vol.29 no.2 • February 2021
A Chance to Get Better Long-Term Care providers, payers and society can learn from the mistakes of COVID-19
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Virtualize Thyself. The pandemic has presented us with unprecedented challenges requiring distributor and manufacturer reps to pivot from traditional selling techniques to virtual interactions. Our experienced sales and service teams are committed to continue as your trusted virtual selling partner and help ensure your success by providing the diagnostic products still critical to you and your customers. Until we can work together in the field again, SEKISUI Diagnostics will be here for you in any other way possible. Because we understand, every result matters.
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FEBRUARY 2021 • VOLUME 29 • ISSUE 2
PUBLISHER’S LETTER By the Numbers.................................4
PHYSICIAN OFFICE LAB PAMA on Pause While COVID-19 took center stage in 2020, PAMA promises to have a major impact on lab testing in 2021................................ 6
IDN OPPORTUNITIES
A Chance to Get Better Long-Term Care providers, payers and society can learn from the mistakes of COVID-19
20 Contracting Executive Profile Susan Schrupp, Senior Vice President and Chief Purchasing Officer at Community Health Systems....................10
Sales
9 Key Factors That Guide Success Contracting Executive Profile
How to build yourself up professionally and personally
Margaret Steele, vice president of sourcing operations, Vizient...............12
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repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2021 by Share Moving Media. All rights reserved. Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Repertoire, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.
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FEBRUARY 2021 • VOLUME 29 • ISSUE 2
TRENDS Preventive Care Guidelines: Too Much of a Good Thing? Researchers suggest it might be time for some ‘de-intensification’........... 26
LEADERSHIP Two Things People Get Wrong About Purpose.............. 34
INFECTION PREVENTION
UV-C Disinfection in the Limelight Next to front-line workers and Anthony Fauci, mobile ultraviolet ‘robots’ could be the pandemic’s biggest rock stars....... 36
Quick Bytes
HEALTHY REPS Health news and notes.............. 38
Technology news
44
Rep Corner
A Working Woman Amanda Taetz learned early on that hard work pays off
40
HIDA Distributors Help Providers Avoid Fraudulent PPE Offers............... 42
NEWS Industry news................................... 47 2
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PUBLISHER’S LETTER
By the Numbers It’s Month 2 of 2021. Let’s hope things are moving back to some normalcy for the world
and our country. Speaking of normalcy, or at least some stability, I thought I’d share some stats from our recent “ReadEx” study. For those of you who took time to do the survey, thank you. For those who may not know what the survey is, every six months we send out a survey about the magazine and the ads you see in it. We do this for two reasons: 1. It provides feedback to our advertisers on how to best message to you. 2. It comes with what we call a companion study allowing you to tell us what you think of the magazine.
Scott Adams
The companion study is where the following stats come from: ʯ You continue to tell us new products featured in the magazine are the No. 1 thing you read, followed closely by the cover story. ʯ 85% of you prefer the magazine in print, while our digital version continues to grow with over 200,000 page views last year. ʯ 35% of you are under 40. ʯ 80% of you told us you use the 2-Minute Drills we produce weekly to learn about products. (If you’re not familiar with these, they are short product videos you can find on RepConnect.) ʯ And finally, the majority of readers spend more than an hour with the magazine each month. So why did I start out with normalcy and stability before giving these stats? The answer is for the last 12 years, each of the above stats (with the exception of digital) have remained very positive. It’s showing us that you continue to utilize the publication in your careers. As always, our priority is you our reader. If there is anything you would like us to work on in the future, please let us know. Have a great selling month. Dedicated to the industry, R. Scott Adams Repertoire is published monthly by Share Moving Media 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia.com; www.sharemovingmedia.com
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PHYSICIAN OFFICE LAB
PAMA on Pause While COVID-19 took center stage in 2020, PAMA promises to have a major impact on lab testing in 2021.
With 2020 overshadowed by the COVID-19 pandemic, it’s hard to believe that the Protecting
By Jim Poggi
Access to Medicare Act (PAMA) was the center of controversy around the federal budget for healthcare and lab spending as well as a serious perceived threat to hospital and physician office revenue and viability since 2017. In fact, PAMA was the cover story for Repertoire in January 2018, subject of multiple podcasts and a key topic for all lab advocacy groups since then. The 10% cuts to Medicare Clinical Lab Fee Schedule payments for three years beginning in 2018 were supposed to be subject to three further years of cuts of up to 15% in subsequent years in order to align Medicare spending on lab tests with private pay.
At the heart of the matter was the finding by the Office of the Inspector General (OIG) published in 2017 that Medicare was paying a premium of 18% to 30% for lab tests compared to private insurance. This finding led to the requirement for “applicable laboratories” to begin reporting their private pay amounts for lab tests beginning in 2017. The analysis of these rates was used to create the new, lower rate of CLFS payments that began in 2018. Concern and challenges heated up quickly and lab advocacy groups filed suit 6
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to challenge the definition of “applicable laboratory” which was considered heavily weighted to reference laboratories, which typically had the lowest private payor rates and excluded most hospital and physician practice labs. Over time the definition of “applicable laboratory” has broadened to include hospital outreach laboratories and a larger proportion of physician office labs. The prevailing sentiment in the laboratory community remains that the data is still skewed toward the large scale, low cost per test settings.
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PHYSICIAN OFFICE LAB Most Medicare CLFS fees were reduced by 10% in 2018, 2019 and 2020. At the same time, applicable labs were required to report their latest private insurance claims data in 2020 to re-set the fees going forward. Then, things started to change. In December 2019, the Laboratory Access for Beneficiaries Act (LAB) was finally passed with the intention of delaying reporting of private pay lab fees by applicable labs by one year. But, it was not intended to delay the reduction in CLFS fees which took place as scheduled in 2020.
Request for further action Despite controversy of the definition of applicable labs and CMS’ agreement to broaden the definition to include hospital outreach labs and smaller physician office labs, lab advocacy groups have continued to petition the courts to cause CMS to take further action on the definition of applicable lab. This case continues to wend its way through federal courts, with lab advocacy groups winning an appeal to allow their case to be heard.
COVID-19 has had many other impacts on lab testing. Ten new CPT codes for COVID-19 RT-PCR, antigen and antibody tests have been created. In September 2020, the Medicare Payment Advisory Committee (MedPAC) convened a public meeting to hear arguments regarding the applicable lab definition and other issues being faced due to implementation of PAMA. MedPAC is an independent federal advisory group and tasked with presenting a report with their findings to Congress in June 2021. Their report is expected to refine the analysis of PAMA spending from 2017 to 2019, review private payer rates from the first round of reporting and look at revised reporting requirements for the second round of reporting in 2022. This is likely to result in the most comprehensive review of PAMA and its impact on the laboratory community since PAMA was implemented. As a result of the COVID-19 pandemic, the CARES Act was passed and, among other stimulus programs, 8
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delayed both the next round of CLFS cuts and reporting of private pay fees by one year. CLFS CPT code reimbursement for 2021 has yet to be published but is expected to be identical to the 2020 CLFS payment schedule.
COVID-19 and lab testing COVID-19 has had many other impacts on lab testing. Ten new CPT codes for COVID-19 RT-PCR, antigen and antibody tests have been created. While the CLFS schedule changes created by PAMA designed a new unified payment amount per CPT code across all Medicare carriers, these new COVID-19 related tests are subject to local payment determinations. Meaning? Payment amounts for these tests are subject to the local Medicare carriers’ discretion. However, both the CARES act and the Families First Coronavirus Act require Medicare, Medicaid and private insurance to pay for COVID-19 testing with no deductibles or copays, both in and out of network. COVID-19 testing has clearly created a mixed bag for the laboratory community. Shutdowns of most physician offices and hospitals sharply reduced lab testing of all types in the second and third calendar quarters of 2020. At the same time, they also reduced access to care for all but the most seriously ill with COVID-19 or other conditions. As new COVID-19 tests have come to market, testing for COVID-19 diagnosis and follow up has sharply increased. Current estimates point to a monthly demand of over 34 million COVID-19 tests per month. At this point, it’s unclear how long this upsurge of tests will continue with vaccines from Pfizer and Moderna just coming to market. It’s also unclear whether the current spike in COVID-19 tests will make up for revenues lost due to shutdowns earlier in 2020. It’s likely to be another year before the dust settles and the full impact of PAMA and COVID-19 and their inter-relationship becomes clear. My initial research on both lab and hospital closures as a proxy for the results of these impacts has not been fruitful. While hospital closures have risen from 2015 to 2019, with 47 closed in 2019 there is no reliable more recent data available. In addition, CLIA lab license data through 2018 shows a slight increase in lab licenses driven by CLIA certificates of waiver, but 2020 data is also not yet available. Moderate and high complexity licenses are down slightly, but that is part of a larger trend that began several years ago. PAMA and the COVID-19 pandemic have both had dramatic impacts on the healthcare system and lab testing in particular. Their inter-relationship is a tug of war with impacts sure to be felt in 2021 and beyond.
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IDN OPPORTUNITIES
Contracting Executive Profile Susan Schrupp, senior vice president and chief purchasing officer at Community Health Systems Susan Schrupp is the SVP and Chief Purchasing Officer for CHS overseeing Supply Chain. Schrupp joined CHS in
May of 2018 and has the responsibility for managing the procure-to-pay process for the health system’s spend of more than $4B annually in supplies and purchased services. Additional areas of responsibility include overseeing contract administration, lab and imaging service lines, travel, and biomedical engineering functions. Schrupp has over 25 years of experience in healthcare group purchasing organizations including Premier, Consorta, and HealthTrust Purchasing Group and executive supply chain roles with Catholic Health Initiatives and MNS Supply Chain.
