, and how did you construct plans to deal with them prospectively afterwards?
• 7:35
  Speaker 3: Yeah, every one of those shortages you mentioned we have had to deal with.
• 7:40
  Speaker 3: It's not something you wish for, but certainly those are important ones.
• 7:45
  Speaker 3: We're in the midst of IV fluids right now and when these arise you do your best up front to avoid it.
• 7:53
  Speaker 3: You mitigate as much as you can.
• 7:57
  Speaker 3: You have resiliency built in, but you can't mitigate everything and sometimes it happens it's cyber or natural disasters or something else.
• 8:05
  Speaker 3: So first is impact.
• 8:08
  Speaker 3: How critical is this item?
• 8:11
  Speaker 3: What's available in the market?
• 8:13
  Speaker 3: How do we respond and how long are we going to be dealing with this situation?
• 8:19
  Speaker 3: And we we have an assessment program where we look at the situation and figure out how we're going to jump in and solve it.
• 8:27
  Speaker 3: Sometimes it's getting the clinical teams together.
• 8:30
  Speaker 3: Iv fluids is a great example of that.
• 8:32
  Speaker 3: We did it.
• 8:33
  Speaker 3: In contrast, media shortages too.
• 8:35
  Speaker 3: How do you change your usage patterns?
• 8:37
  Speaker 3: We have to conserve, and oftentimes what happens in these critical situations is you have to dial in conservation while you try to up your supply and get as much source as you can from around the world, while you dial back usage.
• 8:59
  Speaker 3: And you can only do that with clinical partnerships.
• 9:01
  Speaker 3: Get the clinical partnerships underway first, well ahead of any situation situation.
• 9:06
  Speaker 3: You're much better off when you actually need it and can then say, okay, it's time to do this again, let's activate our programs, and communication is also really critical.
• 9:13
  Speaker 3: It's really important to, in the beginning, assess who needs to know what is happening.
• 9:19
  Speaker 3: How are you going to provide the right level of updates without causing panic?
• 9:23
  Speaker 3: Sometimes you can share too much.
• 9:27
  Speaker 3: That causes everybody to hoard or buy or whatever, and you have to control that.
• 9:33
  Speaker 3: But you also don't want to hide the information.
• 9:35
  Speaker 3: So making sure everybody has the right level of information Sometimes that's perhaps not the clearest view.
• 9:43
  Speaker 3: Like most disasters, you don't know up front exactly everything.
• 9:46
  Speaker 3: That's okay.
• 9:48
  Speaker 3: You can always fine-tune that as you go, and that's what everybody expects is.
• 9:51
  Speaker 3: Information will flow as you fine-tune it.
• 9:54
  Speaker 3: I think, as long as your focus is on the patient first and making sure you're focused on getting them the care, getting the product working with the clinicians, focused on getting them the care, getting the products working with the clinicians, then getting all of the team and communication involved and the right people involved, gets you to that answer.
• 10:12
  Speaker 3: And it starts in the very beginning with having your supply chain built for resiliency, having all the right tools, all the right systems, all the right decisions in place to get you there.
• 10:21
  Speaker 1: You've got a big task, though, with that geography and you know you deal with.
• 10:26
  Speaker 1: You get hit by everything that we talked about potential wildfires and hurricanes and I was going to if Ken makes it to the call and he must have had something come up I was going to ask him how he deals with possible invasion from Canada, since he's in Vermont but he's not here yet.
• 10:49
  Speaker 1: But I became aware of ResLink in about 2018 at the McKenna Lecture Series at Arizona State.
• 10:56
  Speaker 1: I introduced the firm's tools to two of its earliest healthcare organization customers University of Vermont Medical Center and Trinity Health in Livonia, michigan.
• 11:07
  Speaker 1: You know in a nutshell, leanne, tell us what ResLink does, how it scans the event horizon and how it provides information to support the building of a strong disaster preparedness event mitigation program.
