Satisfaction of stakeholders with the government e-marketplace platform in a tertiary care hospital of northern India

INTRODUCTION

E-procurement, the automation of the procurement process, is an important strategy to improve industrial operations management. The e-marketplace is an online intermediary that establishes buyer-seller relationships and facilitates transactions.¹ At the same time, e-procurement in the supply chain allows companies to use the internet to procure direct or indirect materials and handle value-added services, including quality validation.² It involves a triangular relationship between buyers, sellers and e-marketplace service providers.

The procurement cycle includes defined steps, but regardless of the size or scope of the purchase, the procedure always starts with a need analysis and finishes with stock entry, payment and record keeping. Buyers progress through a series of buying stages as they educate themselves and get closer to making a final purchase choice.

The technological capabilities needed by public organizations to conduct the procurement process efficiently and strategically need improvement. Inadequate planning, lack of scientific need forecasting, antiquated procurement procedures and irregular and inconsistent tendering frequency result in higher acquisition costs, extended lead times, stock imbalances and overall commodity insecurity.³

The ability to provide services in a tertiary care hospital rests heavily on a system of procurement that is fair, transparent, focused on quality and makes the best use of public resources. As a result, these acquisitions must be made following the applicable rules and regulations of the government and in a professional, consistent, systematic and economical manner.

The purchase processes used in public sector procurement have often faced brickbats and are time-consuming. Switching to newer purchase regimes and new technology will require a change in the mindset of the stakeholders, capacity building by appropriate training of the concerned officers/officials and setting up of procurement platforms and related infrastructure, besides facilitating such purchase processes by bringing in proper updates to rules and regulations governing the same.

The Government of India (GoI), in the year 2016, unveiled the Government e-Marketplace (GeM) for public sector procurement. Ministry of Finance, GoI has updated its financial rules accordingly. However, any new method may face challenges, and stakeholder’s feedback can help in continual system improvement. We used stakeholder satisfaction to assess the successful implementation of government e-procurement. We analysed the stakeholders’ satisfaction with procurement through GeM compared to conventional purchase methods.

METHODS

We did a prospective study to gauge the stakeholders’ satisfaction regarding using the conventional method and GeM as the mode of procurement. The study was conducted during the years 2020 and 2021 in a public sector tertiary care institute with over 2000 beds. The annual expenditure on equipment and consumables was close to ₹200 crore (US$ 25 million). Professor incharge (Equipment purchase), who deals with the purchase of equipment, and hospital purchase division (HPD), which deals with the purchase of consumables and furniture items, are the two divisions that deal with the procurement in the institute.

While purchasing through GeM, the institute has to create a primary user account on the GeM portal. The primary buyer can only be the Head of the Institute. The primary buyer can further register multiple secondary buyers who are the heads/officials of various departments of the institute.

For this study, the sample included all the secondary buyers registered in the institute, storekeepers and clerks/dealing hands of the HPD. The total number of stakeholders was only 36, so we took the whole population as the participants/sample. A questionnaire was prepared, which included the stakeholders’ demographic profile and questions related to stakeholders’ perceptions about the conventional methods (local or spot purchases, quotations, rate contracts and tenders) and GeM. The questionnaire consisted of questions with responses on a Likert scale (1–5) and open-ended questions. As there were no previous studies of this kind and the total sample was only 36, we obtained the face validity of the questionnaire. We distributed the study instrument to all the stakeholders along with the participant’s information sheet. The collected data were then entered into the data collection sheet (MS Excel, 2016), and the data analysis was done using the Statistical Package for the Social Sciences v. 23. Non-parametric tests were used for statistical inference as data were not normally distributed. Paired Wilcoxon test was used to explore the difference between paired variables. The Stuart–Maxwell test assessed the difference in time for issue resolution and time to receive products. For open-ended questions, we prepared themes and analysed them accordingly. Ethical clearance was obtained from the Institutional Ethics Committee.

RESULTS

Of the 36 officers/officials who were the participants in the study, 32 (88.89%) responded as depicted in Fig 1. Fig 2 represents the designation of purchasers who participated in the study.

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FIG 1.

Summary of demographic/professional profile of the buyers (n=32)

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FIG 2.

Summary of designation of participants (n=32)

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Table I analyses the difference in the stakeholders’ perception of various parameters.

Table II represents the assessment based on the parameters of the conventional method better than the GeM platform or the GeM platform better than the conventional method through the open-ended questions.

The questionnaire also invited suggestions from the buyer group to improve the procurement process through the GeM platform and the conventional method. Table III represents the suggestions given by stakeholders to improve the procurement process through GeM and conventional methods.

DISCUSSION

Due to multiple issues in conventional procurement methods such as tedious procurement process, delays in the purchase process, a perceived lack of transparency, high transaction costs and others, the GoI launched GeM on 9 August 2016.⁴

However, purchases in the hospital and health sector add more complexities than those done by other public sectors simply due to the direct impact on patient care.⁵ In the case of purchases done for the healthcare sector, no compromise in terms of material quality is acceptable. It is a value-based sector where the patient’s life is dealt with.

