Repertoire August 2024

vol.32 n o. 8 • Au g u st 2 024

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The Future of Flu Vaccines

Egg-based influenza vaccine remains the market leader, but biotech firms are examining alternatives.

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CONTENTS AUGUST 2024 • VOLUME 32 • ISSUE 8

The Future of Flu Vaccines Egg-based influenza vaccine remains the market leader, but biotech firms are examining alternatives.  p. 30

2

` SALES

A Word of Thanks

20 The Power of Purpose

` PHYSICIAN OFFICE LAB

4

What’s New with Flu?

Best practices distributor reps can use in preparation for the coming respiratory season.

` LEADERSHIP

10 Vicky Lyle: Empowering Others

Owens & Minor’s Vicky Lyle has a passion for improving the U.S. healthcare supply chain and investing in tomorrow’s leaders.

` EVENTS

14 NDC Exhibition 2024: Back on Broadway in Downtown Nashville ` NEXTGEN SALES

18 A Competitive Spirit

Baxter’s Draven Chisholm shares how college athletics helped cultivate a competitive fire that continues to burn in her sales career.

Knowing one’s purpose plays a significant role in developing the right leadership skills.

24 Butterfingers and Buying Signals

The sweet spot of sales.

26 Acknowledging is Not Agreeing

The power of listening in customer conversations.

` TRENDS

36 Down But Not Out

Cyberattack hits physicians hard, but distributors respond.

40 Cybersecurity Issues Threaten, Test Healthcare Supply Chain

Partnering with IT helps to construct digital rampart around transactional data.

` IDN INSIGHTS

46 The Ongoing Effort to Retain Nurses

Hackensack Meridian Health shares initiatives that their health system has taken to support and retain nursing staff.

51 IDN News ` TECH TALK

52 Improving Diagnostic Testing with Modern Technology

` HEALTH NEWS

54 Health News

` BY THE NUMBERS

56 Psoriasis

The month of August sheds light on individuals living with psoriasis and psoriatic arthritis, along with prevention and treatment options for the disease.

` HIDA

58 From Warehouse to Washington

Ten years of HIDA advocacy.

` NEWS

59 Industry News ` THE CURE

60 Being Your Best Where You Are

Great leaders develop their skills on the job.

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August 2024

` PUBLISHER’S LETTER

1

Publisher’s Letter

A Word of Thanks

editorial staff editor

Graham Garrison ggarrison@sharemovingmedia.com

August 2024

It is with a mixture of pride and a touch of sadness that I write this month’s publisher’s letter. As the publisher of Repertoire Magazine, I have the honor of acknowledging the extraordinary career of a true legend in our industry, Mark Thill, who will be stepping down as editor after 31 remarkable years.

Mark’s name has become synonymous with Repertoire. Since joining our publication, he has penned almost every cover story, a testament to his unparalleled dedication and passion for the medical distribution industry. Over these three decades, Mark has not just reported on the significant developments in our field; he has shaped the conversation, provided invaluable insights, and inspired countless professionals across the United States.

Mark’s commitment extends far beyond his role at the magazine.

His deep understanding of the industry, his analytical mind, and his gift for storytelling have earned him a place in the Medical Distribution Hall of Fame. This recognition is a fitting tribute to a man who has devoted his life and career to advancing our field, ensuring that every milestone, challenge, and innovation was documented and celebrated.

As we reflect on Mark’s contributions, we also look at the profound impact he has had on our readers – the 5,000 plus medical distribution sales representatives who rely on Repertoire for information, guidance, and inspiration. Mark’s stories have not only informed but have also connected us, creating a sense of community and shared purpose.

To Mark, we owe a debt of gratitude. Thank you for your tireless efforts, your unwavering commitment, and your extraordinary ability to capture the essence of our industry in every story you wrote. Your work has left an indelible mark on Repertoire and on each of us who had the privilege of reading your articles.

As we move forward with Graham Garrison our managing editor for the past 17 years, we do so with the lessons Mark has imparted to us – the importance of dedication, the value of a well-told story, and the power of connecting with our community. While Mark may be stepping down, his legacy will continue to guide and inspire us in the years to come.

Please join me in extending our heartfelt thanks and best wishes to Mark Thill as he embarks on the next chapter of his journey. Mark, you will be deeply missed, but your influence and spirit will remain a cornerstone of Repertoire.

2

With deepest gratitude, R. Scott Adams Publisher Repertoire

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editor-in-chief, Dail-eNews

Jenna Hughes

jhughes@sharemovingmedia.com art director

Brent Cashman bcashman@sharemovingmedia.com circulation

Laura Gantert lgantert@sharemovingmedia.com

senior sales executive

Amy Cochran

acochran@sharemovingmedia.com (800) 536.5312 x5279 publisher

Scott Adams sadams@sharemovingmedia.com (800) 536.5312 x5256 founder

Brian Taylor btaylor@sharemovingmedia.com

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Copyright © 2023 QuidelOrtho Corporation AD10184400EN00 (05/23)

Physician Office Lab

What’s New with Flu? Best practices distributor reps can use in preparation for the coming respiratory season.

 As we approach respiratory season 2024-2025, one thing is

certain: the number of respiratory pathogens the physician office needs to contend with is growing.

August 2024

With this change, the amount of information the well-established distribution account manager needs to keep track of is increasing as well. This column will focus on best practices in being prepared for the coming respiratory season. It will provide a review of the past respiratory season and how it may predict this season. It will also discuss the major respiratory pathogens, vaccination, available tests and related reimbursement and some predictions of the coming season.

4

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By Jim Poggi, Principal, Tested Insights

Respiratory season pathogens and dynamics While we used to think of the coming respiratory season as “flu season, with a mix of strep cases,” in recent years it is clear that fall and winter in the U.S. and around the world has become a much broader respiratory season. After the emergence of COVID-19, public health resources raised the specter of a wider variety of respiratory pathogens than the public, and many physician practices, had thought of previously.

Influenza has always been forefront as a seasonal respiratory illness, with vaccination and testing commonplace.

The same is true of Group A strep, though it is known to occur throughout the year, with a seasonal spike in fall and winter.

While RSV has traditionally been thought of as a serious illness for infants, it is now recognized as a serious threat of respiratory infection in the young and old alike. The introduction of RSV vaccines targeted at the elderly population is evidence of this recent trend.

Add COVID to the mix, and respiratory season is a mixed bag

of signs, symptoms, vaccination and testing opportunities. The 2024-2025 season brings with it more uncertainty than ever with a new COVID variant, KP.3.

Consequently, the number of respiratory pathogens your customers are interested in testing for has expanded significantly. So has the age range of the patients they are testing.

At the same time, adoption of both tests led manufacturers to pursue development of additional new respiratory pathogen tests.

These factors led to the development of lateral flow readers for flu and other pathogens including Group A strep and RSV in 2008.

Respiratory test readers were in widespread usage by 2012. Their improvements in sensitivity and

Flu vaccines need to be administered annually and their effectiveness ranges from 40 to 60% year to year, depending upon how well the vaccines target the flu strains anticipated in the coming influenza season.

Respiratory testing past and progress Our respiratory testing platforms have done an admirable job of keeping up with the emergence of pathogens and providing an exceptional range of available tests.

Group A strep tests have been available in lateral flow formats since the mid 1980s, followed closely by lateral flow influenza tests. But respiratory testing use in primary care seemed to plateau with lateral flow flu and Strep A tests being the predominant tests available from the mid-1980s through 2007. In the early going, strep was the dominant respiratory test required by just about every pediatric practice and many multispecialty practices. Adoption of flu tests gradually grew in physician practices as waived flu A+B tests were made available. Along with the growth of flu testing came interest in improving the sensitivity and specificity of the current flu and strep tests.

more objective reading results led to widespread adoption of these platforms. Only two years later in 2014, developments in simplifying molecular tests led to the first molecular assay for influenza.

Since then, the race has been on among manufacturers to create and maintain their installed base of these platforms.

