Around 400 healthcare industry leaders, healthcare providers, regulators, and solution providers from 49 countries participated in an intense week of meetings, workshops, networking activities and on-site visits to hospitals, pharmaceutical companies and wholesalers of medical instruments. The conference had great social media from participants.
It’s no coincidence that Noordwijk, a beautiful sea town in The Netherlands, was chosen to host the 35th Global GS1 HC Conference. This sunset might give you an idea of how great the location was. But more importantly, the impressive work that the healthcare sector is doing in this northern European country may give you yet a better clue.
“Today The Netherlands is recognised as having one of the best healthcare systems in the world. What better place to discuss patient safety?”, said Ulrike Kreysa, GS1 Senior Vice-President Healthcare, in the opening session.
"We launched our healthcare initiative in 2006 and it’s been our most successful initiative, with the biggest impact on people’s lives all around the world”, said GS1 CEO Miguel Lopera welcoming the participants. “GS1 is key to improving patient safety, fighting falsified medicines, and increasing visibility and efficiency in the supply chain. The world is heading towards a globally standardised approach in healthcare which will be less complex and costly”, said Mr Lopera.
Pieter Maarleveld, CEO, GS1 Netherlands, shared some introductory words. “I’m very proud of welcoming so many participants. Orange is the name of our Royal Family. Orange is also the colour of the shirt of the Dutch football team”, said Mr Maarleveld referring to a recent football match.
As we learnt during the week, the lack of standards leads to higher risks of errors in patient care. GS1 Netherlands shared with the audience that 70% of hospitals in the country are currently using GDSN (the Global Data Synchronisation Network used for sharing product master data).
Dr. Lies van Gennip, CEO, NICTIZ, proudly quoted some impressive figures about healthcare in The Netherlands. She shared her thoughts that we have a healthcare system that networks – and we see patients having a more active role.
In the interactive panel, healthcare providers took centre stage to share inspiring stories about how the use of GS1 standards in their hospitals is boosting efficiency, savings, and most importantly, patient safety.
Kevin Downs, Director of Finance and Performance, University Hospitals of Derby and Burton NHS Foundation Trust, UK, chaired this session and kicked off the discussion with some powerful visuals about the seven forces that will change the way we work.
While technology can make workers more productive, there will be significant turbulence as organisations grapple with the complexity and unpredictability of a changing workforce, particularly considering the following factors:
Thomas Klein, Head of Purchasing and Logistics, University Hospital Dusseldorf, Germany, showed his enthusiasm in having another the opportunity to present at a GS1 Healthcare Conference after his first presentation at our Vienna conference 10 years ago.
The University Hospital Dusseldorf (UKD) stands for international excellence in healthcare, research and teaching. A particular strength lies in the interdisciplinary treatment of patients and the close integration of clinical operation and research.
Mr Klein focused on the journey that his hospital has gone through transitioning towards electronic driven procedures. Quoting Heraclitus, he stated: “There is nothing permanent, except change. Let’s start together!”
He discussed the different standardisation processes they have implemented in the hospital, including at the purchasing department, which is seen as the engine of the hospital. Through projects including scanning of the barcodes and implementation of electronic invoicing they are able to gain efficiency while improving patient safety.
Thomas Klein also showed that the medical products coming into the hospital were increasingly labelled with GS1 barcodes. In fact, between 2016 and 2018 the presence of GS1 barcodes in those products increased from 70% to 86%.
Keith Jones, Head & Neck Surgeon, Clinical Director of Head and Neck Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, UK, shared with the participants the huge change he’s seen over the last years in terms of modernising procedures. In the past his hospital was limited by poor data and he shared many ways the hospital used to work: limited and disjointed data, unable to robustly analyse the performance of surgical teams, traceability relied on a paper trail, many systems relied on insertion of free text and manual tracing of batch/lot numbers. One of the things Mr Jones specifically mentioned was that there was no data to praise people’s performance.
His passion for standards for the benefits of his patients was very obvious, as he described how the information that they get from simple scans has changed the lives of my patients.
Henrik Stilling, IT Architect, Aarhus University Hospital, Denmark, explained the importance of good integration of methodologies, standards, applications and technologies in order to implement tracking and identification in the Aarhus University Hospital in Denmark. As people want information about what is moving where (e.g the location of assets), the hosptial has implemented a foundational infrastructure that allows these questions to be answered. He has had a lot of forethought in planning the hospital infrastructure and his results are a model for other hospitals.
Standards are transforming the way we work and how hospitals are designed and built. He accompanied this idea with some practical examples based on his experience at his 2008-2009 designed hospital. “We have embraced change and adopted standards”, he said, so that “we can answer basic procedure questions such as who did what or who might do what, where and when…”.
The hospital’s supply chain is becoming more and more relevant in defining clinical outcomes and is taking a more prominent role in guiding decisions. The quality of the patient’s journey is increasingly defined by the right combination of streamlined procedures and the indispensable human touch.
Susan Moffatt-Bruce, Executive Director at The Ohio State University Wexner Medical Center, US, opened the Panel by envisioning the future of the sector, in terms of the potential of data and standards: “We are in the process of changing from volume to value. This is the future of a value-driven healthcare”, where quality and cost, engagement, teams, communication and patience are key drivers for successful change.
“Healthcare has to be patient-centric so to ensure the very best outcomes. GS1 standards allow us to remain focused and confident that we can deliver care on our commitment to patients”, said Susan Moffatt-Bruce.
For the Salisbury NHS Foundation, the Scan4Safety Programme brought many possibilities. Lorna Wilkinson, Director of Nursing, Salisbury NHS Foundation Trust, UK, shared with the audience the remarkable achievements in her hospital since they started using GS1 standards in 2016.
The Scan4Safety Programme has benefited patient safety around these four principles: “right patient, right product, right place, right process”.
Ms Wilkinson explained that the importance of data for clinicians is to know what happens within their specialty. She quoted Tim Wells, Consultant Cardiologist, Salisbury NHS Foundation Trust:
“The recent implementation of the Scan4Safety project in Cardiology provides us for the very first time
Cardiology is not the only department of the hospital where Scan4Safety has been implemented. Since 2016 different departments including Trauma and Orthopaedics, Day Surgery, Gynaecology and Radiology and ERCP have been part of the Scan4Safety program.
