healthcare logistics & supply chain...
TRANSCRIPT
Healthcare Supply Chain and Logistics Management
Assoc. Prof. Duangpun Kritchanchai, Ph.D
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
• is a system of organizations, people, activities,
information, and resources involved in moving a product
or service from manufacturers, logistics providers,
distributors to end-customers. These stakeholders have
business process which are related each other, such as
procurement, manufacturing, storage, information
technology, distribution and transportation.
Supply Chain
2
Ref: (Christopher, 2010)
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
• is the process of planning, operation and control the flow
of material and service between point of origin and point
of consumption in order to meet some requirements, of
customers or corporations. It involves the integration of
information flow, material handling, production,
packaging, inventory, transportation, warehousing, and
often security.
Logistics
3
Ref: (Bowersox, 2012)
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Healthcare Stakeholders
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Manufacturer(Drug & medical Device)
LogisticsDistributor
Healthcare Provider(Hospital, Clinic, etc.)
Consumer(Patient)
• Industry (supplier/ manufacturer) is one major supply chain process (GS1)
• Pharmaceutical Company (Kim, 2005)
• Logistics provider (warehousing/shipper) is one major supply chain process (GS1)
• Drug Wholesaler (Kim, 2005)
• Healthcare providers is one fundamental partner of the healthcare system (Coleman, 1997)
• Providers including doctors, nurses, pharmacist, allied health, community health, public health professionals and other health provider (HealthConnect, 2003)
• Health felicities/ Dispensaries is one major supply chain process (GS1)
• Consumers (patients) (Kim,2005)
Material flowMaterial flowMaterial flow
Information flow Information flow Information flow
Logistics Operation Level
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Stores ConsumersManufacturer/Suppliers Retail DCs
• Demand Management
All activities related to production and service management
• Master Production Scheduling
• Material Requirement Planning
• Production Scheduling and Sequencing
• Production Control
• Inventory Management
• Warehouse Management
• Distribution Management
• Transportation Management
Front
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Hospital Logistics
Node 1 Node2LINKLogistics
Deliver drug and medical supply
Deliver stuff/LAB specimen
Deliver waste
Deliver sterile medical supply
Deliver fabric/food
Drug Warehouse
Ward
Ward
CSSD
Fabric/Food
Ward/sub-stock
Ward
Disposal site
OR/Ward
Ward
Manage Resource Manage Flows
• Warehouse/Inventory Management
(Drug, Medical supply)
• Capacity Management (stretcher, container,
shipping car )
• Routing, Scheduling (patient,
wheelchair, stretcher, shipping car
in the hospital)
FrontBack Frontsynchronisation CPOE …
Scheduling
Dispensing• collect, order, when and how
much to deliver
• receive/send
• Order/dispense/use drug and medical supply
• Routing & Scheduling resources for delivery
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Vertical Transportation
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Patients
Food for patients
Drugs: Normal and Express
Medical supply:
Normal and Sterile
Medical Device
Blood and blood components
General supplies
Fabric: Normal and Sterile
Full O2 tube
Normal Saline Solution
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Patients
Food for patients
Drugs: Normal and Express
Medical supply:
Normal and Sterile
Medical Device
Blood and blood components
General supplies
Fabric: Normal and Sterile
Full O2 tube
Normal Saline Solution
Chemotherapy drugs
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Patients
Food for patients and medical staffs
Drugs: Normal and Express
Medical supply:
Normal and Sterile
Medical Device
Blood and blood components
General supplies
Fabric: Normal and Sterile
Full O2 tube
Normal Saline Solution
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Patients
Wastes
Returned blood
Dirty fabric
General supplies for
maintenance and return
Infected Medical Supplies
Empty O2
tubeMedical Device for
maintenanceFood trays
Specimens
Patients
Wastes
Returned blood
Dirty fabric
General supplies for
maintenance and return
Infected Medical Supplies
Empty O2 tube
Medical Device for maintenance
Food trays
Specimens
Patients
Wastes
Returned blood
Dirty fabric
General supplies for
maintenance and return
Infected Medical Supplies
Empty O2 tube
Medical Device for maintenance
Food trays
Specimens
Hospital Case Study
(Hospital Case Study)
Floor
Example of goods
รายละเอยดสนคาทขนสง และสนคาทไมขนสง แสดงในเอกสารแนบ 1
1 Food Food for patients and medical staffs
2 Fabric General fabric, Sterile fabric, Patient’s clothes, and Medical staff’s clothes
3 DrugsPrescription drugs for in-patients and out-patients, Drugs for stock wards, Chemotherapy drug, and
Normal saline solution
4 Medical SuppliesPrescription medical supplies, Medical supplies for stock ward, Medical supplies for out-patients,
oxygen tube, Chemical substance, Medical instruments such as Surgical instruments, and syringe
5 Medical Devices Medical Device
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth)
Mahidol University, 2014 All rights reserved.
