07/10/2017 : 0 Comments
The Significance of Diversion in Health Care:
Numerous investigations and studies have found that roughly 10% of U.S. Health Care Workers (HCW) abuse controlled substances, a rate that matches abuse within the U.S. population. The latest data released in 2007 by the U.S. Substance Abuse and Mental Health Services Administration estimated that an average of 103,000 doctors, nurses, medical technicians and health care aides a year were abusing or dependent on drugs. Most drug diversion by HCWs is not discovered, and when it is discovered it is often not reported or prosecuted. Precise data on drug diversion in individual hospitals is difficult to obtain, due to the clandestine nature of diversion, as well as the culture in place in many health care institutions that leave diversion undiscovered and unreported.
The estimated cost of just Controlled Substance drug diversion and abuse to public and private medical insurers is $72.5 billion a year, much of which is passed to consumers through higher health insurance premiums. (National Drug Intelligence Center, 2009) The overall economic cost of drug abuse in the United States is estimated at $193 billion in 2007 (Office of National Drug Control Policy, 2016).
Drug diversion is a significant crime with multiple-victims – patients, HCWs, hospitals, and communities:
- For patients, diversion can lead to them receiving substandard care from an addicted HCW whose job function is impaired by drugs. The HCW might also divert prescribed pain medication away from patients who require them. Also, there have been multiple documented cases of diverting HCWs infecting dozens of patients with Hepatitis, HIV, or other blood-borne infections when the HCW uses a shared syringe to divert the drug.
- For HCWs, nearly every hospital has employed people who became addicted to a drug, and many facilities have dealt with the overdose death of a HCW, often on hospital premises. Beyond general risks to health, drug diversion often ends with civil malpractice actions, loss of professional licenses, and/or felony criminal prosecution for theft and fraud. Annually, hundreds of HCW forfeit their training and medical license following diversion and subsequent addiction.
- For hospitals: there is significant financial damage when drug diversion occurs. Stolen drugs must be replaced without reimbursement, with additional costs due to absenteeism and turnover by addicted HCWs. When drug diversion stories hit the press, hospitals see millions of dollars in lost revenue and fines. For example, Massachusetts General Hospital paid a $2.3 million settlement to the DEA when its employees stole thousands of pain pills. These stories also damage to the hospital’s reputation in the community and harm employee morale. In cases where HCWs have entered falsified administration data and payers were charged for diverted drugs, these fines can involve the False Claims Act or Medicaid fraud, with triple damages.
- For communities fighting drug abuse: HCWs could divert drugs for personal use or provide for others. In 2014, a review of more than 200 prosecutions since 2008 for drug diversion by HCWs discovered just 15% of the prosecuted HCWs were stealing drugs for personal use. Shockingly, many of the involved doctors, nurses and other HCWs were diverting on a large scale, for profit, sending thousands of unprescribed pills to drug abusers in the community.
Problems with Current Methods to Detect Drug Diversion:
Current approaches to preventing drug diversion in hospitals include three complementary techniques:
- 89% of US hospitals lock-up narcotics and other addictive drugs in Automated Dispensing Machines (ADM) like Pyxis and Omnicell machines.
- Most hospitals run “Anomalous Usage” reports that compile ADM data to flag HCWs with unusually high Controlled Substance usage, using commercial off the shelf software (COTS) like Pandora or RxAuditor. Unfortunately, these reports contain significant errors, both Type II “false negative” errors, in that they fail to detect actual drug diversion cases, as well as Type I “false positive” errors, in that the reports flag normal events as possible drug diversion. In short, Type II false negatives let diverters get away, while Type I false positives rob hospital staff and supervision of precious time investigating innocent people. Hospitals typically set an arbitrary threshold of 2-3 standard deviations to define “anomalous” usage, and this arbitrary approach guarantees 0.3-4.5% of HCWs are flagged as potential diverters, most of which is Type I error.
- Many hospitals implement Controlled Substance Diversion Prevention Programs (CSDDP) to limit diversion, with investigation teams, training, and other administrative approaches.
