Sharp differences sharpen thinking

Original post:  Oct 16, 2012

In the past month, I've participated in a number of discussions with individuals representing organizations across the healthcare supply chain. Needless to say, we don't always agree.

One example occurred in the most recent GS1 US workgroup meeting. We were attempting to compile our comments for a submission to the FDA on the proposed UDI rule. GS1 US represents both hospitals and manufacturers at the same time. The hospital groups asked for a comment to reduce the time allotted for the implementation of the rule. On the other side, manufacturers were asking for more time because of the complexity of the rule. Both sides passionately believed that they were right.

On the one hand, there is a need for the data. It is difficult to overstate how hard it is to track individual items without a standardized method to account for them in the stream. On the other hand, the hospitals have no idea how difficult it is to gather information, verify its accuracy, and then to report on that information to the FDA while constantly under the threat of an audit that could literally shut down your business.

At the end of the session, we all agreed that it would be counterproductive to submit a comment that contradicted itself. Since we could not agree on the comment, each side was asked to work within their own organizations to submit that particular comment on that aspect of the rule.

While we didn't come to consensus, the episode did highlight the depth of passion on both sides. It also helped us understand that this vital process will not be implemented easily.

I find that I enjoy discussing these types of issues in depth with others. Debating the issue with others who challenge our thinking really helps to strengthen our own arguments in support of our ideas.

Activity versus Effectivity

Original post:  Oct 1, 2012

In yesterday's sports section, Bob Ryan wrote an interesting opinion piece. He was trying to explain the difference between "Sport" and "Entertainment." In his mind, we are drawn to sport to see an athlete or team compete and possibly win. The outcome is not known prior to the event being contested. That tension and uncertainty results in entertainment. He was very quick to stress that the emphasis should be on the sport and not the entertainment.

In order to highlight the difference between the two, he brought up the fiasco involving replacement referees in last week's Monday Night Football game between the Seahawks and the Packers. A controversial decision that looked to all eyes to be wrong stole the victory away from the Packers and awarded it to the Seahawks. While it was tremendously entertaining--sparking days of passionate discussion about the event and the circumstances leading up to it--it had nothing to do with the sport itself. If anything, it undermined the legitimacy of the contest.

In the same way, at our company we often have to make sure that we do not allow activity to substitute for effectivity. There are times when we seem mired in endless meetings that cover the same points. We should not lose sight of the end goal of reaching some tangible objective. There may be a need to sacrifice some of the activity so that we can reach the more important goal of effectivity.

As I begin a series of discussions with industry peers on the complex world of data standards, I'll try to keep the difference in mind.

Domino theory

Original post:  Apr. 12, 2012

It can be fascinating to watch an elaborately constructed set of dominoes cascading in succession. It's not so much fun when you are in information services. Unexpected cascades typically lead to disastrous results.

Right now, some of our customers are asking for changes that they feel are straightforward. They cannot understand why we haven't adopted these new methods immediately. They may not understand why it is not as effortless as it appears at first glance.

Data standards are simple enough in theory. Unique identifiers help to minimize confusion between trading partners when they refer to the same item at the same packaging level. Unfortunately, it is not always so easy when you are working with the technical systems that support the current business.

At most major manufacturers, there are a number of systems that rely on unique keys to identify items. Those systems generally rely on some internally-generated numbering system that do not rely on data standards. There are other support systems that also use that same identifier to run other related prices. It may start with an order management system but it will not end there. That number is likely used in a pricing system. It might also be in a warehousing system. It might even be a regulatory system. In all cases, they use some internal number to identify individual products. A switch from that internal number to some other unique key will require some delicate work that requires solid coordination in order to get the pieces aligned properly.

Complicating that task even further are some of the differences between our numbering scheme and the data standard itself. Our company typically has a single entry per item with a designated unit of measure that represents the unit of sale. The Global Trade Item Number (Global Trade Item Number (GTIN)) system assigns unique numbers for each packaging level. While many items are only made and sold at a single packaging level, this is not universally true. At our company, there are many products with two or three different packaging levels. There are even a few products with four or more packaging levels!

There are solutions available. It will take some detailed planning and dedicated effort but it is possible. It just won't be easy.