Development of Narcotic Substance Delivery System via Thailand Post Logistic Service
Food and Drug Administration ,Thailand

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
1. Problems and operational system prior to development As a member of the Single Convention on Narcotic Drugs of 1961, the Convention on Psychotropic Substances of 1971, and the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988, Thai Food and Drug Administration (Thai FDA), under the Narcotics Revolving Fund, is obliged to act upon any procedures specified in these conventions. Narcotics have both positive and negative impacts. According to pharmacological definition, narcotic is a chemical agent that induces stupor, coma, or insensibility to pain (also called narcotic analgesic). The agent is crucial for saving patients’ lives. However, several of these substances (especially stimulants and depressants) can be habit-forming and potentially lead to chemical dependency or even substance abuse. The substances are consequently placed under strict control of the three treaties mentioned above to prevent drug abuse or illegal use. An example of the substances found illegally used is pseudoephedrine which is a chemical precursor used to produce amphetamine. In order to ensure that all member nations follow the obligations, the United Nations Commission on Narcotic Drugs (UNCND), formed of delegates from member nations, holds annual meetings to establish framework and assess results. The assessment procedure is carried out by statistical forms being sent out to every member nation to fill out before being collected to finalize results. Each member nation then needs to improve its performance on substance and narcotic drug control accordingly. Narcotics Revolving Fund Office at Food and Drug Administration is the only organization in Thailand of which its main mission is to comprehensively manage and control psychoactive substances namely narcotics, psychotropic substances and volatile substances. The Narcotics Revolving Fund Office is responsible for domestically supplying qualified narcotics with fair price for any use with medical, scientific and industrial purposes. Besides, the office has to ensure that the substances are delivered to private and public medical institutes nationwide under tightened security. Psychoactive substances can be categorized in nine types as follows; Analgesic is used for relieving pain in patients in normal and intensive conditions such as those severely injured by accidents, wars, terrorist incidents, natural disasters or those suffering from chronic diseases such as cancers and HIVs. Morphine, Fentanyl, Codeine and Pethidine belong to this group. Depressant is used for treating patients with chronic diseases. The substances are such as Flunitrazepam, Nitrazepam, Midazolam, Alprazolam and Zolpidem. Appetite suppressant substance is used for treating patients with obesity. An example of the substances in this type is Phentermine. Drugs for Attention-Deficit Hyperactivity Disorder and anesthetic drugs used in surgery such as Ephedrine Ketamine. Stimulants for curing Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) such as Methylphenidate. Anti-addictive drug used as an analgesic such as Methadone. Cough suppressants such as Opium or Codeine. Sympathomimetic drugs such as Pseudoephedrine used for treating nasal and sinus congestion or congested tubes that drain fluid from inner ears. Migraine medications substances, Ergot Alkaloids as an example, used in acute migraine treatment. The Narcotic Revolving Fund has served a total of 1,700 medical institutes including private hospitals, animal hospitals and veterinary clinics nationwide for 40 years. The organization is equipped with a system which only allows the purchase orders which are in line with the laws and regulations imposed by relevant protocols. It also offers a postal delivery service to the customers who are unable to take the substances they purchase by themselves. Most of customers in this group generally live outside the capital Bangkok. Problems and Issues The majority of problems and issues addressed by general customers is delay in delivery. Delivery time period varies due to distance of purchasers’ addresses but it normally ranges from one to two months per delivery. The common complaints filed by the customers are loss and damage of products as well as technical errors in delivery service by post. These issues inevitably pose direct and indirect impact on the patients who are in need of use of the substances in the nine categories across the country.