Despite these activities and the investment of significant time and money, drug diversion continues. Leading healthcare institutions admit that new approaches are required. Recognizing the ongoing problem, the American Society of Health-System Pharmacists (ASHP) has updated Controlled Substance procedures for all hospitals. Hospitals broadly agree that current methods to detect drug diversion have two main weaknesses:
- Data in the ADM only show part of the equation: the dispensing of the drug from the locked cabinet. Detecting diversion also requires drug administration data in the Electronic Medical Record (EMR), as well as data from other systems such as Wholesaler Purchasing Systems, Internal Inventory System(s), or Employee Time Clocks.
- Motivated diverters can game the system with falsified data entries to avoid detection. Moreover, historical anomalous usage reports contain so many “false positives” that overworked supervisors must comb through haystacks of false positives to find true diversion. More advanced algorithms are required to reliably detect diversion without excessive false alarms.
Recognizing these two weaknesses, Invistics is working with the support of the National Institute of Health to develop a solution that can fill the gaps in current Drug Diversion technology with the goal of improving patient and health care worker safety.
Invistics would love to learn more about how we can help your health care system. Call us at 1800-601-3456 to schedule a call or visit our Health Care page to learn more about the Flowlytics solution in Healthcare.
06/28/2017 : 0 Comments
The Life Science industry has a set of unique set of supply chain challenges that add additional complexity for management. In our company experience the following are all “pain” points for managing a successful supply chain at a pharmaceutical company:
- High-Mix of Products – Pharmaceutical companies tend to have thousands of products with many factors such as packaging, languages, dosage forms, and more that add to the complexity of managing a long tail of inventory in the supply chain.
- Compliance Regulations – Due to Drug Enforcement Agency (DEA) regulations over Controlled Substance, Pharmaceutical Companies are required to strictly monitor their drug inventory and ensure their data is “readily retrievable” in the event of an audit.
- Expiration Challenges – Expensive drugs expiring before use is a huge challenge for companies managing pharmaceuticals.
- Mergers and Acquisitions – Due to the competitive nature of the industry, mergers and acquisitions are very common in Life Sciences. The result is a multitude of disparate computer systems that manage their inventory in different ways, and lack the holistic end-to-end visibility of a complete supply chain.
Alexa Cheater, of Kinaxis’ 21st century Supply Chain blog, wrote a great article detailing a list of 8 challenges that Life Science companies deal with in regards to Supply Chain Management:
Lack of robust sales and operations planning (S&OP) tools
Traditional S&OP tools don’t always account for the specific needs of the life sciences supply chain. S&OP in this space requires volume level planning at multiple hierarchies and provide mix level detail including material and capacity constraints at the site and SKU level.
Solution: Implement an S&OP tool that provides easy balancing of supply and demand at multiple levels of aggregation. Planning functionality should include multiple time dimensions with real-time analysis, and give you the ability for robust scenario simulation to evaluate options.
Tenders, trade promotions and new product introductions
It can be hard to manage these types of demands considering they often don’t exist in legacy ERPs. Given approximately 80% of profit from new products comes during launch, this is a crippling obstacle for many.
Solution: Find a way to get that critical data into your ERPs. Supply chain management software exists providing just such a capability. You’ll also need the ability to model the probability of demand for tenders and trade promotions, including probabilities and priority-assignment. Modelling NPIs as pseudo parts (with their own pseudo demand and bill structures) provides much-needed visibility and analysis to projected fulfillment, revenue, capacity and material availability.
You can only satisfy demands with supplies meeting specific characteristics
Expiry dates, stop-sell dates and batch numbers – you have to account for all of these special attributes when looking at your supply. You may think you’re able to fulfill demand, only to discover you don’t have enough products meeting the expiry date requirements to actually deliver. That’s not a great way to improve customer satisfaction levels, and can lead to greater amounts of excess or obsolete inventory.