Today instrumented platforms for common respiratory platforms include visually read lateral flow assays, readers for lateral flow assays, fluorescent immunoassays, single strand displacement DNA/RNA test platforms, RT-PCR platforms and a multitude of other molecular assay types. Differential advantages include sensitivity, specificity, speed to first result, multiplexing of multiple assays at one time and ease of use.

Along with the growth of testing platforms, there have been improvements in LIS/EMR compatibility, ease of use and the range of available assays. Many of these Repertoire

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August 2024

And for a little fun, I plan to take on some of the conventional wisdom that turns out to be more fantasy than fact. With the broad range of information available, your best resources include your key respiratory test manufacturers, vaccine manufacturers and your home office.

To stay informed, you need to keep track of these resources and think clearly about how what you are learning will influence your customer discussions as we approach this respiratory season.

5

Physician Office Lab

very sophisticated molecular technology platforms are CLIA waived.

The emergence of COVID-19 and related “shelter at home” directives also led to the development and deployment of respiratory tests for COVID and other respiratory pathogens at home.

While no-charge, home-use COVID tests are no longer available for home delivery, they are still available at no cost through local health care centers. Most states provide a listing of available locations where they are available. The range of respiratory tests today provides virtually every reasonable permutation of speed, cost, ease and test availability imaginable … until the next unexpected respiratory pathogen emerges. Is it any wonder your physician practice customers look to you and your key lab manufacturers for advice regarding which respiratory tests to perform and on which platform?

A word about vaccines Vaccines for most respiratory pathogens are available at no cost

Influenza. Ironically, while influ-

enza received significant attention from pharmaceutical manufacturers and vaccines have been available since 1942, with the World Health Organization initiating tracking and reporting of influenza in 1952, adoption did not grow until the 1980s. In the U.S., vaccines underwent a number of improvements including the ability to immunize against a variety of influenza strains. Trivalent (vaccines targeting three subtypes) became available in 1968 and currently quadrivalent vaccines are commonplace.

The result? Influenza vaccines today provide a level of protection of up to four strains of flu A and B. While these improvements provide a high level of protection, there is progress still to be made. Flu vaccines need to be administered annually and their effectiveness ranges from 40 to 60% year to

year, depending upon how well the vaccines target the flu strains anticipated in the coming influenza season. More on this later.

In the 2022-2023 season up to 70% of all U.S. adults received the influenza vaccine, far outstripping adoption of the COVID vaccine.

Pneumonia vaccines. Pneumonia vaccines have been available since 1977 in the U.S. and are recommended for children over two years of age, adults and especially for elderly adults.

RSV vaccines. RSV vaccinations

are recommended for expectant mothers, children under 19 months and adults over 60 years of age.

SARS-CoV-2 (COVID) vaccines.

Both mRNA and non-mRNA vaccines are available for SARS CoV-2 and are encouraged. In the past year, CDC estimates about 22% of adults received the COVID vaccine.

Group A strep vaccines. There

is currently no vaccine for Group A strep.

Waived test available?

Reader/molecular platform(s) available

Common CPT codes

Reimbursement range

Influenza

Yes

Yes; multiple

87-400QW; 87804QW; 87428QW (with SARS)

$16.55 for flu A OR B to $70.29 for flu plus SARS

Group A strep

Yes

Yes; multiple

87430QW; 87650-; 97651-QWQW87880QW

$16.81 for lateral flow visual to $41.76 for quantitative DNA probe

SARS-CoV-2

Yes

Yes; multiple

86769; 87811-QW; 87635-QW; 87636-QW (with flu); 87637-QW (with RSV)

$41.38-$142.63 Note: There MAY be other CPT codes

RSV

Yes

Yes; multiple

87420-QW; 87807-QW

$13.10-$13.91

August 2024

Respiratory Pathogen*

for those with healthcare insurance. COVID-19 vaccines are available at no cost to insured and non-insured individuals alike.

* Check with your key laboratory manufacturers for test availability and latest reimbursement advice.

This table is for informational purposes and may not be comprehensive.

6

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Physician Office Lab

August 2024

Looking back sometimes helps us look ahead The 2023-2024 respiratory season was characterized by the end of the official COVID-19 pandemic on May 11, 2023, though COVID remained a serious health concern and remains on the list of the CDC’s leading causes of morbidity and mortality. COVID vaccinations are still available at no cost, and while adoption has waned from the peak of the pandemic, vaccination remains the most effective means of reducing the severity of a COVID infection.

COVID now appears to be settling into a more predictable seasonal incidence rate with the highest level of COVID cases reported in February 2024. From a peak of nearly 8,000 cases per day reported in February 2024, the latest data from March shows a reduction of COVID cases to just over 4,000 cases per day. Last season showed COVID incidence beginning to increase in August with a continuing rise in incidence peaking in February, followed by a gradual decline. There is every reason to believe it will behave in a similar fashion this year.

The CDC characterized the 2023-2024 respiratory season as moderate severity for adults and high severity for children. Type A influenza was the predominant strain in the past year, with H3N2 as the most common subtype.

Vaccination for influenza remains a popular and reliable option, with estimates ranging from 44% to 70% of all Americans vaccinated for influenza. The latest vaccine effectiveness data comes from the prior season and CDC lists the effectiveness of the vaccine overall at 46% which is typical of most influenza seasons on record.

8

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The positivity rate of influenza tests for the 2023-2024 season was reported at up to 16%. Flu A was more common throughout most of the season.

Regarding the relatively low level of positive tests for influenza, there are several factors including sample collection and transportation, timing of swab collection and finally whether the disease was actually flu. Despite the increasing number of patients tested for other respiratory

pathogens in recent years, the positivity rate for flu tests has remained relatively consistent over time.

The 2024 variants: what we know For influenza, type A is expected to be the dominant strain again this year, with H3N2 most likely to be dominant again this year.

While a new avian flu, H5N1 has made headlines based on transmission from animals to humans,

infection and lower the risk of serious complications. The same general statements apply to COVID. What we hear: “I can diagnose

influenza, strep, COVID, etc. by signs and symptoms. I do not need to test.”

Reality: Only 16% of all flu tests performed on symptomatic patients turned out to be positive for flu.

Other pathogens present with similar symptoms. Test to be sure.

What we hear: “The COVID pan-

demic is over; all good from here.”

Reality: Tell that to the 8,000

there have only been five reported cases as of press time, and hopefully the spread of this pathogen will be rare.

The currently dominant strain of COVID-19 is KP.3, a member of the Omicron family. It currently represents 25% of all cases across the United states. Given the rapid mutation of the SARSCoV-2 virus, there is no reliable way to predict whether this variant will continue to be dominant during the coming season.

Facts and fantasy about respiratory diseases What we hear: “All nursing home

patients get a vaccine; no need to test.”

Reality: While all nursing homes routinely administer influenza vaccines (and now COVID), the influenza vaccine is only about 27% effective in older adults and testing, particularly in high density living situations like nursing homes, can result in isolation of infected patients, limit the spread of

While we are presently in a seasonal lull for all respiratory illnesses including COVID, now is the time for you and the physician practices you support to be prepared with prevention, testing and treatment solutions. The most effective distribution account managers see respiratory season from every angle and provide the highest level of consultative assistance to their customers in every element of medical practice during respiratory season. They research disease trends, look for the best vaccination and testing solutions, and in collaboration with their key manufacturing partners, present objective information to their customers to help them make intelligent and informed decisions about how to manage respiratory season.

Are you ready? Are your customers? The best out there are.

Be the best.

Repertoire

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August 2024

people who were diagnosed with COVID each day in February 2024.

While the federal public health emergency for COVID expired on May 11, 2023, COVID remains a serious public health threat.

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Leadership

Vicky Lyle: Empowering Others Owens & Minor’s Vicky Lyle has a passion for improving the U.S. healthcare supply chain and investing in tomorrow’s leaders.