You don’t implement standards overnight. It’s a step by step process that demands persistent efforts to introduce new protocols, that are well worth it, as explained Prof. Dr. Rainer Petzina, Cardiothoracic Surgeon, Medical Director Quality and Risk Management and Patient Safety at University Hospital of Schleswig-Holstein, Germany. They already use a GS1 identification badge for staff with GS1 DataMatrix, GS1 room designation thanks to GLN (the Global Location Number, a tool used to uniquely identify a location) and they are working on future projects such as central sterilisation facility and patient identification wrist band.
“You will not find it difficult to prove that battles, campaigns, and even wars have been won or lost primarily because of logistics.” This was the Dwight D. Eisenhower’s quote that opened Mr Sotiris Tsiafos-Tsiaras presentation. Indeed, as we learnt over the week, “Efficient healthcare is based on sound supply chain processes… Supply chain and clinical work are the two sides of the same coin”, said Mr Tsiafos-Tsiaras, Military Pharmacist, OR Traceability Project Manager, 401 Athens General MilitaryHospital, Greece.
Sound logistic processes and systems are crucial for the outcome of care by the healthcare provider. Supply chain operations affect all actors within the hospital. The fact that these different actors have many different cultures makes it complex.
In order to operate a supply chain, the hospital needs to trace the product from receipt, storage room, wards and operating room to use on a patient. At 401 Athens General Military Hospital, they scan at every single movement of an item and thanks to GS1 standards they capture accurate and good quality data.
CliniClowns, an NGO based in The Netherlands, provides moments of smiles and laughter for sick and disabled children and grownups with dementia, helping them to feel better. This year, for every conference feedback form provided, GS1 Healthcare donated 5 euros to this charity.
Patients are most comfortable when they can completely be themselves, since they are in vulnerable situations. The comfort of a CliniClowns visit is that the clown can truly “be present” with every person in a respectful and mutual encounter.
The clown sees the other person for whom he/she is, and what they can do. The clown recognises that we all have a need for one another, recognising what the other may feel, and invites the patient to play along in what is happening at that moment.
Thrilling the audience with touching images of kids interacting with clowns, Gepco Bokhorst said: “If you see what happens if a clown has contact with kids… you see pure magic. It is amazing what’s happening. Little magic miracles”.
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Dr. Chikayuki Ochiai received the GS1 Provider Recognition Award for his extensive and well recognised effort to further implement GS1 standards in healthcare in Japan and beyond
The GS1 Healthcare award jury recognised Dr. Ochiai for his great achievements for patient safety and cost-efficiency in healthcare, as well as the effect of his work on education of healthcare providers in Japan, the region and beyond.
The 401 Athens General Military Hospital in Greece received the GS1 Provider Best Case Study Award for the implementation of GS1 standards in the hospital, which started in the operating rooms (OR).
The GS1 Healthcare award jury valued this case for the clear qualitative and quantitative results, the generated clinical involvement and the opportunities for replication.
Representatives from St. James’ hospital, the largest academic teaching hospital in Ireland, 3M, a leading Dow Jones Industrial Index company leveraging the use of data and standards in the healthcare sector, and F. Hoffmann La Roche Ltd, an 1896 founded pharmaceutical company shared experiences about their current challenges implementing barcodes.
It’s been a long journey for the St. James’ hospital in Dublin. They are currently involved with a few GS1 standards, but decades ago all their supply chain was paper based.
“If a Hospital was a supermarket, your product would not appear on the shelves if it did not have the following: a GTIN, traceability data and a pricing file as at the day of sale”, said Greg Magrane, eCommerce Project Manager at St. James’ hospital.
He also shared some practical examples on “good”, “not so good” and “very confusing” barcodes, evoking reference to the epic Spaghetti Western classic The good, the bad and the ugly directed by Sergio Leone.
3M, a Dow Jones Industrial Index company with sales in 200 countries, 32.8 billion in sales, five business groups and 93.000 employees globally, has a lot to teach on what it takes to capture better data.
Charity Hovey, 3M Project Manager, shared with the audience the 3M UDI experience from 2014 to 2018. This company’s healthcare strategic intent, “Care pathway innovation for improved and cost-effective health outcomes” may give you an idea of 3M’s success.
“It sounds simple, and thanks to GS1 it works”, said Tatjana Pathare, Global Supply Chain Management Team, F. Hoffmann La Roche Ltd, Switzerland, referring to the GS1 Digital Link Standard.
Referring to her experience at La Roche, Ms Pathare explained that GS1 Healthcare has come up with a solution to potential confusion with the increasing number of barcodes by providing a Digital Link Standard to connect all GS1 barcodes for more information without adding a URL/URI in the barcode.
Dennis Even, IT Director of Pfizer Inc. in the US, chaired this panel. Mr. Ewan explained how technology alone is not the answer. We need technology harmonised with people and processes to be truly successful. We then heard from panel of experts.
In an effort to improve patient safety and efficiency, Mr. Ewan explained how technology alone is not the answer; we need technology harmonised with people and processes to be truly successful.
He went on to discuss how we can increase patient safety by leveraging and adopting technology such as the GTIN and barcode medication administration systems. Barcode medication administration ensures the correct dosage of the correct medication goes to the correct patient. As we learnt through the whole conference week, one standard means we are speaking the same language. An aligned format for globally unique identification at primary packaging level will be foundational for overall success.
Michiel Duyvendak, a pharmacist at St. Antonius Hospital, The Netherlands, shared powerful stories about his hospital’s successful implementation of bedside barcode scanning for the past 8 years.
In The Netherlands, bedside scanning saves 50 lives a year and roughly 20,000 extra hospital days. Mr. Duyvendak said that in the coming decade, as society ages, patients will take more responsibility in managing their healthcare and medicine dosage, including in home care. Primary packaging barcoding is supporting this.
Ad Deeben, Senior Director Marketing Services & Logistics at TEVA in the Netherlands, discussed development of the EAV (primary packaging) in the 1980’s.
The challenges of printing a barcode on blister packs includes: the limited space, the silver packaging makes the barcode difficult to scan, and in case it needs perforations, a barcode would be needed on each blister cell. Next steps include medicines administration, compliance and safety. Recording and information exchange are very critical.
TEVA NL introduced the GTIN last year on their morphine product primary packaging. All in all, alignment to use standards is so important and as Mr. Deeben passionately reminded everyone, if we are aligned, we can do it!
Iain Davidson, Chief Pharmacist and Chief Clinical Information Officer with Royal Cornwall Hospitals NHS Trust in the UK, shared advancements within NHS regarding digital medication.