Schrupp holds a bachelor’s degree in health services administration and a master’s degree in business from Western Illinois University. Repertoire: What is the most challenging/rewarding project you have worked on in the last 12-18 months? Susan Schrupp: Responding to Susan Schrupp COVID-19 has not only been the most challenging project in the past 12-18 months, but also in my entire 28-year career in health care. CHS’ focus has always been to secure the supplies needed to protect our patients and staff, and that continues as our primary focus despite the challenges faced in Supply Chain. Coming to CHS in the role of CPO and re-launching our Supply Chain has been rewarding and gave us a solid foundation for the COVID-19 response. The positive, collaborative spirit by our clinicians, hospital operators, IT, corporate departments, and executive team has been amazing. We’ve set our future vision and outlined key focus areas that include: execution of Clinical Initiatives, enhancing Data Analytics, refining Sourcing, restructuring our Supply Chain Operations, and implementing a single Supply Chain Platform. This is a multi-year journey and we have been highly centered on building the plan collaboratively, communicating our progress and performance, and engaging end users to build an intuitive high performing model. We are seeing a significant return on this investment and we will continue our journey focusing on having the right items, at the right time, at the right price. 10
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Repertoire: What project or initiative are you looking forward to working on? Schrupp: Upgrading our Supply Chain ERP system by moving to the Cloud. We have opportunities to improve our business processes for our hospitals and better leverage the collective volume of the organization. Making our procure-to-pay system more intuitive and efficient for end users to focus on the right cost management areas is key. Our partnership with finance operations and IT is imperative to modernizing our system. Repertoire: How are you better at practicing your profession than you were 5-10 years ago? Schrupp: I believe these areas are essential to continuous improvement in health care supply chain: ʯ Keep focused on clinical partnering. ʯ Communicate your plan and openly and routinely measure progress. ʯ Back assumptions with data. Provide access to data and collaboration with stakeholders to achieve mutual goals. ʯ Ensure incentives are aligned to move collectively in the right direction within your organization and your group purchasing organization. ʯ Keep the door open for feedback from leadership and your team members. I am thankful for honest, direct leaders that share what is on their mind and are engaged to make change and improve.
IDN OPPORTUNITIES
Contracting Executive Profile Margaret Steele, vice president of sourcing operations, Vizient
Margaret Steele joined Vizient in
2010, as a sourcing executive of purchased services after leaving a successful career at Beckett Media where she was named one of the youngest vice presidents, leading publishing and new media before serving as chief operating officer. At Vizient, Steele helped create and launch Vizient’s purchased services advisory offering by working with aggregation groups, regional offices as well as individual member hospitals to help create savings strategies in the products-andservices category.
Margaret Steele
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As vice president of sourcing operations, Margaret directs Vizient’s strategy and implementation of national contract agreements for the medical, surgical and distribution sourcing team. She also has oversight of four Vizient member hospital councils, including clinical and supply, perioperative, respiratory and wound management. These councils offer guidance on areas of focus for contracting and supplier selection. Additionally, she serves as the executive sponsor for Vizient’s large IDN supply network (LISN), which focuses on sharing best practices and education for supply chain professionals and collaboration with suppliers to achieve overall performance improvement. Repertoire: What is the most challenging/rewarding project you have worked on in the last 12-18 months? Margaret Steele: No question, it’s been working collaboratively with the 70-plus person team at Vizient that has been focused on supporting Vizient member hospitals as they confront COVID-19. The last 12 weeks have been nonstop, and this group has been incredibly creative and bold in finding and presenting new solutions for our members that include valuable Vizient contract protections. This includes vetting countless suppliers promising available PPE products as well as expanding current supplier offerings, sourcing through alternative suppliers and/or providing support for expanding manufacturing lines. I’ve never been more proud to work with and be part of such an amazing team and this experience will definitely change how we approach sourcing as we look to do our part to create a more resilient health care supply chain. Repertoire: What project or initiative are you looking forward to working on? Steele: Vizient is so much more than a GPO. I’m excited about continuing to evolve our relationships with members and suppliers so that our conversations are much more strategic and not just focused on price. We want to work together to improve supply chain resiliency and better connect products to clinical outcomes. When we each bring our best forward, it’s amazing the types of innovative programs we can offer to Vizient members. Performance improvement requires data and analytics, deep expertise and innovative conversations moving us lightyears ahead of traditional supply chain. We are focused on supporting our members in their efforts to provide quality care for patients regardless of the type of facility, including when they are receiving care at home.
Repertoire: How are you better at practicing your profession than you were 5-10 years ago? Steele: Ten years ago, I was just entering the healthcare industry. For the first seven years, I was focused on purchased services, working with member hospitals helping them identify, categorize and develop a savings plan for that array of products and services. I then moved to medical, surgical and distribution sourcing, which is quite a bit different than purchased services. After 10 years, I’ve gained a much better understanding of the needs and challenges our members face as well as considerations that are unique to suppliers. I have the opportunity to work with some of the smartest people I know. It’s incredibly humbling but certainly leads to a nonstop learning environment which I truly enjoy.
We want to work together to improve supply chain resiliency and better connect products to clinical outcomes. When we each bring our best forward, it’s amazing the types of innovative programs we can offer to Vizient members. Repertoire: What lesson or lessons do you think supply chain leaders will take from the COVID-19 pandemic? Steele: For years, healthcare providers have been laserfocused on savings. This focus has driven them, in many cases, to the lowest priced product in the market, which is often manufactured in other countries. With the pandemic, we’ve all experienced the consequences of this strategy. Everyone in healthcare now understands the importance of redundancy in manufacturing, stable manufacturing environments and access. This may mean a shift to more North American sites. We will all have to weigh the risk of potentially higher costs versus stability as we move forward. Transparency into the supply chain is key to mitigating future shortages. Our industry must evolve to increase our ability to monitor raw materials, understand the manufacturing origin of the products, how they are transported, manage reserves and increase our collaboration with vetted suppliers. This will help ensure our member hospitals’ focus during emergency situations is not on finding products but on caring for patients. www.repertoiremag.com
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SALES
9 Key Factors That Guide Success How to build yourself up professionally and personally By Sandler Systems Most people say that they want
to be successful in life, achieve their goals and feel content with their accomplishments. For countless people, however, understanding how to reach success can be confusing and daunting. Here are nine key factors that separate those who succeed from those who don’t!
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1. Hard-wired traits There are a few important “success traits” that develop in childhood. Children between age 1 and 6 years who are encouraged to develop ambition and drive are more likely to succeed later. For example, some individuals develop a strong work ethic early in life. Whether it’s following through with chores at home or helping a classmate with an assignment, the need to excel is nurtured and celebrated. These people learn about risk early on, and develop a different outlook; rather than being averse to challenges, those likely to succeed view them as motivation. 2. Soft-wired traits Although there are success characteristics developed in childhood, there are also certain traits that are cultivated throughout life and over time that offer improvement and growth. One soft-wired trait is resilience. Those who succeed in their professional and personal lives are able to push themselves even when they fail. Rather than relaxing in their comfort zones, they understand how to move forward and shatter boundaries. It’s important to note that those who are most successful also take a different view of failure. Rather than seeing it as a negative, they view it as a cog in the wheel of success.
Interestingly, these people often talk about success in the same terms as those at the top of the group. The key difference, however, is that those on the bottom are unwilling to do what is required. They tend to make excuses about why they’re not reaching their goals. You’ll find these divisions to be accurate in both professional and personal life. 5. Tapping into the three influencers of success: belief, behavior, and baggage These three areas can either drive success or hinder people’s progress. The first is belief. All people have deep down inner beliefs that aren’t questioned, from which they develop personal and professional guidelines that govern the choices they make. Those who are successful have strong core beliefs that drive their progress. These core beliefs help to create positive guidelines, followed by rules that are meant to be challenges as the person progresses personally and professionally. Often, when someone wants to improve their life and achieve success, they must be willing to change their innate beliefs.
3. A keen understanding of top behaviors Every position or job has specific behaviors necessary for success. The individuals most oriented toward success have a keen understanding of these behaviors. In sales for example, these behaviors include knowing how to prospect and generate fresh leads for the company. Not only do they show a deep appreciation and comprehension of what is needed to reach their goals, they also carry out the behaviors consistently, and practice those that give predictable results.
Those who succeed in their professional and personal lives are able to push themselves even when they fail. Rather than relaxing in their comfort zones, they understand how to move forward and shatter boundaries.
4. Position yourself for success Within an organization, there appears to be a stratification that occurs, defining the success and behaviors of those who are a part of the group. Generally, you will see a 20/60/20 breakout. The top 20% are the high-performing leaders, the visionaries, those that know what success looks like and how they’re going to get there. The middle 60% are the variable are average performers who sometimes see success, but not consistently enough for them to join those at the top. The bottom 20% are the low performers without the behaviors and beliefs to make genuine success possible.
Everyone has behaviors that impact their success. As mentioned, successful people identify the behaviors that positively impact their success, translate this knowledge into action, and do it consistently. Baggage is the final influencer that holds people back. Countless people have things dragging them down like an anchor. Rather than tackling these issues, they simply choose to mitigate them. To see progress, people must move forward by reducing the impact of this baggage on their beliefs and behaviors rather than trying to work around it. www.repertoiremag.com
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SALES 6. The success triangle Success can be a complex concept. To simplify it, think of success as a triangle of behavior, attitude and technique. All three are critical aspects to a thriving professional career. Behavior is the daily, weekly and monthly activity needed to achieve one’s short-term and long-term goals. Attitude greatly impacts one’s behavior. If a person upholds a “winning attitude” and believes they are effective in their behavior, they will continue to press forward no matter the obstacle. Technique is the third point of the triangle. Technique is the set of skills that separate one person from the next. Non-traditional, unconventional techniques can provide the slight edge one requires to finish on top. This triangular approach helps to break down the components of success and identify which area needs the most development. 7. Head trash Often people find that their minds become filled with distractions based on their internal fears. This is called “head trash.” Most people have a fear of failure. They find themselves stunted by thoughts of what could possibly go wrong and it hinders their ability to move forward. Conversely, however, many people also have a fear of success. They worry that if they see some success, they will have to be successful all the time. In other words, if they start to put up great numbers in sales, they’ll be expected to post those numbers every quarter. They’re afraid of being singled out as successful, and of the additional stress that goes along with it. Understanding “head trash” and moving past it can have a tremendous impact on success. 8. Success needs nurturing It’s helpful to keep in mind that success is a shifting plane, not an end goal. Succeeding and being successful are two different things! While about 2% of the population are goal setters, the other 98% are problem solvers. But goals are important to moving forward and providing the traction needed to progress. Successful people set goals and adjust as needed, to align with their everchanging success.