6 Blood and blood
componentsBlood and blood components
7 Specimens Specimens for Laboratory such as blood tube; hemoculture and urine
8 General Supplies General supplies, Forms and Stationary
9 Patients In-patients and out-patients
10 Wastes General wastes, Infected wastes, hazardous waste, and Recyclable waste
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Drug Flow in Supply Chain
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Suppliers Warehouse Pharmacy Room (Ward) Patients
Doctors
Reimbursement(Payer)
Drug Information
Patient & Medical Information
Warehouse Pharmacies
Financial
Suppliers Warehouse Pharmacies Patients
Doctors
Reimbursement(Payer)
Material Flow
Information Flow
Manufacturing Distribution Procurement Inventory (Warehouse)
Inventory (Pharmacy) Prescription Dispensing Reimbursement
Drug Information
Warehouse Pharmacies
FinancialHospital
Framework for Process Analysis
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Procurement to Receipt
Internal Distribution : Warehouse to
Pharmacy
Prescription to Dispensing
Dispensing to Patient
Financial to Reimbursement
Supplier
Warehouse
Warehouse
Pharmacy
Doctor (CPOE)
Pharmacy
Pharmacy
Patient
Financial Dept.
Reimbursement Agents
Supp
ly C
hain
Proc
ess
•Supplier to Warehouse•Warehouse to Supplier
•WH to Pharmacy•Pharmacy to WH
•Dr. to Pharmacy•Dr. to Patient (non CPOE)•Pharmacy to Dr.
•Patient to Pharmacy•Pharmacy to Patient
•Financial to สปสช•Financial to กรมบญชกลาง•Financial to สปส.
•Procurement •Receipt and storage•Inventory Management
•Demand Management•Recall Management
•Replenishment•Repackaging•Internal Distribution•Store location Stock Management
•Order Entry•Change Order Entry
•Labeling & Packaging•Dispensing•Return Goods
•Reimbursement
Logistics Clinical & Logistics Reimbursement
Manufacturing Distribution Procurement Inventory (Warehouse)
Inventory (Pharmacy) Prescription Dispensing Reimbursement
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Supply Chain
Hospital
Other hospitals
• National Health
Security Office
• social security
• Comptroller General's
Department
• Insurance companies
• Other payers
Vendor
Logistics Flows
• Information flows
• Material flows
• Replenishment/
receiving/sending
PO, Invoice, ASN
Logistics Management
• Vendor Managed
Inventory (VMI)
• Traceability
Data Standard / Data Exchange Standard
EDI – Electronic Data Interchange
Database
Data Warehouse
Decision Support
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Healthcare Supply ChainLogistics Distributor Healthcare Provider
(Hospital, Clinic, etc.)Consumer(Patient)
การผลต (Production)- วตถดบทใชในการผลตถกสงมา
จากซพพลายเออร
- ผลตออกมาเปนผลตภณฑดาน
สขภาพ
+Manufacturer
การคลงสนคา
(Warehousing)- จดเกบผลตภณฑดานสขภาพ
กอนสงไปยงผคาปลก หรอคาสง
การสงสนคา (Shipping)
- จดสงผลตภณฑดานสขภาพไป
ยงผ คาปลก หรอคาสง
การรบสนคา
(Receiving)- โรงพยาบาล ผ คาปลก หรอผ คา
สงรบผลตภณฑดานสขภาพจาก
ผผลต ตวแทน หรอศนย
กระจายสนคา
การสงมอบการดแล
สขภาพ
(Healthcare Delivery)- Patientsไดรบผลตภณฑ
ดานสขภาพจาก
โรงพยาบาล ผ คาปลก หรอ
ผ คาสงทดและเรวขน
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Foundation: need for
Healthcare Supply Chain
Development
Logistics - Macro Level
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Problem in Healthcare Supply Chain
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1. Diverse standard languages and drug codes which Stakeholders use for
communicate with each others
2. Diverse data format used in electronic transactions