Solution: Enable special supply and demand allotment based on these unique parameters and make sure you factor them in when calculating available demand. It’s even better if your technology solution can handle all this automatically, including providing projected excess.
Expiry dates are associated with specific SKUs
With thousands of SKUs all with individual SKU and batch expiry dates, the odds of those items expiring on warehouse shelves becomes a real concern. It directly impacts availability and inventory excess. Not to mention what it does to your inventory risk and bottom line.
Solution: Calculate projected expiry at multiple levels when planning. And don’t forget to consider inherited expiry from lower level supplies. When a batch of products does expire, make sure to stop considering the quantity as viable and plan for new supply to meet future demand. Your best plan of action is to monitor product expiry by country and affiliate-specific criteria related to allowable shelf life, and set up a system of alerts before expected expiry dates, so you can take action before the item is no longer usable.
Multiple production line setups often result in poor equipment utilization and way more inventory than you need at any point in time. It’s inefficient, costly and not a great way to run your operations if you want to stay profitable for long.
Solution: Make sure you connect production of the same material when executing through batches. This will help reduce the number of setups and make your production line more effective in the long run.
Transition dates are assigned for SKUs
That means if regulatory approvals are delayed or expedited, the change in dates affects supply and demand.
Solution: You should model transition dates to work to determine what materials you need to produce to account for the change (including lower level materials).
Increased outside pressures
As with any business, there are often outside pressures that have a big impact inside your operations, and those working in life sciences aren’t exempt. Things like shifts in regulations and changes in approvals are beyond your control. As are patent cliffs, which can have a monumental effect on your revenue streams as competitors get license to sell the same products.
Solution: Make sure you thoroughly evaluate supply chain risk and have all available information before making any decisions. Simulate scenarios and evaluate impacts across the entire supply chain, but ensure you compare the results against key performance indicators so you know exactly where you’ll need to make any tradeoffs.
It can be difficult to manage lot traceability across all levels of your supply chain, including aligning supply to upstream work orders. Without that alignment, you risk not having full visibility into who supplied what and where it ended up. This becomes vital for accountability and in case of recall.
Solution: Connecting your end-to-end supply chain within a single system will help you alleviate this issue. You’ll be able to plan packaging work orders split from different bulk locations based on quota arrangements and create work orders from bulk locations based on products’ batch sizes. That way you’ll always have clear visibility into your supply chain operations.
Invistics has 20 years of experience serving the Life Science industry. We understand the unique challenges of a pharmaceutical supply chain and build a solution to tackle them. Download our Case Study of Shire and Patheon and learn how we can help.
Inventory Optimization for Measuring and Test Equipment (M&TE) - Post IV – Getting trained on the effective use of the Invistics software
05/30/2017 : 0 Comments
This is the fourth in a series of blog posts that documents the journey of a large electric utility in its quest to optimizing its extensive inventory of measuring and test equipment (M&TE). In the first three posts we talked about identifying the problem and finding a solution provider.
This is the fourth in a series of blog posts that documents the journey of a large electric utility in its quest to optimizing its extensive inventory of measuring and test equipment (M&TE). In the first three blog posts we talked about identifying the problem, finding a solution provider, and contracting and setting up the project.
With a contract in place, and all our IT department’s questions quickly addressed, we were eager to start using the software and obtaining some results. As with all other aspects of the project, Invistics had a proposed plan for how to best prepare us to get the maximum benefit from the software through a systematic approach to training.
The training consisted of essentially 3 simple phases; software familiarization, data manipulation and analysis, and process optimization. With each phase Invistics guided us through the process using written instructions, demonstrations, hands-on exercises, and focused coaching.
The first step was to help us become familiar with the software’s features in which we were primarily interested (i.e. Inventory Advisor and Report Manager) and how to submit data for up-load and pre-processing. This focus was important as the Flowlytics software suite has extensive capabilities, and while all were available to us, we were primarily interested in the Inventory Advisor analytics and reporting features. Based on our initial cost benefit analysis, use of these modules alone should more than justify the subscription cost.
