REP-Sept19.pdf

vol.27 no.9 • September 2019

repertoiremag.com

Flu vaccine: Good to go for upcoming season Initial delays shouldn’t affect availability

Keeping the customer happy.

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SEPTEMBER 2019 • VOLUME 27 • ISSUE 9

Flu vaccine: Good to go for upcoming season Initial delays shouldn’t affect availability

PUBLISHER’S NOTE 3 Feet....................................................................................4

PHYSICIAN OFFICE LAB Sepsis Awareness What is sepsis? What level of public awareness is there?...................................................6

DISTRIBUTION

Tom Harris: A doer, not a talker Concordance executive retires after 43 years in the business.................................. 10

IDN OPPORTUNITIES

18 TRENDS

Wearables and the Supply Chain How do med/surg distributors fit in a world of wearable, digital devices?

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Contracting Executive Profile Lisa Thakur, CPA, MBA, FACHE, FHFMA, Corporate senior vice president, ancillary operations, Scripps Health, San Diego, California.................. 14

repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2019 by Share Moving Media. All rights reserved.

Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address.

POSTMASTER: Send address changes to Repertoire, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.

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SEPTEMBER 2019 • VOLUME 27 • ISSUE 9

HEALTHY REPS

HIDA INSIGHTS Back Orders and Shortages Erode Customer Trust

Industry workgroups focus on finding solutions....... 36

WINDSHIELD TIME

Automotive-related news................ 42

Health news and notes

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LEADERSHIP Decisions by Default The decisions you don’t know you’re making could be costing you................................. 50

REP CORNER

QUICK BYTES

On the Run

Technology news

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Tina Richter is passionate about sales, passionate about serving our nation’s veterans...... 52

INDUSTRY NEWS News........................................................................... 55

We go together like…

You play a vital role in B. Braun Medical’s success. And our success depends on each other. Thank you for supplying the products healthcare professionals critically need and making B. Braun a leading healthcare provider.

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PUBLISHER’S NOTE

3 Feet As you know, periodically I write about personal events. So please forgive me for this

Publisher’s Note. Last week, my youngest son, Nicolas Adams (who many of you will remember from the ad with the glove on his head), graduated from the University of North Georgia.

There are a few reasons why I share this information: 1. I’m a proud father (Duh) 2. My days of college tuition are over (Yes!) 3. The real reason – Rodney Bullard, vice president of corporate social responsibility at Chick-fil-a

Scott Adams

Bullard was the keynote for the commencement, and his speech made me think of distributor reps and the space we work in. Bullard told a story of a little lady (Ms. Adams, no relation) who changed his life as a 6-year-old boy. In elementary school, Bullard wasn’t reading at grade level, so Ms. Adams volunteered to tutor him the summer between first and second grade. He said as a 6 year-old it felt like a life sentence spending his summer with Ms. Adams reading. What he realized later was that Ms. Adams had given up her summer as well, and made a difference in his life.

From this story, Bullard pivoted to the students and their ability to change what he called the 3 feet around them. “We’re all superheroes within our own 3 feet,” he said. If you want to change the world, make an impact every day on your 3 feet. Think about the 3 feet that surround the 6,000 med-surg reps that read Repertoire Magazine each month. Think of the number of lives you touch. Think of the support and knowledge you bring your customers for new products, technology, and efficiency.

In my opinion, your 3 feet are as important to our nation’s health as anyone in healthcare.

Two final thoughts: Only you control your 3 feet, and thank you for everything you do daily! I am honored to be in an industry that saves and heals lives every day.

Dedicated to the industry, R. Scott Adams

repertoire is published monthly by Share Moving Media 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia; www.sharemovingmedia.com

editorial staff editor

vice president of sales

Katie Educate

keducate@sharemovingmedia.com (800) 536.5312 x5271

Mark Thill lthill@sharemovingmedia.com managing editor

Graham Garrison ggarrison@sharemovingmedia.com

sales executive - East

Lizette Anthonijs

Lizette@sharemovingmedia.com (800) 536.5312 x5266

editor-in-chief, Dail-eNews

Alan Cherry acherry@sharemovingmedia.com

sadams@ sharemovingmedia.com (800) 536.5312 x5256 founder

Brian Taylor

Subscriptions

www.repertoiremag.com/ subscribe.asp or (800) 536-5312 x5259

2019 editorial board Richard Bigham: IMCO Eddie Dienes: McKesson Medical-Surgical

btaylor@ sharemovingmedia.com

Joan Eliasek: McKesson Medical-Surgical

circulation

Doug Harper: NDC Homecare

Ty Ford: Henry Schein

art director

Laura Gantert

Mark Kline: NDC

Brent Cashman

lgantert@ sharemovingmedia.com

Bob Ortiz: Medline

bcashman@sharemovingmedia.com

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Keith Boivin: IMCO Home Care

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PHYSICIAN OFFICE LAB

Sepsis Awareness What is sepsis? What level of public awareness is there?

By Jim Poggi Sepsis is a word the medical community is becoming

more familiar with every year. And, while statistics point out that 65% of Americans know the word, only 1% of Americans can identify the symptoms. This figure is well below the number of Americans who can identify risk factors associated with heart disease, cancer and stroke.

Yet, there are more than 270,000 deaths associated with sepsis in the U.S. annually. Sepsis is recognized as the number one cause of hospital re-admissions and the single biggest contributor to hospital spending at over $24 billion annually. Sepsis is encountered, diagnosed and treated across the continuum of care including primary care, hospital ER and post-acute care rehabilitation centers.

Key sepsis advocacy groups are driving awareness Clearly there is work to do in education regarding sepsis to reduce morbidity and mortality as well as cost to the healthcare system. As a result, there is a large and increasing body of organizations involved in clinical and public awareness campaigns. Several organizations, including the CDC and major healthcare institutions such as the Mayo Clinic and others have created substantial amounts of clinician and public education materials regarding what sepsis is, how it can be prevented and signs and symptoms that can lead to the urgent need for medical attention. Some of these resources are footnoted at the end of this article.

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In addition, the Sepsis Alliance (https://www.sepsis.org/) sponsors a variety of educational materials and in 2012 created “Sepsis Awareness Month”, which is held annually in September. The Global Sepsis Alliance (https://www.global-sepsis-alliance.org/) is a non-profit organization that sponsors World Sepsis Day annually on September 13. In addition, the Global Sepsis Alliance offers a rich variety of educational materials on sepsis.

The Surviving Sepsis Campaign is a collaboration of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine and has resources available that include recommended diagnostic and treatment protocols and a range of educational materials. (http://www.survivingsepsis.org/Pages/default.aspx). As part of their advocacy campaign, they also actively support Sepsis Awareness Month.

What is the clinical definition of sepsis?

Sepsis itself is not a disease and it is not contagious. While its onset is a complication of an infection, sepsis is the body’s overwhelming and life-threatening response to the infection. As the body fights the infection, it produces chemicals to fight the infection. When these chemicals produce this overwhelming inflammatory response, sepsis is the result.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) (JAMA 2016; 315:

PHYSICIAN OFFICE LAB 801-10) defines sepsis as the development of systemic inflammatory response syndrome (SIRS) in addition to a documented or presumed infection.

pneumonia, influenza and meningitis are considered especially effective in limiting the spread of organisms known to be implicated in development of sepsis.

Which infections cause it?

Who is more susceptible to sepsis?

Sepsis can be caused by a wide range of bacteria, viruses, and fungi. Bacteria are the most common cause, with respiratory, skin, urinary tract and GI infections all known to lead to sepsis.

Unfortunately, it’s the usual folks: children under 1 year of age, the elderly, people with chronic diseases including respiratory and heart disease and those with compromised immune systems.

What are the key symptoms of sepsis?

Is sepsis seasonal?

Abnormal temperature (either high or low), evidence of infection, elevated heart and/or respiratory rate, decreased urine output and a high (>12,000) or (<4,000) low white blood count. The patient often presents with mental confusion and may report that they feel ill enough to die.

Yes, it is. While sepsis is a major health concern yearround, incidence of sepsis peaks during the months when respiratory illnesses peak, due to the higher incidence of pneumonia and influenza cases at that time of year.

How is it diagnosed? What is new?

Patients that present with the clinical signs and symptoms above are also evaluated utilizing several lab tests, including CBC, lactate and procalcitonin. Recently, monocyte distribution width has received clearance as an early sepsis indicator. While there is no single lab test that conclusively diagnoses sepsis by itself, the number of available tests is increasing, and their speed, sensitivity and specificity are improving our ability to effectively diagnose sepsis quickly and confidently.

How is sepsis treated?

According to a variety of expert clinical sources, the key to successful treatment is speed in diagnosing and identifying the condition as sepsis followed by aggressive treatment with antibiotics and supportive fluid replacement therapy. Timely diagnosis and watchful patient management are critical elements of saving lives and reducing the incidence of post-sepsis complications.

What is the role of prevention and immunization for sepsis?

We know prevention is critical for any infection, and sepsis is no exception. Proper hygiene is important. Immunization for

What is the patient impact?

Acutely, sepsis causes over 270,000 deaths in the U.S. alone each year. Its complications can lead to loss of extremities due to reduced circulation. Post sepsis complications occur in approximately 30% of cases and include a variety of physical, mental and affective symptoms including muscle weakness, fatigue, mental confusion and difficulty sleeping.

How can you learn more and even get involved in sepsis awareness events?

All advocacy groups agree that increasing awareness in the healthcare community and the public is an important element to preventing deaths and post sepsis complications. With sepsis diagnosed for more than 1.7 million patients annually, every U.S. community is impacted by it. As medical surgical account managers and members of our community who serve the health care community, we and our suppliers are in a position to help lead discussions and awareness in our community. To make it even easier, many advocacy groups provide templates for education and even communitybased activities. Some of the links below will help you learn more about the kind and variety of ways to become involved in this important health care issue.

Get involved; make a difference.

