vol.30 no.2 • February 2022
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All the World’s a Stage Pandemic proves that healthcare logistics demands a global perspective
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IMMUNOASSAY SYSTEM
FEBRUARY 2022 • VOLUME 30 • ISSUE 2
All the World’s a Stage Pandemic proves that healthcare logistics demands a global perspective
PUBLISHER’S LETTER
IDN OPPORTUNITIES
Remember When You Were New?.........................................2
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HIDA Enhancing Preparedness Through Public-Private Partnerships............................................... 42
PHYSICIAN OFFICE LAB
MARKETING MINUTE
COVID and PAMA: Irresistible force versus immovable object............................................. 4
The Best and Brightest Draw inspiration from the best ads and commercials of 2021............................ 44
TRENDS
HEALTH NEWS
Breaking The Rules Of Healthcare: Selecting The Best Doctors
Under Pressure COVID associated with higher blood pressure levels........................ 46
Finding the ideal doctors for the 21st century means using more effective tests with today’s technology................................... 8 Nattie Leger, Vice President of Supply Chain Value and Clinical Performance, Ochsner Health, New Orleans, Louisiana.................. 14
IDN OPPORTUNITIES Women Leaders in Supply Chain Allison P. Corry, Chief Supply Chain Officer and Vice President, Supply Chain Organization, Intermountain Healthcare, Salt Lake City, Utah....................................... 12
TRENDS Telemedicine: What’s Ahead in 2022? How will it affect procedures performed and products used in the physician office?....... 24
Fit for Human Use Providers need safety and efficacy in medical products and equipment. Add usability, and you’re that much closer to a sale............................................... 36
The Game of Risk Your customers are playing it. You should too.............................................. 40
QUICK BYTES Technology news................................. 48
WINDSHIELD TIME Automotive-related news.......... 50
INDUSTRY NEWS Healthcare supplier and manufacturer AliMed, Inc. names Adam S. Epstein as chief executive officer................... 53 Owens & Minor completes acquisition of American Contract Systems................................ 54 Industry News.......................................... 55
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PUBLISHER’S LETTER
Remember When You Were New? At the beginning of each new year, we talk about making changes and all the good
things we want to accomplish as we start fresh. As I have stated before I usually do this on my birthday, December 30 (don’t worry about my age). So to close 2021, I did my traditional list of things I’d like to get better at in 2022 – health, business, and personal. While goal-setting is a good practice, I’d like to toss out a different challenge for our industry in 2022. The last two years have easily been some of the most challenging we’ve faced. Whenever humans go through tough challenges, we tend to get a little more callus, and maybe a bit more cynical towards work, life and people. This isn’t me pointing fingers, it’s just who we are as humans. But there was a time when we looked at the world a little differently. Remember when you were new to med/surg sales? When all you saw was the upside to every customer visit? When closing a deal felt like you had just won your first Little League game? When giving a presentation gave you butterflies? When cold calling on a practice was a challenge you attacked? When seeing a call from your boss on Friday afternoon made you nervous? When you bragged about putting 80,000 miles on your 1996 Toyota Camry in a year? When attending your first national meeting afforded you 7 hours of sleep in 3 days? When you handed out your business card versus sending an e-card? When growing a relationship with your manufacturer partners was top priority to the success of your territory? When you did your first ride-day and the manufacturer rep closed a lab deal for you? When you called your college friends to tell them how amazing your career was going, or you called your spouse to say you’d just won a trip to Vegas for selling the most power tables? I could go on, but I think you get the point. What if in 2022 we forget how hard the last couple of years have been and we all start acting like we did when this industry was new to us, and we loved it for the greatness that it still is today? We work in the absolute best space, in the best country in the world, and we get to serve the very best of our fellow citizens every day – the caregivers. Whether this is your thirtieth year or your third, my 2022 challenge to every reader of Repertoire is: “Remember when you were new and embrace that person as you face every day this year.” My guess is if we all do this, it will be our best year yet.
Scott Adams
PS: Checkout our 1st ever end-user lead generating QR code on page 11. We’ve done all the work for you, just scan and send.
Dedicated to the industry, R. Scott Adams
Think new and try something new in 2022.
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PHYSICIAN OFFICE LAB
COVID and PAMA: Irresistible force versus immovable object In the conflict between the irresistible force and the immovable object, which one wins?
By Jim Poggi
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In this case, the battle is pitting the Protecting Access to Medicare Act (PAMA) against COVID-19, a formidable worldwide pandemic foe. PAMA is a 2014 law first enforced in 2018 with the goal of aligning Medicare payments for laboratory tests under the Clinical Lab Fee Schedule with rates paid by private insurance. When it was enacted, it caused widespread concern in the U.S. laboratory and healthcare communities. SARS COV-2 came out of the blue in late 2019 and rapidly became a worldwide healthcare concern as it created a pandemic. www.repertoiremag.com
of $10 billion, with first year impact of up to $370 million. Data indicates the first-year impact exceeded $670 million. It looked like PAMA was an irresistible force to be reckoned with. But, from the beginning, there was controversy regarding which labs would report their private payer data to set new reduced CLFS rates. Virtually all professional laboratory societies and medical societies raised concerns that independent reference laboratories were grossly over-represented in the definition of “applicable laboratories” and that their typically lower private reimbursement would skew the new CLFS rates and impact physician office laboratories and hospital outreach laboratories. Concerns were raised about access to care, especially in rural areas, and potential reduction in the number of labs resulting in further consolidation into the largest laboratory systems.
As the new COVID-19 tests have come to market, testing for COVID-19 diagnosis and follow up has sharply increased.
How is the battle shaping up? What’s the current score and who is likely to prevail?
In this corner, PAMA When PAMA was enacted, with reductions in the Clinical Lab Fee Schedule set to take place in 2018 and the expectation that most CPT codes would take the full 10% reduction, things did not look too optimistic for the laboratory business, especially the physician office laboratory. As predicted, in 2018, 88% of the then active 1129 CPT codes were reduced up to the statutory maximum of 10%. The 10-year projection of payment reductions by the Office of the Inspector General estimated a reduction
One national laboratory society observed that while private commercial laboratories represent just under 50% of all CLFS test volume, their data on private pay represented 90% of the data CMS used to reduce CLFS fees in 2018. 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 and Congress to cause CMS to take further action on the definition of applicable lab. Despite these protests and CMS’ agreement to broaden the definition of “applicable laboratory” to include more hospital outreach and physician office laboratories, it looked like PAMA would be uncontested in its impact on the US laboratory testing landscape.
In this corner, COVID-19 Then, in late 2019, everything began to change. A new pandemic virus made its appearance on the worldwide healthcare scene. Coronavirus SARS COV-2 emerged www.repertoiremag.com
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PHYSICIAN OFFICE LAB as the immovable object: in the early going, there were no lab tests, vaccinations, or specific treatments beyond respiratory and symptomatic support. COVID-19 swept across the globe quickly and forcefully. The impact of the COVID-19 pandemic on the worldwide healthcare system has been incredibly broad. COVID-19 has had an impact on 222 countries, with over 275 million cases reported. For context, COVID-19 has infected 3.4% of the total worldwide population since 2019, with the likelihood that many cases have gone unreported. Morbidity and mortality has also been widespread with over 5.3 million deaths worldwide, and over 800,000 in the United States alone.
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As a result of the COVID-19 pandemic, in January 2019, the CARES Act was passed and, among other stimulus programs, delayed both the next round of CLFS cuts and reporting of private pay fees by one year. CLFS CPT code reimbursement for 2021 remained at 2020 levels with no reduction in CPT code reimbursement. Most recently, the Protecting Medicare and American Farmers from Sequester Cuts Act, enacted on Dec. 10, 2021 has delayed cuts to the CLFS further. As a result, no further cuts to the CLFS are expected until 2023, with the statutory maximum set at 15% as previously planned. COVID-19 testing has clearly created a mixed bag for the laboratory community. In the early going, a number of physician practices and testing sites shut down reducing overall healthcare services and essential U.S. lab testing. However there has been a substantial rebound. Emergency Use Authorization has been granted to over 330 COVID tests including a wide range of new tests designed for use at home. As the new COVID-19 tests have come to market, testing for COVID-19 diagnosis and follow up has sharply increased. Current data estimate that over 364 million COVID RT-PCR, antigen and antibody tests have been performed in the U.S. This trend is likely to continue as new variants create additional concern and infection rates are impacted by fall and winter weather, as well as a relaxation of social distancing requirements.
On the lab side of things, PAMA reductions have been delayed for two years largely due to COVID-19. Lab spending under CLFS has increased to about $7.7 billion in 2019 from $6.8 billion in 2016.
The score?
As the COVID-19 pandemic and the emergence of its new variants (Omicron is the latest as of press time) have continued to cast their shadow across worldwide healthcare, the impact of the COVID-19 pandemic has gone well beyond the healthcare community. Largely due to COVID-19, the U.S. Gross Domestic Product (GDP) contracted by 3.5% in 2020, and we experienced the worst U.S. GDP contraction since 1946. As we approached the end of 2021, there were signs of economic recovery, in spite of challenges throughout the transportation and supply chain areas. As of July, 2021, the GDP was surging up 6.5%, and exceeded the preCOVID GDP. However, the U.S. inflation rate was reported as 6.2% in October, the highest since November, 1990. The U.S. economy and jobs outlook was substantially impacted. At its height, COVID-19 was largely responsible for both the U.S. recession of 2020 and the Great Resignation. There is no doubt that its impact on the global supply chain from personal protective equipment to microprocessors will continue well into 2022.
On the lab side of things, PAMA reductions have been delayed for two years largely due to COVID-19. What about lab spending under the CLFS? Lab spending under CLFS has increased to about $7.7 billion in 2019 from $6.8 billion in 2016. The increase is largely due to COVID testing and other new molecular assays despite reductions in fees for most of the top 25 CLFS schedule tests. On the COVID front, COVID infections had declined from their highest levels as of late 2021, but the omicron variant and winter weather is showing an early season surge in cases. The worldwide economy and supply chain have been impacted substantially, but both are showing rebounds. The number of U.S. jobs is expanding and this trend appears stable. We have new testing and treatment technologies including new types of breakthrough vaccines and an expanding number of new molecular technologies. Virtual patient visits are on the rise expanding access to healthcare and we are experiencing a surge in home testing. The winner: progress. Not without pain, but progress nonetheless.
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TRENDS
Breaking The Rules Of Healthcare: Selecting The Best Doctors Finding the ideal doctors for the 21st century means using more effective tests with today’s technology. By Dr. Robert Pearl
At a leading academic hospital in greater New York, a patient I’ll call John has just undergone complex neck sur-
gery. Though the operation went flawlessly, the patient is having trouble breathing. The attending physician and senior resident look down John’s throat to see his vocal cords are nearly closed, restricting airflow and creating a potentially deadly crisis. After ruling out the possibility of nerve damage, the doctors are stumped. Neither has encountered this type of problem before. 8
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Thankfully, it’s 2022 and there’s an app for that. Without delay, the senior resident reaches into her pocket, pulls out her iPhone and, with a few taps, finds a case report identical to John’s. Reading the article, both physicians realize his problem is self-limited and will resolve when the local anesthetic wears off. Half an hour later, the patient is breathing normally and ready to go home. John is fortunate to live in this century. At any point in the last, his doctors would’ve searched their memories (not the internet) for a solution and come up blank. Alarmed, they’d have no choice but to intubate the patient and wheel him to the ICU where he’d suffer, restlessly, until morning. As John’s story illustrates, technology can help doctors avoid medical mishaps and deliver superior care – far better than when physicians rely on memory alone to make difficult decisions. Knowing this, why do medical-school deans and residency directors continue to select future doctors based on standardized test scores, which – more than anything else – measure one’s ability to memorize thousands of arcane facts? The answer to this question lies in the “rules” of the medical profession.
U.S. healthcare ranks dead last among wealthy nations. Americans have the lowest life expectancy, worst infant and maternal mortality rates, and highest incidence of chronic disease compared to people in peer countries. As a nation, we won’t solve medicine’s cost or quality problems by tinkering at the edges or making small modifications here and there. Instead, we must reject and replace the dozens of rules that prevent doctors and others from delivering great care at reasonable prices.
Most of healthcare’s unwritten rules were established long ago, prior to 21st-century advances in science, technology and medical practice.
Breaking the rules of healthcare All doctors adhere to two different sets of rules. There are the written rules, covering everything from human anatomy and physiology to the current laws and regulations that govern the profession. Then there are the unwritten rules, which dictate the “right way” to act. These rules, which heavily influence clinician behavior, aren’t taught in textbooks or lecture halls. They are observed and subconsciously absorbed by medical students and young doctors whilst trying to learn the ropes and earn the respect of physician leaders. Most of healthcare’s unwritten rules were established long ago, prior to 21st-century advances in science, technology and medical practice. Many of them are now outdated – obstructing clinical excellence and holding our nation back. Although healthcare professionals object, vocally and appropriately, to a lot of medicine’s written rules, they rarely question or even consciously think about the unwritten ones. Our nation is suffering the consequences of this oversight. Independent research confirms that Americans receive the most expensive and least effective care in the developed world. Medical spending now exceeds $4.1 trillion annually and accounts for 19.7% of the GPD. Despite how much we spend, the quality of
This article looks at the outdated ways we select and train future doctors. Each subsequent story will highlight an unwritten rule – explaining why it exists, why it’s harmful or wasteful, and what can be done about it.