• 11:22
  Speaker 2: Yeah, I'm happy to and thank you.
• 11:24
  Speaker 2: We're very lucky to have a strong relationship with the University of Vermont, so sorry he hasn't been able to join us yet.
• 11:30
  Speaker 2: But when you think about where healthcare systems buy supplies, there are supplies that come from, you know, distributors, and then there's direct to the manufacturer, and so what we do is we help supply chain organizations really map their supply chain and then, to build off of what Steve was saying, send assessments to those suppliers to begin to identify additional information, whether it's financial risk, cybersecurity, and then, through our AI and the algorithms that we've built, we monitor over 250 type of events that could impact the supply chain.
• 12:09
  Speaker 2: And great examples.
• 12:10
  Speaker 2: Yes, natural disasters are up.
• 12:13
  Speaker 2: Our ResLink research data shows that forest fires, for instance, climbed 80% this year over last year, where flooding has jumped over 200%.
• 12:23
  Speaker 2: But even though natural disasters are on the rise, they still don't hit the top five that we see impacting healthcare organization.
• 12:31
  Speaker 2: Supplies change today.
• 12:32
  Speaker 2: A couple other big ones are factory fires that are existing today, merger and acquisitions and labor disruptions.
• 12:40
  Speaker 2: In fact, we know that 90% of active pharmaceutical ingredients come from China and India, and so even understanding where those core ingredients are really helps.
• 12:53
  Speaker 2: So when we work with organizations.
• 12:56
  Speaker 2: We map the supply chain, we assess the risk by potential impact, which are a number of those and then we engage with supply chain partners.
• 13:06
  Speaker 2: Also, building on what Steve said, collaboration is critical collaboration internally, but also collaboration externally.
• 13:13
  Speaker 2: So we have a collaboration platform that allows our healthcare providers and companies to work directly with their suppliers in the event of a disruption, but also to proactively play so they can identify alternatives.
• 13:28
  Speaker 2: And all those alternatives could be secondary suppliers, inventory, as Steve said but you don't want to create hoarding issues or cost issues but also being able to work with the providers to triage what that impact is going to be to patient care.
• 13:44
  Speaker 2: Where are you going to have to rationalize or do other things?
• 13:47
  Speaker 2: And so there's a full workflow system built within the product as well to do that.
• 13:53
  Speaker 1: So what are the top five disruptions happening right now?
• 13:57
  Speaker 2: Right now we see factory fires is the number one, which is crazy, and that's all across the country.
• 14:02
  Speaker 2: So we look globally, not just within the United States.
• 14:05
  Speaker 2: The second one is merger and acquisitions and closing of a number of plants, which are impacting leadership transitions, believe it or not, are up 85 percent year over year and with those leadership transitions, typically from closing of factories, merger and acquisitions that impact it, labor disruptions, particularly in certain areas of the world, up 31 percent from this time last year.
• 14:32
  Speaker 2: And then the fifth one would be the extreme weather events and, like I said, seeing a surge in all of them, from flooding, fires, hurricanes and typhoons.
• 14:42
  Speaker 2: But overall, if you classify all of them, those are up about 120% from this time last year.
• 14:49
  Speaker 1: So, to be clear, all those disruptions you were talking about that are also occurring in health care are the disruptions that are occurring outside of health care that could influence the healthcare supply chain?
• 15:02
  Speaker 1: That's number one.
• 15:02
  Speaker 1: And number two is your tool is not just utilized by healthcare, it's utilized across all industries.
• 15:12
  Speaker 1: Is that correct?
• 15:13
  Speaker 2: It is.
• 15:14
  Speaker 2: It's across all industries and you know I love that.
• 15:18
  Speaker 2: We talked about the port.
• 15:19
  Speaker 2: You know the Baltimore Port Strike.
• 15:20
  Speaker 2: You know we notified our customers six months ahead of time that this could happen and a number of those organizations were able to take preventive measures and plan for shipments to come in through the West Coast versus the East Coast and look at that.