 Winning the Professional Women in Healthcare’s Jana Quinn Inspirational Award was a tremen-

August 2024

dous honor for Vicky Lyle, vice president, Industry Associations, Owens & Minor.

“Although I did not know Jana Quinn personally, I’ve learned a great deal about the many challenges she overcame and the incredible level of respect that her colleagues had for her,” Lyle said. “It was a true honor to stand on stage with her daughter to receive the award.”

Lyle said she fell in love with the healthcare supply chain business early on in her career at Owens & Minor, when she was just 19 years old. She started out as a trainer and traveled around the country implementing a warehouse management system.

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Repertoire

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Why did you decide to become a certified coach? How does this help you to lead crossfunctional teams?

Becoming chair of the Professional Women in Healthcare (PWH) mentoring committee inspired me to learn more about coaching. My focus as a coach has been on getting hands-on training and mentoring so that I can have a more practical and immediate impact on the people I work with. Coaching and mentoring are very different approaches, and I truly enjoy them both.

As a coach, I ask questions that help customers or teammates find their own answers. To watch a client suddenly make a mind shift or have a lightbulb moment is amazing. As a mentor, I enjoy offering advice to people who might be experiencing challenges in their career. Both approaches are incredibly important when leading a cross-functional team where there tends to be more variation in terms of skill, experience and expertise.

How have you benefited from mentorship during your career?

I’m grateful to have had a lot of wonderful mentors throughout my career, and many of them have been Owens & Minor teammates. For example, I learned a great deal from Gil Minor, the former CEO of Owens & Minor, about how to be a servant leader and how to put teammates first.

Another mentor I had along the way pushed me to go back to school even though I was working full time and simultaneously caring for a child with a serious medical condition. That’s what a great mentor does – they push you to never lose sight of your goals, no matter what life throws at you.

Anne Eiting Klamar, the founder of PWH, was another valuable mentor, along with so many others at PWH. She helped me learn how to think more strategically and how to lead effectively when you’re faced with a challenge.

From a financial perspective, my good friend Arnold Farber has been an invaluable mentor and teacher. He taught me everything I know about the stock market and investing at a young age, and we’re still close today.

But perhaps my most influential mentors are my amazing family, especially my husband and my kids. I am forever learning from them, and they are certainly the truth tellers in my life. I call them my personal board of directors.

What are some keys to leading and developing teams of high performing individuals?

The most important thing to remember is that while we are

all a team with a common goal, each individual player is unique and brings something special to the team. It’s important to talk with teammates and understand their personal goals as well as communicate the overall team goals. We each have a purpose for doing what we do and if I can help teammates connect their purpose to the work they do, they will follow their passion and we will be successful.

What do you value most about your organization?

Our culture of caring. We recently rolled out our new Purpose, Life Takes CareTM, which put into words the spirit and passion that have always defined Owens & Minor and made it such a uniquely wonderful place to work.

Although organizations often say that caring about others and acting with integrity are an important part of their culture, for Owens & Minor it’s ingrained at every level and sets the standard by which we measure ourselves in everything that we do.

Owens & Minor teammates truly care about each other, our customers and the communities we operate in. I think that’s part of the key to our success and longevity as a company.

Why are you passionate about empowering women and diverse suppliers in the healthcare industry?

How have you seen this benefit the industry overall?

I have a passion for helping women find their voice and empowering them to take risks because I have seen how doing that has helped propel my career. You have to be willing Repertoire

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August 2024

Over the years, Lyle has had the opportunity to work in many areas of Owens & Minor including technology, corporate operations, third party logistics and our healthcare services business.

“Touching so many different parts of our business and working side by side with other Owens & Minor teammates to help our customers has only deepened my appreciation for this industry,” she said. “I’m a lifelong learner and have a passion for improving the supply chain.”

In an interview with Repertoire Magazine, Lyle shared insights into leadership, mentorship, and her hopes for the future of the med/surg industry.

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August 2024

Leadership

to raise your hand for the big projects, ask for the promotion and be open to learning new things. And most of all when there are setbacks, don’t let it stop you. I want to encourage women to keep moving forward and up!

I am the fifth child in a family of six children. I was the first to get a high school diploma and the only one that graduated college. My parents owned a small residential HVAC business that went through a period of financial hardship and had to be rebuilt. I learned that you have to keep going even when times are tough. I also learned the importance of working hard to make things happen for yourself.

Owens & Minor has long recognized that empowering women and bringing more diversity to the supplier pool that we work with is not only beneficial to our company, but an extension of our culture of caring. Ensuring that a variety of perspectives are heard and that we’re mindful about how we do business is just part of who we are, and that includes our teammates as well as our suppliers.

I have watched small businesses grow and be successful, and I’ve seen the opposite happen. Sometimes no matter how hard you work and how much you persevere, success comes down to what opportunities you’ve been offered along the way. Owens & Minor has the ability to provide opportunities for small businesses and through my work on supplier diversity councils, I’m proud to be able to bring education and create networking opportunities that help small businesses.

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What are you most hopeful for when it comes to the future of the industry?

Having been an Owens & Minor teammate for over three decades, I’ve been fortunate to have a firsthand view into how much the healthcare supply chain industry has evolved to be more patient focused. Seeing Owens & Minor change and adapt in terms of how

we approach helping our customers and their patients makes me look forward to seeing how the rest of the industry strives to meet whatever changes or challenges are on the healthcare horizon. Because at the end of the day, this industry is built on service, so serving our customers and patients is the goal and hope that drives us all.

Speaking and certification Lyle said she is looking forward to several speaking events this fall. She is moderating a panel and facilitating a workshop at the National Association for Health Care Resource & Materials Management (AHRMM) Conference in September. She is on the board of the Virginia AHRMM Chapter and will be moderating a panel of supply chain executives.

In August, Lyle will complete her Maxwell Leadership certification for speaking, coaching and training. “There’s a lot that I’m excited for this year!”

Events

NDC Exhibition 2024:

Back on Broadway in Downtown Nashville Courtesy of NDC

Jack Stephens shares insights and strategies for the future of healthcare distribution.

NDC Member of the Year: Shared Service Systems.

John Cook moderates the distributor panel with Chris Fagnani (Lynn Medical), Sanjay Shah (Amsco) and Rick Wilburn (Wilburn Medical USA).

John Fairand (Mölnlyke) and Julie Nakos (PDI) share supplier insights and successes through their strategic partnerships with NDC.

 The NDC Exhibition 2024, held May 13-15, made its grand return to downtown Nashville, Ten-

August 2024

nessee, and was a convergence of innovation, education, and strategic networking for the independent healthcare distribution industry. The agenda featured inspiring speakers, hands-on training and vibrant entertainment, fostering professional growth and industry advancements.

The “Rock the Pool Deck” opening reception was more than just a kickoff event; it was a celebration that set the tone of NDC Exhibition 2024. The combination of networking opportunities, unique attractions, and fantastic entertainment against a backdrop of panoramic views of Nashville’s skyline provided an unforgettable experience. One of the highlights of the evening was the live entertainment from industry legend, Gerry LoDuca and his band, The Defibrillators.

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Repertoire

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Events

Jack Stephens, NDC’s President and CEO, kicked off the Opening General Session with an overview of the NDC network’s collective impact on healthcare.

He shared strategies and initiatives NDC is actively pursuing to evolve their partnerships with distributors and suppliers. Following Jack’s remarks, Victoria Arlen’s keynote address, sponsored by Midmark, was a standout moment. Victoria’s compelling story of overcoming immense personal challenges to achieve success resonated deeply with the audience. The energy in the room was palpable, and

attendees left feeling inspired and motivated to overcome their own challenges. The follow-up meet-and-greet event allowed for personal connections, adding to the keynote’s impact.

The Awards luncheon celebrated the achievements within the NDC network, providing a platform to recognize excellence. The celebratory atmosphere fostered a sense of community and appreciation among peers. Following the awards presentation, Rebecca Love’s session on healthcare innovation emphasized the critical role of nurses and the importance of

August 2024

Chris Weaver brings the live music, honky-tonk vibe to NDC Exhibition and the “NDC Taphouse & Listening Lounge”.