Furthermore, any change in systems and processes entails training and re-training of the stakeholders, creating required infrastructure and changes in attitudes and perception and, at times, overcoming the resistance to change. Finally, because GeM is a radically different platform from the earlier procurement method, the stakeholders’ satisfaction with the new system needs to be assessed.

On analysis, three parameters revealed a significant difference. First, a significant number of the participants in the study reported ease of process in GeM. This finding may be because the electronic interface requires less paperwork and physical documentation. Second, the participants rated the conventional purchase method higher than the GeM platform for ease of contacting vendor for service. On the GeM platform, the vendor may be from any part of India and not within a feasible geographic distance to provide efficient and timely service/after-sales support. In the conventional method, the vendors tended to operate through a local network. Third, many participants reported satisfaction with the return policy using the conventional methods compared to the GeM platform. As in the case of GeM, the vendor may be from any part of India; hence, returning any product may prove to be more challenging logistically.

We asked the respondents to give their opinions about the parameter(s) on which they assessed the conventional method to be better than the GeM platform and vice-versa through open-ended questions. In response to this query, 25 participants generated 40 responses. The responses were further categorized into specific themes. Of the 40, 13 (32.5%) responses cited quality control (facility of sample evaluation, formulation and adherence to desired product specifications) as the reason for preferring the conventional method. A study by us during the same period revealed that the rejection rate of products received through purchase on the GeM platform was nearly 20% as compared to none purchased through the conventional method. The rejection was on account of non-conformance to the specifications and quality parameters therein as feature of sample evaluation before ordering was not available on GeM platform. However, as of now, sample evaluation has been incorporated into purchases through GeM.⁵

Another 11 (27.5%) responses cited administrative issues as the reason behind their preference (provision of rate contract and staggered receipt of supplies, better working relations with vendors and more straightforward implementation of return policy). Nine (22.5%) of the responses stated the conventional method to be an easier process than GeM on the perceived account of the ability to choose local vendors, ease of negotiation, easy uploading of tender documents, ease of verification of documents and ease of product demonstration. Another 7 (17.5%) responses reported easier maintenance of products procured through the conventional method because of the ability to procure complimentary after- sales service/parts and negotiate better warranty packages as the reason for their choice.

Similarly, in responding to the query-seeking participants’ opinions regarding the parameters on which they assessed GeM to be better than the conventional platform through the open-ended questions, 37 responses were generated from 25 participants. Of the total responses, 15 (40.5%) cited ease of process for rating GeM to be better than conventional methods due to the easy user interface and ease of comparison of products. Another 12 (32.4%) responses considered GeM to be more efficient in the completion of the purchase process (faster receipt, fulfilment of supply orders), and 10 (27.1%) responses mentioned that transparency in the purchase process was better when GeM is used for procurement as compared to the conventional methods.

The participants in the study also gave their opinions about which purchase platform they considered better as per their own experience. Of 25 participants who gave an unequivocal response, 14 (56%) had a favourable opinion about the conventional methods of purchase, while 11 (44%) chose GeM over the conventional process.

The questionnaire also invited suggestions from the buyer group to improve the procurement process through the GeM platform and conventional methods. Of the total responses received, some suggestions can be implemented at the level of the GeM portal, and some can be incorporated at the institute level.

At the level of the GeM portal, the buyer group desired the user interface to be modified to enable the buyer to see detailed product information, technical specifications to be better displayed, product search to be modified to accept more expansive keywords and product demonstration/sample evaluation be made a part of the process of purchase through GeM. Furthermore, they desired proper checking/verification of the vendors registered on the GeM portal. They wanted the image displayed by the vendor to be of the product offered rather than some proxy or representative image. Some responses sought changes in the delivery format to enable the supply in phases/staggered manner and wanted the option to choose local vendors given the perceived better onsite support/service viz-a-viz that provided by the distant vendor and suggested a wider choice of product and vendor. At the same time, a similar number desired an improved return policy through GeM. One (2.9%) of the respondents was apprehensive about the hidden purchase cost through the GeM platform.

Of four suggestions given for implementation at the institute level, an equal number of responses desired dedicated human resources and the establishment of a committee for implementation of GeM and that the concerned storekeeper should check the product specifications.

In the case of the procurement process through the conventional method, responses received favoured improving the process by providing more staff, an efficient workforce, proper training and orientation and introducing a fast-tracking system/deadlines for each stage of the procurement. The need for having a committee for grievance redressal and resolution of any issue was raised. Other suggestions were streamlining the purchase process, reducing procedural hurdles, availability of purchase manual with all stakeholders and reducing paperwork involved, including replacing manual correspondence with online communication. Some responses favoured ensuring transparency in the purchase process and improving prospective bidders’ awareness of online tenders. One response suggested reducing the time for vendors to respond from the existing 21 days prevalent in the institute.⁶