• 15:36
  Speaker 2: But, to your point, when we think of other things, it's all industries and eventually, somehow, healthcare, you know, sees it, whether it's a supply that is specifically for health care or something that every industry uses, the active pharmaceutical ingredients, active ingredients, impact it.
• 15:53
  Speaker 2: So we also have a huge presence within high tech industry, automotive manufacturing, across the board.
• 16:01
  Speaker 2: But the same disruptions, to your point, they impact everybody.
• 16:06
  Speaker 2: It's just a level of impact that you may feel based on where a key component is coming from, and unfortunately for healthcare, china is a big one, so we see that often.
• 16:18
  Speaker 1: Yeah well, one of the things and, steve, you might want to comment on this too, and Steve, you might want to comment on this too.
• 16:23
  Speaker 1: But one of the things that I see out there, if you're scanning the political horizon, aside from governmental changes in Central and South America the impact of potential tariffs on China, where we are getting an inordinate amount of products from.
• 16:45
  Speaker 1: I don't think many people have a clue as to how dependent we are on them.
• 16:53
  Speaker 1: That's going to cause something that has to be dealt with, am I wrong, steve?
• 16:58
  Speaker 3: Yeah well, hopefully it doesn't lead us to shortages.
• 17:00
  Speaker 3: We are going to have to work through the pricing challenges that come with that the latest shortages we are going to have to work through the pricing challenges that come with that.
• 17:07
  Speaker 3: But you're right, a large portion of medical supplies come from China, and as do many of the active ingredients.
• 17:15
  Speaker 3: That's a big source for it, and I think what Leanne mentioned is exactly right the information is one of the important keys.
• 17:25
  Speaker 3: You can't plan if you don't know how risky it is and if you don't even know where the product comes from, how do you plan for what the disaster might be?
• 17:34
  Speaker 3: So you need to know, and I think that information is key in your concept of how do I become a resilient supply chain, concept of how do I become a resilient supply chain Understanding origin country.
• 17:49
  Speaker 3: Is this coming from overseas?
• 17:50
  Speaker 3: What are my risks in transit?
• 17:51
  Speaker 3: It doesn't necessarily make it any better if it's from some location that may be onshore but is prone to forest fires or flooding.
• 17:59
  Speaker 3: So, understanding that you know and tell me the history of the site and any risks associated with it, and then all of the other risks that we talked about fires or cyber or others all are important data points for us.
• 18:21
  Speaker 3: If somebody is not prepared with their own, the supplier doesn't have their own resiliency plans and it's clear.
• 18:28
  Speaker 3: They've had a lot of shortages or having performance problems, then you know that and you can make that decision up front when you make your sourcing decisions.
• 18:36
  Speaker 3: Do I need multiple vendors?
• 18:38
  Speaker 3: Do I need a different stocking strategy?
• 18:42
  Speaker 3: Do I buy through distributors or direct?
• 18:43
  Speaker 3: All those things apply.
• 18:45
  Speaker 1: You can't make those decisions unless you know and therefore you need to be equipped with the information Lee on stocking, then yeah, you know, my most recent podcast prior to today was with Dr Eugene Schneller from Arizona State, and he made an observation about the health care supply chain from his.
• 19:08
  Speaker 1: He looks at himself as an outsider because he's basically a sociologist who is involved in health care supply chain, but he said that one of the big problems that we've had in health care and I agree with him is that we've outsourced core activities that an industrial supply chain would take on and take care of on their own.
• 19:35
  Speaker 1: For example, the one thing that we've outsourced contracting, especially for commodity items, to the GPOs, and when Hurricane Maria hit back in 2017, nobody knew where stuff was coming from and they didn't know, for example, that regardless of whose name was on the label, many bags were only produced in one place and, to use a technical term, we were screwed by what happened.