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The Defibrillators perform with special guest, Matt Rowan, surrounded by the Nashville skyline.

Repertoire

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creating efficiencies to support a strained workforce.

The Manufacturer Hall sessions provided crucial opportunities for distributor attendees to engage with suppliers and conduct strategic business meetings in a roundtable format. This event provided a vital platform for networking and partnership advancement. This year, the sessions were supplemented with a Dedicated Sales Track, which was developed based on feedback from the NDC Leadership Advisory Council.

To kick off the sales track, NDC hosted a breakfast panel discussion that offered insightful perspectives from leading NDC distributors, setting a thoughtful tone for the day. It was a valuable session for attendees to gain a broader understanding of industry trends, challenges and solutions.

Following the panel, distributors participated in Marketplace Product Training Rotations, hosted by NDC supplier partners.

These hands-on product training sessions were crucial for sales teams, providing practical knowledge and skills that attendees could immediately apply in their professional roles. The interactive format was well-received, emphasizing the importance of practical, applicable training.

To continue supporting the product training initiative, Repertoire Magazine Publisher Scott Adams announced a new training resource available to distributor attendees.

NDC has partnered with Share Moving Media to allow distributors access to the Online Product Training Series, powered by Repertoire Magazine, which will be available on-demand throughout the year.

Wrapping up the sales track, Jim Niekamp’s “Owning the

NDC Member of the Year

` Shared Service Systems NDC Distributor Fast Track Awards

` PENN CARE, Inc. ` AMSCO Medical

NDC Distributor Trendsetter Award

` JNL Enterprises ` Medical Solutions, Inc Longstanding NDC Members, Len & Lane Neeper of Advantage Medical Supply enjoy the “Rock the Pool Deck” reception

NuEdge Distributor of the Year

` Advantage Medical festive atmosphere. In the evenings, Chris Weaver delivered authentic Nashville honky-tonk performances at the “NDC Taphouse & Listening Lounge.” This lively venue also featured live mural artists, late-night bites, and an interactive t-shirt station, ensuring that networking and entertainment seamlessly continued well into the night.

The Closing Celebration at Justin Timberlake’s The Twelve Thirty Club, known for its red velvet décor and sophisticated ambiance, served as a grand finale, seamlessly combining entertainment with networking in a truly memorable setting. BD and Dukal sponsored live entertainment

by Rachel Horter, which further elevated the festive atmosphere, leaving attendees with a lasting impression of the event’s success and impact, perfectly matching the elegance of the venue and its distinguished guests.

The NDC Exhibition 2024 successfully blended educational content, innovative training, and strategic networking opportunities, leaving attendees with not only new knowledge and skills,

NuEdge Supplier of the Year

` Mölnlycke Health Care NDC Outstanding Performance Supplier Awards

` Zoll Medical ` Cardinal Health ` GOJO ` PDI ` Mölnlycke Health Care Marketing Excellence Supplier Awards

` Rising Engagement: Bionix

` Omni-Channel: B. Braun

but also valuable connections and a renewed sense of inspiration.

The event’s return to Broadway in Nashville provided a fitting backdrop for an exhibition that was both professionally enriching and personally enjoyable.

Save the Dates: The NDC Exhibition 2025 will return to the Grand Hyatt Nashville, May 12-14, 2025.

Repertoire

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August 2024

Customer for Life” workshop offered intensive and practical sales training, which attendees found exceptionally beneficial due to its high level of interaction and real-world applicability.

Another notable highlight was the Supplier Panel, moderated by Laura Reline, NDC. This panel explored innovative strategies and collaborative efforts through which suppliers are partnering with NDC to enhance supply chain efficiencies and drive growth. Panelists shared valuable insights on how their joint initiatives with NDC have improved operational efficiencies and fostered mutual growth.

Their discussion highlighted the significance of strategic alliances and leveraging shared resources to optimize the supply chain.

One of the standout additions to this year’s event was the return of 2022 closing party entertainer, Chris Weaver and his band.

Throughout the exhibition, Chris Weaver performed live walk-up and walk-out music to welcome speakers to the stage, infusing sessions and breaks with a dynamic and

17

NextGen Sales

A Competitive Spirit Baxter’s Draven Chisholm shares how college athletics helped cultivate a competitive fire that continues to burn in her sales career.

By Jenna Hughes

 A successful salesperson must be strong, resilient – and much like an athlete – driven to win.

Indeed, Draven Chisholm was inspired to pursue a career in medical sales by her experience as a collegiate student athlete. After realizing that she wanted to work in a competitive team environment, Chisholm began networking in the medical industry during her senior year at Georgia Tech. Following graduation in 2018, she landed a job as an associate sales representative for an orthopedics manufacturer.

Now, as the territory manager at Baxter for the Greater Atlanta Area, Chisholm is responsible for the company’s full legacy well of frontline care products, which includes everything from patient monitoring, ENT supplies, ENT blood pressure and cardiopulmonary, ophthalmic products, physical assessment products, and more.

Chisholm also works closely with local primary care and ambulatory care accounts alongside distribution partners by educating and promoting Baxter’s many solutions.

“To be successful in sales, you must have personal, internal motivators, because there is so much flexibility in the role,” said Chisholm. “Individuals in the position can either take advantage of the flexibility and not do as much as they could, or it can drive them to succeed and take leadership of their business.”

August 2024

Success in a dynamic industry

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Draven Chisholm

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As a student athlete, Chisholm learned the value of time management, motivation, and balance.

Calling on those soft skills, she was able to translate them into the medical field. In Chisholm’s previous role in the OR, 90% of her

Closing care gaps In terms of sales success, something that Baxter as a company really believes in, and that Chisholm spends a lot of time just trying to embody, is determining customer needs. “To begin to position our solutions for a customer, I as a sales rep, first have to understand what they are facing and how our solutions can tailor to that,” she said.

Having a customer-oriented mentality, knowing all of your customer’s stories, staying updated

with the latest trends, consistently reading, following influencers, and more are all great sales resources according to Chisholm, and allows you to improve as a sales rep.

Chisholm is a big proponent of relationship selling. “If your customer trusts you, if you build that relationship from the foundation of cultivating that strong connection of transparency, honesty, then they’re ultimately going to listen to you first and foremost.”

and understanding how many directions distributor reps get pulled in and making sure to have consistent communication with them with that knowledge, whether monthly or quarterly, is important.”

Empowerment A great company to work for invests in its employees and considers each individual crucial to the organization’s overall success, said Chisholm.

“ If your customer trusts you, if you build that relationship from the foundation of cultivating that strong connection of transparency, honesty, then they’re ultimately going to listen to you first and foremost.”

To deliver the best service possible in a post pandemic marketplace, manufacturer sales reps and their distributors must have open, honest conversations with customers about product availability. Transparency is paramount to building trust with physician offices.

Staff shortages are also an ongoing challenge for customers, and something that the prepared sales rep can consult on. “Our job as sales reps is to figure out solutions, so we can bring them to the table to combat labor shortages and enhance staff satisfaction.”

According to Chisholm, those solutions can include easier-to-use products that streamline workflows and lead to time savings.

These products allow customers to spend more time with the patients, thus closing care gaps.

To understand how best to assist distributor reps in the field, Chisholm says, “being consistent

“I really enjoy working for Baxter, because the company surrounds each individual with the culture of winning. They celebrate your individual and team success, and empower career growth,” she said. “The company also surrounds each employee with an endless supply of resources and support to help ensure our success.”

In terms of future career goals, Chisholm says that she would love to eventually lead a sales team. June will marked two years at Baxter.

“I think just having that opportunity to invest in others and build upon that momentum that you once saw as a rep, and to have those rewards investing in the people on your team, I would love to be able to do,” said Chisholm. “But for now, I’m focused on building this Greater Atlanta territory this year and for years to come.”

