Repertoire Feb 23

Start with Empathy

February is the second month of the year, the month all about feelings and Valentine’s Day. When we think about feelings in February, we probably all go to love. While love is an amazing feeling, I’d rather talk about empathy this month. No, not empathy for TCU or my Crimson Tide (that arguably should have been in the playoffs), but empathy for the caregivers and the supply chain teams across the country.

Why do they deserve our empathy? Sitting in meeting after meeting, I’ve listened to countless healthcare workers and supply chain executives talk about the same challenges they are facing. These include:

1. Supply Assurance. Almost every supply chain leader in America lists backorders as their number one issue over the past 12 months and for the months to come. They know there isn’t an overnight solution, but they do expect timely, honest communication – even if it’s not good news. The big thing is that they know and can plan for their organization when backorders are coming.

2. Financial Issues. As all of you know, reimbursement continues to get cut while prices continue to rise. These two components working against the caregivers not only causes them incredible stress, but they also risk us losing their services all together. The ask I have heard from many of the speakers over the past few months is that their suppliers bring them ideas on ways to save money and generate revenue for their organizations.

3. Staffing Shortages. This is a key issue, and we are watching it unfold first hand in New York as caregivers go on strike. My guess is every one of your customers dealing with this issue would be open to any way you can help them alleviate it. They are looking for ideas to increase revenue while streamlining their operations so their patients don’t feel the pain of them being short staffed.

Sorry to be Debbie Downer during the month of love. It isn’t my intent to set us all on our heels thinking about these three big headwinds in the face of our country’s caregivers. Instead, my goal is to encourage you to talk with your accounts about these issues. Sit down with them and let them know you have empathy and want to be a partner to help solve their biggest problems.

Many of the manufacturers who advertise in this magazine have solutions to these three issues facing your customers. Therefore, I encourage you to challenge the manufacturers to help you help your customers. Talk with them and come up with solutions to these issues, and watch your business grow overnight.

It all starts with empathy and letting people know you are aware of the issues, and you want to help. You will be amazed at what this does for your relationship with them.

Dedicated to the industry, R. Scott Adams

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SALSA and CHIPs Anyone?

The latest information related to how the new federal budget act will impact PAMA, and what that means for you and your customers.

Perhaps a different SALSA and CHIPs that you had in mind, based on the headline? In this case, it’s about the Protecting Access to Medicare Act (PAMA) and potential changes coming to its implementation based on new legislation proposed on July 22, 2022, by Richard Burr, Republican Senator of North Carolina. The catchy acronym for this proposed law is SALSA (Saving Access to Laboratory Services Act).

By Jim Poggi

Overall, the SALSA act proposed several changes to PAMA implementation intended to lessen the impact of PAMA in the future. How does CHIP fit in? CHIP (Children’s Health Insurance Plan) is one of the beneficiary groups covered by the Clinical Lab Fee Schedule (CLFS). In summary, any changes to the CLFS impact the reimbursement paid to laboratories for tests performed for beneficiaries of Medicare and other federally funded health care programs.

Spoiler alert: there is important information to follow, but the key elements of the SALSA bill have been incorporated into the 117th Congress’ budget act (H.R. 2617) right before its recess. This is a significant step forward for all laboratories as well as the U.S. healthcare system overall. It will also impact how distributors and our key lab manufacturing partners message our lab customers in the coming years.

A refresher

Just exactly how did we get here?

We need to go back to 2014 when PAMA was first enacted into law. Its premise was that Medicare was paying a premium for laboratory services of up to 20% compared to private insurance. The intent of PAMA was to align CLFS reimbursement with private payer rates by having “applicable laboratories” collect data from their private insurance payment rates and provide this information to the Centers for Medicare and Medicaid Services (CMS). CMS’ task, then, was to compare these rates to those of the CLFS and make downward adjustments to align CLFS with private pay. PAMA legislation called for cuts of up to 10% in each of the first three years and 15% in the following three years to achieve this alignment at the individual CPT code level. The original intent of the legislation was to trim $2.5 billion in lab spending over 10 years. In 2018, year one of PAMA, 996 CPT codes, about 88% of all the lab CPT codes, experienced a reduction to meet this mandate. CMS estimated that the first-year impact of PAMA reductions would be at least $390 million. It turned out to be approximately $670 million. Additional cuts to many of the tests covered under the CLFS took place in 2019 and 2020. As a result of cuts experienced since inception of PAMA, an estimated $4 billion in lab reimbursement cuts have occurred, far more than the original intent of the legislation. Reductions to most CPT codes took place in 2018, 2019 and 2020, but further cuts have been suspended since then due to legislation enacted during the COVID pandemic. Ironically, despite reductions in Medicare spending for routine lab testing due to PAMA, testing due to COVID actually increased total

Medicare spending for lab tests in the past three years.

Since PAMA was proposed, major laboratory organizations including the American Association for Clinical Chemistry (AACC), American Clinical Laboratory Association (ACLA), the National Independent Laboratory Association (NILA) and others including medical societies have cautioned that PAMA legislation included several flaws and could lead to the closure of some laboratories reducing access to lab care especially in rural areas. The most significant flaw has been believed to be the mix of hospital, physician office and independent laboratories designated as “applicable laboratories” to report their private payer rates for lab tests. Over 90% of the data reported to

the definition of applicable laboratories to expand the percentage of hospital outreach laboratories and physician laboratories designated as “applicable laboratories,” but the ratio remained highly skewed to larger independent laboratories.

Several pieces of legislation have been enacted since 2019 that have suspended the first round of 15% cuts proposed under PAMA. These include the Laboratory Act for Beneficiaries (LAB Act) in 2019, the Coronavirus Aid, Relief and Economic Security Act (CARES Act) in 2020 and the Protecting Medicare and American Farmers from Sequester Cuts Act in 2021. However, 2023 was scheduled to be the first year of 15% cuts as mandated under PAMA. This is where SALSA comes in.

Jan. 1, 2023. In addition, there would have been no further changes in the definition of “applicable laboratory” and the skew toward large private laboratories would have remained. However, due to the SALSA enactment in the broader budget bill, there are sweeping changes in how PAMA is implemented with positive impact to hospital and physician office laboratories. Changes to PAMA due to SALSA elements include:

ʯ Stopping the 2023 CLFS cuts

ʯ Permitting annual decreases OR increases in reimbursement of specific tests by 5% maximum

ʯ Increasing the data collection interval from 3 to 4 years

ʯ Requiring CMS to re-evaluate the definition of applicable laboratory to level the playing field for physician office and hospital outreach labs which are presently under-represented. In and of itself, this would decrease the sharpness of reductions.

ʯ Expanding the implementation timetable indefinitely; PAMA only addressed 6 years

CMS was from independent laboratories, while these laboratories only performed 48% of the tests reimbursed by the CLFS. In addition, since private payer rates for lab tests from these laboratories are lower than hospital and POL laboratories, reporting these private payer rates artificially increased the difference between private pay and CLFS reimbursement. In 2019, CMS made some concessions to

Where we go from here

SALSA legislative elements have been incorporated into the final budget bill of the 117th Congress. What is the impact of the SALSA budget elements? If SALSA had not been enacted into law, PAMA would have stayed in place as written with planned cuts of up to 15% for tests still above private pay reimbursement beginning with the new CLFS schedule which would have gone into effect

Over the past three years there have been a number of initiatives, both due to legislation mentioned above and intense lobbying efforts by both laboratory and medical societies to respect the intent of PAMA to assure spending on lab services is monitored and kept in line with private insurance while also making sure that the balance of large private reference labs, hospital labs and physician office labs is appropriately represented in data collection. The changes in data collection as well as definition of “applicable laboratory” due to the recently enacted budget bill seem to be key steps in assuring both of these goals. By assuring that private

The key elements of the SALSA bill have been incorporated into the 117th Congress’ budget act (H.R. 2617) right before its recess. This is a significant step forward for all laboratories as well as the U.S. healthcare system overall. It will also impact how distributors and our key lab manufacturing partners message our lab customers in the coming years.

lab reimbursement is represented closer to its percentage of total Medicare lab spend, a fairer balance of private pay rates for lab tests can be created. This is a major step forward. While its impact needs to be assessed over time, the general consensus is that it will reduce pressure on physician office labs and hospital outreach labs, lessen the number of these labs going out of business or being acquired by large private labs and maintain

Legislation ABCs

access to lab services – especially in rural areas. To some extent, I also expect it to impact the messaging of the three elements of value represented by lab: economic, workflow

and clinical. With some pressure removed from the economic value of lab, the balance of these three elements comes back somewhat to its traditional ratio.

ʯ PAMA (Protecting Access to Medicare Act). First enacted in 2014, its premise was that Medicare was paying a premium for laboratory services of up to 20% compared to private insurance.

ʯ CHIP (Children’s Health Insurance Plan) is one of the beneficiary groups covered by the Clinical Lab Fee Schedule (CLFS).

ʯ SALSA (Saving Access to Laboratory Services Act). The SALSA act proposed several changes to PAMA implementation intended to lessen the impact of PAMA in the future.

At this point, my best advice is to stay in communication with your home office and trusted lab manufacturers who have also closely followed developments and await a plan to implement a communication strategy with them at a corporate level to assist our customers in understanding the future of CLFS reimbursement. With change comes opportunity and those who understand the evolving market will be most prepared to effectively consult their customers.

By assuring that private lab reimbursement is represented closer to its percentage of total Medicare lab spend, a fairer balance of private pay rates for lab tests can be created. This is a major step forward.

Retro Sales Tactics

The new prospecting weapon in a sales rep’s repertoire? An old phone.

By Brian Sullivan

OK “Outside Salesperson,” what the heck are you supposed to do now? You long for the time when your day comprised a few morning pop-by visits to current customers, an hour of drivetime talk-radio on your way to a client lunch at Chilis-Too, followed by a few “checking-in” visits with some old clients to wrap up the day. Remember how great it was to shake a hand, make a friend, and grab a purchase order? Hey, I’m with you.

Regardless of what they tell us, the DNA of an outside salesperson was always engineered to enjoy interacting with clients and industry friends. But over the past couple of years (I won’t bring up that word), many have been slow to get back to the “good old days.” It’s common to hear comments such as:

ʯ “Where I live, there is still a reluctance to let me in and show my product/service.”

ʯ “Prospects and customers are short-staffed, overworked and too busy to see me.”

ʯ “I miss the good old days!”

So, what’s the answer? While nothing is as effective as an oldfashioned in-person visit and a handshake, the phone has now become the most important business tool we own. Yea, I know it sounds so 1980s, but now more than ever it’s our most important weapon. We just have to get better at using it. Make more powerful cold prospecting phone calls than ever, with the objective of creating enough curiosity to have them commit to a Virtual Presentation. More calls done more effectively will lead to more virtual/live presentations. And more virtual/live presentations (done well) will lead to more purchase orders.

The reason many outside salespeople don’t love phone cold calling is that they feel pressure. Former Pittsburg Steelers Football Coach Chuck Noll said it well when he said, “Pressure is what you feel when you don’t know what the hell you’re doing.” Well, pressure is what salespeople feel when they don’t quite know what is going to come out of their mouth when somebody

picks up that phone. But here’s the good news, it’s fixable! The following are six steps that will help you turn more cold calls into more detailed meetings/product demonstrations.

Step No. 1: Ask for Help

Since the beginning of time, salespeople have called the person at the front desk who picks up the phone a “gatekeeper.” But think of the

message that sends to your brain when that’s how you perceive them. That person is more than a gatekeeper, he or she is a real person, having a real day, whose opinion and feelings really matter. Treat the front desk team member with the same joy and respect as you would the big wig in the C-Suite.

While gatekeepers aren’t put on this earth to make our lives miserable, they are there to weed out the valuable calls from the garbage. One way to buy yourself some time on your cold call is to be nice and by asking for help. It’s hard for somebody to be mean to somebody in need.

Example: “Hi, I was hoping you could help me. I am trying to reach __________ and was hoping you could point me in the right direction.” Be casual in your delivery and don’t sound like a stiff salesperson.

Step No. 2: Show Respect for the Prospect’s Time

When the prospect (the person you called to get on the line) picks up the phone, don’t start by asking them how their day is, or how’s the weather out there, or what’d you think of that game last night? You called them out of the blue and they aren’t looking for a new bestie. Those questions waste their time and ooze cheesy sales call.

Instead, quickly introduce yourself and your company name and follow with, “Did I catch you in the middle of anything?” Again, your tone should be warm and respectful. The most common response you will hear is, “How can I help you?” Or “What’s this in regard to?”

Step No. 3: Deliver the Hook

Remember, the most important emotion you need to create in a prospecting call is curiosity. Which means you need to craft and use a powerful “hook” early in the call to make them want to learn more.

Value Hook: The Value Hook is a one-sentence statement that describes the value that your product or services offer. This hook isn’t about what your products do, but what they help your customers do or achieve. To develop your own, fill in this: Our (product) helps companies like yours to ________________, ______________________, and _____________. This often leads to ___________, ___________, and ___________ (put in real world results other clients have experienced.

Step No. 4: The Takeaway

We never want the prospect to feel pressure. Immediately after your Value Hook, follow up with:

ʯ But I don’t know if you are the right person to speak with.

ʯ But I don’t know if you need what our services provide.

ʯ But I don’t know if you are a good fit with what we provide or not.

ʯ But I don’t know if we can help you in the same way that we have helped others.

ʯ But I don’t know if those are improvements you are interested in.

ʯ But I don’t know if those are areas you are concerned about.

Then let the prospect talk first. If they give a curious response or ask a

question back, congratulations! You now have permission to ask questions.

Step No. 5: Ask Questions

The objective of the cold call isn’t to sell something. The objective is to get them to commit to a Virtual/Live presentation. Don’t begin sounding like a pushy salesperson by firing off a bunch of features about your solution. Instead, ask how they are currently doing things, what’s effective about that, what’s not working, and how decisions are made. Then share a few real-world examples of how you helped others. We are simply trying to create enough curiosity for them to be interested to learn more.

Step No. 6: Close for the Virtual/Live Presentation

It’s time to secure the meeting. Reduce pressure with, “Thanks so much for your time today. But I called out of the blue and I’m not sure if now is a good time to discuss this a little further. With your permission, would you be open to a 30-minute Virtual Presentation where I can show you some examples of how we helped other companies like yours? I can make myself available either this Thursday morning or Friday afternoon.”