Sebastien Langlois-Berthelot, Global Serialisation Deployment – Country Rollout Stream Lead for F. Hoffmann-La Roche Ltd, shared his experience for driving implementation of GS1 standards. Two thirds of Roche products are barcoded with GS1 barcodes on the primary package label. He discussed both challenges (e.g. diversity of packaging, small containers/labels, additional investment) and opportunities (e.g. familiarity with Data Matrix, safety at POC scanning, GTIN is already widely supported). Digital Link is also addressing a primary packaging label opportunity to access the same information as the original packaging.
TThis pharmaceutical manufacturer started working with DataMatrix in 2011. Mr. Langlois-Berthelot recommended attendees check out the GS1 DataMatrix position paper from 2017.
GS1 standards are great enablers for the implementation of VBHC, as these standards support visibility, transparency and data exchange on all relevant aspects. All presenters emphasised this from their respective work situations, when stakeholders in healthcare use GS1 standards, that adds value to the patient.
Karen Conway, Vice President Healthcare Value at GHX, US, introduced this panel with a provocative quote from Lewis Carroll’s classic Alice’s Adventures in Wonderland. “If you don’t know where you’re going, then any road will take you there”.
So what is a value-based healthcare system?
Ms. Conway explained that to ensure a value-based healthcare system, we need to think about people and we need to focus on what matters to patients. Making a point about the borderless language of healthcare, she emphasised that we may have different healthcare systems, but this is a universal pursuit.
It’s worth mentioning three definitions that Ms Conway shared with us. According to Michael E. Porter, “The health outcomes achieved that matter to patients relative to the cost of achieving these outcomes”.
According to The Economist Advisory Board, a value-based healthcare system is “a healthcare system that explicitly priorities health outcomes that matter to patients relative to their costs”.
“Value is defined as the outcomes that patients experience relative to the cost of delivering those outcomes. Value-based Healthcare, or VBHC, is healthcare that delivers the best possible outcomes to patients for the lowest possible cost”, International Consortium for Health Outcomes Measurement (ICHOM).
Eric Hans Eddes, Gastrointestinal and Oncological Surgeon at Deventer Hospital, General Director Dutch Institute for Clinical Auditing (DICA), The Netherlands, shared with us his own definition of this concept: “Best possible outcomes for patients for the lowest possible costs”.
After presenting a number of impressive success stories in his clinic – mostly related to patients with breast and colorectal cancer – Dr. Hans Eddes called on the need for constant adaption of new techniques and procedures with a great Darwin quote: “It is not the strongest of the species that survive, nor the most intelligent, but rather the one most adaptable to change”. “Let’s move on!”
Leila McMahon, GS1 Programme Manager at Smith & Nephew, UK, explained her company’s business, and how they support healthcare professionals in their daily efforts to improve the lives of their patients. Smith & Nephew wants to make sure their developments can be used globally with high quality products. The company’s values are performance, innovation and trust..
Ms McMahon shared with us the manufacturer’s perspective on a value-based healthcare system. Healthcare needs to be proactive rather than reactive, preventing problems before they start. Improved quality and outcomes for patients in a more cost-effective approach, she explained. Multiple stakeholders are sources for important accurate data specific to their roles in patients’ lives across the entire ecosystem. Manufacturers need a more hands-on method, establishing programmes and partnerships that demonstrate joint outcome benefits.
What is a safety stop? It relates to prevention of errors during a patient’s journey, explained Hennie Mulder, Registered OR Nurse at Maxima Medical Centre, Veldhoven, the Netherlands.
There are seven crucial moments for safety stops: Pre-operative risk management, planning, scheduled for surgery, control current situation, pre time out, ready for take-off (just before the surgery), sign out for leaving operating room, dismissal recovery and dismissal ward. Scanning the GS1 identifiers on people, product and place helps reduce errors during these critical processes, Ms Mulder said.
Sylvia Thun, Charity Visiting Professor at Stiftung Charité, BIH University of Applied Science Niederrhein, Germany, chaired this session and opened the debate by explaining the purpose of the panel: raising awareness on what standards organisations are doing in the healthcare sector and why it is important for them to work together.
Referring to the ongoing efforts to achieve a worldwide network of people who try to combine genomic data and to make analysis on this data and algorithms, leveraging on HL7, ISO and GS1 standards, she encouraged us to work together for clinical trials and patient related outcomes to achieve better patient care.
Øyvind Aassve, Senior advisor at the Norwegian Directorate of eHealth, shared highlights on the roadmap of the new strategy on the use of international standards, in particular FIHR/HL7 in conjunction with GS1 standards and move away from developing their own standards which will help them build a community.
Robert Stegwee, Director Consulting, Health & Health Tech at CGI, the Netherlands shared with us why standards organisations such as GS1, HL7, SINOMED, NEN, IHE, Nictiz, etc. are indeed happy to work together in The Netherlands: “there is no single standard that is sufficient to tackle a single use case or a single situation.”
National goals in The Netherlands are set and agreed to in a Standard Organisation Council (SDO), where standard organisations come together to coordinate efforts, identify overlaps between standards, analyse gaps and produce relevant advice to the stakeholders.
Michael van der Zel, Enterprise Architect at University Medical Center Groningen, The Netherlands, used an interesting analogy: “if you want to make a nice dish, you need a recipe. We need ingredients from more than one shop… Let’s do “an easy recipe with 4 ingredients” for an IHE Profile, with meat (Hl7 FHr Impl. Guide), vegetables (GS1 barcode) and spices (DCM -s-).
Erik Zwarter Information Manager eHealth, Care and AIDC at Erasmus Medical Center, The Netherlands has over 15 years of experience in different functions and several departments at Erasmus MC. For the last 2 years he’s been part of the IT department. His presentation focused on the implementation of SNOMED. Thanks to this, every healthcare provider is able to scan and share data quickly, reliably and flawlessly within their own work environment.
Beth Wells, Senior Director Healthcare at GS1 US, opened the workshop discussion highlighting that trusted data needs to be:
Diederik Rood, Project Manager at Dijklander Hospital, Hoorn, The Netherlands, reminded the importance of standardised data and shared with us how his hospital is using the Global Data Synchronisation Network to standardise data and data collection.
