3rd place submission in the SCAN Health Virtual Business Case Competition 2021 by Max Bust, Janne Hesen & Stephany Ly from Erasmus University (the Netherlands)

Executive Summary

Covid-19 is a disruptive risk with a domino effect where the negative impacts ripple into each other. Canada’s current health infrastructure is fragile, but its segmentation and regionalization into 10 provinces and three territories can be used to combat this fragility (Chopra & Sodhi, 2014). Each province is responsible for developing their own (electronic) information systems without a national strategy in place (Tikkanen et al., 2020). During the initial covid-19 outbreak this brought no benefits as there were no guiding instruments. Most provinces have no data-systems, no traceability and have to manually count PPE (Snowdon & Forest, 2021). Based on this data and Dutch best-practices, we propose the implementation of a “national crises” platform using a digital dashboard with real-time updates. This proposition entails a centralized governing body during crises to ensure quick decision-making, transparency, and fair resource allocation. It involves Alberta as a template example for other provinces to mirror their digital health systems. This supports the development of a digital supply chain to establish a collaborative infrastructure. The proposed digitized platform refers to “High Tech, High Touch” with co-optation, network perspectives, and collaborative arrangements. High tech refers to using digital technologies in the supply chain processes. High touch refers to human collaborations and best-practice sharing with other industries and countries.

The digitized platform serves as a solution for frontlines in times of crisis by improving supply chain capacity of critical materials, while generating greater visibility, and improved collaboration and coordination among stakeholders (Marques, Martins, & Araújo, 2019). It enables faster and enhanced decision making, which consequently could lead to higher care quality and safety (Lagarde, Huicho & Papanicolas, 2019). Transitioning from manual to digital, information visualization, which could lower crisis response time. Intangible savings are expected to be achieved through increase in quality adjusted life years (QALY) as less errors are expected to be made (Wundes, Brown, Bienen, and Coleman (2010). The balanced scorecard provides a holistic overview with all linked KPIs to the organization’s vision and strategy (Voelker, Rakich and French, 2001).

Strategy action plan

The implementation of the digital platform occurs in multiple stages and is spread across a five-year plan which is depicted in appendix I. Each phase has its own level of responsibility, duration, change management tool and leadership strategy. The first step is to launch a national action plan to generate awareness and announce the supply chain transformation. This phase is paired with data collection to identify similarities and differences among the jurisdictions. The action plan is used to stimulate collaboration and data sharing among jurisdictions. Alberta is recommended as an example for transforming Canadian healthcare supply chain. After which, the next phase will transition all infrastructures from manual to digital systems. This transition could induce change resistance from those content with the status quo (Yuki, 2013). Therefore, it is crucial to increase collaborations with all jurisdictions to build trust, share knowledge, and emphasize the benefits of a digitized platform (Woiceshyn, Huq, Blades & Pendharkar, 2019). To ensure successful completion of the digitalization of the supply chain, the federal level of Canada is recommended to implement a national legislation across all provinces in which global standards and identification systems are mandated. This ensures interoperability and decreases errors (Harlow, 2006). Furthermore, a reporting environment is recommended where all stakeholders can communicate and report. Once the platform receives sufficient buy-in and approvals, then the development phase starts where a third party can be hired through a tendering process. Continuous dialogues are required to provide feedback and implement changes. Finally, the platform can be launched, and its impact evaluated via the balanced scorecard. It remains essential to engage in two-way dialogues and make adjustments accordingly.

The platform engages all stakeholders, stimulating intra- and inter-organizational communication between the provinces and territories. The aim is to create a connected network to make Canada smaller through collaboration and engagement. According to Lemos (2017) there will be a communication plan in place in the order of monitor, message, advocate, consult, dialog and collaborate.

Feasibility of implementation

The costs of the digital platform are beyond the scope of our calculations, however since Canada spends $264 billion every year on healthcare, we assume it is within the country’s financial resources to develop a financial feasibility plan for this platform (EPHPP, 2020). Considering privacy concerns, the digital platform has different access levels. Sensitive data is only available for people with certain clearance levels. Contrarily, the community forum is accessible for lower clearance levels. As the platform has a public nature, concerns can be raised regarding data privacy and ownership. The application of the data federation model in the platform prevents stakeholder data from being duplicated and manipulated. To ensure privacy guarantees for all parties, the platform simply provides the opportunity to request and obtain insights into the data of other parties within the supply chain.

Evidence of best practice

Data and best-practices from different countries and platforms was used to set up this recommendation. The Dutch authorities set up a national crisis structure with a central governing body to allow for flexible and agile responses to covid-19. It further encourages public and private organizations to collaborate with ministries and to provide advice to decision-makers. Sweden proves that it is possible to have nationwide registries. It is recognized that the value of the registree or platform depends on the willingness of health authorities and professionals to support and maintain these tools. These parties are recommended to balance their differing objectives for the common good and create optimal value (Delauney, 2015). Ride-sharing platforms, such as Uber, yield substantial benefits due to its ability to effectively match real-time demand with supply (Zhong et al. 2019). The digitized platform is inspired by such practices and is aimed to match the real-time supply of critical materials with the demand in hospitals. In the short-term Alberta represents the best example of digital health system implementation reflecting the value of digital health systems and supply structure.