Hi all – here is a high-level description (for discussion) of where the “connectors” might be between the HIE and the SCM system. 
18-04-20 OpenHIE and SCM.pptx (867 KB)
Hi Derek.
In theory your description works, but only for single dose SKUs. The challenge in using a vaccination use case with a multi dose unit is that there will normally be open vial wastage compromised of unusable doses after the time period lapses for reuse of remaining doses in the vial. In some cases, an SKU of five-dose vial might only be used once before it must be disposed. Each antigen packaged in a multi dose vial has specific and perhaps unique reuse time restrictions as the antigen begins to degrade once the seal is broken. Some are limited to five hours, others to days. Open vial wastage should be reported for logistics reasons but rarely is due to human factors and perverse incentives. For quality of care, open vial wastage is preferable to turning away a single client in need of vaccination, but HCWs are sometimes penalized for be wasteful because open vial wastage (ok) and closed vial wastage (bad) are treated the same.
TMI, I know.
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chris wright
Practice Lead, Data Visibility & Use**CELL: +41.77.**951.7144 | WWW.JSI.COM/SUPPLYCHAIN 
Hi Chris.
Thanks for starting the discussion on this! Can I ask, though, why you think this approach would only work for single-dose GTINs? My example illustrated consumption based on a 100-dose pack (and assumed 50 doses wasted).
I agree – if we’re considering multi-dose vials, it is important to summarize vaccination transactions by DAY, because the vials are (often) not usable the next day. I tried to lay out a daily-consumption example in my deck to illustrate this… but obviously I didn’t do a good job of explaining it. So… here goes:
If GTIN-1 has 10 doses per vial of Vaccine-1 and we log in the HIE’s shared health record (SHR) that there were 42 vaccination events on April-20 then we can imply the number of vials by applying a “round up” to the next whole integer for vial consumption and then some modulo math to get open-vial wastage…
42 / 10 = 4.2 rounded up = 5 vials of GTIN-1 with 10 - 42mod10 = 8 open-vial doses wasted
If GTIN-2 has 5 doses per vial of the same Vaccine-1, then the modulo math gives…
42 / 5 = 8.4 rounded up = 9 vials of GTIN-2 with 5 – 42mod5 = 3 open-vial doses wasted
Of course, a place where an implied consumption approach doesn’t work well is when a facility has multiple GTINs of the same vaccine (which is not especially common… but happens sometimes). In places where there is a 1:1 relationship between GTIN and vaccine, the implied consumption heuristics yield pretty good results. In high-volume environments, we sometimes try to leverage multiple GTINs (e.g. lower price-per-dose 50-dose GTINs alongside higher-priced 5-dose GTINs) to reduce overall prices while still attempting to mitigate vaccine dose wastage. Usefully, these high-volume clinics are also often the contexts where barcoding technologies can be adopted to explicitly track GTINs (and lots).
An implied consumption approach also does not work especially well when the attempt is made to summarize over a whole week or a whole month (or any time period longer than a vial can remain open). This is because of the issue you’ve identified, Chris. The systemic error such an approach introduces is illustrated by “lazily” trying to imply the weekly consumption of GTIN-2…
Monday: 42 doses
Tuesday: 35 doses
Wednesday: 36 doses
Thursday: 41 doses
Friday: 27 doses
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Hi Derek.
In theory your description works, but only for single dose SKUs. The challenge in using a vaccination use case with a multi dose unit is that there will normally be open vial wastage compromised of unusable doses after the time period lapses for reuse of remaining doses in the vial. In some cases, an SKU of five-dose vial might only be used once before it must be disposed. Each antigen packaged in a multi dose vial has specific and perhaps unique reuse time restrictions as the antigen begins to degrade once the seal is broken. Some are limited to five hours, others to days. Open vial wastage should be reported for logistics reasons but rarely is due to human factors and perverse incentives. For quality of care, open vial wastage is preferable to turning away a single client in need of vaccination, but HCWs are sometimes penalized for be wasteful because open vial wastage (ok) and closed vial wastage (bad) are treated the same.
TMI, I know.
On Fri, Apr 20, 2018 at 16:34 Derek Ritz derek.ritz@ecgroupinc.com wrote:
Hi all – here is a high-level description (for discussion) of where the “connectors” might be between the HIE and the SCM system.
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chris wright Practice Lead, Data Visibility & Use** CELL: +41.77.951.7144** | **WWW.JSI.COM/SUPPLYCHAIN **
Thanks for the additional details, Derek. I see my error in missing the emphasis on the daily transaction data, which works, especially if we also get a periodic routine physical count of SKUs on hand. I also totally agree about the ability to use derived open vial wastage to better target different vial sizes, and have made the same point in other fora. So we are aligned🙂
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chris wright Practice Lead, Data Visibility & Use**CELL: +41.77.**951.7144 | WWW.JSI.COM/SUPPLYCHAIN