Lessons from Phase 1 Premier GLN Transaction Program

Global Location Number Implementation

On your way to better supply chain interactions

Global Location Number Implementation

ExecutiveSummary Reliableinformationaboutdeliverylocationis essentialforproperdeliveryoftheright healthcareproducttotherightlocation,avital componentinensuringpatientsafety.TheU.S. healthcareindustryhasdeclaredstandardsfrom GS1asitschoicefordescribingbasicinformation neededtoimprovepatientsafety,reducecosts andenableanefficientsupplychain,establishing anadoptiondateofDec.31,2010fortheGS1 GlobalLocationNumber(GLN) ThePremierhealthcarealliancesPurchasing PartnersdivisionendorsedtheGS1systemof datastandardsandhasdevelopedprogramsto helpitsprovidermembersandcontracted suppliersimplementandtransactusingthese standardsinpreparationfortheindustry establishedadoptionsunrisedates.Inmid2009 PremierlaunchedtheGLNTransactionProgram inanefforttooutlinetheprocessforGLN implementationforitsmemberhospitals. TheobjectivesofthePremierGLNTransaction Programwereto: BetterunderstandtheuseofGLNRegistry forHealthcare IdentifythestepstoGLNimplementation Identifychallengesinimplementation Sharelessonslearned

AuroraHealthCareandBaxterInternational MissionHospitalandOwens&Minor Participantssharedtheirexperiencesandlessons theylearnedwithothersinordertoaccelerate GLNadoptionbythehealthcareindustryasa whole. LessonsfromPhase1,PremierGLNTransaction Program Premierheldtheprogramkickoffwithaweb basedmeetinginMay2009,andthefirstGLN transactiontookplaceinAugust2009. Participantsdeterminedthatpreparingto implementtheGLNcanbedonerightnowandin shortorder,withimmediatebenefits regardlessofotherimplementationchallenges thatmayexist. ParticipantsidentifiedseveralstepsofGLN implementationthatwereconsistentacrossthe board,andthataredetailedintheprogram summary.Theyinclude: 1. ReconciliationwithGPORoster. 2. EstablishingmaintenancecontrolofRegistry information. 3. EstablishingproperGLNhierarchystrategy. 4. CommunicationswithGPOtoalignGLN hierarchy. 5. Cleansingandreconciliationofshipto locationswithsuppliers&exchange providers. 6. UploadingofGLNtoproviderinformation systems;makenecessarychangestoenable EDItransactionstoincludeGLNsandreplace customnumbers. 7. BegintransactingusingGLN. 8. Identifyingchallengesandestablishingwork aroundsolutionswhenappropriate. 9. Stayinginvolved.

Participants Intheprogram,earlyadopterprovider organizationswerepairedwithsupplierpartners todiscoveranddocumentthestepsnecessary forsuccessfulGLNimplementation.Participants inthefirstphasewere: GeisingerHealthSystemandMedline Industries

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 Amongtheoveralllessonslearned: Participantsagreedthatimplementing Participantsfeltstronglythathospitals theGLNiscompletelyachievablewithin shoulddriveGLNimplementationwith areasonabletimeframe. supplierpartners. Participantsfoundthatthework Providersfeltthattheexercisein requiredtosupportGLN preparingforGLNimplementationwas implementationislargelyfrontloaded. valuableandimportant,and overwhelminglyfeltthattheywere readytogo. Allparticipantsfeltthatprovidersshould startsmallandbasicworkonLevel1in theGLNRegistry(parentorganizations) Allparticipantsfeltthatprovidersshould getstartedwithGLNimplementation andestablishthecorrectshipto rightaway,and,bydoingso,the locations. mystiqueinvolvedwithGLNswill becomemanageable. Providersalsoagreedthatestablishinga processformaintainingGLN Participantsagreedthatimplementation informationintheRegistryisextremely canandshouldoccurinaphased important. approach. Providersalsofeltthatselectinga StayeducatedandgetinvolvedinGS1 strong,customerorientedsupplier HealthcareUSGLNworkgroupsor partnerfortheinitialGLN Premierworkgroups. implementationisimportant. Conclusion Premiermemberhospitalsandcontractedsuppliersinvolvedintheinitialphaseofthe PremierGLNTransactionProgramwillcontinuetobuildupontheexperiencesandlessons learned.PremierisexpandingitsGLNTransactionProgramtoincludeadditionalmember andsupplierpartnerpairings.Healthcareprovidersandsuppliersshouldbeginpreparingfor the2010GLNSunrisenow.

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Lessons from Phase 1 Premier GLN Transaction Program