The training started with written guidance from Invistics that included step-by-step instructions on how to perform the basics of accessing the on-line software and uploading and viewing the data. These instructions were accompanied by a series of webex meetings that Invistics set up. The project manager and the lead technical specialist assigned to our project conducted the webex meetings and demonstrated what they had described in the written instructions and then let us practice on-line while they monitored our progress. Their technique in coaching was effective as they didn’t just jump in and correct us when we went down the wrong path. Instead they asked guiding questions related to what we were experiencing versus our expectations, which helped us figure out on our own how we could get back on track.
The software was intuitive, but as when using any new product, even with clear instructions, there are inevitably questions. This is where Invistics customer support really shined. Any time we had a question they were never more than and e-mail or phone call away. And it wasn’t the typical “help” line many of us have experienced in the past. This was direct contact with the project manager or the technical specialist assigned to our project. Phone calls were answered in person and e-mails were responded to promptly (typically within a few hours if not in minutes). It almost felt like we were their only customer.
The next phase involved becoming proficient in data manipulation and analysis. For this phase the training was on-site at our facility. We were a little surprised to see that Invistics not only had the project manager and technical specialist support the training, but also the president of Invistics and the sales representative we had worked with during the initial request for quote and contract phase. What we found was having these others in the training proved to be very valuable and was very much a part of Invistics’ customer focused approach to support.
During the on-site training the technical specialist led us step-by-step through how to manipulate the data and get different reports and graphical outputs. Going in we felt we knew exactly what we wanted from the software, but it quickly became apparent that we had not fully anticipated its flexibility or ability to parse and analyze the data. This is where having the others from Invistics present was helpful. They were able to give us insights into how others had leveraged the software and make suggestions on different ways we might want to look at the data. One suggestion in particular stood out. We were planning on analyzing M&TE based strictly on unique manufacturer/model numbers. The president of Invistics posed the questions regarding items that had the same functionality, yet had different manufacturer/model numbers and if we had thought about analyzing them collectively (e.g. one inch micrometers made by different companies – functionally the same, but under our method would be analyzed discretely). The solution he helped us discover was based on Invistics’ extensive experience in other industries and involved creating functional “SKUs” that could be applied to similar M&TE.
The other benefit from this intensive on-site training, where we worked through actual scenarios using our own data was, at the end of the day, we had identified specific M&TE where we could reduce inventory and start implementing savings immediately. Again, this is where Invistics proved to be more than a provider of software. They were a solution provider. They not only helped us get meaningful results in the short term, they also challenged us to establish specific measurable milestones to ensure we continued to obtain meaningful savings. At the end of the on-site training we felt fully prepared to start tackling additional manufacturer/models (and combined SKUs).
The following week, as we started identifying additional items for analysis, we realized that the data in our database was not as clean as it should be. We had differing spellings, descriptions, and model numbers for identical items. While some clean up was inevitable, a complete scrub of the data up-front would slow down our progress considerably. When we explained our situation to Invistics they showed us how their pre-processing routines for data was robust enough to deal with much of the minor discrepancies and how we could easily address other items so as not to slow down our progress.
With these issues resolved we quickly went back to uploading data and pulling results. During each of these initial uploads the technical special at Invistics was monitoring and providing suggestions on how we might simplify work on our end by leveraging the capabilities of their software. Any questions we had were immediately responded to as we worked as a team to streamline the process. After a couple of additional iterations we became very comfortable uploading data, using the analytics, outputting graphic and tabular data, and utilizing the results to make preliminary decisions on specific adjustments to the inventory. It quickly became apparent that the savings we were identifying, just during the training phase, would more than justify the subscription cost.
In part V of this blog we will share how the Invistics software allowed us to communicate clearly with our customers and provide them with information in a format that they could relate to, and made it easy for them to embrace the proposed solutions.
04/09/2017 : 0 Comments
The Invistics team will be attending the following upcoming events for Controlled Substance Compliance in 2017. We’ll be there to learn as much as possible about the latest news and technology in the industry.