The current method of collecting data, explained Mr Rood, is time consuming and prone to errors as it involves contacting the supplier, manual registration of GTINs based on product name and external reference number (which is not globally unique) and manual processing of data into the Enterprise Resource Planning (ERP) system and Electronic Health System (EHS). This is why his hospital is now trying to connect suppliers to GDSN to automatically capture product data that is up-to-date. GDSN enables easy import of right product information directly into the hospital’s ERP system. The ERP can easily synchronise this data with the EHS.
The Amsterdam UMC is undertaking “Project GDSN” as part of their focus on master data governance and data quality. Data quality is a must and the different GS1 standards provide the common language to enable having good quality data, explained Yolanda Bokking, Directorate Procurement at Amsterdam UMC, The Netherlands. She also highlighted that manufacturers and suppliers are the ones responsible for providing correct and complete product data and valid and readable barcodes to enable to scan and register products.
There are, however, rocks on the way for getting hospitals, manufacturers and suppliers fully aligned in sharing data in the best possible way. Ms Bokking shed light on three challenges: :
MJ Wylie, Global Data Synchronization and Strategy Deployment Supply Chain Visibility, Johnson & Johnson Supply Chain, US, shared from the manufacturers perspective that product data is a team sport. It’s not about data alone, it’s about the physical product/label to the digital identification. It also has to provide value for all stakeholders, including the patient.
Scott Mooney, Vice President Distribution Operations Supply Chain Assurance, McKesson Pharmaceuticals, US, highlighted that it’s important to recognise that the distributor is not the creator of data. However, as data is really important the distributor needs to be able to break big quantity down and provide hospitals with what they need. “If we can’t do that we might mess up the complete supply chain”, he said.
Lionel Tussau, Director Business Development Europe, 1WorldSync, Belgium, explained that there is growing realisation that data is very powerful. It creates big expectations from data, but only if it is quality data.
There however needs to be consistency in data shared with regulatory bodies and other supply chain actors. Going for the GS1 standard doesn’t mean that all actors have the same understanding of the product data attributes.
If you want something that works, you need to start small and be pragmatic – we need data sets that are manageable for everybody and are relevant for the different use cases and processes that all actors in the supply chain need to the data for.
Leading healthcare regulators, including representatives from the European Commission and the National Medical Products Administration and the State Administration for Market Regulation (China), provided an update of the status of the Unique Device Identification (UDI) regulation in their respective regions and highlighted the essential role of GS1 in this process.
Dr. Salvatore Scalzo, from the EU Commission, gave an update on the EU regulations on medical devices. He reminded the audience about the main novelties of the new regulations, the transitional period (from May 2017 to May 2022) and shared with us recent developments in the UDI system.
Mr Yi Li from the Division of Standard research Center for Medical Device Standardization Administration (CMDSA), National Medical Products Administration, China, gave an overview on the latest developments on the UDI requirements in China.
He also reminded the audience that the benefits of UDI can only accrue if all stakeholders, from the manufacturer to healthcare providers and patients, use UDI throughout their workflow systems.
Jay Crowley, VP and Practice Lead, UDI Services and Solutions, USDM Life Sciences, US, gave a presentation on the UDI regulation in Saudi-Arabia. Through improved traceability the goal of this project is to increase patient safety and optimise patient care.
Joanna Nowak, Head of Medical Device Supplies at University Medical Centre in Gdansk, Poland, gave a presentation about the experience of implementing GS1 standards in the area of medical device identification at her hospital. With over 1.000 beds and more than 120.000 patients annually, it is one of the largest medical centres in Poland.
In 2018, the hospital received an award from GS1 Poland for the successful implementation of GS1 standards. Ms Nowak explained to the audience that taking part regularly in GS1 Healthcare webinars is very helpful, as she learns from other hospitals facing similar challenges.
She explained that they chose GS1 standards as they are the most universal and the most common code used on medical devices. Referring to the specific changes and benefits that they’ve experienced since they started implementing, she mentioned that inventory maintenance costs were reduced by 60% and that thanks to the codes on the products, information about what was used in the treatment process is stored in their IT system. Joanna shared with the audience one final enthusiastic message: “We are very happy after all these changes, but we are looking forward to addressing the next challenges!”
Jan Sterba, Head of Regulatory Affairs & Quality Assurance at Linet Group SE, Czech Republic, did a presentation about the experience of implementing the UDI system in his company that specialises in the production of hospital equipment, nursing home equipment and gynaecological practises.
Mr Sterba walked us through the UDI implementation history at Linet Group SE. In 2010 they started working with GS1 and by 2014 they started contact with UDI FDA regulation. In 2015, they received a request from a public hospital in Sweden for a Unique Device Identifier (UDI) for each medical device. In 2016, UDI was required for devices sold in USA (class II) and that same year Linet Group SE decided to implement UDI for all products as preparation for EU MDR 2017/745. “UDI implementation is a big challenge. It’s a big task. You need to know your responsibilities and we, manufacturers, have a lot of responsibilities”, said Jan Sterba.
The presentation included valuable advice – almost a toolkit! - for companies that have not yet implemented UDI. Among the strategic decisions they should take, according to Mr Sterba, is the type of implementation (do-it-yourself implementation / limited partner implementation / full-on outsource implementation, based on the amount of resources available on the company). Furthermore, companies should decide about whether to do the implementation manually (UDID web interface) or automatically (internal software, hosted software or outsourced service). The presenter also included some advice in terms of company management and the departments that should be involved in the process of implementing UDI.
In this presentation by Blair Korman, Project Manager UDI at Johnson & Johnson Supply Chain, US, Korman covered her company’s Japan project, the proof of concept results, operational improvements from GS1 RFID adoption, the lessons learned and next steps.
“Thanks to GS1 for helping us doing this in the right way”, said Blair Korman as she encouraged other companies in the process of implementing UDI. After sharing the results of the “Japan project” and GS1 RFID adoption, she explained why it makes such a difference to implement RFID with or without standardisation.
Without standardisation, RFID is costly to all as it impedes customer adoption and is not customer centered or supply chain focused. On the other hand, with standardisation the benefits are evident: it reduces infrastructure costs for the customer, enables end-to-end supply chain efficiency and promotes a data sharing environment that has value beyond RFID (securing the supply chain, enabling efficient recording of product information for health records at the customer site and streamlining the product inventory cycle).
It is important to note that in the application of GS1 standards, RFID tags are considered secondary data carriers to barcodes, meaning that there must be a barcode on the product as well as the RFID tag.
In this session, the speakers addressed standards in action for the benefit of those that are more vulnerable in the developing world and overviewed some of the humanitarian work that leading agencies such as USAID and IDA foundation are doing. The use of GS1 standards is helping them accomplish their goals.