Introduction Manylargeindustries,includingtheretail, groceryandmassmerchandiseindustries,have beenusingGS1datastandardsforidentifying locationsandproductsintheirtransactionsfor severalyears,and,asaresult,haverealized significantoperationalefficienciesintheirsupply chains.TheU.S.healthcareindustryhas declaredstandardsfromGS1asitschoicefor describingbasicinformationneededtoimprove patientsafety,reducecostsandenablean efficientsupplychain,andhasthusestablished adoptiondatesofDec.31,2010fortheGS1 GlobalLocationNumber(GLN)andDec.31, 2012fortheGS1GlobalTradeItemNumber (GTIN). ThePremierhealthcarealliancesPurchasing PartnersdivisionhasalsoendorsedtheGS1 Systemofdatastandards,andhasdeveloped programstohelpitsmembersimplementand transactusingthesestandardsinpreparationfor theindustryestablishedadoptionsunrisedates. WithGLNfirstonthehorizon,inmid2009 PremierlaunchedtheGLNTransactionProgram inanefforttooutlinetheprocessforGLN implementationforitsmemberhospitals.The GLNisagloballyrecognizedidentification numberusedintheGS1Systemtoidentifylegal entities,tradingpartnersandcustomerlocations inelectroniccommerceactivities.Inthe program,earlyadopterproviderorganizations werepairedwithsupplierpartnerstodiscover anddocumentthestepsnecessaryforsuccessful GLNimplementation.Participantsthenshared theirexperiencesandlessonstheylearnedwith othersinordertoaccelerateGLNadoptionby thehealthcareindustryasawhole.Participants determinedthatpreparingtoimplementthe GLNcanbedonerightnowandinshortorder, withimmediatebenefitsregardlessofother implementationchallengesthatmayexist.

2010GLNSunrise

Thegoalofthe2010GLNSunriseistouse standardizedlocationidentification(GLNs) byDecember2010,whichmeans:

GLNsareassignedbylocationowners. GLNsareusedinappropriatebusiness transactionsandprocessesbetween tradingpartners. GLNhierarchyisdefinedandmaintained bylocationowners. GLNRegistryforHealthcareisusedto facilitatecorrectlocationidentification.

Formoreinformationabouttheindustry sunrisedatesforboththeGLNandGTIN,go towww.gs1us.org/hcsunrise. Background Reliableinformationaboutdeliverylocationis essentialforproperdeliveryoftherightproduct totherightlocation,whichisavitalcomponent inensuringpatientsafety.Electronicmedical records,automatedorderingsystemsandother healthcareITsystemsallrequirereliablelocation identificationandinformationtoimprove patientsafetyandsupportpatientcare.

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Accuratelocationinformationisanecessityfor allsupplychainpartners,includinggroup purchasingorganizations(GPOs).Ifahealthcare organizationisassociatedwithaGPO,itiscrucial thattheGPOsrosterofhospitalscontainsallof thenecessarylocationinformationinorderto ensurethataccurate,consistentlocation informationisbeingsenttodistributorsand manufacturers.GPOsmayalsoencounter problemsinmanaginglocationinformationin theirrosterofhospitals.Forexample,their rostermaynotreflectthedifferencebetween corporateidentityandphysicallocation.In addition,itmaynothavepreciselocation informationforeachofthevarioushospitals affiliatedwiththehealthcareparent organizationorforeachofthevarious departmentswithinahospital.Iftherosterisnot accurate,ahospitalmaymistakenlyreceive rebatesmeantforother,similarlynamed facilitiesorrebatesmaybeappliedtothe incorrectreceivinglocationwithinthehospital. Asaresult,rebatesandclaimscanbedelayedor evenlost. Althoughhealthcareconstituentsacrossthe supplychainhavecreatedtheirownproprietary numberingsystem[s]inanefforttosolvesome oftheseproblems,doingsocreatednew problems.Somanylocationnumbersystems werecreatedthatmaintainingallofthevarious numbersbecamedifficulttomanage.In addition,providersnowhadtocreateand managemapsbetweenallofthevariouslocation identificationnumbersintheirsystems.Theend resulthasbeenanerrorprone,inefficient approachtolocationidentificationthathasdone littletopromotepatientsafetyanddrivesupply chainefficiencies. Overthepastfouryears,numeroushealthcare organizations,includingproviders,GPOsand industryassociations,havecalledforindustry

implementationofacommon,universaland globalsetofdatastandardsforlocationand productidentification,aswellasasystemto synchronizethisdata.Inaddition,withthe passageoflegislationinthefallof2007,theU.S. Congressmandatedtheuseofauniquedevice identificationsystem AdvantagesoftheGlobalLocationNumbers

Without a standardized approach, supply chain partners often assign their own proprietary location identification numbers resulting in numerous numbers to manage andmaintainforthesamelocation,creating inefficiencies and confusion related to party/location information in the supply chain. The use of GLNs avoids those problems and provides companies and healthcare organizations with a method of identifyinglocationsthatis:

Simple:aneasilydefineddatastructure withintegritycheckingthatfacilitates processingandtransmissionofdata. Unique:GLNsaregloballyunique. Multisectoral:thenonsignificant characteristicoftheGLNallowsany locationtobeidentifiedforanycompany andorganizationregardlessofitsactivity anywhereintheworld. Global:implementedaroundtheworld andsupportedbyGS1USandthe internationalnetworkofotherGS1 MemberOrganizations,coveringmore than100countries,inthelocallanguage.

For more information and details on GLN benefits to providers or suppliers, see the GLN Tool Kits published by GS1 Healthcare US,at:www.gs1us.org/healthcare.