Come say hi! We welcome a chance to make introductions and to discuss our inventory tracking & reporting solutions for CS Compliance.
20th Annual Controlled Substance and State Regulatory Conference
Description: Join us on April 26-28, 2017 at the Caribe Royale Hotel and Convention Center, Orlando, Florida for the 20th Annual Controlled Substance and State Regulatory Conference. The conference will include general sessions, breakout sessions and interactive roundtables hosted by industry leaders, regulatory experts and law firms. As in years past the conference will focus on the latest regulatory challenges and concerns to the industry and provide you with the most useful and up to date information available.
Address: 8101 World Center Dr, Orlando, FL 32821
NADDI 2017 National Conference
Description: The National Association of Drug Diversion Investigators present our 28th Annual Conference from October 17-20 2017 at the Wyndham Grand Downtown in Pittsburgh, PA. This is the national NADDI conference partnering with Law Enforcement, Anti-Drug Community Coalitions, Healthcare Facilities & Pharma.
Address: 600 Commonwealth Pl, Pittsburgh, Pennsylvania, 15222, United States
NASCSA 2017 Conference
Description: The National Association of State Controlled Substance Authorities 2017 annual conference will be held from Oct 17-20th 2017 at the Drury Plaza Hotel in San Antonio, TX. This is the national NASCSA conference for the exchange of ideas, information, and views on legal and regulatory issues relating to controlled substances.
Address: 105 South Saint Mary’s Street, San Antonio, TX 78205
Inventory Optimization for Measuring and Test Equipment (M&TE) - Working with the Vendor to Setup a Project
03/29/2017 : 0 Comments
This is the third in a series of blog posts that documents the journey of a large electric utility in its quest to optimizing its extensive inventory of measuring and test equipment (M&TE). In the first two posts we talked about identifying the problem and finding a solution provider.
The problem, simply stated, was how do we optimize the inventory of measuring and test equipment we support as part of an overall cost saving initiative. We needed to reduce excesses where possible while ensuring required availability when needed. With a clearly stated problem and the available tools we had at hand we realized a viable solution would ultimately involve use of vendor provided analytical software tools.
With Invistics selected as the preferred provider of that software solution, as described in the second blog post, we needed to work out contractual terms, set up the interfaces between our data and Invistics’ solution, and learn how to use the tools to help us optimize our inventory.
The contracting process for a publicly traded electric utility that operates in a regulated market can often seem burdensome due to the regulatory requirements. Our contracts, especially for software, tend to have volumes of fine print to ensure we meet all our regulatory obligations and commercial responsibilities. Having previously managed a group at another company that provided software, I knew the challenges vendors with software solutions have in protecting their investment and their need for contractual controls over the use of their software. With these potentially conflicting interests, I did not look forward to this part of the project.
I was pleasantly surprised that Invistics was able to work directly with our contracts group and come to mutually agreeable commercial terms in very short order. Within days of selecting Invistics, they and our contracts group exchanged respective standard terms and conditions. Where there were potential conflicts these were noted and then with just a few short e-mails and phone call exchanges they were all worked out. Within a week or so a basic contract was in place and ready to go.
That’s when our IT department stepped in. Because the contract involved software-as-a-service (i.e. operating in the cloud), and because cyber security was becoming ever more of a concern for electric utilities, the IT department required additional information as to the how Invistics managed their software and its security. Again having previous experience working with other vendors I realized that it might take weeks if not months for the vendor to answer all the questions, and the follow up questions, our IT department would have.
Again I was pleasantly surprised. Invistics’ chief technology officer was able to provide all the requested information in just a few days. As the response was so complete and showed robust security controls on the part of Invistics, our IT group had only a few follow up questions, which again, Invistics’ chief technology officer was able to answer within a day or so. So we were set to go.