CDC web site: https://www.cdc.gov/sepsis/index.html Sepsis Alliance web site: https://www.sepsis.org/ Sepsis awareness month: September: https://www.sepsis.org/sepsisawarenessmonth/ World sepsis day: https://www.worldsepsisday.org/ World Sepsis Day toolkits: https://www.world-sepsis-day.org/toolkits/ Surviving sepsis campaign: http://www.survivingsepsis.org/Pages/default.aspx

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DISTRIBUTION

Tom Harris: A doer, not a talker Concordance executive retires after 43 years in the business Ask a veteran of medical sales to name the most important trait or charac-

teristic of a high-quality sales rep, and you might expect answers like “persistence,” “responsiveness,” or “a service orientation.”

Ask Tom Harris, and you’ll get a quote from British novelist Jane Austen: “It’s not what we say or think, but what we do that defines us.” Perhaps not a surprising response from someone with a master’s degree in social psychology.

Tom Harris

“ It’s like anything in life. You have options. You try to do the right thing. And you usually win.”

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Harris retired this summer as CEO emeritus of Concordance Healthcare Solutions.

Born and raised in Chicago, Harris joined the family business – Harris Hospital Supply – in 1976. (His grandfather, William Harris, had founded the company during World War II.) “Right out of graduate school, I didn’t know what the heck I wanted to do,” he says. “And 43 years later, here we are.”

They were an interesting 43 years, though, he says. “I was fortunate in that my career was constantly changing. It was timing, to some degree.”

Harris was named CEO of Harris Hospital Supply in 1986. In 2003 he joined other investors in acquiring St. Louis-based Midwest Medical Supply (later named MMS—A Medical Supply Company), and moved his family to St. Louis. Three years later, MMS acquired the Caligor Hospital and Extended Care divisions of Henry Schein. In 2016, MMS, Kreisers and Seneca Medical merged to form Concordance Healthcare Solutions, for which Harris served as coCEO with Roger Benz.

“There was always some kind of new challenge, and that’s half the fun of a career,” he says. “Thirty-four years ago, as CEO of a $10-$12 million distributor in Chicago, I never expected to be co-CEO of a $1.3 billion company. It was a great way to cap my career.”

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DISTRIBUTION But back to that question: What’s the most important trait of a high-quality sales rep?

“In any sales position – which I was in for many years – you’ve got lots of choices. There’s what best for me, individually. There’s what’s best for the company – and that had a different twist for me, as a family member. And there’s what’s best for the customer. Those can be conflicting thoughts.

“But it’s like anything in life. You have options. You try to do the right thing. And you usually win.”

Harris comes well-prepared for the challenges of retirement. When asked about the most important thing(s) one can do to prepare for a successful retirement, he answers, simply, “Stay healthy. Maintain a positive attitude and a sense of humor.”

Farewell to a friend Reprinted from a Concordance Healthcare Solutions blog by Christy Coppus, marketing director, June 26, 2019, marking Tom Harris’ retirement on June 30.

With June 30 being Tom [Harris’] official last day as a full-time employee of Concordance, we take a look back at all he has contributed to the creation of our company and to the healthcare distribution industry throughout his 43 years in the business.

Without Tom’s leadership and vision, Concordance would not be what it is today; his dedication and commitment to our company and our employees is something that we are truly grateful for.

Earning his Bachelor of Science and Master of Art in Social Psychology at Texas Christian University (TCU), Tom spent his college career working hard in the classroom and on the tennis court. He played Division 1 tennis for TCU and made sure to fit some fun into his schedule throughout the years.

After graduation in 1976, Tom returned to his hometown of Chicago and began a successful career in the family business, Harris Hospital Supply.

Starting first as a sales rep, Tom was promoted to director of sales in 1983, and that November he married his beautiful wife, Mary. With a growing company and a growing family, Tom was appointed president and CEO of Harris Hospital Supply in 1986 and also served on the Illinois Masonic Medical Center Foundation Board and as a Chairman of the Healthcare Materials Corporation (HCM).

After 20 years with the family company, Tom branched out and joined a group of St. Louis investors and together they bought Midwest Medical Supply (MMS). Continuing his position as CEO of Harris, he now also held the title of executive vice

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president of MMS and was one of two managing members of the newly acquired company. In 2003, Tom officially merged the two organizations together when he announced the sale of Harris Hospital Supply to MMS, at which time he relocated from Chicago to St. Louis with his family.

Through the moves, mergers and acquisitions of other small medical supply companies, Tom remained a steadfast leader for MMS. In 2016, MMS merged with Kreisers and Seneca Medical to create a near-national distributor. With the vision and direction of Tom, along with his counterpart, Roger Benz, and the members of the operating board, Concordance was officially created.

Tom served as co-CEO beside Benz for the first three years of Concordance, helping to pave the way for the bright future our company holds. We are now home to over 1,200 employees, with 20 distribution centers across the country and continued growth for our locations on the horizon.

We serve the entire care continuum with the same dedication and hard work that Tom has committed to this company over the last 43 years.

Now living full time in sunny Florida, Tom will be enjoying his retirement with his wife. We are happy to know that, while he will no longer be our CEO, Tom will remain a member of our Senior advisory board and have a hand in steering Concordance through the years to come, making sure we are always upholding the values that the company was founded on.

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IDN OPPORTUNITIES

Contracting Executive Profile Lisa Thakur, CPA, MBA, FACHE, FHFMA, Corporate senior vice president, ancillary operations, Scripps Health, San Diego, California Lisa Thakur is responsible for an-

cillary services and business at Scripps Health, such as home health, laboratory, imaging and other business services. She holds a bachelor’s degree in business administration from the University of Washington, and a master’s of business administration from Arizona State University. She is a Certified Public Accountant (CPA) and a member of the American Institute of Certified Public Accountants. Prior to joining Scripps Health, she worked as a finance and business manager at Good Samaritan Medical Center in Phoenix. She also managed financial operations and human resources for Freedom Plaza Retirement Center/ Care Center in Peoria, Arizona.

In 1998 Thakur joined Scripps Memorial Hospital La Jolla, where she was chief financial officer and then chief operating officer. In 2013, she was one of four site executives tapped to move Scripps toward a horizontal, matrixed organizational structure. As corporate vice president of clinical and support services, she assumed system responsibility for supply chain, endoscopy, perioperative services and pharmacy, bringing new system alignment to these functions, which resulted in cost savings of $130 million over six years.

Born and raised in Seattle, Washington, she has two teenage boys, ages 17 and 19.

Lisa Thakur

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IDN OPPORTUNITIES About Scripps Health Founded in 1924 Scripps Health treats more than 750,000 patients annually at its five acute-care hospital campuses, home health care services, 28 outpatient centers and clinics and hundreds of affiliated physician offices. Scripps is also at the forefront of clinical research and has three graduate medical education programs.

Repertoire: Can you describe the most challenging and/or rewarding supply-chain-related project in which you have been involved in the past 12-18 months?

Lisa Thakur: Setting up and leading a new value analysis team. Traditionally, when IDNs speak about value analysis, they are referring to consolidating implant vendors or improving the way they manage new-product requests. We wanted to revamp value analysis and place supply chain in the middle of it. And we have done so. Today, our contracting team and I meet with physicians to analyze new products or standardization opportunities. Typically, a nurse and a data analyst also attend, so we can discuss clinical evidence, utilization and potential contracting strategies.

Supply Chain has gone from having folks question what we were doing and why we were doing it, to becoming one of Scripps’ top-four strategic objectives for the past two years, with amazing results.

Repertoire: Please describe a project you look forward to working on in the next year.

Thakur: Scripps Health recently implemented a new leadership structure in which physicians have oversight over the medical quality and operational efficiency at each of our five hospital campuses in a new Physician Operating Executive (POE) role. Supply Chain is partnering with these new physician leaders on value analysis projects that identify areas of practice variation, utilization opportunities, and overall cost reduction strategies, but that also maintain or improve quality and the patient experience.

Repertoire: How have you improved the way you approach your profession in the last five to 10 years?

Did you have any help doing so, or was there any particular incident that was particularly significant?

Thakur: I have focused more on working directly with physicians and trying to better understand their perspectives. I started presenting potential options to them and then asking them to decide on priorities. I strategize more on what can be done and prioritize based on increasing levels of difficulty.

“ Traditionally, when IDNs speak about value analysis, they are referring to consolidating implant vendors or improving the way they manage new-product requests. We wanted to revamp value analysis and place supply chain in the middle of it.”

It’s a different type of approach – one that has called for adjustment on our side and that of our physicians.

Supply chain provides the physicians with a menu of options, including potential financial and clinical outcomes of their decisions, but leave the ultimate decisionmaking to the physicians. Our physicians have come to respect the unique expertise and skill that the supply chain team brings to the table; they trust us as well as their own decision-making capabilities.

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Repertoire: In your opinion, what will be some of the challenges or opportunities facing the next generation of supply chain professionals? What should they be doing now to prepare to successfully meet those challenges and opportunities?

Thakur: Supply chain folks need to get out and work directly with physicians as true partners, and not just tell them what the priorities are. They need to focus on more than just sourcing and standardization, but also utilization. Also, having nurses work in supply chain to bridge the gaps between clinical and supply chain is an imperative.

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Flu vaccine: Good to go for upcoming season Initial delays shouldn’t affect availability Despite some initial delays, supplies of flu vaccine for

the 2019-2020 season are expected to be more than adequate to meet demand. Its effectiveness, however, will only be measured at the end of the season, as it must be every flu season.

“As of now, it looks like there will be enough flu vaccine available from all manufacturers to meet patient demand,” says Bill Smith, president of Main Street Vaccines, An NDC Company. “The last several seasons, supply has outpaced demand in the marketplace. “[As of mid-July], Sanofi Pasteur announced a three-to-four-week delay in shipping commitments, with partial shipments beginning in late August or September, and all shipments completed by the end of November. The reason they cited for this delay is that the World Health Organization and the FDA delayed selection of the A/H3N2 strain by one month. Historically, though, even when delivery delays occur, it has not impacted the overall supply to the market.

“It will be important for distributor reps to work with their customers to help them plan their immunizations and clinics when vaccine is available.”

