Previously, the procurement and distribution of vital biomedical equipment and consumables across public health facilities faced significant hurdles. The reliance on manual processes for generating and distributing Purchase Orders (POs) created a fragmented and inefficient supply chain, stretching from suppliers to over 15,000 health centres. This lack of digital integration manifested in several critical issues:

• Cumbersome Management and Monitoring: Overseeing the vast inventory of biomedical equipment across a large number of health facilities proved to be a tedious and complex task.
• Delivery Delays and Lack of Tracking: Equipment frequently failed to reach facilities within the stipulated timeframes, compounded by the absence of a system to effectively monitor deliveries. This was particularly prevalent at the Chief Medical and Health Officer (CMHO) levels and in remote locations.
• Premature Payments Due to Faulty Reporting: The submission of inaccurate installation reports by vendors often led to premature payments, creating financial discrepancies.
• Difficulty in Monitoring Maintenance Contracts: The state struggled to effectively track Comprehensive Maintenance Contracts (CMC) and Annual Maintenance Contracts (AMC) for newly supplied equipment due to insufficient detailed information.
• Lack of Awareness Regarding Accessories: Health facilities often lacked clarity regarding the accompanying accessories that should be delivered with the main equipment.
• Absence of Demand Monitoring and Sanction Management: There was no structured process for monitoring the demand for equipment and consumables from individual facilities, nor a unified system for managing administrative and financial sanctions issued by the National Health Mission and the Department of Medical and Health.

An End-to-End Digital Supply Chain

To address these challenges, a comprehensive digital approach was implemented through the expansion of the existing e-Upkaran software. The innovation lies in the complete integration of this software to manage the entire procurement and supply chain of biomedical equipment and consumables across all public health facilities, establishing an end-to-end Digital Supply Chain System.

A dedicated module for procurement and supply chain management was incorporated into e-Upkaran, encompassing every stage, from the initial purchase order generation to the final delivery, installation, and ongoing maintenance of equipment. This system now covers a total of 16,220 facilities and manages a verified inventory of 170,151 items, with 156,996 inventory items included in the Repair & Maintenance Program.

This innovative solution tackles the previously identified issues through the implementation of the following key features and strategies:

• Process Analysis and Design: A thorough analysis of existing processes was conducted to design an efficient and streamlined digital workflow.
• Stakeholder Consultation and Collaboration: Engaging with all relevant stakeholders ensured that the system met their specific needs and requirements.
• Development and Implementation: A robust and scalable software module was developed and systematically implemented across all targeted health facilities.
• Real-Time Monitoring and Tracking: The system provides real-time visibility into the location and status of equipment and consumables throughout the supply chain.
• Demand-Driven Inventory Management: The system facilitates the monitoring of demand from facilities, enabling proactive procurement and distribution.
• Enhanced Reporting and Analytics: Comprehensive reporting and analytical tools provide valuable insights into inventory levels, delivery timelines, and maintenance schedules.
• Customizable Role-Based Access: Different levels of access are granted to users based on their roles and responsibilities, ensuring data security and efficient workflow management.
• User Training and Support: Adequate training and ongoing support are provided to users to ensure effective utilization of the software.
• Monthly Monitoring and Coordination: Regular monitoring and coordination mechanisms are in place to track progress and address any emerging issues.

Methodology Adopted for Efficient Supply Chain Management

To effectively manage the procurement and supply chain system, the following key methodologies were adopted:

• Demand-Driven Materials Requirement Planning (DDMRP): To optimise inventory levels based on actual demand.
• Distribution Requirements Planning (DRP): To efficiently plan the distribution of equipment and consumables across facilities.
• Automated Inventory Tracking: To provide real-time visibility into stock levels and movement.
• Enterprise Resource Planning (ERP): To integrate various aspects of the supply chain management into a unified system.
• Advanced Planning & Scheduling (APS): To optimise delivery schedules and resource allocation.

