1

Developing an Automated Supply Management System for a Home Health Agency

Hanifah Mutesi

 Hahn School of Nursing and Health Science, University of San Diego

Health Care Informatics, Capstone Project

Brenda Boone, PhD, RN

May 6th, 2021

 2

Executive Summary

This project was to develop an automated supply chain management system for a small-

scale home health agency in Southern California that provides high-quality home care nursing

services. The agency works with licensed healthcare professionals to provide personalized home-

based health plans that are convenient for the patient at any time of day. The agency uses paper

to document supply records; therefore, the purchase, billing, and general management

departments are currently using paper documents to receive information that may be untimely or

inaccurate from caregivers. Order management and timely fulfillment are core components of the

supply chain, which means roadblocks in these areas can impact the entire process. Research

suggests that an automated healthcare supply chain management system provides more efficient,

accurate, and cost-effective outcomes, and product availability. In addition, an automated system

increases the efficiency and accuracy of mundane tasks for staff and includes important

information such as product identifiers and expiration dates. This project introduced the

conceptions of supply and demand to a home health agency. The goal of this project was to

eliminate waste and create a highly efficient supply chain management cycle by successfully

transitioning from paper records to electronic records. To achieve this goal, the author focused

on designing and developing an automated supply chain management system, implementation of

Google Forms, and analysis and improvement of process workflow.

Keywords: Supply chain management, google forms, database, home healthcare

agencies
 3

Developing an Automated Supply Management System for a Home Health Agency

Supply chain management (SCM) is the means and activities of sourcing materials or

mechanisms an enterprise requires to establish a product or service and deliver that product or

service to customers (Perkins & Wailgum, 2017). Automation of SCM in the digital age

optimizes workflows to maintain a competitive edge. Supply chain automation refers to

systematizing part or all workflow improvement processes. Basically, it means utilizing

technology to centrally manage a complex web of working parts. Automating all or part of the

supply chain has several potential benefits for businesses, specifically, reducing manual effort

while increasing productivity, efficiency, and accuracy (QuickBooks Commerce, 2021).

Automating SCM improves payments and invoicing, order fulfillment and inventory updates,

customer service, including tracking lead generation and email confirmation, and setting and

expanding the revenue cycle.

According to Perkins and Wailgum (2017) there are six components of SCM.

- Planning: which involves designing and managing the metrics required for the product or

service that brings assessment to consumers, and values organization objectives.

- Sourcing: which involves companies to choose suppliers to provide the goods and

services needed to create products. The supply chain managers use various processes,

including ordering, receiving, managing inventory, and authorizing supplier payments to

monitor and manage supplier relationships.

- Making which involves supply chain managers to coordinate the activities required to

accept materials, quality test, and delivery schedule. Most enterprises measure quality,

production output, and worker productivity to ensure the enterprise creates or receives

products that meet quality standards.

 4

- Delivering: which often is called logistics, involves coordinating orders, scheduling

delivery, invoicing customers, and receiving payments.

- Returning: which requires the supplier to have a responsive and flexible network for

defective, excess, or unwanted products to be returned.

- Enabling: which to operate efficiently, the supply chain requires several support

mechanisms to control data through the SCM and stay in compliance with all

organization policies. We enable processes like fine, Human resources, Information

Technology facilities, portfolio management, product design, sales, and quality

assurance.

Background

A home health agency in Southern California was looking to automate their supply chain

management. The home health agency’s mission is to provide accessible, community-centered,

and individualized services by applying evidence-based patient care. The organization is

accredited by the Accreditation Commission for Health Care (ACHC) and delivers an optimal

experience for patients by partnering with organizations and healthcare professionals interested

in accreditation and healthcare-related services (Direct Care, 2019).

A dedicated unit of healthcare professionals including doctors, caregivers, nurse

practitioners, and sonographers work with a patient to develop a personalized home health plan

that is efficient and effective. Some of the services offered by the agency include nursing care,

physical, occupational, and speech therapy, social services, care from home health aides (such as

bathing and dressing), nutritional support, laboratory and X-ray imaging, pharmaceutical

services, transportation, and telehealth services. The agency offers online booking of licensed
 5

practitioners who are available to address patients’ needs at any time of day through a patient

portal called Kareo, which is a technology platform for independent organizations.