“Manufacturing could not begin until the selection was made by WHO and confirmed by the FDA,” said Michael Szumera, head of Sanofi Pasteur U.S. communications, responding to Repertoire by email in midJuly. (Sanofi manufactures Fluzone Quadrivalent and

High-Dose vaccines, as well as Flublok Quadrivalent, a recombinant, protein-based flu vaccine for persons 18 and over.)

“We are still on track to produce approximately 70 million doses of seasonal vaccine to support nationwide immunization campaigns,” he said. “At this time, we anticipate a slight delay of approximately one month in

“ We are still on track to produce approximately 70 million doses of seasonal vaccine to support nationwide immunization campaigns.

At this time, we anticipate a slight delay of approximately one month in the first shipment of our vaccine, which will be the case across all manufacturers. Shipping of our products will begin in mid-August, with all shipments completed by the end of November.”

– Michael Szumera, head of Sanofi Pasteur U.S. communications

the first shipment of our vaccine, which will be the case across all manufacturers. Shipping of our products will begin in mid-August, with all shipments completed by the end of November.”

An AstraZeneca spokesperson told Repertoire in mid-July that it is likely there may be lower total amounts of vaccine available than the company had anticipated.

AstraZeneca makes the FluMist® Quadrivalent intranasal flu vaccine.

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Flu Vaccine What’s in a flu vaccine?

Three different influenza vaccine production technologies are approved by the U.S. Food and Drug Administration: •E gg-based flu vaccine. The most common way that flu vaccines are made is using an eggbased manufacturing process, which has been used for more than 70 years. Egg-based vaccine manufacturing is used to make both inactivated (killed) vaccine (usually called the “flu shot”) and live attenuated (weakened) vaccine (usually called the “nasal spray flu vaccine”).

• Cell-based flu vaccine. In 2012 the FDA approved a cell-based production process for flu vaccines. At one time, this production process also began with egg-grown Candidate Vaccine Viruses (CVVs), per FDA regulations.

However, on August 31, 2016, FDA issued an approval for Seqirus, the sole FDA-approved cell-based flu vaccine manufacturer in the United States, to use cell-grown CVVs. Cell-

based flu vaccine production does not require chicken eggs because the vaccine viruses used to make vaccine are grown in animal cells. Cell culture technology has the potential for a faster start-up of the flu vaccine manufacturing process.

• Recombinant flu vaccine. Approved for use in the U.S. market in 2013, this production method does not require an egg-grown vaccine virus and does not use chicken eggs in the production process. Instead, manufacturers isolate a certain gene (the hemagglutinin or “HA” gene) from a naturally occurring (“wild type”) recommended vaccine virus.

This HA gene is then combined with portions of another virus that grows well in insect cells. This “recombinant” vaccine virus is then mixed with insect cells and allowed to replicate in these cells. The flu HA protein is then harvested from these cells and purified.

Source: Centers for Disease Control and Prevention

“Following the WHO’s recommendations, it takes approximately six to eight months to produce and approve the full global supply of influenza vaccines,” said the spokesperson. “The WHO’s recommendation of A/ H1N1 and A/H3N2 strains for inclusion in the 20192020 FLUMIST® QUADRIVALENT formulation have yielded lower amounts of potential doses. Lower yields do not impact the quality of the vaccine, but may result in a lower total amount of vaccine available.”

WHO’s recommendation may lead to delayed delivery of all influenza vaccines, the spokesperson added.

“To ensure availability of high-quality product as soon as possible, deliveries of FLUMIST QUADRIVALENT will be spread across the flu season, as opposed to being concentrated in the initial months of the season.”

How effective?

The most common way flu vaccines are made is using an egg-based manufacturing process that is more than

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70 years old. New methods may prove to be more efficient, including cell-based production and recombinant vaccines.

But effectiveness can vary year to year, based on the flu strains that are circulating, says Smith. “Unfortunately, if the virus mutates during the season, as we have seen happen in the past, this can decrease overall effectiveness of the flu shot.”

The past season’s flu vaccine, for example, was only about 30% effective overall, and ineffective against a latesurging strain, reports the CDC. Even so, CDC says that last season’s flu vaccine provided protection against a substantial number of illnesses, hospitalizations and deaths, says Szumera of Sanofi Pasteur.

“Flu viruses are constantly changing, and vaccine effectiveness is often impacted by naturally occurring strain drift,” he says. “However, many studies have found that even in seasons when flu vaccines provide lower protection against infection, they still provide substantial reductions in outcomes such as hospitalizations and death. CDC and other health officials continue to encourage people to get a flu shot every year.”

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Flu Vaccine A vote of confidence for nasal spray this flu season The American Academy of Pediatrics this spring advised families to vaccinate their children against influenza this season with either the flu shot or the nasal spray vaccine for the best protection against the virus during the 2019-2020 flu season.

The recommendation differs slightly from last year, when AAP cited a preference for the injected vaccine over the nasal spray – except in cases where a child refused the shot – based on questions about the effectiveness of the nasal spray in previous seasons.

The AAP Board of Directors approved both options after reviewing the latest data on the inactivated vaccine (IIV), which is injected,

and the quadrivalent live attenuated influenza vaccine (LAIV4), which is a nasal spray given to healthy patients ages 2 through 49.

AAP did not recommend the nasal spray during the 2016-17 and 2017-18 flu season since the spray did not work as well against influenza A/H1N1 strain during the 20132014 and 2015-2016 flu seasons. In 2017 the manufacturer of the nasal spray made changes to the formulation to include a new A/H1N1 strain, and this year infectious disease experts are encouraged by new data from Great Britain that – while dependent on a limited number of cases in other countries – supports the spray’s effectiveness against some strains of influenza.

Meet the 2019-2020 flu vaccine The composition of U.S. flu vaccines is reviewed annually and updated as needed to match circulating flu viruses, according to the Centers for Disease Control and Prevention. Flu vaccines protect against the three or four viruses (depending on the vaccine) that research suggests will be most common. For 2019-2020, trivalent (three-component) vaccines are recommended to contain: • A/Brisbane/02/2018 (H1N1)pdm09-like virus (updated).

• A/Kansas/14/2017 (H3N2)-like virus (updated).

• B/Colorado/06/2017-like (Victoria lineage) virus.

Quadrivalent (four-component) vaccines, which protect against a second lineage of

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B viruses, are recommended to contain the three recommended viruses above, plus B/ Phuket/3073/2013-like (Yamagata lineage) virus.

The World Health Organization (WHO) made the selection of the H1N1 and both B components for 2019-2020 Northern Hemisphere flu vaccines on February 21, and at that time decided to delay the decision on an H3N2 vaccine component. FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) also selected the H1N1 and B components at their first meeting on March 6, but also decided to postpone the selection of the H3N2 component. WHO selected the H3N2 component listed above on March 21, 2019.

VRBPAC chose the same H3N2 component for U.S. vaccines on March 22, 2019.

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Flu Vaccine

Flu testing: Short term, long term Repertoire asked three manufacturers of influenza tests to offer their views on testing for the 2019-2020 season

and beyond, and the impact on distributor sales reps. They were: •T ammi Ranalli, vice president of marketing, North America, Quidel. Quidel offers a continuum of influenza testing solutions from rapid immunoassays to molecular tests: Solana Influenza A+B; Solana RVP (Influenza A+B, and RSV + hMPV); Sofia Influenza A+B for use with Sofia and Sofia 2; and QuickVue Influenza A+B.

• Jonathan C. Overbey, corporate alliances and channel management, Sekisui Diagnostics. Sekisui has three product lines for flu testing: Silaris™ Influenza A&B Test; OSOM Ultra Flu A&B Test; and Acucy, a lateral flow flu test which provides results using a reader.

Repertoire: Where are the majority of flu tests being performed today? Do you foresee that changing in the next five years?

Tammi Ranalli: Historically, the majority of flu testing has been performed in doctors’ offices. Primary care practices tend to be the first line of defense for patients of all ages. Today, this behavioral trend hasn’t shifted, with research data showing volume of flu tests performed at doctors’ offices outnumbering those at hospitals by almost two to one (GHX Data Q1 2019).

It’s worthwhile to note the rise of retail clinics and urgent care centers, where the promise of a quick turnaround time and convenience attracts many patients. We anticipate this growth trend will continue in the next five years and beyond, as the busy population demands convenience and speed without sacrificing quality of care. According to industry data, millennials and busy parents are the core demographics utilizing retail clinics and urgent care centers, and we see them driving the growth of this segment.

Jonathan Overbey: As of today the largest share of flu tests are being performed in doctors’ offices and retail

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• Raquel V. Beckett, MBA, U.S. marketing manager, Point of Care, BD Diagnostic Systems. BD offers the BD Veritor™ System and the BD Veritor™ Plus System.

clinics. The hospital market tests a lot too, but the larger volume is in the POL/retail space. We expect retail clinics, urgent care clinics and even pharmacies to grow significantly over the next few years, driven by a desire on the part of patients for convenient hours and affordable care.

Flu testing may or may not move to the OTC space, but there will be more CLIA-waived testing available to the patient/consumer in the future.

Raquel V. Beckett: Currently volume is mostly done in doctors’ offices, followed by hospitals, followed by retail and urgent care clinics. We expect retail clinics, urgent care clinics and even pharmacies to grow significantly over the next few years driven by a desire from patients for convenient hours and affordable care Repertoire: Any thoughts about the upcoming 2019-2020 flu season that might be of particular interest to Repertoire readers and their customers?

Ranalli: For the upcoming flu season, it’s always challenging to predict exactly what the U.S. will see, which is why we enabled our Sofia and Solana platforms with Virena, a

HIPAA-compliant patient de-identified infectious disease tracking and data management system that allows our customers to monitor flu outbreaks on both a local and national level.