9. The formula for success There is a distinct formula that can be used to understand success and what certain people do differently that helps them land on top. This formula is comprised of goals, the top behaviors, and using the optimal Key Performance Indicators. In other words, those who are going to succeed will set the needed goals, understand the behaviors necessary to help them achieve those objectives, and be able to measure their progress and behaviors.
Those who are successful have strong core beliefs that drive their progress. These core beliefs help to create positive guidelines, followed by rules that are meant to be challenges as the person progresses personally and professionally. Those who are successful have carefully balanced both psychological and behavioral elements; they not only understand the ‘why’ behind their actions, but they grasp what they need to accomplish and how to execute accordingly. Those who are unable to move beyond mediocrity find themselves focusing on one element or the other, but they struggle to bring them together. Successful people are able to so keenly fuse the psychological and behavioral elements together that they use them as cornerstones to build themselves up professionally and personally. Interested in learning more about how to achieve success – both professionally and personally? To schedule a complimentary 30-minute advisory session on goal-setting, a success formula, or other sales or sales management challenges, send your request and contact information to SalesTips@repertoiremag.com with “Free Consultation” in the subject line.
About Sandler Training With over 250 local training centers around the globe, Sandler is the worldwide leader for sales, management, and customer service training. We help individuals and teams from Fortune 500 companies to independent producers dramatically improve sales, while reducing operational and leadership friction. © 2021 Sandler Systems, Inc. All rights reserved.
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By Mark Thill
A Chance to Get Better Long-Term Care providers, payers and society can learn from the mistakes of COVID-19
Ask Dallas Taylor, RN, “Why are there so many COVID-19-
related deaths in nursing homes and long-term-care facilities?” and she’ll ask you right back, “What do you know about long-term care?” Taylor is director of nursing at the Village of St. Edward Community in Fairlawn, Ohio, and was a member of the federal government’s Coronavirus Commission for Safety and Quality in Nursing Homes. She acknowledges the challenges nursing homes face, and the “cracks in the system” that the pandemic exposed. But after working in the field for 20 years, she wouldn’t work anywhere else. And she believes that COVID-19 can bring about longterm improvements in nursing home care. Ever since its appearance, COVID-19 has jeopardized the health and well-being of nursing home residents and staff. By the end of the first week of December, almost 82,000 nursing-home residents and 1,200 staff had died due to COVID-19, reported the Centers for Disease Control and Prevention. Recognizing the problem, the Centers for Medicare & Medicaid Services in May convened a commission of experts to draw lessons learned from the early days of the pandemic and develop recommendations for future actions to improve infection prevention and control measures, safety procedures, and the quality of life of residents in nursing homes. A call went out for people to www.repertoiremag.com
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A Chance to Get Better
participate in the Coronavirus Commission for Safety and Quality in Nursing Homes. Taylor heard about it and submitted an application. Ultimately, she was one of 25 people selected for the months-long task, which culminated with the publication of a 36-page report in September. The Commission issued 27 recommendations and accompanying action steps organized into 10 themes. But its members also issued this caveat: “Unless accompanied by sustainable, systems-level change addressing the issues discussed in the report, these recommendations will likely be inadequate to enable nursing homes to prevent the next crisis.” The question is, will systems-level change take place?
‘We weren’t designed for this’ “I wasn’t expecting to be selected,” says Taylor, who was director of nursing at Eliza Bryant Village in Cleveland, Ohio, when she submitted her application to be a member of the Commission. “Once you get involved in something like that, you realize that everybody – whether they’re in Nebraska, Texas or California – is going through the same things you’re going through in Ohio.”
“When I got into long-term care, hospitals kept patients for weeks; we wouldn’t get them until they were stable,” she says. “Now, they may come three, four or five days after heart surgery. They have more complex illnesses. They require more care. We have people who can’t breathe, people with diabetes who have to be monitored on a routine basis. Nursing homes weren’t designed for this.” Funding hasn’t kept pace with these new demands, says Taylor. “Nursing homes do not have the resources, funding or financial stability to allow one person to focus on one task,” she says. “For instance, I am the director of nursing and the infection preventionist. The assistant DONs, in addition to their regular duties, also handle wounds and manage other programs, such as restorative care and staff development. “We weren’t designed to handle a pandemic. We didn’t have ventilators; we didn’t have the necessary medicine on hand.” Nor did they have adequate PPE. “What has been so different with COVID-19 is the constant use of PPE. Before, you may have had an outbreak of flu for a couple of weeks, twice a year. But when the whole building gets sick, that’s something we couldn’t
Reuse of N95s en masse
COVID-19 forced providers to do things they hadn’t considered before, such as reusing single-use items. On March 28 – in the early days of the pandemic – the U.S. Food and Drug
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Administration issued an Emergency Use Authorization (EAU) for the use of the Battelle Critical Care Decontamination System (CCDS) for use in decontaminating compatible N95
respirators for multiple-user reuse. Shortly thereafter, Battelle got a $400 million federal contract to decontaminate N95 respirators and offer the service free to hospitals. Battelle is a nonprofit science and technology development company located in Columbus, Ohio. Battelle had actually developed the decontamination process – which uses concentrated hydrogen peroxide vapor – in response to the 2014 Ebola outbreak, but only implemented it during the COVID-19 pandemic. At its peak, the company operated 48 decontamination facilities, but by the beginning of December, as the federal contract was winding down, that number was down to 21. At that time, the company had decontaminated more than 3 million N95s, according to a spokesperson.
Commission recommendations In May, the Centers for Medicare & Medicaid Services convened the Coronavirus Commission for Safety and Quality in Nursing Homes to solicit lessons learned from the early days of the pandemic and develop recommendations to improve infection prevention and control measures, safety procedures, and the quality of life of residents in nursing homes. In September, the Commission published 27 recommendations and accompanying action steps intended to respond to:
ʯ Ongoing supply and affordability dilemmas related to testing, screening and personal protective equipment. ʯ Tension between infection control measures and quality-of-life issues associated with cohorting and visitation policies.
ʯ A call for transparent and acces-
sible communications with residents, their representatives and loved ones, and the public. ʯ Urgent need to train, support, protect, and respect direct-care providers. ʯ Outdated infrastructure of many nursing-home facilities.
ʯ Opportunities to create and
organize guidance to owners and administrators that is more actionable. ʯ Insufficient funding for quality nursing home operations, workforce performance, and resident safety.
The report can be viewed at https://sites.mitre.org/nhcovidcomm/wp-content/uploads/sites/14/2020/09/FINALREPORT-of-NH-Commission-Public-Release-Case-20-2378.pdf
accommodate.” And because COVID-19 affected every area of the United States, nursing homes such as Eliza Bryant had nowhere to turn for relief. “We thought that because nursing homes are funded by CMS, we would not have a problem getting the supplies we needed. We never dreamed it would be such a struggle.” What’s more, prior to COVID-19, the reuse or decontamination of singleuse PPE was unheard of, she says.
Game-changer In the pandemic’s early days, Holly Heights Nursing Home in Denver received N95 respirators, isolation gowns and face shields from a local construction company, says Executive Director Janet Snipes, LNHA, another member of the Coronavirus Commission. “Once we received these items, it was a game-changer in containing the spread of the virus. “Now we have the ability to test our residents and staff; we have more PPE than we did when the pandemic started; and we understand that general community spread [of the coronavirus] leads to nursing-home spread,” she says. Staffing remains a challenge. “It’s one of the things I think a lot about,” says Snipes. The industry lacks sufficient numbers of RNs, LPNs and CNAs. “People have
to be incentivized to go to school to learn these skills and then to work in nursing homes.” Fulfilling one of the Commission’s recommendations – hiring an infection preventionist – remains a struggle for nursing homes across the nation, she adds. “When the pandemic began, our community had two full-time infection preventionists.” But one had to remove herself from work because of comorbidities, and the other was diagnosed with COVID and had to isolate for 14 days. “Infection preventionists are so valuable in our day-to-day operations. We need a program that will help us obtain both IPs and nursing staff in general.” Given the emotional trauma of treating residents with COVID-19, long-term-care facilities have found it more difficult than ever to retain staff, says Snipes. “You hear a lot about PTSD; it’s very real. We’ve had staff who say they’ll never work in healthcare again. And to this day, some continue to seek counseling to help them cope.” But she looks forward to a different – and better – future for long-term care. The Holly Heights team is working on strategic planning now. “I see more private rooms in the future,” which will help slow the spread of infectious diseases, she says. And the facility has made changes to its physical plant, such as installing HEPA air filters, air-purifying units and ultraviolet lighting to disinfect rooms. www.repertoiremag.com
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A Chance to Get Better
Snipes says she sees a future in which federal and state surveyors serve as partners with nursing homes to improve patient’s care and quality of life. And while infectious disease will always be a threat, COVID-19 has served as a valuable learning experience, she says. “I can’t imagine not always having a three-month supply of PPE on hand or the training for how to use it properly.”
Cautiously optimistic Meanwhile, Dallas Taylor is cautiously optimistic about the future. “The Commission made a lot of good recommendations. But if our recommendations are pushed to the wayside, things will get worse before they get better. “Nursing homes are expected to do things that they were never designed to do. Most of our workers are underpaid and underexperienced in dealing with a pandemic such as COVID-19, yet they have the incredible task of being responsible for someone whose life is in their hands while taking care of themselves. And the pandemic isn’t going anywhere anytime soon. “But I am hopeful. Those of us in long-term care believe in what we’re doing, and we love it. We just need people to listen.” Editor’s note: The report of the Coronavirus Commission for Safety and Quality in Nursing Homes can be accessed at https://sites.mitre.org/nhcovidcomm/wp-content/uploads/ sites/14/2020/09/FINAL-REPORT-of-NH-CommissionPublic-Release-Case-20-2378.pdf
For nursing homes: A moment in time “Everybody understands nursing homes are under siege,” says Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation and a member of the federal Coronavirus Commission for Safety and Quality in Nursing Homes. “[COVID] exposed fundamental flaws in nursing homes in this country. Having the spotlight makes this a moment in time when we must act. Policymakers are paying attention, the sector is undergoing major upheaval.” The Foundation – a private philanthropy dedicated to improving the care of older adults – has several projects in the works to facilitate change, she says. It is working with the FrameWorks Institute to reframe the narrative around nursing home care – one based on “the actual story and science of longterm care, instead of the
back-and-forth headlines we see every day.” The Foundation is also working with the Institute for Healthcare Improvement, the American Hospital Association and the Catholic Health Association of the United States to promote “Age-Friendly Health Systems,” that is, systems that focus on what matters most to older adults, and that provide care aligned with residents’ goals and preferences. The Age-Friendly approach has been adopted in 1,100 care sites, says Fulmer. Additionally, the Foundation is the primary sponsor of an initiative by the National Academies of Sciences, Engineering and Medicine to examine how the nation delivers, regulates, finances and measures quality of nursing home care, including challenges brought to light by COVID-19.
