We Must Solve Our Healthcare Supply Chain Issues Now!


Well, it's happened again!

Another supply chain disruption.  This time it's IV fluid supply.

It is reported that 60% of the IV fluid supply for hospitals in the United States comes from the Baxter plant in North Carolina which was recently was shut down by damage from hurricane Helene.

Do you remember in 2017 when hurricane Maria caused damage to factories in Puerto Rico where IV fluids were produced?

There was a shortage of IV fluids then, too.

And even back then there were public health officials crying out for a change in our supply chain model to prevent such weather disasters from adversely affecting so many facilities and patients.

It was reported then that 50% of US hospitals endured shortages of IV saline solutions.

That was 7 years ago!

And Baxter was one of the companies hit hardest then because it had three manufacturing facilities located in Puerto Rico. 

After hurricane Maria, there were meetings of high ranking officials discussing possible solutions to supply chain issues. 

Baxter announced that they were making changes to the facilities in Puerto Rico to prevent such shortages in the future. 

Then, hurricane Fiona hit Puerto Rico in 2022. It was a category 1 hurricane, unlike Maria which was a category 5. 

The changes Baxter had made to their facilities between Maria and Fiona actually did work.

There were no disruptions from hurricane Fiona at Baxter. 

Was that because it was a substantially weaker hurricane than Maria? Or because of the changes?  That is still up for debate.

The thing that is clear from hurricane Helene is that we still need the medical supply chain to have multiple manufacturing sites.

The concept of concentrating the majority of supply production at any one site is just a recipe for disaster.

It seems we still have not learned that lesson!

Yes, it may make good business sense to concentrate it all in one place. Fewer employees, more efficiency, specialization, less redundancy of resources, decreased overhead, etc.

But when healthcare providers are having to ration medical supplies such as IV fluids, no one cares about the business wisdom of concentrating production in one facility.

It appears we have learned very little from these extreme weather events that have caused such supply chain disruptions.

What will happen if there is a terrorist attack on one of these facilities?

Or a cyberattack?

Or a disruption in the electrical supply to such facilities?

The potential for major disruption of US healthcare delivery is still very real.

It doesn't appear that we have learned enough from the recent past.

Or if we learned anything, it has only been theoretical. And perhaps actual change is tied up in congressional committee discussions and think tanks rather than being rolled out and implemented.

Real changes do not appear to have occurred on any large scale. 

I assume we will wait until there is a much larger disaster before meaningful changes to the healthcare supply chain become a reality. 

We have been warned.  

It's far beyond time to have acted!


​Ben Holt, M.D.