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Overbey: We look at several indicators to try and predict the upcoming flu season. One data point is flu activity in the Southern Hemisphere as they enter the fall/winter season during our summertime. As of [mid-July], the flu season in Australia and New Zealand was very active and strong, which could indicate a strong season for us. We also look at the effectiveness of the year’s flu vaccine. Last year’s flu vaccine was around 30% effective and didn’t address the H3N2 strain, which drove more illness and hence more testing. These two indicators should have us plan on another long and strong flu season in 2019-2020.

“I think we will see a split in flu testing methods by channel. There is significant pressure to provide fast, accurate and reliable testing at reasonable costs with convenient hours for most patients, while those patients requiring extra care with chronic conditions will seek more specialized diagnosis and treatment.”

– Raquel V. Beckett, MBA, U.S. marketing manager, Point of Care, BD Diagnostic Systems

Beckett: Monitor flu trends in Australia and Asia, as these tend to be indicators of what we can expect for our flu season in North America.

Repertoire: Your thoughts about the future of flu testing and its impact on Repertoire readers and their customers?

Ranalli: We see healthcare, as a whole, shifting closer to the patient, and flu testing is part of that overall dynamic.

Historically, our focus and our strength as a company has been on innovating to serve the needs of patients and healthcare workers in the decentralized, point-of-care segment of the marketplace, so we’re excited about the opportunities there.

A lot hinges on having the right needles. That’s why Terumo’s SurGuard®3 offers some very convincing benefits.

Sharper – Patients benefit from a more comfortable injection, as our needles are 10%* sharper than the market leader and sharpest on average among major brands Safer – Safety mechanism includes a lock for both the needle and the hub, and is designed to minimize the ability to be removed Smarter – Clinicians can choose how they activate the safety mechanism using their finger, thumb or hard surface as dictated by the clinical situation We make some great points. Whatever you’re looking for in a safety needle, SurGuard®3 from Terumo has you covered. For more information, call Terumo at 800-888-3786 or visit terumotmp.com to find your Terumo representative.

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All rights reserved. PM-00628. *Data on file. Terumo Medical Products, April 2016.

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Flu Vaccine “ As of today the largest share of flu tests are being performed in doctors’ offices and retail clinics. The hospital market tests a lot too, but the larger volume is in the POL/retail space. We expect retail clinics, urgent care clinics and even pharmacies to grow significantly over the next few years, driven by a desire on the part of patients for convenient hours and affordable care.”

– Jonathan C. Overbey, corporate alliances and channel management, Sekisui Diagnostics

Overbey: Flu testing is quickly moving to reader-based and molecular testing methods. The FDA has sent a clear message (i.e., the 2018 flu reclassification) that only the most sensitive and accurate testing methods will remain on the market. Molecular methods are the future because these tests are confirmatory, which means you only have to test one time; there is no need to back up any negative results from other methods.

Beckett: I think we will see a split in flu testing methods by channel. There is significant pressure to provide fast, accurate and reliable testing at reasonable costs with convenient hours for most patients, while those patients requiring extra care with chronic conditions will seek more specialized diagnosis and treatment.

OTC flu tests?

Healthcare providers administer flu tests in physicians offices, retail clinics, even drug stores. Will they ever be available over-the-counter? At least two companies are working on it.

In July 2018, Lucira Health (then named Diassess) reported it was awarded a contract with the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary of Preparedness and Response at the U.S. Department of Health and Humans Services. The contract established a partnership to advance development of its flu diagnostic technology for use in physician offices and eventually in consumers’ homes, according to the company.

Emeryville, California-based Lucira says that its flu-diagnostic technologies give a highly accurate diagnosis within 20 minutes.

Beginning with a nasal swab, the sample is inserted into a disposable DNA test. The batterypowered device analyzes the sample, and a digital readout indicates either influenza A, B, or a negative diagnosis. The in-home version will use a smartphone application to directly

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connect the consumer to treatment options, the company said.

Also in July 2018, San Diego-based Cue Health announced it had been awarded up to $30 million in base funding and options from BARDA to accelerate the development and regulatory validation of an over-the-counter and professional use Influenza and Multiplex Respiratory Pathogen diagnostic cartridges for the Cue Health Monitoring System.

The system uses a reader to test clinical samples in a disposable test cartridge and then sends the results to a mobile application. The mobile application is said to provide access to features including interventional components such as telemedicine consultations for consumers and prescribing capabilities for physicians.

The Cue Influenza Cartridge will be focused on detecting Influenza A and B. The Cue Multiplex Respiratory Pathogen Cartridge will be a multiplex assay capable of detecting and differentiating between multiple respiratory pathogens.

Attempts by Repertoire to reach Cue Health and Lucira Health were unsuccessful.

Flu Season Facts The 2018-19 flu season was moderate, but the longest lasting season in 10 years. And moderate though it may have

been, it still resulted in somewhere between 36,000 and 61,000 deaths in the United States. (The data is still being analyzed.)

Here’s what the Centers for Disease Control and Prevention says about this past flu season.

•T he 2018-19 influenza season was a moderate severity season with two waves of influenza A activity of similar magnitude during the season: A(H1N1) pdm09 predominated from October 2018 to midFebruary 2019, and A(H3N2) activity increased from mid-February through mid-May. • Nationally, influenza-like illness activity began increasing in November (2018), peaked during midFebruary (2019), and returned to below baseline in mid-April (2019). The season lasted 21 weeks, making it the longest season in 10 years.

• During October 1, 2018–April 30, 2019, a total of 18,847 laboratory-confirmed influenza-related hospitalizations were reported (cumulative incidence for all age groups = 65.3 per 100,000 population).

The overall peak occurred during the week ending March 16, 2019 (week 11). The hospitalization rate was highest among persons aged ≥65 years, who accounted for approximately 47% of reported influenza-associated hospitalizations.

• Using data available from October 1, 2018, to May 4, 2019, CDC estimates that influenza virus infection has caused 37.4 million–42.9 million symptomatic illnesses; 17.3 million–20.1 million medical visits; 531,000–647,000 hospitalizations; and 36,400–61,200 deaths in the United States.

• T he 2019-2020 vaccine recommendations; WHO and the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory

Committee made the influenza vaccine composition recommendation for the United States. Both agencies recommend that influenza trivalent vaccines contain an A/Brisbane/02/2018 A(H1N1) pdm09-like virus, an A/Kansas/14/2017 A(H3N2)-like virus, and a B/Colorado/06/2017like (B/Victoria lineage) virus. The quadrivalent vaccine recommendation included the trivalent vaccine viruses and a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

• Complete medical chart abstraction data in FluSurvNET were not expected to be finalized until later in 2019; however, as of June 13, 2019, data were available for 7,531 (40.0%) hospitalized adults and children with laboratory-confirmed influenza. Among 6,399 hospitalized adults with information on underlying medical conditions, 92.6% had at least one reported underlying medical condition that placed them at high risk for influenza-associated complications. The most commonly reported underlying medical conditions among adults were cardiovascular disease (45.0%), metabolic disorders (42.9%), obesity (39.4%), and chronic lung disease (29.9%). Among 1,132 hospitalized children with such information, 55.0% had at least one underlying medical condition; those most commonly reported were asthma (27.1%) and neurologic disorder (14.7%). Among 759 hospitalized females aged 15–44 years with information on pregnancy status, 152 (28.7%) were pregnant.

Source: CDC Morbidity and Mortality Weekly Report, June 21, 2019

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TRENDS

Wearables and the Supply Chain How do med/surg distributors fit in a world of wearable, digital devices?

The names are new: AliveCor, Empatica, EnLiSense,

Nemaura, VivaQuant.

The technologies are new: KardiaMobile, Embrace2, the SWEATSENSER and the sugarBEAT® continuous glucose monitor.

And so are the questions being raised about wearables: • How accurate are they?

• Will they alter the way chronic disease is managed?

• Who will pay for them – insurers, patients, providers?

• How will they pay for them – e.g., outright purchase, rental/lease, subscription?

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Investors, patients, payers and doctors are asking such questions. Med/surg distributors should probably do the same.

“As part of a subscription-based service, we do not see the role of traditional distributors,” Nemaura Medical CEO Faz Chowdhury told Repertoire in an email.

Following is a look at three companies developing wearables, and their plans on how to bring them to the U.S. market.

Nemaura Medical In July, Nemaura Medical (Loughborough, England) submitted a De Novo 510(k) medical device application to the

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TRENDS U.S. Food and Drug Administration for its sugarBEAT non-invasive continuous glucose monitor. Less than two months earlier, in May, the company had received CE Mark approval to market and sell the device throughout the European Union.

SugarBEAT consists of a daily, disposable adhesive skin patch connected to a small rechargeable transmitter, connected via Bluetooth to a mobile application, which displays glucose readings at five-minute intervals throughout the day.

Passing a mild electric current across the skin, sugarBEAT draws a small amount of glucose molecules out of the interstitial fluid, which sits just below the top layer of skin, into a chamber within the patch. The transmitter measures the glucose levels in the chamber, then transmits the reading.

“We believe sugarBEAT is best positioned to conquer this market – of over 25 million diabetics in the U.S. – where we have a sensor that can be worn on intermittent days/ periodic intervals, with a view to enhancing patient training/ coaching to change lifestyle, diet, etc., says Chowdhury, who holds a masters degree in microsystems and nanotechnology, and a doctorate in nanomedicine and drug delivery.

“In the UK the NHS is currently funding ‘Apps’ with subscription-based services to help pre-diabetics avoid becoming diabetic and Type 2s to go into remission, in order to save on the long-term socioeconomic costs,” he says. “We believe governments and healthcare providers around the world will increasingly adopt this stance.

“We have already seen what Livongo is achieving with mainly coaching, and more recently with the use of a 14-day invasive sensor,” says Chowdhury. “SugarBEAT can provide a superior level of service at a significantly reduced price (since sensors will only be used infrequently), therefore penetrating a far deeper patient pool.

We believe for these reasons, sugarBeat is positioned for the type 2 market.”

“ Since our platform is 100% noninvasive and diagnostic, we expect it to be a Class II FDA device that can be made available OTC when we bring it to market.”

– Sriram Muthukumar, CEO, EnLiSense

Questions remain as to how sugarBEAT will be marketed and sold. Will it be available only by prescription?

