Taking The Supply Chain Pulse
St. Onge’s Healthcare Hall of Famer and industry icon, Fred Crans, chats with leaders from all areas of healthcare to discuss the issues of today's- threats, challenges and emerging trends and technologies in a lighthearted and engaging manner.
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Taking The Supply Chain Pulse
Disaster Planning Continuation: How Outside Expertise Transforms Healthcare Supply Chains
Hello and welcome to another episode of Taking the Supply Chain Pulse. I'm Megan with St Onge Company and I'm here to introduce this week's guest, Ken Jensen, from the University of Vermont Health Network, here to discuss disaster planning and crisis mitigation. Take it away, Fred.
Speaker 3:How to make your supply chain ready for things that happen that you may not know anything at all about. Ken has got an interesting background. He's a former Navy lieutenant. He worked for Keurig Green Mountain Coffee. So he's come from outside of health care into health care, working in a very forward-thinking health system in Vermont where Charlie Michelli was the former leader. So, ken, it's great to have you here. Welcome.
Speaker 1:Thanks, Fred Great to be here.
Speaker 3:So tell us a little bit about yourself, Ken, and your background and how you got to UVM.
Speaker 1:Well, I think you already did, but I'll try to add a little color. I did spend quite a bit of time in the Navy I did. My first stint was enlisted. I was a nuke electrician submariner. I was then got out and went to school back home at University of Rochester in New York where I grew up and received a commission and went back as a surface warfare officer. And I got out, as you said, as a lieutenant.
Speaker 1:When I transitioned out of the service and I was not in supply chain when I was in the service got interested. After I got out I started working for Cargill. I worked in their sweeteners division business unit. I worked down in Chattanooga, tennessee. We located to Tennessee because my wife's family had she had some brothers that were in Memphis. I had some family that was up in Louisville. We were close enough for holidays but not close enough for dinner and we relocated to Chattanooga. When I got out of the service I started working there in a manufacturing and distribution terminal for the sweeteners business.
Speaker 1:So a lot of sugar, cocoa sugar, blended cocoa sugar, corn syrups, sweet fructose corn syrup that we were delivering to the region. And then we, my wife and I, had kids and uh, we were uh taking my oldest daughter to uh to to daycare one day and we were singing along to the abc song and we got to I for isabel the inchworm, and there was Isabel and we said no, no, no, we've got to get back north she, she and I are both from New England, she's French Canadian, I'm from Rochester, as I said. And so we came up to Vermont, maybe a little bit sooner than we had had originally planned, but we had always hoped that we would land here. But we had always hoped that we would land here. And then I came up here and started working for Green Mountain Coffee Roasters Keurig Green Mountain Coffee Roasters in supply chain. So I had Vermont Distribution, multi-channel Distribution Center, asrs, here in Waterbury in Waterbury, vermont, and then joined a consumer packaged good model where you put various specialties together and I did the supply chain side of our partners program.
Speaker 1:So when we started working with our Starbucks, our Dunkin', our Smucker's, kraft, all of those partners that were co-manufacturing or that we were branding in the K-Cups, started working on the design, contracting and supply and operational design for those programs. I was here in Vermont and then got linked in with Charlie and history from there he was interested in bringing in some supply chain experience that maybe didn't grow up in health care specifically, and it was just a great opportunity and perfect timing. That's who I am.
Speaker 3:Well, about three things came out of that conversation. I don't know if you know it or not, but I was born and raised in upstate New York. I'm from Corning, graduated from high school in Bath, New York, so that's not very far away from Rochester. Number two if I were to stereotype people, I would say you've got to be a short guy because you were a submariner. You can't be too tall to be a submariner. Is that a fair statement?
Speaker 1:You have less bumps on your head if you are shorter I'm 5'7".
Speaker 3:There you go. See, I don't have a lot of bumps on my head.
Speaker 3:I'm 6'3.5" I thought robinson wanted to be a submariner when he was uh in at the naval academy and of course he was what? 611 or so that was a problem. Uh and uh, and then, of course, you talk about charlie. The thing that I think is is ironic is that you're coming into health care because I want to talk about what you, what you learned from your other industries that you brought to health care. But you're coming into healthcare because I want to talk about what you learned from your other industries that you brought to healthcare. But you're coming into healthcare where the emphasis is always on improving processes and saving money, from having worked for a company that purposely sells something at about four times the cost than a little pod, as it would if you made a whole pot of coffee with it. How were you able to get around that?