Infection prevention training In November, the Centers for Medicare & Medicaid Services recognized 1,092 nursing homes in which 50% or more of staff completed CMS training designed to help staff combat the spread of COVID-19. More than 125,000 individuals from 7,313 nursing homes completed the training, representing approximately 12.5% of approximately one million nursing home staff in the country. The training modules for frontline staff include: ʯ Hand hygiene and PPE. ʯ Screening and surveillance. ʯ Cleaning the nursing home. ʯ Cohorting. ʯ Caring for residents with dementia in a pandemic.
The modules for management include those topics as well as: ʯ Infection prevention and control. ʯ Emergency preparedness and surge capacity. ʯ Addressing emotional health of residents and staff. ʯ Telehealth for nursing homes. ʯ Getting your vaccine delivery system ready.
The training is available on the CMS Quality, Safety & Education Portal at https://QSEP.cms.gov.
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Preventive Care Guidelines: Too Much of a Good Thing? Researchers suggest it might be time for some ‘de-intensification’ Editor’s note: The following is fourth in a series about changes occurring among primary care physicians.
Does anybody actually oppose the concept of preventive medicine for kids and adults? Ask yourself: How many
people do you know who believe that regular blood pressure checks at the pediatrician’s office or annual well-woman visits are bad?
Yet in a research report and accompanying editorial in JAMA Internal Medicine this fall, clinicians from the University of Michigan and elsewhere raised a red flag: They ask, Have we reached a point where providers have too many guidelines to keep track of, including those pertaining to preventive care? When professional societies or governmental agencies add recommendations to their guidelines, do they remove others of lesser value? Is it time to “de-intensify” preventive care guidelines? 26
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“Much of health care involves established, routine, or continuing use of medical services for chronic conditions or prevention,” write the authors of “Identifying Recommendations for Stopping or Scaling Back Unnecessary Routine Services in Primary Care.” “Stopping some of these services when the benefits no longer outweigh the risks (e.g., owing to older age or worsening health) or when there is a change in the evidence that had previously supported ongoing treatment and monitoring, presents
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1. Moulik Moulik PK, PK, Mtonga Mtonga R, Gill R, Gill GV. GV. Amputation Amputation andand mortality mortality in new-onset in new-onset diabetic diabetic footfoot ulcers ulcers stratified stratified by etiology. by etiology. Diabetes Diabetes Care. Care. 2003;26(2):491-494. 2003;26(2):491-494. Kamaratos 2. Kamaratos AV, Tzirogiannis AV, Tzirogiannis KN, KN, Iraklianou Iraklianou SA, Panoutsopoulos Panoutsopoulos GI, Kanellos GI, Kanellos IE, Melidonis IE, Melidonis AI.stratified Manuka AI.stratified Manuka honey-impregnated honey-impregnated dressings dressings in the in the treatment treatment of neuropathic of neuropathic diabetic diabetic footfoot ulcers. ulcers. Int Wound Int Wound J. 2012;9:1-7. J. 2012;9:1-7. Moulik 1. Moulik PK, PK, Mtonga Mtonga R, Gill R, Gill GV. GV. Amputation Amputation andSA, and mortality mortality in new-onset in new-onset diabetic diabetic foot foot ulcers ulcers by etiology. by etiology. Diabetes Diabetes Care. Care. 2003;26(2):491-494. 2003;26(2):491-494. FifeKamaratos 3. Fife CE, CE, Carter Carter MJ, Tzirogiannis MJ, Walker Walker D,KN, Thomson D,KN, Thomson B, Eckert B, Eckert KA. KA. Diabetic Diabetic foot ulcer off-loading: off-loading: TheThe gap between between evidence evidence andand practice: practice: Data Data from from the the U.S. U.S. Wound Wound Registry. Registry. Advances Advances infoot Skin infoot Skin and and Wound Care. Kamaratos 2. AV, Tzirogiannis AV, Iraklianou Iraklianou SA, SA, Panoutsopoulos Panoutsopoulos GI,foot Kanellos GI,ulcer Kanellos IE, Melidonis IE, Melidonis AI. gap Manuka AI. Manuka honey-impregnated honey-impregnated dressings dressings in the in the treatment treatment of neuropathic of neuropathic diabetic diabetic ulcers. ulcers. IntWound Wound IntCare. Wound J.2014;27(7):310-316. 2012;9:1-7. J.2014;27(7):310-316. 2012;9:1-7. Armstrong 4. Armstrong DG, DG, Nguyen Nguyen HC, Lavery LA, B, LA, van van Schie Schie CH,KA. CH, Boulton Boulton AJ, foot Harkless AJ, Harkless LB. Off-loading LB. Off-loading the the diabetic diabetic foot foot wound: wound: a randomized a randomized clinical clinical trial. trial. Diabetes Diabetes Care. Care. 2001;24(6):1019-1022. 2001;24(6):1019-1022. Fife 3. Fife CE, CE, Carter Carter MJ, MJ, Walker Walker D,HC, Thomson D,Lavery Thomson Eckert B, Eckert KA. Diabetic Diabetic foot ulcer ulcer off-loading: off-loading: TheThe gap gap between between evidence evidence andand practice: practice: DataData from from the the U.S. U.S. Wound Wound Registry. Registry. Advances Advances in Skin in Skin andand Wound Wound Care. Care. 2014;27(7):310-316. 2014;27(7):310-316. Armstrong 4. Armstrong DG,DG, Nguyen Nguyen HC,HC, Lavery Lavery LA, LA, van van Schie Schie CH,CH, Boulton Boulton AJ, Harkless AJ, Harkless LB. Off-loading LB. Off-loading the the diabetic diabetic footfoot wound: wound: a randomized a randomized clinical clinical trial.trial. Diabetes Diabetes Care. Care. 2001;24(6):1019-1022. 2001;24(6):1019-1022.
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a challenge for both clinicians and patients and is rarely done successfully even when evidence favors cessation.”
Personalize preventive care “If we don’t work to get healthier as a nation, we will not be able to afford our healthcare,” says Eva Chalas, M.D., FACOG, FACS, president of the American College of Obstetricians and Gynecologists. “The steady and rather dramatic rise in healthcare cost is unsustainable. “Prevention is truly worth a pound of cure,” she says. “Unfortunately, most Americans take better care of their cars and pets than their health. The obesity epidemic – which is responsible for the development of many other conditions, including hypertension, heart disease, type 2 diabetes, cancer and musculoskeletal diseases, amongst others – continues to be on the rise. We must convince our populations to engage in healthier lifestyles, and that medications are not a substitute for lifestyle changes.” Preventive care guidelines can help, but “we should not practice ‘one size fits all’ medicine,” says Chalas. “I believe that preventive care should be personalized and as such, based on each patient’s risk factors to develop a particular condition.” In this, she agrees with the JAMA researchers, who advise against performing annual cardiac testing in individuals at low risk for cardiovascular disease. “Gaps in health care of our patients continue to exist, and we need to find ways to engage them in their healthcare to minimize risk of development of chronic diseases, such as obesity, type 2 diabetes, hypertension, 28
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heart disease and cancers related to inherited deleterious mutations. Because obstetricians and gynecologists care for their patients across their lifespan, we are uniquely positioned to predict the risk of development of these conditions, since many initially occur in pregnancy, and help patients mitigate these risks.
Preventive care should be personalized and as such, based on each patient’s risk factors to develop a particular condition. “I believe that in the future, we will be using genetic information to identify risk factors for chronic diseases at birth, and working with parents and pediatricians on mitigation strategies,” she says.
‘Clear and unambiguous’ Suzanne Berman, M.D., a pediatrician in Crossville, Tennessee, and chair of the American Academy of Pediatrics’
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TRENDS Section on Administration and Practice Management, agrees with the JAMA authors that subtracting one preventive care guideline for every new one that’s added isn’t a bad idea. But it’s not always possible, particularly with pediatrics. It’s difficult to characterize any pediatric preventive-care guidelines as non-essential, as they may add decades – not merely months or years – of healthy living to kids’ lives, she says. But like the JAMA authors, Berman believes that guidelines – whether for prevention or therapy – must be clear and unambiguous. “A guideline that says ‘Avoid use of drug X for condition Y’ is too vague,” she says. “What does ‘avoid use’ mean?” Does it mean never use the drug for that condition, or does it mean only use it under certain circumstances? And are those circumstances clearly defined? AAP policy-writers of the organization’s Bright Futures preventive care guidelines strive for precision, she points out. First launched in 1994 and updated regularly, Bright Futures offers a schedule of recommended preventive services for children, and it forms the basis for Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program. Berman points out one more difficulty associated with guidelines: It can take a long time – years, in fact – for new ones to become standard practice. For example, a study may show incontrovertibly that early supplementation of iron for babies with anemia improves outcomes, yet years may pass before the majority of pediatricians are onboard. Perhaps it’s force of habit on the part of physicians or even insurers, or simply the fact that it takes time for the majority of clinicians to become aware of new guidelines, let alone integrate them into their practices. At the same time, years may pass before the majority of doctors finally abandon practices that have been discredited. “We sometimes shake our heads and ask, ‘How can people still be doing that?’” she says. “After all, we are supposed to learn how to continually evaluate medical evidence.” But doctors are busy, they have their families and friends, or they may simply fail to stay current with certain protocols if they rarely see patients to which they apply.