B. Strategic Approach

 2. What was the solution?
2. Solution Proposers, Executors and Concerned Persons During year 2011 – 2012, the Narcotic Revolving Fund conducted meetings and discussion sessions with related persons to hear their opinions with regards to the addressed issues and find out solutions to respond. The meetings are classified into three groups as follows; 1. Three seminars attended by doctors, medical personnel and physicians including both experienced and newly graduated ones from the central, southern and northeastern regions of Thailand. 2. Two seminars attended by doctors, medical personnel and staff in charge of storing narcotic medicines across the country. 3. A seminar attended by leaders of pharmaceutical profession and medical staff from narcotics storage units at hospitals nationwide. The Narcotic Revolving Fund used social networking tools such as email, Facebook and four regional medical networks to acquire needed information and conducted the customer satisfaction report in 2013. The information from both referred sources shows that; Convenience and speed of delivery are key factors that customers (82.8%) most concern, however, they are rated least satisfied by customers (65.43%). After taking the information into the SWOT Analysis, the Narcotic Revolving Fund concluded external and internal factors of the problems as follows; External factors Security and quality control of delivery system The (former) delivery system of narcotic substances causes delays, consumes a lot of time and cannot guarantee precise delivery period to customers. Medical narcotic substances are not segregated from other parcels during delivery process, thus, they are prone to regular error, damage and loss. Transports used for delivery service have no quality control. The substance packages are often reported damaged, broken or leaked due to lack of suspension system. Delivery tracking system There is no monitoring system to track delivery status. Customers have to call the Narcotic Revolving Fund office during office hours and then contact Thailand Post office by themselves. No coordinator is assigned to respond to emergency cases. Internal factors All steps in the process starting from purchase order, order approval, order verification to delivery process are done manually without any automatic program. Officers have to type data manually using Microsoft Excel software. The whole process is therefore time-consuming and prone to error making. The involved process is complicated and resource-consuming unnecessarily. The staff has to manually prepare medicines, load them into trucks and send them to the Nonthabutri Post Office which then needs to transfer the stock to the Central Post Office. The Central Post Office then delivers the stock to the purchasers. It can be concluded that the former system of narcotic substance delivery (via normal postal service) is economical but causes high risk of safety, delayed delivery service and complicated working process. It inevitably affects customer’s satisfaction and the patients who need the medicines for their treatments. After analyzing the problems, the Narcotic Revolving Fund has come up with strategies and action plans to improve its services and provide high speed delivery. The strategies can be divided into 2 main areas as listed below; - Revision and minimization of internal operations process - Application of Information Technology (IT) for more effective service The Narcotics Revolving Fund then created the development plan for the Medicine Delivery Service by Thailand Post Logistic System and proposed an establishment of a working team for this project to Dr. Boonchai Somboonsuk, the Secretary of Food and Drug Administration. Furthermore, it also asked for approval for implementation in November 2012 from the Narcotics Revolving Fund Committee. After that the Director-General of the Narcotics Revolving Fund arranged a meeting with the Chief Executive Officer of Thailand Post Co., Ltd. to address the issues and call for collaboration and support in the form of partnership. The working team together with the joint committee from both organizations discussed and drafted the development plan for narcotic substance delivery system based on the accumulated information (during fiscal year 2012-2013). The team designated strategies, directions, objectives, timeline, indicators and framework as well as assigned officials to follow up the progress in a weekly meeting on Mondays. The technical teams from both organizations had worked in collaboration for three months (January - March 2013) to design a telecommunication system and develop a program to serve the whole operational process. Meanwhile, meetings were arranged regularly among involved officers to brainstorm ideas to adjust and eliminate unnecessary steps in the internal operations process in response to the newly-developed program. Once the prototype of program was ready, the program was trialed and a training plan was designed to prepare the related officers from both organizations to work efficiently in the new system. The system named ‘Shipping Tools’ was finally launched on April 1, 2013. Following the initial launch of the system, the Food and Drug Administration and the Thailand Post Co., Ltd. signed an MOU and officially introduced the Shipping Tools system to the public on June 21, 2013 at the Thailand Post headquarter.