Rule No. 1: The best doctors are the ones with exceptional memory Each year, roughly 50,000 graduating seniors apply for 20,000 medical-school openings. For those fortunate enough to get accepted, the chances of landing a residency spot at a top academic medical center are even slimmer. Now, imagine you’re the dean of medicine at a prestigious university or a residency director in a highly competitive specialty. With far more applicants than available positions, your job is to decide which skills and qualifications separate the best from the rest. If you’re anything like your peers, you’ll lean heavily on standardized-test scores. As a rule of thumb, candidates who score below the 80th percentile on the MCAT or STEP exams need not bother applying to top medical schools like Harvard or Stanford. They also won’t land an interview for a coveted residency position like neurosurgery or cardiac surgery. www.repertoiremag.com
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TRENDS The problem with this process for weeding out applications isn’t merely the reliance on standardized tests. The problem is what these tests measure. The ability to hold and recall facts was vitally important in the 20th century. Back then, a doctor wanting to access the totality of medical information would need to lug around a 100-pound backpack stuffed with textbooks and journals. Conducting a “quick search” for an obscure case report (like the one that saved John) was impossible. So, as a rule, the “best and brightest” doctors were the ones with the encyclopedic memories. And the most effective instrument for finding those physicians was national standardized testing.
The foundational skills doctors need for tomorrow include technological competence, complex problem-solving abilities and effective communications. Selecting the best doctors for tomorrow With easy access to smartphones and terabytes of digitized medical information online, memorization is no longer the profession’s defining skill. To kickstart healthcare’s transformation, we must break and replace the outdated rule that the best doctors are the ones with the best memory. To find the ideal doctors for the 21st century, a better rule would be to identify candidates who can (a) use modern technology to access reliable information, (b) synthesize medical data into a coherent treatment plan and (c) effectively communicate that information to patients from diverse backgrounds. Physicians who do these three things, consistently, can deliver far better care than doctors of the 20th century ever could.
To help medical schools and residencies identify and train the ideal doctors of tomorrow, here are two initial steps: ʯ Modify standardized testing. Today’s MCAT and STEP 1 exams are day-long marathons of applied memorization where test takers must summon obscure facts without the assistance of smartphones. A more useful exam would require participants to employ 21st-century tools to solve 21st-century medical problems, the kinds of complex challenges doctors encounter in real life. Rather than banning phones from testing centers and peppering students with multiple-choice questions, exam writers would require the use of mobile tech to source and apply clinical information. This approach would most closely simulate future clinical practice.
ʯ
Change the curriculum. Medical students know their performance on the STEP exams will determine their ability to compete for the most desired specialties. That’s why second-year students spend an average of 10.6 hours per day cramming for the exam, leaving little time for classwork. This obsession among students drives school administrators and faculty bonkers, which is why STEP 1 will become pass/fail in 2022. But that change, alone, won’t alter the rule that residency directors use to identify the best future doctors. In fact, most directors with whom I’ve spoken plan to substitute STEP 1 with another test that overvalues memorization, STEP 2, as their basis for measuring a doctor’s potential.
The foundational skills doctors need for tomorrow include technological competence, complex problem-solving abilities and effective communications. The ability of doctors to master these skills will determine, among other things, whether a patient like John spends a hellish night in the ICU with a plastic tube jammed down his larynx or goes home fully recovered 30 minutes after surgery. Breaking the outdated rule for selecting medical students and residents is only a first step toward transforming American healthcare. There are many more rules left to break.
Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. All profits from the book go to Doctors Without Borders. For more information or to sign up for his newsletter, visit robertpearlmd.com. 10
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IDN OPPORTUNITIES
Women Leaders in Supply Chain Allison P. Corry, Chief Supply Chain Officer and Vice President, Supply Chain Organization, Intermountain Healthcare, Salt Lake City, Utah Editor’s note: The following interview originally ran in the December 2021 issue of The Journal of Healthcare Contracting, a sister publication of Repertoire Magazine.
The Journal of Healthcare Contracting: What are the characteristics of a successful supply chain leader in today’s marketplace? Allison Corry: I think there are three major characteristics of a successful supply chain leader today. Be Bold. A great coach and mentor of mine talks a lot about the ability to be bold. This results in bold leadership, ideas, fearlessness, and energy. With all the challenges facing industry, we have to be bold. Have Resiliency. If we have learned anything from the pandemic, it is that of greater importance to preparedness and flexibility is resiliency. While we all do our best to be proactive and adjust on the fly, there will be challenges that require correction. Our personal and team’s ability to be undiscouraged and quickly resilient is a key attribute of success. Live your Mission/Vision/Values. Try and remember the “so what” of what motivates you, your teams, your organizations when you’re in a rut. By getting to the most foundational mission of what your work contributes to or enables, you can find the spark needed for reinvigoration.
Allison P. Corry
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JHC: What is the most interesting/challenging project you’ve worked on recently, or an initiative you look forward to working on? Corry: Recently we’ve been working on a Procurement team transformation which has really been fulfilling. The main objectives of the assessment and design work involved a comprehensive look at our current maturity as a function, comparing our organizational structure to non-healthcare procurement models, and identifying some foundational gaps that needed attention before we were prepared to scale and support organizational growth. We’ve been clarifying roles and accountabilities, re-evaluating what we do well and what we need to do well, identifying how to encourage development and growth from our teams, and identifying where we need automation support in our Procurement processes. This multi-year transformation is the result of significant thoughtful design, heavy communications of the vision to garner team buy-in, and now, deliberate systematic implementation. Hopefully we can return to AHRMM in 2022 and give an update on our journey with some meaningful metrics to show the value of our efforts! JHC: What is the best piece of wisdom/advice you’ve received in your career? Corry: One of the best nuggets I received goes something like this quote from Kristi Hedges, Leadership Coach, “In chaos, there is opportunity. Most major career accelerations happen when someone steps into a mess and makes a difference.” I find this to be really true. If you can walk into any situation and make it clearer, more organized, less stressful, etc., you don’t need a title or an award to be noticed or recognized.
Seize the opportunity to make something/anything incrementally better because you can. JHC: What advice would you give to other women who are pursuing careers in supply chain? Corry: We (women in supply chain) are becoming less rare and that’s exciting! If you need inspiration, look to other industries where there are quickly growing numbers of women leading global supply chains for Fortune 500 organizations. Leverage the professional networks available through your organization
(among others) position, is actively ramping up the Vizient partnership, is preparing for operational integration of the team and volume of M&A acquisitions, and implementing a very thoughtful, function-specific 3-5 year roadmap of improvement for each of our areas. My current goals are to in/ formally lead the teams through these changes in a way that motivates and fulfills the team so we continue to bring the greatest value to our organization and indirectly to the communities we serve. If we can get through this magnitude of change together, I’m confident we can lead together through anything!
Currently I’m focused on leading the team through the major transitions we are juggling while staying focused on our core function in supply chain. or via industry groups and remember that not all of these need to be specifically aligned to your work. For example, through my career I’ve engaged with academic alumni boards, healthcare or supply chain related industry groups, women in leadership associations, etc. They all help provide a support network so you don’t forget the most important piece; just keep going! JHC: What are your current professional goals? Corry: Currently I’m focused on leading the team through the major transitions we are juggling while staying focused on our core function in supply chain. In addition to pandemic-related ongoing impacts, Intermountain has a vacant CSCO leader
JHC: What one thing makes you most proud? Corry: I couldn’t be prouder of the team and the growth and tenacity they’ve shown over the 2.5 years I’ve been at Intermountain. I’ve found the leaders and team to be proud, highly capable, and entrepreneurial in spirit in a way that has driven results. The team has been tremendous at recognizing that there can be better and easier ways to do things if we step back and reassess what we should be doing as a function. In short, the team was highly successful before my arrival and has taken our new charted direction in stride and shown tremendous growth as we work to have an industry-leading procurement function. www.repertoiremag.com
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IDN OPPORTUNITIES
Women Leaders in Supply Chain Nattie Leger, Vice President of Supply Chain Value and Clinical Performance, Ochsner Health, New Orleans, Louisiana Editor’s note: The following interview originally ran in the December 2021 issue of The Journal of Healthcare Contracting, a sister publication of Repertoire Magazine.
The Journal of Healthcare Contracting (JHC): You’ve had extensive clinical and nursing experience prior to your time in supply chain. Can you talk about the benefits of having that experience? Nattie Leger: My responsibility at Ochsner is to lead clinical supply chain or the clinical integration of supply chain. I believe it’s critical to have a clinical and nursing background because it provides me with the ability to evaluate situations through a different lens. Seeing through a clinical lens allows me to see how our Supply Chain decisions will impact our clinicians and patients. For example, when I’m partnering with our sourcing team on executing a contract, I can add clinical content that could have impact downstream with our clinicians or the patients that we serve. In addition, my clinical experience enhances my ability to collaborate with clinicians in the pursuit of triple aim initiatives, focusing on quality, patient safety, clinical outcomes, while being financially responsible and good stewards of our resources. JHC: Moving forward, what project or initiative are you looking forward to working on? Leger: The past year and a half has been the most challenging period
Nattie Leger
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that I’ve experienced in my career. In 2005, I went through Hurricane Katrina, but with a global pandemic topped with Hurricane Ida this year, now this was a huge curve ball. As we move on from a reactionary response to the pandemic and hurricane we are shifting and working on several key initiatives. We’re integrating with other health systems to become stronger and able to provide services to a larger number of communities. We recently merged with a health system in Southwest Louisiana. Our vision at Ochsner is to be able to provide healthcare to all of Louisiana and reaching out to the Gulf Coast. Our mantra as we go forward with Ochsner Health is not only focusing on acute care, but how do we increase optimal health in our community?
our community and working with local and diverse companies to become Ochsner vendors which in turn improves our community. In addition, Supply Chain supports the local community-based facilities that are providing high-quality care to our at-risk populations. JHC: What characteristics are key for supply chain leaders to see success for themselves and their departments? Leger: I believe whether you’re in supply chain or another division, you must be a servant leader and be humble. You must be resilient, stay positive, be a good listener, communicator, and a visionary. And you cannot shy away from difficult situations. Those are some key characteristics you must have, whether you’re
Our ultimate responsibility in healthcare is to our patients. But with COVID, it gave you an even greater challenge of responsibility to your clinicians. If you look at the health statistics, Louisiana usually ranks as the 49th or 50th state because we have a large percentage of low-income citizens with health issues and an inability to access health care. So, our population health isn’t the best. Ochsner has taken on the challenge “40 by 30.” By 2030, the goal is to move Louisiana from 49th or 50th to at least the 40th state in the rankings. And how does our healthcare supply chain impact that? Supply Chain is partnering in this initiative, by reaching out into
dealing with a pandemic or the global disruption supply chain, which is just as traumatic right now. Embodying these characteristics will set you up for success. JHC: How do you continue to grow and develop as a leader? Leger: There are always opportunities to grow, but you must seek and embrace the opportunities. Some examples are being well-read and seeking the advice from people in other leadership positions, inside and outside of healthcare. Then I incorporate
these new strengths into my leadership style and development. Years ago, as a clinical leader, I learned an important fact about appropriate communication skills from the airline industry. For example, how often do you want planes to take off and land safely? Is 80% of the time OK? Is 90% of the time OK? Or are you looking for that 100% of the time? To avoid miscommunications, the airline industry identified that the pilot, and tower had to be sending and receiving the same communications with each other to avoid crashes. So, when I am communicating with individuals, I want to ensure I am receiving and sending correct information to avoid any miscommunications, because my miscommunications could put patients at risk. JHC: How have you managed to stay motivated despite all the disruptions and challenges? Leger: It’s been an extremely challenging time. In addition to all the disruptions, there was an added stress of not wanting to fail your clinicians during the pandemic. If you failed to secure PPE that was needed, not only were you failing your clinicians in their job, but you were also putting them at risk for injury or death due to their exposure to COVID. Our ultimate responsibility in healthcare is to our patients. But with COVID, it gave you an even greater challenge of responsibility to your clinicians. And failure was not an option. So, during these extreme times, you must stay strong and focused to be able to lead your team. First, you must take care of yourself before you can take care of others. Stay positive, identify the small wins, and know your lines of support. It takes a village to accomplish great things. www.repertoiremag.com
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By Mark Thill
All the World’s a Stage Pandemic proves that healthcare logistics demands a global perspective A year ago, were you aware of the term “dwell time?”
Did the word “container” connote anything other than Tupperware? Did you know how many weeks in a typical month an over-the-road trucker is away from home? Had you ever stopped at the Corwith Yards on the Southwest Side of Chicago to see what goes on at a railroad intermodal freight terminal? How quickly would you have made the connection between a resin factory fire in Texas and the availability and price of medical products? How about a cold spell in the Lone Star State, a hurricane in Puerto Rico, a cargo ship stuck in the Suez Canal, a drought in Taiwan affecting microchip production, or a virus causing concern among authorities in a Chinese city named Wuhan? Due to world events of the past 24 months, healthcare supply chain executives are finding that what they once took for granted, what they learned from the logistics gurus, doesn’t necessarily work during pandemics. www.repertoiremag.com
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All the World’s a Stage
“PPE supply was the biggest challenge for 2020,” says Mark Henderson, senior vice president of sales and marketing for Concordance Healthcare Solutions. “The issues in 2021 have been much broader, as it is not just about aligning supply and demand, but rather the challenges related to getting product from the manufacturers to the distributors and providers. You can have an accurate picture of product needs and manufacturing volumes, but if you cannot get product from point A to point B in a timely fashion, you have an issue.” Getting products from point A to point B ain’t what it used to be. The question is, will it ever return to “normal?” Based on comments gathered by Repertoire, even if we don’t see a full-blown paradigm shift, we will see changes, especially: ʯ Advances in visibility – transparency – across the supply chain. ʯ Creative ways to store products, such as 3PLs or what one distributor calls “living stockpiles.” ʯ Increased attentiveness to alternative or substitute products, just in case.