Step No. 7: Repeat

Knowing what to say on a cold prospecting call will lead to more meetings, both virtual and live. The only other decision you must make is how often you do it. Do it more, and you will get more meetings, and more sales. Sell more, and your next time at Chilis-Too, you’ll be the one picking up the tab.

Brian Sullivan, CSP is Founder of PRECISE Selling and a member of the National Speakers Association. Brian is author of the books “20 Days to the Top” and “PRECISE Leadership”. To learn more about Brian’s Cold Prospecting Tips and Sales Process, reach him at bsullivan@preciseselling.com

Surface Disinfection By the Numbers

Facts and figures that highlight the need for proper surface disinfection products and protocols in the healthcare setting.

The goal was a lofty one even before COVID hit. Included in its Healthy People 2020 initiative, the Office of Disease Prevention and Health Promotion, a part of the U.S. Department of Health and Human Services, announced one of the areas of focus was to prevent, reduce, and ultimately eliminate healthcare-associated infections (HAIs). HAIs are infections that patients get while receiving treatment for medical or surgical conditions. Many HAIs are preventable. HHS has since updated its initiative to Healthy People 2030, to set data-driven national objectives to improve health and wellbeing over the next decade, with eliminating HAIs remaining a key priority.

In order to reach that goal, healthcare providers have their work cut out for them. The following facts and figures illustrate the prevalence of HAIs and the need for proper protocols, products and medications to reduce and ultimately eliminate them.

1 out of 25

At any one time in the U.S., one out of every 25 hospitalized patients are affected by an HAI, according to information compiled in 2020 by the Office of Disease Prevention and Health Promotion.1

1.7 million

In U.S. hospitals, the Centers for Disease Control and Prevention (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year.2

$28.4 billion

HAIs in U.S. hospitals have direct medical costs of at least $28.4 billion each year, according to the CDC. Certain factors raise the risk of contracting HAIs, including invasive procedures, severity of illness, not adhering to best practices for prevention, and overuse or improper use of antibiotics.3

$12.4 billion

HAIs also account for an additional $12.4 billion in costs to society from early deaths and lost productivity.

MRSA

49-65%

In its HAI Reduction and Implementation Tool Kits, the CDC provided findings of current estimates that

suggest 49-65% of healthcare-associated S. aureus infections reported to NHSN are caused by Methicillinresistant Staphylococcus aureus (MRSA) a cause of staph infection that is difficult to treat because of resistance to some antibiotics. 4

94,360

An estimated number of invasive MRSA infections that occur annually in the U.S.

18,650

Associated deaths due to MRSA each year.

86%

Percentage of all invasive MRSA infections that are healthcare-associated.

The market

$987 million

According to industry analysis from Grand View Research, the U.S. surface disinfectant market size was valued at USD 987.00 million in 2019 and is expected to grow at a compound annual growth rate (CAGR) of 9.2% from 2020 to 2027.5 “This growth can be attributed to the prevalence of healthcare-associated infections in the country, coupled with favorable government regulations concerning the usage of disinfectants for medical hygiene,” the report overview stated.

The good news

70%

Most HAIs are preventable and can be reduced by up to 70% through effective Infection Prevention and Control (IPC) measures.6 “Studies have shown that proper education and training of health care workers increases compliance with and adoption of best practices (e.g., infection control, surface disinfection, hand hygiene, attention to safety culture, and antibiotic stewardship) to prevent HAIs,” the HHS states on its website.

HP Surface Disinfectant

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1 Healthy People 2030 | health.gov

2 Healthcare-Acquired Infections (HAIs) – PatientCareLink

3 Health Topics - HAI - POLARIS (cdc.gov)

4 MRSA_toolkit white 1 19 10 (2).ppt (patientcarelink.org)

5 U.S. Surface Disinfectant Market Size Report, 2020-2027 (grandviewresearch.com)

6 Pillars for prevention and control of healthcare-associated infections: an Italian expert opinion statement | Antimicrobial Resistance & Infection Control | Full Text (biomedcentral.com)

1. List N: Disinfectants for Use Against SARS-CoV-2. Feb 28, 2022, www.epa.gov/pesticide-registration/ list-n-disinfectants-use-against-sars-cov-2. *Always follow Product Label for Cleaning/ Disinfection Directions.

Hospital-at-Home Distribution Program Launched

Cardinal Health’s Velocare™ offers last-mile fulfillment in one to two hours.

Cardinal Health took a deep dive into the hospital-at-home movement this past fall with the launch of Velocare ™ , a supply chain network and last-mile fulfillment service capable of reaching patients in one to two hours with products and services required for hospital-level care at home. Through what it described as a strategic collaboration with Bostonbased Medically Home, Cardinal Health at-Home Solutions was already supporting a Medically Home health system customer with Velocare.

The announcement also signaled Cardinal Health’s deepening ties with Medically Home. In January 2022, Cardinal Health joined Baxter International and Global Medical Response in a $110 million round of funding for Medically Home.

How it will work

Here’s how the Velocare program works:

1. Orders are placed through the Velocare platform for specific goods and/or services to be delivered to patients receiving care in hospitalat-home programs. Common items available through delivery include medical waste containers, medically tailored meals, medical supplies, medical devices, and remote-patientmonitoring (RPM) technology. All contracting, credentialing and integration within the Velocare supplier network will be managed by Cardinal Health.

2. When an order is placed, a care coordinator team reviews and routes it to the nearest local Cardinal Health depot or warehouse for immediate service.

3. The depot team loads items into a Cardinal Health vehicle and delivers them to the home in coordination with the patient and/or care team. Velocare technology is used to ensure care is delivered to patients on time.

4. After a hospital-at-home stay has been completed, Cardinal Health arranges for the collection of remaining medical supplies. RPM technology is cleaned, tested and reconditioned in a facility registered by the Federal Drug Administration, then redeployed. Cardinal Health consolidates billing and invoicing across its network of suppliers to streamline the payment process.

Medically Home works with a number of leading health systems across the country, says Alex Hoopes, director, healthcare innovation, Cardinal Health at-Home. “We have launched our pilot with one of those customers so we can test and learn in a controlled environment before expanding. There are several existing and future Medically Home customers that we believe will benefit from Velocare.”

Lower-cost, safer venue

Cardinal Health for many years has supported patients who are managing chronic conditions in their home through its at-Home Solutions business, says Hoopes. This business includes Edgepark, a provider of medical supplies shipped direct to more than 3 million customers per year. “Now, with the introduction of Velocare, we are supporting patients with more extensive conditions and building capabilities to support patients throughout their entire care journey. We envision a world where the patient receives continuous treatment in their

home with the intensity of services throttling up and down as their healthcare needs evolve.

“The home can be a lower cost, safer place for patients to receive care and heal, and payers are one of the primary beneficiaries of those advantages,” he says. “Oftentimes, the reliability of the supply chain can be a rate limiter for higher acuity hospital-at-home programs, so our work addresses that rate limiter. We are also seeing more payers vertically integrate into being care providers, and their provider teams can directly leverage Velocare’s capabilities.”

Among innovations Cardinal Health is developing for the program are small-format depots and short-haul vehicles. The traditional Cardinal Health distribution center can be 200,000 to 300,000 square feet, primarily serviced by 53-foot semi-trucks, says Hoopes. “That model is ideal for large, routine deliveries to healthcare facilities. Velocare uses small-format depots that are a hundredth that size and situated right in the heart of population centers, closer to our patients’ homes. We also use smaller, nimbler delivery vehicles so we can navigate urban areas with ease. We modify our vehicles to act as small, rolling warehouses so we can go directly from one patient to another, which improves our efficiency.”

Medically Home

Medically Home has developed highly differentiated software that takes complexity out of the hospitalat-home supply chain, says Hoopes. “I describe them as a translator –taking a clinical order from a doctor and ‘translating’ it into activities that need to be fulfilled by supply chain and logistics teams like ours. Medically Home’s platform also bundles

those activities and consolidates them so fewer actors can do more in fewer trips to the home.”

In a recent company newsletter, Medically Home CEO Rami Karjian said that “the single biggest contributor to the ability to scale HaH [hospital-at-home] is logistics, that is, the ability of a health system to transition from providing tests, treatments, medicine and supplies in the hospital to providing them quickly and reliably in a home, on demand at any time of day or night.

Some health systems have been building their own HaH infrastructure, often relying on home health providers and existing remote patient monitoring tools that were designed for low-acuity, post-acute patients, he said. The result is a misfit between what can be delivered and what an HaH program requires. “Health systems taking a DIY approach have struggled, relying on manual processes that without a supplier network and logistics platform can only support an average daily census of just a few patients.”

More than 7,000 patients have been treated using Medically Home’s platform, as delivered by health systems across the country, according to the company. Some examples.

ʯ Mayo Clinic: In June 2020, Mayo Clinic announced a new care model intended to deliver “innovative, comprehensive, and complex care to patients – all from the comfort of home via a new technology platform.”

Mayo selected Medically Home as its implementation partner for the program.

ʯ UNC Health. In January 2021, Chapel Hill, North Carolinabased UNC Health announced it had reached an agreement with

Medically Home to establish an Acute Care at Home Program. The program would offer hospital-level services at home to patients who would otherwise require inpatient hospitalization for serious illnesses. The health system planned to gradually extend the program to patients served by its other 10 hospitals across North Carolina and evaluate opportunities to offer the service in partnership with other North Carolina hospitals.

ʯ OSF HealthCare. Peoria, Illinois-based OSF announced its partnership with Medically Home in January 2022 to establish an Acute Care at Home Program. The announcement occurred one year after OSF opened its OnCall Digital Health building. Patients of OSF HealthCare Saint Francis Medical Center in Peoria would be the first to have the OSF OnCall Hospital at Home option starting in the summer of 2022, with plans to extend the program.

ʯ Yale New Haven Health. In June 2022, the Connecticut IDN announced its partnership with Medically

Hospital-at-home

Home to deliver hospital-level care to Medicare patients meeting certain clinical and social stability criteria who live within 25 miles of Yale New Haven and Bridgeport hospitals. The IDN was expected to expand the program to other YNHHS hospitals in the future.

ʯ Cleveland Clinic. In May 2022, Cleveland Clinic announced that beginning in the fall of 2022, it would collaborate with Medically Home to provide acute and post-acute hospital-level care to patients in their homes, initially in the Florida region.

ʯ Covenant Health. In September 2022, Knoxville, Tennessee-based Covenant Health announced its collaboration with Medically Home as a part of Covenant Health’s newly established Advanced Care at Home program. The program initially would be offered through Covenant Health’s Fort Sanders Regional Medical Center in Knoxville and ultimately to patients receiving care from Covenant Health’s other acute-care hospitals throughout East Tennessee.

The delivery of acute-care services to patients at home (i.e., hospital-at-home programs) is becoming a more important factor in the trend toward home-based care.

Up to $265 billion worth of care services (representing up to 25 percent of the total cost of care) for Medicare Fee-for Service (FFS) and Medical Advantage (MA) beneficiaries could shift from traditional facilities to the home by 2025 without a reduction in quality or access, according to McKinsey & Company. Add hospital-at-home programs, and the firm suggests that 20 to 30 percent of additional Medicare FFS and MA spending for acute care could be delivered at home.

The Centers for Medicare & Medicaid Services has stated that treatment for more than 60 different acute conditions, such as asthma, congestive heart failure, pneumonia, and chronic obstructive pulmonary disease (COPD) care, can be treated appropriately and safely in home settings with proper monitoring and treatment protocols. However, higher-acuity and more complicated conditions (for example, severe sepsis, unstable cardiac arrhythmias) cannot yet be treated at home in a highquality and economical way.

The CMS Advanced Hospital Care at Home Program has established a model that has been widely adopted by health systems. More than 114 systems and 256 hospitals in 37 states had applied with CMS for approval by late September 2022.

Participating hospitals must have:

ʯ Appropriate screening protocols before care at home begins to assess both medical and non-medical factors.

ʯ A physician or advanced practice provider to evaluate each patient daily in-person or remotely.

ʯ A registered nurse to evaluate each patient once daily in-person or remotely.

ʯ Two in-person visits daily by either registered nurses or mobile integrated health paramedics.

ʯ The ability to provide immediate, on-demand remote audio connection with an Acute Hospital Care at Home

team member who can immediately connect either a registered nurse or physician with the patient.

ʯ The ability to respond to a decompensating patient (i.e., a person at increased risk of disease progression or death) within 30 minutes.

ʯ The ability to track several patient safety metrics with weekly or monthly reporting, depending on the hospital’s prior experience level.

ʯ A local safety committee to review patient safety data.

ʯ Use of an accepted patient leveling process to ensure that only patients requiring an acute level of care are treated.

Supply Chain Leader Profiles

and brought their talents to bear on a global problem. Our CEO summed it up well with “Calm over Chaos, Faith over Fear.” Resiliency, collaboration and creativity are here to stay.

What’s the most important risk you took and why?

Bruce Radcliff, System Vice President, Supply Chain, Advocate Aurora

What are the most important attributes of successful supply chain teams today?

Successful supply chains need to be agile, engaged with their clinical stakeholders and transparent across all levels of the organization with a collaborative and strategic roadmap.

What project or initiative are you looking forward to working on?

I’m looking forward to tackling innovative ways to handle the labor shortage

of today and the coming years. Our team members are one of our greatest assets and keeping them engaged, empowered and feeling valued is a rewarding investment of our time.

What changes brought about by the pandemic are here to stay in the supply chain?

The call for transparency and management of risk combined with the creativity and resolve of supply chain to put patients’ needs first will never leave us. Our teams rose to the challenge

During the pandemic, our supply chain continued to innovate and even converted our distribution model just a few months before our new ERP deployment. The movement to a higher service just-in-time distribution model was not at an optimal time. However, we took the risk to ensure our clinicians continued to get the dynamic services needed in the face of extreme labor shortages. We rolled from that distribution conversion into a big bang deployment of system-wide ERP across finance, human resources, supply chain and payroll.

How do you continue to grow and develop as a leader?

I believe in bringing your whole self to work and, as such, I have put together a group of a few trusted mentors to give me feedback and share their perspectives on not only leadership skills but also where I am as a person. This gives me a sounding board not only for new ideas but also to transfer their experiences and perspectives into my development. Not every lesson needs to be learned on our own. I’m always amazed at the willingness of people to help, if you ask and commit to listening.

Editor’s note: The following supply chain leaders were featured in The Journal of Healthcare Contracting’s Ten People to Watch issue.

What do you consider before promoting someone?