• 20:07
  Speaker 1: So, as a supply chain leader and you're also a member of the Health Industry Resiliency Coalition, which is a group of leading IDNs that are working on the concept of uh, of resiliency and being able to be proactive do you feel that you are taking more and more responsibility for your whole supply chain operation and do you think that people need to be aware of and try to do that Certainly the assessment of risk and understanding the impact of that in your sourcing decisions is critical.
• 20:53
  Speaker 3: We have historically done a lot of contracting ourselves and we can ask those questions.
• 21:00
  Speaker 3: So as part of our work with Accelerate, we do that on behalf of the members for Accelerate.
• 21:06
  Speaker 3: So when we assess sourcing opportunity, we're asking the questions up front that Leanne talked about in history and location and performance and focus on that as a component of the sourcing process.
• 21:23
  Speaker 3: It's it's a seesaw.
• 21:26
  Speaker 3: You can't go too far on one way or the other.
• 21:28
  Speaker 3: If all you focus on is cost and you're just looking for the lowest cost alternative, regardless of any resiliency problems, you're going to have issues.
• 21:39
  Speaker 3: And if you go the other way, you might have six different vendors all located down the street in Cleveland, incredibly resilient but incredibly costly, down the street in Cleveland, incredibly resilient but incredibly costly.
• 21:54
  Speaker 3: So you can't get too far into your own supply chain and we're not going to own all the manufacturers and put them in our backyard, right, so you understand what your risk is and then you walk the balance with okay, is this an acceptable level of risk and how do we best manage that?
• 22:11
  Speaker 3: And, like I said, it may be decisions around how you're buying, where you're buying, how much you're buying, and at least that way you are understanding the risk and you're balancing it and making that cost trade-off decision as part of it.
• 22:27
  Speaker 3: As you buy from a GPO, you can ask the same questions you can look to what are?
• 22:33
  Speaker 3: those key drivers in your resiliency and understand how critical is this item to me.
• 22:40
  Speaker 3: The first step we do in our assessment is criticality.
• 22:45
  Speaker 3: You can't control all of the SKUs 35,000 plus SKUs so you have to do a criticality assessment.
• 22:53
  Speaker 3: Is this used broadly?
• 22:55
  Speaker 3: Is it used in patient care?
• 22:57
  Speaker 3: Is it used in surgery?
• 22:58
  Speaker 3: Are there multiple options in the market?
• 23:01
  Speaker 3: All those things are important in a criticality assessment which tells you how much you should care, how much time you should be spending with it.
• 23:09
  Speaker 3: And can you dive in a little deeper?
• 23:10
  Speaker 3: Can you afford to carry more inventory of this, which tells you how much you should care, how much time you should be spending with it.
• 23:13
  Speaker 3: And can you dive in a little deeper?
• 23:14
  Speaker 3: Can you afford to carry more inventory of this?
• 23:16
  Speaker 3: And if it's low criticality, maybe you're spending less time on it.
• 23:19
  Speaker 3: But at highly critical things IV fluids, for example you should be thinking about that plan, right.
• 23:25
  Speaker 1: You know you're bringing up something, and it's a term that I learned from outside of health care.
• 23:31
  Speaker 1: It's funny I spent my whole career in health care supply chain, didn't know anything about supply chain, knew a lot about dealing with sales reps and clinicians, but not much about supply chain.
• 23:42
  Speaker 1: But industry has a phrase called a plan for every part, and you hit on the fact that we have 35 or 40,000 SKUs, but there probably are about 200 items that you could identify that you just can't deal without.
• 23:57
  Speaker 1: I mean the, the simplicity of IV solutions, which are a commodity generally in the storeroom and not in the pharmacy.
• 24:06
  Speaker 1: That's where they're stored, they're managed from, but if, but if they're not there, all of your high dollar procedures are in jeopardy.
• 24:17
  Speaker 1: People that are getting chemotherapy are in jeopardy.