Repertoire

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August 2024

workday was spent directly with the customer, usually a surgeon operating on a patient. In transitioning to her role as territory manager, she again had to lean on her skills honed as a student athlete to succeed at the expectations required by physician offices.

“In my current role, it was a fun challenge early on to try to navigate how to balance my time.

My former manager, Christopher Allen, and now Nicole Gibson (who was in my role previously) have been great assets in helping me to balance my time with channel partners, customers directly in the field, planning follow up and planning my day back in the office,” said Chisholm.

Once Chisholm understood the balance required of territory managers better, she felt comfortable at work and really began to thrive at Baxter. “I’m passionate about our company, products, and solutions, and about bringing expertise to our customers, specific to what they’re facing and their business goals. This includes their value drivers to enable their success at the point of care with our channel partners,” she said.

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Sales

The Power of Purpose Knowing one’s purpose plays a significant role in developing the right leadership skills.

August 2024

By Pete Mercer

 What are you here for? Are you fulfilling your purpose? Finding your purpose can be a tricky

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journey. Too often, we cite our skills, positions at work, or even our job descriptions as what we are “meant to do” with our lives. www.repertoiremag.com

Our purpose runs much deeper than that. It plays a significant role in developing effective leaders – it acts as a sort of compass, guiding each person to what they were meant to do with their particular skillset. If we are all here for a reason, why not make the most of our purpose?

Repertoire Magazine recently spoke to Elizabeth Dixon, the CEO and president of the Trilith Foundation, about the power of purpose and effective leadership tactics. The Trilith Foundation is a nonprofit organization dedicated to enriching the lives of creatives and makers through mental, physical spiritual and relational support.

Dixon has been on a leadership journey for several years – she has worked for the corporate offices of Chick-fil-A, founded a sleepwear brand, and worked as an author and public speaker to “help make the daunting doable” for her audience. As a public speaker, she discusses how to connect executive leadership with their team members, create engaging customer experiences, and what it means to find your purpose.

Truett Cathy said, ‘Marry the mission and date the methods,” and I think that is as relevant as ever.” In other words, stay loyal and focused on the “why,” while changing up the “how” as needed.

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About Trilith Foundation Currently, Dixon’s role at The Trilith Foundation allows her to create and lead a nonprofit designed to inspire human flourishing and enrich the lives of creatives who work to inspire the world. Through that mission, Trilith Foundation has hosted a series of events with speakers like Michelle Williams, Juliet Funt and Dan Cathy, as well as musicians like Jon Foreman, Mat Kearney, and the Atlanta Pops Orchestra.

“Our programs feature the Trilith Experience, an enrichment initiative designed to inspire creativity by offering tours of both Trilith Studios and the Town at Trilith,” she said. “Additionally, we provide a mental health subsidy program that offers financial support to professional creatives seeking mental health resources, including counseling.”

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Sales

partners with the Town at Trilith, a walkable community for makers and creatives, and Trilith Studios, a major motion picture studio lot.

This environment is designed to facilitate the creative process and celebrate excellence.

“When do you lead with the human element and when do you lead with the technology element? The answer to this is found from knowing your customer, a rigorous pursuit of a seamless experience and continual feedback and change.”

The power of purpose

August 2024

In addition to an accomplished career in several leadership roles, Dixon is also a published author of two books: “The Power of Customer Experience: 5 Elements to Make an Impact” and “The Strength of Purpose: A Guide to Knowing and Living Your Reason for Being”.

“The Strength of Purpose”, Dixon’s latest book, aims to help readers find their purpose and a sense of meaning in all the chaos of everyday life. As the world becomes more complicated and overwhelming, it’s more important than ever for us to understand why we do what we do.

That power of purpose should not be underestimated as it can make the difference between a leader who is effective at what they do and one who is not. Dixon said, “As leaders, if we can’t articulate our purpose, leading effectively becomes challenging. It’s common to unknowingly tie our purpose solely to our job, but the reality is our purpose existed before our current job and will continue beyond it.”

In Dixon’s book, she outlines several questions to ask to help discover purpose and ensure alignment in our lives, focusing on three main components: ` Thoughts – Is our purpose reflected in our daily mindset? ` Decisions – Do our choices reflect our purpose? ` Work – Does our job allow us to live our purpose?

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Elizabeth Dixon

She shared that in a recent workshop that she facilitated, one of the participants shared that their purpose was their job description. From there, they were able to open the group discussion that led him to a revelation.

“As he processed crafting a purpose that is greater than his job, he began to light up with passion for how his current job is more meaningful to live his purpose than ever thought. This mindset shift showed him the powerful impact he could make every day in his current position,” Dixon said.

The customer experience in 2024 As the business landscape continues to evolve, so should our approach to the customer experience.

Stagnation can be dangerous for any business, especially those in the healthcare sector. New technologies and tools are developed each year that can optimize the provider’s performance and improve the patient’s experience, which makes it more important for us to be prepared to evolve with these changes.

Dixon said, “In 2024, customer experience continues to evolve with technology. Efficiencies that used to be too costly for small companies are now achievable for all. Yet, this blend of humanity and technology requires careful balance.”

As technology continues to evolve to meet our needs, it’s our responsibility to ensure that we don’t abandon the human element that helps to build the connections with our customer base. Providing personal touches and building relationships is the cornerstone of the healthcare sales industry, making that balance critical to your success.

“Within these enhancements it creates a tension worth managing – humanity and technology,” she said. “When do you lead with the human element and when do you lead with the technology element? The answer to this is found from knowing your customer, a rigorous pursuit of a seamless experience and continual feedback and change.”

Leadership tactics for 2024 The idea of leadership is typically tied up in the role or position that we hold at our company. While that’s certainly a way to distinguish and designate leaders within our community, it’s important to understand that leadership isn’t always about the job title.

“Leadership shows up everywhere in life,” Dixon said. “I see it in my kiddos at school – there’s a line leader role that rotates, but the true leadership is seen on the playground. It is the same for us in our lives! There are titles and roles that require us to be responsible for others, but true leadership shows up in the people that you want to follow.”

Dixon uses the mantra “be the person that you want to follow” as a way to challenge herself, regardless of the season of leadership she’s in or the responsibilities she stewards.

When she experiences personal growth, she also finds that the type of person she wants to follow changes as well.

As for how leadership should look today, Dixon looks to the founder of one of the companies that she used to work for: Truett Cathy. “Truett Cathy said, ‘Marry the mission and date the methods,” and I think that is as relevant as ever.” In other words, stay loyal and focused on the

“why,” while changing up the “how” as needed.

For this approach, leaders should be fully committed to the mission and vision of the organization. No matter what, that mission is the goal of all your efforts and strategies – innovation, excellence, service, teamwork, partnership and growth.

The methods, while important, will change. There will always be newer pieces of technology, processes, systems, products, and efficiencies.

She said, “When we can see the difference, it helps us stay fluid where we need to and hold fast where we need to.”

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Explore the future

© 2024 HORIBA, Ltd. All rights reserved.

Sales

Butterfingers and Buying Signals The sweet spot of sales.

By Brian Sullivan

 Ever had a customer say “Yes,” “Wow,” or even “How much?” If so, congratulations! You’ve just

heard what we call security alarms – signals that the customer is ready to buy. The trick now is to resist the urge to bombard them with more information. Remember, sales isn’t a boxing match where you keep throwing feature jabs and benefit hooks. It’s about being succinct and knowing when to stop.

Know when to say when A fundamental aspect of PRECISE selling is saying just enough to advance the sale – no more, no less. Think about it: when someone overwhelms you with too much information, don’t you just shut down? On the other hand, when they give you just enough to pique your interest, you remain engaged and satisfied. It’s like indulging in candy. Let me illustrate with a story.

August 2024

A sweet lesson from Christmas past Christmas in Connecticut was a grand affair when I was eight. My extended family of over thirty-five cousins would gather to celebrate.