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Ongoingindustrypilotprogramsareshowing thatsuccessfuladoptionofthethreeGs GLN,GTINandtheGlobalDataSynchronization Network(GDSN)isachievableinthenear termwiththepotentialforimmediatevalue. Manyproviderorganizationsarealsorequiring theirmanufacturerpartnerstoincorporatethese identificationstandardsinordertosecure contracts. PremierannouncedinJulyof2008thatsuppliers thatsignitsnationalcontractsmustadoptGS1 standardswithinfiveyears,startingfirstwiththe GLNin2010.Premierdecidedtoissuethis requirementbasedonyearsofinputfrom memberhospitalsanditsownparticipationin industrystandardsefforts.Premieralsoissued therequirementinordertohelpaccelerate industrywideimplementationofthestandards (seetimelineandroadmapgraphics).

ofstandardsimplementation.Itbelieves implementingthesestandardswillhelpits memberhospitalsimprovepatientsafetyand reducecosts.Tothatend,Premierlaunchedthe GLNTransactionPrograminMay2009. GLNTransactionProgram GLNprovidesgloballyuniqueidentificationfora functionalentity(suchasahospitalpharmacyor accountingdepartment).Participantsinthe PremierGLNTransactionProgramsharethe beliefthattheGLNwillprovideanewandbetter wayofconductingsupplychainbusiness,andare committedtousingGLNintheirdaily transactions. TheobjectivesofthePremierGLNTransaction Programwereto: BetterunderstandtheuseofGLNRegistry forHealthcare IdentifythestepstoGLNimplementation Identifychallengesinimplementation Sharelessonslearned Thefollowingprovidersandsupplierpartners werepairedtoparticipateinthePremierGLN TransactionProgram: GeisingerHealthSystemandMedline Industries AuroraHealthCareandBaxterInternational MissionHospitalandOwens&Minor Premierheldtheprogramkickoffwithaweb basedmeetinginMay2009,andthefirstGLN transactiontookplaceinAugust2009. TheSingleSourceofTruth: TheGS1USGLNRegistryforHealthcare TheGLNRegistryforHealthcareisadirectory ofhealthcareandhealthcarerelatedfacilitiesin theU.S.,withcorrespondingGlobalLocation Numbers(GLNs).Membersofthisregistry,

Premiersiterativeapproachtoward comprehensivestandardsadoption: 2008Launchedoutreachandeducation programforprovidersandsuppliers; modifiedcontracttoinclude requirementsforstandards compliance. 2009Requestedthatprovidersand suppliersrecognizeGLNsandthatthe suppliersbegintoregisterGTINsfor theirproducts. 2010ChampionrecognitionanduseofGLN byallprovidersandsuppliers. 2012ChampionuseofGTINforallproducts fromallsuppliers,andtheuseofGTINs byallproviders. Asanationalhealthalliance,Premierbelievesit hasasignificantroletoplayintheacceleration

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whichincludehospitals,healthcare manufacturersanddistributors,andother interestedparties,canaccessanupdatedlistof industrymanufacturers,distributors,retailers, hospitals,clinicsandmailorderpharmacies, developedtoensuretheaccuracyoftheirsupply chainactivities. Asaservicetoitsmembers,Premierhas allocatedGLNstoproviders,includingallowned facilitiesandaffiliates.Therearemorethan 70,000locationsregisteredtoPremierproviders intheRegistry.Asaresultofthiseffort,the hierarchyusedintheRegistrymatchesthe structureusedinthePremiermemberroster,

Premiersofficiallistofallmembersand associatedaddresses.Generally: LevelOneistheMainParent,thelocation thatactivelyreceivesproductsorthe corporateentityusedinPremierrecords. LevelTwoisanyentitythatreportsdirectly totheMainParent. LevelThreeisotherbuildingsand/orthe subordinatedepartmentsofLevelTwo. LevelFourisanadditionallevelthatcanbe usedfordesktopdeliveryorJustinTime (JIT)locations.

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StepstoGLNImplementation ThoughtheGLNimplementationexperience differedbetweenthehospital/supplierpairings inthePremierGLNTransactionProgram,there wereseveralstepsthatwereconsistentforall theparticipants: 1. ReconcilewithGPORoster. ThoughPremierhadregisteredGLNson behalfofitsmembership,provider participantsfoundthattheinformation housedintheRegistrywasnotalways consistentwithhowtheythemselveswould ascribeGLNsfortheirorganization. Providersworkedtocleanseandreconcile theinformationintheRegistryeither directlywiththeRegistryorwithPremier. TheprocessresultedinanaccurateGLNat thehighestlevel,withthatinformation matchingwiththePremierRoster.Providers inthisprogramreportedthatthisprocess tookapproximatelyfivetoeighthours. You should cleanse your location data before you build your GLN hierarchy. No one knows your hospitalsystemlikeyoudo,somake sureyourGPOandtheGLNRegistry areinsyncwithhowyouwantyour organizationalstructuretolooklike, and have them make corrections if needed. StuartWooster AuroraHealthCare 2. TakemaintenancecontrolofRegistry information. Ashospitalsopenandclose,newaffiliations areaddedorofficesmove,GLNswillneedto beupdated.Participantsrecommendedthat someoneonstaffbeassignedtoeitherwork

withtheGPOtokeeptheRegistryandGPO Rosterinformationuptodateandcurrent, orselfmaintaintheinformation. 3. EstablishproperGLNhierarchystrategy. OnceyouhaveaccurateGLNsassignedat thehighestlevels(parentlocation),youll needtoestablishtheproperhierarchyof locationsintheRegistry,includingaffiliated clinics,laboratoriesandotherfacilities.Keep inmind,whenmakingassignments,that GLNscanbeusedformanybusiness purposes,including,butnotlimitedto:GPO rostering,distributorsalestracingsande commercetransactions. 4. CommunicatewithyourGPOandthose organizationsenablingyourecommerce transactionstomakesureyourGLN hierarchyisinalignmentacrossallparties. ThisisanimportantsteptoensurethatGPO reportingisaccurate,rebatesaresenttothe correctfacilityatthecorrecttime,and orderssentviaelectroniccommercehave accurateinformationforshippingandother supplychainrequirements. By using a consistent numbering andnamingconvention,suchasthe GLN, providers can be assured purchases that qualify for rebates will be accurately captured with rebate checks going to proper locations. PatSmith MissionHospitals

