Some existing boundaries in Healthcare management

Some boundaries still to be addressed in Healthcare - an outsider's perspective:


- The gap between "clinical products" and "physical/logistic items". 
When a physician wants clinical information for prescribing, he has the clinical attributes of a product (or product type). But for the pharmacist, this item has also logistic features, like location, price, packaging... And they are referring to the same thing.

- The difference between a catalog item (e.g. Renault 5 TL) and an instance of that (my first car, license plate FZ-09-62)
This very simple difference (or the lack of awareness) is breaking implementations of barcodes, RFIDs,


-The separation between Clinical domains and Healthcare Management. 
After seeing struggles between clinicians and business managers, the gaps between these 2 domains are obvious. The conflicting interests are usually taken (wrongly) as reasons for discussing who's better. To me, the most obvious is that multi-criteria decision making is common, and healthcare management (minimizing costs, maximizing benefit to patient and society) is a clear example where bridges are needed.

On Stock management in Pharmacy

Daily examples to describe some problems around the resupply of items in a Pharmacy:

The most usual approach to organized supply of items seems to be
Minimum Level Reordering

In this case, (which introduces the concept of reorder point), the reorder quantity can be fixed, but the frequency of refills depends on the consumption.
This is like we go shopping (for a predetermined number on units) immediately when we see we are short on some item.

In other cases, there may be a continuous (e.g. weekly) supply. In this case the frequency is fixed, but the refill amount depends on the quantity needed . This is when we go monthly or weekly to a big store - the amount we buy is usually variable.

Personally, like everyone, I think, I do not buy when the stock is below a given level. I note it in my list, and I consider the time between purchases and other factors to determine the quantity to buy.

More interesting for healthcare (but trivial to any person): when I go shopping, I take into account not only the current stock, and the usual stock, but also any additional factors that may influence e.g. the desired stock level - taking into account that I have one more person with me will increase the amount of food that I must buy.

This introduces the notions in Operations Research, where much advanced knowledge exists, and should be applicable to healthcare.

Healthcare logistics are still one step behind "normal" logistics, and the exploration of use cases should permit some innovation in healthcare.

User Interface guidance

Good design guidance from Microsoft about healthcare systems. 

http://www.mscui.net/

Nice move, addressing medication first.

Will keep it in the background. Or foreground, if needed.