Abstract
Central Medicines Procurement for National Health Insurance System began in 2008 after the National Health Security Office (NHSO) has set reimbursement for medical used in public hospitals. Starting from reimburse for medication that is used to treat diseases with high treatment costs (through the High-Cost Disease Fund), disease prevention vaccine (through the EPI Vaccine Fund which is in the normal budget) and medication for AIDS patients (through the AIDS fund) and others, currently NHSO has gone through the pooled-procurement process and distribution of these pharmaceuticals from central inventory to all public hospital all over the country. Government audit agency. Few years ago, a sudden change in purchasing unit by take into consideration of auditor recommendation that the purchasing unit should be independent from funds holder to comply with good governance practice. The medicine procurement committee has established of a group of public hospitals, a public hospital network (NPHs), as a temporary purchasing unit and under the process of determining what is the appropriate structure and characteristics of purchasing unit should be and how the technology could help solving this issue. Demand forecast. Under the overall procurement and distribution cycle, pooled-procurement supply chain processes, NHSO is responsible for preparing procurement plans by using last year medicine consumed as the baseline to forecast items and quantities to be purchased. Purchasing Unit. Purchasing Unit is responsible for the procurement processes − biding, tendering, or buying, etc. in accordance with government procurement policy − and then the Pharmaceutical Organization is responsible for managing and monitoring central stock as well as manage to deliver according to the hospital order. Public Hospital. Under this scheme, each public hospital must manage its own medical stock and under this policy, they are not allowed using government budget to buy such the items that that policy restricted to be in pooled purchase. Replenishment and drug quality are issues within the supply chain processes. Tracking medicines lot number those are delivered to hospitals all over the country is needed in the case that any lots found expired or unmet quality, it must be replenished, return, or claim to the supplier who sell them. Central Procurement Monitoring System-CPMS will be implemented to track procurement planning, purchasing and distribution of medicines to the users (public hospital), but still one last mile problem. This research emphasizes on the studies and analysis of procurement and distribution processes for Central Medicines Procurement in UC Scheme to seek for adjustment for concrete execution, and design and develop pilot system to monitor the medicine procurement and distribution. This includes studying and suggesting the integration of IT system development and procedure that are relevant to procurement and distribution for Central Medicines Procurement. The study results are as followed: Study results in guidelines for process adjustment: According to the comparison study between the process in nowadays and before 2017 fiscal year, the procurement and processes for Central Medicines Procurement are being under control of the fiscal year cycle, and sourcing in accordance with the Government Procurement Act in 2017. Some medical and supply lists have an inconsistent condition in supply chain that make them inconsistent with their operations, resulting in congestion. Take an example, as the temporarily drug shortage occurs, the demands in supplies from the market or the seller’s drug storage will augment. Along with the impact on the balance of the fiscal year procurement, and demand planning and the drug storage administration of the next cycle. Analytical results in the gap between procurement and distribution processes for Central Medicines Procurement in UC Scheme: The supply chain downstream is an untraceable system. It begins as hospital receive medical supplies all the way to dispensing medicines to the patient. Due to the Central Medicines Procurement in special project is one of the tremendous supply chains, each hospital has a distinguish drug management system. Despite the medical records are individually recorded, tracking the source of the medicine dispensation are inaccurate, which highly affected the qualitative management, for instance, drug lot tracking, expiration date on borrowing, returning, and changing medicine. Moreover, the drug codes that do not meet the similar standards and agreements are not contributed in every process in managing and monitoring level. Analytical results in the comparison of a general practice and IT potentiality that needs to be developed: When contrasting the IT potentiality of an organization in the procurement and distribution of medicine, the are 3 major agencies are all possessed the nation-leading in IT potentiality. They can analyze, adapt, and develop IT system to accommodate the new arisen demand on time. Whenever the problem in medicine procurement and distribution processes have been discussed, IT system is the essential drive to resolve all the conflicts. Despite its explicit role and a lot of co-operated agencies, it was discovered an ambiguous conclusion on the selection of the IT system’s owner. This will affect the sustainability of system along with the usage expansion, development, and maintenance. Analytical results in design and develop pilot system to monitor the medicine procurement and distribution: Research team have developed the sample screen of pilot system and represented the original screen to 3 dominant agencies, which are consisted of NHSO as a planner in medicine demand forecasting, Rajavithi Hospital as a procurement agency, and GPO as a seller agency. The design for 3 interrelated agencies can monitor the planning and procuring status, and also check the report overview. It has been recognized as a highly benefit function especially in cutting the delayed procedure from communication and confidential exchange of information with each other. Nevertheless, the pilot system has not been assigned to any agencies, it was temporarily installed at NHSO server, which situated in NGO office. Policy Recommendation: The major problem is lack of host to implement IT, and information for management and monitoring. Hence, determining the stakeholder in different level of IT system explicitly will generate confidence for examination and evaluation of the medicine procurement and distribution cycle. Along with expanding the results of pilot system and conducting as mechanism to drive and administrate the cycle of procurement and distribution processes for Central Medicines Procurement in UC Scheme. It is done by regulate the approach and method in directing information in every single process in order to ensure that exchanged data are precise, trustworthy, compliant with the law, regulations, and notices that would shorten and smoothen the procedure, simultaneously. Additional research topics: 1) Applied Global standard Pharmaceutical Product Code: GS1 Automatic Identification and Data Capture Standards in Healthcare. 2) Blockchain-based solution: A new ecosystem should be introduced to enable all stakeholders to share single trusted source of information on the procurement and distribution of the Central Medicines Procurement in UC Scheme using permissionless blockchain to solve the last mile problems within the procurement and distribution processes reconciliation.
