Only 2 in 10 U.S. health care executives have real-time visibility across care settings, leaving most organizations unprepared for looming supply chain disruptions and shortages.

"Without real-time supply-chain visibility, teams are forced to make critical decisions with incomplete information." said Jeff Wagner vice president of pharmacy, respiratory care and ECMO services for Texas Children's Hospital.

The recent Tecsys Health System Pharmacy Supply Chain Survey found a widening gap between perceived preparedness and operational reality. Most health systems and their pharmacies still are making mission-critical decisions using manual processes or siloed systems that do not connect with each other and provide conflicting data that hides risk until it's already too late. As a result, leaders often make high-stakes decisions with delayed, partial or manually reconciled information, even as disruptions occur with increasing frequency.

Over the past decade, pharmacies have added automation systems, analytics platforms, controlled-substance cabinets, carousel technologies, drug-diversion tools, sterile-compounding software and more. Yet despite these tools, the survey found that three-quarters of systems still lack full integration among their clinical systems, enterprise resource planning and pharmacy supply chain platforms. Even fewer, just 13%, have full integration among automation, software, robotics and pharmacy supply chain platforms.

Among other key findings from the survey:

  • Visibility is the most critical and persistent constraint Only 20% of leaders report full, real-time visibility across care settings. The remaining 80% rely on delayed, partial or manual tracking.
  • Preparedness collapses under pressure. More than three-quarters of leaders are not, or are only somewhat, prepared for managing major disruptions, with only 23% feeling very prepared.
  • Drug shortages remain rampant and consistently escape line of sight. Four in five say shortages caused the most disruption to their pharmacy operations in the last 12 to 24 months.
  • Tariff and pricing pressures are building. Two-thirds of leaders are preparing for pharmaceutical tariffs by diversifying suppliers or nearshoring, and more than 80% say rising drug costs are having an impact on performance.
  • Data readiness -- not a lack of ambition -- is slowing AI adoption. Only 15% report fully deployed AI or machine learning cases for demand forecasting, inventory optimization, drug shortage prediction or risk modeling. Thirty-five percent are still in pilot phases while 17% currently have no plans at all.
  • Although pharmacy sees itself as strategic, the C-suite doesn't. Nearly half of pharmacy leaders say their function is strategic, but only 15% of other senior leaders agree.

The escalating visibility crisis marks an inflection point, said Dr. Valerie Bandy, vice president of pharmacy solutions for Tecsys.

"Health systems can continue to accept disruption as inevitable or invest in the insight required to anticipate and manage it," he said. "As pressures on health care delivery intensify, pharmacy's role will only expand. Whether that role is defined by constant crisis response or by strategic leadership will depend on how clearly pharmacy, and the systems it relies on, can see what lies ahead."

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