Medical supply inventory management systems for EMS

Today's complex EMS environment requires administrators to constantly juggle issues like tightening budgets, drug shortages, strict governmental regulations and a highly engaged and connected staff — all while operating in a litigious society. Using yesterday's approach to inventory management and supply and logistics is no longer an acceptable practice [1].

There are several significant aspects to automated inventory control and management for today's EMS agencies, in both the public and private sectors. Having a reliable, effective and efficient inventory management system can help an organization reduce costs, limit waste, improve employee relations and limit liability. It can also positively impact patient care by having the right supplies and drugs available when needed [1].

For some time now, private-sector EMS agencies have used automated solutions to improve their fiscal bottom line by reducing costs and limiting waste. Increasingly, public-sector EMS agencies are seeing a similar need as their local funding from government or donations from stakeholders have declined or remained stagnant.

EMS agency leaders cannot continue to rely on emotional appeals to their stakeholders to justify their fiscal needs. The trend in local governments is for transparency and accountability to show taxpayers where and how their money is being spent [1].

EMS agencies across the board are also facing more demanding requirements for reimbursement from medical insurance companies, Medicare and Medicaid for the supplies and drugs used when rendering patient care. The health care environment is rapidly changing with reduced reimbursements, new government regulations and an increased focus on compliance. This added complexity makes managing billing and coding in house much more challenging [2].

Inventory control and management software benefits
Current and developing technologies in ICM can enable EMS agencies to improve both their efficiency and effectiveness in a variety of ways including, but not limited to [3]:

• Preventing medical inventory from expiring or being overstocked
• Centralizing inventory control among departments and vehicles
• Improving EMS medical staff productivity and performance
• Ensuring that every ambulance is fully equipped with life-saving medications and devices
• Logging the movement or usage of medical inventory

Inventory control to prevent narcotics diversion
Diversion is the theft of any pharmaceutical to be sold or traded for personal gain. Resale of narcotics is not limited to common street crime but also can involve Medicare fraud, theft from other providers, organized crime and a host of other crimes [4].

In its simplest form, detection of the loss of pharmaceuticals is a basic inventory control function. The three variables are replenishment of warehouse or central inventory, documented usage, and replenishment of in-station or in-ambulance inventory. Depletion of inventory is fairly predictable over time and can therefore be forecast as well [5].

Here is a common sense, simplistic example of monitoring inventory: You order what you use. There is no reason to order anything more than at the rate you use it and by using percentages of increase, the variances become highly recognizable. Use percentages because in drug inventories, units may not raise a flag [5].

For example, an increase of 10 units of morphine in this months requested inventory for Station #6 may not seem out of line compared to the stations ordering history, but if those 10 additional units of morphine represent a 15 percent increase over what's previously been ordered each month that might be cause for a closer look.

Electronic tracking of supplies
Barcoding has become the basis for the majority of ICM systems on the market today. A barcode-based system streamlines the process by enabling an agency to track the life-cycle of any item: from the initial receipt of an item at the warehouse; the distribution of the item into the supply chain such as sending it to a specific EMS station; use of the item for patient care. Key inventory management and control functions that lend themselves to barcoding include [5]:

1. Managing Inventory of Standard Medical Consumables
Keep it simple by barcoding and tracking standard inventory items by location, number and quantity. Track a variety of standard stock inventory like bandages, gauze, and more.

2. Tracking Medication Inventory
Categorize medication using batch-lot numbers to efficiently and effectively keep track of expiration dates. Having an accurate picture for medication ins and outs, as well as on-hand quantity and reorder levels, can ensure that each EMS vehicle has the right medication inventory on board when an emergency strikes.

3. Serialized Inventory Tracking
Track chemicals and oxygen tanks individually using serial numbers to meet government mandated requirements, and to better prepare yourself when serialized inventory items are needed.

Electronic medication dispensing systems
Cart-mounted electronic medication dispensing systems, also known as med carts, have been a fixture in most medical facilities, such as hospitals and nursing homes, for many years and are now making their way into the EMS realm. Keeping medications under lock and key is an inventory security control measure for sure, but it's not an effective strategy for managing and controlling how those medications are used.