As I look to move someone into a new opportunity, not only am I

evaluating their portfolio of work, team engagement and potential but I’m also evaluating what they have done to prepare their existing team

members for their movement. Great leaders prepare their potential successors and teams by providing appropriate growth opportunities.

Relationships with suppliers are interesting. We’re not highly committed at a 90% rate, for example, with one supplier for med device. It just doesn’t make sense. Actually, having more of a mix of suppliers – a few more suppliers than just one – has helped us be a little more flexible in meeting our practice needs, especially in this environment. Also, do we pay more for reliability? Those are the conversations we’re having now.

Mayo stood up a strong business continuity team prior to the pandemic. As we’ve worked with that team, looking at our three- or sixmonth risks, we’ve pulled in some different factors like diversification of suppliers and their redundancies. The pandemic forced us to ask questions at a deeper level.

Jane Torzewski, Director, Category Management, Medical Device Team, Mayo Clinic and Captis

What are the most important attributes of successful supply chain teams today?

We ensure that the contracts team is engaging closely with the clinical practice side and that administrative support works with the clinical side too to meet their needs. The contracting process, the bid process and also the legal terms and conditions are all a part of that.

My role is making sure we meet our timelines. I’ve had the fortunate experience of working in value analysis when I’ve been in contracting. I managed most of our ortho and neuro agreements until a couple of

years ago, many of which are in the med/surg area, so I have expertise to guide the team.

How has the contracting process changed in the past two years as well as your relationships with suppliers?

We’ve learned to be much more agile in our approach to contracting. We have to pivot very quickly when we have issues with supply constraints – when we’re trying to put out a fire. In my world, we’re seeing real constraints on supplies due to manufacturing issues like raw material concerns and freight concerns.

What changes brought about by the pandemic are here to stay in the supply chain?

It accelerated some trends that we were already talking about. The virtual environment was one of them from a staff perspective and we leaned into that. We weren’t a virtual staff prior to the pandemic, but we’ve embraced digital tools and technologies from a staffing perspective.

We’ll continue to deepen our digital connectivity platform, utilizing virtual visits and virtual care networks as we move forward. These were trends that were talked about and on our 2030 plan, but Covid accelerated the need. It’s understanding that work can be done differently. That’s a change in thinking. It’s how the work is getting done

today and our team would argue we’re more productive.

But we’re trying to balance a virtual environment and coming together for collaborative intent. Contracting is a skill and an art. It’s difficult to teach that skill when you’re virtual all of the time. So, we’re trying to make it a hybrid situation bringing people back together to learn and mentor one another.

What project or initiative are looking forward to working on in the next year or 18 to 24 months?

Several years ago, Mayo embarked on a very robust plan to digitize its supply chain. That has resulted in a lot of automation and digitization for Mayo and digital tools that have elevated our ability to look at data and work with our stakeholders at a deeper level of understanding. Now, Mayo is starting to enter into some new relationships and new ventures along those lines. It’s exciting stuff.

From a career and contracting perspective, it’s going to broaden our world. It will allow our team to collaborate with new members and entities in a different way. During the next 18 to 24 months, it’s about capitalizing on the work we’ve done over the last several years and bringing a best-in-class supply chain into play.

What is your approach to leadership and managing employees?

People come from different places to work in sourcing and with different skill sets. When I look to mentoring someone, I look for someone with key qualifications. They must have an ability to form strategic relationships and are a people person.

That’s something they have shown in previous work.

There are a lot of skills you can teach but there are some foundational, bedrock type of characteristics that are very hard to teach. Those bedrock skills need to be in place and then you can mentor and grow your staff. I have to start with the right person and then I can mentor them to the right place.

They must have the ability to speak confidently to physicians, but also form good relationships amongst their team members. We champion successes. The team knows we’re about trying to elevate opportunities and look to successes. They need to be curious about all aspects of the work they’re doing. If I have a person who’s curious and wants to work hard, coaching and mentoring becomes a joy.

How do you keep your team motivated despite conflicts and obstacles?

Mayo, like everyone else, is trying to figure out how to make their employees happy and keep them challenged and satisfied. It’s something I think about a lot. On the one hand, I’m happy they’re achieving so much. On the other hand, I want to keep them more motivated. So, how do you do that?

For me, keeping an employee motivated is a factor of making sure they know that their work is valued – actually telling them that and praising success. Also, giving employees opportunities to step outside their current role and into a leadership position gives them experience in something else. It helps their exposure within the organization and with stakeholders they’ve never met before. That elevates their career, confidence and skill set.

You must also be a strong advocate for your team. Previously as a nurse, advocacy for my patients was a huge factor and one that translates to being a manager and director. When you’re dealing with internal or external stakeholders, sometimes you need to step into that advocacy role. It teaches them that you can have compassion, courtesy and professionalism, while continuing to evolve and elevate your own team.

How do you align your organization with your vision and mission?

The needs of the patients come first at Mayo. That’s the cornerstone and beacon we put into play for all of the work we do. The humility and opportunity to serve in that role is of paramount importance. While in a negotiation session with a supplier, they’re coming from their viewpoint and we’re coming from ours, but our viewpoint is always going to be elevated. At the end of the day, we’re bringing in products to meet the needs of a patient who desperately needs them.

We also look to values like stewardship, integrity and compassion. Being a steward of the dollar is important, while also ensuring we’re getting the best value for our patients so that our doors remain open, and they can access the best care. We’re also in a business environment and need to value the confidentiality of information while working with suppliers and internal stakeholders. And finally, professionalism and compassion go hand-inhand. You must remain professional but also understand the perspective of internal stakeholders from a compassionate viewpoint.

‘Advanced Practice’ or ‘Scope Creep?’

Disagreement about the role of nurse practitioners and physician assistants.

Do you refer to nurse practitioners and physician assistants as “advanced practice providers,” or as “nonphysician providers”? Both labels are correct, but each represents a different perspective on how – and by whom – healthcare should be delivered. One emphasizes the services these professionals can potentially provide, while the other hints at what they cannot or should not do.

Physician assistants are healthcare professionals licensed or credentialed to practice medicine with physician supervision. Today, there are more than 159,000 PAs practicing in every state and medical specialty. Advanced practice registered nurses (APRNs), on the other hand, include nurse practitioners, clinical nurse specialists, nurse anesthetists and nurse midwives, according to the American Nurses Association. Today, more than 200,000 APRNs are treating Medicare patients, and approximately 40% of Medicare beneficiaries receive care from APRNs.

The roles these providers will assume in healthcare could become more important as the U.S. grapples with current and future shortages of healthcare workers.

National data shows there will be a shortage of up to 3.2 million healthcare workers by 2026, says Jennifer Orozco, president and chair of the American Academy of Physician Assistants. Today more than 99 million Americans lack adequate access to primary care and more than 158 million lack adequate access to mental health care, she says. Projections show almost 81 million people will be over the age of 65 by 2040. On top of this is a continuing rise in obesity and chronic diseases such as diabetes and heart disease.

Orozco believes physician assistants are essential to ensure patients have access to the care they deserve. “Physician assistants are defined by their commitment to putting their patients first and applying their medical expertise, comprehensive diagnostic skills, and compassion to improving the health of their patients and communities,”

she says. “They know that quality care starts with a human connection, which is why we are drawn to the profession.”

The case for expanded scope

Whether physician assistants or advanced practice registered nurses (APRNs) assume greater responsibilities in the exam room remains a question. Advocates believe they should be allowed to practice to the full extent of their educational and professional experience – and hence assume greater responsibilities. But others pejoratively call that “scope creep.”

“Outdated laws limit flexibility, generate unnecessary paperwork and burdensome administrative constraints, and prevent providers from going to areas where a physician may not be practicing,” says Orozco. “In order to meet growing healthcare needs, these outdated laws must be updated to reflect how medicine is delivered in 2022. Many states removed these outdated barriers during the pandemic, which is how we were able to take care of so many. Now is the time to remove them permanently.

“The PA profession’s commitment to team practice is powerful,” she continues. “The PA and physician who work together keep all the benefits of the team without the legal risks and administrative burdens that agreements entail.”

In its 2021 report “The Future of Nursing 20202030,” the National Academy of Medicine voiced its support for greater roles for APRNs, writing, “Expanding scope of practice for advanced practice registered nurses,

‘Advanced Practice’ or ‘Scope Creep?’

including nurse practitioners – which allows them to prescribe medication, diagnose patients and provide treatment independent of a physician – would significantly increase access to care, particularly in rural and underserved communities, which tend to experience high poverty rates and a heavy burden of chronic disease.”

Even some payers have weighed in. According to a 2018 UnitedHealth Group report, if all states were to allow nurse practitioners to practice to the full extent of their education and training, about 31 million more people living in primary care shortage areas would have access to the primary care they need to stay healthy.

But not everyone agrees. As of early 2021, 27 states restricted full practice authority for nurse practitioners, according to the National Academy. Furthermore, major physicians’ associations – including the American Medical Association – have voiced concern over expanding roles for APRNs and PAs.

In a report adopted in 2022, the AMA said the core issue is that “the skill sets and experience of nonphysician practitioners are not the same as those of physicians.” AMA added that when nonphysician practitioners identify themselves as “doctors,” consistent with the doctoral-level degrees they earned, it may create confusion and be misleading to patients and other practitioners. (The AMA was referring to nonphysician practitioners who have received advanced training resulting in a doctorate degree, such as a doctor of nursing.)

AMA argues that:

ʯ Nonphysician care can cost more than that provided by an M.D. (Research shows that in states that allow independent prescribing, NPs and PAs were 20 times more likely to overprescribe opioids than those in prescription-restricted states, according to AMA. Moreover, X-ray ordering rose by more than 400% by nonphysicians, primarily NPs and PAs, between 2003 and 2015.)

ʯ Access to care is not improved by employing more NPs and PAs. (In reviewing the practice locations of primary care physicians compared to NPs, physicians and non-physicians tend to practice in the same areas of the state, according to AMA. This is true even in those states where, for example, NPs can practice without physician involvement.)

ʯ Surveys show that most patients believe a physician’s years of education and training are vital to optimal patient care, especially in the event of a complication or medical emergency.

What’s in the future?

Growth in responsibilities for advanced practice registered nurses will come when “healthcare consumers demand access to high-quality care and the realization that APRNs are limited in their ability to practice to the full extent of their education and clinical training due to old and outdated barriers posed by some federal statutes and regulations, state practice acts, and institutional rules,” says Sean DeGarmo, PhD, RN, ACNSBC, FNP-BC, ENP-BC, director, American Nurses Credentialing Center, Advanced Practice Initiatives and Certification Outreach.

Growth in APRNs’ responsibilities has already occurred, says Phyllis Whitehead, PhD, CNS/APRN, ACHPN, PMGT-BC, FNAP, FAAN, president of the National Association of Clinical Nurse Specialists. Key areas with growing responsibility for CNSs include prescriptive and full practice authority. A recent update showed that 24 states allow independent prescribing for the CNS and an additional 15 allow prescribing with a collaborative practice agreement with a physician.

“The expansion of the CNS’s role in primary care, home care and hospice, community and public health particularly under the Obama administration created new opportunities for CNSs,” she says. “The timing was right, as when the pandemic hit, CNSs were already working across hospitals, systems, in homes and the community.”

Advanced practice registered nurses are optimistic that the “Improving Care and Access to Nurses (ICAN) Act,” introduced in the House of Representatives in September 2022, will help advance the scope-of-issue cause. “The ICAN Act would ensure that certified nurse-midwives and other APRNs are able to provide comprehensive, coordinated, high-value care to the people and families they serve,” the American College of Nurse-Midwives said in a press release. If passed, the law would:

Phyllis Whitehead

‘Advanced Practice’ or ‘Scope Creep?’

ʯ Authorize certified nurse-midwives (CNMs) to bill for services related to training medical interns and residents in obstetrics in teaching facilities.

ʯ Enable CNMs to be included alongside nurse practitioners and physician assistants as providers eligible to certify and recertify a Medicare beneficiary for home health services without being subject to physician supervision.

ʯ Enable CNMs to issue a prescription or written order for durable medical equipment, prosthetics, orthotics

Who’s who in the exam room

Physician assistants

Physician assistants are healthcare professionals licensed or credentialed to practice medicine with physician supervision. According to the American Academy of Physician Assistants, they generally can:

ʯ Take medical histories

ʯ Conduct physical exams

ʯ Diagnose and treat illness

ʯ Order and interpret tests

ʯ Develop treatment plans

ʯ Prescribe medication

ʯ Counsel on preventive care

ʯ Perform procedures

ʯ Assist in surgery

ʯ Make rounds in hospitals and nursing homes

ʯ Do clinical research

ʯ Counsel on preventive care

Despite the current healthcare workforce shortage, the PA profession continues to grow, says Jennifer Orozco, president and chair of the AAPA, noting that the Bureau of Labor Statistics estimates the profession will grow 28% between 2021 and 2031. “PAs account for more than 500 million patient visits each year –a number that will continue to grow as we push to modernize healthcare teams and use every team member to the fullest extent of their education and training,” she says.

In 2021, the AAPA passed a policy affirming “physician associate” as

and supplies (DMEPOS) to Medicare beneficiaries as well as provide face-to-face encounters without being subject to physician supervision.

“Modern healthcare requires flexibility,” said ANA President Ernest Grant, PhD, RN, FAAN, when ICAN was introduced. “We cannot not be hindered by antiquated barriers to practice or petty turf wars over perceived hierarchies. The health of our patients and communities must come first.”

the official title for the PA profession. (The title will be phased in over time.) “The new title directly addresses the common misperception that PAs merely ‘assist’ physicians, when in reality, they do so much more,” she says.

Advanced practice registered nurses

Advanced practice registered nurses hold at least a master’s degree in addition to the initial nursing education and licensing required for all registered nurses (RNs). They include nurse practitioners, clinical nurse specialists, nurse anesthetists and nurse midwives.

