Supply Chain Slowdown Affecting Some Healthcare Facilities

Noticed a shortage of aluminum crutches at your local hospital lately? You’re not alone.

As the U.S. battles a slowdown in its overall supply chain, healthcare facilities are not exempt from feeling the pinch. “Gloves, particularly nitrile gloves, continue to be difficult for hospitals and health systems to source, as are diapers (adult and infant),” Mike Schiller, senior director of supply chain at the Association for Health Care Resource & Materials Management, said in an email. “Raw materials shortages continue to impact the health care supply chain, including aluminum, which impacts durable medical equipment including crutches, walkers, and canes.”

In addition, “semiconductor shortages create delays for medical equipment and devices like patient monitoring systems and CT scanners,” he continued. “Power shortages, labor shortages, and logistic constraints continue to directly and indirectly impact the health care supply chain.”

Shortages at Pharmacies, Doctors’ Offices

Pharmacies are also reporting issues; a survey of 318 independent pharmacies by the National Community Pharmacists Association (NCPA) found that 60% of respondents said they were affected by supply chain issues. Survey respondents were asked to type in up to three products they’re finding in short supply, and antibiotics came up frequently — specifically ciprofloxacin, NCPA president Douglas Hoey, RPh, MBA, said during a phone interview at which a public relations person was present. Whether that shortage was specifically due to supply chain issues “is a little bit hard for me to say,” Hoey said. “I had not heard specific complaints about this specific antibiotic, but just because I hadn’t heard specifically that it was in short supply before this, that doesn’t mean that the recent supply chain problems are the cause.”

Over-the-counter products also were mentioned frequently, accounting for about 25% of the products listed by respondents, he added. And with cough and cold season coming up, it would be a good idea for clinicians to collaborate with pharmacists on alternatives in case there’s a shortage of a particular cough or cold remedy, Hoey suggested.

What about shortages at physician offices? “We are hearing that the major challenges are continued need and cost of PPE, cleaning supplies, and having to obtain new technology for virtual care,” Andrew Hajde, CMPE, assistant director of association content at the Medical Group Management Association (MGMA), wrote in an email. However, he added, “We are not currently hearing many if any complaints about being able to obtain gloves and masks, though some organizations have had to utilize additional supply vendors as needed.”

Although MGMA is not hearing much about other specific shortages among its members, “there are reports and new stories beyond those from MGMA members, specifically of shortages of blood tubes, drug shortages, prescription vials and raw materials for producing medical equipment — including semiconductors, which are needed in the production of equipment like ventilators and respiratory equipment,” Hajde said. ” There were also some reports in hospitals of shortages of crutches, walkers and wheelchairs… It’s definitely of great concern to MGMA members and the medical community as a whole if they are unable to obtain lifesaving drugs and medical equipment both when and where they need it.”

What About a “Fast Pass”?

What can be done to solve the problem? One possible solution is developing a “fast pass” for medical supplies, said Linda Rouse O’Neill, vice president of supply chain policy and executive branch relations at the Health Industry Distributors Association (HIDA). “Think of it as a Disney ‘get to the front of the line’ concept,” she said. “How can we create that in a way that is recognized across the transportation system? It’s going to start with the ports — some sort of system where that container is flagged and is recognized across the transportation system as having critical medical supplies that need to go to the front of the line. It’s got to be off the ship first; it’s got to go to the port first; it’s got to get on the rail first; it’s got to get on the chassis in the trucks first; and then it’s got to go to small parcel first as well.”

Blair Childs, a spokesman for Premier, a healthcare products distributor, said his company — which is a member of HIDA — supports that idea. “We were discussing this yesterday with the leaders over in the White House and a number of our supply chain people,” he said in a phone interview. “So apparently you actually can kind of ‘triage’ — so if the shipping is coming into the country, you can prioritize some over others. So we’re looking at systems to enable that, so should there be a immediate or significant shortage of surgical gowns or gloves … that they can expedite certain parts of what’s being shipped over.”

Hoey, of NCPA, agreed. “To the extent that life-saving and quality-of-life medications could get prioritized or are being prioritized, I do think that’s an important idea,” he said. “There are some things that we would hate to do without, but we can live without. Medications we can’t live without — literally. So being able to prioritize some of those medications is an important policy decision.”

Ramping Up Domestic Supplies

Another idea would be to use the Defense Production Act to get more medical supplies produced in the U.S. rather than overseas. The Biden administration says that “if they get early warning they can actually utilize some of the capabilities of the Defense Production Act,” said Childs. However, “as you can well imagine, it’s not something you can do at the drop of a hat. It’ll take a little while to gear all that up, but they seem to think that they can do that.”

What should be done to prevent similar bottlenecks from occurring in the future? A better blend of sources is what’s needed, according to Childs. “The way we source the products is that we seek to get a balanced approach — near-shore, offshore, and domestic,” he said. “That is what our ideal is … but that’s not what we can get because there’s no manufacturing domestically in some instances, and there’s not even manufacturing near-shore. So that’s been a concern.”

The Biden administration has attempted to address the problem by convening supply chain stakeholders to solve problems and issuing a report on specific supply chain issues and ways to address them. In October, the administration announced several actions by public and private entities, including the Port of Los Angeles and the International Longshore and Warehouse Union, to increase hours and staffing at the ports. The administration also is asking Congress to establish a Critical Supply Chain Resiliency Program at the Department of Commerce to monitor and solve supply chain issues.