“USAID has been a great partner over the last year for GS1, helping implement standards all around the world”, said Ulrike Kreysa, GS1 Healthcare Senior Vice-President, as she introduced Samuel Oh, MIS Catalog Manager at USAID Global Health Supply Chain Program – Procurement and Supply Management (GHSC-PSM) Project, US.
USAID is active in 41 developing countries, focusing on improving the provision of health commodities through global commodity procurement and logistics, with the aim of combating HIV/AIDS, Malaria, Maternal & Child Health/Zika. GHSC-PSM also focuses on strengthening in-country supply chain systems through supply chain technical assistance and global collaboration. Their aim is to engage strategically to improve long term global supply of health commodities.
Michiel de Goeje, Director Quality Affairs at IDA Foundation, The Netherlands, discussed the importance of ensuring all communities have access to medicines. The IDA has 3.000 products in their portfolio, 950 products in stock in their warehouses, 6 offices worldwide, 245 employees from 25 nationalities, 30 local agents and 500 active customers in 130 countries.
The work of IDA foundation focuses on providing essential medicines for tuberculosis, malaria, emergency response, reproductive, maternal and child health and non-communicable diseases, including oncology. Mr De Goeje explained that they chose GS1 in response to an initiative started by GHSC-PSM. GS1 standards contribute to supply chain transparency, patient safety and improve master data and warehouse handling.
Dr. Monica Eimunjeze, Director Registration and Regulatory at National Agency for Food & Drug Administration and Control, Nigeria, advised the audience to participate about the 2nd African GS1 Healthcare Conference in Lagos, Nigeria, 17-19 September 2019. Dr Eimunjeze highlighted the intense programme, including sessions about pharmaceutical traceability and global trends in pharmaceutical distribution, among other topics.
In this panel, Heinz Kobelt, Director European Affairs, EAEPC, kickstarted the discussion with a presentation about The European Medicines Verification System – from concept to full operation. He was then joined by Dr. Stefan Artlich, Director Track&Trace, Bayer, Germany and Dr. Jean-Michel Descoutures, Hospital Pharmacist, Argenteuil Hospital, IHF, France.
Heinz Kobelt, Director European Affairs, EAEPC, Belgium, kickstarted the discussion with a presentation about The European Medicines Verification System EMVS – from concept to full operation. He gave an overview of the basic requirements of the FMD directive and the role of the European Medicines Verification Organisation (EMVO) focusing on the design and development of a European hub, establishing a blueprint approach for national roll-out, financing of ramp-up phase and ensuring on-boarding of manufacturers and National Systems.
Mr. Kobelt explained the great benefits the platform brings. They can bring any issue to the EMVO… as it is a first platform for dialogue. This is very important for an industry going through a lot of change..
Dr. Stefan Artlich, Director Track & Trace, Bayer, Germany, enthusiastically introduced by Christian Hay as “the father of all this”, delivered a presentation about EU-FMD implementation at his company. Industry collaboration with authorities was key for developing this model, Mr Artlich explained. After walking us through the conceptual phase of the project (2010-2013) and the implementation phase (2014-2019), he concluded “We are very proud of the European model we have developed, and we have inspired others around the world”.
One out of 20.000 medicines sold in Europe are fake, but in developing countries up to 70% of certain medicines are fake, explained Andreas Fischer, Lead Pharmacist Clinical services at University Hospital of Dresden, Germany, showcasing why track and trace is so important.
He gave an overview on the process of implementing the EU-FMD in this hospital, showcasing the benefits but also the current problems. Finally, he mentioned some global challenges such as ensuring the role out of the successful implementation across Europe, optimising of current processes, additional cost for further development and ongoing support, digital transmission of invoices with electronic codes and medicine shortages and delays.
Dr. Jean-Michel Descoutures, Hospital Pharmacist, Argenteuil Hospital, IHF, France, delivered a presentation about the first month of decommissioning implementation for the FMD in his hospital. To showcase the magnitude of the track and trace challenge, he shared some interesting data. In France between 12-19 September 2017, 433 000 illegal and counterfeit medicines were seized by customs.
In terms of the results that this early phase of implementation is having in Argenteuil Hospital, Dr Descoutures shared some figures: They have an average of 1100 boxes a day [53–2820], the average delay for authentication and decommissioning is 2,5 seconds per box or 45 minutes per day, 78% of the boxes have no unique identifier, but 21% have already a tamper-proof device; among the 22% boxes with a serialised number, 1,6% have no tamper-proof device. All together only 20% of the boxes are totally compliant with the FMD after this first month of implementation.
During this session we saw the official launch of the new GS1 Application Standard for the Identification of Investigational Products in Clinical Trials. This development will help the industry to consistently identify investigational products along the entire supply chain, defining the rules, roles, and responsibilities for the allocation of GS1 identification keys and the barcoding of investigational products, primarily from the time of kit assembly to use and, if necessary, destruction.
Mike Meakin, Vice President, Global Quality, Regulatory & Compliance at DHL Life Sciences & Healthcare, led this session and he reflected afterwards on the importance of this new standard. He commented of the positive discussion in the Clinical Trials panel. Many of the manufacturers said they were committed to implementing the new standard this year and this will provide benefits across the supply chain including full traceability, fewer errors, improved inventory, and leveraging barcodes to ensure better patient safety.
Olivia Chauvel, Hospital Pharmacist, CH Victor Dupouy, France gave the hospital point of view. She started by sharing a few concepts and definitions related to clinical trials, the key functions and the main challenges for stakeholders involved in a hospital. She concluded by showing some great examples from the impressive range of investigational products at CH Victor Dupouy and the benefits the implementation of standardisation of investigational product labeling will bring.
Ms Chauvel explained how use of barcode scanning can assist organisations to switch from being paper-based to computerised, ultimately allowing nurses and doctors to even more focus on patient care. In Ms Chauvel own words: “We see a great benefit in the standardisation of investigational product labelling because it will be a fantastic time saver for us. It will also help us to improve our inventory management.”