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5. Cleanseandreconcileyourshipto locations. Earlycoordinationwithyourtradingpartners andecommerce/exchangeprovideris criticaltothisprocess.Withoutproper coordinationbetweenallpartiesinthe transactionprocess,yourtransactionscould fail. Selectsupportivesupplierpartnersthatare readytomeetyourGLNneeds.Reviewyour shiptolocationswithparticipating supplierstoensureGLNsinthesuppliers systemsareappropriatelymappedtothe existingsupplierassignedaccountnumbers forthoseshiptolocations. Oncethemappinghasbeenvalidatedand cleansed,communicatetheseshipto locationspromptlytoyourexchange providerwhowillhelpensurethe appropriateregistering,mapping,andcross referencesforaccuratetransactions. 6. UploadGLNtoyourMMISorERPsystem. YourMMISorERPsystemmayrequirean upgradeorpatchtoenabletheuseofGLNs intransactions.Itishighlyrecommended thatyouconfirmyoursystemsrequirements withyourvendorearlyinthisprocessto ensurethatyoureffortswillbesuccessful. 7. BegintransactingusingGLN1 Understandthemethodbywhichyour supplierconductsecommerceandhowit workswithyoursystembeforeyoubegin transactingwiththeGLN.Thereisnoone sizefitsallapproach,witheach
1

implementationparticipantswilltakelessons learnedforthenextone. Byworkingtogetherearlyintheprocess, yourorganization,tradingpartners,system vendor,andecommerce/exchangeprovider cantakethenecessarystepstoaccurately representyourshiptolocationsusing GLNs,helpingensureyourtransactions processwithouterrorsortheneedfor manualintervention. We plan to keep working with our provider customers, implementing GLNs in a controlled manner. We plan to make system changes to support the GLN for any customer wishing to use it, and in the meantimearemaintainingmethods forGLNandnonGLNcustomers. DaveRolston Medline 8. Identifychallengesandestablishwork aroundsolutionswhenappropriate. Participantsexperiencedchallengesintwo mainareas:systemswhichrequired upgradesorpatchestoallowtheuseofGLNs inEDI,andtheneedfordedicationandclose communicationamongallpartiesinvolvedin transactingpurchaseorders:provider, supplier,MMISvendorandecommerce/ exchangeprovider.Barriersnot encountered,butconsideredpossibleby participants,includedlackofavailable resourcestosupportupfronttimeinvolved incleansingandreconcilingaccount informationwithGPOorsupplierorMMIS vendor,ecommerce/exchangeprovider partners.

Duetospecificimplementationchallenges,notallpairings wereabletoconducttransactions.

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While there can be challenges alongtheway,GLNimplementation isnotrocketscienceitonlytakesa commitment to a better way of doing things, open communications and support of your trading partners. DeborahTempleton GeisingerHealthSystem

9. Stayinvolvedandcontributetothegrowing healthcareGLNknowledgebank. Takeadvantageofexistingresources, includingeducationalprogramsand materialsfromorganizationssuchasyour GPO,yourMMIS/ERPVendor,youre commerce/exchangeprovider,GS1 HealthcareUS,andindustryorganizations suchasAHRMM,SMI,andMDSCC..

ContactPremier ForquestionsrelatedtoPremiersindustrystandardsinitiatives,pleaseemail datastandards@premierinc.comtoreachthefollowingcontacts: JosephPleasant SeniorVicePresidentandChiefInformationOfficer MarlaWeigert GroupVicePresident,ContractManagementandAdministration KarenBoswell VicePresident,DataManagement LalitThakur Director,MasterDataManagement CarlGomberg BusinessAnalyst,ProductInformation

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GLN Transaction Program Experience