The situation “Things are more difficult now than at any other point in the pandemic,” Abby Pratt, senior vice president for global strategy and analysis for AdvaMed, the medical manufacturers association, told Repertoire in December. (The Advanced Medical Technology Association, or AdvaMed, represents companies that produce medical devices, diagnostic products and digital health technologies.) “In the early stages, it was limited to things like PPE and COVID technologies. But now, delays, bottlenecks and disruptions are making headlines, just as they are in every other sector. It’s not only affecting products and materials imported into the United States, but also raw materials, supplies and components that are coming into the U.S. for manufacturing and production in this country.” James Sembrot, senior vice president, U.S. Supply Chain, Cardinal Health, says, “As an industry, the supply chain is facing increased global demand for product and movement of product, primarily from Asia-Pacific to the United States. Additionally, the supply chain is encountering container shortages, port congestion and operational constraints, vessel availability challenges, disruptions in shipping schedules and increased wait times, labor shortages and heightened shipping costs.” 18
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Ocean freight delays and raw material inflation have caused significant constraints, adds Robert Rajalingam, president, U.S. Medical Products and Distribution, Cardinal Health. “Resins, corrugate and metals have experienced significant cost increases. Because of the winter storm impacts, and prior to that, the fire at the resin manufacturer, Total Petrochemicals, we’re dealing with a market that’s been constrained for well over a year. “During a global pandemic environment and with many manufacturers on allocation, the challenges compound,” he says. “Plus, resin is not only used to form plastics, like sharps containers, but it is also used in nonwoven fibers, tubing, flexible packaging, etc.”
‘ Moving forward, successful supply chain professionals will need to possess a global acumen, understanding how disruptions, like raw material shortages, labor, political unrest, etc., may impact their supply chains.’ Container costs have grown to eight times the normal rates, he says. Over a recent 12-month period, Cardinal Health spent $48 million on charters to bring in product from Asia. “But this system is not cost effective and not a long-term strategy.”
A crisis by any other name “Part of the definition of ‘crisis’ is a time of great difficulty,” says Henderson. “Personally, I prefer to think of it as a tremendous challenge that we will need to resolve collaboratively across suppliers, distributors, providers,
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All the World’s a Stage
logistics organizations and state and local agencies. Any supply chain that has a patient at the end of it needs to be prioritized.” The difference between 2020 and 2021? “I’m not sure I would call [the current situation] a crisis anymore, as it was in 2020,” says Steve Martin, senior vice president of supplier management for Nashville-based NDC Inc. “Product is moving. It’s just moving slower and at a much higher cost. Supply chain issues have negatively impacted our fill rates as we still have a significant number of products that continue to be on allocation or in short supply. Also, the increase in lead times from suppliers makes it difficult to quickly react to changes in product demand from our distributors.
‘ You can have an accurate picture of product needs and manufacturing volumes, but if you cannot get product from point A to point B in a timely fashion, you have an issue.’ “The rising cost of freight across all modes has significantly impacted the cost to serve suppliers, NDC and our distributors,” he continues. “We have seen unprecedented increases in product costs, sometimes appearing as an ‘order surcharge,’ which is directly related to the global and national supply chain issues.” Supply chain and clinical professionals may not be using the word “crisis” to describe the current situation, but they are definitely in pandemic mode, says Mike Schiller, senior director of supply chain for the Association for Health Care Resource & Materials Management of the American Hospital Association. In addition to sourcing supplies through traditional channels, they are diversifying vendor portfolios and employing conservation and utilization strategies. 20
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Two years into the pandemic, the industry has moved beyond PPE-only shortages to shortages in other business sectors that are directly or indirectly affecting the healthcare supply chain, he says. These include: ʯ Semiconductors: As of late December, shortages were causing 9-to-12-month equipment delays. ʯ Aluminum products (crutches, walkers, canes): In response, some organizations are seeking donations from the community. ʯ Blood collection tubes: Varying, rolling backorders. Solutions and conservation strategies include using EMRs to view and manage orders, review blood draw requests. ʯ Pediatric supplies (e.g., diapers, formula, nipples, small French urine collection catheters, butterfly needles and umbilical cord catheters, neonate blood pressure cuff size 4, cardiac leads). Solutions include purchasing individual components – urine specimen cups, sticks, wipes, etc. – and assembling kits, exploring reuse of disposable blood pressure cuffs or moving to reusable cuffs. ʯ Resin products (e.g., suction canisters, sharps containers, soap containers, decontam wipes tubs, hand soap and foaming soap dispensers). Solutions include exploring reusable sharps containers. Inflation is another concern, says Schiller. Although GPO and other contract pricing has remained relatively stable throughout the pandemic, supply chain professionals can expect increases due to supply/logistics demand and constraints, new supply and multisource contracts, and diversified vendor portfolios. “We are encouraging supply chain leaders and healthcare organizations to explore other non-labor cost-savings opportunities, with a key area being purchased services.”
Visibility A common theme among supply chain executives is the need for greater visibility across the supply chain. But given the many constituencies involved – raw materials suppliers, factories, ocean carriers, railroads, trucking firms, med/surg distributors and health systems – that won’t be easy. “Raising the bar on accuracy and visibility of data from suppliers is critical as we move forward,” says Henderson. “Combined with visibility to our on-hand inventories and demand signals from customers, we can move
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All the World’s a Stage
toward a proactive supply chain powered by actionable information. Automating this process ... is key.” In November, AdvaMed, the Health Industry Distributors Association (HIDA) and International Safety Equipment Association (ISEA) announced they were collaborating with port leaders to test processes for prioritizing medical supply containers. The organizations have engaged the Federal Maritime Commission and the White House Supply Chain Disruption Task Force in their efforts. “But we have to approach it terminal operator by terminal operator, because they are not interoperable,” says Pratt. “There’s no single system spanning all these different actors. That’s why we are looking at greater interoperability and visibility.”
resiliency,” says Rajalingam. In March 2020, the company began working with freight-tracking software startup FourKites Inc. on a pilot to track shipments of personal protective equipment between manufacturing plants and the company’s distribution centers. Centralized advanced planning data allows those in the supply chain to jointly conduct forecasting and supply chain simulations and plan alternative options, says Rajalingam. “It also drives network inventory optimization. “Through extensive collaboration with leading 3PL organizations, we are expanding access to secure equipment (i.e., containers), capacity and alternative routes; increasing visibility to enable quick, data-backed decisionmaking; increasing visibility to the location of shipments across oceans, through ports, etc.; and managing supply chain costs.”
No paradigm shift on JIT
Curtis Lancaster, chief supply chain officer, Westchester Medical Center Health Network (WMCHealth), Valhalla, New York, says the health system’s supply chain team collaborates regularly with its clinicians and distribution partners, and uses AI-powered software to identify global trends that may affect the supply chain. “We also collaborate with onshore and near-shore partners that reduce our reliance on offshore suppliers,” he says. WMCHealth comprises 10 hospitals and includes an academic medical center, acute care children’s hospital, multiple community hospitals, skilled nursing facilities and two practices with over 850 providers. Cardinal Health is making “significant investments in technology to drive greater visibility, sustainability and 22
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Choke points, logjams and bottlenecks notwithstanding, healthcare supply chain experts aren’t predicting a widespread about-face on just-in-time. “I don’t think you’ll see a paradigm shift,” says Pratt. “Companies will do more to invest in risk mitigation and might build these learnings into their processes, but when things normalize, they will want to be efficient.” That holds true for products that are perishable as well as those in which innovation occurs rapidly. “If you stockpile too much, you will have some obsolescence. So it’s a balance.” Concordance Healthcare Solutions found 3PL storage to be in high demand during 2020 and into 2021, says Henderson. “Much of this was PPE products, but the service can apply across any category. We will continue to ramp up these programs for both providers and suppliers to increase access to products.” Says Mike Schiller, “Just-In-Time, Low Unit of Measure and Lean principles will need to be re-evaluated across the entire supply chain continuum. COVID has highlighted our need for more transparency, robust analytics and improved utilization data – the capture of product use at the point of consumption.” Moving from par inventories to demand planning, where possible, may help achieve better alignment between on-hand inventory levels and actual use.
Solutions Charlotte Perkins, interim vice president of supplier and portfolio management for Owens & Minor, says the
company’s Americas-based manufacturing has helped maintain the supply of personal protective equipment throughout the pandemic. “We manufacture our own raw materials in North Carolina and convert them into N95 respirators, isolation gowns, surgical gowns, ear loop masks and other PPE in our plants in Texas, Mexico and Honduras.” In addition to self-manufactured products, Owens & Minor partners with more than 1,000 branded manufacturers. “We have recently seen minor supply chain challenges with IV solutions and syringes, as well as a slight increase in demand for IV catheters,” says Perkins, adding that the company’s allocation practices have enabled it to fulfill demand even during the peak of the pandemic. For more than 10 years, Owens & Minor has provided an outsourced logistics offering to help customers address pandemic storage requirements and to manage supply streams from multiple sources, she adds. In 2020, the company expanded this capability across the entire network, with more than 25 Owens & Minor distribution centers now actively delivering Outsourced Logistics services. In addition, Owens & Minor clients can now subscribe to alerts via the SMART Card (Supplier Metrics & Accountability Report Tracker) for bi-weekly snapshots and updates, keeping them aware of product constraints or supply chain disruptions. Steve Martin says the NDC team has devised several solutions to help members maintain an adequate supply of products and equipment, including: ʯ Distributor allocations based on historical demand or as directed by suppliers. ʯ Lead time adjustments from suppliers to accommodate supply chain issues, sometimes increasing the amount of stocked inventory to account for longer lead times. ʯ Careful review of new business opportunities on products that have longer lead times to protect NDC’s ability to service existing business from distributors. “NDC doesn’t manage the inbound logistics of shipments from suppliers, which is managed by the suppliers themselves,” says Martin. “So it is important for us to be well informed of the status of inbound containers or shipments. Many suppliers have established regularly occurring calls with NDC to review the status of containers/
shipments, update production lead times, review product allocations, and provide general business updates.” Many NDC members have established multiple supplier relationships for impacted products, where possible, he adds. “Some members have begun sourcing more products directly from manufacturers to increase their control over product visibility and access. This includes looking at alternative ports of entry for products that source via ocean freight. “Many NDC distributors are also working with their provider customers to encourage them to increase their safety stock on critical items. Some have expanded existing warehouse space and/or added warehouses in strategic geographical areas, so they can provide stockpile services to their provider customers.”
‘ As an industry, the supply chain is facing increased global demand for product and movement of product.’ Cardinal Health’s Robert Rajalingam says that the company is actively lobbying Capitol Hill with other industry associations for resolution of the current backup of medical products. “We are also working with the federal government to prioritize releasing backlogged containers with critical medical supplies. Plus, we’ve had a high level of involvement with HIDA and AdvaMed, as well as the ports of Los Angeles and Long Beach and the Federal Maritime Commission, to structure a broad-based prioritization process for identifying and expediting critical medical supplies through the ports.” Says AHRMM’s Mike Schiller, “Moving forward, successful supply chain professionals will need to possess a global acumen, understanding how disruptions, like raw material shortages, labor, political unrest, etc., may impact their supply chains. They will need to remain strategic and reduce or eliminate risk from their supply chains through deeper collaboration with existing suppliers while looking to build relationships with local and community businesses.” www.repertoiremag.com
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TRENDS
Telemedicine: What’s Ahead in 2022? How will it affect procedures performed and products used in the physician office? By Mark Thill
Telemedicine soared in 2020 due to the pandemic. Usage has plateaued since then, but it’s a safe bet it’s not go-
ing away. And with it comes questions. What role will it play in urgent care and chronic care management? Will it lead to fewer in-person visits, or more? Will it change the type – and number – of procedures performed in the clinic? How about the type – and volume – of medical supplies, devices and equipment used there?
“We don’t pretend to read all the tea leaves; but we believe the right ecosystem is a hybrid model,” that is, a combination of face-to-face and virtual visits, says David Houghton, M.D., MPH, chief of the Division of Movement Disorders at Ochsner Health in New Orleans and head of the health system’s telemedicine and digital health initiatives. “That means providing the level of care that is appropriate every time and providing patients with accessible and available technology that complements the important patientprovider relationship.” Video or audio telemedicine can offer access to a clinician for patients who lack transportation or who can’t take time off from work, according to researchers from Kaiser Permanente Division of Research, Oakland, California. “Still, it is unclear whether telemedicine visits adequately address the patient’s clinical concern, are more likely to require subsequent followup outpatient care, or are more likely to be followed by a serious health event that requires an emergency department visit or hospital stay,” they wrote. 24
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Legislative and regulatory boost Regulatory and legislative adjustments in response to the pandemic boosted telemedicine in early 2020. The Centers for Medicare & Medicaid Services used emergency waiver authorities to expand access to telehealth services, including waiving geographic restrictions and allowing beneficiaries to receive telehealth
in their homes. Additionally, the HHS Office for Civil Rights relaxed enforcement of Health Insurance Portability and Accountability Act (HIPAA) privacy requirements for videoconferencing. Physicians enrolled in the Medicare program licensed in any state were granted the authority to provide telehealth services to people anywhere in the U.S. if the state allows it.