Hans von Steiger, Director/Team Leader of Clinical Supply Chain Strategy Management at Pfizer, US, gave us the manufacturer’s perspective. He talked extensively about the benefits for all stakeholders from having a single standardised identifier and barcode that could be used in supply chain, but also the product “verification” apps that are being developed in the sector. Hans also talked about TransCelerate, a global biopharmaceutical research and development community funded by 70 pharma companies that collaborate to optimise development processes to enable e-labelling and reduce the amounts of human readable text, a source of errors. Hans actively ensures TransCelerate is aware of the work being done with GS1 standards, and how the members of this group can leverage these. The ultimate goal is reducing the amount of Clinical supply barcodes that are not standardised in line with the new application standard across industry and vendor systems.
“With this new standard I am convinced we will have great benefits not just in the commercial space and at the clinical sites but also for patients who are going to have more information available to them, so they are taking the right drug, they're taking it properly and they are getting the right treatment and the right therapy, too”, Mr Von Steiger said.
Lastly, Pierre Fernandez-Barbereau, Project Management Clinical Supply Chain at Sanofi, France, explained the critical importance of having identification standards in blinding studies where products cannot otherwise be differentiated. You have to do some masking to make sure that the kits cannot be differentiated. This is also the role of the clinical supply chain packaging area in clinical trials. At the same time, we need to ensure that we give the right kit to the right patient at the right site with the right storage conditions, as this is really key.
Mr Fernandez-Barbereau also shared with the participants the impressive work from the Clinical Trial Mission Specific Work Group lead by its Chairs (Pfizer, SANOFI & CH Victor Dupouy). 60 Representatives from 37 clinical trial organisations worked in less than six months to successfully develop and ratify the Clinical Trial Application Standard.
The GS1 Application Standard for the Identification of Investigational Products in Clinical Trials is now available for use by all parties involved in clinical trial processes.
Upon closing this panel, several participants involved in clinical trials showed enthusiasm in starting the work immediately towards implementation.
During this session we had discussions on processes and patient safety from different angles with representatives from the University Hospital Schleswig-Holstein, the Medical Education and Research Centre KAFGH, the Salisbury NHS Foundation Trust and The University Hospital Zurich.
Dr. Hajo Reissmann, Head of Medical Supplies at University Hospital Schleswig-Holstein, Germany, gave a short introduction before presenting the other members of the panel. “In our opinion, processes and patient safety are closely intertwined. We have to look at processes a lot. In Germany, like in many countries, healthcare is in a squeeze. Resources are not abundant, so we have to get more efficient. Efficiency has to do with processes. While doing so, we should not jeopardize patient safety, but it must be enhanced”, said Dr. Hajo Reissmann opening the debate.
Dr. Shih-Chung Huang, Director of the Medical Education and Research Centre KAFGH (Kaohsiung Armed Forces General Hospital), Chinese Taipei, presented about the “Experience of clinical UDI applications with smart medical management system relying on GS1 standards”. His hospital evolved from using an in-hospital code with a never-ending database, which needed a lot of manpower, to automatic data capture through the use of GS1 UDI barcode, e-work, getting exact information rapidly and sparing human brainpower because the hospital can now rely on automated processes and information.
Dr. Huang discussed a few of the applications in the hospital where the UDI is used. In the operation room the use of the UDI enables accurate and rapid recording of key clinical staff information. In the warehouse, it is easier to track and trace products by using the barcodes. Furthermore, accounting can use an e-form to execute accurate, clear and automatic billing, and through the cloud the hospital’s suppliers can obtain real-time stock level information about the hospital medical materials. They can then take the initiative to replenish the goods according to the experiences of past use and reduce wasted inventory time.
One of the main challenges, according to Dr. Huang, is that unfortunately not 100% of the items have a UDI label yet. Some suppliers are not willing to include the UDI on the label of their products. For now, in case the product is not recognisable by scanning, the hospital uses a reference number to find it, this, however, is not ideal since it is not globally unique.
The Salisbury NHS Foundation Trust Hospital in the UK was selected by the NHS as one of the six demonstrator sites in the Scan4Safety Programme, which goal is introducing standards sets to make sure that the right patient receives the right product at the right place through the right process. This provides clarity on the full patient journey, including the procedures performed, the equipment that has been used, the devices that have been implanted and what medication has been administered by whom.
Lorna Wilkinson also discussed the Point of Care Scanning that her hospital implemented. It proved that scanning enabled various improvements:
In the future, the hospital will further focus on “never-event” prevention. For prevention of using the incorrect implant, scanning of incorrect items will alert the user . Also, the hospital will further work on the implementation of standards in and use the GS1 identification key for each relevant actor, procedure, product or location in this pathway.
Alexander Soland, Head of Logistics & Services at University Hospital Zurich (USZ), Switzerland, explained that the main goal of his project is more efficiency and safety in the hospital supply chain process. The hospital wishes to achieve efficiency and quality, and reduce complexity, through standardisation, coordination and collaboration between producers or suppliers and the logistics centre and the hospital. In the end, the main benefit will be transitioning into a real network partner where the USZ Logistics & Services Centre is a collaborative distribution platform that can fully supply all the hospital’s facilities.
Mr Soland highlighted that consistent standardisation of all three levels in the supply chain is important: organisational, physical and informational. On the organisational level, matching of demand and supply will enable efficient planning and management. On the physical level, standardised, weight-optimised containers and carriers will enable an efficient flow of goods. On the digital level, traceability and implementation of the GS1 identification standards like GTIN (Global Trade Item Number), GRAI (Global Returnable Asset Identifier) and GLN (Global Location Number) will enable having efficient data, data value and easy information exchange.
Asked about the delivery time from central logistics to the institution, Christian Schlaepfer, Project Manager Logistics, Site Manager at USZ said: “It’s our responsibility that the goods that are needed are always on site”.
The session, moderated by Tom Pereboom, Chair SVN - Association for Sterilisation, the Netherlands, kicked off with a discussion from Andy Crosbie, Manager of Post-market Surveillance Strategy, Medicines & Healthcare Products Regulatory Agency, UK, on the vital cycle of implants.
Having worked in implant regulations for 30 years, Andy Crosbie, Manager of Post-market Surveillance Strategy, Medicines & Healthcare Products Regulatory Agency, UK, had a lot to share with us. He kickstarted his presentation with the photo of tennis sportsman Andy Murray in hospital, after receiving a hip replacement last January. “How long will Andy’s implant last?”, asked Mr. Crosbie. Indeed, the vital cycle of implants was one of the most discussed topics in this panel.