Will people with diabetes buy the device directly from the company? Will they rent them? If so, from whom?

“Yet to be determined,” says Chowdhury. “But all of the above are anticipated options, as part of subscriptionbased services that offer much more than just the device.”

For members only Technology companies aim to tie patients and consumers tightly to them, disrupting conventional relationships.

For example, in the world of subscriptionbased services, “patients” are considered “members” by companies such as Mountain View, California-based Livongo. The company develops technology to help people – members – manage hypertension, diabetes, weight management and behavioral health.

“Livongo’s team of data scientists aggregate and interpret substantial amounts of health data and information to create actionable, personalized, and timely insights and nudges delivered

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to our members to help them stay healthier,” says the company on its website. In fact, when glucose readings are out of range, a Livongo “diabetes response specialist” may call or text the member to alert them to take action.

“Our smartwatch integration allows us to capture information from our Members, add it to our AI+AI engine, and return actionable, personalized, and timely information back to them,” said Livongo President Jennifer Schneider, M.D., M.S., in a press release. “By offering another way to access personalized health insights, we are able to more easily influence positive behavior change, which we know can lead to better health.”

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TRENDS Companies are coming hard and fast into the wearables arena. Here are a few of the more recent entrees.

Company

Product

Dollars/cents

AliveCor (Mountain View, California)

KardiaMobile 6L, six-lead personal ECG device. FDA clearance May 2019

Patient purchases bundle from AliveCor when setting up the Kardia app. (One-year connection.) Physician practice bills insurance every 30 days for remote patient monitoring.

Bloomlife (San Francisco, California)

Smart Pregnancy Tracker (launched in 2017) for contraction tracking. Company intends to submit an enhanced product, Bloomlife Plus, for regulatory approval in late 2019. Bloomlife Plus would detect early labor onset.

Smart Pregnancy Tracker is available by weekly subscription ($20).

Bloomlife Plus has not been submitted to FDA yet.

Empatica, Cambridge, Massachusetts

Embrace2: FDA-cleared wristband detects patterns associated with tonic-clonic epileptic seizures in patients 6 years and over.

Prescription necessary.

$249 plus subscription plan (starting at $9.90 per month and rising based on number of caregivers who receive alerts).

EnLiSense, Allen, Texas

SWEATSENSER Dx platform technologies: Uses sweat to detect early warning of changes to body’s physiological state (infection).

Not available

Nemaura Medical (Loughborough, England)

SugarBEAT® continuous glucose monitor; FDA De Novo application filed July 2019

Will be subscription-based. Company says daily price is expected to be comparable to cost of using glucose meters and strips.

Omron Healthcare (Lake Forest, Illinois)

HeartGuide™ wristwatch: Wearable oscillometric wrist blood pressure monitor. Cleared

by FDA December 2018.

List price: $499. Complimentary access to HeartAdvisor, corresponding mobile app.

Verily (South San Francisco, California)

Study Watch: FDA cleared as Class II medical device (Jan 2019) for its on-demand ECG feature. Prescription only.

Not available

VivaLNK (Campbell, California)

Vital Scout: ECG monitoring device

Wellness monitor $149 (online).

Four adhesives: $5.99.

VivaQuant (St. Paul, Minnesota)

RX-1 identifies and reports cardiac arrhythmias. FDA clearance April 2019.

Not available

EnLiSense EnLiSense’s SWEATSENSER Dx platform uses passively expressed sweat to detect biomarkers related to various diseases, CEO Sriram Muthukumar told Repertoire in an email. “It can report levels in real-time and at low levels and therefore can be applied for pre-symptomatic situations. We have to date been able to establish detection of biomarkers for diabetes, infections, and immunological diseases.” EnLiSense is located in Allen, Texas.

“Since our platform is 100% non-invasive and diagnostic, we expect it to be a Class II FDA device that can

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be made available OTC when we bring it to market,” said Muthukumar. The company intends to sell it to patients and users through healthcare providers, pharmacies and commercial channels, such as Amazon. The company would not share how it intends to price the device.

In late 2018, EnLiSense was one of three companies to receive research and development funding from DRIVe, that is, the Division of Research, Innovation and Ventures, which was established by BARDA (the Biomedical Advanced Research and Development Authority), part of the Assistant Secretary for Preparedness

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and Response within the U.S. Department of Health and Human Services.

(The other two companies receiving DRIVe funding were Petach Tikva, Israel-based Biobeat and San Francisco-based Spire. Biobeat’s wristwatch has been cleared by the FDA for monitoring blood pressure, heart rate, oxygen saturation, respiratory rate, stroke volume, cardiac output, sweat, skin temperature and other factors, under a technique known as reflective photoplethysmography.

Spire Health is a developer of the Spire Health Tag, a wearable device that monitors real-time bio-signals, like breathing, heart rate, heart rate variability, activity and other changes in the health signatures of the user’s health data. A companion app sends notifications to the user’s cell phone that could potentially be used to alert users to impending illnesses before they strike.)

Bloomlife The Smart Pregnancy Tracker from San Francisco-based Bloomlife is designed for simplified contraction tracking

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and is not intended for diagnostic purposes, Eric Dy, CEO and co-founder, told Repertoire in an email. “The technology combines a discrete wearable patch with data analytics to provide moms with a convenient and accurate way to automatically track and time contractions. This information provides reassurance to moms, helps them more easily communicate with their care team, and make more informed decisions toward the end of pregnancy.”

The device is available for rental from the Bloomlife website for $20 a week.

Bloomlife intends to submit an enhanced product – Bloomlife Plus – for FDA consideration later this year.

Bloomlife Plus would identify labor onset.

“Once the clinical and healthcare economic value is substantiated, medical distributors can help drive widespread adoption through their extensive networks and sales teams,” says Dy. “Bloomlife is bringing long overdue innovation to prenatal care, and we’re excited to find partners to help bring our vision to the market.”

Editor’s note: This is the first in a periodic series on wearables. Future articles will address such questions as: How is the FDA dealing with them? How are Medicare and other payers reimbursing physicians for remote monitoring of patients? Who will be buying and selling these devices and systems? What do Repertoire readers need to know?

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HIDA INSIGHTS

Back Orders and Shortages Erode Customer Trust Industry workgroups focus on finding solutions

By David Forbes, Program Director, Healthcare Supply Chain Collaborative, Health Industry Distributors Association When supply and demand are out of alignment, bad

things happen. When demand outpaces supply, shortages occur, and patient care is threatened. If supply exceeds demand, products expire and risk of obsolescence kicks in.

Better aligning supply and demand in the healthcare supply chain is the ambitious goal of the Healthcare Supply Chain Collaborative’s new “supply chain visibility” initiative. HIDA created the collaborative to bring all types of leaders together – providers, GPOs, tech companies, manufacturers, and distributors – to work on problems like this that impact the entire end-to-end supply chain.

A few articles I read recently highlighted the importance of this work. In one instance, providers were complaining that their new distributor had too many back order issues. In another, clinicians were disparaging their own health system because of product stock-outs. I’m betting that in both cases the problems were tied to larger shortages across the supply chain – but the users didn’t know that and the blame was misdirected.

The takeaway was that back orders and stock-outs erode trust. But at the same time, trust is critical to improving the situation: • If clinicians trust their supply chain departments, they’re less likely to hoard products and exacerbate shortages.

• If customers trust their suppliers, they’re more likely to share information about usage changes that are likely to shift demand patterns.

• If manufacturers trust their distributor partners and their end customers, they will be more transparent when supply disruptions occur.

The supply chain visibility initiative aims to help build that trust. We’ve formed four workgroups so far, and each includes leaders from across the supply chain. We are accepting more participants, so please contact me at Forbes@hida.org if you’d like to get involved.

Supply Chain Visibility Workgroups Workgroup

Goal

Current Project

Supply Chain Visibility Steering Committee

Better align supply and demand, alleviating product shortages and overruns

Standard definitions and metrics

Demand Planning Workgroup

Improve demand planning and forecasting

Demand planning maturity path

Shortages and Back Orders Workgroup

Ensure product availability

Best practices for product substitutions

Supply Chain Disruption Workgroup

Ensure emergency readiness and supply chain resiliency

Event response guide for a weather emergency

The Healthcare Supply Chain Collaborative’s second annual Supply Chain Visibility Conference takes place Feb. 5-6, 2020 in Coral Gables (Miami), Florida.

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HEALTHY REPS

Health news and notes Eat better and skip the supplements A new evidence review suggests that few nutritional supplements or dietary interventions offer any protection against cardiovascular disease or death, and some may actually cause harm. Findings from a meta-analysis were published in Annals of Internal Medicine. Current U.S. dietary guidelines recommend several healthy eating patterns, including Mediterranean and vegetarian diets, but they do not recommend routine supplement use to reduce the risk for cardiovascular disease or other chronic diseases. Nonetheless, one out of two persons in the U.S. uses some form of supplements with the reported goal of improving overall health.

Evidence does indeed suggest that reduced salt intake

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is protective for all-cause mortality in participants with normal blood pressure, and that omega-3, long-chain fatty acids are protective for myocardial infarction and coronary heart disease. And yes, folic acid shows some protective benefit for stroke. BUT combined calcium plus vitamin D intake may increase the risk for stroke.

Other supplements, such as multivitamins, selenium, vitamin A, vitamin B6, vitamin C, vitamin E, vitamin D alone, calcium alone, folic acid, and iron, or such dietary interventions as the Mediterranean diet, reduced saturated fat intake, modified fat intake, reduced dietary fat intake, and increased intake of fish oil supplements, do NOT seem to have significant effect on mortality or cardiovascular outcomes.