Pairing1:GeisingerHealthSystemandMedline
OrganizationInformation

GeisingerHealthSystem

Medline

OneofthenationslargestIDNs. Nationslargestprivatelyheld Servesmorethantwomillion nationalmanufacturerand residentsincentralandNortheast distributorofhealthcare Pennsylvania.Recognizedasonthe suppliesandservices. forefrontoftheelectronichealth www.medline.com recordsinnovation. www.geisinger.org GLNTransactionProgram DeborahTempleton,VicePresident, DaveRolston,VicePresident, participants SupplyChainServices eBusiness DarrelDudeck,SupplyChainSystem Analyst Relevantsystems Lawsonv.9.0.0.4forMMIS.Contains SAPERP,directEDIwith information functionalitythatallowsforGLNusage Geisinger Transactionrelationship Transactsdirectlywithitsdistributors andsomemed/surgmanufacturers Geisingerusesacentralsourcingmodel,inwhich BecauseofGLNimplementation,Geisingers mostofthenetworksmed/surgsuppliesare DeborahTempletonismoreconfidentinflow deliveredtocentralizedlocations,andthenare andaccuracyofdataexchange,andthe distributedinternallybyGeisinger.Geisinger hospitalsabilitytogettherightproducttothe rightplace.WiththeGLNinplace,weare enumerateditsGLNsattheshiptolocations reapingthebenefitsofusingconsistentlocation (centralsourcing),andreconciledthis identification,includingstreamlined informationwithbothPremierandMedline. communications,morereliableproduct GeisingerprocesseditsfirstordertoMedline shipmentsandcleanerbusinessdocuments.In usingtheGLNonAugust17,2009,andby addition,throughtheprogram,wevebeenable October5,2009,hadworkedoutallelementsof todevelopaGLNadoptionapproachwhichwe theirprocess.Theyaresuccessfullyusingthe cannowleveragewithourothersuppliers,she GLNinallMedlineorders(850)andorder said. acknowledgements(855),withthecorrect productsbeingreceivedinthecorrectlocations. Templetonacknowledgedthatwhilemany providersandsuppliersmaybereluctantto Currently,Geisingerprocessesmorethan15 purchaseorderseachdaywithMedline,some changetheiraccountnumberingmethodology containinghundredsoflineitems.SoonMedline duetofearoftheunknown,oncetheinitial EDIinvoices(810)toGeisingerwillalsoinclude upfrontworkiscompletedandthefirsttrading theGLN. partnerisonboardwithGLNimplementation, youvemadeitthatmucheasierforthenext

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supplierrelationship.Thiswillbecomeacookie cutterprocess.Itwillgeteasierandeasier. MedlinesDaveRolstonagreed,andstatedthat, althoughnotallprocessesmaybeinplacefor eachtradingpartnertotransactwiththeGLN, dontletperfectgetinthewayofgood. Keepitsimple!Startingsmall,andwithone tradingpartneratatime,theindustrywillbe abletogetthisdone,andwillbeableto surmountanybarrierstoimplementation. Medlineismakingsomeenhancementstoits ERPsystemtosupportGLNsenterprisewide,but startedwithatacticaltypesolutionsotheycould getstartedusingGLNsmorequickly.Medline usedthismethodtocrossreferenceitscustomer shiptodatawiththecustomerGLN. AccordingtoRolston,thisprocesswillworkfor eachhospitalthatwantstoimplementGLN during2010,whilealsoservingtheneedsof hospitalsthatarefurtherbehindinGLN implementation.Practicalexperienceallowsus tomaketherightkindofenhancementstoour ERPforlongtermuseandsupportoftheGLN. AttheearlystageofGLNimplementation,both GeisingerandMedlinefoundthattheactual preparationforGLNusagehasmanybenefits, including: Cleansedmasterdata StrengthenedsupplierandGPOrelationship withstreamlinedcommunications ConfidenceintheinformationtheGPOand supplierpartnerhasforshiptolocations EstablishedareplicableGLNpreparation processthatcanbeusedforthenexttrading partner

Keyexperiencetakeaways: Takecontrolandcleanupyourhierarchyin theGLNRegistryforHealthcareasearlyin theprocessasyoucan. Communicateandplanwithyourvendor partnersfrequentlyduringtheprocess. Itisbettertotrythingsonasmallerscale andgrowfromthere.

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Pairing2:AuroraHealthCareandBaxterInternational
OrganizationInformation

AuroraHealthCare
Wisconsinintegratedcaresystem. www.aurorahealthcare.org

BaxterInternational

Global,diversifiedhealthcare company.Manufactures productsin26countries. www.sustainability.baxter.com GLNTransactionProgram StuartWooster,Manager,Corporate BarbZenner,SeniorProject participants Purchasing Manager Relevantsystems InternallydevelopedMMIS ConvertinggloballytoJDE8.12 information (U.S.targetisJuly2011) Transactionrelationship Sends/receivesordersviaEDIthrough GHXexchange tousetheGLN.Moreinformationcanbe Auroracurrentlyusesacustom,homegrown foundat: materialsmanagementinformationsystem http://www.ghx.com/65boutGHX/IndustrySt (MMIS),andtransactsordersviaGHX.Auroras andards/tabid/827/language/en MMISsystemisuniqueinthatitusesa US/Default.aspx) customizedelectroniccommunicationformat, whichdoesnotmakeitpossibletocurrently AuroraworkedwithBaxtertoreviewallexisting transactusingGLNsviaGHX.Asaresult,Aurora accountnumbers,eliminatingoutdatedor hastakenotherstepstoprepareforGLN duplicatenumberssothatbothorganizations implementationreadiness,including: hadthecorrectfacilitieslisted.Inaddition, AuroraconfirmedtheGLNdatainitsPremier IncorporatedtheGLNfieldinRequestsFor roster.AuroraopenedanewhospitalinMarch Proposalstosuppliers 2010,ispreparingforasecondnewhospitalin WorkedwithPremiertoensureGLNfields October2010andisproactivelyensuringGLNs areintheGPORosterandanupdateprocess areassignedpriortolaunch. isestablished ConcludedthatAurorawillutilizeGLNsfor eachshiptoaddressthatappearon PurchaseOrders Chosetheformatforoutboundordersthat includesboththeGLNandthepreexisting accountnumberbasedonguidelinesinthe GHXsdocumentUsingGLNswithGHX,a supplementtotheGS1HealthcareUSGLN ToolKit. (Note:GHXhaspublishedatoolkitand othermaterialsfortradingpartnersthatplan IstronglyadvocatethatprovidersassignGLNs totheircurrentshiptolocations,theplaces wheresuppliesaredeliveredfromthesupplier, saidStuartWoosteratAurora.Forsuccessin implementation,youneedtokeepthingsas simpleaspossible,andprioritizehowyouwill assignGLNs.Waituntilyouhaveagood understandingofGLNsandthehierarchybefore assigningGLNstoeverydeliverylocation,suchas