Speaker 1:I've seen many razor razor blade models in healthcare as well, fred, and you know that that is not exclusive to outside of healthcare. Yeah, there's a lot of commonality, a lot of elements of supply chain management that are common to and elements of healthcare, and there are other elements that I wasn't exposed to. Coming in the GPOs, the group purchasing organizations their scope, breadth and services that they provide was not something that I was familiar with outside of healthcare. So there's a lot of things that I brought with me, things that I may not use as much as I wish we could sales and operations planning, manufacturing, scheduling and planning, the predictive analytics elements of it. I think that we still have a lot of opportunity in. But, you know, I think that there are some great learnings that I brought in with me, some that I've been able to take advantage of, others that I just didn't have exposure to.
Speaker 3:It's interesting. I mean you're fortunate For those folks that are out there that may have never seen this podcast before or listened to it. I mean you work with Charlie Michelli. Charlie Michelli is easily one of the brightest guys that anyone could ever work with. He's also an imaginative guy that can see beyond the obvious and recognize possibilities in people that don't have a healthcare background. You have a pretty diverse team together there at the University of Vermont. Can you tell us about some of the members that Charlie has brought into the fray there, including you?
Speaker 1:So we do have a lot of very diverse backgrounds. I think that you know we have a good balance between those that have that grew up in and have a lot, have years, decades of health care experience and a lot of folks in operations that that may be coming from from other outside organizations. We also on our contracting team have have the majority of them are all lawyers, right, so super helpful when we work with our general counsel and all of our local contracting working with the regional MPC and GPOs as well.
Speaker 3:We've got a bunch of different folks that was what I was struck by was a number of lawyers that Charlie had Charlie had hired to to sort of develop real expertise in contracts and contracting. Do you do you think that, do you think that that has really helped, having that, having those types of insights?
Speaker 1:I do. I think that you know Rachel Raines is our director of network contracting and you know she and I have had conversations about this in the past, where you know it's not necessarily a requirement for the specific elements in the job description but it is an enabler and I think we've got it. Certainly makes us better having that exposure and experience, much the same way we do in operations.
Speaker 3:Interesting and, of course, some of the people that Charlie has hired have to be able to sing so they can join the band.
Speaker 1:Yes.
Speaker 3:The thing that I cannot sing. You're lucky, you know, you, you, you avoided that. But the reason we're going to have this, we're going to have a three-person podcast. A couple of episodes ago and you had gotten tied up in something else, and the reason I wanted to have you on board in that three-person episode was because the other two people one was from a company called Resolink, and we'll talk about that in a minute, and the other one was Steve Downey from the Cleveland Clinic, which is a huge IDN with geography across the entire country, just about with, you know, ohio, florida, arizona.
Speaker 3:You're a. You're sort of a medium sized IDN, sort of sort of located, you know, in a, in a specific and unique geography. I mean, your major fear is whether or not you're going to be invaded by Canada or whether they might want to build a wall. Those are two things that are probably real, but you've been affected. You've gone through the same things that these other folks have, and so I was just going to ask you know, what specific unplanned for disruptions have you encountered during your time on the job and what unique or what approaches to problem-solving have you taken about those?
Speaker 1:I think, like every other system, whether we're rural or large, you know, we've experienced some of the same disruptions. I mean the three things that are jumping out to me, probably because of recent events with Hurricane Helene and Baxter, and the IV solutions is Hurricane Maria and COVID, right, right. So I would, I would point to those as recent unplanned disruptions that I've had an opportunity to be involved in. What anything that you want to know?
Speaker 3:about? Yeah, I mean, how did it? How did it hit you? Were you caught off guard by Baxter going down? And, if so, what did you do to mitigate it?
Speaker 1:Absolutely. We'll talk a little bit later about some of the monitoring that we do to. You know, monitor for events or anything that could have an impact on our direct, second or third tier suppliers. But there's a balance between what you can do and what the impact is. So you know the Baxter disruption, you know the length of time that this disruption, the scope and scale of the disruption even if we had some and we do we have a service center that's offsite at the main and we do. Do we have a service center that's offsite at the main hospital in Burlington, vermont, where we oftentimes will take longer positions would have absorbed short-term disruptions? The challenge is what's short-term, what's long-term? You know what kind of? What is the extent of the efforts that you have to mitigate some of those disruptions? I think that that's the hard piece to manage.