NEW PAMA CPT codes now available in the app

Pama updated CPT codes 2018 Infectious Disease Tests Test - Panels Basic Metabolic Panel (9 tests) Comprehensive Metabolic Panel (17 tests) Electrolyte Panel (4 tests) Hepatic Function Panel (10 tests) Lipid Panel (6 tests) Renal Function Panel (12)

CPT 80048/QW 80053/QW 80051/QW 80076 80061/QW 80069/QW

2017 Fee $11.60 $14.49 $9.62 $11.21 $18.37 $11.91

2018 Fee $10.44 $13.04 $8.66 $10.09 $16.53 $10.72

Change -10% -10% -10% -10% -10% -10%

Cardiac/Liver/Other Tests Albumin (Serum) Albumin (Urine) ALP ALT Aspirin Therapy AST Bilirubin, direct Bilirubin, total BNP CK,MB CK/CPK GGT LD Microalbumin (Quantitative) Microalbumin (Semi-quantitative) Total Protein Troponin I

82040/QW 82042/QW 84075/QW 84460/QW 85576/QW 84450/QW 82248 82247/QW 83880/QW 82553 82550/QW 82977/QW 83615 82043/QW 82044/QW 84155/QW 84484/QW

$6.79 $7.10 $7.10 $7.27 $29.47 $7.10 $6.88 $6.88 $46.56 $15.84 $8.93 $9.88 $8.28 $7.93 $6.28 $5.03 $13.50

$6.11 $7.78 $6.39 $6.54 $26.52 $6.39 $6.19 $6.19 $41.90 $14.26 $8.04 $8.89 $7.45 $7.14 $6.23 $4.53 $12.47

-10% 10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -10% -1% -10% -8%

Lipid Tests HDL LDL Lp(a) Apolipoprotein Total Cholesterol Triglycerides

83718/QW 83721/QW 82172 82465/QW 84478/QW

$11.24 $13.09 $21.26 $5.97 $7.88

$10.12 $11.78 $21.09 $5.37 $7.09

-10% -10% -1% -10% -10%

Diabetes Tests Fructosamine Glucose on home use meter-type device Glucose Tolerance Test, each additional specimen > 3 Glucose Tolerance Test, initial 3 specimens Glucose, quantitative blood type Hemoglobin A1c

82985/QW 82962 82952/QW 82951/QW 82947/QW 83036/QW

$20.68 $3.21 $5.38 $17.66 $5.39 $13.32

$18.61 $3.28 $4.84 $15.89 $4.85 $11.99

-10% 2% -10% -10% -10% -10%

Renal Function Tests BUN Creatinine Creatinine (Urine)

84520/QW 82565/QW 82570/QW

$5.42 $7.03 $7.10

$4.88 $6.33 $6.39

-10% -10% -10%

Individual Tests Amylase Calcium Ferritin Iron

82150/QW 82310/QW 82728 83540

$8.89 $7.08 $18.70 $8.88

$8.00 $6.37 $16.83 $7.99

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Find the new codes in The Black Book

Other tools available for distributors are: vol.26 no.1 • January 2018

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January 2018

2 Minute Drill Videos

Podcasts

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HEALTHY REPS Truth or consequences You might assume that well-accepted medical advice (e.g., fish oil reduces risk of heart disease) is supported by mounds of scientific research. Not so, according to an article in The New York Times. Researchers recently discovered that nearly 400 routine practices were flatly contradicted by studies published in leading journals. Following are just 5 true things that contradict conventional “wisdom:” 1) Peanut allergies occur whether or not a child is exposed to peanuts before age three; 2) fish oil does NOT reduce the risk of heart disease; 3) testosterone treatment does NOT help older men retain their memory; 4) if a pregnant woman’s water breaks prematurely, the baby does NOT have to be delivered immediately; and 5) to protect against asthma attacks, it will NOT help to keep your house free of dust mites, mice and cockroaches.

highest levels of mercury listed on the FDA’s chart. To view the guidelines, go to https://www.fda.gov/food/ consumers/advice-about-eating-fish

Acne drug and pregnancy The acne drug isotretinoin – formerly sold as Accutane – is known to cause miscarriages and birth defects. Yet a recent study published in JAMA Network finds that many women on the drug still become pregnant. Looking through the FDA’s adverse event reporting system, researchers found that between 1997 and 2017, more than 6,700 women became pregnant while taking isotretinoin, and some 11% of these pregnancies ended in miscarriages. The year with the highest number of pregnancies – 768 – was 2006. That same year, the FDA mandated a program known an iPledge to make women aware of the drug’s risks and require them to take contraceptives or vow abstinence. The rate of women on isotretinoin getting pregnant then dropped by more than half by 2010, although other factors – including the use of IUDs and other long-term contraceptives – could have contributed to the dip in pregnancies.

Current U.S. dietary guidelines recommend several healthy eating patterns, including Mediterranean and vegetarian diets, but they do not recommend routine supplement use to reduce the risk for cardiovascular disease or other chronic diseases.

Go fish The U.S. Food and Drug Administration released revised advice regarding the consumption of fish. The guidelines, which provide advice for people in the U.S. 2 years of age and older, recommend that adults eat at least 8 ounces of seafood per week based on a 2,000-calorie diet. They also emphasize that seafood has many nutrients, several of which have important roles in growth and development during pregnancy and early childhood. The revisions are designed to help consumers who should limit their exposure to mercury choose from the many types of fish that are lower in mercury, including salmon, shrimp, pollock, canned light tuna, tilapia, catfish and cod. It is important to note that women who might become pregnant, or who are pregnant or breastfeeding – along with young children – should avoid the few types of commercial fish with the

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Who should use testosterone replacement therapy

Many people can benefit from testosterone replacement therapy, according to experts at MD Anderson Cancer Center. They include people who have had a serious medical treatment like chemotherapy or radiation, or who have injured a testicle. But taking testosterone to solve problems with fatigue, low energy or sinking sex drive without a full check-up can disguise the real causes of these symptoms.

Testosterone should be checked at least twice using a blood test, says Conor Best, M.D., assistant professor in Endocrine Neoplasia and Hormonal Disorders at MD Anderson Cancer Center. Both tests should be done in the morning between 7 a.m. and 10 a.m. If the tests show a low level, patients should discuss the possible causes with their doctor before deciding if testosterone replacement therapy is right for them. Diabetes and obesity, as well as increasing age, can lead to low testosterone. But if there’s no clear cause for low testosterone, working on diet and increasing exercise can often be the answer.

WINDSHIELD TIME Chances are you spend a lot of time in your car. Here’s something that might help you appreciate your home-away-from-home a little more.

Automotive-related news Wheelchair-accessible autonomous vehicle Autonomous transportation startup May Mobility has begun developing a prototype of a wheelchair-accessible autonomous shuttle vehicle, and in July gathered feedback from people in Columbus, Ohio, who would actually be using the shuttle, reports TechCrunch. May Mobility’s design includes accommodations for entry and exit, as well as for securing the passenger’s wheelchair once it’s on board during

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the course of the trip. The company learned from the first round of feedback that its design needs improvement in terms of making the ramp longer to facilitate more gradual onboarding and disembarking, as well as optimizing pickup and drop-off points. May Mobility plans to work on implementing some improvements before deploying its vehicles, but expects accessible shuttles to soon be in operation in pilots in Columbus, Providence and Grand Rapids.

the fitness center attached to the Lincoln-Mercury/Land Rover-Jaguar store in Merritt Island, Florida – assuming you wouldn’t rather play pool or watch a movie. “Service and parts are very important to dealerships right now,” Patrick Manzi, senior economist at the National Automobile Dealers Association was quoted as saying. “Cars are selling on the Internet, and there’s more competition and more access to vehicle prices than ever before. Margins from selling new cars have been consistently on the decline, so dealers are focusing on service. They’ve realized they can help grow customer loyalty by standing out in the amenities.”

There’s the immediate cost of the ticket, of course. But many automobile violations can lead to double-digit percentage increases in car insurance premiums.

For the urban rep

Lunch at the auto dealer?

The waiting rooms attached to auto service departments tend to be dismal places, with stale coffee, patched seats, cable news on a flickering TV and last week’s copy of Sports Illustrated, notes The New York Times. But at some dealerships, that no longer passes muster. Today, you can get blackened chicken or grilled salmon on the lunch menu at Honda of Fort Worth, or a complimentary workout at

Now you can know just how miserable your commute will (or won’t) be before you even get to the train station, reports CNET. Google Maps rolled out a feature this summer that predicts how crowded a train, subway or bus will be based on previous rides. Riders can see this information and then decide if they want to stick it out or wait for things to clear up. The company also launched live updates on traffic delays for buses in locations where it doesn’t already have real-time information from local transit agencies. Riders can now see if their bus will be late and how long they’ll have to wait.

They’ll also get more precise travel times based on live traffic conditions, and will be able to see where the delays are on the map. The two features were expected to roll out in around 200 cities worldwide, and are available on both Android and iOS.

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WINDSHIELD TIME Watch out! It’s a safety device!

To respond to this growing interest in Mobile Driver Licenses/ Identification Cards (mDL) AAMVA has brought together the Card Design Standard (CDS Committee) and the Electronic Identity Working Group (eID WG).

The true cost of a speeding ticket Getting a speeding ticket can cost you much more in insurance penalties than the initial fine, and the financial fallout can last years, according to an analysis from Zebra, an insurance comparison website, reports The New York Times. There’s the immediate cost of the ticket, of course. But many automobile violations can lead to double-digit percentage increases in car insurance premiums. Many insurers charge the penalty, or surcharge in insurance lingo, for three years after the violation, meaning you’ll still be paying the price long after the check for your ticket has cleared.

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Vehicles are getting increasingly sophisticated, with more and more of them able to stay in a lane and maintain a set speed and following distance with minimal driver input. But this kind of automation has limitations that can be tricky for drivers to grasp, and two new Insurance Institute for Highway Safety (IIHS) studies highlight misperceptions or gaps in drivers’ understanding. One study revealed how the names manufacturers use for these systems can send the wrong messages to drivers regarding how attentive they should be. Another found that drivers don’t always understand important information communicated by system displays. “Current levels of automation could potentially improve safety,” IIHS President David Harkey was quoted as saying. “However, unless drivers have a certain amount of knowledge and comprehension, these new features also have the potential to create new risks.”

Digital driver’s licenses in the future?