Nurse practitioners (NPs) take health histories and provide complete physical examinations; diagnose and treat common acute and chronic problems; interpret laboratory results and imaging studies; prescribe and manage medications and other therapies; provide health teaching and supportive counseling; and refer patients to other health professionals as needed. An NP’s practice may also include education, research, and administrative services. Specialty areas include:

ʯ Acute care

ʯ Adult health

ʯ Family health

ʯ Gerontology

ʯ Neonatal health

ʯ Oncology

ʯ Pediatric/child health

ʯ Psychiatric/mental health

ʯ Women’s health

Clinical nurse specialists are advanced practice registered nurses who have graduate preparation (a master’s or doctorate) in nursing, according to the National Association of Clinical Nurse Specialists. In the majority of states, clinical nurse specialists must obtain certification based on a population area. Current certification examinations based on population include:

ʯ Adult/gerontology

ʯ Pediatrics

ʯ Neonatal

“CNSs are unique and one of the most versatile APRNs,” says Phyllis Whitehead, PhD, CNS/APRN, ACHPN, PMGT-BC, FNAP, FAAN, president of the National Association of Clinical Nurse Specialists. “They can work at hospital/health systems, medical practices, longterm care facilities, retail clinics, and home care.” The top 10 hospitals in the country employ CNSs, she says, and 62% of CNSs work in hospitals that are either accredited by the American Nurses Credential Center Magnet™ Recognition Program or are seeking accreditation.

is responsible for over 10 million visits to physician offices per year

Cepheid’s Xpert® Xpress MVP test aids in diagnosing conditions related to vaginitis

Vaginitis and vaginosis are responsible for over 10 million visits per year to physician offices by women in the U.S., making it the most common gynecologic diagnosis in primary care.1

The Xpert® Xpress MVP (multiplex Vaginal panel) test from Cepheid is a new FDA-cleared on-demand PCR test designed to aid clinicians in diagnosing distinct sexually transmitted infections, including bacterial vaginosis (BV), Candida species associated with vulvovaginal candidiasis, and trichomoniasis, that cause overlapping symptoms in women and potential co-occurrence.

“There’s a significant need in the marketplace for this test,” said Cisco Merrill, National Sales Director, Alternate Site for Sunnyvale, Calif.-based Cepheid.

Easy-to-use testing

The test is for patients ages 18 and up. Its single sample collection is designed to run on the easy-to-use GeneXpert® systems for increased efficiency and to reduce repeat visits. And its easy-to-use testing provides physicians with same-day results for appropriate treatment the first time. There is less than one minute of hands-on time and results within one hour.

“Patients may present with what’s considered cross infections and will test positive for one or two of these different infection states,” Merrill said. “But if a clinic is only testing specifically for one infection state, something may be missed. So, a patient might not get put on a good treatment plan.”

Merrill says this can lead to mistrust for patients.

“It’s a sensitive subject,” he said. “So, the ability to test in-house and meet and treat in one visit is powerful.”

“Our Xpert Xpress MVP test allows clinicians to test for three different infection states,” he continued. “That way, the treatment can align with the ailment. These infection states present similarly but are treated very differently. Getting patients on the right path to recovery is a winning proposition that resonates with our distributor reps and their customers.”

Target markets

Most women depend on their primary care physician or OB-GYN to diagnose vaginitis and vaginosis. But urgent

care is also emerging as an alternative market. These markets, as well as labs that reps usually call on, are four primary target markets for the Xpert Xpress MVP test.

“It’s a moderately complex test and we have a very strong program that helps customers transition from waiver to moderate complexity,” Merrill said. “A strategic team will assist throughout the entire licensing process and the team can also work with licensing agencies that assist clinics from waiver to moderately complex.”

Merrill says Cepheid is seeking a CLIA waiver but launched the Xpert Xpress MVP test in the moderately complex category.

Cepheid’s GeneXpert systems and Xpert tests automate highly complex and time-consuming manual procedures for institutions of any size to perform best-in-class PCR testing.

Vaginitis

2023: Time for Solutions

Last year brought its share of challenges. Finding solutions is the hard work awaiting everyone in the healthcare community this year.

Editor’s note: The following is the second part of a two-part series.

2022 presented all kinds of challenges for providers, patients and public health professionals. No doubt many of those challenges will linger in 2023, and new ones will arise. However, researchers, providers, public health professionals, lawmakers – and medical sales professionals – can be expected to keep working through the tough issues facing them. In the first part of this series, Repertoire examined respiratory season, monkeypox, retail clinics, inflation and workforce issues.

This article will examine:

ʯ Remote patient monitoring

ʯ Climate change

ʯ Opioids

Remote patient monitoring: Preferred by many, but glitches remain

Remote patient monitoring (RPM) continued to grow in 2022, largely because of technology advances and the preferences of patients, doctors and payers. The market for RPM was expected to reach $6.42 billion by 2030, an 18.64% compound annual growth rate during the forecast period 2022-2030, according to market research firm Market Research Future®. But the work of weighing costs against potential health benefits was expected to continue in 2023 and beyond.

COVID-19 boosted demand for remote patient monitoring services, as patients found it difficult to attend healthcare facilities and undergo hands-on medical evaluations, according to Market Research Future. The pandemic experience prompted investment in cutting-edge technological solutions to assist with managing medications, tracking disease symptoms and remotely monitoring vital signs. Expect demand to increase globally in the upcoming years, the firm said.

Another factor leading to growth in remote monitoring is the expected increase in the number of people with chronic conditions, predicted Forrester. A quarter of U.S. adults will be monitored remotely for chronic conditions. Weight scales, pulse oximeters, blood glucose meters, blood pressure monitors, heart monitors, and wearables were expected to improve clinical prognosis and help patients overcome socioeconomic hurdles, such as lack of transportation.

But remote patient monitoring comes with its own set of glitches, including the potential for data breaches and worries about data privacy. And then there’s the difficulty of integrating patient-generated health data into the physician office EMR.

At its 2022 Annual Symposium, the American Medical Informatics Association reported the results of an EHR vendor survey dealing with the challenges of integrating patient-generated health data (PGHD) – such as that gathered via remote patient monitoring – with the EHR. Factors contributing to the difficulty of making such data actionable included:

ʯ Lack of regulations and industry standards. Disparities exist among EHRs, devices and applications, according to survey respondents.

ʯ Patient technology hurdles. Technical and data literacy must be considered for the target population. Do they have access to broadband Internet? Are they proficient in using monitoring devices (which can be challenging for those with multiple devices, or those with multiple chronic illnesses and who are often older)?

ʯ Manual data entry and lack of analytics. Automated data entry is preferred.

ʯ Lack of care delivery models. Responsibility for the data is needed and it needs to be tied to health outcomes to select the most appropriate data type and device to create value, said survey respondents. But national standards around care models for patientgenerated health data are lacking.

Challenges aside, the EHR survey respondents listed factors that can contribute to the success of remote monitoring. They included:

ʯ Organizational support and readiness, i.e., consistent processes on how to leverage PGHD and gain buy-in across the enterprise.

ʯ Clinical champions to advocate and champion the use of remote monitoring.

ʯ Targeted delivery model. PGHD needs to be tied to a clinical focus (e.g., congestive heart failure or hypertension), so that data and devices can be selected that are appropriate for specific clinical outcomes.

ʯ Data governance. Protocols and triggers need to be incorporated into the EHR to encourage patient selfmanagement and clinician decision making. In addition, analytics are needed to eliminate “noise” in the data collected, and decisions need to be made as to how data will be analyzed over time.

ʯ Interoperability. Data needs to be exchanged seamlessly among separate organizations, systems and sources.

ʯ Technical support, particularly support for patients. Support ought to be provided by a technical person from the clinic or organization, the device manufacturer, or outsourced. (Clinical staff, such as RNs, are not the best fit for this role.)

ʯ Economic viability. The use of PGHD needs to be incorporated into the business model of the organization to demonstrate revenue generation or cost-savings.

We Deliver Supply Chain Solutions

In today’s reality of high vendor backorders, working with Dukal can ensure you have what you need, when you need it.

> Skin and wound care

> Diagnostic equipment

> Personal care and admissions

> Disposable apparel

> Exam room equipment and supplies

> Patient care

> Personal protection

> Surgical solutions

Well before congested ports began to snarl supply chains, Dukal has been committed to providing the highest level of transparency and trust to ensure our products are available to meet the everyday demands of today’s healthcare professionals.

Climate change: It’s about health

Hurricanes, floods, wildfires and extreme heat caught the world’s attention in 2022 and will most likely do so in 2023. But amidst the gloomy forecast lay a bright spot: By the end of 2022, the healthcare community appeared to be embracing its role in helping address climate change.

According to the World Health Organization, climate change threatens the essential ingredients of good health – clean air, safe drinking water, nutritious food supply and safe shelter. Between 2030 and 2050, it is expected to cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress. Areas with weak health infrastructure –mostly in developing countries – will be the least able to cope without assistance.

In the weeks leading up to this past November’s climate talks in Egypt at the 27th Conference of the Parties of the UNFCCC (COP27), WHO made a strong case that health should be front and center during the climate change negotiations.

“Our health depends on the health of the ecosystems that surround us, and these ecosystems are now under threat from deforestation, agriculture and other changes in land use and rapid urban development,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. The direct damage costs to health (i.e., excluding costs in agriculture and water and sanitation), is estimated to be between US $2–4 billion per year by 2030.

The combination of these factors means the impact on human health is likely to accelerate. “But there is room for hope, particularly if governments take action now to honour the pledges made at Glasgow in November 2021 and to go further in resolving the climate crisis,” he said.

Closer to home, in June, the American Medical Association adopted a policy declaring climate change a public health crisis. The policy called for AMA to advocate for limits on global warming to no more than 1.5 degrees Celsius, reduction of U.S. greenhouse gas emissions aimed at carbon neutrality by 2050, and support of rapid implementation and incentivization of clean energy solutions and significant investments in climate resilience through a climate justice lens.

Three months after AMA‘s announcement, the American College of Physicians – which represents 160,000 members – released a position paper on environmental health. “The quality of the environment can contribute to common diseases, such as stroke, heart disease, asthma and cancer,” ACP wrote in its paper. “Interventions such as reducing air pollution and water contamination, providing protection from ultraviolet radiation, and mitigating climate change can improve health outcomes for persons with communicable and noncommunicable diseases.”

In June, 61 of the largest U.S. hospital and health sector companies responded to the Biden Administration’s Health Sector Climate Pledge, committing to reduce greenhouse gas emissions 50% by 2030. That’s a positive step, as the healthcare sector accounts for 8.5% of U.S. emissions, according to The White House. The commitments represent over 650 hospitals and thousands of other providers across the country.

Opioids: Fentanyl is the biggest problem

Opioid addiction remains a painful part of life today and no doubt will remain so in 2023. Healthcare professionals have learned much about the problem and have reduced prescriptions for legal pain medications. In fact, over the past 10 years, opioid prescribing has been reduced in every state – and nearly 50% nationally, according to the American Medical Association. But their efforts will be challenged by manufacturers and distributors of illegal synthetic opioids, especially fentanyl.

More than 932,000 people have died since 1999 from a drug overdose, reports the CDC. In 2020, 91,799 drug overdose deaths occurred in the United States, 75% of which involved an opioid. Provisional data from CDC’s National Center for Health Statistics indicated there were an estimated 107,622 drug overdose deaths in the United States during 2021.

In November, the CDC released updated and expanded recommendations for clinicians regarding pain care. The 2022 Clinical Practice Guideline addresses the following areas: 1) determining whether to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use.

“We’ve been able to improve and expand our recommendations by incorporating new data with a better understanding of people’s lived experiences and the

challenges they face when managing pain and pain care,” Debbie Dowell, MD, MPH, chief clinical research officer for CDC’s Division of Overdose Prevention, said in a statement.

Despite these positive efforts, however, drug-related overdose and death continue to increase, primarily due to illicitly manufactured fentanyl and fentanyl analogs, according to the AMA. In response to the fentanyl threat, the federal government in April 2021 made federal funding available for purchase of rapid fentanyl test strips. The strips can be used to determine if drugs have been mixed or cut with fentanyl, providing people who use drugs and communities important information about fentanyl in the illicit drug supply so they can take steps to reduce the risk of overdose.

Despite the efforts of providers, lawmakers and communities, the fight against fentanyl will no doubt continue to be fierce in 2023.

Building Surgical Case Carts from The Customer Up

Case carts are crucial within a hospital or surgery center. A fully stocked cart, with all of the necessary supplies and instruments for a surgical case, needs to get to the OR on time to maximize efficiency. Carts getting to the OR late or without crucial items can cause chaos in the OR and plays havoc with the surgery schedule. Metro decided to go directly to the users to find out the biggest problems with the carts they were currently using and work on real solutions. Here are the biggest problems Metro heard from customers and distributor partners.

Case Carts are Missing Items

Case carts house many vital components for a surgery including surgical packs, supplies, and instruments. Most carts have no system that tells an outside observer if something is missing. Many hospitals use orange traffic cones on the tops of carts to indicate there are missing items!

Metro designed their new CaseVue™ Surgical Case Carts with four color indicators clearly visible on the top of the cart that identifies the status of the cart. If it has a green indicator showing, the cart is ready for use. Orange means there is a missing product, blue indicates a cancelled case, and red indicates biohazard waste on board and that the cart needs cleaning. The colors can also be customized to your facility needs.

Case Carts are Bulky, Heavy, Noisy, and Hard to Maneuver

With all of the labor shortages healthcare facilities are facing, keeping

workers healthy is particularly important. A fully loaded cart can weigh hundreds of pounds so designing the cart ergonomically with maximum maneuverability is imperative.

The new CaseVue™ Surgical Case Carts offer two exclusive ergonomic features. The swing up handle allows for workers of various heights to steer the cart easily. The optional 5th wheel steering assist is ground-breaking, assuring maximum control in transit.

The Thermoplastic Rubber casters were designed to mitigate vibration noise from being transferred to the cart body. The doors bumpers, reinforced floor, and contoured side panels along with the new casters make this cart one of the quietest available in the market.

After Cleaning, Cart Handles are Too Hot to Handle

Case carts go through the cart wash after each case. Many facilities have potholders available so that health-

care workers can touch the newly cleaned carts without getting burned.

Metro has cool touch, antimicrobial handles on all of their case carts so no need for potholders. The case carts are also constructed of Type 304 Stainless Steel which has superior corrosion protection. These carts can go through the cart wash several times a day so being more rust resistant helps these carts last longer.

CME Corp has a list of criteria we use to choose our strategic manufacturer partners. Working collaboratively with CME as partners as well as offering superior products are two of the top criteria. We are a proud strategic partner of Metro’s. For more information about the new CaseVue™ Surgical Case Carts or any Metro product, please contact CME at 800338-2372 or visit www.cmecorp.com.

Changing case carts is challenging and a CME Account Manager can help arrange a 30-day demonstration to help make that decision easier.

Diagnostics Challenges with Elderly Patients

State-of-the-art diagnostic technologies are a must, but patient engagement is just as important.