Speaker 3:Well, I know that during COVID, for example, charlie and you guys did a lot of partnering with local manufacturers with linens and with things like that, to sort of be able to create a supply flow that wasn't there beforehand. I know that worked pretty well. Have you maintained any of those relationships since the pandemic ended?
Speaker 1:We have. It probably started with Hurricane Maria, where and it started with Charlie starting to gather this supply, this Vermont supply chain coalition, nia or the New England Health Alliance for Health, which includes the Dartmouth health system and the state of Vermont, government representatives emergency management resources, bringing those together and sharing, being being very transparent with with the challenges that we're facing, with the challenges that we're facing, how we're addressing those. We looked at opportunities for us as a coalition to look at aggregation and buys for and I'm going back to COVID at this point right. So we looked at some of the supplies that we all were in need of and looking for opportunities for the state all were in need of, and looking for opportunities for the state, dartmouth and UVM all to collaborate on in securing and bringing in that we otherwise might not have had access to. We did look at local providers for hand sanitizer. We aren't currently still using that. We aren't currently still using that, but we did look at that as well.
Speaker 3:We looked at creative ways to sterilize and reuse masks during the time, protection and you know, evaluated those to see how we could, you know, prolong the inventory that we currently had and minimize any potential disruption, and, is that collaborative, is something that continues today? I mean, the thing that struck me was that you had you had state of Vermont folks, you had emergency management, you had a significant group of non-healthcare entities involved in a coalition that you formed. Has that coalition stayed together? Does it continue to meet? Do you continue to talk about what ifs and things like that, or did it end when the last crisis did?
Speaker 1:No, I think it took a little bit of time not a lot of time, a little bit of time to get it stood up back during COVID. But once it was in place it was well received. It was well. You know, everybody really valued the input, the transparency, the information that they received from it and it was we maintained it. We've maintained it ever since. We met far less frequently but we still maintained it. We have since increased the frequency. We meet again this Thursday. We're meeting weekly right now to continue to review right now on the IV solutions.
Speaker 3:Right, and that's an important thing. I mean, the problem that I've seen in healthcare over my time in health care is that as soon as a crisis is passed and you have survived, things revert to normal, which ain't very good to begin with, which is going back to the same strategies that you used before the crisis took place, forgetting all the lessons that you learned and waiting to be caught off guard by the next big thing. And you're you're sounding like that. You have. You have put things in place to help avoid that. Is that fair?
Speaker 1:I think it's, I think it's fair to say in the context of the coalition and the work that that that that body does the participation. I think everybody, all the participants, find it very valuable and it is a good cross-section of folks. And, yes, I do agree with that that is good.
Speaker 3:The other thing that happened that Charlie got involved in early on is with Resolink. Resolink is a software as a service that gives you what I would call horizon scanning of things going on in the world. Could you tell our listeners a little bit about that and how you have used it?
Speaker 1:So we have several services that we use. Resolink is one of them. Resolink is great. It is not health care specific in the information that we're receiving from them. It is looking at geopolitical and any potential supply disruptions and communicating those out. So it's. The one thing I would say about Resolink is that it is. It's a big umbrella, right. So you're getting a lot of information there. There may be and I don't want to speak out of turn there may be some services that allow you to narrow that specifically to your purchase history, like we do with ECRI alerts on recall management, right, but without that, without sharing that information, it does become a pretty broad umbrella. You can get overwhelmed with the amount of information that you receive through that service. But if you're looking for the information, it's a great service to have. We do subscribe to it, we do use it, we monitor day-to-day alerts and we internally review them for applicability.
Speaker 3:Yeah, I know that Charlie had told me that because of one of the services you use I don't know which one it was, but that he had a heads up that there was going to be a shortage or a disruption in the availability of bauxite, which is a key component of producing aluminum, and he was able to, you know, get plans in place or be aware of what products he might have to find alternative products for. Can you tell us a little bit about that?
Speaker 1:So I'm not familiar with the example that he shared with you or which of the monitoring systems that we have several and there's oftentimes a lot of overlap. So we do use Resolink. We also have Supply Risk Solutions, srs, and that is more of a healthcare focused similar to the information that you would get from Resolink, but it's more focused on healthcare. We use the Premier Supply Disruption Manager as well, which is not as forward-looking. It's more based off of any delays that they're seeing across the GPO members. If they're seeing delays in order, processing or receipts, they start to. They've got some correlation, some algorithms that they use to provide some predictive analytics on potential disruption six weeks out, provide some predictive analytics on potential disruption six weeks out. So we use that Resolink, herc. Herc is more of an accreditation than it is a monitoring solution, but we've got several disruption management systems that we are using.