In 1976, my cousin Matt and I braved the snowy landscape to reach Cavanaugh’s Convenience Store. There, I splurged on a whole bag of bite-size Butterfingers. The first few were heavenly, but by the seventh, my stomach had other ideas. I felt as if someone had placed a car jack under my tongue. Too much of a good thing had turned bad, and I learned my lesson: moderation is key.

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Don’t overwhelm your prospects In sales, think of your presentation points as Butterfingers. Offer your prospects just enough to excite them – no more. Leave them wanting more, eager to sink their teeth into the next piece of information. If you overload them, they’ll end up feeling nauseated, just like I did with my Butterfingers.

When your customers start to show signs of excitement – those security alarms – it’s time to wrap up and move forward. Common examples include: ` “Hmmmmm.” (high pitch) ` “Oooooooo.” ` “Ahhhhhhh.” ` “Woooooow.” ` “How much?”

These signals, often accompanied by enthusiastic gestures, indicate that your presentation is hitting the mark. Now’s the time to close the deal.

phase can derail a sale. Always have all necessary forms on hand and understand them thoroughly.

This preparedness prevents you from stumbling and losing the sale.

Secure solution agreement

Advancing the sale

Handling objections gracefully

After identifying these security alarms, seek confirmation from your prospects to ensure you’re on the same page. A simple security question like, “Can you see how my solution will make your life easier by __________?” works wonders. Fill in the blank with the benefits you’ve discussed and agreed upon.

Observe your prospect’s reactions to your financial package. If they give you positive signals, it’s time to move forward. Use an “assumptive close” to transition smoothly from the presentation phase to the postsale phase. For instance, say, “Great, John. I’m glad the finances make sense. Then with your permission, I would like to schedule a training session for your staff. Would next week or the following week work better?”

Objections are a natural part of sales. Instead of fearing them, embrace them as opportunities to address concerns and reinforce the value of your product. When a customer raises an objection, listen carefully, acknowledge their concern, and respond thoughtfully. For example, if a customer says, “I’m not sure about the cost,” you can respond with, “I understand. Let’s break down the

Prospects won’t commit until they know the cost. Separate the product discussion from the financial one. Ensure you’ve established: ` An observable need ` Your product as the solution ` A sense of urgency Once these are clear, transition smoothly into the financial discussion with a positive attitude.

Use a statement like, “Let’s see if it makes financial sense,” to ease into the conversation. This reduces pressure and shows that you’re providing information for them to make an informed decision.

Know your financials inside out Treat your financial discussion with the same importance as your product presentation. Be familiar with every detail of your financial paperwork. Indecision during this

When a customer raises an objection, listen carefully, acknowledge their concern, and respond thoughtfully.

Avoiding common pitfalls One common mistake salespeople make is not being prepared for the financial discussion.

It’s not enough to know your product; you must also be wellversed in the financial aspects of the sale. This includes understanding financing options, payment plans, and being able to explain these clearly to the customer. Bringing all necessary paperwork and knowing it inside out can make a significant difference. Imagine you’re about to close a deal, and you realize you’ve left crucial documents

cost and see how the value aligns with your needs.”

Conclusion Being PRECISE in sales means knowing when to stop talking and move forward. Keep your prospects excited with just enough information, secure their agreement, and handle the financial discussion with confidence. By doing so, you’ll turn those little yeses into one big fat yes. Remember, the key to successful selling is not in overwhelming your customers but in engaging them with the right amount of information and enthusiasm.

Brian Sullivan, CSP, is the founder of PRECISE Selling and a leading voice in the field of sales training and development. He believes in the potential of every salesperson to achieve their best and continually challenges sales professionals to reach new heights. To have Brian Sullivan or one of his stable of trainers and coaches help your team get to the top, visit him at www.preciseselling.com Repertoire

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August 2024

Show them the money

back at the office. This not only disrupts the flow but also signals unpreparedness, which can make the customer hesitant.

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Acknowledging is Not Agreeing The power of listening in customer conversations.

By Patrick T. Malone

 “What’s the point of talking to anyone if you don’t tell them what you think?” – Jon Krakauer,

August 2024

American writer, mountaineer, Pulitzer Prize finalist.

I suppose when you are a Pulitzer Prize finalist, some people might want to know what you think. But when I read the quote above, I immediately think arrogant, self-centered, egotistical and variety of other unflattering

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descriptors that most often are used with a prima donna.

Unfortunately, many sales representatives have come across the same way, causing decision makers to build walls to shield themselves from this boorish

behavior. These walls may be the gatekeepers who cannot buy but control access to the actual decision maker, or those who cannot say yes but can say no.

Many office managers or practice managers have assumed this role.

Discover what they think Some years ago, Stephen Covey wrote “The 7 Habits of Highly Effective People”, and one of those habits is “Seek first to understand and you will be understood.”

So, in answer to this column’s lead question, the point of talking with another person is to find out what they think as much as it is to tell them what you think.

Many people will say all of this is easy to understand but difficult to do. I am convinced you can simplify that process if you remember the following four tips. Try this and then determine if it helps you understand more about your practices, do more business with them, and reach the quiet confidence that is the mark of a real professional.

1 Give the other person your 100% attention Our computers and smart phones are excellent at multi-tasking, but most human beings are mediocre at best. So, one thing at a time – be present in the conversation. Make the other person feel as if they are

the only person in the room. Then take it one step further. Clear your mind by suspending your own point of view at that moment in time. When you do this, you will hear things you missed before and understand the other’s situation so clearly that the perfect solution will appear with little effort.

the fear is respect is interpreted to mean “agree” but nothing could be further for the truth. You are simply demonstrating respect for the other person’s right to hold a different point of view than your own now. Unless you do this, you will never have an opportunity to explore and influence other points of view.

Too many times we say we understand and then do or say something that shows we have no idea about the situation at hand.

2 Respond appropriately

Respect

The appropriate response is much like driving a car in traffic. So, if the other traffic is going 20 MPH in the slow lane, it would be inappropriate to try to drive 80 mph with your hair on fire. Slowing down or speeding up based on the other’s reactions in the conversation demonstrates that your responses are appropriate to their situation.

The good news is these four suggestions are remarkably effective in getting others to be open and feel comfortable telling you exactly what they think and, in many cases, why they think that way. That allows you to tailor your conversation in such a way that it makes good sense to those with whom you are talking. The sad news is there are four suggestions to remember and if you are like me, I sometimes have trouble walking and chewing gum at the same time. I need simple.

So simply remember the word RESPECT. If you demonstrate sincere respect for other points of view, the other three suggestions will happen naturally.

So, despite the Pulitzer Prize finalist’s thoughts, the real purpose of conversation is not to tell people what you think. The real purpose is to find out what they think so you can communicate what you think in the most effective manner.

3 Prove that you understand The operative word is PROVE. Too many times we say we understand and then do or say something that shows we have no idea about the situation at hand. So instead of saying you understand, prove that you really do understand by asking a relevant question or restating a synopsis of the situation as you understand it.

4 Demonstrate respect for other points of view This is most difficult when facing a point of view which is the opposite of your own point of view. For some

Patrick T. Malone is a business advisor and leadership mentor based in Taylors, South Carolina. He is the co-author of the bestselling business book “Cracking the Code to Leadership” and may be reached at ptm4936@gmail.com or 404-630-7504.

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August 2024

On the other end of the spectrum are many sales reps who are also talkative, but their motivation is self- protection. Their descriptors are timid, unsure, scared and often “new.” Their biggest fear is the decision maker will ask them a question to which they will not have an answer. So, to prevent that embarrassing situation, they try to control the conversation by doing a data dump on their audience. So once again the walls that decision makers have built are effective in screening out these amateurs.

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SPONSORED: Bionix

August 2024

Bionix celebrates 40 years of innovation, collaboration with medical professionals Bionix has been dedicated to ensuring safety for non-specialists for 40 years. Its founders introduced the FlexLoop Safe Ear Curette® in 1984 to help speed diagnosis and treatment for conditions like ear infections. With this tool, pediatricians and family practitioners could perform cerumen removal, diagnose and begin treatment during the same visit.

