Critical Visibility Gaps in Hospital Pharmacy Supply Chains

Valerie Bandy, PharmD, vice president of pharmacy solutions at Tecsys, explains that limited real-time visibility across pharmacy inventory and care settings remains one of the biggest constraints on hospital pharmacy and supply chain performance. According to a survey by her company, only 20% of healthcare leaders report having real-time, systemwide visibility into pharmacy inventory, and even among that group, roughly three-quarters say they are not fully prepared to manage major disruptions.

Bandy emphasizes that health systems cannot predict every disruption, but improved visibility can significantly reduce risk and improve response. The most common visibility gaps occur across multiple operational boundaries: between wholesalers and health systems; between centralized warehouses and pharmacy operations; between central pharmacies and individual hospitals or clinics; and even within hospitals themselves across inpatient, outpatient, and procedural areas. Fragmentation is especially common where different automation systems—such as automated dispensing cabinets—or standalone outpatient sites operate independently, sometimes ordering and managing inventory without central pharmacy oversight.

Because of these disconnects, many pharmacy teams operate with delayed, partial, or siloed data. Instead of integrated, real-time insight, they rely on manual reports, lagging indicators, and experience-based judgment. In today’s environment—where drug shortages, price volatility, and supply disruptions are constant—this lack of visibility forces organizations into reactive rather than proactive decision-making.

Operationally, that reactivity leads to several negative consequences. Pharmacies often discover shortages too late to respond efficiently, overorder to create buffer stock, and carry excess inventory to compensate for uncertainty. These practices increase costs and tie up resources unnecessarily. Bandy notes that without connected, cross-setting visibility, even well-intentioned preparedness efforts fall short. The result is a cycle of defensive purchasing, fragmented coordination, and elevated financial and operational strain across pharmacy supply chains.

Bandy also comments on how hospitals can better prepare for future shortages; the risks in relying on those aforementioned manual or fragmented tracking processes; and much more.

A transcript of her conversation with PC can be found below.

PC: Tecsys’ new survey shows that only 20% of healthcare leaders report having real-time visibility across pharmacy inventory and care settings. What specific visibility gaps are most common today, and how do they affect day-to-day pharmacy and supply chain decision-making?

Bandy: Health systems aren't magical—they can't predict the disruptions that will happen, but if they can start to gain some of that visibility, it really starts to mitigate some of those issues. The visibility crisis and health system pharmacy survey that we did at Tecsys found that that lack of visibility is really that biggest constraint holding pharmacy supply chains back. A lot of the common gaps that we see are between either the wholesalers and the health systems, the health systems’ warehouses, if they're centralized and doing some kind of consolidated or centralized pharmacy services, even within the health system between the central pharmacies and the hospital or the clinic location, so they aren't talking to each other, and within the hospitals across pharmacies, so whether that's within their automation, like ADCs, or their procedural areas where they have some automation, as well as those outpatient settings, which may or may not have any automation and may just be rogue and ordering things on their own and keeping track of their own inventory without the knowledge of the central pharmacy.

With that 20% that you mentioned, those are the systems that felt like they had full real-time visibility into the inventory across their care systems, and only about three quarters of those are not fully prepared to manage the disruption. We're already at a low 20% and three quarters of that 20% are not ready.

Today’s hospitals are really operating in an environment where drug shortages, pricing, volatility, disruption are just constant norms for them, and the organizations are relying on those delayed or partial visibility to manage them. Day to day, that means pharmacies are pushing into reactive decisions instead of proactive decisions. They're relying on a lot of manual processes, like reports and delayed data and just kind of gut checks on what they've been used to dealing with, instead of real-time insight. Without that integrated visibility, the pharmacies are really being forced again into reactive decision making, and they're discovering those shortages too late. They're ordering more than they need to compensate for what they need on hand, and then just absorbing so many unnecessary costs.