Speaker 3:HERC is Health Industry Resilience Collaborative. Is that correct?
Speaker 1:Yes, that is yes.
Speaker 3:Boy. I give myself credit for that one.
Speaker 1:Yeah.
Speaker 3:Sorry.
Speaker 1:I could have spelled that out for you, sorry.
Speaker 3:So do you think that at the University of Vermont that you have fostered a culture of respond versus react and, if so, what would you recommend to others in situations, geography such as yours, smaller IDNs that are not near major metropolises, and things like that?
Speaker 1:Yeah, I think, fred, this goes back to the earlier question where certainly the preference is not. I think that the preference would be to certainly respond as opposed to react right just using the language and the framework. However, it goes back to the scale and you know it goes back to. You know to what degree and to what extent it's difficult to prepare for everything and prepare for the scale, everything and prepare for the scale. So I think that it's a balance between what you can do in select areas.
Speaker 3:Yeah, and I think what you pointed out that sort of has occurred to me during this conversation is that one of the key things is building good relationships with everyone involved in the process and even, in your case, bringing in folks that wouldn't immediately appear to be involved in the process. You know folks from outside of health care and local agencies and stuff, so would it be fair to say that creating and maintaining those relationships leaves you with a infrastructure in place that the next time something does happen, you can flip the switch and get back to effective work more quickly?
Speaker 1:I think it does. Yeah, it's not just the participants in the coalition that I was describing for you either. When we think about some of the creative solutions that we had for masks during COVID you know it was biomed engineering. It's a very transparent and inclusive process. A lot of internal and external resources as appropriate and applicable. That I think we've done a great job, you know, establishing and maintaining, and so I think that I do think that that's important.
Speaker 3:Yeah, transparency and inclusion. So, with your previous history, of your previous work history, would it be fair to say that it's highly unlikely that University of Vermont Health Network would ever have a shortage of access to coffee?
Speaker 1:I can't commit to that. Really, really.
Speaker 3:Do you guys brew your own coffee or do you have pods throughout the whole organization? Nope.
Speaker 1:No commitment there we're going to focus on. We're going to focus on uh, on patients and patient safety. We do certainly. I just wouldn't. I know that that's intended to be funny, but no, I would not commit to that okay, well, I thought maybe you know inside track might help you there.
Speaker 3:So so you know that, having been said, what keeps you up at night now that, uh, is, you know, at the front end of your concern right now.
Speaker 1:Um well, I think that what's keeping me up right now is the is the iv solutions right? And the recovery and the timing of the recovery. I'm encouraged by a lot of the conservation efforts that we expect will be able to be sustained beyond the recovery, but right now we certainly still have a gap between when that recovery is going to take place and you know what our usage rates are, patient safety and having the supplies that we need for our patients that's first and foremost.
Speaker 3:Did that really? Has it really impacted, you know, revenues like holding up the key high-dollar procedures for you guys?
Speaker 1:So we haven't even evaluated. I know that we will do an after-action review. We'll look at what the impact of some of the costs are during some of our sourcing efforts during the events. We'll look at what the impact is to some of the delayed procedures that we have had, because we have delayed some procedures, especially with some of the large volume irrigation solutions that are recovering a little bit later with the North Coke facility. So I think that we'll look at that after the fact. What we've been looking for is just making sure that we have the solutions that we need to take care of those most needing patients.
Speaker 3:Well, ken, I'll tell you I'm really happy to have had you on the podcast today and I'm happy for you. You're a very fortunate guy from my perspective. You've fallen into friendship with one of the industry's most insightful leaders, most forward thinkers, and you've been able to learn and to be able to assume the reins there, and I know you're going to do great things with your role in the future. So thanks so much for being on the podcast and hope to see you soon.
Speaker 1:Thank you, Fred, and I look forward to talking to you again too.
Speaker 2:Well, that's all for today. Thanks again for joining and, as always, don't forget to subscribe and connect with us online, where you can find all of our episodes. If you have a topic you'd like to discuss or want to be a guest on the show, you can reach out to Fred directly at F-C-R-A-N-S at S-T-O-N-G-E dot com. See you next time.