• 24:20
  Speaker 1: And so you have identified what I was hoping to hear that you understand which things are important and you give them special attention.
• 24:29
  Speaker 1: Is that fair?
• 24:30
  Speaker 3: Exactly, fred.
• 24:31
  Speaker 3: I will tell you where we're taking.
• 24:33
  Speaker 3: This is the next level and that's third-party risk overall.
• 24:45
  Speaker 3: And if you say, what does that mean?
• 24:46
  Speaker 3: What other industries have solved it?
• 24:47
  Speaker 3: Third-party risk is not just supply risk.
• 24:49
  Speaker 3: Don't just look at the widget you're buying and what's the history of on-time performance from that, but look at the overall risk to the organization for that third party you're working with.
• 25:02
  Speaker 3: Is there legal risk?
• 25:04
  Speaker 3: Maybe your contract's not best structured, or maybe you're sharing data that needs better data controls.
• 25:10
  Speaker 3: Or if there's a AP risk, they're having you pay by check mailed to some place that you're like this is not a really clean, I know where my money is going.
• 25:24
  Speaker 3: Transaction or cyber Right.
• 25:27
  Speaker 3: Transaction or cyber right.
• 25:34
  Speaker 3: There may be cyber risks.
• 25:35
  Speaker 3: And how do you in a vendor management view interface all of that together with a?
• 25:38
  Speaker 3: This is a risky business to do.
• 25:41
  Speaker 3: It may be at the skew level, where you say a plan for that skew.
• 25:45
  Speaker 3: Or it may be like an IT service that you're buying and you say this is a high cyber risk and we have that example in the industry.
• 25:55
  Speaker 3: Right and OK.
• 25:57
  Speaker 3: If you had identified that as a risk, you would have put some controls around that, perhaps on the contract, perhaps with multiple sources, perhaps with cyber audits.
• 26:10
  Speaker 3: I'll tell you, one of the best benchmark industries I've seen for that is banking.
• 26:15
  Speaker 3: Banking has really tight controls and regulations around third-party risk and if you examine, it they have.
• 26:25
  Speaker 3: You do questionnaires on the supplier from all those aspects and if you hit above a threshold, it makes you do a more deeper assessment in that area of the supplier.
• 26:37
  Speaker 3: Where can you button up around it?
• 26:41
  Speaker 3: Perhaps you need better contracts or better cyber audits or better vendor visits, because there's risk that comes from something.
• 26:50
  Speaker 3: Now, that's taking just supply risk and taking it even further into.
• 26:57
  Speaker 3: Okay, what is the risk to me by having this person as a business partner?
• 27:02
  Speaker 1: Yep, so have you been?
• 27:04
  Speaker 1: Has your organization been hit hard on the bottom line because of procedure disruptions, because of the IV situation?
• 27:17
  Speaker 3: So we have not canceled any cases and worked hard at that.
• 27:23
  Speaker 3: We are absolutely working through the program.
• 27:27
  Speaker 3: Though we were affected and we've been mitigating it with conservation strategies, we up front on the supply chain side had assessed it as a critical skew.
• 27:39
  Speaker 3: We had looked at what's our purchasing route for these things, all the stuff we've talked about and we've done some changes in that front and we'd adjusted our inventory levels to help kind of cushion our response to this, because it does take you time to get the clinical changes in place.
• 27:59
  Speaker 3: Conservation managers don't just happen in it in a couple hours.
• 28:03
  Speaker 3: You have clinical protocols you have to enact, so you need time and if you only have a few days of inventory that's a really hard thing to do.
• 28:10
  Speaker 3: So we fortunately had some inventory that gave us a chance to bring those conservation measures in place and then get ourselves to the point where we're conserving, to where we're getting supplies from very closely partnered with the supply community to keep us going, closely partnered with the supply community to keep us going.
• 28:30
  Speaker 3: It's a real national challenge and a lot of people are affected by it.