However, the agency needed to take a thorough look at their supply chain and work to

eliminate waste, save time, and create a highly efficient automated supply chain management

cycle to ensure supplies used during each patient visit were properly recorded for tracking and

billing purposes. With guidance from the supply chain manager, a preliminary database and

effective workflow of the staff was developed. This would ultimately provide accurate inventory

management, improve operational efficiency, improve customer experience, and increase

transparency between business and customer and most importantly improve financial

management.

Statement of the Problem

The home care agency operates 24 hours a day, 7 days a week. As such, patient needs

must be addressed around the clock and the staff should be provided with necessary supplies.

Currently, the agency is using a paper-based records management system and stored documents

as well as supplies in the supply room. This wastes time for the staff, who must keep manual

count of the supplies that are running low, which slows down the daily operations, delays the

billing process, and creates mismanagement of finances. For these reasons, the agency should

implement an automated supply chain management system to eliminate all the delays and

improve on the overall organizations operations.

 Patient, Intervention, Comparison, Outcome, and Time (PICOT) Question

Does implementing an automated supply chain management system for a small

healthcare agency, in place of the paper-based records, improve inventory management, accuracy

in billing, and financial management in the long run?

 6

Literature Review

Traditionally, supply chain management (SCM) systems were founded by large

companies that sought to be profitable wanted to vertically integrate supplier functions and

distribution activities to maximize production and logistical control (Ingram, 2016). However, in

recent years, effective SCM has emerged as a significant competitive advantage for companies in

very different industries (Ingram, 2016). Modern firms heavily rely on SCM to outsource

services and supplies that perform one or more production, procurement, and distribution

functions. In general, SCM improves quality assurance, timely delivery, and adherence to

responsible business practices in an environment of teamwork and transparency to experience a

tremendous competitive advantage (Ingram, 2016).

In healthcare, supply chain management is typically a complex and fragmented process

involving managing medical supplies, acquiring services, and well-timed delivery of goods and

services to the providers and patients. To complete the process, information about medical

products and services usually goes through many independent stakeholders, including

manufacturers, insurance companies, hospitals, providers, group purchasing organizations, and

several regulatory agencies (LaPointe, 2019).

Healthcare organizations aim to cut costs, especially as payers start to tie claims and

reimbursement amounts to quality and cost performance. Many healthcare agencies have looked

to the billing and services portion of the revenue cycle for budget decreases, but others have

started to promote efficiency through healthcare supply chain management (LaPointe, 2019).

Other factors of healthcare supply chain management involve the participation of

regulatory agencies, such as the Federal Drug Administration, the Center for Disease Prevention

and Control and healthcare payers, like Medicare, Medicaid, and private health insurance
 7

companies. Regulatory agencies and payers determine if a medical resource is fit for consumer

use and whether providers will reimburse for using it on specific patients (LaPointe, 2019).

In the internet era and amid technological innovation, supply chains have become a

complex collection of disparate networks accessed anytime. In their latest iterations,

technologies such as artificial intelligence, machine learning, the Internet of Things, automation,

and sensors are transforming the way companies produce, maintain, and distribute new products

and services. The best supply chain strategies call for a demand-driven operating model that can

successfully bring people, processes, and technology together around integrated capabilities to

deliver goods and services with extraordinary speed and accuracy (Oracle, 2021). Automated

SCM equip employees with tools that add more value to the business. SCM can predict failure

before it happens and then take steps to prevent it so the supply chain can continue uninterrupted

(Oracle, 2021).

Effective supply chain management system helps facilities to analyze possible loopholes

in healthcare and recommends controls that can improve healthcare. In hospitals, an incorporated

supply chain should be executed to meet objectives, as it ensures proper linkage of the hospital's

various departments, operations, and revenue cycle management, integrating all the different

organization processes, including medical billing and coding, which improves pricing accuracy,

greater levels of transparency, and coordination in all departments (LaPointe, 2019).

Dissemination of actionable data and more revenue cycle accountability ensure accurate

utilization of resources, and most significantly, streamline the income cycle in the form of timely

reimbursement (Abhijit, 2019).

A supply chain is not only about products. It is also about people, such as physicians,

providers, manufacturers, and distributors who buy, move, and use the system. An efficient
 8

supply chain is about delivering low-cost care as goods and supplies, such as moving a pair of

nurse’s gloves from point of purchase to point of use. The availability of medical and non-

medical supplies at the right time lowers the inventory wastage, maximizes patient care, leads to

increased appreciative employees, increases active treatment plans from all the human supply

links (DiChiara, 2019).