Electronic medication dispensing systems provide benefits for both EMS providers and managers. Providers benefit from:

• Secure, automated access to narcotics and supplies
• Better adherence to controlled substance policies
• Intuitive and easy-to-use software to accurately and completely document usage
• Integration of usage into the patient care/billing report

The management/ownership benefits of an electronic medication dispensing systems include improved:

• Compliance with state and DEA regulations for medication storage and dispensing
• Inventory control and dispensing of narcotics
• Control of EMS provider access rights
• Inventory tracking and documentation of drugs used in patient care
• Billing accuracy for medications used in patient care

Biometric security
One of the top components of inventory control and management is biometric security, which uses an individual's biometric finger print to verify all transactions. This prevents someone from making false transactions or supervisors or managers having to make sense of illegible paper signatures. For added speed and security the biometric reader can also be used to login to inventory control software.

Beyond paper-based data collection and information management
In addition to inventory control and management, today's electronic information management systems for EMS operations can include a host of other data collection and reporting features that improve an EMS agencies efficiency and effectiveness. One example is performing vehicle inspections with an electronic check sheet. If the inspection check sheet is integrated with inventory management and fleet maintenance software it can greatly enhance an agency's operational intelligence. By replacing time-consuming paper check sheets crew members can be more accountable for supplies and equipment. All information captured during the inspection processes can be used to manage and report on an agency's operations performance and needs [6,7].

Another example is the use of a web-based inventory check sheet to conduct inventory of on-hand supplies. Expiration dates on medical supplies are also captured to ensure that inventory is safe and ready for administration. On-hand inventory is balanced against par stocking levels to automatically generate supply requests. Optimally those supply requests are sent electronically to the supply room and processed based on an agency's operational procedures.

Asset verification
The equipment used by EMS providers to provide patient care, particularly biomedical equipment such as defibrillators and medication pumps, represent a significant financial investment by the agency. Keeping track of that equipment as it moves through the operation is a critical risk management activity.

Electronic asset tracking enables end users to verify that equipment checked out to a station or vehicle is indeed at the location or report the missing equipment. If equipment is subsequently located, they can add it to their inspection and automatically transfer ownership to the new location or vehicle allowing missing assets and assets in motion to be recovered. If an asset requires maintenance the user can also record the maintenance while in the field using the check sheet.

Logging supplies by call
Using electronic reporting also enables the EMS provider to capture the supplies used on a per call basis. Crew members can enter the run number or ePCR number and enter the supplies used on the call. Once completed, the vehicle's inventory is updated and a supply request is created. These electronic call records can later be used to report on supply usage and matched up with an agency's ePCR records for quality assurance reviews.

General inspection questionnaires
Electronic reporting programs on the market today enable an agency to create customized questionnaires for any type of location or equipment inspection. These questionnaires are a basic element to any inspection process and provide supervisors and fleet managers with timely alerts on anything from narcotics usage to vehicle mileage and repair orders.

Fleet management integration
Fleet managers can receive information from electronic reporting check-sheets that will provide them with vehicle mileage, operating hours and any repair orders in real time. This makes planning scheduled maintenance and handling off-schedule repairs much easier.

Before you get started
Before purchasing any software vendor's product, it is useful for an agency's leadership to conduct a self-assessment to answer some key questions.

• Why do we need to collect and analyze data"
• What data should, or must, be collected"
• Who will be responsible for entering the data"
• How will the responsible parties enter the data"

These are important internal assessment questions. Far too often software purchasing decisions are made by those in leadership or technology positions within an organization without much thought about one of the most important components in any automated system: the end user who needs to integrate use of the software with their primary mission of patient care.

A majority of the data that most EMS agencies need to collect and analyze for their ICM originates at the level in the organization where the services get delivered. The earlier in the process that an agency's managers gain input from these stakeholders, the greater the chance that whatever reporting software is eventually chosen will be the right one.

References

1. 4 ways to better manage EMS inventory http://ift.tt/1lsIMUO

2. Avsec, R. 5 steps to buying fire department reporting software. FireRescue1.com http://ift.tt/1zEy4G7

3. McKesson. EMS Medical Billing & Revenue Cycle Management. http://ift.tt/1SvEeQV

4. ASAP Systems. Barcode Inventory System for Fire Rescue & EMS. http://ift.tt/24mRbAr

5. nMed. Prescription Drug Theft & Pharmacy Security. http://ift.tt/1SvEgIr

6. ASAP Systems. Barcode Inventory System for Fire Rescue & EMS. http://ift.tt/24mRbAr

7. OperativeIQ. Electronic Check-sheets. [Available on-line] http://ift.tt/24mR9Zz

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