Key Features and Components of the Project

The e-Upkaran software boasts a range of features designed to streamline the biomedical equipment supply chain:

• Asset and Valuation Tracking: Comprehensive tracking of equipment assets and their valuation.
• Efficient PO Management: Streamlined generation, tracking, and management of Purchase Orders.
• Preventive Maintenance Record Keeping: Digital records of preventive maintenance schedules and activities.
• Reduction of Downtime and Repair Costs: Proactive maintenance and efficient repair tracking minimise equipment downtime and associated costs.
• Informed Decision-Making Support: Data-driven insights to support better planning and resource allocation.
• Complaint and Resolution Tracking: A system for logging and tracking equipment complaints and their resolution.
• Prevention of Equipment Failures: Proactive maintenance and monitoring help prevent unexpected equipment failures.
• Timely Vendor Payments: Efficient processing and tracking of vendor payments.
• Customizable Roles and Activities Management for EMMS Users: Tailored access and functionalities for users involved in the Equipment Maintenance Management System (EMMS).
• Online Reports: Generation of various online reports, including Equipment Stock Register, Complaint Status Monitoring, and Inventory Costing.
• Web-Based on Open Source Platform: Accessible through web browsers and built on a flexible open-source platform.
• Centralised Dashboard: A unified view of key supply chain metrics and information.
• Dynamic Reporting and Data Analysis: Flexible reporting tools for in-depth data analysis.
• Secured and Configurable Architecture: A secure and adaptable system architecture.
• Role-Based Access Control: Ensuring data security and appropriate access levels for different users.

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Ground Impact: A Transformation in Healthcare Operations

The integration of the e-Upkaran software for biomedical equipment and consumable supply chain management has yielded significant positive impacts on the ground:

• Timely Deliveries: The system has ensured that essential equipment and consumables are now delivered within the specified timeframes, drastically reducing delays and guaranteeing that healthcare facilities have the necessary resources when they need them most. This improvement directly enhances the efficiency and responsiveness of healthcare services.
• Enhanced Accountability and Transparency: Real-time tracking and monitoring have fostered greater accountability and transparency throughout the entire supply chain. This minimises the potential for discrepancies and ensures accurate recording and verification of all transactions and deliveries.
• Improved Maintenance and Reduced Downtime: Proactive maintenance scheduling and comprehensive tracking of maintenance contracts (CMC and AMC) have significantly reduced equipment downtime and associated repair costs. This guarantees that biomedical equipment remains in optimal working condition, leading to more reliable and higher-quality healthcare services.
• Enhancement of Biomedical Equipment Repair & Maintenance Programme: The automated inventory within e-Upkaran has substantially improved the Biomedical Equipment Repair & Maintenance Programme. It provides detailed equipment history, including cost and maintenance contract information, enabling quicker mapping of equipment by service providers and immediate complaint registration for nonfunctional equipment, ultimately leading to faster repairs and reduced downtime.
• Informed Decision-Making: Robust data analytics and reporting capabilities provide actionable insights into available inventory, order statuses, and maintenance schedules. This empowers facilities with the information needed for better planning, budgeting, and overall resource management.
• Better Resource Management: Facilities can now generate new demands based on their existing stock levels, available space, specialists, and manpower. This leads to more efficient resource allocation and ensures that equipment and consumables are available where and when they are most needed.
• Improved Hospital Services: The consistent and timely availability of equipment and consumables has significantly enhanced the quality of hospital services. Healthcare providers can now deliver improved and uninterrupted care to patients, leading to better patient outcomes and increased satisfaction.
• Increased Facility Awareness: Health facilities now possess greater awareness regarding their upcoming equipment and consumable supplies, including details about accessories and parts specified in purchase orders. This knowledge empowers them to hold suppliers accountable and ensure the receipt of complete and functional equipment.
• Reduction of Misleading Information: The system has effectively addressed delays in procurement and supply and has minimised instances of misleading information from suppliers concerning supplies and installations. This ensures that all equipment and consumables are delivered and installed according to the agreed-upon specifications, enhancing the overall reliability of the supply chain.

In conclusion, the integration of the e-Upkaran software has fundamentally transformed the efficiency, transparency, and accountability of biomedical equipment and consumable supply chain management. This digital approach has led to significant improvements in healthcare service delivery and resource management across public health facilities, ultimately benefiting both healthcare providers and the communities they serve.

Insights shared by: Neha Giri, IAS, Managing Director, Rajasthan Medical Services Corporation Ltd, Government of Rajasthan

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