A 70-year-old patient walks into the physician’s office complaining of stomach pain. There’s a chance they have hearing loss, making communication difficult. They might have comorbidities and are taking multiple prescription medications, each with its own side effects and drug interactions, making it difficult to isolate the problem at hand. They could have memory loss and find it difficult to recall when their symptoms began. Nor can the doctor get a good read on their circumstances outside the office, such as their housing situation, access to nutritious food, and social or family relationships.

Taking all these factors into consideration, the odds of misdiagnosis, underdiagnosis or overdiagnosis is high.

In July, the National Academies of Sciences hosted a workshop on “Advancing Diagnostic Excellence for Older Adults.” In the Proceedings, published in November, there’s little mention of diagnostic technologies. Rather, the emphasis was on the interaction between the care team and patient. According to one participant, the vulnerability of older adults due to isolation, challenges related to hearing, cognition and mobility, as well as complications from medications create challenges in caring for this population and highlight the need for whole-person care.

What’s the problem?

In a six-year-old study, researchers from Australia combed literature for data on the rates of misdiagnosis of common diseases in older populations. While admitting that literature was limited, they concluded that clinically significant rates of overdiagnosis and underdiagnosis exist for Parkinson’s disease, heart failure, acute myocardial infarction, dementia and chronic obstructive pulmonary disease.

They concluded that the presence of physical comorbidities was consistently associated with lower accuracy regarding the diagnoses of COPD, dementia, Parkinson’s, heart failure, stroke/TIA (transient ischemic attack) and acute myocardial infarction, possibly because complaints and fatigue due to concurrent diseases mask features that support or refute the index diagnosis.

“Our results emphasize the need for clinicians to be systematic and circumspect in verifying past diagnoses or making a new diagnosis in older patients,” they wrote.

Barriers

But doing so isn’t easy. At the workshop, participants identified the many challenges facing healthcare providers as they pursue correct diagnoses for their elderly patients, including:

ʯ Atypical medical presentations among older adults. For example those with acute myocardial infarction may present with shortness of breath instead of chest pain, and hyperthyroidism may present as weight loss instead of other common symptoms.

ʯ The fact that common symptoms such as fatigue or apathy have many possible causes, and older adults – particularly those with cognitive impairments or hearing or vision problems – may have difficulty articulating them.

The Society to Improve Diagnosis in Medicine

The Society to Improve Diagnosis in Medicine (SIDM) catalyzes and leads change to improve diagnosis and eliminate harm from diagnostic error. We work in partnership with patients, their families, the healthcare community, and every interested stakeholder. SIDM is the only organization focused solely on the problem of diagnostic error and improving the accuracy and timeliness of diagnosis. In 2015, SIDM established the Coalition to Improve Diagnosis to increase awareness and actions that improve diagnosis. Members of the Coalition represent hundreds of thousands of healthcare providers and patients – and the leading health organizations and government agencies involved in patient care.

Source: Society to Improve Diagnosis in Medicine , www.improvediagnosis.org

ʯ Age-related physiological changes, which may cause false positives on tests if using normal ranges based on younger persons.

ʯ Hearing loss, which can make it difficult for patients to keep up with a conversation, particularly in potentially stressful situations (such as a doctor visit).

ʯ Diminished cognitive function, which has been associated with a high rate of adverse drug reactions in older adults.

ʯ Multiple chronic conditions. Clinicians may assume that a condition is discrete and can be managed in isolation. But that’s not always the case with older adults.

Whole-person care

One workshop participant – Beverly Canin, co-chair at SCOREboard Patient Advocate Board – observed that the most difficult part of being a patient is being treated as a number or a body part, according to the Proceedings. (SCOREboard’s mission is to improve aging and cancer research and care delivery.) That’s especially true for older adults, who often already feel marginalized, she

‘Diagnosis is a complex issue, particularly among the aging population, who bring the sum of their lived experiences to the diagnostic process.’

said. Patients often report that clinicians are interested in symptoms and clinical data instead of their story, but studies have shown that more than 80% of diagnoses can be made just by listening.

Charlie P. Hoy-Ellis, assistant professor at the University of Utah, expressed support for person-centered diagnosis of lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults. Social positions over the life course can result in profound influences in health and well-being, he said. As an example, queer people experience stressors – acute or chronic – associated with being a minoritized population, which can be implicated in chronic health conditions such as asthma, diabetes or depression.

Sonja Rosen, M.D., chief of geriatrics at Cedars-Sinai, noted that researchers and health system leaders have refined evidence-based geriatric care models with four features known as the 4Ms, which might help improve diagnosis. (4Ms is a framework for care devised by AgeFriendly Health Systems, an initiative of the Institute for Healthcare Improvement, The John A. Hartford Foundation in partnership with the American Hospital Association and the Catholic Health Association of the United States.) The 4Ms are:

ʯ What Matters. What Matters to each older adult, their goals and preferences for care, guides the healthcare team and aligns care to what really matters to them.

ʯ Medications. Age-related changes can increase the chances of side effects from medications. The health team monitors all medications, decides if medications

are still necessary, and ensures older adults’ medications do not interfere with What Matters, Mentation or Mobility.

ʯ Mentation (mind and mood). The health team pays attention to this aspect of care, screening for changes that could be related to dementia, depression and delirium.

ʯ Mobility. Staying active and moving daily is how older adults stay strong, maintain function and do What Matters. The healthcare team ensures safe mobility to keep older adults moving.

Patient engagement

Speaking with Repertoire, Jennie-Ward Robinson, PhD, CEO of the Society to Improve Diagnosis in Medicine

POC testing of long-term-care patients

Repertoire asked Jeff Reid, senior commercial marketing manager, Sekisui Diagnostics, to comment on the role of point-of-care diagnostics in the diagnosis and treatment of elderly people.

“In the past 40 years, the life expectancy in the United States grew slightly over 4%, which is a fairly consistent rate for other developed countries around the world. As life expectancy continues to rise in developed countries, so will the number of elderly patients. A high number of these elderly patients are found in nursing homes and residential care facilities. In fact, 70% of

people who reach the age of 65 will need long-term care at some point.

“These types of care settings rely heavily on point-of-care testing. Not only does point-of-care testing help differentiate between a medical condition and a cognitive factor, but it also helps improve decisions around empirical therapy. Since elderly patients have an increase in comorbidities that require diagnosis,

they have a higher chance of receiving unnecessary treatment. This causes the patient to be at a high risk of receiving unnecessary medications, which can lead to an increased risk of adverse drug effects and cognitive impairment. It is crucial for nursing homes and long-term care facilities to make the most informed decision around treatment, which can be done through point-of-care testing.”

Dr. Jennie-Ward Robinson

(SIDM), said the Society is a firm supporter of the 4Ms as a guide that may be leveraged toward accurate diagnoses. “Diagnosis is a complex issue,” she says. “Particularly among the aging population, who bring the sum of their lived experiences to the diagnostic process. It is important to include family and caregivers with the patient to reduce the risk of diagnostic error.”

The elderly population presents their health-related complaints, influenced by social determinants of health, which have shaped the course of their health concern, she says. “Perhaps they have been impacted by limited income, transportation, access to care, difficulty articulating symptoms, memory loss, hearing loss. In addition, other factors may threaten and complicate an accurate, timely diagnosis. But we also have to ask, ‘How prepared are clinicians to recognize and value these social determinants, and communicate across these boundaries?’ In addition, what are the implications for these considerations among communities of color, who represent high growth rates within aging populations?”

If clinicians were equipped to capture the life course experiences of patients and their families, along with recognition of the social determinants of health, these resources could become critical assets to foster the construction of a timely and accurate diagnosis and satisfaction with their health care. “SIDM advocates for a balanced interaction based on shared decision making, which supports patient involvement in constructing their diagnosis.” Among other solutions, many healthcare providers have launched responsive solutions that encourage patient engagement in their care. “SIDM supports this approach!” she says.

“Imagine a world where we could attain diagnostic excellence! In that world, clinicians could be better informed by patients’ and families’ experiences. Further, this approach is growing in models within medical education that bridge families and communities with their providers. The goal is to improve dialogue, listening, and the likelihood of a satisfied patient less likely to experience harm.”

Resources:

“Diagnostic errors in older patients,” International Journal of General Medicine, www.ncbi.nlm.nih.gov/pmc/articles/PMC4881921/

Advancing Diagnostic Excellence for Older Adults: Proceedings of a Workshop in Brief, National Academies of Sciences, Engineering, Medicine, https://nap.nationalacademies.org/catalog/26789/ advancing-diagnostic-excellence-for-older-adults-proceedings-of-aworkshopSociety to

Improve Diagnosis in Medicine, www.improvediagnosis.org/about

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Familiarity and Trust

The importance of an established brand in frontline care.

By Pete Mercer

helping to deliver workflow efficiencies, and then helping to manage patients where they are most comfortable – at home,” said Salibra.

Looking to the future of frontline care

As for where Welch Allyn as a brand is headed, Salibra says that they are really excited for the future of the business. By embracing technologies like artificial intelligence in the diagnostics portfolios, the company plans to offer autonomous AI software as a diagnostic service, combined with products like the RetinaVue 700 imager, which will help to advance options for detection of diabetic retinopathy.

Welch Allyn is a recognizable, respected brand in the healthcare arena, with deep ties to clinicians and physicians starting medical school.

“Welch Allyn has an enormous brand equity with providers because of that familiarity and trust, going all the way back to the experiences they first had in med school and then the experiences they have with the products later in their careers,” said, Alisa Salibra, the Vice President of Global Marketing for Frontline Care at Baxter. In a recent podcast, host and Repertoire publisher Scott Adams sat down with Salibra to discuss the recent acquisition of Hillrom by Baxter and the future of frontline care.

Baxter recognizes that Welch Allyn truly means something to those working on the frontlines of healthcare, and because of that brand equity, will continue to use the Welch Allyn name in the frontline care portfolio. That portfolio has four key pillars: intelligent diagnostics, connected monitoring, cardiology, and respiratory health, which are the four key areas

of how the organization manages their major business.

Across the whole of frontline care, Baxter is continuing to work on driving innovation and progress through all four of those segments. “Our goals really focus around enabling earlier diagnosis through innovation, advancing the ways that we help clinicians predict deterioration,

No matter what happens, Baxter’s strategy and appreciation for their channel partners will not change. Salibra said, “Distributors were a really important element to Welch Allyn, they remained important to Hillrom, and they are important to Baxter as a key element of how we reach our customers every day in frontline care. From an operational perspective, distributors are very important to our reach.”

Baxter’s frontline care pillars:

ʯ Intelligent diagnostics

ʯ Connected monitoring

ʯ Cardiology

ʯ Respiratory

BAXTER AND WELCH ALLYN ARE NOW ONE TEAM

You may not know Baxter as well as you know Welch Allyn, but that’s about to change. A strong legacy of healthcare progress meets a future of new possibilities that will help your team make the days and lives of clinicians easier.

To see how we’re transforming care visit www.baxter.com/meet-acute-care

The Acceleration of ASCs

ASCs are gaining both more patients and importance in the marketplace, but they have their share of unique challenges.

There are several traditional care shift drivers that have been present for years in the Ambulatory Surgery Center (ASC) space – things like payment incentives across sites, and minimally invasive surgical techniques that permit surgeries to occur on an outpatient basis.

But there are also new drivers impacting the shift of care from the acute space to ASCs, said Amber Lewis, director of strategic marketing at Henry Schein Medical. “Many of these are a response to the impact of COVID-19,” she said.

For example, CMS’s Hospital Without Walls waiver program provided regulatory flexibilities to ASCs

and the home setting. This was an attempt to relieve capacity constraints that hospitals had been experiencing at that time, Lewis said. The capacity constraints had been largely cited as a factor driving shifts to the outpatient space with physicians looking to clear their backlog or expedite their ability to serve patients by performing more surgeries at ASCs.

“Beyond COVID, there are forces that we’ve seen propelling siteof-care shifts for the first time, such as the expansion of covered procedures and freestanding surgery settings, and the adoption and utilization of management tactics for those higher complexity, higher cost procedures,” Lewis said. “There’s also greater standardization and specialization of care

models, which should enable sameday discharges. And finally, we’ve seen rapid expansion of outpatient access points, particularly for ASCs, which is arguably the top benefactor of the shifts-in-care momentum that we’re currently experiencing in the industry as a whole.”

Lewis, along with Scott Jackson, vice president of surgical solutions, and Erica Smith, surgical solutions manager, were panelists of a recent Henry Schein Medical Webinar on ASC trends. The three Henry Schein Medical leaders provided insights into several topics affecting ASCs.

Growth opportunities abound

While CMS pulled back a bit in 2021 by reinstating the inpatient-only list and removing some 250 procedures from the ASC payable list, there are still a notable number of procedures that remain on the ASC covered list, Lewis said. The continued migration from inpatient to outpatient is primarily driven by ortho, spine and cardiac service lines. Notable orthopedic procedures, such as total knee and total hip procedures, remain on the ASC payable list and represent meaningful revenue and margin implications for hospitals.

Spine surgeries are one of the largest growth opportunities for ASCs. Lewis cited data from HIDA that 88% of spinal pain relief surgeries may be performed in outpatient settings by 2028. “And this growth is fueled by shorter recovery times, increasing payer willingness to reimburse, and less invasive surgical technologies.”

Cardiology was the fastest growing ASC specialty in 2022. “In fact, ASCs are likely to be completing half of all cardiovascular procedures by the mid to late 2020s,” Lewis said.

Consistent with historical shifts, the care shift migration of ortho, spine, and cardiac procedures from the inpatient to outpatient setting is a trend that should continue for at least the next three to five years. “This is driven by the reimbursement gaps between inpatient and outpatient, the evidence of favorable patient outcomes in the outpatient setting, and the convenience factor for patients,” she said.

Costs are going up

ASCs spent on average in aggregate over $6.5 billion every year on medical supplies and equipment, said Jackson. “To put that in perspective, if you look at the typical ASC, they’ll spend roughly 28 cents of every revenue dollar on supplies,” he said. “And when you think about their total expenses to run their facility, that runs just second to labor. We all know that labor costs have risen significantly as well. When running an ASC, the cost of supplies matters a lot, as well as the cost of labor.”

If you put the cost of supplies in comparison to other areas of care, such as hospitals and physician offices, a hospital will spend about 14% of their total budget on supplies, and a physician office will spend about 4%.

