5. Summary and conclusions
This special issue presents a collection of papers that explore the complexity of supply chain management in health services. Clearly, much research work needs to be done. All authors in this special issue emphasize the fact that supply chain management in a health care setting is characterized by some unique features, which make it difficult to transfer knowledge from the industrial sector to a health care sector in a direct way. At the same time however, it can be concluded that existing concepts, models and supply chain practices can be extended to supply chain management in health services and existing research underpins the assumption that the health sector can benefit from the lessons learned in the industrial sector.
Starting from the research classification matrix depicted in Figure 2, many issues that need to be explored further, can be addressed. Based on the papers in this special issue, at least five main research areas with respect to supply chain management in a health care setting can be defined.
First of all, it seems to be important to further explore the role information technology can play in supporting the management and control of supply chain practices. Additionally, more research seems to be necessary to address the enablers and barriers when implementing information technology in a health service context. Second, the influence of different stakeholders on establishing supply chain management relationships both within as well as between different health service providers still is rather unknown. It seems to be worthwhile therefore, to study into more depth the influence of power and interest relationships between the stakeholders during the process of adopting, shaping and implementing supply chain management relationships. Third, it seems to be of importance to study into more depth the strengths and weakness of management philosophies like lean and agile manufacturing, business process management and Lean Six Sigma in the context of health services. Many of these philosophies are often used together with supply chain management practices. Little is known however, about how these philosophies are applied by health care providers and to what extent health care providers can benefit from these practices. A fourth main field of research which can be associated with supply chain management in health services relates to performance metrics and the results being achieved by health care organisations when implementing supply chain practices. Clearly, performance measurements in a health care setting seems to be more complicated compared to industrial companies due to the complexity of concepts like “quality of care” and the rather tacit character of some performance metrics. There seems to be a general consensus about the added value supply chain management practices can have for health care organisations. Making this added value more explicit by performance metrics as well as the conditions under which this added value emerges without doubt is one of the main challenges research on supply chain management in a health service context is facing. Finally, applying supply chain management concepts to patient flows requires special attention to the specifics of services. Being inseparable multiactor delivery processes in which the patient himself participates as both object and co-creator in the interaction with various healthcare professionals (customer-supplier duality) supply chain management in a service setting is far from simple. New developed concepts of disease management for chronic diseases show that supply chains get longer with combinations of different care providers in which the patient himself often is in the lead. How this interacts with and influences the supply chain definitely is an important and challenging issue in future research on healthcare Supply Chain Management.
In line with the conclusions of Croom et al. (2000), it can be concluded therefore that next to studies with a monodisciplinary focus, an interdisciplinary focus on supply chain management issues in health services seems to be necessary. The complexity of the questions as well as the multidimensional scope of the problems requires knowledge from different disciplines. Hopefully, this special issue is going to be a small step towards gaining a more thorough understanding of supply chain management in health care services.