Goals and Objectives

The main goal of the project was to automatically link the organizations’ departments in

an end-to-end strategy that eliminated time waste, reduced cost, and improved efficiency of the

daily operations without decreasing the quality of the services offered to the patients. The project

was to automate the supply and demand of the inventory using Google Forms and develop a new

database for record keeping. The following are the project’s objectives:

 Design a supply chain management database (see Appendix A);

 Create and implement the use standardized Google Forms (see Appendix D);

 Perform workflow analysis and improve workflow and performance quality (see

Appendix B).

Design and Project Development

During the design and development of the project, we discussed the management’s needs,

conducted the workflow analysis, built the database, and formulated the Google forms with the

agency management.

Workflow Analysis and Performance Improvement

The first phase of the project was to work on the workflow analysis, assessment, and

valuation, and improve performance. A combination of developing a database, Google forms

improved the workflow and therefore increased the system’s performance. An efficient workflow
 9

gives insight into the organization processes, thus eliminating unnecessary and redundant daily

tasks. The improved workflow increased accountability and reduced the micromanagement of

the various integrated departments. Automation of the SCM will smooth the workflow, which in

return improved communication between the departments and among the staff. Improving

quality of the organization services thus promoting consumer experience.

See appendix A.

Creating a Supply Database

The next phase of the project was to initiate a pilot of the supply database using

Microsoft Access, concentrating on the framework of the database using Forms to enter, edit, or

display supplies in the database. Generate reports in an informative layout to evaluate and

analyze the organizations' supply chain by linking other organization department processes with

notifications and updates from the supply department. The database should be user-friendly and

easy to access and navigate. The project assimilated all the essential information for supply chain

efficiency and built an alert system for the supply manager to know when to order more

products. The project manager used a Gantt chart to plan and schedule the project

implementation phases. The Gantt chart helped identify the resources needed and managed the

timeline to complete the tasks (see Appendix B).

Google Forms

The last project phase was to design and implement two kinds of Google forms, one

called the Supply Request Form for requesting supplies from the supply department to be used

by all staff, and the second called the Supply Return Form, which is to be completed by the staff

after their specific duties. The forms were integrated into the database to update the database

system automatically using a data integration tool named Kloudio. The forms were accessible,
 10

precise, and easy to understand and fill out. Each form had a section where supplies can be

selected and then linked to their assigned barcode in the database. For each section, the quantity

section could be entered so the product quantity can be updated in the system. The second form

included the patient information section, which updated the billing department for accurate

information on products used during the patient care. See appendix C

Conclusion and Next Steps

In conclusion, healthcare organization leadership teams should evaluate their SCM

features, consider acquiring new analytics tools, and prepare for a future in which every dollar,

along with every medical and non-medical supply item, can be tracked, managed, and used

effectively to meet newly revised healthcare reforms (Abhijit, 2019)

A productive project’s essential areas of action are to ensure the Google Forms

automatically transfer information to the database, and that it updates the supply records using

the barcodes, including the expiration dates. The database should send out alerts or notification

messages to the purchasing department, supply manager, and billing offices for updates. The

management department should encourage the use of Google Forms by all staff. We would also

suggest using analytical tools to analyze the supply and demand of the products.
 11

References

Abhijit. (2019, January 8). Supply chain management in healthcare industry. Leading Medical

Billing Outsourcing Services Company in the USA.

https://www.medisysdata.com/blog/supply-chain-management-in-healthcare-industry/

Direct Care. (2019). Home. Direct Care. https://www.yourdirectcare.net/

DiChiara, J. (2019, December 18). Why Healthcare Needs Value-Based Supply Chain

Management. RevCycleIntelligence. https://revcycleintelligence.com/features/why-

healthcare-needs-value-based-supply-chain-management

Ingram, D. (2016, October 26). About Supply Chain Management Systems. Small Business -

Chron.com. https://smallbusiness.chron.com/supply-chain-management-systems-

43344.html.

LaPointe, J. (2019, March 14). Exploring the Role of Supply Chain Management in Healthcare.

RevCycleIntelligence. https://revcycleintelligence.com/news/exploring-the-role-of-

supply-chain-management-in-healthcare

Oracle. (2021). What is SCM (Supply Chain Management)? Oracle.

https://www.oracle.com/scm/what-is-supply-chain-management/

Perkins, B. &Wailgum, T (2017, August 27). What is supply chain management (SCM)?

