Directional sketch · planning coverage

The hidden scale of health supply planning.

Most people can picture a product, a clinic, and a forecast. What is harder to see is the planning surface created when thousands of products must be considered across hundreds or thousands of locations. Every product–location pairing is a potential planning relationship. When active, it must reconcile demand, usable supply, lead times, variability, constraints, policies, capacity, and commitments.

We created this visualization to make that hidden scale tangible. It begins with a single vaccine refrigerator and expands through clinics, hospital networks, and national health systems. The figures show maximum planning coverage—not actual plans, calculations, or human decisions. The point is to show how rapidly the territory a planning system must govern can expand, even before shared suppliers, substitutions, transfers, budgets, and other network relationships add further complexity.

Start here · the simple version

How much might the planning system need to cover?

Everything you might supplyMedicines, vaccines, parts, diagnostics, and other products
Every place you might supply itClinics, hospitals, warehouses, and other stocking points
Every possible item–place relationshipThe largest planning-coverage envelope the system may need to govern

For each relationship that is actually active, the system must work out what is needed, what is usable, when it can arrive, what might change, which rules apply, how much capacity exists, and what has already been promised.

For mathematically minded readers

The same idea, written as two equations.

Equation 1

Maximum planning coverage

Cmax = |I| × |S|

I = items in scope · S = served or stocking locations · Cmax = maximum possible item–location relationships

Equation 2

The planning function

Pi,s = F(Di,s, Ui,s, LTi,s, Vi,s, Ci,s, Πi,s, Ki,s, Mi,s)

i = one item · s = one stocking location · evaluated across the planning horizon

Pfeasible supply plan
Ddemand
Uusable supply
LTlead times
Vvariability
Cconstraints
Πpolicies
Kcapacity
Mcommitments
The bars show maximum planning coverage—not actual plans, calculation volume, or human decisions. Actual active coverage is the sum of the assortments stocked or governed at each replenishment point and is usually smaller than the full cross-product. Every active relationship can still inherit policies, evidence, constraints, and authority from the wider network.
Every bar is divided into ten equal parts.Ten becomes ten ones; 100 becomes ten tens; 1,000 becomes ten hundreds. The shared x-axis remains the authoritative linear scale as the field of view expands.
Planning coverage · one common linear axis Scroll to expand the coverage envelope
Scale 1 of 12
Point of care · 1 stocking pointOne vaccine refrigerator10 vaccines and related products × one clinic stocking point. Each active relationship carries demand, cold-chain capacity, lead time, expiration, and replenishment requirements.Coverage · 10 relationships
Single site · 1 locationIndependent outpatient clinic100 routinely stocked medicines, diagnostics, emergency products, and clinical supplies × one location.Coverage · 100 relationships
Small network · 5 locationsFive-clinic medical groupThe same 100-item core clinical assortment × five stocking locations creates a maximum envelope of 500 possible item–location relationships.Maximum coverage · 500 relationships
Community network · 5 locationsCommunity health center network200 medicines and clinical supplies × five stocking locations creates a maximum envelope of 1,000 possible relationships.Maximum coverage · 1,000 relationships
Mid-size urban hospital system · 5 facilitiesHospital-scale coverage2,000 medicines and supplies × five facilities creates a maximum envelope of 10,000 possible relationships. Actual active coverage depends on the assortment stocked and governed at each facility. For contrast, the 100-relationship outpatient clinic is 1% of this envelope.Maximum coverage · 10,000 relationships
Regional system · 10 hospitalsLarge regional hospital network · core2,200 medicines and supplies × ten hospitals creates a maximum envelope of 22,000 possible relationships.Maximum coverage · 22,000 relationships
Regional enterprise · 300 care locationsLarge regional hospital network · full footprintIf the full 2,200-item assortment were relevant across 300 hospitals, clinics, and care locations, the maximum coverage envelope would contain 660,000 possible relationships. Actual active coverage would be sparser.Maximum coverage · 660,000 relationships
Federal health system · 170+ medical centersVA · catalog-to-center envelopeVA reports 35,000+ medical and surgical items available through MSPV across 170+ medical centers. Multiplying those published counts produces a maximum envelope of 5.95 million possible catalog-to-center relationships—not 5.95 million actual plans or stocked assortments.Maximum coverage · 5.95 million+ relationships
National supply network · 11,263 served sitesKenya · a national medical-supply networkKEMSA reaches health facilities and testing sites across all 47 counties, supporting a country of approximately 54 million people. An illustrative envelope of 1,000+ products × 11,263 served sites contains at least 11.26 million possible relationships if every product is in scope at every site.Maximum coverage · 11.26 million+ relationships
LMIC national system · 20,799 public facilities · 114M peopleEthiopia · a national public-health supply networkIn a low- and middle-income-country context, EPSS supplies public health institutions across Ethiopia, a country projected to have 113.8 million people in 2026. An illustrative envelope of 1,000 products × 20,799 public facilities contains 20.8 million possible relationships.Maximum coverage · 20.8 million relationships
High-income system · 1,500+ hospitals · 59M peopleNHS England · a universal national health systemNHS England serves approximately 59 million people—roughly half Ethiopia’s population. Yet an illustrative catalogue-to-hospital envelope of 620,000+ products × 1,500+ hospitals produces at least 930 million possible relationships. Catalogue breadth and network structure—not population alone—drive the difference.Maximum coverage · 930 million+ relationships
National thought experiment · 342 million peopleWhat if every American were in one coverage envelope?A population-scaled thought experiment—not a proposed system or operating plan. Serving 342.3 million people at the same maximum coverage density as the NHS England illustration would be equivalent to almost six NHS Englands.Maximum coverage · ≈5.4 billion relationships
The coverage expands. Human workload does not have to.

The chart shows the maximum number of item–location relationships a system might need to cover. It does not represent actual stocked relationships, calculations, individual plans, or human workload.

Real supply networks are more selective and structured. Not every product is stocked at every location. Product tiers, segmentation, aggregation, and dependent replenishment reduce the number of active relationships.

But those relationships are also connected. They may share suppliers, substitutes, transfers, capacity, budgets, commitments, policies, and decision authority. These connections create the real planning complexity.

Governance does not mean asking people to approve every relationship. It means controlling the evidence, policies, calculations, authority, and exceptions used across the network.

How Vista makes this manageable

Scale the calculations. Concentrate human judgment.

Vista separates the scale of calculation from the scale of human attention. It can evaluate a large planning surface without requiring people to touch every relationship.

Some figures come from published operating data. Others are clearly identified modeling assumptions. The U.S. endpoint is a 2026 thought experiment, not a proposed system. It scales NHS England’s maximum coverage envelope from approximately 59 million people to 342.3 million U.S. residents, producing about 5.4 billion possible relationships.
The final view · one true linear scale

What the slope actually looks like.

These are the same twelve coverage envelopes from the scrolling sequence, connected in order without a logarithmic scale. Every point retains its original value and color.

The apparent flat line is real. The first ten examples—including Ethiopia’s 20.8 million-relationship envelope—occupy less than four-tenths of one percent of this full scale. NHS England creates the first visible jump. The U.S. hypothetical becomes the wall.