Jim Huttner, MD, PhD, and Andrew Milligan, PhD, founded Bionix when they recognized an opportunity to evolve the healthcare industry uniting their medical expertise and inquisitive nature. They aimed to develop solutions that would change the way procedures were performed and improve the care that patients received. Their FlexLoop Safe Ear Curette® innovation expedited patient care and provided a new revenue stream for primary care physician offices offering cerumen removal.

Today, Bionix serves both medical professionals and over the counter (OTC) consumers in domestic and international markets and has an extended market in offering in radiation therapy and Patient Safety and Compliance products.

“Our team has brought procedural challenges from the field to our labs, collaborating

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with engineers to create devices tailored by medical professionals, for medical professionals,” Dr. Huttner said. “The products invented at Bionix have been used daily in our medical offices, providing valuable insights into the real-world problems encountered in daily medical practice.”

Bionix’s network has grown during the past 40 years with clinicians contributing innovations through sharing challenges, proposing product ideas and evaluating concepts developed by the Bionix team.

Chris Becker, Bionix President and CEO, says collaboration with their customers is fundamental to Bionix’s success. “Our growth began with groundbreaking products and expanded as we continued to create innovative solutions for everyday procedural issues,” he said.

Bionix has introduced many innovations to the market like: ` The first Safe Ear Curette® in 1984. ` The OtoClear® Ear Irrigation Tip for safe and effective ear irrigation in 2000. ` The first Lighted Ear Curette™ in 2004. ` The next generation of the Lighted Ear Curette – ClearLook® Lighted Ear Curette™ – in 2022.

Bionix and its distribution partners Bionix’s relationships with its distribution partners are strong and profitable.

“Our marketing team focuses on generating and sharing qualified leads for our product lines, while our sales team consistently drives targeted sales opportunities to our distribution representatives,” Becker said. “By leveraging customer data and emphasizing both clinical benefits and financial value for end users, we ensure that our distributors, their sales teams and customers all receive significant value from our partnerships.”

Becker says Bionix prioritizes meaningful partnerships versus transactional vendor relationships, and it values its mission dedicated to serving medical professionals and their patients.

By focusing on their needs, Bionix achieves success.

During the next 40 years, Bionix will continue to develop products internally but also spur growth through sourcing quality offerings and making targeted acquisitions to enhance its ability to serve its customers in major markets.

“We plan to expand our offerings in the primary care and radiation therapy sectors, exploring opportunities in related markets,” he said.

Simply The Best

bionix.com

Now and into the future.

Learn more about the history of Bionix Complete Ear Care.

The Future of Flu Vaccines Egg-based influenza vaccine remains the market leader, but biotech firms are examining alternatives.

August 2024

R

espiratory season is almost upon us, and with it, tests, doctor visits and vaccines. Though the targeted strains of flu vaccine change every year, the way those vaccines are produced and sold do not. But that might be changing.

Every respiratory season has the public health community atwitter about eggs. That’s because the most common method used to produce each year’s seasonal flu vaccine involves a laborious, time-consuming process, according to the National Institute of Allergy and Infectious Diseases (NIAID). Scientists select vaccine strains months in advance of the upcoming flu season and then grow the selected flu virus strains in chicken eggs. Sometimes an existing but unexpected flu strain becomes prevalent during flu season, making the vaccine a poor match to the circulating strains.

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The Future of Flu Vaccines

August 2024

Providing protection against the H5N1 bird flu virus may lead to further complications, as it will call for more eggs. Many of them. The Administration for Strategic Preparedness and Response of the U.S. Department of Health and Human Services reports that officials are moving forward with a plan to produce 4.8 million doses of H5N1 avian flu vaccine for pandemic preparedness.

Despite its drawbacks, the egg-based influenza vaccine remains by far the market leader. It’s a known entity and it’s effective. But following the development of mRNA-based COVID vaccines from Pfizer and Moderna, the federal government, public health officials and pharmaceutical companies are exploring a variety of options, including mRNA for influenza vaccine and vaccine produced in mammalian and insect cell lines that don’t pose the same risks as eggbased shots (e.g., allergic reactions).

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Cell-based vaccines A cell-culture-based production process for flu vaccines was approved by FDA in 2012. Originally, this production process also began with chickenegg-grown candidate vaccine viruses (CVVs). But in 2016, the FDA issued an approval for Seqirus, the sole FDA-approved cell-culture-based flu vaccine manufacturer in the United States, to begin using cell culture-grown CVVs. Currently, cell culture-based manufacturing is used to make inactivated flu vaccines (e.g., flu shots), not LAIV (nasal spray flu vaccine).

The process of creating cell culture-based flu vaccines involves several steps. First, CDC or one of its laboratory partners uses influenza viruses that have been grown in cultured mammalian cells to make CVVs, which are then provided to the vaccine manufacturer. Next, the vaccine manufacturer

4.8

million The Administration for Strategic Preparedness and Response of the U.S. Department of Health and Human Services reports that officials are moving forward with a plan to produce 4.8 million doses of H5N1 avian flu vaccine for pandemic preparedness.

then mixed with insect cells and allowed to replicate. The flu surface protein called hemagglutinin is then harvested from these cells and purified. Flublok Quadrivalent by Sanofi is an example of a recombinant flu vaccine.

Scientists are also developing novel influenza vaccine platforms that could be produced more efficiently. NIAID’s Vaccine Research Center is developing DNA or gene-based vaccines against seasonal and pandemic influenza that have been tested in clinical trials. A DNA vaccine contains a small, circular piece of DNA that includes genes that code for proteins of a flu virus. When the vaccine is injected into the body, cells read the genes and make virus proteins, which self-assemble into virus-like particles. The body then mounts an immune response to these particles.

mRNA While protein-based vaccines deliver a virus-like protein (antigen) ready-made, directly to the immune system, mRNA vaccines deliver genetic material (created in a laboratory) that instructs the body’s cells to produce the antigen, according to biotech firm Novavax. That antigen in turn triggers an immune response. mRNA vaccines do not contain any live virus and cannot cause infection.

Compared to protein-based vaccines, mRNA vaccines are relatively new. While the first mRNA flu vaccine was tested on mice in the 1990s, it wasn’t until 2011 that the first mRNA vaccines were tested in humans. This delay was because the mRNA immediately degraded before it could be translated into the antigen protein.

That issue was solved by advances Repertoire

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August 2024

inoculates the CVVs into cultured mammalian cells (instead of into chicken eggs) and allows the CVVs to replicate (i.e., make copies) for a few days. Then, the virus-containing fluid is collected from the cells and the virus antigen is purified. The manufacturing process continues with purification, virus inactivation, and testing. Finally, FDA tests and approves the vaccines prior to release and shipment.

NIAID and industry partners are exploring ways to move away from both the egg-based and cellbased flu vaccine production methods toward recombinant DNA manufacturing for flu vaccines. This method does not require an egg-grown vaccine virus.

Instead, manufacturers isolate a certain protein from a naturally occurring (“wild type”) recommended flu vaccine virus. These proteins are then combined with portions of another virus that grows well in insect cells. The resulting “recombinant” vaccine virus is

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The Future of Flu Vaccines

in vaccine nanotechnology, which helped protect the mRNA as it is delivered to the cell. The first mRNA vaccines to complete all stages of clinical trials and be licensed for use were for COVID-19.

But because mRNA technology can be used to produce vaccines more quickly than conventional vaccine manufacturing technologies, scientists expect it can help create a shot that better matches the season’s flu strains and as a result, offer better protection, according to Pfizer. Another key benefit of mRNA technology is its flexibility, which may allow scientists to quickly “edit” vaccines. For viruses like the flu that are constantly changing and require vaccines that must be updated each year, once a path is established with the FDA or other regulatory authorities, scientists may be able to swap out the mRNA instructions to match with the then-circulating variants.