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nursingstations,binsandothersupply locations. Woosteraddsthatcommunicationthroughout theGLNimplementationprocessisvital.Thisis animportantindustryinitiativeand,thoughyou mayrunintochallenges,intheenditisallabout patientsafety.Thisisaneffectivewaythatwein thehealthcaresupplychaincanenhancethe qualityandreducethecostofcarefor patients. BaxtersBarbZennerexpectsthatthegreatest benefitsGLNcanprovidetosuppliersareinthe areasofreportingandrostermanagement,as wellastimesavingsassociatedwithtracingand chargebackprocesses.Forthebestresults earlyon,providersshouldstartsmallonly usingGLNsforshippinglocationsinitially. Hospitalsandsuppliersneedtotraintheirstaff onGLN,andavoidingerrantprocesses.Gone shouldbethedaysofsettinguponeoffaccount numbersbasedonaspecificdepartment (attentionline)inthehospital. BothZennerandWoosteragreedthatGLN implementationprovidesanopportunityto cleanseaccountinformationandestablishago forwardprocessformanagingtheGLNinaone toonerelationshipapproach.WhileBaxtercan accommodateGLNstodayinourcurrentsystem viaacrossreferencetableforaccountnumbers andGLNs,ourERPupgradewillincludeunique fieldsfortheGLNandfortheGTIN,promising morestreamlinedprocessesandaquicker recognitionofbenefits,saidZenner.

Keyexperiencetakeaways: Makesureyourrosterupdateprocessis robustandincludetheGLNonallRFPsto accelerateadoption. Waituntilyouhaveagoodunderstandingof GLNsandthehierarchybeforeassigning GLNstoeverydeliverylocation. Workwithyoursuppliers,yourMMIS/ERP vendorandyourecommerce/exchange providerasearlyaspossibletoensurethat yoursystemandpartnersarereadyto conducttransactions.

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Pairing3:MissionHospitalandOwens&Minor
OrganizationInformation

MissionHospital
Regionalleaderinadvancedmedical careforWesternNorthCarolina. www.missionhospitals.org

Owens&Minor
Leadingdistributorofmed/surg suppliestotheacutecare market.Leadingproviderof supplychainmanagement solutionswithannualrevenue ofover$7.2billion. www.owensminor.com SangChong,Enterprise Architect Customapplication(currently inprocessofbeingupgraded)

Sends/receivesordersviaEDIthrough GHXexchange ecommerce/EDIpartner.Thecomplexitieswill MissionHospitalwouldliketosimplifyits lessenandtherewardsincrease. electronicorderingprocessbyhavingone commonnumberforallofitsvendorsand Smithisnotwaitingforallthesystemstolineup suppliers.Ifavendorknowsmebyasingle beforegettinghisGLNsready.Itisextremely numbertoday,anaccountnumberthey importanttogetstarted,andidentifytheissues assigned,Iinitiallythoughtweshouldbeableto youwillencounter,andspendsometime simplychangethatnumbertomynewGLNand creatingsolutionsforthose,hesaid.Earlyin moveforward.Outsideofsystemfieldsize theprogram,Missionspenteighthoursaweek limitations,Iwasntsurewhyithadtobemore foraboutamonthontheGLNimplementation complicatedthanthat,Smithsaid. process,includingtimespentonbecoming Unfortunately,Missionwasnotsuccessfulin familiarwiththeGLNRegistry. placinganorderusingaGLNduringthecourseof WearereadytotransactwiththeGLN,our theGLNTransactionProgram.Smithdiscovered supplierpartnerO&Misready,andonceweget thatwhileitisimportanttokeepthingssimple,it ourissuesresolvedwithourMMISsoftwareand isalsoimportantnottooversimplify ourexchangepartner,itwonttakeuslongto expectationseithergiventhemultilayered getgoing. natureoftodayshealthcaresupplychain. MJWylie,DirectorofGlobalData GoingintothePremierGLNTransaction StandardizationforGHXreflects,Thisisanother Program,O&MsSangChongexpectedto: reasonastowhyitssoimportantto Testandgainexperienceinconfiguring communicateearlyandoftenamongall systemsandprocessingelectronicsales participants;supplier,MMISvendorandyour orderswithGLNs.

GLNTransactionProgram participants Relevantsystems information Transactionrelationship

PatSmith,MaterialsManager MMISisLawsonv.8.1.9.0

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SuccessfullyprocessEDIsusingGLNswith selectedpartners. IdentifyhowGLNscouldbeusedandwhat theinitialimplementationwouldrequire. EstablishthedefaultprocessforGLN transactionstobeusedwithothertrading partners. Bebetterequippedforthefull implementationtobereadyforthe December2010GLNSunrisedate.

i)

UpgradingproviderMMISsothatit cangeneratetheEDIsforGLNinthe correctformat ii) Involvingecommerce/exchange providersfromthebeginningto facilitatetheconversionservicefor theprovider.

