Journal of Modern Medical

Introduction
In the 1990s, with the increase in competition, the production and service sectors faced challenges related to production and service delivery at the right time and place and at the lowest cost. To remain in this competitive market, organizations realized that it is not enough to improve efficiency within the organization, and this efficiency improvement should be done throughout the supply chain. Today, supply chain management (SCM), with the aim of optimizing operations, seek to replace the flow of information with the flow of goods and materials. Timely access to information and management of relationships between organizations is considered as a source of competitive advantage for business in supply chains. Successful SCM depends on timely access to information, which requires effective integration of information sources. In the health sector, the issue of information quality has a special place, because this sector is responsible for maintaining the health of society. On the other hand, factors such as the high complexity of systems in health care institutions compared to other industries, the importance of efficacy in these organizations, the pressure to reduce costs, and finally the process of specialization and strengthening the position of patients all lead to attention to the importance of sharing quality information in the supply chain. One of the most important supply chains in the hospital is the supply chain of medicines and consumables. The current research aims to investigate the factors affecting the sharing and quality of information in pharmaceutical and medical consumable SCM.

Methods
This is an analytical survey study. The study population consists of 78 people involved in the supply chain of medicines and consumables including (hospital manager, pharmacy technical manager, pharmacy internal manager, medicines storekeeper, consumable equipment storekeeper, collector, procurement manager, accounting manager, supervisor, and information technology expert) in teaching hospitals affiliated to Isfahan University of Medical Sciences in 2017. They all were selected using a census sampling method. The data collection tool was a questionnaire designed based on Li and Bin (2006)’s study. In this questionnaire, the effects of environmental uncertainty, inter-organizational facilitators, and relationships between different involved departments (three independent variables) on information sharing and information quality (two dependent variables) in pharmaceutical and medical consumable SCM were measured. This questionnaire had 74 items rated on a five-point Likert scale. Its face validity and content validity were confirmed by the opinion of the professors of the Department of Health Information Technology of Isfahan University of Medical Sciences, and its reliability was confirmed using Cronbach’s α coefficient (α=0.93). In the present study, the partners in pharmaceutical and medical consumable SCM included hospitals, sellers and suppliers of drugs and consumables, and senior staff managers (including the vice president of food and drug, the vice president of support, and the vice president of treatment). Data analysis by factor analysis method was done using SmartPLS software, v‌ersion 23 and the significance level was set at 0.05.

Results
Among 78 participants, 62.8% were men. The results in Table 1 showed that environmental uncertainty and inter-organizational facilitators had no significant effect on information sharing and information quality, but the factor of interdepartmental relationships was effective. The component of “supplier uncertainty” related to the environmental uncertainty factor had the highest weight with a coefficient of 0.905. On the other hand, the “commitment” component related to interdepartmental relationships had the highest weight with a coefficient of 0.865. Also, the component of “top management support” with a weight of 0.997 had the greatest effect in defining the inter-organizational facilitators.




Conclusion
Honesty, commitment and common vision among supply chain partners can improve the information sharing and information quality in pharmaceutical and medical consumable SCM. The best information systems can achieve improved performance when different members involved in the SCM have willingness to share information. The inter-organizational facilitators and environmental uncertainty have no significant relationship with information sharing and information quality in pharmaceutical and medical consumable SCM. However, the support of senior management, information technology management (two components of environmental uncertainty), accuracy in selecting suppliers, and paying attention to the pharmaceutical needs of patients as the final customers of the supply chain of medicine and medical consumables should not be neglected.

Ethical Considerations

Compliance with ethical guidelines
This study was approved by the Ethics Committee of Isfahan University of Medical Sciences (Code: IR.MUI.ZNOREMA.REC.1396.496).

Funding
The present article was extracted from the master's thesis of Malikeh Nouranian, approved by Department of Health Information Technology, School of Management and Medical Informatics, Isfahan University of Medical Sciences.

Authors' contributions
Initial idea, proposal development and data gathering: Malikeh Nouranian; Consultation and supervision in the preparation of the proposal: Sakineh Saghaeiannejad Isfahani.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors are grateful to the Research and Technology Vice-Chancellor of Isfahan University of Medical Sciences for approval and financial support and to the staff of Isfahan University of Medical Sciences teaching hospitals who assisted in the implementation of the research.





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