 3. How did the initiative solve the problem and improve people’s lives?
3. Initiations The Shipping Tools system was initiated to deliver the narcotic substances to medical centers and hospitals which are not able to pick up their orders across the country. The system applies online IT which enables the medicine orders to be transferred directly from the medicine storage to the Thailand Post. Under the concept of “Cut one, Grow four”, the Narcotics Revolving Fund attempted to eliminate unnecessary procedures and increase effectiveness in four areas including speed of service, quality control, high security system and customer’s satisfaction. The system is currently served by 16 post offices nationwide to ensure effective delivery. Details Former System Shipping Tools System 1. Delivery time 1-2 months Less than 3 days 2. Steps FDA Nonthaburi Post Office Central Post Office Post Office at destination Customers (5 stops) FDA Shipping Tools Center at Chaengwattana Post Office Customers (3 stops) 3. Logistic method FDA officers load parcels into pick-ups and send to Nonthaburi post office. Thailand Post’s transports pick parcels up from the FDA medicine warehouse. 4. Database link None Database is linked directly between the FDA and the Thailand Post. 5. Security system - Parcels of narcotic medicines are mixed with other parcels. - No tracking system - Transports specially allocated to carry only narcotics - GPS tracking system attached with transports 6. Temperature Control None Air conditioning system and temperature control (set at 25 degree Celsius) 7. Notification System None Automatic SMSs carrying 13 digit numbers are sent to any customer to use in tracking their deliveries. 8. Traceability By calling to the FDA office during office hours. 24 hours availability of delivery status update on website 9. Mistake Prevention None 3-color label system 10. Return and Claim policy None Wrong or damaged deliveries can be returned immediately. 10. Report Control system None. Customers need to call the FDA office to follow up. The program automatically generates a daily summary report which is later submitted to chief officers in two organizations. 12. Time control service None Officials monitor and control the Postal’s service in the Hub and in the region on the matters, while the online report must be submitted on a daily basis. The Shipping Tools system was truly achieved by revising down its procedures, reducing unnecessary tasks and installing IT to enhance efficiency of delivery chain. The system also provides transparency in its service. Both customers and service operators can track status of their deliveries. The new system promises high-speed and punctual deliveries. The issues found in the former system are successfully resolved with the new system.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
4. Successful Strategies 4.1 The organization has Develop and implement with partnership as part of state agencies which hold social responsibility. (Patients) 4.2 Success of the project is shared and celebrated by two state agencies. However, the mutual cooperation is ultimately for the full benefits of the public. 4.3 According to the value chain, the delivery of narcotic substances shall be set as the primary activity of the Narcotics Revolving Fund’s process. 4.4 According to the SWOT Analysis, the Narcotics Revolving Fund has strong financial potentiality for development project. 4.5 The Narcotics Revolving Fund included this development project in its strategy plans for fiscal year 2013 – 2016 which aim to be achieved. 4.6 The joint committee from the two organizations was set up to develop the system and program at the beginning of the project, resulting in friendship and mutual pride of the project achievement. 4.7 Training sessions are organized to introduce proper application of the new system to customers from public and private hospitals as well as animal hospitals nationwide. The customers are also invited to share their feedback. (Plan of action : Detail in attached file)

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
5. Concerned persons The project aims to resolve the problems found in the process of narcotic substance delivery to customers and reported directly by customers. In addition, it is initiated in response to the FDA Secretary’s policy requiring the agencies under the FDA to revisit and adjust working procedures, using IT technology, for better services. The Narcotics Revolving Fund, therefore, put the issue in its urgent agenda and started implementation according to its two following strategies. - Revision and minimization of internal operations process - Application of Information Technology (IT) for more effective service To achieve the project goals, the Narcotics Revolving Fund called for collaboration from the Thailand Post, who has been responsible for delivering stock to customers, to jointly design and develop a program to improve the former system of medicine delivery. The joint team worked under support of the executive officers from both organizations three months (January - March 2013). Meanwhile, involved officers attended regular meetings to brainstorm ideas to adjust and eliminate unnecessary steps in the internal operations process. The Once the prototype of program was ready, the program was trialed and a training plan was designed to prepare the related officers from both organizations to work efficiently in the new system. The system named ‘Shipping Tools’ was finally launched on April 1, 2013. Following the initial launch of the system, the Food and Drug Administration and the Thailand Post Co., Ltd. signed an MOU and officially introduced the Shipping Tools system to the public on June 21, 2013 at the Thailand Post headquarter.
 6. How was the strategy implemented and what resources were mobilized?
6. Resources The Organization has allocated resources to each areas to facilitate and support the project. In terms of Technical Resource, Shipping Tools program is used for recording medicine delivery data and tracking delivery status. It was jointly developed by the Narcotics Revolving Fund and the Thailand Post. The latter counterpart funded all the costs. Meanwhile, in human Resource department, 5 personals are assigned for their responsibility in the following roles; 2 persons for picking and packing orders, while 2 personels are in charge of quality control as well as one person take care of loading data into Shipping Tools system. For Material Resource, the organizations swapped from using the prior sizes of boxes, which includes 4 different sizes of medicine boxes (original sizes) , No. 1 Small 0.18 meters x 0.18 meters x 0.18 meters, No. 2 Medium 0.42 meters x 0.18 meters x 0.20 meters, No. 3 Large 0.34 meters x 0.28 meters x 0.22 meters, No. 4 Extra Large 0.36 meters x 0.30 meters x 0.36 meters and the applying stickers to show the emergency status of packages. Speaking of Logistic Cost, with assistance of the Thailand Post, cost of delivery under the new system is based on package size instead of package weight. No. 1 package costs 60 baht per parcel, No. 2 package costs 70 baht per parcel and No. 3 and 4 package costs 80 baht per parcel The annual capital of the former system is 846,000 baht while the estimated annual capital of the new system is 1,157,055 baht, accounting for an increase of 311,055 baht per year (36.7%). However, the estimated annual income generated under the new system is only 0.06%. The figures will be presented to the Narcotics Revolving Fund Committee and the FDA Secretary for final decision upon investment. In term of Meeting Cost, Organization of relevant meetings is funded by the NRF.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
7. Achievement The organization has made it success in reducing procedures and service time. The number of procedures is cut down from five to three steps while the delivery service time is fastened from 1-2 months to within 3 working days. Beside, the Shipping Tools System has ensured safety of the narcotics delivery as better security system help lower risk of delivery error and loss. Apart from safety and speed of delivery, the delivery process becomes traceable, online database are accessible and shared by the Thailand Post and the FDA’s medicine warehouse. The improvement of the vehicle in delivery also play a key role in the improvement of the delivery, as specific vehicle for drugs and narcotics are used to prevent being confounded and the GPS is installed in every vehicle to track and monitor the vehicle.The Global Positioning System (GPS) is installed to the vehicle to provide a space-based satellite navigation system that provides location and time information in all weather conditions as well as screening the drivers. During the delivery process, and automatic SMS with 13 digit tracking number will be sent to customers to check status of the delivery. The Three-color label system is also applied to categorize the package. Yellow and green labels are to tell the accuracy of number of medicines whereas red indicates urgent status of the delivery. In case of damage and mistakes, customers will be able to reject and return the parcel once the parcel is delivered, the system will inform the return status afterward on a daily basis. The program will summarize delivery achievement on the daily basis and the report will be submitted to the chief officer everyday. The new system also guarantee “Quality control to the hand of customers“ as Temperature control devices are installed in delivery trucks. Temperature is set at 25 degree Celsius. Furthermore, the new system also considered “Customer’s Convenience priority” as customers can track and trace the delivery status online 24 hours a day with the 13 number digits provided to customers via SMS automatically. Customer will have no difficulties checking their parcel during non-office hours. Officials monitor and control the Postal’s service in the Hub and in the region on the matters, while the online report must be submitted on a daily basis.