WhileO&MandMissionhadsomedifficulties gettingthepilotsuccessfullycompleted,Chongis notdisappointed.Wewereabletocapture somelessonslearnedthatwillhelpinfuture implementations.MissionandO&Marealso continuingtoworktogethertoovercomethe hurdlesandworkouttheprocess,Chongsaid. Inaddition,O&Misintheprocessofupgrading itsbackendsystems.Expectedtobecompleted byJan.2011,thesystemwillaccommodateGLNs inEDItransactionswithO&Mcustomers. ForGLNpilots,Chongoutlinedthefollowing implementationsteps: 1) IdentifythetradingpartnertotesttheGLNs onsalestransactions. 2) Definescopetypicallylimitedtosalesorder EDIdocumentsandlimitednumberofGLNs. 3) TheproviderregistersGLNswithintheGLN RegistryforHealthcare. 4) TheproviderforwardstoO&Mthe conversiontablethatmatchesthelegacy accountshiptocodestothenewGLNs. 5) Thecrossreferencedataisenteredto O&MspilottableforGLNs. 6) SalesEDI(850)istested. a) Ifissuesoccur,ensurethefollowing optionswereconsideredandaccounted foraccordingly:

GLNimplementationisdoablebytheSunrise dateforDec.2010.Nooneneedwaituntil everythingisperfectorlinedup.Getstarted, identifyyouropportunitiesandchallenges,and youllsoonbeonyourwaytomorestreamlined supplychaininteractions,Chongsaid. Keyexperiencetakeaways: Getinvolvedwithworkgroupsand conferencestolearnaboutthebenefitsof usingGLNs StartsmalluseGLNsonsalesEDIs,and startwithafewGLNsattheshiptolevel. Involveallpartiesearlytogettheprocess clearlydefined.

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Lessons Learned
Acrosstheboard,participantsexperienced benefitsfromthestepstheytooktopreparefor GLNtransactions,regardlessofwhetheran actualtransactiontookplace.Amongthe lessonslearned:

implementationwithagoodsupplierpartner willhelpinidentifyingchallengesand solutionsinusingtheGLN.

Participantsagreedthatimplementingthe GLNiscompletelyachievablewithina reasonabletimeframe.

Participantsfoundthattheworkrequiredto supportGLNimplementationislargely frontloaded.Attheverybeginningofthe process,theseprovidersspentroughlyeight totenhourstogetGLNscleansedand reconciledwithPremier,aswellas communicatedandmatchedwithsupplier accountnumbers.OnceaGLNmaintenance processisinplace,providersfoundthat approximatelytwohoursaweekneedstobe dedicatedtotheeffort.

Participantsfeltstronglythathospitals shoulddriveGLNimplementationwith supplierpartners.Inmostcases,suppliers willcomplywithcustomerrequestsand collaboratetofigureouthowtoovercome implementationchallenges.

Despitethefactthat2ofthe3pairingswere unabletocompleteatransaction,providers feltthattheexerciseinpreparingforGLN implementationwasvaluableand important,andoverwhelminglyfeltthat theywerereadytogo.

Allparticipantsfeltthatprovidersshould startsmallandbasicworkonLevel1inthe GLNRegistry(parentorganizations)and establishthecorrectshiptolocations.

Allparticipantsfeltthatprovidersshouldget startedwithGLNimplementationrightaway. Bydoingso,themystiqueinvolvedwith GLNswillbecomemanageable.Oneofthe biggestbarriersidentifiedissimplythe unknown,whichquicklydisappearsonce theprocessisstarted.

Providersalsoagreedthatestablishinga processformaintainingGLNinformationin theRegistryisextremelyimportant.GLN maintenanceneedstobecomearoutine businessprocessandsecondnatureto ensurelongtermsuccess.

Participantsfeltthattherewasnoreasonto waitonGLNimplementation.Evenifa provideriswaitingforasystemsupgrade,or desirestoultimatelyhaveallhospital deliverylocationsenumeratedwithGLNs, implementationcanandshouldoccurina phasedapproach.

Providersalsofeltthatselectingastrong, customerorientedsupplierpartnerforthe initialGLNimplementationisimportant.As GLNexpertiseisnotestablishedin healthcare,thereisafeelingofwereallin thistogether,andstartingtheGLN

Stayeducatedandgetinvolvedin workgroupsandusergroupssponsoredby GS1USandotherindustryorganizations.

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 Conclusion

Healthcareprovidersandsuppliersshouldbeginpreparingforthe2010GLNSunrisenow. ThroughtheuseoftheGLN,criticallinkagesinthesupplychaincanbeclearlyidentified anduniversallynumbered.TheGLNwillenhancethehealthcareindustrysabilitytoensure therightproductgetstotherightplaceattherighttime.WiththeGLNSunriseonthe horizon,thePremiermemberhospitalsinvolvedintheinitialphaseofthePremierGLN TransactionProgramwillcontinuetobuildupontheexperiencesandlessonslearned. PremierisexpandingitsGLNTransactionProgramtoincludeadditionalmemberand supplierpartnerpairings.