This is where it always gets interesting. You know the routine. The salesman on the car lot never leaves your side, they are there to answer all the questions, they seemingly can’t be too helpful. In fact, you couldn’t get rid of them if you wanted to. That is until you complete the sales paperwork. Then you have a hard time getting them to return even a phone call. So now that Invistics had the contract, how responsive would they be?
This is where I think Invistics separates itself from many other providers; customer service and interface. As soon as the contract was in place we got a call from Invistics setting up an initial consultation on how they could best assist us in getting up and running. We set a date for a webex meeting. On that call Invistics started by asking us about how we wanted to proceed, any limitations we had, what resources we would be assigning, and what timeline expectations we had. After carefully listening, they then laid out a game plan based on that input for getting us access to their software and getting us trained.
An obviously very experienced project manager had been assigned to our project and facilitated that meeting. While very much a take-charge person, she was good about stopping and drawing us out when she sensed we might not have fully understood some point of discussion, or when she sensed we might have an unspoken concern. While I felt we were in very good hands with the assigned project manager, I was also pleased that the salesman was part of that meeting as well as the chief technology officer, and the president of the company. Not sure if we are just that special or if the president routinely attends these kick off meetings, but we certainly felt like a valued customer.
Within days of that call Invistics had set us up within their system, provided us with the necessary links to their software, and set up those of us who would be accessing the software with login IDs and passwords. We now had secure access to the software and were ready to go. Well almost.
After poking around the software, which we were assured we couldn’t break, we realized that while the interfaces were simple and straight-forward we would need some training. Fortunately, as part of the initial webex meeting, training was discussed and a tentative schedule had already been agreed upon. Quite frankly the speed at which all this happened took us somewhat by surprise. Because we assumed getting to this point might take months, instead of just a couple of short weeks, we needed to scramble on our end to get our ducks in a row, as Invistics was obviously prepared to help us fast track this project.
In part IV of this blog we will share how Invistics set up and went about training us on the best use of their software.
03/29/2017 : 0 Comments
According to a new report by CNBC:
Americans are in more pain than any other population around the world. At least, that’s the conclusion that can be drawn from one startling number from recent years: Approximately 80 percent of the global opioid supply is consumed in the United States.
Pain drugs are the second-largest pharmaceutical class globally, after cancer medicines. “There was about 300 million pain prescriptions written in 2015,” Irina Koffler, senior analyst, specialty pharma, Mizuho Securities USA, told CNBC.
The 300 million pain prescriptions equal a $24 billion market, Koffler said, but it’s not a market evenly divided around the globe. Rampant use of opioids in the United States, which represents only 5 percent of the global population, points to a larger divide between affluent nations and the rest of the world when it comes to prescription painkillers.
“If you include Canada and Western Europe, [consumption of global opioid supply] increases to 95 percent, so the remaining countries only have access to about 5 percent of the opioid supply,” said Vikesh Singh, assistant professor of medicine and director of the Pancreatitis Center at Johns Hopkins University.
The opioid epidemic is deeply entrenched in an American culture that relies on the various manufactured opioids for pain relief. Invistics is dedicated to working with all links in the Drug Supply Chain starting from quota procurement in manufacturing, to research & development, and distribution to track and maintain the inventory of opioids and other controlled substances are being widely produced and distributed in our country.
See see our web-based software solutions can help: http://www.invistics.com/flowlytics-overview/for-dea-compliance/
03/28/2017 : 0 Comments
In queueing theory, Kingman’s formula states that the mean waiting time is given by:
AQT = Average Queue Time.
p = Utilization, expressed as decimal
Ca2 + Cs2 = arrival and process coefficient of variations.
τ = average process time
So what are the practical, manufacturing take-aways?
- The longer the average process time is, the more important is the queue length. For example a process that takes a minute, with a queue of 5, is much better than a process that takes an hour with a queue of 5
- Utilization is king. If utilization is low (~50% or less), arrival variation and process variation will have a small impact. If utilization is high (80% or higher), arrival and process variation will matter much more.
- service, and assembly, extra capacity may not be as expensive compared to it’s manufacturing counterparts. This is because it is easy to move/add employees between functions.