• 28:39
  Speaker 3: A lot of folks are working through conservation techniques and other supply options in this disruption and it's a really hard thing to manage.
• 28:44
  Speaker 3: It is absolutely one of those critically assessed SKUs but, as Leanne would tell you, I'm sure the Resolink data shows you what that plan would affect.
• 28:56
  Speaker 2: Yeah, I would say to build on that, steve, you know, you know and I appreciate the comment from health care, but again, I'm biased because I started as a provider as well.
• 29:08
  Speaker 2: You know there is immense complexity in supply chains and it's hidden in multi-tier and so where we can say that about health care, you know, I know from our data that even on other industries that say they really know supply chain and they get into it in manufacturing, they may have good visibility on tier one, which is where they directly buy, from their visibility on then who their suppliers are buying, from drops to about 20% on the second tier.
• 29:37
  Speaker 2: So even those very complex, you know they go and that's one of the reasons when I talk about mapping the supply chain.
• 29:43
  Speaker 2: We help them do that work.
• 29:45
  Speaker 2: And then by the tier three they have less than 5%, which increases their risk up to 90% that they're going to have a disruption.
• 29:54
  Speaker 2: And to Steve's point, yes, that's why I say weather definitely a problem, but we think about some of the other, even compliance and regulatory issues.
• 30:04
  Speaker 2: So you know UFLPA, which is, you know, a forced labor act, that is a very impactful thing and it happens in tier three, manufacturers or providers.
• 30:15
  Speaker 2: They don't know that because they're looking at tier one, and so I appreciate the statement, but I would just say, working across industries, I will tell you every industry has blind spots and that there is complexity in it, and understanding it goes along with what Sue was saying.
• 30:33
  Speaker 2: You have to be able to take the time to prepare up front and, as we all know, the best reaction is when you have proactively planned, and that is hard work.
• 30:45
  Speaker 2: It's not easy, you know, not to go through a technical bend, but, yes, there's AI and autonomous mapping that can give you lots of data, but unless you start to do those validations with the suppliers, you know that data is only as accurate as where you're getting the data source from, and so I just I don't know.
• 31:04
  Speaker 2: I just wanted to add that, yeah, I understand the comment on supply chain and healthcare, but it's like every industry, the complexity gives them blind spots on tier two and tier three, more than most people would think.
• 31:18
  Speaker 1: Okay, you know to build on that.
• 31:21
  Speaker 1: Just an aside about AI.
• 31:23
  Speaker 1: This is how old I am.
• 31:25
  Speaker 1: When I first saw AI, if you look at it the capital I looks like a lowercase L and I kept wondering who the hell Al was.
• 31:38
  Speaker 2: Some of us may remember Al, the little alien too, that was here.
• 31:43
  Speaker 1: Anyway, to add on to that, both of you, I'd like to have your input on this.
• 31:49
  Speaker 1: What advice would you give to any healthcare organization faced with creating a plan?
• 31:56
  Speaker 1: Say, I'm a smaller IDN or one of the two or three remaining standalone community hospitals out there in the country and I don't have the resources, like the very large IDNs have, to be able to focus just on this.
• 32:13
  Speaker 1: I'm trying to get my work done and day-to-day transactional stuff.
• 32:17
  Speaker 1: What advice would you give about creating a plan to mitigate disasters?
• 32:31
  Speaker 2: I go and then I'm sure you have a very additional experience on this.
• 32:35
  Speaker 2: You know, first and foremost, to Steve's point you're not going to map every SKU, let's be honest, you can't do that.
• 32:40
  Speaker 2: And so, with the organizations that we work with that are smaller, like you know, identify your top 100, or even start with your top 50 that are going to create critical impact.
• 32:52
  Speaker 2: So identify those suppliers it's the old 80-20 rule and then really think through how could we assess the risk by each of these suppliers?
• 33:04
  Speaker 2: So assess the risk and then identify the alternatives.