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TRENDS The waivers also allowed physicians to practice from home. What’s more, CMS’ Interim Final Rule allowed for payment for audio-only evaluation and management (E&M) services. In November 2021, CMS announced it would continue to reimburse providers for extended Medicare telehealth services through Dec. 31, 2023. These regulatory changes brought about desired results. The share of Medicare visits conducted through telehealth in 2020 increased 63-fold, from approximately 840,000 in 2019 to 52.7 million. And in July 2021, McKinsey & Company released a report showing that telehealth utilization had stabilized at levels 38X higher than before the pandemic. American Medical Association 2020 survey data demonstrates a dramatic upswing in the use of telehealth between 2018 and 2020: ʯ In 2020, 79% of physicians worked in a practice that used telehealth compared to only 25.1% in 2018. ʯ The percentage of physicians who used telehealth to manage patients with chronic disease or to diagnose or treat patients also increased (9.9% to 59.2% and 15.6% to 58%, respectively). ʯ Twenty percent of physicians said their practice used remote patient monitoring, up from 10.4% in 2018. ʯ Sixty-seven percent of physicians worked in a practice that used phone call visits with patients in 2020. ʯ Fifty percent of physicians were in a practice that used telehealth to provide care to patients with acute disease and 34.3% to provide preventative care. 26
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Telemedicine by specialty American Medical Association survey data demonstrates a dramatic upswing in the use of telehealth between 2018 and 2020. The practicelevel use of videoconference and phone visits was over 75% in cardiology, endocrinology/diabetes, gastroenterology, nephrology, and neurology. In addition, the AMA survey data showed: ʯ Hematologists/oncologists had a high rate of videoconference visits (88.5%) but were less likely than other medical specialties to report the use of visits by phone (68%). ʯ Endocrinologists/diabetes physicians were the most likely to report use of telehealth to diagnose or treat patients (71.9%), manage patients with chronic disease (92.1%) and provide preventative care (52.6%). ʯ More than half of gastroenterologists, nephrologists, and neurologists said their practices used telehealth to provide acute care. ʯ Thirty-three percent of medical specialists said their practices used remote patient monitoring. This was driven by high rates of use among cardiologists (63.3%) and endocrinologists/diabetes physicians (41.6%).
‘ I know the work done by the digital medicine team has taken care of the patient’s most pressing conditions, so I can focus on the immediate reason for the visit.’ All that said, a plateauing of usage has occurred. In September 2021, FAIR Health reported that telehealth utilization, measured as a percentage of all medical claim lines, fell from 5% to 4.5% nationally from May to June 2021. By comparison, telehealth utilization rose 2% nationally the previous month, following decreases each month from February to April. Other changes from May to June 2021 involved the top five telehealth diagnoses: ʯ Joint/soft tissue diseases and issues rose from No. 4 to No. 3.
ʯ
ʯ
Acute respiratory diseases and infections rose nationally from No. 3 in May to No. 2 in June. Urinary tract infections appeared in fifth place among telehealth diagnoses in the South in June 2021. This was the first time since the start of the pandemic in March 2020 that this diagnosis appeared on any regional or national list, although it had been common on the lists prior to the pandemic.
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TRENDS ʯ
Mental health conditions remained in the No. 1 spot among telehealth diagnoses.
Primary care “Clearly telehealth has been embraced by physicians of many specialties and their patients,” says Christopher Garofalo, M.D., owner of Family Medicine Associates in South Attleboro, Massachusetts, and chair of the Massachusetts Medical Society Committee on Sustainability of Private Practice. “We saw a large increase in the use of telehealth visits in our private family medicine practice, using the visits for both acute and follow-up care.” (In March 2020, the Massachusetts Medical Society co-founded The Telehealth Initiative, designed to support physicians implementing telehealth. Other cofounders were the American Medical Association, Florida Medical Association, Texas Medical Association and the Physicians Foundation.) “At the start of the pandemic we used telehealth to provide some Medicare Annual Wellness Visits, as the physical exam is quite limited, and even for some annual checkups for adults and well-child checks,” says Garofalo. In 2021 the number of telehealth visits decreased to around 10% to 15% of all visits and were conducted only for acute and follow-up care. Even so, he predicts that telehealth visits “will be overall higher than prior to the pandemic, but not as high as we saw early on in the pandemic.” Garofalo saw a greater uptake of telehealth among his primary care colleagues than among subspecialists. “That’s to be expected, as primary care has a smaller number of visits that are procedures,” he says. Even so, he saw office notes from most of his subspecialists, especially, early in 28
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‘ For telehealth to remain a successful option for physicians and patients, it is imperative that a telehealth visit be reimbursed at parity and in the same manner as an in-office visit.’ the pandemic, as most elective procedures were on hold. Certain subspecialists, such as GI and neurology, had more telehealth visits than more “hands-on” specialists, such as those in dermatology and orthopedics. “One of the great advantages of telehealth is that it often brings us directly into the home environment of the patient and their family,” says Garofalo. “We can ask them to get their medicine bottles and look at them, rather than relying on handwritten notes. We can ask them to move the phone or the laptop camera to give us a view of their environment, which can help inform us if there a lot of clutter or poor lighting that may increase their fall risk. We can take a virtual look into their kitchen cabinets and refrigerator to help assess dietary habits.”
Impact on in-office visits Ochsner Health’s Houghton has found that telehealth – including remote monitoring – has improved the quality of in-person primary care visits. “I know the work done by the digital medicine team has taken care of the patient’s most pressing conditions, so I can focus on the immediate reason for the visit, whether it’s back pain, an orthopedic issue or a behavioral health issue. I can focus on the patient-doctor relationship, because I know that the other work is being done continually.” And it’s being done better, he adds. “Because of digital medicine, we don’t just work with a handful of blood glucose readings; now we have dozens. We have 30 or 40 times the amount of data and we can manage the patient not only reactively, but proactively.”
Definition of terms The word “telemedicine” means different things to different people, but the Centers for Medicare & Medicaid Services refers to three main types of telemedicine services: ʯ Telehealth visits. Routine office visits provided via video (requires synchronous, real-time audio and/or video communication) with new or established patients. ʯ Virtual check-ins. Short patient-initiated communications with a healthcare practitioner via telephone or other telecommunications device to decide whether an office visit or other service is needed. ʯ E-visits. Non-face-to-face patient-initiated communications with a healthcare practitioner through an online patient portal
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TRENDS Telemedicine may lead to fewer diagnostic procedures in the office. Kaiser Permanente researchers reported in November 2021 that laboratory tests or imaging were ordered in 59.3% of office visits, compared with 29.2% of video visits and 27.3% of telephone visits. Medication was prescribed more often in the clinic – 60% of visits compared with 38.6% by video and 34.7% by telephone. The differences could be due to patients choosing to see their doctor in person when the severity of their medical complaints was higher, they said. Regarding other diagnostic tools, such as EKGs, stress tests or pulmonary function tests, “I haven’t seen these types of diagnostics move out of the office setting,” says Garofalo. “Some test results, such as PFTs, are much improved by having office staff educate and coach the patient. I also am not sure that EKGs will be replaced in the traditional sense. While a single-lead EKG reading on a remote device can be helpful for very basic monitoring of certain conditions such as atrial fibrillation, patients with acute cardiopulmonary symptoms will still require a 12-lead EKG in the office to help triage and determine best medical management.”
Kinks Telemedicine is an evolving science, with kinks to straighten out. A survey-based study published in December 2021 showed mixed feelings about telehealth visits on the part of older patients with chronic kidney disease as well as their care partners and clinicians. Patients reported concerns that their home diagnostic equipment was not as accurate as professional equipment at the clinician’s site, and they complained 30
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of a loss of social connection with their clinician. Meanwhile, clinicians in the survey viewed telehealth as compromising quality care due to an inability to conduct physical examinations and laboratory tests, including inaccurate edema and blood pressure measurement. They also reported poorer telehealth experiences with older patients, those from low socioeconomic status, patients with limited health literacy or a hearing impairment, and non-English-speaking patients. Both clinicians and patients in the survey noted technical challenges too, such as spotty internet connectivity and application issues. However, all described telehealth as more
convenient, less costly, and more efficient for patients than clinic visits. “Our findings … suggest that telehealth may best supplement rather than supplant in-person visits for patients who are older and chronically ill,” said the study’s authors. One of the pre-pandemic limitations that hampered the use of telehealth was lack of reimbursement from payers, including Medicare and Medicaid, says Dr. Garofalo. “For telehealth to remain a successful option for physicians and patients, it is imperative that a telehealth visit be reimbursed at parity and in the same manner as an in-office visit.” When asked what impact virtual care might have on point-ofcare testing, lab expert Jim Poggi of
‘ One of the great advantages of telehealth is that it often brings us directly into the home environment of the patient and their family.’
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TRENDS Tested Insights LLC says, “I think it depends on whether the physician practice is offering the virtual visit or whether the patient is using one of the many ‘pop-up’ online services. Will telehealth and virtual visits change where patients receive future care? Probably to some extent. They are a new gateway to healthcare, for sure. I have concerns about whether they impede progress on antibiotic stewardship and how broadly telehealth visits are used.” More than 23,000 patients have voluntarily opted to use Ochsner Health’s telemedicine and virtual
medicine initiatives. Participation is voluntary on the part of physicians too. Rather than making them mandatory, Dr. Houghton and the Ochsner team intend to continue encouraging participation by presenting ongoing proof that the programs work. High HEDIS scores for telehealth visits are testament to their effectiveness and patients’ experience of care. “When physicians see this, they ask, ‘Why wouldn’t I want my HEDIS scores to be better?’” Among Ochsner’s patients, satisfaction with telemedicine is high, as reflected in net promoter scores,
which measure the loyalty of customers (patients) to an organization. “Some of the early euphoria around telemedicine has waned, as both patients and providers became more experienced and critical,” says Houghton. “But our scores have remained high, even among our most vulnerable patients, including those who are economically disadvantaged and those with comorbidities. The fact that the programs offer a lot of touches has been the driver,” he says. “We will never have to make participation a requirement.”
Telemedicine’s digital cousin: Remote patient management In 2015, Ochsner Health in New Orleans launched the Hypertension Digital Medicine program, which provides digitally enabled chronic disease management to patients with hypertension. The voluntary program serves approximately 13,000 individuals across 10 states. As explained in a 2021 American Medical Association report, “Moving Beyond Dollars and Cents in Realizing the Value of Virtual Care,” each program enrollee is assigned a care team (clinician, pharmacist and health coach) responsible for providing education, medication reconciliation and management, and lifestyle recommendations according to established hypertension treatment guidelines. Custom visual tools developed within the electronic health record display the enrollee’s social needs, trending blood pressure over time, hypertension-related comorbidities, patient activation level, health literacy and relevant lab results. Program enrollees are asked to submit at least one blood pressure reading per week. Care team members contact enrollees regularly by phone and review readings and treatment options for improving blood pressure control. Enrollees are encouraged to work with the care team to co-create the treatment plan by choosing among various lifestyle and medication options. Each enrollee receives a monthly report on their progress and tips for achieving better blood pressure control. Information about the enrollee’s progress is also available to their primary care provider. Ochsner reports the following statistics: receiving usual care ʯ Program enrollees over the evaluation achieved greater period of six months. blood pressure control compared ʯ Program enrollees with a propensityhad more frequent matched group that interactions with their received usual care care team and more (79% versus 26%). blood pressure measurements recorded ʯ Medication adherin the EHR compared ence improved 14% with matched patients among patients in assigned to usual the Digital Medicine care. Current enrollees program and declined submit, on average, 2% among patients
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4.2 blood pressure readings per week. Ochsner reports that the program has enabled primary care clinicians to provide an elevated level of support to patients, which has enhanced clinician satisfaction. The program saves $77 per member per month compared with usual care.
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A recent evaluation found that primary care physicians experienced a 29% reduction in the number of in-clinic visits from participating patients. Primary care clinicians reported the program helped reduce their workloads and enabled them to expand access to other patients.
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CME CORP
Healthcare Equipment Delays? Channel Partnerships Can Help! Opening a new clinic or ambulatory surgery center on-time is always wrought with many challenges, including equipment lead times, construction delays, product loss/damage, and getting required biomedical checks completed. During the Covid-19 pandemic these challenges have become amplified. Demand is high, raw materials
diminished, and logistics are bottlenecked all over the world. Lead times have lengthened considerably, including not only the healthcare equipment needed for a new healthcare facility but also construction materials. Exacerbated workforce shortages caused by the pandemic affects many phases of the supply chain, including manufacturing, planning, purchasing, warehousing, assembly, delivery, and biomedical start-up checks.
When faced with these new challenges, the healthcare supply chain responded in many constructive ways. Collaboration between manufacturers, distributors and customers intensified, and many innovative solutions evolved to meet ambitious construction deadlines. One of the harder hit product categories during Covid-19 was the Storage Solutions sector. Most stainless steel, chrome, and plastic, the three most prevalent storage materials, come from outside the US. Lead times for most items were approximately four weeks prior to Covid-19. They have increased to more than four months over the last two years. CME Corp is an equipmentcentric full-service distributor that offers turn-key solutions for new construction projects. Metro is the world’s leading manufacturer of storage equipment. They teamed up these past two years to innovate some storage solutions and meet some very tight timelines for their mutual customers.
Nevada Ortho Clinic Needs Equipment in Eight Weeks Late in 2020, when the healthcare supply chain was really starting to 34
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Metro top track system
feel the effects of the Covid-19 pandemic, a new 18 room orthopedic clinic was built in western Nevada. The equipment needed for the new clinic was ordered in mid-December, with a go-live date in mid-February, a tough timeline in even the best of times! They ordered a Metro top track system for their storage needs. When the order first was submitted, the system was backordered until midMarch, which was not acceptable to
the customer. Metro, CME, and the customer got together to strategize on how to meet this near impossible goal. Metro shipped in temporary loaner carts and prioritized/expedited the top tracks. Since items were shipped piecemeal, CME had to deploy their installation team several times to complete the install. They had enough shelving configured early enough so the clinic could stock most of their supplies. The installation took three deliveries over a two-week period, the last delivery being on the day the clinic opened. CME’s install team went beyond the call of duty, as there was also a massive snowstorm during this timeframe. The CME project management team, Metro’s customer service, and the customer communicated almost daily during this project, which was crucial to getting it completed. The clinic opened on time and the customer was extremely satisfied!