- Since many service processes are longer than manufacturing processes, variation is generally more tolerable in service than in manufacturing. In other words, it is generally much more effective to focus on reducing failure demand than variation when it comes to service organizations.
- Reducing time variation is generally less critical than reducing utilization. Utilization is affected by errors which generate failure demand or rework.
- Arrival variation should not be ignored. It is just as important as process variation. Can your arrival variation be influenced through salesmen, incentives, informing customers or reducing supply chain amplifications?
- The work release behavior of processes upstream of bottleneck is important. The smoother (less lumpy) the orders come in at those work stations, the faster the bottleneck will process the orders.
Additionally, the Theory of Constraint advocates 5 steps of improvement: identify, exploit, subordinate, elevate, and repeat. Kingman’s equations gives these additional insights:
-To identify the constraint (bottleneck), it is easier to examine only the load and compare it with demonstrated capacity. Kingman shows that overload begins at less than 100% utilization, and that sensitivity variations is particularly important at high utilization.
-Exploiting constraints should include variation reduction in addition to other methods such as buffering with Inventory.
-Subordinating other resources should include looking upstream of the constraint to examine arrival variation coming into the bottleneck.
Kingman’s equation ties together Lean, 6 Sigma, TOC, and service systems to show that there’s not a one-size fit all when it comes to adding value to your operations. The key is in knowing when to apply each school of thought.
(Be sure to check out John Bicheno’s “The King of Equations” in the Lean Manufacturing Journal for more information and tips related to Kingman’s equation).
03/03/2017 : 0 Comments
The Center for Disease Control, in it’s most recently updated Data Brief, listed the following as key findings:
- The age-adjusted rate of drug overdose deaths in the United States in 2015 (16.3 per 100,000) was more than 2.5 times the rate in 1999 (6.1).
- Drug overdose death rates increased for all age groups, with the greatest percentage increase among adults aged 55–64 (from 4.2 per 100,000 in 1999 to 21.8 in 2015). In 2015, adults aged 45–54 had the highest rate (30.0).
- In 2015, the age-adjusted rate of drug overdose deaths among non-Hispanic white persons (21.1 per 100,000) was nearly 3.5 times the rate in 1999 (6.2).
- The four states with the highest age-adjusted drug overdose death rates in 2015 were West Virginia (41.5), New Hampshire (34.3), Kentucky (29.9), and Ohio (29.9).
- In 2015, the percentage of drug overdose deaths involving heroin (25%) was triple the percentage in 2010 (8%).
- Deaths from drug overdose involving heroin tripled from 8% in 2010 to 25% in 2015 (Figure 5).
- For drug overdose deaths involving natural and semisynthetic opioid analgesics, which include drugs such as oxycodone and hydrocodone, the percentage decreased from 29% in 2010 to 24% in 2015.
- The percentage of drug overdose deaths involving methadone also decreased, from 12% in 2010 to 6% in 2015.
- For drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl and tramadol, the percentage increased from 8% in 2010 to 18% in 2015.
- The percentage of drug overdose deaths involving cocaine increased from 11% in 2010 to 13% in 2015.
- Drug overdose deaths involving psychostimulants with abuse potential, which include drugs such as methamphetamine, increased from 5% in 2010 to 11% in 2015.
While the growth of traditional opioid abuse seems to have slowed down, the data shows that more and more people who are abusing drugs are switching to street drugs such as Heroine or synthetic opioids such as Fentayl.
See how Invistics’ Flowlytics software suite can help Pharmaceutical Registrants handle the tracking and electronic monitoring of their Controlled Substances with visual dashboards and configurable reporting.
03/02/2017 : 0 Comments
Our last blog post provided a general summary of Kingsman’s Equation and how it relates to your manufacturing operation. Today we’re going to delve a little deeper into the equation to prove that when it comes to lowering the Average Queue Time (or Average Wait Time) of your resources, Utilization is King.