 8. What were the most successful outputs and why was the initiative effective?
8. System installment to track and system assessment A regular assessment of Program and system development is carried in the weekly meeting. Information, comments, and observations are collected from the customer representatives who are invited to the meeting as well as the system transmission via social media channel during the trial and launch phase. 8.3 Full system launch - The FDA Secretary is required to report the two following indicators to the Public Health Minister. 1st Indicator: 85% of narcotic delivery via Thailand Post reaches destination within 3 days. 2nd Indicator: 90% of customers is satisfied with delivery service. 2. Calculation formula: Number of medical institutes receiving parcels within 3 days** X 100 ______________________________________________________________________ Number of all medical institutes on the delivery list*** ***Data can be retrieved from Shipping Tool system. Report showing the ratio of narcotics dispense and delivery within 10 days. The results indicates that during the first quarter the delivery process achieving within 10 days are at 81.11 percent and gradually rises to 91.27 percent in June. In the fourth quarter, the completion of the delivery process climbed to it’s peak at 93.86 percent and remain stable at approximately 92 percent since then. Another form of report also shows the average service time of narcotics ordering and delivery. According the results of the Shipping Tools system performance monitored since the beginning of the trial on April 1, 2013 onwards, the system has achieved the successful criteria in terms of number of delivery and average service time. In the3rd quarter the duration of the delivery process took approximately 9 days but after the 4th quarter, the delivery time is only 7 days.