Evidence-based medicine “Preventative care is an integral and important part of family medicine,” says Amy Mullins, M.D., medical director for quality and science, American Academy of Family Physicians. “Screening for disease, then altering the course of that disease if needed, is life-changing for patients and ultimately saves the health care system dollars. 30
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AAFP supports the use of evidence-based medicine, she adds. “This involves all aspects of medicine and is necessarily complex, complicated, and requires the use of many different guidelines.” The AAFP reviews recommendations put forth by the United States Preventive Services Task Force (USPSTF) and the CDC’s Advisory Committee on Immunization Practices (ACIP), and either chooses to agree or disagree with their recommendations, says Mullins. “We also review guidelines from other medical organizations and either endorse, provide an affirmation of value, or do not endorse. “Guidelines are routinely updated, and some are retired, as are the quality measures that are typically developed using the guidelines. The USPSTF and ACIP recommendations are also routinely updated. The AAFP utilizes a specific methodology for developing clinical practice guidelines based on available evidence and patient preferences.”
Preventive care guidelines: Resources ʯ Advisory Committee on Immunization
Practices (ACIP), Centers for Disease Control and Prevention, www.cdc.gov/vaccines/acip/ index.html ʯ Bright Futures, American Academy of Pediatrics, https://brightfutures.aap.org/Pages/ default.aspx ʯ Clinical Preventive Services Recommendations, American Academy of Family Physicians, www.aafp.org/family-physician/patient-care/ clinical-recommendations/clinical-practiceguidelines/clinical-preventive-servicesrecommendations.html ʯ Comparative Guideline Tables, American College of Physicians, www.acponline.org/ clinical-information/guidelines/comparativeguideline-tables. (Summaries of recommendations from a variety of U.S. and international organizations regarding controversial topics in screening, prevention and management. Available to ACP members.) ʯ Women’s Preventive Services Initiative (WPSI), American College of Obstetricians and Gynecologists, www.womenspreventivehealth.org/about ʯ U.S. Preventive Services Task Force, www.uspreventiveservicestaskforce.org/uspstf
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Formulation Counts Achieving optimal hand hygiene practices starts with the right products Hand hygiene is the primary measure for providing safer care in healthcare facilities.1 Although substantial
improvements in hand hygiene practices have occurred in recent years, many healthcare facilities continue to encounter challenges in achieving optimal hand hygiene practices.
Proper hand hygiene is more than just washing and sanitizing regularly. If healthcare personnel (HCP) have dry or cracked skin, they are not only compromising their first line of defense against illness, they are also less likely to wash or sanitize hands because it is uncomfortable to do so. Choosing products that are formulated with mild and effective ingredients available offers HCP protection
against skin damage and is a critical foundation for a hand hygiene program. Product formulation can also greatly influence the overall antimicrobial efficacy of alcohol-based hand rubs (ABHRs), the preferred method of hand hygiene when hands are not visibly soiled. It is more of an important factor than alcohol concentration alone. Product formulation www.repertoiremag.com
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can also influence the amount of ABHR needed to achieve efficacy. When formulated properly, ABHRs containing 70% ethanol have been proven to meet global standards when tested at volumes more representative of normal product use in healthcare environments.2 Almost all previous studies evaluating the efficacy of ABHR products have used application volumes of 3-5 mL or more.3 However, such large volumes are seldom used in clinical practice in U.S. healthcare settings. Two studies in which HCP were given the opportunity to select the volume of ABHR to apply to their hands during routine nursing activities, the mean volume of product applied ranged from 0.73-1.09 mL per application.4,5 These findings suggest that HCP apply variable amounts of ABHR to their hands at much lower volumes than the recommended product application for efficacy. HCP are prone to do this to achieve short dry times that allow them to return quickly to their duties.
[HCPHW]) and European Norm (EN) 1500 global standards. Additionally, using ASTM E1174, the efficacy of these formulations was compared head-to-head against 7 representative commercially available ABHRs and 2 World Health Organization (WHO) recommended formulations containing alcohol concentrations of 60% to 90%. These tests used an application volume of 2mL, which is a more realistic volume used by healthcare workers. The two ABHR products based on 70% ethanol, in a gel and foam format, met U.S. Food and Drug Administration (FDA) efficacy requirements when tested at a volume of 2 mL. In contrast, the 7 additional ABHR products and 2 WHO-recommended formulations failed to meet the same efficacy standard, suggesting that the majority of ABHRs used in U.S. hospitals may have substandard efficacy at realistic volumes. The two 70% ethanol ABHR formulations were also evaluated at dispenser output of 1.1mL, the mean product outputs for 8 commercially available ABHR product/dispenser combinations. Given the fact that HCP prefer lower volumes, they are also less likely to actuate a dispenser more than once to save time. If the ABHR in the dispenser isn’t formulated properly, HCP are not achieving proper efficacy with a single dose of product. Both the gel and foam test products met FDA efficacy requirements at both the first and the tenth application. This is the first report to demonstrate that well-formulated ABHR can meet FDA efficacy requirements at a volume achievable with a single-dispenser actuation. In conclusion, these studies collectively demonstrate that when formulated properly, ABHRs can meet efficacy standards at volumes that accurately reflect actual use in clinical settings. Our results demonstrate the importance of careful ingredient selection and proper formulation when developing ABHRs to maximize antimicrobial efficacy.
Given the fact that HCP prefer lower volumes, they are also less likely to actuate a dispenser more than once to save time. If the ABHR in the dispenser isn’t formulated properly, HCP are not achieving proper efficacy with a single dose of product. Efficacy in the real world The fact that HCP prefer to use low volumes of ABHR questions the efficacy of product in use. Can an ABHR meet efficacy at real world dosing standards? Two novel ABHR formulations containing 70% ethanol were evaluated according to American Society for Testing and Materials (ASTM) E1174 (Health Care Personnel Handwash
1. C enters for Disease Control and Prevention. Guidelines for hand hygiene in health-care settings—2002. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002;51 (RR-16):1-45. 2. Edmonds, Macinga, Comparative efficacy of commercially available alcohol-based hand rubs and World Health Organization-recommended hand rubs: Formulation matters 3. Rotter ML. Hand washing and hand disinfection. In: Mayhal CG, ed. Hospital Epidemiology and Infection Control. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2011:1365-1383. 4. Leslie RA, Donskey CJ, Zabarsky TF, Parker AE, Macinga DR, Assadian O. Measuring alocohol-based hand rub volume used by healthcare workers in practice. Antimicrob Resist Infect Control 2015;7:P295. 5. Acquarulo BA, Sullivan L, Gentile AL, Boyce JM, Martinello RA. Mixed-methods analysis of glove use as a barrier to hand hygiene. Infect Control Hosp Epidemiol 2019;40:103-5.
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LEADERSHIP
Two Things People Get Wrong About Purpose By Lisa Earle McLeod
All the cool kids have purpose. Or so it seems. As more organizations begin to adopt corporate purpose statements,
we see announcements on social media, a push for purpose-driven hiring, and CEOs deliver inspirational townhalls.
Yet for many front-line leaders, keeping an aspirational purpose alive in the cadence of daily business is challenging. Much like keeping your fitness goals or parenting aspirations front and center during a pandemic, an inspirational purpose sounds great on your best day, but in the face of stress and uncertainty, it often falls by the wayside. The economics of pointing an organization towards a higher purpose have been well documented. Aligning your team around a noble purpose bigger than money 34
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drives greater employee engagement, better customer retention, and improved competitive differentiation, all of which translate into better financial performance. After working in the purpose space for over decade, helping more than 200 firms and authoring the two seminal books about Noble Purpose in business, I’ve observed two common misperceptions that keep organizations from reaping financial and emotional rewards of purpose.
1. Purpose is purely about philanthropy Yes, you can and should use your purpose to make the world a better place. Yet, if your team thinks your purpose is about charity or simply doing good in your community, it will get sidelined. Fast. To ensure that your purpose drives your organization, it must sit at the center of your commercial model. For example, when a banking client of ours landed on the purpose “We improve financial health,” one of their first actions was to create tools to help their customers assess their baseline financial health and harness their analytics to help their customers anticipate roadblocks that may hinder their financial health. This tells the team and their customers: Our purpose, the impact we have on customers, is the foundation of every action we take. We trained their sales team to focus on the customer’s financial health during sales calls, and managers, even if they never interacted with customers directly, were trained to identify the impact their team had on the customer’s financial health. This ensures that everyone in the organization understands their role in delivering the purpose. Our counsel to clients is activate your purpose with your customers and employees before zooming in on philanthropy. You want to ensure you have concrete methods for delivering on your purpose inside your business model. ACTION: Train your sales team and front-line employees to activate your purpose with customers.
In our experience with clients, we find that layering on even a single metric for purpose can shift your strategic north. One of our clients is an IT firm whose purpose is simply, “We help make small businesses more successful.” When they began measuring how much time they were saving their clients, team performance soared. Instead of focusing internally on their own results, the team focused outwards on how they made a difference to clients. The leading indicator – time we saved clients – helped them both predict and influence the lagging indicators, like productivity, and ultimately revenue. ACTION: Choose one simple metric to assess progress against your purpose, even if it’s imperfect and anecdotal.
Activate your purpose with your customers and employees before zooming in on philanthropy. You want to ensure you have concrete methods for delivering on your purpose inside your business model.
2. Purpose can’t be measured Revenue and profit are front and center metrics, but they’re actually lagging indicators. They’re the results of the beliefs, behaviors, and words many months ago. To assess a more qualitative pillar like purpose, organizations must look towards leading indicators. You want to add metrics that help you predict the future, not just measure the past. You can measure progress against your strategic purpose by assessing your impact on customers and employees. The World Economic Forum recently released a comprehensive set of 21 Stakeholder Capitalism Metrics firms can incorporate into their scorecard.
The world is changing. Brian Stafford, host of the recent World Economic Forum: Measuring Stakeholder Capitalism and CEO of Diligent says, “There’s an evolution towards stakeholder capitalism, when the business round table shifted and made that part of their stated purpose, it allowed CEOs and boards to put a different framing from around what the goals are. “ The way we measured success in the past will not be how we measure success in the future. If you want to reap the reward of purpose, make it the center of your business and measure your progress.
