Tuesday, September 25, 2012

Smarter Medicine: The next step in the CDC’s revolution in delivery of childhood vaccinations.

Vaccine: http://www.flickr.com/photos/sanofi-pasteur/5283533286/
The CDC went live with VMBIP, the Vaccine Management Business Improvement Project in Febrary 2007, deploying in a step-wise fashion over a little bit more than a year. [1] This program consolidated a scattered and inefficient supply chain into a more simple and streamlined state designed to be more responsive to providers and hopefully more fault-tolerant.

In an article on VMBIP’s genesis and deployment “Smarter Medicine” the CDC observed that there was a great deal of resistance to the notion of a centralized ordering process for vaccine. Rather than have end-point providers order directly from a single source, local health departments instead preferred to field and process orders themselves so that they could preserve direct contact with the providers and capitalize on opportunities to continue to promote new vaccine programs and evolving practice. Rather than push the issue, the CDC prudently decided to let that component of existing process remain intact. In the longer run, however, it is clear that preserving an extra step in the order process is not only inefficient but also preserves an opportunity to introduce error and delay in the process.

Unsurprisingly, the CDC appears to have seen things in a similar light, and is working actively to remove that intermediate step with their Vaccine Tracking System to which they have attached the typically unwieldy acronym “VTrckS.”

Launched December 2010, VTrckS “allows health care providers to input their vaccine requests (orders) directly online thereby improving efficiency and accountability of public dollars,” [2] that is, it does exactly what the CDC proposed initially with its centralized call center. (Italics mine.)

This system is the next step in the CDC’s transformation of its childhood vaccine supply chain allowing it more direct control over the supply process and optimal delivery sizes. Direct order entry also increases visibility of the ordering and distribution process for both supplier and recipient.

From a change management perspective, one might reasonably argue that delay in implementation of a centralized ordering clearinghouse cost the CDC nothing: it would have taken time to design the system and bring it online in any event, and clearly the first order of business was consolidation of the supply chain. Additionally, it is likely that had they pushed the issue at the outset of the VMBIP program, they would have encountered resistance from local health departments, possibly jeopardizing the entire initiative.


The CDC delayed implementation of a centralized ordering clearinghouse initially because of pushback from local health departments. How are the same departments responding now, five year later?

[1] Copeland, M.V. (August 26, 2008) “Smarter Medicine” Strategy + Business. Retrieved 25 August 2012 from http://www.strategy-business.com/article/08307.
[2] CDC website: Vaccine Tracking System (VTrckS) accessed 25 August 2012.

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