Dr. Hinne A. Rakhorst, Chair Dutch Association of Plastic Surgeons, the Netherlands, provided some powerful figures that illustrate how important this topic is. 1 in 30 Dutch women have a breast implant (approximately the same as hip arthroplasties), 70% of the breast implants are aesthetic versus 30% that are reconstructive. In 2015 a Dutch breast implant registry was created. The more data is stored and shared among practitioners, the more benefits for patient safety. Dr Rakhorst also highlighted how using GS1 identification keys and the GDSN can support this implant registry and ultimately full traceability to the patient.
Henrik Stilling, IT-Architect, Aarhus University Hospital, Central Denmark Region, gave an overview on the National Danish Implant Registry (mandatory for all surgical implants from 1st of July 2018). 1 in 20 manual registries contain errors and scanning is simple… Real-time scanning is a driver for safety asset when used correctly; it is easy to implement but requires a high level of understanding to use, Mr Stilling explained. His hospital chose to implement GS1 standards for as part of these processes.
Blair Korman, Senior Project Manager Supply Chain Visibility at Johnson & Johnson, did a presentation about “Using UDI to support Product Registry”. After explaining Johnson & Johnson’s portfolio (consumer, medical devices and pharmaceuticals), Ms Korman gave an overview of UDI’s goals, the key role of GS1 in this process and the main developments that are taking place this year in China, Korea, Chinese Taipei, Saudi Arabia and Brasil.
During this session, we announced some exciting news for our organization. GS1 and OpenPEPPOL, two leading players enabling electronic business around the world, signed a Memorandum of Understanding (MoU)
Scott Mooney, Vice President Distribution Operations Supply Chain Assurance at McKesson Pharmaceuticals in the US led the panel regarding EDI for accuracy and efficiency between partners in the Healthcare supply chain.
Holger Clobes, Internal Senior Consultant eCommerce with B.Braun Group in Germany insisted that master data is a key foundation for EDI.
Legal requirements to exchange data often begin with the invoice. It is also important to keep in mind the potential obstacles of EDI. These include master data challenges (incorrect data, data not up-to-date), no use of standards (GLN, GTIN) or even too many standards.
The future of EDI could include interoperability between different standards and new technologies. In closing his presentation, Mr Clobes referenced the GS1 Healthcare EDI Implementation Kit and GS1 EDI Strategy 2018-2020 (May 2018), reminding us that standards are always needed.
Dennis Black, Global Regulatory Operations of Becton Dickinson (BD) in the US maintains that EDI set-up is critical. He noted that EDI is best for repeatable transactions without variable rules or conditions. BD has been working with GS1 standards for more than a decade, and they’ve learned a lot in the process.
GTIN adoption has increased rapidly over the last 10 years, and these GTINs can be leveraged in EDI transactions. Challenges in adopting EDI include the inability of older healthcare provider ERP systems and MMIS (Maintenance Management Information System) to hold and process the standards, as well as the willingness of stakeholders to align data, test and validate transactions.
Greg Magrane, eCommerce Project Manager at St. James’s Hospital (SJH) in Dublin, Ireland, shared his views from the hospital perspective, building on a 20 year relationship with GS1. St James’s first track and trace pilot using GS1 standards dates from 2011 and the hospital has been fully committed to implement GS1 standards since then.
Mr Magrane discussed the importance of accurate data as a foundation for EDI - The correct association of the unit of measure is critical. He described how using GTINs and GLNs, GS1 XML and having the EDI messaging fully integrated into the St James’s SAP system is critical. Mr Magrane also explained that the service target is to process 90% of all Health Service Executive - which provides public health services in hospitals in Ireland - invoices electronically by 2020. As a final message Mr Magrane encouraged suppliers to become involved by making the commitment, allocating resources to the project, engaging with the SJH project team, join GS1, publishing product data to Irish National Product Catalogue, and implement EDI.
Heran Gerba, Director General of the Ethiopian Food and Drug Authority, provided details on the content of this new regulatory framework aiming at improving patient safety and healthcare supply chain efficiency in Ethiopia. Its implementation will take place in three phases over 8 years. As of July 2021, regulated medicines will be identified and barcoded using GS1 standards, hence following global trends and ensuring worldwide interoperability of the Ethiopian drug traceability system.
Reflecting on her country’s strategic efforts implementing a new traceability regulation, Ms Gerba commented that they have long vision spirit and true commitment in ensuring patient safety.
Ömer Hakan Simsek, Head of the IT Department from the Turkish Medicines and Medical Devices Agency, gave a presentation on ITS (an abbreviation of Turkish Pharmaceutical Track and Trace System), which is the infrastructure designed for track and trace of all medicines in the supply chain in Turkey.
This System covers every medicine box across all steps of supply chain, from production / import until consumption, explained Mr Hakan Simsek, after being introduced by Ulrike Kreysa’s praising words: “We know your long journey, and your achievements”. Indeed, this track and trace project started more than 10 years ago (2007).
Turkey's track and trace system includes an app that allows citizens to inquire about their own medicines using their smartphones. Thanks to this tool, they can learn from scanning the GS1 DataMatrix and accessing the database the name, expiration date, price, if the medicine is recalled and more.
The ITS system is good for the health but also very positive for the pocket of the Turkish people. It has produced some estimated savings of 90 million dollars in 2017 and 72 million dollars in 2018.
Andreas Walter, General Manager at the European Medicines Verification Organisation (EMVO), delivered a presentation about the EU’s Falsified Medicines Directive (EU FMD). He introduced the EMVO, which represents a unique collaboration model between supply chain stakeholders comprised of EU medicine manufacturers, parallel distributors, wholesalers, pharmacists, hospitals and hospital pharmacists.
Andreas Walter started his presentation introducing the EMVO, which represents a unique collaboration model between supply chain stakeholders comprised of EU medicine manufacturers, parallel distributors, wholesalers, pharmacists, hospitals and hospital pharmacists. EMVO’s driving mission is patient safety: the safety of patients across Europe is at the centre of our work, he explained.
He congratulated his colleagues in Turkey, referring to their decade long track and trace efforts, and pointing out how they have helped shape many discussions in Europe.
“We were launched six weeks ago and it is a success”, he said regarding the EU FMD implementation. Mr Walter’s presentation included some interesting country-specific statistics of those countries participating in the programme.
From 27 November 2019, the US Drug Supply Chain Security ACT (DSCSA) will require wholesalers and distributors to verify the unique identifier of returned products before these can be placed into inventory for resale. A manufacturer who receives a verification request from a re-packager, wholesale distributor or dispenser will be obliged to respond to that request within 24 hours. Against this backdrop, pharmaceutical supply chain trading partners asked GS1 to develop a verification messaging standard.