About the author Lisa Earle McLeod is a leading authority on sales leadership and the author of four provocative books including the bestseller, Selling with Noble Purpose. Companies like Apple, Kimberly-Clark and Pfizer hire her to help them create passionate, purposedriven sales organization. Her NSP is to help leaders drive revenue and do work that makes them proud.
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INFECTION PREVENTION
UV-C Disinfection in the Limelight Next to front-line workers and Anthony Fauci, mobile ultraviolet ‘robots’ could be the pandemic’s biggest rock stars.
Microbiologists know that ultraviolet radiation can
disinfect air, water, and nonporous surfaces. For decades, UV-C radiation – the highest energy portion of the UV radiation spectrum – has been used to reduce the spread of bacteria, such as tuberculosis. Today, because of COVID-19, UV-C is becoming a rock star. News about UV-C “robots” – mobile units that are wheeled into patient rooms or ORs for rapid disinfection – is
showing up in daily newspapers, whose editors are likely to compare them to R2-D2. Hospital staff have even given them names, including Jabba, Zappy and Flash. But cuteness doesn’t come cheap. These units can cost anywhere from $80,000 and $100,000, so it’s not certain how widespread they will become. And at that price, they won’t make their way into the physician’s office or urgent care clinic any time soon.
Can UV-C radiation kill SARS-CoV-2? Here’s what the U.S. Food and Drug Administration says UV-C radiation is a known disinfectant for air, water, and nonporous surfaces. UV-C radiation has effectively been used for decades to reduce the spread of bacteria, such as tuberculosis. For this reason, UVC lamps are often called “germicidal” lamps. UV-C radiation has been shown to destroy the outer protein coating of the SARS-Coronavirus, which is a different virus from the current SARS-CoV-2 virus. The
destruction ultimately leads to inactivation of the virus. UV-C radiation may also be effective in inactivating the SARS-CoV-2 virus, which is the virus that causes the Coronavirus Disease 2019 (COVID-19). … However, currently there is limited published data about the wavelength, dose, and duration of UV-C radiation required to inactivate the SARS-CoV-2 virus. In addition to understanding whether UV-C radiation is effective at
inactivating a particular virus, there are also limitations to how effective UV-C radiation can be at inactivating viruses, generally. … UV-C radiation can only inactivate a virus if the virus is directly exposed to the radiation. Therefore, the inactivation of viruses on surfaces may not be effective due to blocking of the UV radiation by soil, such as dust, or other contaminants such as bodily fluids.
Source: U. S. Food and Drug Administration, https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medicaldevices/uv-lights-and-lamps-ultraviolet-c-radiation-disinfection-and-coronavirus
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Do they work? Science seems to support the effectiveness of UV-C radiation in inactivating the COVID-19 virus. On its website, the U.S. Food and Drug Administration says that “UV-C radiation may be effective in inactivating the SARS-CoV-2 virus,” [underscore added by the editors]. But the companies marketing UV-C units are more emphatic. They cite studies that show 99% or more effectiveness in inactivating the virus in a hospital room in anywhere from 2 minutes to 15 minutes. Highland Hospital in Rochester, New York, was an early adopter of UV-C technology, acquiring its first mobile unit about nine years ago, says Ann Marie Pettis, RN, BSN, CIC, FAPIC, director of ambulatory infection prevention and control. Prior to COVID-19, they were used primarily to combat Clostridium difficile and norovirus outbreaks. Today the environmental services team operates their units to combat the coronavirus and other infectious disease in the emergency departments, patient rooms and ORs.
Cost has been a factor in slowing down the adoption of UV-C units in hospitals, says Pettis, who is also president-elect of the Association for Professionals in Infection Control and Epidemiology (APIC). In addition, the science to prove their effectiveness has been somewhat slow in coming. “These are not easy studies to devise,” she says. “But I think SARS-CoV-2 has increased the interest level, and that might loosen some purse strings.” UV-C isn’t a cure-all, she says. All surfaces must be cleaned prior to the UVC treatment. “You can’t sterilize dirt.” Furthermore, UV-C isn’t effective on soft surfaces, and its effectiveness diminishes in shadowed areas. “There’s some geometry associated with using them, as you want to make sure the UV light hits all the surfaces in the room.” That may mean opening drawers, clearing off hard surfaces, and treating the patient-room bathroom as a discrete area. What’s more, UV-C is a danger to eyes and skin, so once the unit is positioned in the room, all personnel and the patient must leave and close the door prior to turning on the unit.
Who’s who in UVC lighting ʯ Permanently installed unit ʯ Mobile unit ʯ Handheld unit
American Ultraviolet (Lebanon, IN)
www.americanultraviolet.com
CleanSlate UV (Buffalo, NY))
www.cleanslateuv.com
ʯ UV “chamber” for disinfection of
Dynamics Inc. (Pittsburgh, PA)
www.nanowaveair.com
ʯ Tabletop unit inactivates aerosolized
Protec Scientific Inc. (Utica, NY)
www.protec99.com
ʯ Handheld unit
Puro (Lakewood, CO)
www.purolighting.com
ʯ Mobile unit ʯ Ceiling/wall fixtures
PurpleSun (Long Island City, NY)
www.purplesun.com
ʯ Configurable mobile unit
R-Zero Systems (San Jose CA)
www.rzero.com
ʯ Mobile unit
Sanuvox (Montreal, QC)
https://sanuvox.com/product/asept-2x
ʯ Portable twin units
Steriliz LLC (Rochester, NY)
www.rduvc.com
ʯ RD™ UVC System: mobile and fixed
Tru-D SmartUVC (Memphis, TN)
www.tru-d.com
ʯ Mobile unit
UltraViolet Devices (Valencia, CA)
www.uvdi.com
ʯ Mobile unit
UV Innovators (Cary, NC)
www.nuvawave.com
ʯ NuvaWave handheld unit
Vioguard LLC (Bothell, WA)
www.vioguard.com
ʯ Drawer-like unit for mobile devices ʯ Self-sanitizing keyboard and trackpad
Xenex (San Antonio, TX)
www.xenex.com
ʯ Mobile unit
mobile devices
COVID-19 in fast-moving air
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HEALTHY REPS
Health news and notes Butter or margarine? And if margarine, stick or tub? Margarine is made from vegetable oils, so it contains unsaturated “good” fats – polyunsaturated and monounsaturated fats, according to Mayo Clinic. These types of fats help reduce low-density lipoprotein (LDL), or “bad,” cholesterol when substituted for saturated fat. Butter, on the other hand, is made from animal fat, so it contains more saturated fat. But not all margarines are created equal. Some margarines contain trans fat, which, like saturated fat, increases blood cholesterol levels and the risk of heart disease. In general, the more solid the margarine, the more trans fat it contains. So stick margarines usually have more trans fat than tub margarines.
Obesity outmaneuvers cancer Obesity has been linked to increased risk for over a dozen different types of cancer, as well as worse prognosis and survival, according to Harvard Medical School. Over the years, scientists have identified obesity-related processes that drive tumor growth, such as metabolic changes and chronic inflammation, but a detailed understanding of the interplay between obesity and cancer has remained elusive. In a new study in mice, Harvard Medical School researchers have uncovered a new piece of the puzzle, with implications for cancer immunotherapy: Obesity allows cancer cells to outcompete tumor-killing immune cells in a battle for fuel. The findings, published in the journal Cell on Dec. 9, reveal that a high-fat diet reduces the numbers and antitumor activity of CD8+T cells – a critical type of immune cell – inside tumors.
Stress and heart health among women How a woman feels about her roles at home and at work during midlife can affect several factors that influence her heart health. A study, published Dec. 11 in the Journal of the American Heart Association, found that women who felt more stressed at their jobs or in their roles as caregivers, mothers and spouses had greater odds of having high 38
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blood pressure, being overweight and not eating a healthy diet. Conversely, those who felt their roles were more rewarding were substantially more likely to be physically active and to not smoke. And that can potentially help their heart health, said lead author Andrea Leigh Stewart. Still to be answered: Do the stress and rewards influence a woman’s heart-healthy behaviors, or do those behaviors affect her feelings about her roles?
Better you know Up to 1.6 million (or about 1 in every 100) women and girls in the United States have a bleeding disorder, many undiagnosed. Bleeding disorders, such as hemophilia (and von Willebrand disease, or VWD) are conditions in which specific proteins in the blood are missing or do not work properly, making it hard for the blood to clot. The National Hemophilia Foundation in partnership with the Centers for Disease Control and Prevention have launched “Better You Know,” a campaign to raise awareness of bleeding disorders among women and girls.
Smile (even with a mask), and your baby smiles with you In the neonatal intensive care unit at Oregon Health & Science University’s Doernbecher Children’s Hospital, COVID19-related restrictions meant that everybody visiting infant patients had to wear a mask, according to a report in Portland Monthly. Registered nurse Mollie Poor noticed the toll it was taking. She recalls one baby who had been born prepandemic but was still being treated when the restrictions came into place. “[The baby] had been smiling, and after a lot of prolonged mask use [by parents and the care team] she stopped smiling as much because she never saw anyone smiling back.” The NICU implemented clear masks, which have a foam rim sealing the nose and chin, but which give parents the ability to connect and smile with their babies. “[For] a lot of moms holding their babies for the first time, or breastfeeding, being able to smile down at their babies has been pretty impactful on them,” she says.
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REP CORNER
A Working Woman Amanda Taetz learned early on that hard work pays off It has been years since Amanda Taetz learned about work ethic, business
operations, and loving what one does for a living. She never forgot the lessons, and today she applies all of them to her work as executive vice president of MediGroup, the Missouri-based non-acute-care group purchasing organization. As a kid, she helped her father, Russell Worthington, and her grandparents run Worthington’s Delivery, a local delivery service in Fort Worth, Texas. “I spent every summer helping my grandmother in the office and riding along with my dad on deliveries,” she says. “They both made sure I stayed busy
and basically taught me the ropes to run the business. I would read maps and route out deliveries, answer the phone, watch how to change the oil in the trucks, calculate bills, etc. … I learned from an early age that hard work pays off.” Her mother, Kathy Heimburger, has worked in long-term care for as long as her daughter can remember, and currently does social work at a long-term-care facility in St. Louis. “Hearing about her day and stories about the residents, and seeing how much she truly loved what she did, made me want to find something I loved as well.” Her stepfather, John Heimburger, owns a travel agency in St. Louis. “He taught me those ‘tough life lessons.’ You want a car? Get a job. Want to go to college? Get a job. So, I got a job at the age of 15 and have been working ever since. Looking back, it was probably the best lesson he could have taught me. It built my work ethic and character, and gave me a will and drive to succeed.”