3. Lack of a median tool for effective communication between stakeholders
Identification Codes
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Originators Description Digit Length Lowest Level
Bureau of Health Service System Development Drug type, generic name, strength, dosage
form, manufacturer code
24 Generic name
Food and Drug Administration Tax identifier, manufacturer code, class,
group and GTIN code
30 Trade name
Government Product and Service Code (GPSC) Class, category, and running number 22 Class
The Government Pharmaceutical Organization (GPO) GTIN 13 of GS1 standards 13 Trade Name
The Comptroller General’s Department (CGD) Running number - Trade name
Department of Medical Sciences (DMSC) Source, manufacturer code, active ingredients 11 Generic name
Thai Customs Department (TCD) Class, subclass, and statistical information 16 Class
Each stakeholder has own drug code which is communicated for internal organization, but cannot be communicated
with others.
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Common problems
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LogisticsDistributor
Healthcare Provider(Hospital, Clinic, etc.)
Consumer(Patient)
Manufacturer(Drug & medical Device)Manufacturer code which can
be used in its own
organization
Distributors code Hospital code which can be
used within hospital, mapping
between hospital code with other
codes, some hospitals have
several hospital codes
Drug consumption does not
be recorded generic name
and cannot be
communicated with
manufacturer
No standardized code as
primary code throughout the
supply chain
Complexity of communication
between IT system of
each organization
No effective response
Resource waste:
Cost, time, staff to communicate data
Risk to
Medication Error
Impa
cts
/ Ana
lysis
AS-IS
Fou
nd
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Healthcare Supply Chain
16
Logistics Distributor Healthcare Provider(Hospital, Clinic, etc.)
Consumer(Patient)
Production-Receive
raw materials from suppliers
- Produce into medical
products
+Manufacturer
Warehousing- Stock medical products
before shipping to
wholesalers and retailers
Receiving- Hospitals, wholesalers or
retailers receive medical
products from
manufacturers, sellers or
distributers
Healthcare Delivery
- Patients receive
medical products from
the healthcare
provider more
effectively
The problem must be solved throughout the supply chain
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
1. identify the uniqueness of drugs and medical materials to communicate through the supply chain
How to solve the healthcare supply chain problems
2. Develop a single datapool to provide standard data which is useable to all players in the
supply chain
Logistics DistributorHealthcare Provider
(Hospital, Clinic, etc.)Consumer(Patient)Manufacturer
(Drug & medical Device)+
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Standard Drug Code
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885 4567 389012
Drug Code Manufacturer Code
Check DigitCountry Code
1. UNIQUENESS 2. GLOBALIZATION 3. MACHINE READABLE
Be able to distinguish the
characteristic of each drug in
base unit level
Be able to refer particular drugs
throughout the Global healthcare
supply chain and logistics
Be able to be read by data
capture devices
GLOBAL STANDARD DRUG CODE
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
• GTIN is used as a primary key to access the drug information in Datapool(DRUGNET).
