The REAL Next Threat

Today is September 30, 2024. It is 3:09 PM Eastern. I have had no phone since 11 AM. Like most Americans and the preponderance of companies both within and outside of healthcare, I am totally dependent on my cell phone and the internet. I long ago got rid of my “land line” (which was not a real land line, but part of my internet service), so, for the last five and a half hours, I have been as helpless as a newborn babe.

I can’t get anything beyond basic emails on my cellphone.

I am operationally paralyzed.

Welcome to the next existential threat to both the healthcare supply chain and society in general.

Over the last quarter century, our entire civilization has transitioned from a manual/analog one to a digital one. Over those years, we have eschewed “old” technology such as land line telephones in favor of the slickest, most up to date digital equipment.

And now, at 3:59 PM Eastern time, I am completely unable to make a simple telephone call.

When the crisis of the moment is solved (again, for the moment), several things will happen. First, we will be lied to by the provider of our cell service. Then, things will return to normal. After five minutes, I will have totally forgotten about the entire “crisis.”

It is now 5:18 PM. Phone service returned at 5:13.

The crisis is over. I have forgotten about it.

But should I have?

What if a major digital infrastructure disruption hit the healthcare supply chain?

Let’s take a look…

Breakdown of Supply Chain Coordination

The healthcare supply chain is an intricate network of suppliers, manufacturers, logistics providers, and healthcare facilities, all working in tandem to ensure that vital medical supplies, medications, and equipment are delivered where they are needed. At the core of this complex system lies real-time digital communication. Internet-based systems and wireless telecommunications allow for the seamless exchange of information, ensuring that orders are placed, tracked, and fulfilled efficiently.

A total disruption of the digital infrastructure would sever this line of communication, leading to:

• Delayed Deliveries: Without real-time tracking and ordering systems, healthcare providers would be unable to ensure the timely delivery of critical supplies such as medications, blood products, personal protective equipment (PPE), and medical devices. This delay could result in hospitals and clinics running out of essential items.
• Inefficient Inventory Management: Automated inventory management systems that rely on digital platforms would be rendered ineffective. Healthcare facilities might struggle to monitor stock levels, leading to either overstocking (increasing storage costs) or understocking (risking the unavailability of crucial items during patient emergencies).
• Coordination Failures: Disruption of communication with suppliers and distribution centers would prevent healthcare providers from efficiently coordinating shipments. The cascading effect could lead to supply bottlenecks, especially for products with short shelf lives such as vaccines and blood products.

Patient Care and Treatment

The consequences of a disrupted healthcare supply chain would directly affect patient care, potentially resulting in life-threatening situations. Without reliable digital systems, healthcare providers would face the following challenges:

• Medication Shortages: Many healthcare providers rely on just-in-time inventory for medications, meaning they maintain only a small stock of drugs on hand. A failure in the digital infrastructure would impede the replenishment of these stocks, resulting in medication shortages. This could be especially critical for patients who require life-saving drugs such as insulin, anticoagulants, or chemotherapy agents.
• Postponed Surgeries and Procedures: Elective surgeries, diagnostic tests, and critical procedures depend on the availability of surgical tools, sterilization supplies, and diagnostic equipment. Disruption to the supply chain could lead to postponed or canceled procedures, resulting in deteriorating patient outcomes and increased mortality rates for those with urgent medical conditions.
• Telemedicine and Remote Monitoring Loss: Modern healthcare has seen a rise in telemedicine and the use of remote monitoring devices for chronic disease management. A loss of internet connectivity would hinder remote consultations and monitoring, cutting off patients from their healthcare providers. For patients with conditions that require ongoing monitoring, such as heart disease or diabetes, this disruption could have fatal consequences.

Healthcare Facility Operations Under Stress

Beyond the immediate medical supplies, healthcare facilities rely on digital tools for numerous operational aspects, such as electronic health records (EHRs), diagnostic equipment, and patient management systems. A failure of these systems would introduce several operational challenges:

• Electronic Health Records (EHRs) Inaccessible: The vast majority of healthcare providers use EHRs to manage patient records. Without internet access, healthcare workers would lose access to these records, making it difficult to track patient histories, medication regimens, allergies, and diagnostic information. This would force providers to revert to manual systems, increasing the risk of errors and inefficiencies.
• Medical Equipment Malfunctions: Many modern medical devices, from ventilators to imaging machines, rely on cloud-based systems for diagnostics, software updates, and monitoring. A disruption in the digital infrastructure could lead to equipment malfunctions or render these devices inoperable, further hampering patient care.
• Emergency Response Delays: Hospitals and healthcare facilities rely on communication networks to coordinate emergency response teams and ambulance services. Without wireless communication, delays in response times could lead to a significant increase in fatalities, particularly in critical care situations such as cardiac arrests, strokes, and trauma cases.

Rise in Black Market and Counterfeit Goods

In the face of a disrupted supply chain, healthcare providers might struggle to secure necessary supplies through traditional channels. This could give rise to a black market for medical goods and an increase in counterfeit or substandard products. In desperate times, hospitals may be forced to source supplies from unverified vendors, leading to a host of issues:

• Increased Risk of Patient Harm: Counterfeit medications and medical devices can pose serious health risks to patients, potentially leading to ineffective treatments or even fatal outcomes.
• Loss of Trust in Healthcare: As counterfeit goods circulate, public trust in healthcare institutions may erode, especially if hospitals are found to have used substandard products during treatment. This could undermine overall confidence in the healthcare system during an already turbulent time.

Economic Strain on the Healthcare System

The economic impact of a total disruption to the digital infrastructure would be enormous. The healthcare system, already facing financial pressures, would encounter further challenges due to:

• Increased Costs: The inefficiencies caused by manual processes and delayed deliveries would raise operational costs. Hospitals may need to invest in alternative, often more expensive, supply channels or stockpile essential supplies as a precaution.
• Supply Chain Reconfiguration: In response to prolonged disruptions, healthcare organizations might be forced to reconfigure their supply chains, investing in redundant systems, alternative suppliers, and local production capabilities to avoid future crises. This reconfiguration would demand significant financial resources.
• Insurance and Legal Repercussions: Disruptions in patient care and potential harm caused by counterfeit goods or delayed treatments could expose healthcare providers to a wave of legal challenges and insurance claims, further straining financial stability.

What I Learned: The Urgent Need for Resilience

Today’s six-hour crisis taught me something: You need a plan!

A total disruption of digital infrastructure would have far-reaching consequences on the healthcare supply chain, impacting everything from the availability of critical supplies to patient care and operational efficiency. While it is difficult to fully predict the outcomes of such an event, it is clear that healthcare systems must proactively invest in building resilience. This includes developing contingency plans, enhancing offline capabilities, stockpiling essential supplies, and improving cybersecurity measures.

In a world where healthcare is increasingly reliant on technology, safeguarding the digital infrastructure has become synonymous with safeguarding lives. The healthcare sector must prioritize investments in resilient, adaptable supply chains that can continue to function even in the face of a complete digital breakdown. Failure to do so could result in a health crisis far more devastating than any individual disruption.

Let Us Help

For over forty years, the St. Onge Company has been helping organizations both large and small craft solutions to make it possible for their supply chains operate at peak efficiency. Our Healthcare Team is currently working with many of the nation’s leading HCOs to help them optimize their supply chains of the present and to plan, design and implement the supply chains of the future. Our goal is to improve operations at each step along the way until it reaches its ultimate destination- the patient’s bedside.

For information on how we can help your organization, contact Fred Crans at fcrans@stonge.com to set up an exploratory conversation.