The annual saleable returns in US are estimated at 60 million pieces across the industry. McKesson saleable returns represent approximately 90 million dollars per year, explained Scott Mooney, Vice President Distribution Operations Supply Chain Assurance at McKesson Pharmaceuticals, US.
With the new regulation, distributors must associate the original transaction information, the transaction history and the transactional statement with a saleable return. They must also verify that the product identifier affixed to the product corresponds with the data the manufacturer assigned.
“We went to GS1 and they developed a new standard in record time”, said Mr. Mooney. The new Lightweight Messaging Standard for Verification of Product Identifiers allows supply chain partners to verify that a product in their possession is suitable for forward distribution.
In Egypt all pharmaceutical products are subject to barcoding, serialisation and state reporting to the government. Dr. Haytham Abdellatif, Track & Trace project manager at the Egypt Ministry of Health, presented on his country’s programme.
Dr. Haytham Abdellatif started his presentation with an overview of his country’s market, composed of 165 pharmaceutical manufacturers, 75,000 pharmacies, 3,000 distributors and wholesalers, 120 million patients, representing a pharmaceutical trade volume of 3.8 billion US dollars.
He walked the audience through the Egyptian Track and Trace System timeline (2016-2019) and their commitment to combat counterfeit in Egypt in 2019.
He then went on to explain how in a very short period of time, they managed to bring on board 80% of their manufacturing base and in a very cost-effective manner. Key to this was the implementation of GS1 global standards along the way, as a means to reduce cost and complexity for stakeholders.
After completing his PhD in San Diego, California, Dr. Pieter Helmons, Hospital Pharmacist and Chief Pharmacy Informatics Officer at St. Jansdal Hospital Harderwijk, The Netherlands, went back to his home country where he was “allowed” to continue his Californian research on the effects of information technology on medication safety with a focus on medication-prescribing and administering. His passion for medical errors prevention was very telling as he presented in Noordwijk.
“This is what keeps my clock ticking. When I think I was the one who prevented some harm to a patient”, said Pieter Helmons in a powerful presentation centred on how standards can help preventing medical errors.
Barcodes on medication save 47 lives in The Netherlands each year. Identifying where errors can happen is crucial for preventing them, he explained. Dr. Helmons presentation included specific statistics about the percentage of errors in prescribing, transcribing, drug surveillance, preparing, dispensing, administering, monitoring and storage / logistics.
Mr. Sotiris Tsiafos-Tsiaras, Military Pharmacist and Traceability Project Manager, after receiving a GS1 Provider Implementation Best Case Study award for the implementation of GS1 standards at 401 Athens General Military Hospital.
“My country was in a tough financial and economic crisis over the last years, we were operating in a difficult economic environment… we needed very badly to improve hospital supply chain operations, cut-down costs and enhance patient safety”, said Mr. Sotiris Tsiafos-Tsiaras, Military Pharmacist and Traceability Project Manager, after receiving a GS1 Provider Implementation Best Case Study award for the implementation of GS1 standards at 401 Athens General Military Hospital.
“Efficient healthcare is based on sound supply chain processes, but happy staff is paramount for better care. You need to have the staff involved in implementing barcode scanning so that you can get all the benefits”, said Mr. Tsiafos..
The Greek Army's Medical Supplies Centre has been using GS1 standards in warehouse operations since 2015 with very good results. This experience was brought by Mr Tsiafos to the hospital. There are a number of benefits that the GS1 standards have brought to the hospital, including: accurate data, information about what was used on each patient, automated checking of expiry dates, implant tracking, stock accuracy, visibility, better forecasting and fewer losses.
Dr. Chikayuki Ochiai, Honorary President at NTT Medical Centre Tokyo, received the GS1 Recognition Award for his contribution to GS1 Healthcare efforts over the years. The jury recognised Dr. Ochiai’s great achievements for patient safety and cost-efficiency in healthcare, as well as the effect of his work in education of healthcare providers in Japan, the Asia Pacific region and beyond.
As he shared with the audience that he is turning 70 in June, Dr. Ochiai reflected with great emotion on his over a decade long collaboration with GS1. Since the GS1 Healthcare conference was held in Tokyo in 2008, Dr. Ochiai has greatly contributed to the use of GS1 standards in hospitals.
His presentation touched on experiences of UDI implementation in NTT Medical Center Tokyo, provided a brief introduction to GS1 Barcodes in Japan, overviewed activities of GS1 Healthcare Japan, talked about current developments in the Japanese Government and identified problems to be solved in promoting GS1 standards in the field of healthcare.
After conquering leukaemia in 2008, Maarten van der Weijden went on to become an Olympic swimming champion for the 10 kilometres distance. Since then he has committed to spreading a message of hope for those struggling in life, and his powerful story inspired many and was a great final session of our conference.
“I had challenged myself. I wanted to swim the Elevencity tour. It is 4:30 in the morning. I decided to swim those 200 km to raise funds for cancer. It’s dark outside. People came by”. As Maarten Van der Weijden started telling his story, the audience was immersed in his powerful message.
Maarten van der Weijden conquered leukaemia and in 2008 became an Olympic swimming champion for the 10 kilometres distance. On 12 March 2001 he was diagnosed with lymphatic leukaemia. As the only one in the room of eight patients in the Amsterdam hospital that survived this severe illness, he’s been extremely grateful for the medical staff that helped him. Mr van der Weijden committed since then to spread a message of hope for those struggling in life.
The powerful message of hope of Maarten inspired many and was a great final session of our conference.
Ravi Mathur, CEO of GS1 India, invited the participants to attend the 36th Global Healthcare Conference in New Delhi (5-7 November 2019). India’s capital, a vibrant city with rich cultural attractions, offers a unique setting for the conference. Among the topics that will be covered, Mr. Mathur mentioned: GS1 standards in clinical processes, Traceability in healthcare, Trends in medical device identification, Global regulatory requirements, Fighting medicine falsifications.
Scott Mooney, McKesson, GS1 Healthcare Tri-Chair, did a final presentation to close such an exciting week, thanking all the attendees. He reminded the participants about some of the most important topics covered during the conference, such as: higher adoption of standards by hospitals, the use of GS1 standards expanding globally (Africa), the continued need for quality in master data and high level commitment to adopt GS1 standards for identification of investigational products. See you at our 36th GS1 Global Healthcare Conference in New Delhi!