The topic of “putting a driver’s license on a cellphone” has enjoyed attention in the press recently, according to the American Association of Motor Vehicle Administrators.

Various initiatives are being undertaken in this area. At this time most appear to be proof-of-concept or exploratory in nature. Interest is being expressed by a variety of stakeholders, including driver’s license administrators, legislators, vendors, and the general public. To respond to this growing interest in Mobile Driver Licenses/Identification Cards (mDL) AAMVA has brought together the Card Design Standard (CDS Committee) and the Electronic Identity Working Group (eID WG).

The CDS Committee is responsible for enhancing interoperability between issuing authorities in respect of, among other things, driver’s licenses.

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QUICK BYTES Editor’s note: Technology is playing an increasing role in the day-to-day business of sales reps. In this department, Repertoire will profile the latest developments in software and gadgets that reps can use for work and play.

Technology news Cool on demand Summer heat is with us a little while longer. Homeowners who install a smart thermostat like Nest can control their electric fans and air conditioners at a set schedule. But the rest of us can use a cheaper solution – a Wi-Fi-connected power outlet, also known as a smart plug. It’s simple, according to The New York Times “Personal Tech.” Leave your fan’s power switch in the “on” position. Plug the smart plug into a power outlet, and then plug your electric fan into the smart plug. Install the plug’s companion app on your phone. Inside the app, connect the plug to your WiFi network and name the plug “fan.” From here, you can

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schedule the plug to turn off at a specific time. If you leave the house and forget to turn off the fan, you can use the app to manually shut it off. Some examples of smart plugs: a $17 device from TP-Link, which works with an app called Kasa; and the Womo Mini, which costs around $25.

Here come the foldables Microsoft is planning to release a small foldable Surface the first half of next year, according to Forbes. The foldable Surface is expected to have two 9-inch screens with a 4:3 aspect ratio, according to Jeff Lin, associate director, consumer electronics at IHS Markit. The device is also

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QUICK BYTES expected to 1) use Windows 10 OS new version – WCOS (Windows Core OS) – for dual display UI (User Interface); 2) run Android Apps and iCloud service in Windows 10; and 3) feature always-on connectivity function (LTE or 5G). Devices makers are expected to turn to foldable designs in the coming years as they strive to move mobile devices beyond long-established single-screen products.

Wireless earbuds with noise cancellation Truly wireless earbuds have exploded in popularity over the past couple of years, but one feature they often lack is active noise cancellation. Sony was preparing to release its new wireless WF-1000XM3 earbuds with active noise cancellation, and Google Assistant built in, reports 9to5Google.

Sony advertises strong battery life for the WF-1000XM3.

ambient sound, and customizable touch controls, too. Price was expected to be $230 through outlets such as Amazon.

Bixby at your service Bixby may be the forgotten child of virtual assistants, but Samsung is still hoping it can break through and compete with the likes of Siri, Alexa and Cortana, reports Engadget. Samsung has opened its Bixby Marketplace in the U.S. and South Korea, where users can download services to customize their assistant. The Marketplace offers Bixby apps, which Samsung calls “capsules,” including Google Maps, Spotify, iHeartRadio, NPR and Yelp. There are also the usual app store features like staff picks, user reviewers and categories to find the app you want. The development of the Bixby Marketplace could be the prelude to Samsung releasing its delayed Galaxy Home smart speaker to challenge the Amazon Echo and Google Home devices, though Bixby still has a way to go before it controls your home.

Protect your privacy from apps

The earbuds themselves offer six hours of playback while using noise cancellation, and another 24 hours of power within the charging case. That case can also deliver 90 minutes of playtime with just 10 minutes of charging, and it also uses magnets to guide and hold the earbuds in place, as well as using USB-C. Sony has delivered native Google Assistant with the new earbuds. A tap and hold of the right earbud’s touchpad triggers the Assistant. Other features include pausing music when one earbud is taken out, a “Quick Attention” feature that lets in

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Sony was preparing to release its new wireless WF-1000XM3 earbuds with active noise cancellation, and Google Assistant built in, reports 9to5Google.

www.repertoiremag.com

Apps on your smartphone or other mobile devices can be convenient tools to access the news, get directions, pick up a ride share, or play games. But these tools can also put your privacy at risk, warns the Department of Homeland Security. When you download an app, it may ask for permission to access personal information – such as email contacts, calendar inputs, call logs, and location data – from your device. Apps may gather this information for legitimate purposes – for example, a rideshare app will need your location data in order to pick you up. However, app developers gain access to this information and may share it with third parties, such as companies who develop targeted ads based on your location and interests. Some steps to take: Review app permissions; be cautious with signing into apps on public Wi-Fi networks; avoid connecting your smartphone to any computer or charging station that you do not control. More tips may be found at https://www.us-cert.gov/ ncas/tips/st19-003

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LEADERSHIP

Decisions by Default The decisions you don’t know you’re making could be costing you

By Lisa Earle McLeod

Do you make your decisions by design, or by default?

Your life is the sum of your decisions. A business is created by the decisions the leaders make or don’t make. A family exists and operates because of decisions.

One of the biggest challenges with decision-making is not the decision we make, it’s the decision we don’t make. I call it, the default decision. It’s where you keep moving, going along with the routine, without realizing you had a chance to make a different decision.

You stick with the same product lines, or the same client base, or the same dietary habits. You raise your kids like your parents raised you. Or perhaps you employ the same relationship model with your spouse for decades even though your circumstances dramatically change.

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It doesn’t feel like a decision.

There’s not a moment when someone puts options in front of you, or a time when you officially accept or decline a different path. Yet, every day you continue as is. The decision is not made by design; it’s made by default.

These are the most dangerous kinds of decisions.

Take action As a business consultant, I frequently see organizations falling behind because the leaders are not proactively looking at where they should be making new decisions.

In the Harvard Business Review article “Who Has the D?” Paul Rogers and Marcia Blenko write, “Decisions are the coin of the realm in business.

Every success, every mishap, every opportunity seized or missed is the result of a decision someone made or failed to make.”

They point out, “Making good decisions and making them quickly are the hallmarks of high-performing organizations.” Yet very few organizations have a decision-making model and criteria.

The first challenge is to decide what to decide. Do you evaluate your offerings and structure every year, every 5 years, or every buying season? What are the indicators you use to assess change? To make good decisions, and make them quickly, leaders have to pay attention to subtle shifts.

My waistband tells me cess is key. Teams are a collection My waistband tells me when it’s time to make different nutrition deciwhen it’s time to make of individuals who show up with their own subconscious models. sions. It shows up there even before different nutrition For example, do you make decithe scale. Organizations have similar indicators. If you’re a small organidecisions. It shows up sions quickly based on your gut, or do you take your time to gather zation, it may be informal intuition. there even before the all the info? Both styles can work.

If you’re a larger organization, it may But imagine a team where half the be market perception, student outscale. Organizations people were inclined to go fast and comes, or economic indicators. have similar indicators. the other half want to go slowly.

Decision-making is one of the We recently created a decision core functions of an executive team. model for an Executive Leadership If you’re not there to make deciteam. We included a process for deciding what to decide, sions, there’s no point getting together. It’s just as easy to weighing options, involving others, along with criteria for put your head down in your own silo and send your report when to delay and when to jump. to your boss.

Your life, your work and your family are too imporEffective teams (and individuals) are proactive tant to leave the decisions to default. Design your deciabout decisions. Deciding what to decide is the first sions, and success follows. step. Then, using an agreed-upon model and proLisa Earle McLeod is a leading authority on sales leadership and the author of four provocative books including the bestseller, Selling with Noble Purpose. Companies like Apple, Kimberly-Clark and Pfizer hire her to help them create passionate, purpose-driven sales organization. Her NSP is to help leaders drive revenue and do work that makes them proud.

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corner

On the Run Tina Richter is passionate about sales, passionate about serving our nation’s veterans.

Here’s Tina Richter on life and living:

• Stay focused and don’t be afraid to commit to the unknown.

• Don’t be afraid to reinvent yourself and make changes that in the long-term will be of benefit.

• Do what you like and have fun along the way.

• Never burn a bridge, because you never know where you may come across that person/ company again.

For Richter, director of channel management for AliMed, this is more than a philosophy of life. She lives it.

Her dad, Jerry, worked in the Firestone tire factory in Decatur, Illinois, until he was laid off in his late 60s. It was a scary time for him, recalls Tina. But he recovered and began a second career applying epoxy floor coating, something he did until age 79. “He was a workaholic,” she says. And he remains super busy today, at age 85. (Her mom, Sharon, passed away in 2013.)

His daughter inherited her father’s work ethic and combined it with two passions of her own – sales and entrepreneurship.

Selling by age 12 By age 12, she had her own babysitting company. She mowed lawns. She sold ears of corn along the highway

Tina Richter

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in front of her house. And if there was a candy drive for some cause or other, she usually won. “I’d be out selling after dark,” she recalls. “My dad would tell my mom, ‘Don’t stop her,’ and my mom would say ‘But she could get hurt.’”

By age 16, she was working at The Buckle, a jeans store. While pursuing a degree in fashion merchandising at Southern Illinois University in Carbondale, she worked 30 to 40 hours a week at a Dillard’s department store. After graduation in 1996, she moved to Chicago and began working for The Limited Too, an apparel store for young girls and infants. Within six months she was managing a store in Bloomington, Illinois, where she doubled overall sales in eight months and reduced overall loss by 2 percent.

After that, she managed a Limited Too in Evansville, Indiana, for 18 months, and bought her first house at age 24.

She was transferred to Indianapolis to be a district manager in training.

Medical sales By then, she knew she wanted to go into outside sales.

“In retail, customers come to you. But I’m high energy. I wanted to go out and find customers. I love the hunt and I enjoy winning the business.”

Given her appreciation for human anatomy, medical technology and the opportunity to help take care of others, Richter found the prospect of medical sales appealing. In

2000, she became a sales rep for FLA Orthopedics, selling orthopedic soft goods and bracing products to the DME/ HME market. She became a regional business manager after one year. In 2003, she moved to Arizona.