Mastering logistics end to end. CIO. https://www.cio.com/article/2439493/what-is-

supply-chain-management-scm-mastering-logistics-end-to-end.html#:~:text=Supply

%20chain%20management%20(SCM)%20is,product%20or%20service%20to

%20customers.&text=Effective%20supply%20chain%20systems%20help%20both

%20manufacturers%20and%20retailers%20reduce%20excess%20inventory
 12

QuickBooks Commerce. (2021). Using supply chain automation to overcome operational

challenges. Inventory Management Software. https://www.tradegecko.com/blog/supply-

chain-management/supply-chain-automation-overcome-operational-

challenges#:~:text=Supply%20chain%20automation%20refers%20to,a%20workflow

%20to%20improve%20processes.&text=Automating%20part%20or%20all

%20of,productivity%2C%20efficiency%2C%20and%20accuracy
 13

Appendix A

Implementation Plan 1

Step #1:

 Identify and understand the home health agency needs and objectives.

 Analyze the current workflow.

 Breakdown the supply processes including the communication, service delivery, and

current supply chain.

Step #2:

 Process documentation.

 Automate the work process by Focusing on system components that match

capabilities and limitations of the agency.

 Redesign options to adjust the workflow processes improve work environment

Step #3:

 Implementation of new workflow with the databases and forms.

 Refine the workflow assessment.

 14

Appendix B

Implementation plan 2

Step #1:

 Identify the database software to be used.

 Implement proper database software based on research and supply manager’s

preference.

Step #2:

 Input inventory data into the database.

 Perform quality checks and system verification process on data in the database

system.

 User acceptance tests (UATs).

 User/Administrator training and testing of the supply management system.

Step #3:

 Monitoring and evaluation for continuous improvement of the SCM

 Database handover and data confirmation process.

 15

Appendix C

Implementation plan 3

Step #1:

 Create and design the Google forms, one Supply Request Form and the Supply

Return Form for all.

 Implement Google forms include list of supply names and quantity from the database

Step #2:

 Assessment and evaluation of the forms to be completed by supply manager.

 User acceptance tests (UATs).

Step #3:

 Training and testing of the use forms to staff.

 Form handover
 16

Figure 1

Microsoft Access Database showing the Medical Supply Table

 17

Figure 2

Current Workflow showing the agencies workflow processes

 18

Figure 3

New Workflow with improved work processes

 19

Figure 4

The Gantt Chart showing the project implementation actions and the timeline.
 20

Figure 5
Supply Requisition Google Form
 21

Figure 6

Supply Return Google Form

 22

Appendix D

Health Science Knowledge and Skills Competency

The Health Science Knowledge and Skills competency was met by demonstrating

knowledge of healthcare terminology and the healthcare delivery system, understanding the use

of technology to solve healthcare problems as shown in the research and analysis of the

healthcare supply chain management and home health agencies.

Leadership and Systems Management Outcome

The Leadership and Systems Management Outcome was met by demonstrating

proficiency in designing healthcare programs, applying concepts of strategic planning to the

development of a strategic plan, and exercising ethical leadership principles during project

development and In addition, developing a Gantt chart to track time and the progress of the

project demonstrated exemplary leadership skills.

Systems Design and Management Outcome

The Systems Design and Management Outcome competency was met by demonstrating

knowledge in skills in applying workflow analysis in supply chain management. The

competency was also met by demonstrating an understanding of integration of technology

systems in a small healthcare organization.

Data and Knowledge Management Competency

The Data and Knowledge Management competency was met by demonstrating proper

techniques to collect, manipulate, and store data to analyze the problem. I used Microsoft Access

database to format supply data and used SQL functions to analyze supply inventory and billing

statements.
 23

Quality and Regulatory Competency

The Quality and Regulatory competency was met by using methods for design of

performance improvement and including analysis tools to evaluate human supply links and

technology systems. I suggested an automation of the system and notification of every record for

performance improvement so the supply chain process can save staff time, eliminate waste, and

reduce costs.

Social Justice and Community Activism

The Social Justice and Community Activism competency was met by addressing

substantial economic and social inequalities for the patients who need home care services to

benefit from every dollar spent. It is essential to understand that everyone should receive quality

care at an affordable cost and account for every dollar spent.