Massachusetts Ambulatory Surgery Center Passes DPH Inspection Early in 2021, a Boston-area surgery center (ASC) expanded their footprint and added six new operating
rooms. The facility needed extra storage space, and a walk-through with Metro and CME account managers culminated in a CAD drawing that detailed several areas of high density, mobile, and stationary shelving solutions. The DPH inspection was scheduled for mid-May so that the new space could be certified for use. As time passed, Metro realized some of the items would not meet this inspection date. CME, Metro, and the customer met virtually to discuss options and possible solutions. With the customer’s blessing, Metro substituted some of the materials and carts to be able to meet the deadlines. The CME team was able to complete 80% of the installation in time for the inspection. The customer was ecstatic and the ORs were in use the next week.
Customized CAD drawing of top track shelving
items will be delivered on-time to meet a February, 2022 need-by date.
Lessons Learned Nashville MOB Maximizes Storage Space In early 2021, a Nashville-area medical center was expanding their medical office building (MOB). At their current location they had big storage issues, as supplies were literally falling off shelves due to inadequate space. The new build-out was 61,500 sq. ft. and the storage space needed to be planned in advance to meet their needs. Metro, CME, the customer project manager, and the architect worked on the layout collaboratively and decided on top track shelving to maximize the storage space. The project included 201 shelving units with 1,058 shelves and 5,290 linear feet of shelving. The customer would never have supplies falling off the shelves in this new space! CME’s account manager worked with the customer and Metro early enough so that they could plan for extended lead-times on this project. The order was placed in September and all
The current pandemic continues to cripple the healthcare supply chain and will not resolve itself anytime soon. Healthcare systems need to be mindful when addressing new construction needs. Here are five things we recommend: ʯ Plan early and include distributors, manufacturers, and fellow team members in this early development stage. Get lead times well ahead of the project so that timelines can be met. ʯ Order early and work with partners who will over-communicate and give you visibility into where your products are at all times. ʯ Look at alternate products if lead-times move out too far. ʯ Find a partner who can help augment your depleted workforce including logistics and biomedical services. ʯ Be flexible and look for partners who are flexible also.
These are tough times, and the best solutions can come from collaboration and being adaptable. CME Corp is a full-service healthcare equipment and turn-key logistics company providing personalized support and service. With service centers nationwide, CME offers more than 2 million medical products from a total of over 2,000 manufacturers. CME is a healthcare system’s complete equipment solution by providing product selection, sales, warehousing, assembly, staging, direct-to-site delivery, installation, and biomedical services for all its equipment. For over 80 years, Metro has been the world’s leading manufacturer of storage and transport equipment. From our innovative wire and polymer shelving lines to the revolutionary Starsys product line, and a broad range of healthcare cart solutions including the Lifeline emergency cart, Flexline procedure carts and Lionville series medication carts, Metro puts space to work in healthcare facilities of all sizes. www.repertoiremag.com
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TRENDS
Fit for Human Use Providers need safety and efficacy in medical products and equipment. Add usability, and you’re that much closer to a sale. Pharmaceutical labels and packaging that look so much like others, patients get the wrong medication. An insu-
lin pump that’s difficult to program or calibrate. Blood pressure tubing that is erroneously connected to an IV catheter, resulting in a fatal air embolus. These things happen, usually chalked up to “medical error.” But who’s responsible? The nurse? Pharmacist? Respiratory therapist? How about the manufacturer?
The fact is, manufacturers of medical devices and equipment jump through hoops with the FDA to demonstrate their products are designed with “human factors” in mind. It’s called “human factors engineering.” Basically, it refers to the ease of use of a medical product, device or piece of equipment. It’s an important point, because if it’s not easy to use, someone’s going to get hurt, either a patient or a healthcare worker. For that reason, human factors engineering – though an unlikely tagline – can be an important selling tool for medical salespeople.
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Warm and fuzzies? Making something usable isn’t about warm-and-fuzzy addons. Rather, usability is designed into the device. In fact, the U.S. Food and Drug Administration has a definition for human factors engineering and usability engineering: “The application of knowledge about human behavior, abilities, limitations, and other characteristics of medical device users to the design of medical devices including mechanical- and software-driven user interfaces, systems, tasks, user documentation, and user training to enhance and demonstrate safe and effective use.” Patrice Tremoulet, PhD, human factors scientist for ECRI, says she would add the word “comfortable” between “safe” and “effective.” “Clinical users (and patients) need to be able to use things not only safely and effectively but also comfortably, otherwise you set them up for either repetitive stress injuries or inadvertent misuse during times of fatigue.” “No product development occurs where the goal isn’t ease of use,” says Mary Beth Privitera, PhD, FIDSA, professor of biomedical engineering at the University of Cincinnati and co-chair of the Association for the Advancement of Medical Instrumentation (AAMI) Human Engineering Committee. “But sometimes it gets lost.” Often that’s because the people designing medical devices aren’t the ones practicing medicine. The FDA and industry groups feel a special urgency today to prevent that from happening. “Use errors caused by inadequate medical device usability have become an increasing cause for concern,” write the authors of the international standard IEC 62366, which specifies how manufacturers should analyze, specify, develop and evaluate the usability of a medical device as it relates to safety. “Many of the medical devices developed without applying a usability engineering (human factors engineering) process are non-intuitive, difficult
to learn and difficult to use. As healthcare evolves, less skilled users, including patients themselves, are now using medical devices, and medical devices are becoming more complicated.”
Three tenets Priviteria points to three fundamental tenets of human factors engineering. “First, there must be a clear definition of who the user will be, taking into consideration demographics, physical characteristics, language, education level, etc. And because most products are made for the global market, cultural norms have to be considered too.” Second, designers must try to understand the use environment and its variability. “A device may start in the OR, then follow the patient to the PACU, then to the floor, and perhaps even home.” A physician may initially place the device on or in the patient, but a nurse, respiratory therapist or other clinician may be responsible for maintaining it. There is also the question of how the provider/s can review historical data, such as that from monitoring devices. And third, “you have to consider the use environment and use scenario,” she says. “So, if I know the user, the use environment and the use scenario, I – as the manufacturer – can ask questions like, ‘How can I make this better by design?’”
User interface A term often associated with computers – user interface – is key to human factors engineering. The FDA defines it as “all points of interaction between the user and the device.” It comes into play when the user sets up the device (e.g., unpacking, setting up, calibrating), uses it, or performs maintenance on it (e.g., cleaning, replacing a battery, repairing parts). User interface involves: ʯ The size and shape of the device (particularly a concern for hand-held and wearable devices). ʯ Elements that provide information to the user, such as indicator lights, displays, auditory and visual alarms. ʯ Graphic user interfaces of device software systems. ʯ Overall user-system interaction, including how, when, and in what form information (i.e., feedback) is provided to the user. ʯ Components that the operator connects, positions, configures or manipulates. ʯ Hardware components the user handles to control device operation, such as switches, buttons and knobs.
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Components or accessories that are applied or connected to the patient. Packaging and labeling, including operating instructions, training materials, and other materials.
The FDA says that physical, mental and emotional characteristics of users must also be considered by product manufacturers. They include: ʯ Physical size, strength, and stamina. ʯ Physical dexterity, flexibility, and coordination. ʯ Sensory abilities (i.e., vision, hearing, tactile sensitivity). ʯ Cognitive abilities, including memory. ʯ Literacy and language skills. ʯ General health status. ʯ Mental and emotional state. ʯ Level of education and health literacy relative to the medical condition involved. ʯ General knowledge of similar types of devices. ʯ Knowledge of and experience with the particular device. ʯ Ability to learn and adapt to a new device. ʯ Willingness and motivation to learn to use a new device.
‘ The fact of the matter is, we’ve realized we can’t develop safe medical devices without considering usability.’ “The healthcare workforce is large and very diverse,” says Tremoulet. “So it’s important to test new devices and equipment not only with users who are representative of intended users, but also others, including patients and caregivers. Whenever possible, principles of universal design – making things that everyone can use – should be applied.” The environments in which the medical device or equipment might be used – including clinical environments, non-clinical environments, community settings or moving vehicles – are also part of human factors engineering. Questions to be considered include: ʯ Lighting level: Is it low or high, making it hard to see device displays or controls? www.repertoiremag.com
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Noise level: Will users have difficulty hearing device operation feedback or audible alerts and alarms, or distinguishing one alarm from another? Does the room contain multiple models of the same device, component or accessory, making it difficult to identify and select the correct one? Will the room be full of equipment or clutter or busy with people and activities, making it difficult to maneuver and providing distractions that could confuse or overwhelm the device user? Will the device be used in a moving vehicle, subjecting it and the user to jostling and vibration that could make it difficult to read a display or perform fine motor movements?
Progress “Today, manufacturers and providers realize that improving usability – not just of devices and equipment but also of workflow and workplace layout – is more likely to have a sustained significant positive impact on patient safety than training, incentives, establishing organizational goals or creating mandates,” says Tremoulet. Says Privitera, “The fact of the matter is, we’ve realized we can’t develop safe medical devices without considering usability. Ten years ago, we were just recognizing the need to take into account human factors. The conversation has changed: Now it’s about what constitutes good human factors engineering.” The expectations from a regulatory standpoint have also increased, she says. The FDA’s Human Factors
Premarket Evaluation Team serves as consultants on the multi-disciplinary review team of various premarket submissions in the agency’s Center for Devices and Radiological Health (CDRH) and other centers. The team is responsible for evaluating use-related risk analyses, and human factors/usability information and validation study data included in the submission. The recommendations are reviewed and incorporated in FDA letters to the device manufacturer. “When a medical device is easy to use, it means the manufacturer has taken the time to learn about the customer, the use environment, the context of use, and then put features in that make sense,” says Privitera. “We’ve really advanced.” Providers themselves can play a role in advancing the craft of human factors engineering, says Tremoulet. “They can provide candid feedback, both positive and negative, to manufacturers about their existing products. Manufacturers want their products to be used safely and effectively, and even comfortably, but they don’t always have good access to representative end users. Concrete feedback, which can be anonymous, is extremely valuable to them. Within healthcare organizations, encouraging management to obtain samples that can be tested in clinical environments or in simulation before purchasing large quantities, is also helpful. “Any usability issues uncovered should be carefully considered by management/purchasing organizations and shared with manufacturers.”
Why is Human Factor Engineering important to medical devices? For medical devices, the most important goal of the human factors/usability engineering process is to minimize userelated hazards and risks and then confirm that these efforts were successful and users can use the device safely and effectively, according to the FDA. Specific beneficial outcomes of applying human factors/usability engineering to medical devices include: ʯ Easier-to-use devices, device’s status and operation, user manuals, ʯ Safer connections between ʯ Better user understanding of a ʯ Reduced need for user training device components and accespatient’s current medical condition, and retraining, sories (e.g., power cords, leads, ʯ More effective alarm signals, ʯ Reduced risk of use error, tubing, cartridges), ʯ Easier device maintenance ʯ Reduced risk of adverse and repair, events, and ʯ Easier-to-read controls and displays, ʯ Better user understanding of the ʯ Reduced user reliance on ʯ Reduced risk of product recalls. Source: www.fda.gov/medical-devices/device-advice-comprehensive-regulatory-assistance/human-factors-and-medical-devices
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REGISTER REGISTER TODAY! TODAY!
May 16 – 18, 2022 May 16 – 18, 2022 Westin Westminster | Denver, Colorado Westin Westminster | Denver, Colorado
Keynote Speaker, Keynote Speaker, Mike Rayburn Mike Rayburn
The 2022 PWH® Leadership Summit lineup will The 2022 PWH® Leadership Summit lineup will Open include Leadership Insights (TED-style Talks) Open to to women women and and men men include Leadership Insights (TED-style Talks) at all leadership levels. addressing pressing issues in leadership today, at all leadership levels. addressing pressing issues in leadership today, motivating keynote speakers, engaging panel motivating keynote speakers, engaging panel discussions and breakout sessions that will cover a host of topics. discussions and breakout sessions that will cover a host of topics. What IF? Tentative Agenda What IF?Speaker, Mike Rayburn Tentative Agenda Keynote Keynote Speaker, Mike Rayburn Mike Rayburn is a TEDx Presenter who teaches Mike Rayburn is a TEDx Presenter who teaches innovation, change and peak performance using worldinnovation, change and peak performance using worldclass guitar and humor to create a transformational class guitar and humor to create a transformational experience and generate exponential results . experience and generate exponential results . • Innovation: finding and creating the opportunities, • Innovation: andthat creating the opportunities, products andfinding processes others miss . products and processes that others miss . • Change: moving from managing change • Change: moving from managing change to creating change . to creating change . • High Performance: making those opportunities happen . • High Performance: making those opportunities happen . Rayburn is a music/internet pioneering entrepreneur, Rayburn is a music/internet pioneering feature artist on Sirius/XM and Artist in entrepreneur, Residence at feature artist on Sirius/XM and Artist in Residence at High Point University . High Point University . For artists, innovation, peak performance and change For artists, innovation, performance andqualified change are their lifeblood . Mikepeak Rayburn is uniquely are their lifeblood . Mike Rayburn is uniquely qualified to teach artistic principles in a business context, giving to teach artistic principles in a business context, giving businesses and teams the edge they need to innovate businesses and teams the edge they need to innovate and perform . and perform .