For every system whether it’s a single machine or an entire factory, the time a resource spends as raw material or work-in-progress can be divided into two parts.
- -Process Time. This is value-added time it takes per machine or machines to process the resource and churn out a finished product.
- -Queue/Wait Time. This is non-value added time the resources are set aside to wait at the queue of machine or bottleneck, on a machine’s setup, etc
Lead Time = Queue Time + Process Time. In most manufacturing systems, the Queue time can comprise 80-85% of the lead time. This is all non-value added time that should be reduced in order to maintain a Lean operation.
Now let’s take another look at Kingsman’s equation:
AQT = Average Queue Time.
p = Utilization, expressed as decimal
Ca2 + Cs2 = arrival and process coefficient of variations.
τ = average process time
so what does this mean exactly? First let’s look at some examples where utilization(p) is at .25, .5, .7, .9, and .99. For these examples, we’ll just assume: (Ca2 + Cs2)/2 = 1 and process time(τ) = 60 minutes.
Case 1: If p = .25, Average Queue Time (AVQ) = (.25/(1-.25) * 60 = 20 mins
Case 2: If p = .5, Average Queue Time (AVQ) = (.5/(1-.5) * 60 = 60 mins
Case 3: If p = .7, Average Queue Time (AVQ) = (.7/(1-.7) * 60 = 140 mins
Case 4: If p = .9, Average Queue Time (AVQ) = (.9/(1-.9) * 60 = 520 mins
Case 5: If p = .99, Average Queue Time (AVQ) = (.99/(1-.99) * 60 = 5940 mins or 99 hours
In this example since (Ca2 + Cs2)/2 = 1, the STDEV of the respective variables would have to equal the mean to get 1. While such high variability does exist in the real world, it’s not very common. But regardless, this example is enough to illustrate two very important take-aways.
1.) Despite such high variability in both arrival and process times. If the utilization of the machine(s) is low, as it is in case 1 or case 2, the Average Queue Time is still manageable. This is because in terms of reducing your AQT, machine utilization is by far the most important factor.
2.) As you can see from the exponential increases in AQT over the cases, it is very, very wasteful to run your machines at such high utilization because your Average Queue Time goes through the roof. Can you imagine an 99 hour Average Queue Time for each of your products? And the screeching of your customers or sales reps? No thanks.
One final thing I should note is that the AQT in Kingsman is not the exact AQT, but more of a likely upper bound of your real AQT. Though it’s accurate enough to get the point across.
01/31/2017 : 0 Comments
The Wall Street Journal published an article summarizing how one company, Inditex, is beating the competition with speed:
The company’s ability to respond quickly to customer taste has long been the subject of industry study. Now its American rivals are emulating some of the short cuts that have helped Inditex expand to more than 7,000 stores in 92 countries and earn €20.9 billion ($22.1 billion) in sales last year, double what it earned in 2008.
This copy is for your personal, noncommercial use only. To order presentationready copies for distribution to your colleagues, clients or customers visit http://www.djreprints.com. http://www.wsj.com/articles/fastfashionhowazaracoatwentfromdesigntofifthavenuein25days1481080981 BUSINESS Fast Fashion: How a Zara Coat Went From Design to Fifth Avenue in 25 Days Few have been able to replicate the design-to-store pace that has made Inditex the sales leader
One way that Inditex speeds production is by making 60% of its garments in Spain and nearby countries. Retailers such as J.C. Penney Co. are now turning to closer suppliers in Central America, relying less on those in Asia. That, along with some streamlining in design and logistics, has cut delivery time of some J.C. Penney-brand items from nearly 10 months to about eight, the company said. Former industry leader Gap Inc., whose annual sales have been stagnant for the past decade, is moving some of its manufacturing from Asia to the Caribbean. It is also speeding up conception of some garments, sometimes approving new items for production within 24 hours.
Invistics helps manufacturers speed up their supply chain velocity by tracking Cycle Time between supply chain steps and implementing goals to accelerate the flow of products from initial production to shipment to the customer.
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