Sustainable Healthcare: In Supply Chain’s Sweet Spot

I like this definition because it goes beyond more commonly used value equations that have focused  narrowly on the quality and outcomes of a specific episode of care, divided by the cost of delivering that care.  This definition takes into account all of the factors that impact health outcomes for people and populations, including the social, economic and environmental determinants of health that play an even greater role on overall health than any clinical care received.  It also considers the impact on the resources needed to keep patients healthy, now and in the future.   In other words, it is a longer term, systems-based approach.   

The logic is sound, when you consider that even if a patient receives the best care possible in the hospital, the outcome of that care could easily be undermined if the patient goes home to an environment that is not conducive to healing.   Further, when people do not have access to good food, live in impoverished and/or violent communities, or are exposed to air or water pollution (as examples), they often have higher rates of chronic disease, which make them higher risk patients, consuming greater amounts of resources during their care.  All of this not only increases the costs of healthcare delivery but also the negative environmental impacts resulting from more intensive healthcare operations, which are responsible for close to 10 percent of our nation’s total carbon footprint.  To more effectively manage resources, the authors recommend starting with the carbon hotspots: pharmaceuticals (including those prescribed in primary care), medical devices, equipment and instruments used in acute care, and the energy consumed in the operation of hospitals and other healthcare facilities. 

Even more importantly, the authors speak to the need to prevent the need for care in the first place by fostering community structures that support healthy populations and the ability of individuals to actively promote their own well-being.  Then, when care is needed, the goal should be to increase access and efficiencies in the provision of highly effective interventions to those who need them, while limiting the use of treatments (and the associated resources) that are known to deliver little or no value. 

Achieving the author’s recommendations is not the job of supply chain alone.  It takes a concerted and coordinated effort across multiple functions, from clinicians and finance to operations and supply chain, as well as those community organizations with expertise in social, economic and environmental resource management.   That said, supply chain is perfectly equipped to help align the various parties to achieve this broader definition of value.  After all that’s what supply chain professionals do already, working with multiple stakeholders to understand the clinical, financial and increasingly social and environmental impacts of the resources procured and utilized in the delivery of health and healthcare.