2022 Pricing 2022 Pricing
Member Member
Non-Member Non-Member
$895 $895
$1,095 $1,095
Registration deadline: May 2, 2022 Registration deadline: May 2, 2022
ONLINE REGISTRATION NOW OPEN: ONLINE REGISTRATION NOW OPEN: www.mypwh.org www.mypwh.org
Monday, May 16 Monday, May 16 2:30 – 3:30 pm . . . . . . . . New Member/New Attendee 2:30 – 3:30 pm . . . . . . . . New Attendee Meet Member/New & Greet Meet & Greet 3:30 – 4:30 pm . . . . . . . . Opening Keynote: 3:30 – 4:30 pm . . . . . . . . Opening What IF?,Keynote: Mike Rayburn What IF?, Mike Rayburn 4:30 – 6:00 pm . . . . . . . . Opening Reception 4:30 – 6:00 pm . . . . . . . . Opening Reception 6:00 pm . . . . . . . . . . . . . . Small Group Dine Around Town 6:00 pm . . . . . . . . . . . . . . Small Group Dine Around Town Tuesday, May 17 Tuesday, May 17 6:30 am . . . . . . . . . . . . . . Morning Mindfulness: Yoga 6:30 am . . . . . . . . . . . . . . Morning Mindfulness: Yoga 7:00 – 8:30 am . . . . . . . . Breakfast & Sponsor Showcase 7:00 – 8:30 am . . . . . . . . Breakfast & Sponsor Showcase 8:30 – 11:00 am . . . . . . . Opening General Session: 8:30 – 11:00 am . . . . . . . Opening Opening General Remarks,Session: Leadership Opening Leadership Insights &Remarks, PWH Leadership Awards Insights & PWH Leadership Awards 11:00 am – 12:00 pm . . . Mentoring Networking Event 11:00 am – 12:00 pm . . . Mentoring Networking Event 12:00 – 1:15 pm . . . . . . . Lunch 12:00 – 1:15 pm . . . . . . . Lunch 1:15 – 3:00 pm . . . . . . . . Breakout Sessions 1:15 – 3:00 pm . . . . . . . . Breakout Sessions 3:15 – 4:15 pm . . . . . . . . General Session 3:15 – 4:15 pm . . . . . . . . General Session 6:00 pm . . . . . . . . . . . . . . Fashion Frenzy & Dinner 6:00 pm . . . . . . . . . . . . . . Fashion Frenzy & Dinner Wednesday, May 18 Wednesday, May 18 7:30 – 8:30 am . . . . . . . . Breakfast & Mentor Meet Up 7:30 – 8:30 am . . . . . . . . Breakfast & Mentor Meet Up 8:30 – 9:30 am . . . . . . . . Leadership Panel 8:30 – 9:30 am . . . . . . . . Leadership Panel 9:45 – 11:00 am . . . . . . . Closing Keynote: Women Leading 9:45 – 11:00 am . . . . . . . Closing Keynote: Women Leading with Impact, Colette Carlson with Impact, Colette Carlson All times listed are Mountain time. Schedule subject to change. All times listed are Mountain time. Schedule subject to change.
Register Register today today to to attend attend the the industry’s industry’s only only conference conference dedicated to diverse and inclusive leadership development! dedicated to diverse and inclusive leadership development!
TRENDS
The Game of Risk Your customers are playing it. You should too.
Todd Nelson, FHFMA, MBA, director of partner relationships and chief partnership executive, Healthcare Financial Management Association
Hospitals and medical practices were introduced to risk-based contracting decades ago, with the advent of
health insurance. In 1982, Medicare raised the bar for hospitals by introducing prospective payment in the form of DRGs, or diagnosis-related groups. Since then, the stakes have kept rising. Today, Medicare, Medicaid and private insurers are pushing ahead with value-based contracts, putting pressure on providers to offer high-quality care cost-effectively. As providers assume more risk, they need their suppliers to help.
Todd Nelson, FHFMA, MBA, director of partner relationships and chief partnership executive with the Healthcare Financial Management Association, addressed the impact of value-based contracting on healthcare providers and their suppliers at the 2021 IMDA/HIRA annual conference in September. Repertoire followed up by asking Nelson about risk and what it means for healthcare providers and suppliers. Nelson served as vice president and CFO of a rural Midwest hospital for 15 years prior to joining HFMA. 40
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Repertoire: It seems that hospitals were forced to assume risk when the feds introduced DRGs in 1982. Would you agree? Why or why not? Todd Nelson: Hospitals did assume some risk when DRGs were introduced, but they quickly learned the levers to pull to mitigate that risk. Those levers were mostly financial (controlling labor and supply cost, length of stay, etc.) and they were able to recover some through various payment mechanisms for higher cost/ LOS [length-of-stay] cases. Additionally, not everything
was included in the DRG, so hospitals could make it up in other volume (i.e., fee-based) revenue sources. Rep: Haven’t hospitals and health systems managed risk since they began contracting with insurance companies? If so, what’s different today? Nelson: This difference is really managing the clinical risk of caring for a population. When working with an insurance company, the risk is negotiating a payment rate that is too low. The insurance company is taking the risk for greater volumes of patients or procedures. In the new models of value-based payment, the hospital is taking the risk for the clinical side of things as well as cost. It’s an entirely different set of skills, actuarially – more like those of an insurance company. Rep: How successful are hospitals and health systems in terms of managing risk today? What mistakes have they made? And where have they achieved success? Nelson: As noted previously, hospitals and health systems have been managing various types of risk for decades. The key here is that the stakes are much higher when managing all the financial and clinical risk on behalf of the patients they serve. Additionally, payment incentives are not always aligned. For example, the financial incentive for the hospital may be to reduce the number of visits by keeping the patient healthy and out of the hospital, but the physician may still be paid on a fee-for-service model, which encourages more visits. Rep: Do you believe there are limits to how much of a health system’s revenues can come from riskbased contracts? If so, what are those limits? Nelson: I am not sure there is a hard and fast rule, or amount of revenue that can come from risk-based contracts. Although organizations must have a good base of financial reserves to meet their payment obligations – and those are higher the more risk contracts they take on – it really depends on each individual organization as to what they can handle. Rep: Do hospitals and health systems evaluate medical technology differently today than they did, say, 10 or 15 years ago, because of risk-based contracting? If so, how? And why? Nelson: Hospitals and health systems are continuing to evolve their evaluation approach over time as the demand
for resources continues. As organizations accept risk and value-based agreements, the evaluation process considers more than just the “price at the pump.” It takes into account other factors such as resource reduction down the line, lower length of stay, length of recovery, medication or supply cost changes, and impact on clinician time/satisfaction.
‘ In the new models of value-based payment, the hospital is taking the risk for the clinical side of things as well as cost. It’s an entirely different set of skills, actuarially – more like those of an insurance company.’ Rep: How should distributors and manufacturers of new technologies adjust their sales and marketing strategies accordingly? Nelson: Don’t get me wrong: Initial cost is still important, and that is the easier story for the sales rep to tell. A more difficult strategy is telling the story of how your technology impacts the other intangibles (e.g., satisfaction, outcomes, community or environmental impact), all of which are becoming more prevalent in providers’ decision-making process. Even though those areas are more difficult to measure and explain, they should be included in their sales/marketing strategies – as they get to the overall value proposition of the technology. Rep: Any other messages for dealers about their role in working with health systems as they operate in a risk-based environment? Nelson: I think the best advice I can give is to listen to your customers and understand their pain points and the problems they are trying to solve on behalf of their patients and communities they serve. If you can understand those, you can find ways to work with them to help improve the overall health of the community – a true win for everyone. www.repertoiremag.com
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HIDA
Enhancing Preparedness Through Public-Private Partnerships The persistence of shipping bottlenecks and the emergence of the Omicron variant of COVID-19 have continued
to be top of mind for our industry. Despite these challenges, HIDA’s commitment to advance the value of distribution in healthcare remains unchanged.
HIDA has been working closely with the Assistant Secretary for Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services (HHS), where we continue to stress the importance of public-private partnerships to enhance preparedness. Our advocacy has extended to include transportation. We have set up pilot programs with the Ports of Los Angeles and Long Beach to “Fast Pass” medical supplies quickly through the port and on to our customers. While it is hard to predict the course of particular variants and their impact on supplies, distributors and manufacturers need to keep the flow of medical supplies moving. We have continued to urge all stakeholders in the supply chain to prioritize medical supplies to move faster, and with fewer delays. Among our policy recommendations are the following: ʯ Expand Fast Pass Pilot Program: HIDA supports the expansion of the Fast Pass pilot program, especially to ports on the Eastern Seaboard. Research conducted by HIDA found that three of the four most congested ports for medical supplies could be found on the East Coast – at Savannah, New York/New Jersey and Charleston.
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Lift Restrictions on Empty Returns: The timely transport of medical supplies moves in a circle. For full containers to move out of the ports, empty containers must return. HIDA recommends lifting restrictions on the return of empties in order to expedite the flow of containers. Ground Empties: The movement of containers depends on the availability of chassis. But too many chassis are idled while they remain attached to empty containers. HIDA recommends
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grounding these empties, thereby freeing up chassis to transport more containers full of supplies.
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No-Appointment Trucking for Medical Supplies: The appointment-based system for picking up containers has contributed to terminal congestion. Delays at one appointment cause truckers to miss the next appointment. HIDA recommends allowing trucks to pick up medical supply containers at ports without an appointment.
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Pop-Up Ports Designated for Medical Supplies: Pop-up locations have eased supply chain bottlenecks for many retailers. HIDA recommends designating space at lots outside the ports for medical supply containers for trucks to pick up.
Linda Rouse O’Neill, Vice President, Supply Chain Policy and Executive Branch Relations, Health Industry Distributors Association
The timely transport of medical supplies moves in a circle. For full containers to move out of the ports, empty containers must return.
Medical supplies need to be moved to the front of the line at ports, railyards and truck terminals. Public-private partnerships are vital to COVID response. The commercial market will continue to coordinate with government stakeholders to support providers. We will remain vigilant, no matter the variant.
L E T ’ S MOV E
FORWARD
We have all worked around the clock to support our customers during the pandemic. Thank you for your commitment in meeting our customers’ needs. The availability of vaccines and testing are leading to more normalcy. Abbott is ready with ID NOWTM instruments and molecular respiratory assays to provide the testing solutions needed.
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WE ARE HERE TO SUPPORT YOU AND YOUR CUSTOMERS.
REACH OUT TO YOUR ABBOTT REPRESENTATIVE TODAY.
877.441.7440 The ID NOWTM COVID-19 EUA has not been FDA cleared or approved. It has been authorized by the FDA under an emergency use authorization for use by authorized laboratories and patient care settings. The test has been authorized only for the detection of nucleic acid from SARS-CoV-2, not for any other viruses or pathogens, and is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostic tests for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Act, 21 U.S.C. § 360bbb3(b)(1), unless the authorization is terminated or revoked sooner. © 2021. All rights reserved. All trademarks referenced are trademarks of their respective owners. Any photos displayed are for illustrative purposes only. Any person depicted in such photos is a model. COL-03075-1 06/21
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MARKETING MINUTE
The Best and Brightest Draw inspiration from the best ads and commercials of 2021 Between a pandemic and the world struggling to get back to “normal,” ads and commercials in 2021 have
transformed through the year. While savvy marketers remained focused on the overall strategy and audience targeting, creatives needed to deliver a memorable ad experience with more prospective buyers consuming media faster than ever before.
From all industries ranging from healthcare to industrial, the global crisis shaped a new digital experience for consumers to stay connected and connect with brands across multiple platforms and media types. It’s even affected the advertising trends and budget spending on new channels, with 44% of marketers stating that they’ve completely changed their channel approach in 2021. In this post, you’ll discover the top ads and commercials in 2021 to help you determine your future strategy. This past year brought new trends and debuted a fresh collection of campaigns to excite and convert consumers into customers. After all, 37% of brands have increased their TV ad spend since 2019, and it shows no signs of slowing down next year. Ready to boost your creative strategy next year? Let’s dive in.
The Biggest Ad and Commercial Trends to Watch Developing ads and commercials isn’t a nice-to-have for healthcare businesses. With more people consuming video content and ad campaigns than ever before, it’s one of the best ways to build awareness and credibility with potential customers. Before diving into the latest and most significant campaigns, it’s essential to understand how trends this year impacted the creative strategy and drove improved results. 44
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Here are the top trends brands took advantage of in 2021: ʯ Programmatic and AI advertising: Using realtime data, you can connect with hyper-targeted consumers across multiple channels based on their patterns and behaviors. ʯ Going green: Highlighting your environmental impact
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and sustainability practices show consumers that you care about the greater good. Mobile-first: Designing your campaigns for the 9:6 vertical ratio encourages more engagement on digital and social platforms. User-generated content: Leveraging your customers to create campaigns on
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platforms like TikTok and Instagram Reels allows you to better connect with your audience in a more authentic way. Authentic representation: Featuring campaigns that display a diverse spectrum better represents and amplifies your entire audience. New colors: Staying away from neutrals and embracing natural colors, like teal and orange, evoke more emotion.
Moving into 2022, the trends you will implement will vary depending on your services and target audience to drive high-performance results. Next year, some common trends you can expect to see include inclusive photography, data visualizations, branded memes, and colorful illustrations.
Top Ads and Commercials in 2021 for Your Brand to Leverage Looking back at 2021, ads and commercials might remind you of all the twists and turns this year took. Brands unable to adapt to trends might have encountered new obstacles to building long-lasting relationships with customers. However, there wasn’t a shortage of creativity for brands willing to innovate and take a chance. Here are the top 2021 campaigns to help inspire your future ads and commercials: 1 McDonald’s – “Lights On” During the pandemic in the United Kingdom, McDonald’s closed its doors before offering the beloved Big Macs and Sausage McMuffins through at-home delivery. Once the company established online ordering, they introduced the three posters in popular geographic locations that show the “M” arch over common residential areas.