She worked for Angiotech for several years, selling such products as suture and biopsy needles, as well as Ottobock, a manufacturer of artificial limbs. In 2013, she joined AliMed as orthopedic sales manager. This entailed growing the orthopedic sales market through the company’s distributors, such as DJO, Cascade and SPS. “We had nice results in the first full year with a focused plan, and we ultimately started seeing positive sales results,” she says. “Once this happened, the Big Box distributors – Medline, Performance Health and Direct Supply – were added to my responsibility.” In 2015, she was promoted to Western regional manager (while maintaining responsibility for distribution), and ultimately became director of channel management.

“I am continually analyzing our business and looking at areas where we are missing an opportunity and where we need to pay more attention,” she says of her current role.

“I am constantly studying competition and finding ways to become more competitive. I have identified what products are winners for us in various markets.”

She works in the field with MTMC sales representatives “to teach them this strategy and how they can increase their

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corner overall performance,” she says. “I want them to know that they are constantly supported for success.”

Working with veterans Today, calling on government accounts – particularly, VA hospitals and DOD hospitals – has become Richter’s passion. While working at Ottobock, she learned a great deal about amputees and artificial limbs. “Helping our veterans was so rewarding,” she says. “I would spend hours working with ladies and gentlemen coming back from Afghanistan at Balboa Navy Medical Center, and it was very humbling.

Richter and her boyfriend Brian Oosdyke.

“I would spend hours working with ladies and gentlemen coming back from Afghanistan at Balboa Navy Medical Center, and it was very humbling.”

Many were in their early 20s and had lost their limbs fighting for our country. It taught me a lot about being a patriot and seeing what these individuals sacrifice for our country.”

She has continued her work with veterans at AliMed. In 2018, she visited 51 VA hospitals with MTMC sales reps. “It was a humbling experience for all. But the great

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news is, we increased sales and learned how valued AliMed is in VA hospitals.” She still enjoys traveling to VA facilities with the MTMC reps today.

Richter considers herself lucky to have worked with great people in her career. “Jim Meeker, who I started working for in 2003 at Angiotech, has always been someone I could bounce ideas off and use in challenging times with sales and leadership. Jim is the one who brought me into AliMed, and we have worked closely together since.

He has always been consistent, fair, and most of all, he believed in pushing me to the next level.

“John Keady has also been a wonderful mentor for me since joining AliMed,” she continues. “He has supported me with ideas, and I have learned a great deal from him since 2017. His background with Welch Allyn and his ability to bring fresh ideas to our organization are refreshing.”

She has learned a great deal about sales from those she has worked with in the retail and medical industries. Examples: • I t takes a lot of time to build your reputation and trust. It can all be ruined in seconds if you are not honest.

• Always do what you can within reason to make the customer satisfied and trust you. Be an advocate for them and exhaust all options, so it’s a win and they are happy with the outcome.

• Be fair in leadership. EVERYONE deserves an opportunity to do what they are good at, and maybe their current role isn’t the best for their talents. Get to learn your people in both sales and management.

Many times, we don’t know what we don’t know….

It’s great to always learn from others.

• YOUR WORD IS ALL YOU HAVE!!!! Once you break it and trusts dissolves, it’s very hard to get it back.

• Since she has been in management, she learned to always have her replacement ready – someone to take her place so she could advance to the next level.

Richter lives with her boyfriend, Brian Oosdyke; two English Bulldogs (Church and Daisy); and a 16-year-old Shih tzu (Sadie). She cooks, runs, and regularly takes classes in hot yoga (temperature over 100 degrees and humidity anywhere from 40 to 60 percent.)

“When I started, I thought, ‘This is a death wish,’” she says of the hot yoga. “But it has changed my life. It is the only time of day I can disconnect and just be. No phone, computer, distractions.”

Industry news Owens & Minor names Mark Zacur as chief procurement officer Owens & Minor Inc (Richmond, VA) announced the hiring of Mark Zacur as SVP, chief procurement officer.

Zacur has over 20 years of experience in supplier management, including various leadership roles in healthcare distribution and manufacturing. He has also served as a Board Member Mark Zacur of The Health Industry Distributors Association (HIDA) since 2012 as well as HIDA’s Board Chairman in 2015. Mark also serves as a Board Member at St. Clair Hospital, a non-profit and independent acute care medical center (a Watson Health Top 100 Hospital and member of the Mayo Clinic Care Network) located in southwestern Pennsylvania.

“Mark brings extensive professional experiences from his prior executive leadership roles,” said Edward A. Pesicka, President & Chief Executive Officer of Owens & Minor. “We recognize that Mark’s expertise and successful track record will be instrumental to growing our business.”

He succeeds Charlie Colpo, SVP, strategic supplier management, who will retire in August.

Cardinal Health names Stephen Mason as leader of Medical segment Cardinal Health (Dublin, OH) announced that Stephen Mason, president of the Cardinal Health at-Home Solutions business, was promoted to CEO of Cardinal Health’s Medical segment. Mason will succeed Jon Giacomin, who

will be departing the company in mid-August to assume a CEO position at a privately-held company. Since 2016, Mason has overseen Cardinal Health at-Home Solutions, a component of the Medical segment that has delivered strong and consistent growth. Prior to that, he led Cardinal Health’s Kinray pharmaceutical distribution business.

Mason also has deep experience leading sales, sales operations, and sourcing teams within the company’s Pharmaceutical Distribution business, including the Consumer Health, Sales Administration, Retail Independent Sales, and Retail National Accounts teams.

Mike Kaufmann, CEO of Cardinal Health, commented, “We are pleased to name Steve Mason as the new CEO of our Medical segment. He is a proven leader who has consistently generated positive results in every business he has led within the company. With Steve at the helm, we look forward to building on the steady progress underway in the Medical segment as we continue to execute on our strategy to generate improved performance and long-term growth.”

Sekisui Diagnostics announces relocation of global headquarters Sekisui Diagnostics (Burlington, MA) announced that, as of June 26, 2019, its global headquarters has relocated to One Wall Street, Burlington, Massachusetts. A main driver for the move was to break away from the one room, open office structure and unused lab area, to create a modern, inviting space that supports effective collaboration but also appreciates the need for individual work, the company said.

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NEWS Henry Schein Medical announces availability of Medpod MobileDoc 2, driven by Uber Health Henry Schein Medical, the U.S. medical business of Henry Schein Inc (Melville, NY) and the exclusive distributor of Medpod Inc, announced the availability of Medpod MobileDoc 2, integrated with Uber Health. The medical microcart, which is packed into a portable, carry-on sized case, will enable healthcare practitioners to conduct remote telediagnostic examinations for patients in nontraditional care settings, such as homes, offices, schools, ambulances, and senior care facilities.

“Henry Schein Medical is eager to bring this expanded Medpod offering to our customers in multiple market segments, helping transform their practices and improve relationships with patients looking for convenient access to health care,” said Brad Connett, President, U.S. Medical Group, Henry Schein. “Together with Medpod and Uber Health, we look forward to expanding off-site point-of-care options our customers can rely on to meet their patients’ portable needs.”

Medpod and Uber Health have entered into an agreement, with Uber Health providing Medpod access to Uber Health’s browser-based online dashboard, allowing for the integration of the Uber Health service directly into Medpod’s end-to-end telediagnostics platform. As a result, practitioners with a MobileDoc or MobileDoc 2 can dispatch an Uber driver partner to a patient’s location, or arrange for a patient to be driven

by Uber Health to a clinical care setting.

“Our new partnership with Uber Health, and launch of Medpod MobileDoc 2, will help break down barriers that had previously required diagnostic exams to take place in traditional care settings,” said Jack Tawil, Chairman and Chief Executive Officer, Medpod Inc. “With the MobileDoc 2’s ability to take the physician office environment into patients’ homes and other non-traditional settings, we can create new convenient care delivery options and access points for patients.”

Roche expands the Global Access Program to include tests for TB, Hepatitis, HPV Roche (Switzerland) announced the Global Access Program is expanding beyond HIV to include Mycobacterium tuberculosis (MTB), Hepatitis B and C (HBV and HCV), and Human Papillomavirus (HPV) for low and middle income country programs where the disease burden is the highest. In total, the Global

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Access Program now includes molecular diagnostics for HIV-1 viral load, HIV-1 and HIV-2 early infant diagnosis, the cobas Plasma Separation Card — an innovative plasma collection device, MTB and MTB RIF/INH, Hepatitis B and C, and Human Papillomavirus. All these assays run on the cobas 4800/6800/8800 platforms for various testing volume needs enabled by the cobas Plasma Separation Card that transports samples from remote areas/sites to the central lab for further processing.

CVS to move into kidney dialysis market CVS Health has started clinical trials of a home kidney dialysis device. CVS will test HemoCare, a dialysis device created by Dakea Research and Development.

The clinical trial will enroll about 70 patients and will work to compare the results for the at-home test to when dialysis is performed by a nurse. The trial is expected to be completed at the end of 2020. If successful, the device would hit the market in late 2021.

CVS doesn’t expect to perform dialysis at its own facilities or stores. The move would set up CVS as a competitor for two of the largest operators of U.S. dialysis centers, Fresenius Medical Care and DaVita.

Intermountain launches new IT startup aimed at value-based care Intermountain Healthcare (Salt Lake City, Utah) launched Castell, a new company aimed at boosting value-based care capabilities among providers and payers. Rajesh Shrestha was named president and CEO of the company, in addition to his role as Intermountain VP and COO of Community Based Care. Castell is a health IT platform that “will enable the health system as well as other organizations to accelerate their transition from a volume to value,” Intermountain said. Castell will offer a comprehensive platform of tools and services to support transformation and improvement, including: A proven value-based clinical care model called “Reimagined Primary Care”; a technology and analytics platform to guide care; streamlined affiliated network management; digital tools to address virtual care, patient experience, and social determinants of health; access to cutting-edge initiatives and innovation coming out of Intermountain Healthcare; and the opportunity to utilize care pathways and clinical best practices developed by Intermountain Healthcare.

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