 9. What were the main obstacles encountered and how were they overcome?
9. Obstacles, problems and management strategies At the first stage, customers were not accustomed to the new service. The fund received several calls, asking for information. At the first stage, the number of Thailand Post’s officers assigned to coordinate and supply information to customers, especially those in rural hubs, was insufficient. They also provided wrong information to customers. While, incomplete transfer of data from the former system to the new system. The solutions are Explanation provision via public relations channel which are the MOU Signing Ceremony between the two units in a bid to officially introduce the project to the public. and Meetings which were set up to acknowledge the new system to the customers across the country. The meetings were funded by the fund.Thailand Post put more officers in place and supplied them with additional information needed to facilitate customers. At the first stage, Thailand Post’s programmers temporarily moved to operate in the fund’s office.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
10. Benefits and advantages Advantages FDA/Thailand Post For the Delivery time with the New Tools system, time delivery drops significantly and the packages will be delivered within 3 days delivery time warrantee. Steps 3-step service has provided advantages to the FDA and the Thai Postal service. Meanwhile, Risk and Cost Reduction has been successfully managed as Thailand Post (Chaengwattana Post Office) sends the transports to pick up deliveries at the fund’s warehouse instead of the fund transferring the deliveries to Nonthaburi Post Office by itself as before. Digitized and Organized system, the data-based link Information of goods and customers are shared in online database accessible by the FDA and the Thailand Post which is highly beneficial to the FDA and Thailand Postal Service. Specific vehicle for drugs and narcotics to prevent being confounded has been exercised for the stringent measures. The GPS installment was done in every vehicle to track and monitor the vehicle. The quality control measure has been tightened with temperature is being controlled in the vehicle at 25 degrees Celsius. For the Notification system, an automatic SMS with 13 digit tracking number will be sent to customers to check status of the delivery. Apart from the safer protocol, the new system also shows transparency and traceability as there is a 24 hours availability of delivery status update. Mistakes are prevented by the 3-color label system in favor of the medical institutes and Thai Postal Service. The organization also prioritizes its customers’ right by set up return and claim policy. Return and claim can be filed immediately. The report control system has also been expedited for the benefit of the narcotics uses, the program will summarize delivery achievement on the daily basis and the report will be submitted to the chief officer every day. Time control service Officials monitor and control the Postal’s service in the Hub and in the region on the matters, while the online report must be submitted on a daily basis. The system has provided preventive measures and systematic delivery to ensure that hospitals and medical care units will receive correct orders within the time frame. With the temperature control system, drugs and narcotics are ensured to be kept in good condition. Moreover, the GPS system has played a key role to receive information and have the delivery watched around the clock.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
11. Is the project sustainable? The Shipping Tools is the primary activity in the Value Chain of the Fund service under the 2014-2017 fiscal budget. The development project is divided in two areas, namely the development of medicine delivery system via Thailand Post logistic service or the Shipping Tools system development and the development of online ordering and reporting IT system to serve hospitals, clinics and medical units nationwide In response to the application of Shipping Tools system, all relevant officers have been trained to operate and the Contact Point Center was already set up to coordinate, follow up and solve the problems occurring under the service system as well as receive feedback or complaints from customers across the country. In addition, the User Manual is distributed to all officers operating with the Shipping Tools system, limited access of users is enabled in the system and the system has become of officer’s performance indicators. All legible orders of medical narcotics will be sent to the center of the EGA cloud system as an online data, the center will accumulate the purchase request and register the order as an internal process before sending the substances or order to the Thai Postal service.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
12. Lessons learned Originating from problems and pressure raised by customers, the project aims at creating social responsibility, knowledge sharing, collaboration in decision making among relevant officials. Furthermore, by introducing Information Technology (IT) as a major part of the service, officials are able to develop their potentials and skills to excel their service. Even though the development project is carried out by two state agencies under different authorizations, both parties share the same mission towards the benefits of the citizens or patients. The project helps promote working in collaboration and knowledge sharing which leads to the pride shared by the two agencies. Key success factors The partnership of two government agencies in laying down strategies to develop their services for the public benefits. It is the joint project implemented by the two agencies from the start to the end of the project. The Narcotic Revolving Fund applies partnership strategy to collaborate with Food and Drug Administration and the Thailand Post as the government agencies to uphold its responsibility to the Thai society. The collaboration includes creating a service system that responds to the customer’s desire as much as possible. The right decision of the Chief Executive Officer originated of the project. The project is accomplished within a short period of time due to the support from the chiefs of the related agencies even though the initial research shows that costs will rise in both agencies. The Narcotic Revolving Fund has promoted the delivery development as the primary activity after applying Value Chain analyzing method. It also prioritizes the project as its national agenda. Participation of the responsible agents in brainstorming and finding solutions to develop the delivery development plays the key role in providing efficient standard to the customers which the fund consider its priority. The Shipping Tools system is a masterpiece of the two organizations to display its collaboration between two government agencies in supporting mutual work and process. Both will maintain their standard of service and extend their scope of work for the compatibility with the shipping tools in the future. The system will need to provide concrete online purchase system, online document endorsement, postal payment service as well as door-to-door narcotic delivery.

Contact Information

Institution Name:   Food and Drug Administration ,Thailand
Institution Type:   Government Agency  
Contact Person:   Mr.Morakot Jaroonwattana
Title:   Director of Narcotic Revolving Fund  
Telephone/ Fax:   +6625907711
Institution's / Project's Website:  
E-mail:   morakotfda@gmail.com  
Address:   Ministry of Public Health, Tiwanon Road
Postal Code:   11000
City:   Muang District
State/Province:   Nonthaburi
Country:  

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