While the design is relatively simple, the powerful message of being available for customers in the comfort of their own homes was fitting for the time. Takeaway lesson: When evoking an emotional response, a minimalist design allows your audience to focus more on the message.
but also co-promoting Jordan’s upcoming Amazon Prime movie, “No Remorse.” While the focus was Alexa, Amazon successfully promoted two products and delivered even more impact to viewers. Takeaway lesson: Utilize your ad campaigns to highlight a mix of products and services relevant to your target audience.
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Relief – “A Better Way to Get Out of Debt” When Netflix released the hit “Squid Games” series, many brands attempted to leverage the sudden popularity but often failed due to the nature of the game-show murder context. However, Relief took an interesting view of the series by printing out cards that say, “There’s a better way to get out of debt.” By Relief handing these cards out in key geographic regions like Miami and New York, the company quickly resonated with fans of the TV show and drove more app downloads. Takeaway lesson: Leverage culturally relevant events to highlight your products and services, but make sure it’s meaningful to avoid trying to jump on the bandwagon without reason. Amazon – “Alexa’s Body” Since most people recognize the “Alexa” voice, Amazon explored the idea of Alexa having the body of this year’s hottest celebrity actor, Michael B. Jordan. With voice assistants rising in popularity and Alexa earning 26.7% market share, Amazon displayed this ad in the 2021 Super Bowl by testing the creative limits of the family-friendly event. What makes this commercial particularly successful is not only highlighting a successful product, 3
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Heinz – “Draw Ketchup” Regardless of your industry, brands that define the category so much that consumers can only think about them are the ultimate flex. This proves true with Heinz’s commercial, which challenged people worldwide to “draw ketchup.” The result? Everyone drew the Heinz bottle. Not only does this commercial highlight Heinz’s global impact, but it also showcases the brand in a transparent light through user-generated content. Heinz also utilized multiple ad cuts across digital channels and created a contest for consumers to win a customized bottle of ketchup to keep the campaign interactive. Takeaway lesson: Don’t be afraid to be more playful with your ad campaigns to pique interest.
Boosting Brand Storytelling with Ads and Commercials in Healthcare If you’re ready to create a new ad campaign or commercial in 2022, you’ll want to learn the lessons of past advertisements to make the most out of your resources and budget. Depending on your goals – brand awareness, lead generation, etc. – your campaign will need to evoke emotion, leverage current trends, and utilize user-generated content to drive results. www.repertoiremag.com
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HEALTH NEWS
Under Pressure COVID associated with higher blood pressure levels
The COVID-19 pandemic hasn’t just been detrimental to respiratory health. According to new research published
in the American Heart Association’s journal Circulation, COVID has also been associated with higher blood pressure levels among middle-aged adults across the U.S.
Nearly half of American adults have high blood pressure, a leading cause of heart disease, and nearly 75% of all cases remain above the recommended blood pressure levels. The shift to remote health care amid the pandemic for numerous chronic health conditions including high blood pressure and had a negative impact on healthy lifestyle behaviors for many people. “At the start of the pandemic, most people were not taking good care of themselves. Increases in blood pressure were likely related to changes in eating habits, increased alcohol consumption, less physical activity, decreased medication adherence, more emotional stress and poor sleep,” said lead study author Luke J. Laffin, M.D., co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic in Cleveland, Ohio. “And we know that even small rises in blood pressure increase one’s risk of stroke and other adverse cardiovascular disease events.” 46
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“Even in the midst of the pandemic, it’s important to pay attention to your blood pressure and your chronic medical conditions. Get regular exercise, eat a healthy diet, and monitor your blood pressure and cholesterol.” Researchers accessed de-identified health data from an employee wellness program (included employees and spouses/partners) to assess changes in blood pressure levels before and during the COVID-19 pandemic. The data included nearly a half million adults across the U.S., average age of 46 years, 54% women, who had their blood pressure measured during an employee health screening every year from 2018 through 2020. The researchers compared monthly average blood pressures between 2018 and 2019 and blood pressure measures in January through March 2019 to January
through March 2020 (pre-pandemic). They then reviewed blood pressure changes comparing April to December 2020 (during the pandemic) to April to December 2019 (pre-pandemic). The analysis found: ʯ During the pandemic (April to December 2020), average increases in blood pressure each month ranged from 1.10 to 2.50 mm Hg higher for systolic blood pressure (the top number in a blood pressure reading that indicates how much pressure the blood is exerting against the artery walls with each contraction) and 0.14 to 0.53 mm Hg for diastolic blood pressure (the bottom number in a blood pressure reading indicates how much pressure the blood is exerting against the artery walls while the heart is resting, between contractions) compared to the same time period in 2019. Before the pandemic, blood pressure measures were largely unchanged when comparing study years.
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Higher increases in blood pressure measures were seen among women for both systolic and diastolic blood pressure, among older participants for systolic blood pressure, and in younger participants for diastolic blood pressure.
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From April to December 2020, compared to the pre-pandemic time period, more participants (26.8%) were re-categorized to a higher blood pressure category, while only 22% of participants moved to a lower blood pressure category.
“From a public health perspective, during a pandemic, getting vaccinated and wearing a mask are important. However, the results of our research reinforce the need to also be mindful of chronic health conditions such as the worsening of blood pressure,” Laffin said. “Even in the midst of the pandemic, it’s important to pay attention to your blood pressure and your chronic medical conditions. Get regular exercise, eat a healthy diet, and monitor your blood pressure and cholesterol. See your doctor regularly to learn how to manage your cardiovascular risk factors.” Read more at: https://newsroom.heart.org/news/u-sadults-blood-pressure-levels-increased-during-the-covid19-pandemic.
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 Bye bye, BlackBerry It was a sad beginning to 2022 for tech nostalgia. Service on BlackBerry cellphones shut down for good on January 4, closing the door on a piece of technology that helped usher in a revolution in communications, CBS News reported. BlackBerry announced in September 2020 that it would stop updating operating systems and software for its devices on January 4, 2022. The move impacts devices running BlackBerry’s 7.1 OS as well as earlier platforms, BlackBerry 10 software and BlackBerry PlayBook OS 2.1. Other related services, including BlackBerry messenger and BlackBerry hosted emails, also are ending. Bloomberg reported that the company’s appeal waned as Apple Inc.’s iPhone and a slew of Android handsets with larger displays, better graphics and wider app offerings took over the market during the past decade.
LG releases Filmmaker Mode LG recently rolled out a feature update which will enable all LG 2020 and 2021 4K and 8K UHD Smart TV customers to automatically be able to view movies and series on Prime Video in Filmmaker Mode, allowing them a viewing experience the way the content creators intended it. Filmmaker Mode was created by the UHD Alliance, comprised of the world’s leading consumer electronics manufacturers, film and television studios, content distributors and 48
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technology companies, seeking to ensure the best UHD viewing experiences. First unveiled in 2019 and featured in LG TVs in 2020, Filmmaker Mode was designed to preserve the visual intent of the content creator, bringing the home viewing experience as close as possible to that of an actual theatrical release. LG and Amazon now take that vision a step further with Prime Video content embedded with a signal that automatically triggers Filmmaker Mode on 4K and 8K UHD LG TV models running webOS 5.0 and webOS 6.0. 1 This ability for compatible TVs to detect and adjust settings to Filmmaker Mode without the need for the viewer to change the setting manually is “an industry first,” LG said in a release, and paves the way for future TVs to better support streaming services without imposing additional steps on viewers.
Microsoft releases new Teams offering Microsoft Corp. announced the general availability of Teams Essentials, the first-ever standalone Microsoft Teams offering, designed specifically for small businesses. Priced at $4 a month, Teams Essentials gives small businesses a professional and affordable meetings solution to support collaboration, connection and productivity in a hybrid work environment. “We know how difficult the past 20 months have been for small businesses. They’ve had to demonstrate extreme flexibility to adapt, often with limited access to tools and technology,” said Jared Spataro, corporate vice president of Modern Work at Microsoft. “Teams Essentials is built specifically to meet the unique needs of small businesses, enabling them to thrive in this new era of work.”
Teams Essentials provides expansive limits and features for hosting professional meetings and collaborating in one place: ʯ Unlimited group meetings for up to 30 hours ʯ Meetings with up to 300 people ʯ 10 GB of cloud storage per user ʯ Teams Essentials also includes existing and new capabilities available in the free version of Teams to meet the needs of small businesses:
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Simple, easy invitations require only an email address. Users are not required to sign up, sign in or install Teams to participate in a meeting. In addition to Outlook Calendar integration, new Google Calendar integration makes it easy to schedule meetings in Microsoft Teams. *Coming soon Professional meeting tools and capabilities like meeting lobby, virtual backgrounds,
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Together mode, live closed captions and live reactions. Never lose context or continuity with always-available chats in Microsoft Teams. Quickly start a group project and host meetings with anyone, assign tasks to teammates, and create polls to receive feedback quickly all in one hub with the new small-business group chat template. *Coming soon to desktop and web
Kicking it Freestyle Samsung Electronics recently announced the launch of its all-new portable screen and entertainment device, The Freestyle. The Freestyle offers first-of-its-kind technology and flexibility to deliver optimal viewing and entertainment for customers looking to bring video and audio content wherever they go, the company said. Targeted toward Gen Z and millennials, The Freestyle is a projector, smart speaker and ambient lighting device all rolled into one lightweight, portable device. When it comes to portability, The Freestyle weighs only 830 grams allowing to change any space into a screen with ease. Unlike conventional, boxy projectors, The Freestyle’s versatile cradle allows rotation of up to 180 degrees, enabling
users to show high-quality video anywhere – tables, floors, walls or even ceilings – no separate screen required. The Freestyle comes with full auto keystone and auto leveling features, enabled by industry-leading technology. The features allow
the device to automatically adjust its screen to any surface at any angle, providing a perfectly proportional image every time. Additionally, the auto focus feature allows The Freestyle to display a crystal-clear image on any surface, at any angle,
up to 100 inches in size. The Freestyle also comes with a dual passive radiator enabling a clean and deeper bass without distortion, and its 360-degree sound radiation allows customers to enjoy a cinemaquality sound experience no matter where they are.
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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 Hyundai Santa Fe receives Kelley Blue Book 2022 Best Buy Award Hyundai announced it has received a 2022 Kelley Blue Book Best Buy Award for the 2022 Santa Fe in the 2-Row Midsize SUV segment. The Best Buy Awards are the culmination of expert vehicle evaluation and testing of nearly every new vehicle available. The comprehensive process includes an analysis of vehicle-related data, including vehicle transaction prices, 5-Year Cost-to-Own data, consumer reviews, ratings, and retail sales information.
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Honda conducting pilot of new road condition monitoring system Honda Research Institute USA, Inc. announced it is developing a road condition monitoring system that uses vehicle technology to evaluate road conditions in an effort to detect possible hazards. With this vehicle-generated road condition reporting system, Honda hopes to help road operators monitor lane marking conditions in a more frequent, efficient and cost-effective way that helps fulfill Honda’s concept of “Safety for Everyone.” Honda Research Institute is conducting a pilot program in Ohio to evaluate a system that uses GPS coordinates and sensors such as cameras to collect real-time road condition information that can be shared with road operators. Honda is collaborating with the Ohio Department of Transportation and plans to start providing road condition data in early 2022, from Honda vehicles used as part of the pilot program, to help enhance the efficiency of the road maintenance operation in Ohio. Honda Research Institute also is exploring how connected vehicles can access the anonymized data to adjust Honda and Acura Advanced Driver Assistance System’s (ADAS) perception settings, and if needed, warn drivers if lane markings are faded or are in need of repair. When monitoring lane marking conditions, the system visually classifies lane lines to the left and right of the vehicle using four color codes: green, yellow, grey and red. Green and yellow classifications respectively indicate ideal to good lane marking conditions. The system displays grey classifications when there
are no lane lines and red if the lane markings need repair. That road condition information, including longitude and latitude coordinates along with relevant images and video clips, is captured by the vehicle, anonymized, and then streamed to a secure platform for analysis. Road operators can access this platform to identify the location, type and severity of the road condition and hazard information, and obtain a still image and video. In addition to lane markings, Honda Research Institute plans to expand the system’s application to monitor other types of road conditions. It hopes the system can prove useful in keeping all roads safer for everyone.
Ford planning to double production of the F-150 Lightning™ pickup Ford Motor Company said it is planning to nearly double production of the F-150 Lightning™ pickup at the Rouge Electric Vehicle Center in Dearborn to 150,000 trucks per year to meet high demand for the first allelectric version of the F-Series. “With nearly 200,000 reservations, our teams are working hard and creatively to break production constraints to get more F-150 Lightning trucks into the hands of our customers,” said Kumar Galhotra, president of The Americas & International Markets Group, Ford Motor Company. Due to “unprecedented customer interest,” Ford announced it is implementing a wave-by-wave reservation process, with reservation holders being asked to watch for an invitation via email from Ford or to log into their Ford.com account over www.repertoiremag.com
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WINDSHIELD TIME
the next few months. Those who don’t receive invitations to convert for the 2022 model year will have an opportunity to order a future model year vehicle in due course. Flexibility is key to Ford’s production system and the way teams are now working to deliver the company’s future lineup of electric vehicles. To deliver this latest increase, a small task force of employees from manufacturing, purchasing, strategy, product development and capacity planning are finding ways to quickly adapt and expand production of the groundbreaking pickup, the company said. Ford is working with key suppliers – as well as with its own manufacturing facilities Rawsonville Components Plant and Van Dyke Electric Powertrain Center – to find ways to increase capacity of electric vehicle 52
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parts, including battery cells, battery trays and electric drive systems.