Foundation Need: Standard Drug Code (GTIN) &
Data Pool (DRUGNET)
• There was a collaboration with medical supplier to input their drug information
to DRUGNET and attach barcode on their packaging which deliver to hospitals
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Hospital use GTIN as a primary key to access the drug information in Datapool.
Drug suppliers use GTIN to identify drugs and input drug information to Datapool.
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Infrastructure of standard data and standard data
interchange within healthcare supply chain in Thailand
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Standard data
Electronic data interchange, auto-
replenishment
Standard Electronic data
interchange
Drug information,
DatapoolStandard data
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Solution for logistics problems in hospitals
SuppliersHospital
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Master data
Ward using the data
Master data
Electronic Data Interchange (EDI) Portal
Remarks
Developing National Database, healthcare information system and increasing patient safety in drug consumption (TRF-NRCT., 2011-2014)
Implementation of Electronic Data Interchange In Healthcare Supply Chain (TRF, 2013)
A Drug Traceability for Enhancing Healthcare Logistics and Supply Chain Management in Thailand (TRF-NRCT., 2013)
encrypt/decrypt data between
senders and receivers
Datapool
Standardization
StandardizationStandardization
Traceability
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Current communication situation between hospital and suppliers
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Hospital
Suppliers 1
Suppliers 2
Suppliers 3
Suppliers n
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Healthcare Supply Chain and Logistics Management
23
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
What are the Benefits of Healthcare Supply Chain and Logistics Management?
Efficient Logistics Management in Hospitals (Inventory and Transportations)Data Integrations and Synchronization
(Information Sharing and Management)TraceabilityResults in Patient SafetyNationwide Efficiency and Information Visibility
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
How do we get there?For Material Flows : สราง Standard Product IdentificationsFor Information Flows : สราง Standard Data and Standard Data Exchange
Providing a Global Standard Database and Data Exchange
Becoming Regional Medical HUB
Thailand Excellent Quality in Healthcare Professionals and Services with this “Efficient Materials and Information Management at Global Standard”
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
What are we doing?Adopt , Apply and User Global Barcoding System in RamathibodiHospital , Siriraj Hospital
Build a Single Database of all Healthcare Material InformationsUsing Global Standard Data
First begin with Ramathibodi Hospital , Siriraj Hospital , Srinakarin Hospital Data
D/B
Implement Data Exchange System Using Global Standard Exchange
First Implement with Ramathibodi Hospital , Siriraj Hospital , Srinakarin Hospital and Bangkok Hospital
First Workshop for Data Input into , “The Database” on 26th
November 2013 with ……….. Suppliers of Ramathibodi Hospital , Siriraj Hospital , Srinakarin Hospital and Bangkok Hospital