• 33:08
  Speaker 2: You may not put them in place until disruption happens, but have those alternatives up front and ready to go, whether it's this, you know, a secondary list of suppliers, inventory and you know the mapping.
• 33:22
  Speaker 2: To me, that's where you start.
• 33:24
  Speaker 2: And then, most importantly, not just because of ResLink, I would say monitor that, because the faster that you know during any disruption or emergency, we all know that time matters.
• 33:37
  Speaker 2: It matters in life saving, it matters in your ability.
• 33:41
  Speaker 2: So finding the ability to monitor those top 100 suppliers would be critical.
• 33:47
  Speaker 3: Love it.
• 33:48
  Speaker 3: Totally agree, leanne, the criticality assessment first it.
• 33:53
  Speaker 3: Totally agree, leanne, the criticality assessment first.
• 33:55
  Speaker 3: I would say the first thing is recognize the need to do it and make time to do it.
• 33:59
  Speaker 3: So the fact that a supply chain leader would take the time to build a resiliency plan and figure out how to get the resources to do it is the first part of the battle.
• 34:10
  Speaker 3: Then now work through at the category level and then forward into the SKU level of where do I have to focus?
• 34:20
  Speaker 3: And I think you can go at it from the supplier view.
• 34:25
  Speaker 3: We do that at third-party risk.
• 34:27
  Speaker 3: You also go at it from the categories down to the SKUs.
• 34:29
  Speaker 3: What's my criticality?
• 34:31
  Speaker 3: Understanding all the information you can get and you build that into your sourcing events.
• 34:38
  Speaker 3: Ask those questions, look for what data you're getting on origin, monitoring performance and then, as you have business reviews things sharing on-time performance or challenges absolutely.
• 34:53
  Speaker 3: Communicating, building your communication plan ahead of time.
• 34:57
  Speaker 3: Reviews things sharing on time performance or challenges Absolutely.
• 35:01
  Speaker 3: And communicating, building your communication plan ahead of time.
• 35:04
  Speaker 3: When I have a shortage of level A, I'm going to do this and level B, I'm going to do that.
• 35:09
  Speaker 3: Sometimes it may just be a substitute and you work with the suppliers on substitutes.
• 35:11
  Speaker 3: You still have to talk about substitutes.
• 35:13
  Speaker 3: You have to communicate.
• 35:14
  Speaker 3: Fine, how are you going to communicate subs all the way up until this is a critical emergency.
• 35:21
  Speaker 3: I'm going to impact cases.
• 35:22
  Speaker 3: Who am I going to tell and what role is the CEO going to play?
• 35:26
  Speaker 3: Does the board need you know?
• 35:28
  Speaker 3: all kinds of communications arise that plan that ahead of time and if you can get ahead of those things and then whatever systems, whatever information feeds you can get for yourself you're not going to be able to watch everything in watching news feeds of disasters around the world is fascinating.
• 35:48
  Speaker 3: It's like watching a news channel all day.
• 35:50
  Speaker 3: It's incredible and you can get overwhelmed prioritizing that understanding where your problems are.
• 35:53
  Speaker 3: Absolutely Fascinating.
• 35:53
  Speaker 3: It's like watching a news channel all day.
• 35:54
  Speaker 1: It's incredible and you can get overwhelmed Prioritizing that understanding what your problems are, absolutely, but the idea is you need you need to know that it's important enough to focus on and work on and, I would add, to sell to your senior senior leadership, because my experience over 50 plus years is that as soon as the crisis is resolved and our heroic intervention has saved the day again, senior leadership has always had a tendency maybe not at the clinic, but in other places reverting to the same old plan as before, which is find better prices and get rid of people, and so there's some convincing in there of this is important and we need to stay on this and continue to be prepared, to be ready when something happens.
• 36:48
  Speaker 1: Is that fair?
