Vertical Focus: Healthcare
Vaccines Prepare for Liftoff
Ghana is the first country in the world to use drones to deliver the COVID-19 vaccine to healthcare facilities. COVAX, an initiative led by UNICEF, shipped 600,000 doses of the AstraZeneca/Oxford vaccine from its facility in India to Ghana, using Zipline's national drone delivery service. The goal is to deliver at least 2 billion doses to low- and middle-income countries by the end of 2021.
Drone delivery ensures rapid, equitable access to the vaccine for the 12 million people in Ghana living outside cities. UPS transfers the vaccines to the distribution center and provides ground delivery to the government's regional cold stores. Once the vaccines arrive at the distribution center at Mpanya, they are flown to healthcare facilities in the region.
Zipline's distribution center—part fulfillment warehouse and part drone airport—is equipped to deliver more than two tons of temperature-controlled medicine weekly.
Domestic Production Is the Best Medicine
In April 2020, prices of 3M N95 masks rose 6,136% as demand spiked. Shortages could have been worse if not for the tens of thousands of makers and manufacturers that pivoted to create supplies, says a Harvard Business Review report. Here's how domestic production can create stronger healthcare supply chains before the next crisis, the report says:
Respond to aid in a coordinated way. Overwhelmed hospital staff responded to an influx of calls offering help by setting up electronic mailboxes or posting needs on their websites. Needs shifted so fast that items in short supply one week were overflowing the next.
Hospitals and healthcare facilities will benefit from a single point of contact for coordinating with alternative manufacturers and personal protective equipment (PPE) donors.
Curate and vet equipment designs. Without FDA approval, new designs from inexperienced suppliers could be ineffective. Open Source Medical Supplies, founded by makers and doctors, created a library listing 195 open-source designs for PPE and medical devices. This eliminates the need for suppliers to create customized designs and enables them to produce effective items faster.
Identify alternative suppliers early. Manufacturers producing critical supplies often weren't on the radar for hospitals. Forming relationships now and adding firms to approved vendor lists will help healthcare facilities pivot quickly during a crisis.
For example, Maryland Made to Save Lives' database lists manufacturers in the state by area of expertise, allowing healthcare facilities to find alternate suppliers.
Perform drills to test supply availability. Preparing for large-scale supplier disruption should be incorporated into disaster drills. While it's common for hospitals to hold emergency preparedness drills, they often don't involve suppliers. Many smaller facilities, such as nursing homes and community clinics, don't hold drills but should start.
Cut red tape for billing and payment. During a crisis, rigorous invoicing processes can be a liability. Allowing local facilities and managers greater discretion in billing can enable faster response. One potential approach is a discretionary fund. Another is a public rapid-response fund.
Data-Sharing Is Caring
Moderna and IBM are partnering to explore artificial intelligence, blockchain, and hybrid cloud technologies that foster near-real-time tracking of vaccine administration. The initiative aims to accelerate secure information sharing between governments, healthcare providers, life science organizations, and individuals.
Initial work will focus on exploring IBM capabilities in the United States, including solutions that provide end-to-end traceability to address potential disruptions. The solutions enable governments and healthcare providers to quickly and securely share data regarding individual vaccine batches as they travel from manufacturing facilities to administration sites.
One of IBM's blockchain-based solutions, called Digital Health Pass, helps individuals maintain control of their personal health information and share it securely. Organizations can use it to verify health credentials for employees, customers, and travelers based on certain criteria, such as test results, vaccination records, and temperature checks.
Patching Up Transparency
Digital solutions can improve healthcare supply chain transparency and ease future disruption in these three ways, says a report from Labnews.co.uk:
1. Easing shortages. Medical workers report facing order quantity restrictions for PPE, forcing them to use makeshift supplies in-house. Platforms such as GetUsPPE.org can help match available PPE with the locations that need it most. In approximately two weeks, the tool sent 83,136 PPE items to 135 U.S. healthcare facilities.
2. Streamlining appointments. Even in initial vaccine rollouts, many areas experienced appointment no-shows and shortages that delayed second doses. QliqSOFT launched a chatbot that alerts patients when vaccines are available and when they're due for a second dose. The chatbot also provides transportation options, making it easier for patients to reach vaccination sites.
3. Replenishing supplies. Online platforms make it easier for people to refill prescriptions, which can help improve patient outcomes. During the pandemic, many pharmacies waived prescription refill limits, using online interfaces to implement blocks when people tried to refill prescriptions with more than a specific amount of stock remaining. This helped patients get more of their medication, while offering distributors the transparency to prevent unnecessary stockpiling and unexpected shortages.
Tossing Out Paper Problems
Paper inserts containing dosing and technical information are legally required inside every box of medicine. If the information is incorrect or out of date, it can cause recalls that disrupt the entire drug supply chain.
Drug company Novartis came up with a blockchain solution that provides patients with digital versions of the inserts that can be updated in real time, which speeds up packaging lines and reduces the number of recalls.
Patients download an app and scan a 2D matrix, similar to a QR code, on the outside of the drug package. The scan recognizes the manufacturer and sends a request for up-to-date digital information for the drug. The technology uses random identifiers so patients don't need to worry if their personal health information is secure.
Novartis started a public-private partnership with the EU to move forward with the project, named PharmaLedger, in collaboration with experts in the pharma and technology sectors.
Now with 29 partners and $22.1 million in funding, Novartis and Merck are both testing the blockchain solution as a secure way for different entities to communicate without revealing confidential information.
How Low Can You Go?
A new reusable ultra-low temperature shipping box, developed by Softbox, is helping Pfizer distribute its COVID-19 vaccines, and provides safe storage at administration sites.
The box maintains the required low temperatures for the mRNA vaccines during shipping for at least 10 days when left unopened. Based on current guidelines, the box can be opened twice per day for up to three minutes at a time. This allows clinicians at administration sites to access the vials required for each day's vaccine clinic without exposing the remaining vaccines.
The box's high-performance insulation materials, in conjunction with dry ice, ensure long-term temperature control. Through a process called "re-icing," the dry ice can be replenished to ensure maximum thermal protection of the vaccines, which can be stored for up to 30 days or more.