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 AboutPremier ThePremierhealthcareallianceismorethan2,300U.S.hospitalsand66,000plusotherhealthcaresites workingtogethertoimprovehealthcarequalityandaffordability.Ownedbynotforprofithospitals, Premiermaintainsthenation'smostcomprehensiverepositoryofclinical,financialandoutcomes informationandoperatesaleadinghealthcarepurchasingnetwork.Aworldleaderinhelpingdeliver measurableimprovementsincare,PremierworkswiththeCentersforMedicare&MedicaidServices andtheUnitedKingdom'sNationalHealthServiceNorthWesttoimprovehospitalperformance. HeadquarteredinCharlotte,N.C.,PremieralsohasofficesinSanDiego,PhiladelphiaandWashington. AboutthePremierGLNTransactionProgram Participants AuroraHealthCareisanotforprofitWisconsin healthcareproviderandanationallyrecognized leaderineffortstoimprovethequalityofhealth care.Auroraoffersservicesatsitesinmorethan 90communitiesthroughouteasternWisconsin. http://www.aurorahealthcare.org. BaxterInternationalInc.,throughits subsidiaries,develops,manufacturesand marketsproductsthatsaveandsustainthelives ofpeoplewithhemophilia,immunedisorders, infectiousdiseases,kidneydisease,trauma,and otherchronicandacutemedicalconditions.Asa global,diversifiedhealthcarecompany,Baxter appliesauniquecombinationofexpertisein medicaldevices,pharmaceuticalsand biotechnologytocreateproductsthatadvance patientcareworldwide. www.sustainability.baxter.com GeisingerHealthSystem(Danville,PA),founded in1915,isoneofthenationslargestintegrated healthservicesorganizations.Servingmorethan twomillionresidentsthroughoutcentraland northeasternPennsylvania,thephysicianled organizationisattheforefrontofthecountry's rapidlyemergingelectronichealthrecords movement.Geisingeriscomprisedofthree medicalcentercampuses,a700membergroup practice,anotforprofithealthinsurance companyandtheCenterforHealthResearch dedicatedtocreatinginnovativenewmodelsfor patientcare,satisfactionandclinicaloutcomes. Formoreinformation,visitwww.geisinger.org. GlobalHealthcareExchange,LLC(GHX)enables healthcareprovidersandsuppliersinNorth AmericaandEuropetoreducecostsand improvemarginsbyautomatingprocesses, reducingoperatingexpensesandincreasing knowledgebaseddecisionmaking.Productsand servicesincludetradingpartnerconnectivity, orderandcontractmanagementandvalidation, datasynchronization,salesforceautomationand businessintelligence.EquityownersofGHXare AbbottExchange,Inc.;AmerisourceBergen Corp.;BaxterHealthcareCorp.;B.BraunMedical Inc.;Becton,Dickinson&Co.;BostonScientific Corp.;CardinalHealth,Inc.;Covidien;C.R.Bard, Inc.;FisherScientificInternational,Inc.;GE Healthcare;HCA;Johnson&JohnsonHealthCare SystemsInc.;McKessonCorp.;MedtronicUSA, Inc.;Owens&Minor;Premier,Inc.;Siemens; UniversityHealthSystemConsortium;andVHA Inc.Formoreinformation,visitwww.ghx.com.

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MedlineIndustries,thenation'slargest privatelyheldmanufactureranddistributorof healthcareproducts,manufacturesand distributesmorethan100,000productsto hospitals,extendedcarefacilities,surgery centers,homecaredealersandagenciesand othermarkets.HeadquarteredinMundelein, IL,Medlinehasmorethan800dedicatedsales representativesnationwidetosupportits broadproductlineandcostmanagement services.Overthepastfiveyears,Medlinehas beenthefastestgrowingdistributorofmedical andsurgicalsuppliesintheU.S.,servingasthe primarydistributortoover450majorhospitals andhealthcaresystems.Asaleading distributor,Medlineoffersacomprehensive arrayofconsultingandmanagementservices encompassingthesupplychainandlogistics, utilizationandstandardization,businesstools andenhancedreportingcapabilities,andon staffclinicians.http://medline.com/ MissionHospitalistheregionalreferralcenter forWesternNorthCarolinaandtheadjoining regionandisaccreditedbyTheJoint Commission.MissionHospital,anotforprofit, independentcommunityhospitalsystembased inAsheville,NC,wasformedwhenSt.Joseph's HospitalandMemorialMissionMedical Centerstartedanorganizationalpartnershipin 1996.Thispartnershipwasfollowedbyafull mergeronOctober27,1998,whenSt.Joseph's HospitalwaspurchasedfromtheSistersof MercybyMemorialMissionMedicalCenter. TodaythesehospitalsarepartoftheMission HealthSystem. http://www.missionhospitals.org/.

Owens&Minor,aFORTUNE500company headquarteredinRichmond,Virginia,isthe leadingdistributorofmedicalandsurgical suppliestotheacutecaremarketandaleading providerofhealthcaresupplychain managementsolutionswiththeannualrevenue ofover$7.2billion.Owens&Minoroffersafull, integratedsuiteofsupplychainmanagement servicesforsustainablesolutionsfromoriginof producttodeliverytopatientbedside. www.owensminor.com.

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