“An ASC spending 28 cents of every revenue dollar, certainly it makes the cost portion of the supply chain very relevant to an ASC,” Jackson said. “And then when you think about the device-intensive procedures for spine and orthopedic and cardiac, these are very expensive

Amber Lewis

Erica Smith

Scott Jackson

to perform. Now, yes, they do bring a much higher level of revenue and reimbursement for the typical ASC, but the cost of performing those procedures is significantly higher than what ASCs have been accustomed to with other procedures that they have historically performed within the single and multi-specialty center. The cost of these procedures is going to increase significantly with the types of procedures.”

Inflation’s effect

The other variable that’s impacting the cost equation is inflation. “We all know the pressures that inflation has brought, especially to all of us as consumers, but for ASCs, it has hit them in many impactful ways,” Jackson said.

recoup some of the losses that ASCs have felt from inflationary pressures. One is case costing. “There’s probably not a more singular, more important area for an ASC to manage than their case costing. It gets to the root of what they need to understand to manage their costs.” Being able to understand their cost – not only supply cost, but the cost of labor, overhead, and equipment, will be key.

OR time is also important, because if properly managed, “it allows the ASC to set goals around each one of those procedures and manage to those goals in order to, in some cases, reduce the cost, or in other cases to contain the cost,” Jackson said.

Another other area of opportunity is standardization. “Think about

procedure doesn’t get performed. ASCs learned the importance of backup suppliers, contacts and relationships with those suppliers, credit limits and other things that they would need in order to conduct business with someone aside from their primary supplier.

The ASC industry has gone through a lot over the past few years, but one of the biggest challenges was just sourcing products. “I think that was probably one of the biggest takeaways going forward, is the need for a backup plan,” Jackson said.

Tackling burnout and staff shortages

Even before the pandemic, staff shortages and burnout were already on the radar of ASCs. When COVID hit, it was all hands on deck with healthcare staff working 12- to 36-hour shifts to help save lives. “We are definitely seeing staffing shortages from burnout,” Smith said.

A study recently published by the American Hospital Association calculated that the cost of supplies has increased over 20% through the end of 2021 versus pre-COVID. “And that was just through 2021,” he said, “so if you factor in 2022, we have ushered in a whole new round of cost increases for medical products and supplies.”

At the end of 2022, the cost of supplies has risen exponentially for all points of care, hospitals, ASCs, and all cares to service.

Jackson provided several examples of things that can be done to

some of these device intensive procedures, and the physician preference items that come into play,” Jackson said. These could be implants, devices, biologics, and some of the specialty equipment. “It’s important that ASCs work to standardize to limit the number of manufacturers they’re working with in order to better negotiate on some of those expensive devices and implants.”

Product availability a consideration

If an ASC doesn’t have the products to perform a procedure, then the

She referenced an OR manager report from 2021 showing open positions for RNs at 40%, and it’s closer to 50% in 2022. For surgical techs, open positions jumped from 28% to 42%. “This is all over ASCs as well as any other healthcare facilities,” Smith said. “We’re seeing these increases of procedures that are able to be performed in the ASC space, which is great, but we don’t have the staff to be able to do it.”

Smith listed several best practices to keep staff, including increased pay, more input on decision making and heightened infection prevention in the facility.

Automation is another key to helping staff track drug expiration dates and follow up with patients. “Where can we automate things where we don’t have to manually do things?” Smith asked.

ASCs learned the importance of backup suppliers, contacts and relationships with those suppliers, credit limits and other things that they would need in order to conduct business with someone aside from their primary supplier.

Think Like A CEO & Take More Confident Action

Judi Holler, Speaker, Author & Entrepreneur

Throughout history, the biggest misconception about improv theater is that improvisers just wing it. And that couldn’t be any further from the truth. It is the preparation and the adoption of a CEO mindset that allows an improviser to think on their feet and make confident decisions. This interactive keynote is designed to help participants use the experimental ideas from the improv theatre and apply them to the unscripted stage of everyday life.

Judi Holler is a keynote speaker, podcaster, best-selling author, and entrepreneur who imagines a world where the word regret has been eliminated from the conversation.

Excellent content & amazing subject matter experts.

___

All sessions were high quality content and the networking opportunities offered made it easy to engage.

___

Enjoyed the purposeful times to network.

WHAT LEADERS EXPERIENCE AT THE SUMMIT:

EMPOWERING critical networking & leadership skills

LEARNING how to be a more confident leader

CONNECTING with others to have a more positive approach

DEVELOPING skills to be better positioned for future career opportunities

ACQUIRING strategies to get a seat at the table

EMBRACING new connections and a new sense of purpose & ambition

GAINING practical takeaways on leadership and success in our industry.

Keynote Speaker: Judi Holler

ASCs See Influx of Private Equity Investment

How are ASC strategies and operations changing in a post-pandemic climate?

By Daniel Beaird

A large amount of private equity (PE) capital is ready to be deployed within healthcare services. Partnerships between PE firms and physician groups can result in significant benefits to boost the financial strength of orthopedic groups, as just one example, and other clinical group ownership businesses, especially after the pandemic upset the climate.

Transaction activity in the physician group sector has accelerated rapidly in the post-pandemic atmosphere. A panel discussion at Share Moving Media’s First Annual Ambulatory Surgery Center Meeting in Atlanta last November tackled this issue for ambulatory surgery centers (ASCs) as well as ASC strategies and operations, and how GPOs and suppliers work with the non-acute supply chain.

Share Moving Media is the parent company of The Journal of Healthcare Contracting and Repertoire Magazine.

PE firms’ entry into the ASC market

PE firms are increasingly acquiring ambulatory surgical centers (ASCs) across the nation. But what are the implications for clinicians and patients? A recent NIH study identified 91 ASCs acquired by PE and 57 ASCs acquired by nonPE entities from 2011-2014 that found “no statistically significant observed change in the probability of an unplanned hospital visit, total costs, or total encounters

after acquisition by PE relative to acquisition by non-PE entities.” 1

And when PE-acquired ASCs were compared to matched ASCs that were never acquired, it found the same – no statistically relevant change of an unplanned hospital visit, total costs, or total encounters. But as more physicians sell to PE firms, it has raised apprehension about costs and quality.

The next three to five years will be an important period to watch, according to Robert Mayhew, director of procurement and contracting at Revo Health, which is a management services organization that partners with physicians in business and clinical intelligence, ASC development and management, and professional services. Mayhew spoke about the ASC market in the U.S. at Share Moving Media’s First Annual Ambulatory Surgery Center Meeting last November. He was joined by Sanchia Patrick, vice president of strategic marketing for Henry Schein Medical, and Hilary Grittner, vice president of non-acute sales for Provista Distribution on a panel discussion.

“There are so many ASCs and independent physician groups that there isn’t a one size fits all. It will be different depending on the group,” he said.

There are groups that want the money and the freedom that comes with it, and there are groups that want to build something generational. Minnesota-based Revo Health works with the latter. It is owned by physician partners, Twin Cities Orthopedics (TCO), and isn’t a PE-backed company. It has a management agreement aimed at providing services, lowering costs and making ASCs more efficient. But it isn’t just ASCs, according to Mayhew. It’s the entire circle of care as the

management company is involved closer to the practice level today.

“There’s a resurgence of single specialty and that is PE’s focus. You see it with ophthalmology centers,” Mayhew said. “Eventually, groups merge and sell to bigger players.”

PE firms are creating new strategies and consolidation in the market. But who will help them understand the market?

“It’s a great opportunity to start working closely with PE firms,” Grittner added. “And to help them understand the pressures of the healthcare supply chain. There’s a lot going on in the non-acute space.

We’re trying to create a partnership with them to say, ‘let us be at the table with you and educate you on how you can operate in a timely manner and get what you’re looking for.’”

The healthcare industry is trying to fully grasp PE firms as buyers as they put pressure on each player in the field.

“It’s real,” Patrick said. “PE leaders are competitive and driven to ensure that the operating line is profitable and will grow. It’s an intensity to respect and it puts pressure on everyone to be relevant. Constructive tension causes the best of us to rise.”

PE firms are focused on states like Florida, Texas and California with large retiring populations and dense ASC locations.

ASC strategies

For suppliers, developing an ASC strategy is specialty specific, according to Patrick. “Pick a specialty and master that specialty, and then pick another,” she said. “Ask ‘what’s your value proposition by specialty?’ That’s a worthy exercise for your go-to-market strategy.”

The ASC market is threefold. There are national groups, independent physician groups and hospital-owned groups and those three segments require different go-to-market approaches.

“You need unique points of differentiation and value props for each of those segments,” Patrick said. “How you sell to a C-suite buyer for a large group is very

The ASC market is threefold. There are national groups, independent physician groups and hospital-owned groups and those three segments require different go-to-market approaches.

different from a GI center, for example. What are your SEO strategies for ASCs? Where do you rank when a customer googles you? Be informed about that because it’s so much of it. So many decisions are already made before you even have an opportunity to get in front of them.”

Grittner said Provista, a leader in group purchasing in non-acute healthcare, partners closely with its distributor and supplier partners to prospect together and understand where they are going in the market.

“We’re not marketing specifically to specialty because we know from a GPO and contracting perspective which contracts go into which ASCs, and the majority are multispecialty,” she said. “We have ophthalmology groups, oral surgery groups and orthopedic groups, but when you look at what they’re spending, it’s consistent across the board with some subsets of specialty.”

Provista has made a large investment in technology for ASCs to make data-driven decisions with its proprietary materials management software platform Envi®. It provides end-to-end procurement expertise, data-driven processes and modern technology.

“This market is a little behind on understanding their data,” Grittner said. “Some groups do it better than others, but we need transparency in the market. Technology is a goal of ours. How do we get it to each of our members so that we can help them make more data-driven decisions? It’s a broader discussion around total value.”

Grittner is challenging her team to ask ASCs what their strategy is: where they are trying to go and

explaining their headaches. “We layer solutions in,” she said. “Maybe it is a technology play to help create efficiencies and become more profitable. We have to be gamechangers.”

Supply assurance programs coming out of the pandemic can also help create a valuable partnership with ASCs and Provista has invested heavily in additional programs that allow for supply assurance.

“I laugh at conferences when there are five of us who manage 250 surgery centers and there are 50 people from one health system,” he said. “We are grossly outnumbered. But when COVID happened, we were fighting the same battles. We needed gloves too, but the hospitals got first dibs, and it exposed a lot of weaknesses within the ASC supply chain because we don’t always have the data.”

“We’re buying product, as well, for our members to house it and have it in the U.S.,” Grittner said. “We’re enhancing programs around drug shortages as well. That’s a value add as we partner together.”

Provista is asking for a threesided relationship between the customer, the GPO and the supplier partner. “It’s not about beating up the supplier for the right price. It’s about having enough to go around and how we get there together,” Grittner said. “We all have to be at the table having the same conversation. The cost is going up and reimbursement isn’t. They’re not getting paid more for the patient. It’s our job to bring solutions to what we’ve provided in the past.”

ASCs run lean

ASCs run lean, regardless of their ownership structure. There’s typically one person who is scrubbing, trading and ordering, according to Mayhew.

When faced with these challenges, ASCs don’t always know where to turn, especially the independent groups.

“It’s being able to rely on the distributor rep,” Mayhew said. “The independent ASCs need help. They have a sliver of the resources that acute care has but the same expectations and demands.”

“The clinical managers at independent ASCs are worn out,” Patrick added. “We need to help them and buoy them. They’re doing the cases and the ordering and more.”

She asked suppliers to implement voice of the customer (VoC) programs to hear the passion and problems along the customer journey at ASCs. “There are different customer journeys. A supply customer journey is different than technology and different than a solution,” she said. “There are questions about workflow and efficiency. How can we help solve that? That’s where ASCs are focused whether PE-backed or not.”

1 Private Equity Acquisitions of Ambulatory Surgical Centers Were Not Associated With Quality, Cost, Or Volume Changes

Supply assurance programs coming out of the pandemic can also help create a valuable partnership with ASCs and Provista has invested heavily in additional programs that allow for supply assurance.

March 21–24, 2023

Hyatt Regency Coconut Point, Bonita Springs, Florida | HIDA.org/ExecCon

Navigate Inflationary Pressures, Staffing Shortages, And Revenue Shortfalls

Alan Beaulieu President, Institute for Trend Research

2023 Economic Outlook: Navigating An Inflationary Economy

Beaulieu, whose company predicts economic trends with 94.7% accuracy at 12 months out, will share actionable ideas on thriving as the economy shifts.

Jeffrey Moser Principal, Sg2

Site-Of-Care Shifts: What To Expect And How To Prepare

The future of healthcare is outside the hospital. Learn the details of how and why in this session.

Larry Van Horn, PhD Associate Professor, Health Economics & Management; Exec. Director of Health Affairs

Owen

Graduate School

of Management, Vanderbilt University

How

Consumerism

Is Changing

The Game In Healthcare

Explore the future of price transparency, new innovations in care delivery and how to respond.

The Latest Trends In The Lab And Physician Markets

Help your entire team to better understand your customers’ shifting challenges and priorities in 2023.

Lab & Diagnostics: Trends And Outlook session

Mara Aspinall, President and CEO, HealthCatalysts

Review the biggest trends in lab and what the future may hold as automation and other disruptors change the customer perspective.

Customer Insights: How Lab Providers Are Addressing Challenges And New Opportunities

Gain insights on how lab providers are adapting new processes and implementing new technologies to alleviate some of the operational challenges.

Understanding The Lab Regulatory And Reimbursement Landscape

This session will cover the latest regulatory and reimbursement updates that will affect your lab customers.

A Robust Response to Respiratory Season

With a recent acquisition and continued innovation, QuidelOrtho is committed to bringing testing closer to the patient.

With COVID, flu and RSV all making headlines, this year’s respiratory season promises to be one for the ages. One market leader ready to meet that demand is QuidelOrtho. The diagnostics company has undergone a transformation during the past few years with its acquisition of some Alere business and the acquisition of Ortho Clinical Diagnostics.

In a recent podcast, Repertoire Publisher Scott Adams spoke to QuidelOrtho Chairman and CEO Doug Bryant about some of those changes and what it means for supply chain leaders.

Scott Adams, Publisher: With the acquisition of Ortho, you have essentially doubled overnight. Talk to me about running an operation that doubled and integrating all the complexities.

Doug Bryant, Chairman and CEO, QuidelOrtho Corp.: We need to be as good as we can be in order to achieve what I would call transformational events from time to time. Can your organization come together, rise to the challenge that’s in front of you and get it done? Can you do it in a way that keeps everybody intact, keeps everybody motivated in wanting to do the next big thing?