Audi increasing investments in electromobility Audi doubled its product portfolio of purely electric models in the last year, the company said in a release. With the world premiere of the Audi e-tron GT1 at the start of the year and the Audi Q4 e-tron in the spring, 2021 was characterized entirely by implementation of the roadmap. Furthermore, with its investment planning for the next five years, Audi is accelerating the transition toward becoming a provider of networked and sustainable premium mobility. In particular, advance payments for future vehicle projects are being increased once again, with a sum total of about €37 billion. The premium manufacturer
is earmarking about €18 billion for electrification and hybridization alone and thereby emphasizing its clear commitment to electromobility. From 2033 on, the future of the Audi brand will be fully electric, the company said. The company is continuing to pick up speed along the way: Audi doubled the number of fully electric models in its range in 2021. That means that Audi is putting more electric cars than combustion engines on the market in the current year. With the new models Audi e-tron GT quattro1, Audi RS e-tron GT2, and the first fully electric models in the compact segment, the Audi Q4 e-tron and Audi Q4 Sportback e-tron, the electric portfolio has grown by four additional models. By 2025, the company aims to have more than 20 fully electric models in its lineup.
NEWS
Healthcare supplier and manufacturer AliMed, Inc. names Adam S. Epstein as chief executive officer Healthcare product manufacturer and distributor,
AliMed, Inc. (Dedham, MA) announced the promotion of Adam S. Epstein, 51, to the position of Chief Executive Officer. In his new role, Epstein will oversee the company’s general operations and its diversified portfolio of products sold to a majority of the country’s leading healthcare providers. In his prior role as Chief Commercial Officer, Epstein directed all customer-facing, demand generation and product development activities. Under his new leadership, AliMed will continue to build a robust portfolio of contracted positions with major, national GPO’s, IDN’s, and Distribution partners to drive sales growth. The company has also reinvested in product development and has a strong pipeline of new products now commercializing for use in both acute and post-acute care settings. AliMed’s strong brand identity is synonymous with 50-years of innovative products and customizations developed to address a range of healthcare challenges. “Adam has done a great job strengthening our relationships with major customers and key sales partners,” said AliMed’s Chair of the Board and President, Alexandra Cherubini. “He is committed to remaining relevant to our key partners and inspiring customer loyalty to our brand. He is a tremendous leader and I’m confident he will guide our business to even greater success.” Epstein has worked at AliMed since late 2019. Prior to that, he held senior roles at UFP Technologies (NASDAQ: UFPT) and Dielectrics, Inc. leading the development, commercialization, and sales of medical products and devices. “I am excited about continuing to build the business with our talented and dedicated team of professionals,” Epstein said. “The important work AliMed does, enables caregivers to positively impact their patients’ lives. Our mission is helping people help people. We’re proud to be doing that on many fronts, through our broad product portfolio, signature service, and community engagement program, AliCares.” Epstein holds degrees from the University of Rochester and the Isenberg School of Management at UMASS.
Adam S. Epstein
“Adam has done a great job strengthening our relationships with major customers and key sales partners.” — Alexandra Cherubini, Chair of the Board and President, AliMed
AliMed Inc. headquartered in Dedham, MA and founded over 50 years ago by Barbara and Julian Cherubini, built its reputation on high-value, differentiated offerings and exceptional service. This specialty medical supplies manufacturer and distributor has onsite customization capabilities for both domestic and international care providers, dealers, and distributors. AliMed’s broad portfolio of healthcare products is designed to improve patient outcomes and experience, serving needs from “hospital to home”. www.repertoiremag.com
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NEWS
Owens & Minor completes acquisition of American Contract Systems Owens & Minor, Inc. (Richmond,
VA) has completed the acquisition of American Contract Systems (ACS) (Bloomington, MN), a provider of kitting and sterilization services for Custom Procedure Tray (CPT) solutions. “Bringing into Owens & Minor the capabilities that American Contract Systems offers in the CPT market will further strengthen our ability to meet and exceed our customers’ collective needs for surgical procedure trays,” said Edward
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A. Pesicka, president and CEO of Owens & Minor. “Custom Procedure Trays represent a critical component of medical-surgical supplies. The ACS acquisition expands our existing U.S-based kitting operations, and advances our focus on local solutions and local support for Owens & Minor customers. We are also excited to build upon ACS’s unique local sterilization capabilities. Through its proprietary sterilization process, ACS is able to offer sterilization capabilities without the
high-volume use of ethylene oxide that others use for sterilization, making it safer for our communities and our environment.” “We are pleased to join forces with an industry leader such as Owens & Minor,” said ACS President and CEO David Thomson. “Our two companies have partnered for decades in using HALYARD*- branded products for customers’ CPT needs. This acquisition will enhance our combined abilities to serve customers with a stronger CPT offering.” ACS offers a differentiated CPT solution that will complement existing CPT options within Owens & Minor. The company provides a proprietary, environmentally sound sterilization process to the CPTs that is easily deployed near the point-ofuse. This unique sterilization solution, already deployed in facilities across the U.S., will be combined with Owens & Minor’s Americasbased footprint. This is the first acquisition Owens & Minor has made since acquiring Halyard Health in 2018. “Empowering our customers to advance healthcare is in Owens & Minor’s DNA and is the driving force behind every decision we make,” Pesicka said. “We look forward to working with our new ACS teammates in bringing highly innovative solutions to the healthcare industry.”
NEWS
Industry News STAT-Technologies, FDI Medical merger announced
Henry Schein’s Stanley Bergman honored by The National Hispanic Health Foundation
STAT-Technologies, Inc. (Golden Valley, MN), a medical supply distributor specializing in point-of-care and CLIAwaived technology and wellness screening technology, has merged with FDI Medical (Natick, MA), an independent medical distributor allocating preventative and diagnostic health testing products.
Stanley Bergman, chairman of the board and chief executive officer at Henry Schein, Inc. (Melville, NY), was honored by The National Hispanic Health Foundation (NHHF) for his leadership in helping to improve health equity and supporting the needs of Hispanic communities and health professionals. The NHHF is the philanthropic arm of the National Hispanic Medical Association (NHMA) and it honored BergStanley Bergman man at its 18th Annual New York Hispanic Health Professional Student Scholarship Gala. Henry Schein has supported the mission of NHHF and NHMA to recruit more members of the Hispanic community into healthcare careers, advocate for increased Hispanic faculty at dental and medical schools, and expand access to and improve equity in healthcare. Most recently, the Henry Schein Cares Foundation has supported the efforts of NHHF and NHMA to reduce vaccine hesitancy and bridge cultural barriers to vaccine access in Latino communities, including the “Vaccinate for All” campaign, which includes cultural competency tools to engage and encourage Latino and Hispanic Americans to get vaccinated.
Perry Witkin, president of STAT-Technologies, said: “The FDI team is world class and is passionate about the same things we are – consulting with customers to make the best point-of-care medical test purchases possible. Like STAT-Technologies, FDI selects the highest quality products to distribute to their customers and provides exceptional customer service. In an increasingly competitive and specialized environment, by combining our operations and staff we significantly expand our product offerings and access to resources for our customers. In addition, Greg Lunt, who has been our friend for 20 years, and the FDI sales staff will be staying on with us to ensure a smooth transition and continued growth.” Greg Lunt, president of FDI Medical, said: “The healthcare industry is advancing faster than ever before, so constant improvements and access to economies of scale in including supply chain, warehousing and financing is a priority for us. Having the ability to better serve all of our customers was a driving factor for our merger with STAT-Technologies.”
Investors entering into supply chain technology at fast pace Companies that exceed $1 billion valuations are jumping into the logistics sector to help digitize the world’s supply chain operations. Large investment funds are injecting money in at a fast pace for digitally focused ventures in freight, delivery and warehousing. Supply chain technology startups raised $24.3 billion in venture funding in the first three quarters of 2021, 58% more than the full year total for 2020, according to the Wall Street Journal.
Quidel Corp. signs definitive agreement to acquire Ortho Clinical Diagnostics for approx. $6B Quidel Corp. (San Diego, CA) and Ortho Clinical Diagnostics Holdings plc (Raritan, NJ) have entered into a definitive agreement in which Quidel will acquire Ortho, one of the world’s largest in vitro diagnostics companies, for $24.68 per share of common stock using a combination of cash and newly issued shares in the combined company for an equity value of approximately $6 billion. The transaction is expected to close during the first half of fiscal year 2022, subject to customary closing conditions. www.repertoiremag.com
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NEWS The combined organization will unite technologies and platforms to benefit customers with expanded access to clinical chemistry, immunoassay, molecular diagnostics, immunohematology, donor screening and point-of-care diagnostics offerings. “The combination with Ortho will help solidify Quidel as a leader in the diagnostics industry, bringing together innovative, complementary products, solutions, and services that enhance the health and well-being of patients across the globe,” said Douglas Bryant, President and Chief Executive Officer of Quidel, who will serve as Chairman and Chief Executive Officer of the combined company. “Establishing a stronger leadership position, we expect the combined company will emerge as a global player with top-tier R&D capabilities, a more diverse product pipeline, and broader geographic footprint. Importantly, our complementary cultures are underpinned by a commitment to our customers, patients, and the communities we serve, reinforcing our confidence in the longterm value creation of this transaction. We are impressed by what Ortho has accomplished for patients. We look forward to joining together to continue the strong patient focus that is core to our mission, creating an organization with a shared goal of discovering, developing, and delivering innovative solutions to our customers.” “Quidel shares our commitment to customers and passion for the patients we serve. By bringing together Quidel’s point-of-care diagnostics with Ortho’s vast global reach, there is a substantial opportunity to capitalize on the cross-selling opportunities, move into attractive adjacent markets, and accelerate innovative product expansion and the development of molecular technologies,” said Chris Smith, Chairman and Chief Executive Officer of Ortho. “Together, we will continue to advance life-changing diagnostic solutions to improve patient outcomes and deliver economic benefits to the healthcare system.”
HCA Healthcare acquires MD Now Urgent Care with 59 locations in Florida HCA Healthcare, Inc. (Nashville, TN) has purchased MD Now Urgent Care, a network of 59 urgent care centers in Florida. The transaction significantly expands HCA Healthcare’s reach as one of the nation’s largest providers of urgent care, currently operating more than 170 clinics across 19 markets. MD Now is the largest urgent care provider in Florida. The acquisition of these MD Now centers, combined with the November announcement of HCA Healthcare’s plans to build three additional hospitals in the state, 56
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will enhance HCA Florida Healthcare’s ability to offer patient-centered, high-quality care to more Floridians and meet the growing need for healthcare services in the state. HCA Florida Healthcare currently serves 6.4 million patients each year at more than 400 affiliated sites of care across Florida. The transaction was completed at the end of 2021. The terms of the transaction were not disclosed.
Cardinal Health, Baxter invest in Medically Home Medically Home announced a new, $110 million round of funding from strategic investors including Baxter International Inc., Global Medical Response (GMR) and Cardinal Health who will each have representation on the company’s Board. Cardinal Health, Mayo Clinic and Kaiser Permanente are providing additional capital on top of their previous investments, demonstrating confidence in the growing expansion of the model nationwide. The Medically Home model unlocks patients’ homes as safe alternative sites to receive high and lower acuity care across the care continuum in the comfort and convenience of their homes. This capability is designed to increase health system capacity and resiliency, while meeting the needs and wants of patients, who often prefer to be cared for at home or in a homelike setting. More than 7,000 patients have been treated using the Medically Home platform and ecosystem, as delivered by health systems across the country and utilization is expanding rapidly. The model is expected to increase demand for a nextgeneration clinical workforce that combines centralized care oversight (guided by physicians and nurses in medical command centers) with field clinicians (nurses, paramedics, and technicians), who work seamlessly as a team. This work force is supported by Medically Home’s national partners that bring all the needed clinical and supportive services, medication, medical equipment, technology and other capabilities that create a safe and effective site of advanced medical care. Suzanne Foster, President, Cardinal Health at-Home Solutions said, “Our continued partnership illustrates Cardinal Health’s strong commitment to Medically Home and the unrelenting efforts of so many to transform healthcare and expand the accessibility of safe, effective hospital-level care at home. Enabling health equity and decentralized care for patients to receive hospital level care is no longer healthcare of the future – it’s here today, and Cardinal Health is devoted to working closely with Medically Home and its partners to collectively provide optimal, in-home patient experiences and outcomes.”
Better BP is Better Care Set the stage for better care and set yourself apart with this Midmark approach. We designed the only fully integrated point of care ecosystem to help promote a more consistently accurate blood pressure measurement by targeting 3 key areas using 3 unique products. 2
Accurate, Consistent BP Capture
IQvitals® Zone™ with the SPRINT BP Protocol introduces automation at the point of care that can help ensure a higher level of standardization, minimizing human variables while maximizing consistency and data accuracy.
Midmark 626 Barrier-Free® Examination chair with Patient Support Rails+ and IQvitals Zone shown.
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Proper Patient Positioning
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Accurate, Consistent BP Capture
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= Better BP Contact your Midmark Representative to start the conversation. See all 3 at midmark.com/betterBP3
1 https://www.aafp.org/afp/2005/1001/p1391.html © 2022 Midmark Corporation, Miamisburg, Ohio USA
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EMR Connectivity
™
Tough on germs
At Sri Trang infection prevention is our calling. Ventyv® is the premier brand of Sri Trang USA, Inc. Sri Trang is a proven glove producer protecting the world against infection since 1991. We look forward to protecting you and your patients.
Visit sritrangusa.com/rep or ventyv.com for more information Hello@ventyv.com • Sri Trang USA, Inc. • 5820 W. Cypress St., Ste H • Tampa, FL 33607 Call 1-844-784-5683 (844-STGLOVE)