Sold on sales
Amanda Taetz
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Taetz got sold on sales during college, working at a Clinique counter at a Dillards department store in St. Louis. “I loved interacting with people, up-selling products, and helping people find solutions to their skin or makeup problems. I thrived in that role and was promoted to counter manager and picked up more hours. The more I worked and sold, the more drive I had to be the best. It was that role that sealed the deal for me going into sales.”
After the retail experience, she worked for her stepfather for a few years selling tropical vacations and destination weddings. But she became antsy sitting behind a desk, and began looking for a role in outside sales. She found one with a beer distribution company. “Being a beer drinker myself, this was a dream job, but it just had too many downfalls ultimately,” she says. But she had made good contacts, one of whom – a sales rep for PSS (now McKesson Medical-Surgical) – referred her to MediGroup CEO Andy Klearman. “I had absolutely no idea what I was getting myself in to and I had a huge learning curve, but it was the best decision I’ve ever made.” At the time, relatively few physician practices understood group purchasing, she recalls. And distributor reps were none too eager to see their customers enroll in a GPO. MediGroup hoped to change that by partnering with distributors and earning their trust. “It made a huge difference,” she says. “We make sure that everything we do and decisions we make align with and support our distributor partners’ objectives. That will never change. It’s our job as a GPO partner to make sure we bring value, solutions and savings to the table. It’s important to understand that what’s best for the customer is not always going to fall on a GPO contract, and we get that. Amanda with Evie and MJ.
During COVID-19, there were months of no selling – just trying to find solutions and help our members get in touch with suppliers. “The distributor rep’s role has evolved over the years, so our main objective is to make things as easy as possible,” she continues. “We do that by working with their contract teams to ensure contract connections, correct tiers, DEA/HINs are loaded, etc., and we work directly with our members to get them connected to all the savings and solutions available to them through our valueadded vendors. It’s a team effort, and it creates that stickiness in an account we all want.”
Pandemic demands solutions As it has for just about everyone in the healthcare supply chain, COVID-19 has challenged the people at MediGroup.
“It shifted our focus completely,” says Taetz. “We were in a huge sales growth mode and had a lot planned for 2020, including the launch of a new program, but dropped everything to focus on helping our members and distributor partners.” PPE was a primary concern for many MediGroup members. But the GPO was also asked to provide assistance with practice protocols for the pandemic, telehealth services, even floor stickers to remind people to maintain a safe physical distance. “There were months of no selling – just trying to find solutions and help our members get in touch with suppliers,” she says. “We were walking on eggshells, trying to be respectful of the situation while offering solutions to help. Once things started to re-open, we supported our distributor partners and our members in getting practices back up and running.” Amanda Taetz has two “amazing” kids who keep her busy with baseball games, skate parks and everything else. MJ is 9 and Evie is 6. She is an avid reader, but also likes to travel, roller skate, tend to her yard and garden, and enjoy a good beer. www.repertoiremag.com
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HIDA
Distributors Help Providers Avoid Fraudulent PPE Offers The ongoing battle against COVID-19 continues to generate unprecedented demand for personal protective
equipment (PPE). Faced with continued shortages, healthcare providers may be tempted to deal with unfamiliar sellers, even though many offers have proven to be fraudulent. Healthcare distributors can help providers reduce or avoid these risks.
What are the business risks associated with using an unfamiliar PPE source? The most critical risk is receiving unapproved, unsafe products. Providers who have used unvetted sources report having received incorrect product, poor quality items, or counterfeit items that fail to protect staff adequately. Other risks include losing money and wasting staff time.
What can you do to minimize the risk of sourcing from unknown vendors? Healthcare providers can trust their distributor partner to vet new sources. Purchasers who do their own sourcing should be aware that offers that sound too good to be true often are. If considering an unfamiliar source, do basic due diligence such as checking references and securing a sample. Watch for red flags including: ʯ Unrealistic promises such as too-good-to-be-true prices or volumes ʯ Advance-payment requirements ʯ Last-minute changes in payment instructions ʯ Claims that the goods are not yet produced ʯ Sellers who refuse to state which company they represent until it is time to make an agreement
What is a distributor’s role in vetting new sources of PPE? Distributors vet and identify new PPE sources, leveraging the expertise they have developed as trusted partners with both providers and manufacturers. Additionally, some distributors have international employees or agents who can evaluate inventory at overseas sites.
What other resources are available to determine if a new source is legitimate? Many manufacturers of PPE post helpful end-user purchasing information on their websites, such as lists (or hotlines) 42
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to confirm authorized sellers, the models and list prices at which their products may be sold, and descriptions of the intended use, labeling, packaging and certification of various PPE supplies. Government regulators also maintain databases providers can check to determine if a vendor is authentic: ʯ Office of Inspector General Exclusions Program identifies federally excluded organizations and individuals (https://oig.hhs.gov/exclusions/ index.asp) ʯ System for Award Management tracks whether an organization can do business with the federal government (www.sam.gov/SAM) ʯ FDA Establishment Registration & Device Listing identifies companies and the US Agent registered with the FDA (www.accessdata.fda.gov/scripts/ cdrh/cfdocs/cfRL/rl.cfm) ʯ FDA 510(k) Database identifies whether a company provided proof to the FDA that its products are as safe (www.accessdata.fda.gov/scripts/cdrh/ cfdocs/cfPMN/pmn.cfm) ʯ Counterfeit Respirators/Misrepresentation of NIOSH Approval resource page describes how to spot counterfeit product (www.cdc.gov/niosh/ npptl/usernotices/counterfeitResp.html) Throughout the COVID-19 pandemic, distributors have partnered with their provider customers to secure FDA-approved PPE and to identify appropriate substitutes for products that are in particularly short supply. Providers can continue to rely on distributors to find and deliver the supplies they need to keep themselves and their patients safe. For more distributor resources including infographics and FAQs to share with clients, visit HIDA.org/ UnderstandingHealthcareDistribution.
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QUICK BYTES Editor’s note: Technology is playing an increasing role in the day-to-day business of sales reps. In this department, Repertoire will profile the latest developments in software and gadgets that reps can use for work and play.
Technology news Immerse yourself LG Display announced that it will showcase the world’s first 48-inch Bendable Cinematic Sound OLED (CSO) optimized for gaming at CES 2021. The 48-inch Bendable CSO display utilizes OLED’s advantages as its paperthin screen bends and unfolds with a curvature radius of up to 1,000R, meaning that it can be made to bend up to a radius of 1,000mm without affecting the function of the display. It can therefore be turned into a flat screen while watching TV and used as a curved screen while gaming. The curved display offers a uniform viewing distance from the middle of the screen to its edge, maximizing the visual immersion that is popular among gamers. In addition, the company’s CSO technology enables OLED displays to vibrate and make their own sound without the use of any speakers, offering a vivid sense of reality as if the on-screen characters were talking directly to 44
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the viewer. The 48-inch Bendable CSO display’s ultra slim film exciter, which is the part that vibrates the display, has been reduced to a thickness of just 0.6mm from 9mm and therefore allows viewers to enjoy a thinner screen as well as highly impressive sound.
Who needs a desk phone? Microsoft is overhauling its calling features inside Microsoft Teams, reports The Verge. A new calling interface will show contacts, voicemail, and calling history in a single location. It’s designed to allow Microsoft Teams to more easily replace desk phones, with built-in spam call protection, reverse number lookup, and the ability to merge calls. Microsoft Teams users will also be able to transfer calls between mobile and desktop soon, allowing people to move locations in the middle of an audio or video call. The Teams app will let people join without audio on an
additional device, or transfer the call and end it automatically on other devices. Microsoft says this particular feature will be available in early 2021.
the Alexa app, and Amazon is also planning to support group calling through its Alexa app. There are no limits on call times. Without the Alexa app supporting group calling, it’s limited to requiring hardware for now, though.
A 15-year-old laptop?!? Dell wants to redesign its products so every one of them can be recycled or reused rather than thrown out, reports Fast Company. But that will take some doing. A typical laptop might have more than 200 components made from multiple materials that are glued and screwed together. It’s not simple to dissemble for recycling. The company is testing a design that would let someone push a pin in the side of a device to trigger the whole thing popping apart. “We want to go from something that might take an hour to disassemble to two minutes or less,” Ed Boyd, senior vice president, was quoted as saying. The company is also focusing on how to make its products last longer. Outer materials may be designed differently to resist signs of wear (or to acquire a patina over time, like vintage tools). Inside, artificial intelligence and machine learning could help the system last longer by making adjustments over time for energy efficiency. Software can continue to be upgraded over the cloud. “Imagine buying a PC and it lasts for 10 or 15 years, because it’s faster in year 10 than it was in year one!” said Boyd.
Did you hear his tweet? Twitter says its beta test of audio chat rooms – a feature called Spaces – is now live, reports CNET. The feature would allow users to share audio clips in tweets and direct messages. Users would also be able to create their own rooms for others to join, and they would have control over who can speak in those spaces. Twitter was also reported testing live transcriptions, emoji reactions, reporting and blocking, and sharing tweets in Spaces.
Clearer vision for those with macular degeneration An estimated 11 million people in the U.S. have some form of age-related macular degeneration, and the number is expected to double by 2050. Pleasanton, California-based IrisVision has introduced a set of goggles that use the technology of a Samsung smartphone to enhance vision for those who are visually impaired by macular degeneration, reports Lifewire. “IrisVision helps the user’s brain use the parts of their eyes that still function properly and provides enough information to fill in the gaps and remap the scene captured by the smartphone camera into a complete picture,” IrisVision co-founder and CEO Ammad Khan was quoted as saying. The goggles aren’t cheap, costing about $3,000.