In the Alere asset acquisition, we basically doubled our revenue at the time. We also had to operate in 130 different countries and set up order to cash systems. And we had to put in place the backbone and the infrastructure in all those countries. In some cases, we commercialized on our own and in other cases we were heavily reliant on distribution.

It was easier in the U.S. because we knew the players and had such great relationships with them, but we didn’t outside of the U.S. We were

Doug Bryant

trying to vet various distribution partners and make decisions on how to go to market in those countries with the products we had. It’s far easier now when we’re merging with a company that already had that.

Secondly, we went from zero to 16 million tests per week with QuickVue as well as millions of tests per week with COVID

We were one of the first companies in the market with a PCR test. We clearly didn’t have the manufacturing capacity to compete, but we built it. We had a head start with QuickVue, but we were competing with some big companies who had scale already. That was transformational.

Our people started believing in our capability. We took a company that was small and got in the ring against the big guys. We got big pretty quickly. With the cash we had on hand and our ability to access capital markets, we’ve been able to pull this off pretty nicely.

Adams: We were talking about a heightened respiratory season compared to the last several respiratory seasons. That bodes well for QuidelOrtho and the next couple of quarters. But what do you guys have that’s coming that distributors can look forward to?

Bryant: We can count on a respiratory season that we haven’t seen in a few years. When we have robust respiratory seasons, our distribution partners do really well.

Our increased capacity and control of our supply chains could be a competitive advantage for us because our competition has already said that they won’t have product for a while. We started ramping up a while ago, so we’re going to be in pretty good shape.

To add some more boxes and make up for our competitors’ shortfalls is going to put a lot of strain on our operations team, but they’re up for it. That’s the number one thing.

Long-term, there are probably about 20 of our projects tied to new assays for Sofia. Those in distribution that have been so helpful in placing all those Sofias are going to be the beneficiaries because we’re just going to have more product. I think that sort of relationship bodes well for both of us.

Bryant: We have both a unique opportunity relative to our competitors to compete in a segment that I call not too big and not too small. For the medium hospital lab, small reference lab and clinics associated with those hospitals, we’re uniquely positioned because we can provide products into the central lab all the way out to the clinics. That’s a little bit unusual.

Pair that with the fact that we’re in transfusion medicine. So, every hospital that does blood typing knows their Ortho rep, which means

We’re also seeing a continued movement to bring testing closer to the patient. That could be in a hospital setting, but it also could be urgent care or the physician office. The train has left the station in terms of the public understanding that if you don’t feel well, maybe you should go get tested for something.

There’s an expectation on the part of the average person that if they see a physician, they expect to get a test and they want to know the answer. Then if it’s treatable, they want to be treated on the spot. That’s another factor we will bring to our distribution partners – the ability to keep moving products closer to where the patient lives.

Adams: Where does QuidelOrtho fit into the competitive landscape? How are you unique from your competitors?

everybody knows the Ortho rep. Our market share in that particular segment is very high.

On the donor screening side, we do really well, particularly with red cells. And we would love to do even better on the plasma side, which is the growing component of donor screening these days.

Not every diagnostics company has a transfusion medicine business. There aren’t that many. That makes us look a little bit different than just about everybody.

Our increased capacity and control of our supply chains could be a competitive advantage for us because our competition has already said that they won’t have product for a while.

The Road to Health

How one distribution leader’s investment in his own health carried over into his family and professional life.

By Pete Mercer

At the start of every new year, millions of people make the resolution to take their health seriously and get in better shape. Whether most of those people follow through on their resolutions or not, setting those health goals is critical to helping you take care of yourself and achieve professional success. Your health and your success are two sides of the same coin: you cannot have one without the other.

Noah Lam learned this firsthand when he realized that he needed to make a change for his family and the success of his business. Lam is the president of Connetquot West, a national home healthcare product supplier that specializes in health and wellness products based in Edgewood, New York.

“It’s so easy for business leaders to get so entrenched in the day-today stuff that they begin to neglect their personal health,” Lam said. “But what we fail to realize is that our health and our personal success are two very intertwined concepts. Without your health, you will lose your ability to make money.”

In 2007, Lam was sitting on the couch eating a pint of HäagenDazs ice cream and watching Forrest Gump run across the country when he thought, “I could do that.” He decided then and there that he wanted to run in the 2008 New York City Marathon. After that, he and his wife trained for and eventually ran in the 2009 New York City Marathon. Since that moment on the couch in 2007, Lam has been on an incredible health journey full of ups and downs that has allowed him to take back his own health and reinvest it into Connetquot West, while also investing in the lives of young athletes through a nonprofit he launched in 2017.

A healthy lifestyle

Following the marathon races in 2008 and 2009, Lam continued to run and keep in shape. While training for the 2012 New York City Marathon, he herniated his back so badly that he needed surgery. He opted for treatment through acupuncture instead of surgery, and he was ready to run again in the spring of 2013, but he hit another roadblock. While putting on his running shoes one day, Lam suffered a seizure. He woke up in the hospital, disoriented and confused about what happened.

Recovery from the seizure took some time, but he was eventually able to get back to a place where he could run again. After he recovered, he had the opportunity to see a friend compete in an Ironman triathlon –an intimidating race that combines running, biking and swimming. This encouraged him to train and prepare for triathlons himself, something he had never considered doing before.

Unsurprisingly, it was not an easy journey to get ready for triathlon races. Lam said that there were plenty of times where he would ask himself questions like “What am I doing? What am I doing here?” He would be on the bike trainer for four or five hours, completely losing himself in the process.

“You do kind of disappear for a little bit. I am lucky I had the family support and teamwork to pull me through. Without that, it just does not balance out,” Lam said. Once he added the training elements for the swimming and biking components to his process, he still needed to balance his need for sleep, family time, and work responsibilities.

Even with all of the plates balancing at once, Lam has been able to find that happy medium of training, family, work and sleep. It does not happen without sacrificing something along the way, but Lam has deftly stuck that balance with everything going on in his life.

Lam said, “I had been running for five years and never thought that I would do something that would require swimming. The biggest thing for me with triathlons was being stuck in the middle of the water without a life preserver. You have to sink or swim.”

Starting Lightning Warriors

With his new love for triathlon races, he invited his son to participate in

an upcoming race. At one of his son’s first races, Lam saw that his son enjoyed the triathlon and would strive to win more races in the future. “I wanted to support my son, and I knew he needed to train with others. I created a triathlon team because the closest team was in Massachusetts.”

Lightning Warriors is a nonprofit organization based in Long Island, New York, that focuses on making triathlons an accessible sport to young athletes. They work with each of these athletes to unlock their potential as athletes and leaders. Membership through Lightning

Warriors covers any fees associated with coaching, usage of facilities, and USA Triathlon members. Instead of a fee, the organization simply asks that each athlete volunteer and participate in fundraising opportunities, own the proper equipment required for competing, and be kind and courteous to everyone competing and coaching at events.

At the time of his first triathlon, Lam says that his son was a little unsure of himself and still trying to figure out who he was and what he was interested in. On the day of his first triathlon, Lam’s son was nervous

and completely zoned out. But after finishing the race in 10th place, there was a total change in his disposition – an evident pride that he had completed something.

“I think the real transformation for him was that he got to do it. He achieved something that he probably thought he could never do. And once he tasted that, he excelled at it. He knew that he would be good at it. He finished a race, and I really believe he did his best.”

His son continued to improve, and even got to a point where he finished in 3rd place at the national level before breaking his leg. During his recovery, Lam knew that his son would need other kids to train with. In addition to there being no local teams for his son to participate with, Lam knew that he needed to start something because he wanted “to see other kids participating in triathlons with his son.”

Triathlons require an immense amount of training and preparation on the part of the athletes, which makes something like Lightning Warriors an incredible opportunity for young athletes. Not only are the athletes getting the training and coaching they need, but it is also creating more accessible opportunities for kids who are passionate about the sport.

Lam said, “I wanted to make whatever I built more diverse and more accessible to more kids. I wanted to reduce any barriers for any kids that wanted to do a triathlon.”

Lightning Warriors now has over 100 kids on the team, giving them a place to get in shape and participate in a sport they love.

Reinvesting in CMI Medical

By investing in his physical and mental health, Lam had a new opportunity to

reinvest in the future and success of his company. This experience translated perfectly to helping him follow through and better achieve goals in his work.

“I think it really comes down to being more focused in any business, regardless of whether it’s healthcare or making screws and things like that,” he said. “You value what time you have, and you make the most of what you can do. For me, the health hurdle was more of a byproduct of the mental hurdles that you have to go through.”

With the challenges of the last few years, Lam has been able to leverage this approach to help his customers. CWI Medical, like everyone else, had to navigate the especially challenging early days of the pandemic with supply chain disruptions.

Yet it is precisely those challenges that require Lam’s approach

to focus on the important aspects of the business and push through the challenging days. He said, “It’s more of a mental exercise than a health exercise to get what you want.”

For Lam, it is all about being prepared for whatever might happen. Just like the triathlon training with Lightning Warriors prepares athletes for each component of the triathlon race, preparing your organization for the foreseen and unforeseen challenges will better pave the road for success for your company.

At the end of the day, Lam is grateful for his new lease on life. Competing in marathons and triathlons has given Lam a second chance to transform his personal health, the health of his family, and the health of his company. “If I didn’t take a step back and take care of myself, I wouldn’t be here now.”

Heart Health and Respiratory Season

February is American Heart Month. How can the flu affect heart health?

February is American Heart Month, when the CDC’s Division for Heart Disease and Stroke Prevention shines a light on hypertension or high blood pressure, which is a leading risk factor for heart disease and stroke. Cardiovascular disease can affect adults of any age. And one in five adults who died of cardiovascular disease in 2019 were under the age of 65.

But February is also historically the peak month of flu season. So, how can the flu or other respiratory illnesses affect heart health? A recent Sekisui blog examined.

Infection, inflammation are body stressors

An influenza infection stresses the body and can increase the risk of having a heart attack or stroke, and an underlying health issue like heart disease can cause the flu to transition into something worse. Pneumonia and bacterial pneumonia are the top complications. But cardiac issues like myocarditis, which is inflammation of the heart muscle, or arrhythmia can occur, and so too can stroke.

White blood cells are the body’s first responders and cause inflammation in their fight to protect the body from an infection, bacteria or virus. This increased activity in the body can lead to blood clots, raised blood pressure and swelling or scarring of the heart. These stressors make plaque within the arteries more vulnerable to rupture, which can block oxygen to the heart or brain causing a heart attack or stroke.

Vaccination rates for high-risk patients are not suitable

Flu vaccination in high-risk heart health patients has been associated

with a 28% reduced risk of heart attack, a 47% reduced risk of TIA (transient ischemic attack) and a 73% reduced risk of death. But the rate of seasonal flu vaccination among high-risk groups like those over the age of 50 and nursing home residents is extremely low.

serious complications from the flu are greater for patients with chronic diseases. According to the American Heart Association’s scientific journal Circulation, getting an annual flu shot can save heart failure patients’ lives. As the population ages during the next decade, heart failure is expected to increase.

Reducing premature death

Flu vaccinations are underutilized, so the American Heart Association partners with the American Lung Association and the American Diabetes Association to deliver the message to providers and the general public that all adults and most children should be receiving flu vaccinations every year.

Patients with high blood pressure, diabetes or emphysema critically need flu vaccinations because

In the study published in the journal and funded by the Danish Heart Foundation, it was found that flu vaccination was associated with an 18% reduced risk of premature death, even after accounting for other factors like medications, other health conditions, income and education. And an annual flu vaccination following a heart failure diagnosis was associated with a 19% reduction in both all-cause and cardiovascular death when compared with no vaccination.

Physicians and cardiologists who care for patients with heart failure must be aware of the benefits of flu vaccinations for these high-risk patients. Lead study author Daniel Modin, an investigator from the University of Copenhagen in Denmark, said flu vaccinations may be regarded as a standard treatment in heart failure similar to medications.

How Social Media is Changing Healthcare Industry Marketing

The sheer number of social media users should be enough to convince healthcare companies to start using the platform to reach their audience. However, there are other reasons to consider it, such as the platform’s purpose.

Here are some of the most common ways consumers use their social accounts:

ʯ Connecting with others

ʯ Reading news

ʯ Sharing information

ʯ Entertaining themselves

While many social media channels started as places for individuals to connect, today, consumers use them to learn, shop and discover. What makes healthcare social media such a valuable channel for discovery is the access businesses have to information.

Over half the world’s population is on social media, giving healthcare workers a powerful platform for reaching B2B customers and patients. Social media and the healthcare industry aren’t a new combination. Many medical businesses took to the platform during COVID-19 to educate patients in the middle of medical uncertainty.

Even though the height of the pandemic is over, healthcare companies are keeping up with their social media strategies because they see the value in this creative and personal platform.

In July 2022, 59% of the world’s population was on social media. The average time users spent on social platforms was 2 hours and 29 minutes. In America alone, 72% of adults use at least one social media platform.

When social media users and businesses create accounts, they share demographic and firmographic data. Social media uses this data to personalize each user’s experience by offering relevant insights based on that data.

For example, a consumer that visits healthcare businesses on social media is more likely to see healthcare-related topics on their feed.

Which Social Media Platform is Best for Healthcare?

You don’t need to market on every social media channel to be effective. Instead, consider these top channels for your healthcare strategy.

Facebook is the most popular social media platform, with 2.94 billion users. In the U.S., 69% of adults say they use Facebook. It’s a versatile channel for connecting with potential customers and educating your audience.

YouTube is the second most visited site, just under Google and before Facebook. Even though YouTube has 1.7 billion users, it sees 14.3 billion visitors monthly. On YouTube, you can reach your audience with creative long-form video content.

Instagram reaches an audience of 1.3 billion users. Through video stories and images, businesses can share quick snippets of information with an audience of patients and companies.

TikTok deserves an honorable mention because it has a higher engagement rate per post than Instagram or YouTube. In 2022, TikTok reached 1 billion monthly active users, including several notable healthcare TikTok personalities. The platform can be used to educate and connect through shortform video content.

LinkedIn is the top social media channel for B2B marketers. LinkedIn has 55 million business accounts and users who are key decisionmakers from leading businesses. Use the platform to share your thought leadership content and educational articles for a targeted B2B audience.

The following are five ways those social media channels are transforming healthcare marketing today with new social media marketing opportunities.

No. 1. Building Personal Relationships

Social media is a chance to turn business partnerships into relationships. You’ll also see greater brand loyalty

when there are relationships between you and your customers.

Through social media, you can communicate with your customers and patients using comments and social chat. You can also interact with posts from related businesses to build brand awareness.