• 36:50
  Speaker 3: And having surgeries postponed because you don't have the stuff is also really bad for your costs.
• 36:55
  Speaker 3: Yeah, and having more expensive substitutes that you're not on contract for, that you have to overnight freight in, are worse, yep.
• 37:04
  Speaker 3: So actually having a preparedness plan is the right financial decision as well.
• 37:10
  Speaker 3: It could be worse if you're not careful.
• 37:13
  Speaker 3: Think about what happened with all these shortages.
• 37:15
  Speaker 3: The cost to the organizations was really high.
• 37:19
  Speaker 3: So preparing ahead of time and getting the right things in place and putting in the monitoring actually in the end is better off.
• 37:27
  Speaker 1: Right?
• 37:28
  Speaker 1: Well, I know that I got one more question for Leanne before we go, but there's going to be a second episode of this and that is the Ken Jensen episode, because Ken works with my younger brother, Charlie Michelli, and Charlie was the first person that I was instrumental in showing Resolink to, and Charlie saw the importance of it so quickly that he said I don't need to hear anymore send me a contract, because he understood the value of data and because of that, the smaller IDN up in Vermont has been ahead of many of the crises because of the way they've used the data.
• 38:13
  Speaker 1: So I appreciate your folks' input and it's been great.
• 38:19
  Speaker 1: It's always great to talk to you, Steve, and it's great to meet you.
• 38:23
  Speaker 1: Leanne, I would ask you to tell our audience how they can get more information about Resolink.
• 38:30
  Speaker 1: We've stayed away from a sales pitch in here, which is what we want to do, but I think it's important that, if you could, to give them contact information, because I think people need to investigate the idea of software as a service to help them build their plans.
• 38:47
  Speaker 2: Yeah, I appreciate that, fred.
• 38:48
  Speaker 2: I mean there's several ways.
• 38:50
  Speaker 2: One it's resilinc R-E-S-I-L-I-N-C dot com and we have amazing blogs, I would say, and papers on this as well that you can subscribe to and get to learn more about it.
• 39:02
  Speaker 2: So it would accept.
• 39:03
  Speaker 2: You know, definitely you can always reach out to me via LinkedIn, but then there's always at sales at resilinc dot com is an email that all of us respond to.
• 39:14
  Speaker 2: That you can get to.
• 39:15
  Speaker 2: But I'm with you, I think, at a minimum.
• 39:18
  Speaker 2: Really, we have some great life sciences papers, white papers we've written recently and specifically on health care that I think for the listeners they would appreciate.
• 39:29
  Speaker 1: Great Well, thank you both so much for being here.
• 39:31
  Speaker 1: And Steve, it's all right.
• 39:33
  Speaker 1: We're four miles away from each other.
• 39:34
  Speaker 2: We never see each other except at meetings.
• 39:37
  Speaker 1: You know you don't know this, leanne, but one of the big anchor industries in Cleveland Ohio is Sherwin-Williams.
• 39:47
  Speaker 1: I know it's crazy actually, I know it's crazy actually, and the clinic has nothing but white paint everywhere.
• 39:56
  Speaker 1: They should be an advertisement for Sherwin-Williams, but they're.
• 40:00
  Speaker 1: Sherwin-williams flat white, that's what they are.
• 40:02
  Speaker 3: There's a special color, there is a special color.
• 40:06
  Speaker 2: Well, it's clean, right, see if it's clean.
• 40:10
  Speaker 1: That's the idea.
• 40:11
  Speaker 1: I have a problem because I've got monocular vision.
• 40:14
  Speaker 1: I'm always looking out at one eye at a time, so I don't have good depth perception and without anything to separate man, it all seems like it's in the same plane.
• 40:22
  Speaker 1: I just like to pull Steve's leg a little bit.
• 40:28
  Speaker 1: Thank you so much, folks, and we look forward to seeing you next week when we will be talking with Jane Pleasance from the Strategic Marketplace.