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
Medical Healthcare and Logistics Hub
http://www.youtube.com/watch?v=r5hgkXNWvw8
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
สมมนาเชงปฏบตการ “กรอกขอมล Database ใน Web application”
เพอให Suppliers นาเขาขอมลยาและเวชภณฑในฐานขอมลกลาง (DRUGNET)
วนท 26 พฤศจกายน 2556 และ 22 มกราคม 2557 ณ ศนยการประชมแหงชาตสรกต
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
งานประชมสมมนาวชาการเรอง GO LIVE : Healthcare Supply Chain & Logistics
การขนระบบจรง : การจดการโซอปทานและโลจสตกส
วนท 20 สงหาคม 2557 เวลา 13.00 น. – 16.00 น. ณ ศนยประชมแหงชาตสรกต
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มผเขารวมประชมสมมนาจานวน 150 คน
ประกอบไปดวย
- ผอานวยการและผแทนจากโรงพยาบาล
- ผแทนจากหนวยงานสาธารณสข
- ผแทนจาก Suppliers
จดประสงคเพอนาเสนอหลกการและตนแบบระบบ
การเชอมโยงแลกเปลยนขอมลทางอเลกทรอนกส
(Electronic Data Interchange: EDI) ระหวาง
โรงพยาบาลกรณศกษาและ Suppliers ทไดนารอง
ระบบขนจรงสาเรจแลว
Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
HC Links: Web EDI, VMI & TRACEABILITY
ตวอยางหนาจอ Login เขาระบบ HC Links
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
1. ใหความสาคญสงสดตอการพฒนางานสาธารณสขตามแนวพระราชดาร และ
โครงการเฉลมพระเกยรต เพอเทดพระเกยรตพระบรมวงศานวงศทกพระองค
2. พฒนาระบบบรการสขภาพใหทกคนบนแผนดนไทยสามารถเขาถงบรการทม
คณภาพอยางทวถง โดยใชทรพยากรสขภาพอยางมประสทธภาพและเปนระบบ
ทยงยน
3. สรางเสรมสขภาพและคณภาพชวตของประชากรไทยตลอดชวงชวต
4. สรางเสรมความเขมแขงของกลไกนโยบายสาธารณะเพอสขภาพททางานขาม
ภาคสวน
นโยบายของรฐมนตรกระทรวงสาธารณสข
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
5. พฒนาประสทธภาพการบรหารจดการบคลากรสขภาพ
6. พฒนาความมนคงของระบบยา วคซน เวชภณฑ และเทคโนโลยทางการแพทย
7. จดการโรคตดตอและภยคกคามดานสขภาพ
8. สนบสนนการพฒนาระบบสขภาพโลก (Global health)
9. สนบสนนการวจยสขภาพอยางครบวงจร
10. พฒนาและสงเสรมระบบธรรมาภบาลในกระทรวงสาธารณสขและองคกรดาน
สขภาพของรฐ
นโยบายของรฐมนตรกระทรวงสาธารณสข
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Copyright © 2014 Healthcare Supply Chain Excellence Centre (LogHealth) Mahidol University, 2014 All rights reserved.
8.1 จดทาและดาเนนการแผนยทธศาสตรดานสขภาพโลกและภมภาคอาเซยนของประเทศไทย โดยอาศยจดแขงระบบสขภาพไทยเพอสนบสนนการพฒนาเศรษฐกจสงคมและสขภาพของประเทศการประกนความมนคงของมนษยการเสรมบทบาทและภาพลกษณของไทยในเวทระหวางประเทศการเปนศนยกลางการผลตและพฒนาบคลากรสขภาพรวมทงรองรบการเปนประชาคมอาเซยนทงนโดยความรวมมอระหวางกระทรวงการตางประเทศกระทรวงสาธารณสขและองคกรดานสขภาพทงในภาครฐและเอกชนรวมทงภาคประชาสงคมทงนโดยใชกลไกสมชชาสขภาพภายใตพระราชบญญตสขภาพแหงชาต
8.2 การพฒนาใหประเทศไทยเปนศนยกลางดานสขภาพของภมภาคอยางสมดลและยงยน
(1) พฒนาระบบความสมดลในการใชทรพยากรดานสขภาพเพอมใหนโยบายการพฒนาประเทศไทยใหเปนศนยกลางดานสขภาพของภมภาค สงผลกระทบดานลบตอการบรการสขภาพ แกคนไทย ภายใตระบบหลกประกนสขภาพแหงชาต
(2) พฒนาระบบสารสนเทศในการรองรบการเชอมโยงขอมลผปวยและสถานพยาบาลทงภายในและกบตางประเทศ รวมทงการพฒนา Healthcare Logistics
(3) สงเสรมความรวมมอระหวางภาครฐและเอกชนดานบรการสขภาพ เพอผลกดนใหประเทศไทยเปนศนยกลางดานบรการสขภาพอยางยงยน
8. สนบสนนการพฒนาระบบสขภาพโลก (Global health)
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Thank you for your attention
ศนยความเปนเลศดานการจดการโซอปทานสขภาพ
มหาวทยาลยมหดล (LogHealth)25/25 ถ.พทธมณฑลสาย 4 ต.ศาลายา อ.พทธมณฑล จ.นครปฐม 73170
โทรศพท 02-889-3599 โทรสาร 02-889-2399อเมล [email protected]