Cardinal Health shows another way to invest in building relationships. It regularly highlights its employees and customers. These personal stories and pictures put a face to the brand, focusing its business on people and solutions rather than medical supplies and sales.

No. 2. Motivating Actions

Healthcare companies are at the frontlines of medical battles as communities strive to diagnose early, find treatment, and raise awareness of diseases. Social media can be your battleground to fight for a healthier future and motivate change one patient at a time.

Johnson & Johnson uses its social platforms to raise awareness of common and rare diseases and help people seek treatment early.

No. 3. Reaching a Larger Audience

Social media advertising grew to $137 billion, overtaking paid search at $135 billion. Through social media’s more advanced algorithm, businesses can target a niche audience and reach more of their market. When more of your intended audience sees your ads, you’ll also see greater returns from your advertising investment.

One of the most popular forms of social media advertising is retargeting. 77% of B2B and B2C marketers use retargeting on Facebook and Instagram. Retargeting ads connect with leads and website visitors interested in your brand but didn’t convert yet.

No. 4. Connecting Directly with Patients

Patients are growing increasingly interested in their healthcare. Healthcare manufacturing businesses are seeing a rise in patients researching them directly instead of only connecting through healthcare facilities.

Social media allows traditional B2B healthcare companies to connect directly with end-user patients. Through this channel, healthcare companies can educate patients and provide resources so patients can make more informed healthcare decisions.

For example, patients know what new treatments or equipment are available on the market and can ask their primary care providers about these care options.

No. 5. Creatively Educating Your Audience

Webinars, blog posts, and email marketing are all highly effective at reaching your audience with educational content. However, marketers can see more results by diversifying their approach with more creative content.

Social media is a creative outlet that allows healthcare marketers to break away from the norm. For example, Doctor Mike on YouTube addresses trending health topics from a trained medical perspective. He takes TV shows, news stories, and social media claims and dives into what’s accurate and misleading in pop culture.

Share Moving Media offers the latest insights and trends in healthcare marketing. Use our leading news and resources to build a creative and highly effective social media strategy that perfectly complements your healthcare marketing campaigns. Visit sharemovingmedia.com for more information.

Succession Planning is Part of Leadership

Why it’s important for the stability of the organization to have a successful succession plan.

By Vicky Lyle, Vice President, Industry Association, Owens & Minor

Succession planning is an important part of leadership because it is critical to the ongoing success of an organization. Leaders must encourage the leading members of our organizations to seriously consider how to sustain our organization’s momentum and mission, groom future leaders, and delegate authority effectively. As a leader, it is especially important to develop others to be our successor for the day that we step into a new role.

As of Jan. 1, 2023, Allison Therwanger will be at the helm of the Professional Women in Healthcare® (PWH®) organization as the 2023-2024 chair. I have been honored to serve as PWH ® Chair during the 2021-2022 term. PWH ®

is our industry’s only organization focused solely on leadership development, specifically leadership diversity, and we take succession planning seriously!

Many of you already know Allison. She is the vice president of Innovia

Medical Corporation. She has been at my side as chair elect throughout the past two years. Allison has been a member of PWH® and the treasurer since the organization’s beginning. She is a strong leader and will continue to advance our mission of

creating a culturally inclusive industry equally led by women.

With each new PWH® Chair, the leadership team of PWH® strives to take the PWH® organization to the next level. We learn from one another and support each other. As of January 1, I will take on the duties of the past chair position, and for the next two years, I will continue to serve in a supporting role to help Allison with whatever she needs. As Allison steps into her new chair role, Ashleigh McLaughlin, chief financial officer of IMCO, will step into the chair elect role and begin her twoyear training to become chair.

PWH® has a wonderful succession planning program that has helped us over the years stay focused on our strategic goals, grow the organization, and most importantly

advance our mission and make our vision a reality. We use the “9-Box” succession planning tool. This tool is used to identify the performance and potential of our team, including those who are ready to take on advanced positions and those who may need more development. The tool helps us build a bench of resources as others move up or out of our organization. Does your company have a succession plan? If not, consider planning tools that that can help you get started.

What if you aren’t part of the succession planning process? How do you play a role in your succession plan placement?

ʯ Talk to your manager – let your interest be known!

ʯ Network with others in your organization – ask for advice

ʯ Identify your gaps – and work on those skills

ʯ Use tools such as Clifton Strengths Finder to identify your strengths and share them

There are many tools to help you get involved in the succession planning process. The most important thing, though, is to have a succession plan. The PWH® organization will be around for many years to come, and it is important for the stability of the organization to have a successful succession plan. I know that our next chair, Allison Therwanger, is ready to lead PWH® because of the strong succession plan that the PWH® organization has in place to prepare her for this role as it prepared me for this role as well.

Navigating the New Normal of Supply Chain Challenges

Supply chain friction is here to stay, in one form or another. Recently, congestion has eased at our nation’s seaports, with fewer delays at cargo terminals. But as one set of disruptions have eased, other challenges have emerged to their place.

Labor Issues

In December, HIDA urged Congress to take steps to maintain the freight rail system and avert any rail strike. As Americans weathered a difficult flu season and a surge in pediatric RSV cases, it was no time to disrupt the medical supply chain. The consequences would have been dire, with the potential to impede the delivery of medical products needed to treat patients, protect providers, and save lives. HIDA urged President Biden to take action to avert a rail strike. Fortunately, Congress intervened in a bipartisan fashion and passed legislation to settle the labor dispute and keep the supply chains moving. However, attention will now focus on the current labor negotiations at the West Coast ports.

Fuel Shortages

Although the cost of gasoline has come down from last year’s peak, the price of diesel fuel has remained stubbornly high. This autumn, diesel fuel supplies fell to their lowest level since the U.S. government started keeping records in 1982. Limited refinery capacity and the Russian invasion of Ukraine have contributed to price increases. Separately, a directive from the International Maritime Organization two years ago to require most oceangoing ships to replace their highsulfur bunker fuel with less polluting fuels,

which has slowly increased demand for diesel. Energy analysts estimate that the global shipping fleet was now consuming half a million barrels of diesel a day, or roughly 2% of the world’s supplies.

Unpredictable and Fragile Supply Chains

According to research from The Advisory Board, healthcare providers are facing long-term shortages of medical products and greater unpredictability in the supply chain. More than 90% of provider executives report that they are still experiencing product shortages. Every link in the supply chain is potentially fragile. In the last three years, we’ve seen bottlenecks in air freight, shipping, trucking and rail. Distributors have shown great resourcefulness and resolve to overcome the multitude of challenges they have faced.

HIDA continues to work with supply chain experts among our member companies to monitor shipping and transportation trends. We facilitate meetings with port officials and federal agencies to resolve bottlenecks. We know that transportation is a healthcare issue, and continue to focus on long-term solutions to create a “fast pass” system to expedite critical products so patients and providers can get the medical supplies they need.

By Linda Rouse O’Neill

Linda Rouse O’Neill, Vice President, Supply Chain Policy and Executive Branch Relations, Health Industry Distributors Association

Industry News

Midmark earns award for creating a healthy workplace for its teammates

Midmark announced the company received a gold-level Healthy Worksite Award from the Healthy Business Council of Ohio (HBCO).

The Healthy Worksite Award recognizes Ohio employers who demonstrate a commitment to employee wellness through comprehensive worksite health promotion and wellness programs. Applicants are scored on the extent their wellness programs facilitate and encourage employee health, enhance productivity and ensure a healthy work environment.

of its teammates. In 2020, Midmark was named Healthiest Employer in Ohio and Michigan powered by Springbuk, Inc.

Cardinal Health appoints new CFO

Cardinal Health and its board of directors announced that Aaron Alt will become the company’s new chief financial officer. Alt will succeed interim CFO, Trish English and will report to CEO, Jason Hollar, as a member of the company’s Executive Committee effective Feb. 10.

In his capacity as CFO, Alt will lead financial activities across the enterprise, including Financial Strategy, Capital Deployment, Treasury, Tax, Investor Relations, Accounting, and Reporting. Additionally, he will lead the Corporate Development team.

Alt most recently served as EVP and CFO for Sysco Corporation, the leading global foodservice distribution company. In this role, he drove significant improvements to the balance sheet and underlying profitability of Sysco.

On its Versailles campus, Midmark maintains an onsite wellness center staffed by a nurse and offers flu shots, mammograms, vascular and skin screenings, blood pressure checks and other wellness checks throughout the year. The company also offers weekly onsite massage sessions, outdoor walking paths and fitness center spaces for group and individual workouts.

This is not the first time Midmark has been recognized for its commitment to the health and well-being

Prior to Sysco, Alt was SVP and CFO for Sally Beauty Holdings, an international specialty retailer and wholesale distributor of professional beauty supplies. He has also held senior executive roles in Finance, Operations and Grocery Transformation at Target Corporation. Prior to joining Target, he held senior-level Finance and Operations positions with Sara Lee Corporation.

Aaron holds an M.B.A. from the J.L. Kellogg School of Management at Northwestern University, a J.D. from Harvard Law School and a B.A. in History and Political Science from Northwestern University.

Aaron Alt

CME announces the addition of two new warehouses

CME Corp., the largest equipment-only distributor of medical products in the U.S., is pleased to announce the addition of two new warehouses.

“CME Corp. has experienced significant growth in both the Chicago and Dallas markets over the past few years resulting in the need to increase our operational infrastructure. We have outgrown our existing warehouse footprints in both markets due to an increase in the level of direct-to-site (DTS) and warehousing related activity. As a sales territory grows, part of the evolution is the warehouse infrastructure needed to support that growth. The current sales activity as well as the growth potential necessitates the investments in these markets,” said Eric Robinson, vice president of operations.

The Dallas warehouse has increased the overall warehousing capacity by approximately 55% for that market. The Chicago warehouse increases warehouse capacity by approximately 60% and is well positioned to serve both the local Chicago market as well as function as an operational hub for the Midwest region, according to a release. Both warehouses will be operational in January 2023. Eric Robinson also added that “geographically, it made good strategic sense to bolster our presence in the middle of the country. This will allow us to continue to streamline and enhance our Direct-to-Site (DTS) related offerings in these regions.”

Sysmex appoints new CFO

Sysmex America, Inc. announced that Chris Cappella has joined the company as chief financial officer. He will lead Sysmex America’s regional finance organization and financial activities including accounting and controllership, financial planning and analysis, tax, internal audit and treasury.

“Chris is a proven leader with a superior track record of delivering results and creating value,” said Andy Hay, chief executive officer of Sysmex America. “Known for his ability to unify teams and targets across finance and non-finance functions, Chris will be a strong partner as we continue to innovate and grow.”

Prior to joining Sysmex, Chris held a variety of finance leadership roles at Roche, most recently as the vice president of finance for Core Lab. At Roche, he was instrumental in driving growth through the cross-functional integration of agile strategies. Before his time at Roche, Chris was a finance manager at Brightpoint, Inc. He started his career at Ernst & Young and is a Certified Public Accountant.

Henry Schein donates hygiene packs to ease humanitarian crisis in Ukraine

Henry Schein announced that its Henry Schein Cares Pack Program, a global cause-marketing campaign to engage health care customers, including dentists and physicians, reached more than 27,000 Ukrainians who have been affected by the current humanitarian crisis.

As a result of the campaign, more than 200 Henry Schein health care customers purchased $10 hygiene packs, which included toothbrushes, toothpaste, soap, and shampoo, and were kitted by more than 300 Team Schein Members, customers, and their families and friends. This took place at the Company’s Reno, NV and Grapevine, TX distribution centers, as well as sites in France, Italy, Germany, and Australia.

“For more than 20 years, Henry Schein has had emergency preparedness and disaster response as a core focus area,” said David Kochman, chief corporate affairs officer, Henry Schein. “Through Henry Schein Cares, our global corporate social responsibility program, our goal has always been to provide health care supplies to our long-standing non-governmental partners, and to help those most in need. This year, that need is and continues to be in Ukraine. Through a simple hygiene kit, we hope it offered a small boost to morale, self-esteem, mental health, and overall health. On behalf of Team Schein, we send our sincerest thanks and appreciation to our customers for their contributions that led to the success of this program.”

Once items were purchased and kitted, nonprofit partner, MedShare, worked with local partners such as Razom for Ukraine and RescueNow, and International Medical Corps distributed the kits directly to beneficiaries in Ukraine and Poland.

Better BP® is Better Care

Midmark designed the only fully integrated point of care ecosystem to help promote a more consistently accurate blood pressure measurement by targeting 3 key areas

Proper Patient Positioning

Patient positioning during blood pressure (BP) capture can impact the accuracy of BP measurements. The American Medical Association (AMA) recommends the patient’s back be supported, feet fl at on the fl oor, legs uncrossed and arm supported at heart height. 1

Accurate, Consistent BP Capture

Automation at the point of care can help ensure a higher level of standardization, minimizing human variables while maximizing consistency and data accuracy.

EMR Connectivity

Seamless connectivity to the EMR saves time and reduces the likelihood of data transcription errors.

Learn

INVENT. CREATE. PROTECT.

revolutionized personal hand protection forever with the invention of the world’s first nitrile exam glove. Since that time, the integrated manufacturer has accomplished a “Legacy of Firsts” for health care providers:

SUPPLY CHAIN ASSURANCE. CHAIN OF CUSTODY. BORN AND BRED IN THE .

2022

 Stood up two more high speed monorail lines now with 800M glove capacity annually

1990

 Invented of the world’s first nitrile exam glove

 First 510(k) for the world’s first nitrile exam glove

 Patent for nitrile exam held for over a decade

 Research, development, and production of nitrile exam gloves in the USA since 1990

1990

1995

2000

 Inventor of the world’s first nitrile accelerator-free exam glove (low dermatitis potential)

2012

 Invented ECO BEST TECHNOLOGY ®

 Launched the world’s first biodegradable nitrile exam glove

2010

 Additional 40,000 square foot expansion in 2022

2021

 Stood up two high speed monorail lines adding 400M glove capacity annually

 29 Chemotherapy Claims and Fentanyl Tested

2020

 510(k) for the Fayette, AL production facility

2020

2004

 Inventor of the world’s black nitrile elocstratic discharge glove

2018

 Expanded Eco Best Technology ® in all exam gloves

2019

 40,000 square foot expansion in Fayette, AL

BE THE FIRST TO BRING YOUR CUSTOMER A USA MADE EXAM GLOVE FROM A TRUSTED MANUFACTURER SINCE 1970.