Just-in-time inventory. Agile. Supply-demand disconnect.
These business buzzwords have popped up with regularity in recent state briefings on the COVID-19 vaccination campaign in Connecticut, widely recognized as one of the nation’s most effective in terms of getting available inventory into residents’ arms.
“You see sometimes vaccines [in other states] are sitting on the shelf and not being used and collecting dust,” Gov. Ned Lamont said during one of his recent COVID-19 briefings. “We’re not letting that happen. With just-in-time inventory, we’re being very careful.”
The embrace of business principles and practices may share some of the credit for the vaccine campaign’s success so far, said Mike Stimson, director of strategic engagement and process at CONNSTEP, a nonprofit manufacturing consulting firm.
“There certainly are a lot of advantages in the use of these principles for this current situation,” Stimson said. “It certainly makes sense.”
Take just-in-time, a manufacturing system that originated in Japan and made its way into American business starting in the 1980s. When applied to inventory, just-in-time means to bring in a product in response to actual demand instead of stockpiling.
With the currently available COVID-19 vaccines from Pfizer and Moderna, just-in-time works well with a highly perishable product that needs specialized storage and handling and is subject to intense demand, Stimson said. The just-in-time process also has the potential for a much quicker path between the maker and the customer ‒ in this case the pharmaceutical company and the willing patient.
“With something like a vaccine that can be either fragile or has the risk of spoiling, that becomes important,” Stimson said.
And aside from the vaccine itself, just-in-time allows for more efficient use of resources like ultracold storage and specialized distribution capacity. With ever-shifting supply and demand around the state, a business-powered supply chain can also respond more quickly to changing conditions.
“It gives you more agility to shift priorities as the landscape changes,” Stimson said.
Balanced approach
Flexibility and agility have been key principles at work in Connecticut’s COVID-19 vaccine campaign since the initial planning stages, said Josh Geballe, the state’s chief operating officer. In his post as COO, Geballe has been a highly visible spokesperson for the vaccine effort along with top Department of Public Health (DPH) officials.
Key to the state effort so far has been balancing the impulse to micromanage the process on the one hand and the “wild west” approach in states like Florida that has led to seniors camping out on sidewalks to get the shots.
Perhaps due to the business background he shares with Lamont, Geballe has advocated for and pursued a centrist position for Connecticut’s vaccine program, despite the state’s reputation in the business community for bureaucracy and over-regulation. (Geballe was a tech executive before joining the state government and spent 11 years at IBM.)
For example, in New York vaccinating someone who isn’t yet eligible for a vaccine can lead to a hefty fine. In Connecticut, if a provider has extra vaccines that are in jeopardy of being wasted, they’re encouraged to use that supply, even if it goes to people not yet eligible for inoculation.
“We’re racing the virus right now and so we need to get the doses out to people as quickly as we possibly can,” Geballe said. “That is not a goal that lends itself to micromanagement.”
The latest milestone was the state opening its largest drive-through vaccination clinic at Rentschler Field in East Hartford, which will help Connecticut reach its ambitious goal of getting 7,000 to 10,000 people vaccinated weekly.
The biggest complaint in Connecticut so far has been the limited availability of COVID-19 vaccines, but that’s largely out of the state’s control as the federal government is overseeing the national stockpile. There have also been complaints about long waits online and on the phone for eligible residents to sign up for a shot.
From the first weeks of planning for a mass campaign of COVID-19 testing and treatment, the state reached out to the business community and hospitals in addition to state agencies to ensure that the public and private spheres worked together to best reach the population.
Private labs agreed to partner with the state on testing samples for the coronavirus in the first weeks of the crisis and later when mutated variants of COVID-19 started appearing. Business owners at first reached out with potential locations for mass testing and now are offering help with transportation and storage of the vaccine, Geballe said.
For example, Bozrah-based The Gilman Brothers Co. worked with the Army Corp of Engineers to design a vaccine transport system that safely moves vaccines, while maintaining their ultracold temperatures.
“We don’t have time to build structures from scratch,” Geballe said. “We’ve been partnering with everything.”
Consulting firepower
Some in the national media have attributed Connecticut’s efficiency in getting vaccines to patients to the presence of Benjamin Bechtolsheim, who works as the COVID-19 program coordinator at DPH. Although largely behind the scenes, Bechtolsheim brings to his role six years of experience as an associate partner at McKinsey & Company, the consulting giant.
Bechtolsheim started working at DPH in December directly from McKinsey, where he worked in the firm’s social sector practice providing strategic and operational support to nonprofits, philanthropies and public agencies, according to his LinkedIn profile.
DPH spokesperson Maura Fitzgerald said Bechtolsheim, who was unavailable to comment for this story, works to mesh the efforts of many agencies to maximize the vaccination campaign’s effectiveness.
“This is an all-hands-on-deck response,” Fitzgerald said.
Part of that response is the application of just-in-time principles to inventory of the vaccine on a daily basis at vaccination sites like health centers and hospitals. Hoping to avoid what Lamont has called a “supply and demand disconnect,” the state has mobilized a distribution system that can move vaccines at the end of the day from a site that has more doses than patients to one that needs more.
Due to accurate reservation and registration systems, however, the network has had to move relatively few doses as of mid-January, Lamont said.
“We’ve got a lot of good pre-planning,” Lamont said, adding that Connecticut was one of the first states to get above 2% in the percentage of population vaccinated.
The small number of doses that have been shipped from site to site illustrates the experience and agility of the planning process, CONNSTEP’s Stimson agreed.
“The state has done a good job in turning to some of the experts who know how to do this,” Stimson said. “They know these concepts exist, they’ve seen it work very successfully in business and they’re looking for ways to really respond quickly.”
“We’ve got a lot of knowledge in this state on how to do things right,” Stimson added.
Geballe also credited the state’s knowhow with the relative success of the vaccine campaign so far.
“In this crisis this state has worked together so well,” Geballe said. “It’s an incredible testament to the people of Connecticut and the businesses of Connecticut who really rallied to the challenge here.”
