Medical Biology Laboratories - Why has logistics become so crucial ?
More than 70% of medical diagnoses and treatment decisions are based on the results of medical biology examinations. Recent developments have placed logistics at the heart of the challenges of medical biology laboratories. We take stock of their problems and the solutions mobilized to address them.
A sector in consolidation
In the space of a decade, the French landscape of medical biology has changed considerably, notably as a result of the 2013 Ballereau law. Introducing new requirements for the quality and reliability of biology examinations, this law also aimed to maintain equitable access to medical biology services throughout the country. To this end, and taking into account the investments required to align with the new standards and obtain COFRAC accreditation, the law encouraged collaboration between laboratories, while regulating the modalities of their association or grouping.
We have thus moved from a network mainly composed of small independent laboratories carrying out samples and most of their treatment on site, to a consolidated, much more financialized sector, dominated by large medical biology companies and large groups of independent biologists. As a result of this concentration, the number of companies operating medical biology laboratories has increased from 5,000 in 2008 to 400 in 2023. Today:
- 3 players — Biogroup, Cerba and Inovie — now hold more than 40% of the national market;
- 25% of the market is in the hands of generalist laboratories — such as Synlab, Unilabs or Eurofins — whose human health activities represent only a part of their turnover;
- Truly independent laboratories still account for about 35% of the market.
(source : viedebio.com)
A model involving complex logistics
In the scheme that has emerged, including among the self-employed, the establishments that continue to be called “medical analysis laboratories” are in reality mainly points for receiving patients and taking samples. Deconcentrated, they take care of the pre-analytical phase as close as possible to the patients, while the treatments and analyses themselves are carried out by technical platforms. For example, for its 930 local laboratories, Biogroup relies on 130 technical platforms. Inovie has 65 technical platforms serving more than 550 local sites.
While the pooling of technical platforms guarantees a better level of equipment and a maximum utilization rate of facilities and skills, this organization has a counterpart: it requires complex logistics. Samples taken at local laboratories must be sent several times a day to the home technical platform (or, if applicable, to a specialized technical platform) within strictly regulated transport deadlines and conditions (triple packaging, controlled temperature, etc.).
To ensure this logistics, medical biology groups use either their own couriers or specialized service providers, in particular the Healthcare departments of the main courier carriers such as Chronopost Healthcare, Star Service Healthcare, etc.
3 critical requirements for flawless logistics execution
Whether or not the transport part of the pre-analytical process is outsourced, laboratories and/or their logistics providers should strive to:
- Rationalize the territorial network,
- Develop the most effective transportation plan for each sector;
- Efficiently integrate home blood sampling.
Meeting these 3 requirements is decisive both for the quality of execution of logistics operations and for their economic profitability.
1 – Perfecting the territorial organization
The first step in setting up a sustainably effective logistics scheme is to rationalise the territorial network, in order to be able, in a second step, to define which laboratories to assign to the various technical platforms in the territory in question.
>> The studies and simulations carried out using sectorization software such as Nomadia Territory Manager make it possible to make informed decisions about the optimal location of local laboratories and technical platforms.
>> The search for the “theoretical” optimum to cover an entire territory may, for example, lead a medical biology group to relocate or merge some of its technical platforms. It can also help it determine the optimal location of additional local laboratories whose creation (or acquisition) will strengthen its presence in the territory without cannibalizing the activity of existing sites.
2 – Build the most efficient transport plan possible
Whatever the changes envisaged in the medium term, the medical biology company/group must have a transport plan that allows it to fulfil its mission based on the existing network, even if it is not optimised. In very concrete terms, it is a question of determining the means to be implemented to collect the samples taken by the laboratories and deliver them in a timely manner to the competent technical platform(s).
The creation of these transport plans and their declination into regular rounds for each courier are all the more complex as it is necessary to take into account, in addition to the location of the laboratories and technical platforms, the criteria of delays between the time when the samples were taken and the time when the samples are actually processed by the technical platform. These deadlines (4 to 6 hours maximum depending on the nature of the samples) largely govern the frequency of visits to collection points. This frequency must itself be optimized to take into account the processing capacity of the technical platform.
Taking these multiple constraints into account generally results in a greater number of short rounds in the field than in most sectors of activity. Optimising the frequency of courier visits is what guarantees at the same time:
- Strict compliance with health standards and pre-analytical conditions;
- Smoothing out the activity of the technical platforms during the day;
- And, ultimately, the communication of test results within the deadlines announced to patients.
>> Large medical laboratories and their logistics managers rely on our Nomadia TourSolver solution to determine at which technical platform the samples of the various local laboratories should be deposited and, on this basis, calculate the order in which they should be collected in order to optimize the number of visits to each collection point.
>>Among the benefits of our optimization solution, these customers mention in particular:
- Reducing delays for couriers at collection points by a factor of at least 2;
- Productivity gains resulting in a 15% to 20% reduction in the number of FTEs (couriers) and vehicles;
- A halving of the number of crossings thanks to the rationalization of travel.
3 – Efficiently integrate home samples
The ageing of the population and the increase in chronic pathologies requiring regular laboratory examinations are accompanied by a growing demand for samples taken at patients’ homes. Carried out by self-employed nurses or laboratory employees, this activity is accompanied by specific needs in two areas:
- Making appointments with patients, taking into account possible recurrences and sampling conditions specific to each prescribed examination (fasting or post-prandial sampling);
- The deposit of samples taken at home at the appropriate laboratory to be integrated into existing rounds, without derogating from the requirements of pre-analytical deadlines and storage.
To develop this demanding activity, more and more of Nomadia’s client medical laboratories are using our Nomadia Field Service solution.
>> Coupled with their call center, it allows them to offer patients optimized appointments and to establish realistic schedules for the nurses taking into account, among other criteria, the distances between the patients visited as well as the times of passage of the couriers to the various laboratories where the samples must be deposited.
>> The associated mobile business application accompanies nurses in the field and allows them to report the hazards they encounter during their rounds, to warn patients of a possible delay or, if necessary, to be replaced by the nurse who can intervene most quickly on a particular patient without calling into question the entirety of his or her own round.
If, as a medical biology laboratory or a specialized logistics provider, you recognize yourself in one of the issues presented in this post, do not hesitate to contact our experts in the Healthcare sector to find the solution and support that meets your needs.