New video and audio calling feature for Echo devices Amazon launched a new group video or audio calling feature for Echo devices, reports The Verge. Up to seven participants can join an audio or video call on supported Echo devices like the Echo, Echo Dot, and Echo Show. Echo owners will be able to create and name groups using
AirPods to the Max Apple recently unveiled the AirPods Max, wireless headphones that bring the magic of AirPods to an over-ear design with high-fidelity sound. AirPods Max combine a custom acoustic design, H1 chips, and advanced software to power computational audio for a breakthrough listening experience with Adaptive EQ, Active Noise Cancellation, Transparency mode, and spatial audio. AirPods Max come in five gorgeous colors, including space gray, silver, sky blue, green, and pink. From the canopy to the ear cushions, every part of AirPods Max “is carefully crafted to provide exceptional acoustic performance for each user,” Apple said. The breathable knit mesh canopy, spanning the headband, is made to distribute weight and reduce on-head pressure. The stainless steel headband frame provides strength, flexibility, and comfort for a wide variety of head shapes and sizes. Telescoping headband arms smoothly extend and stay in place to maintain the desired fit. www.repertoiremag.com
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WINDSHIELD TIME Chances are you spend a lot of time in your car. Here’s something that might help you appreciate your home-away-from-home a little more.
Automotive-related news Flying cars could become a thing
Manufacturers improve headlight offerings
Uber has scaled back some of its most ambitious hightech programs, including its air mobility business, reports NBC News. But interest in flying cars and taxicabs continues nevertheless. In December, Uber offloaded Uber Elevate, its air taxi operation. Joby Aviation of California will take over Elevate as part of a deal in which Uber will invest $75 million in the startup. Meanwhile, Hyundai and Toyota are ramping up their air mobility plans. In October, Hyundai said it would set up a separate unit to develop a complete lineup of airborne products. Meanwhile, Toyota is backing Cartivator Resource Management, which had been planning to demonstrate a single-seat flying car during the Tokyo Olympic and Paralympic Games, which have been delayed until next year. Still unanswered: Where will they park???
Several manufacturers improved their 2021 headlight offerings by eliminating or modifying inferior choices, according to new ratings from the Insurance Institute for Highway Safety. Since 2020, vehicles have only been able to qualify for the higher of the Institute’s TOP SAFETY PICK+ awards if they come equipped with good or acceptable headlights across all trims. (Many manufacturers have historically sold models with several different headlight systems of varying quality.) The 10 car models to be recognized are the Audi A7, Honda Accord, Hyundai Palisade, Mazda CX-30, Nissan Altima, Subaru Ascent, Toyota Highlander, Volvo S60, Volvo XC40 and Volvo XC60. The Institute rates headlights on the distance that their low beams and high beams illuminate straight and curved roads. On a straightaway, good-rated low beams illuminate the right side of the road ahead to at least 325 feet. Poor ones might light up 220 feet or even less. IIHS engineers also deduct points for headlights that produce glare that can momentarily blind oncoming drivers. Extra credit is awarded for systems with high-beam assist, a feature that automatically switches between high beams and low beams, since research shows that most drivers don’t use their high beams enough.
Driving facilities decline in 2019
Edmunds recently revealed its top rated cars, trucks and SUVs for 2021. Among the winners:
ʯ Top rated SUV: Kia Telluride ʯ Top rated luxury SUV: Mercedes-Benz GLE ʯ Top rated truck: Ford F150 ʯ Top rated sports car: Chevrolet Corvette ʯ Top rated EV: Tesla Model 3 ʯ Top rated luxury EV: Ford Mustang Mach-E ʯ Top rated sedan: Kia 5 ʯ Top rated luxury sedan: Mercedes Benz E-Class
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Traffic deaths decreased nationwide during 2019 as compared to 2018, and alcohol-impaired driving fatalities decreased to the lowest percentage since 1982, when the U.S. Department of Transportation’s National Highway Traffic Safety Administration started reporting alcohol data. There were 36,096 fatalities in motor vehicle traffic crashes in 2019. This represents a decrease of 739 (down 2%) from the reported 36,835 fatalities in 2018, even though vehicle miles traveled (VMT) increased by 0.8%. As a result, the fatality rate for 2019 was 1.10 fatalities per 100 million VMT – the lowest rate since 2014, and down from 1.14 fatalities per 100 million VMT in 2018. Pedestrian and pedalcyclist fatalities dropped as well.
NEWS
Industry News Henry Schein Medical helps automate, streamline patient waiting room process with Yosi Health Henry Schein Medical, the U.S. medical business of Henry Schein, Inc. (Melville, NY), recently entered into a distribution agreement with Yosi Health, a provider of digital patient scheduling, registration, payment, and communication cloud-based software solutions. According to Henry Schein, for physicians and patients looking for a streamlined waiting room process, Yosi Health’s patient intake solution, Yosi Intake, can create a contactless waiting room by enabling patients to register at home, helping to improve the patient experience and reduce administrative costs for the practice. Integrated with industry-leading electronic medical record (EMR) and practice management solutions, Yosi Intake and Henry Schein can help deliver a customizable digital solution for scheduling and document management, as well as co-pays and payments. As a result of this partnership, Yosi Health expands Henry Schein Medical’s SolutionsHub to help fulfill the clinical, financial, and operational needs of primary care physicians and specialists, group practices, physicianowned labs, ambulatory surgery centers, and Integrated Delivery Networks (IDNs)/Health Systems.
Tenet to sell urgent care platform to FastMed Tenet Healthcare (Dallas, TX) and FastMed Urgent Care announced they have entered into a definitive agreement under which FastMed will purchase Tenet’s urgent care platform, which is operated under the CareSpot and MedPost brands and managed by Tenet’s United Surgical Partners International (USPI) subsidiary.
FastMed is one of the nation’s largest independent urgent care providers with 104 locations in North Carolina, Arizona and Texas. The transaction will add 87 CareSpot and MedPost centers, increasing patient access to FastMed’s healthcare services in Arizona and Texas, while enabling the company to expand into Florida and California where most of the acquired centers are located. The transaction is expected to be completed in the first quarter of 2021, subject to regulatory approvals and customary closing conditions.
Thermo Fisher Scientific completes acquisition of Phitonex Inc Thermo Fisher Scientific completed the acquisition of Phitonex, Inc. (Durham, NC), a company that has pioneered a spectral dye platform for high-resolution biology applications designed to accelerate research and development in cell therapy, immuno-oncology and immunology research. Phitonex’s product offering will enable Thermo Fisher to offer greater flow cytometry and imaging multiplexing capabilities to meet evolving customer needs in protein and cell analysis research, the company says. The Phiton platform acts as a structure that can maintain a higher number of fluorescent dyes in very specific ways, allowing researchers the ability to analyze single cells in high resolution. This allows researchers to achieve deeper biological insights and more comprehensive data from their cell samples. With the ability to rapidly create a multitude of different dye labels, research teams can significantly increase the number of proteins and cell populations that can be identified in a single flow cytometry experiment. www.repertoiremag.com
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NEWS “Phitonex’s platform is a natural extension of Thermo Fisher’s existing tools for protein and cell analysis applications,” said Peter Silvester, SVP and president of life sciences solutions at Thermo Fisher Scientific. “Combining this new technology with our existing portfolio and expertise in this space will unlock the Phiton platform’s great potential and deliver unparalleled flow cytometry performance so our customers can gain more valuable insights from a single cell and expedite discovery.”
Mercury Medical forms U.S. distribution agreement with Medovate Mercury Medical (Clearwater, FL) has formed an agreement with Medovate (UK) to distribute its medical device
SAFIRA (SAFer Injection for Regional Anesthesia) regional anesthesia device in the U.S. SAFIRA is an FDA-cleared Class II medical device “set to transform regional anesthesia around the world by making it a one-person procedure,” the company says. The device puts control of the injection in the hands of the anesthesiologist, freeing up assistants to carry out other tasks. The company also says the device helps to improve patient safety by reducing the risk of nerve damage as it prevents injection above 20psi. Mercury Medical will distribute SAFIRA throughout 28 U.S. states. This will cover the East Coast, the Southern states and the West Coast including the states of New York, Delaware, Florida, New Jersey, North Carolina, South Carolina, Texas, Mississippi and California.
Abbott’s BinaxNOW COVID-19 rapid test receives FDA emergency use authorization Abbott (Abbott Park, IL) announced in December that the U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization (EUA) for virtually guided at-home use of its BinaxNOW COVID-19 Ag Card rapid test for detection of COVID-19 infection. Abbott is bringing BinaxNOW, a rapid test, into the home where the result is delivered in minutes without the need to send it out for processing. The $25 cost for the test and service is the lowest currently available for at-home testing, Abbott says. To facilitate the delivery of the BinaxNOW test to the home and the guided collection and testing process, Abbott has partnered with digital health solutions provider, eMed. Abbott and eMed expect to deliver and administer 30 million BinaxNOW at-home tests in the first quarter of 2021, with an additional 90 million in the second quarter. Since launching BinaxNOW in August, Abbott has ramped up capacity to 50 million tests a month in its U.S. facilities that are currently being distributed through the federal government and is expanding further so even more people have access to the tests. The eMed service offering costs $25 a test, and eMed takes care of determining eligibility,
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the guided self-collection process, public health reporting requirements and gets people their results through their NAVICA app in a matter of minutes. Through eMed and the NAVICA app, people can use authenticated BinaxNOW results to enter into venues that accept the NAVICA digital certificate. The virtually guided process preserves the integrity of the testing process and state-mandated reporting obligations, while ensuring equitable access to people who need tests through the prescription process.
MidmarkÂŽ Workstations + Telehealth Enabling Healthcare from Anywhere
It was predicted that there would be 1 billion telehealth visits in the US in 2020, yet as of January 2020, 76% of healthcare organizations in the US lacked a virtual care program.1 We can help. Midmark Workstations are made to order with customization that can assist with the integration of technology at the point of care, wherever that may be. Learn more at: midmark.com/telemedicine
Cameras not included. 1 https://go.forrester.com/press-newsroom/us-virtual-care-visits-to-soar-to-more-than-1-billion/ Š 2021 Midmark Corporation, Miamisburg, Ohio USA
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