Roper St. Francis’ formula for resiliency includes fostering collaboration with both suppliers and nearby health systems.
When Doug Robertson reflects on his 23-year career at Charleston, S.C.-based Roper St. Francis, one theme stands out: evolution. What began as a straightforward purchasing role has expanded into a dynamic leadership position overseeing purchasing, contracting, and supply services across four acute hospitals, multiple surgery centers, and more than 100 physician practices. Today, as director of Supply Chain, Robertson is responsible for ensuring that the health system’s 680 beds remain supported by a steady flow of supplies, a task that has grown increasingly complex in the wake of the COVID-19 pandemic and ongoing global uncertainty.
“We’ve always had the responsibility to make sure products are available at the right price and in the right place,” Robertson said. “But over the years, supply chain has been asked to take a much broader role. It’s not just about surgical packs or gloves anymore; it’s waste management, landscaping, courier services, etc. We’re engaged in making sure every service agreement delivers quality and value.”
Beyond single-sourcing
One of the most significant lessons learned from the pandemic was the danger of depending too heavily on a single supplier. Before COVID, healthcare organizations often relied on primary vendor relationships to drive cost efficiency. But when supply lines fractured, hospitals were left scrambling.
Robertson has intentionally shifted his strategy toward diversification. “We saw how critical it was to have formal relationships beyond our primary distributor,” he said. “We always had good informal ties, but now those are formalized. We’ve signed contracts, we do quarterly business reviews, and we’re engaging more deeply. That gives us options when disruptions hit.”
This new approach reflects a broader cultural shift, moving away from an exclusive cost-driven mindset toward a more holistic view that values reliability, proximity, and resilience. Robertson points to a Texas-based mask manufacturer that kept his hospitals supplied during the pandemic. “We saved hundreds of thousands of dollars by having that domestic partner,” he explained. “Sometimes the cheapest product isn’t the best choice if it leaves you vulnerable.”
Collaboration across borders
Resiliency isn’t only about contracts – community matters too. Robertson sits on the board of the South Carolina Society of Healthcare and Supply Chain, a network that began meeting during the pandemic. The group convenes supply chain leaders from across South Carolina, North Carolina, and Georgia, along with national organizations and distribution partners.
“We wanted to make sure everyone had a voice,” Robertson said. “We brought in professors, national leaders, distributors, anyone who could help us understand what was happening and what we could do about it.”
The group paused temporarily but reconvened after Hurricane Helene devastated Baxter’s North Cove facility in North Carolina, which produces 60% of the nation’s IV solutions. “That was a wake-up call,” Robertson said. “It reminded us how fragile the system still is.”
Since then, regular meetings have continued, offering a space for hospitals to share strategies, best practices, and early warning signs. “It’s been a great success and a great way for all the supply chain leaders across the state to touch base and just ensure we’re all engaged.”
Preparing for the unknown
When asked about the greatest threats to supply continuity, Robertson doesn’t hesitate. “Geopolitical threats,” he said. “Tariffs, trade restrictions, and environmental disasters are what keep me up at night. The danger is that critical items, low volume but high acuity supplies like perfusion or dialysis fluids, get held up at the border or cut off entirely. If that happens, hospitals don’t just struggle. They could be forced to shut down services.”
To mitigate risks, Roper St. Francis relies on constant vigilance. Robertson’s team monitors open orders daily, maintains open lines with distributors, and taps into tools a predictive analytics platform used by their distribution partner. “It’s proactive inventory analysis,” he explained. “If utilization ticks up slightly, we see it right away and can plan. For example, when adding new surgeons, we know to scale custom pack production four to eight weeks in advance. That keeps our 30-day supply steady and prevents surprises.”
The health system also participates in Vizient’s Reserve program, a safeguard that sets aside critical supplies for participating members. “We haven’t had to use it yet, but knowing it’s there helps me sleep better at night,” Robertson said. “Pharmacy uses it regularly to stay out of the gray market, and it’s reassuring to know we’ve got that protection.”
Even with predictive tools and formalized contracts, Robertson stresses that resiliency ultimately comes down to people. His supply chain team includes an RN who works side by side with materials management. “That’s been a game changer,” he said. “She has the clinical insight and the relationships to bring everyone together when there’s a back order or recall. Within hours, we can make adjustments and ensure there’s no gap in patient care.”
Strong local networks also make a difference. “Working with supply chain leaders throughout South Carolina has been invaluable. We’re fortunate to have such strong connections – not just to share supplies when needed, but to exchange best practices and rely on each other for guidance and support.”
Looking ahead
If Robertson could wave a magic wand, he would increase domestic manufacturing capacity. “That would be the simplest path to resiliency,” he said. “But realistically, it’s not possible for every category. Some supplies are too costly or environmentally difficult to produce here. It’s a catch-22. The price we demand is part of what drives production overseas.”
Still, Robertson remains optimistic. By fostering deeper partnerships, leveraging technology, and maintaining open collaboration across hospitals and suppliers, he believes healthcare can weather the uncertainties ahead.
“We can’t purchase our way out of every situation,” he said. “Resiliency comes from vigilance, relationships, and the ability to react quickly. If we keep building those strengths, we’ll be ready for whatever comes next.”