Despite its promise, it’s unlikely mRNA influenza vaccines will make a big dent in the market, at least in the immediate future.

“I’m not of the opinion that mRNA will be that groundbreaking or paradigm-shifting, as other researchers believe it will,” says Doug CamposOutcalt, M.D., MPA, adjunct senior lecturer, Public Health Practice, Policy and Transitional Research Department, Mel & Enid Zuckerman College of Public Health, University of Arizona. “The COVID vaccines are very effective to start with, but immunity wanes fairly quickly, and we’re not sure of the vaccine’s long-term implications. What’s more, mRNA vaccines can be reactogenic; people do not like the reactions. We’ll probably get down to an annual or every-six-month shot based on the circulating strain. So mRNA isn’t a huge advantage over other technologies.

“Yes, producing egg-based vaccines is a slow process. That’s the main problem with it. But we have other technologies – recombinant, cell-based and other methods coming through the pipeline. I don’t think mRNA will be the only option for flu vaccine.”

August 2024

COVID-19/flu combo vaccine in the works

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Moderna, Pfizer and BioNTech, and Novavax continue to work on developing a combination COVID-19/influenza vaccine.

In June, Moderna announced that its Phase 3 trial of mRNA1083, an investigational combination vaccine against influenza and COVID-19, met its primary endpoints, eliciting a higher immune response than comparison vaccines used in the trial.

“Combination vaccines have the potential to reduce the burden of respiratory viruses on health systems and pharmacies, as well as offer people more convenient vaccination options that could improve compliance and provide stronger protection from seasonal illnesses,” CEO Stéphane Bancel said in a statement. The company will engage with regulators on next steps.

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Meanwhile, in May, Novavax and Sanofi announced a licensing agreement granting a license to Novavax’s adjuvanted COVID-19 vaccine for use in combination with Sanofi’s flu vaccines while Novavax develops its own COVID-19-Influenza Combination vaccine candidate.

“Our new partnership combines Novavax’s proprietary recombinant protein and nanoparticle technologies, Matrix™ adjuvant and R&D expertise, with Sanofi’s worldclass leadership in launching and commercializing innovative vaccines,” said Novavax President and CEO John C. Jacobs in a statement.

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Trends

Down But Not Out Cyberattack hits physicians hard, but distributors respond.

 On Feb. 21, a company many in the industry were not familiar with – Change Healthcare –

experienced a cyberattack that critically impacted the U.S. healthcare system. At the time, the healthcare clearinghouse touched one in three patient records and processed 15 billion healthcare transactions annually. Potentially devastating to many physician practices and their patients, the cyberattack provided distributors an opportunity to step in and help them weather the storm.

“Cyber incidents are the new normal,” says Ryan Hungate, DDS, MS, chief clinical officer, Henry Schein One. “The numbers are increasing because of growing vulnerabilities in healthcare systems,” wrote the editors of The Lancet in late May. “Electronic health records, medical devices, laboratory services, pharmacies, clinical decision support systems and many more applications and services are digitally interconnected and used by many different users.

“Use of new digital technologies, such as mHealth, telehealth, and AI-supported diagnostic tools, accelerated during the COVID-19 pandemic and were added with little consideration of security issues. At the same time, many healthcare providers and services still use outdated technologies and software.

This interconnectedness makes healthcare systems an easy target.

Cybercriminals only need to find one weak entry point to paralyze the entire system.”

What is Change Healthcare?

August 2024

For many physicians, hospitals, and health insurance companies, Change Healthcare serves as a clearinghouse through which

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Impact on physicians In his statement to the Senate Committee, Anders Gilbert, senior vice president, government affairs for the Medical Group Management Association (MGMA), pointed out that MGMA members experienced myriad negative consequences following the cyberattack, including severe billing and cash flow disruptions, inability to submit claims, limited or no electronic remittance advice (ERA) from health plans, an inability to transmit electronic prescriptions, a lack of connectivity to data infrastructure, health information technology disruptions and more.

“Physician practices diligently instituted workarounds for various processes to remain operational, which required significant labor costs and time to institute, diverting critical resources from patient care. The lack of cash flow led to medical groups having to make difficult financial decisions as it was early in the year and practices already had limited working capital on hand due to tax considerations. Smaller practices were particularly affected given their tight margins and had to utilize lines of credit with high interest rates just to keep their doors open.”

In addition, 62% of respondents said they were still using personal funds to cover practice expenses and 34% were not able to make payroll.

From a fiscal perspective, the cyberattack affected stand-alone hospitals (i.e., those not part of a larger IDN), rural hospitals and physician offices that lacked the financial resources to weather the storm, says Tim House, national vice president of sales, Concordance Healthcare Solutions.

“When a breach occurs, it can impact the ability to order product, pay for product and submit claims. The financial burden has

‘ A strong relationship between the distributor and the care provider can help facilitate the continuity of care that the patient needs.’

Even a month after the cyberattack, the American Medical Association reported its members were experiencing ongoing difficulties. An AMA survey showed that 90% of the surveyed physicians reported that they were still losing revenue from unpaid claims. More than one-quarter said that their practice revenue for the prior week was down by more than 70%, compared with an average week before the cyberattack. Among other findings: ` 85% continued to experience disruptions in claim payments. ` 79% still could not receive electronic remittance advice. ` 75% reported barriers with claim submission. ` 60% faced challenges in verifying patient eligibility.

a domino effect. But a strong relationship between the distributor and the care provider can help facilitate the continuity of care that the patient needs. During this breach we offered our support to multiple facilities, and that strengthened our relationships with them.”

Distributors respond “Our two biggest concerns were helping make sure our customers could see patients during and after the cyberattack, and making sure they had enough money to keep their doors open,” says Dr. Hungate.

Henry Schein One was able to help customers transition quickly to alternate clearinghouses, he says. “For those who were more adversely affected we were able Repertoire

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August 2024

eligibility inquiries are received and responded to, claims are submitted and processed, and remittance is sent back to the physician or health care provider, pointed out the American Medical Association in a May 1 statement to the U.S. Senate Committee on Finance, which was investigating the cyberattack. For some payers, Change Healthcare even handles claims payment.

“Change Healthcare also plays a primary role in communicating prescriptions to pharmacies and determining pharmacy, insurance and patient costs. It facilitates exchanges between physicians, hospitals and labs – including the ordering of labs and the sending of results. Change Healthcare supports the exchange of information related to prior authorizations and other utilization management requirements. And it has products and services that reach into practice management systems and electronic medical record systems for dozens of other practice management, clinical and revenue cycle purposes.”

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to facilitate financial assistance. It was a matter of letting them know ‘we’ve got you, here are the steps you need to take next, and here’s what you need to understand about how you may be affected in the weeks or months ahead.’”

The company created dedicated websites with the latest news about the cyberattack. As helpful as these measures were, practices still had technological kinks to iron out, such as re-registering for electronic remittance advice.

hospital in particular was very appreciative of those efforts, he says. “We extended DSO from 15 days to 180 days, which took the burden off their entire system, allowing them to pay their physicians and other past-due bills that were mission-critical.

“Our reps worked directly with customers to replicate orders that were in our system from prior weeks to ensure they had product on their docks,” says House. “We also leveraged our

August 2024

‘ Our two biggest concerns were helping make sure our customers could see patients, and making sure they had enough money to keep their doors open.’

Concordance was able to replicate orders from previous days’/ weeks’ orders without the need for customers to submit a new order if their system became inoperable, says House. “Our system is smart enough to see patterns, provide predictability and demand forecasts so that we can meet their needs. We worked tirelessly in a manual setting to ensure we got product to their docks and ultimately to the patient.

“Another action that we took was to extend payment terms for some customers. One medium-size

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Surgence tool to look at proactive inventory reports and on-hand inventory.” (Concordance describes Surgence as a healthcare supply chain ecosystem that fully connects providers, distributors and suppliers by bringing visibility to supply and demand information.)

What happens next time?

“The cyberattack on Change Healthcare made it evident that there are significant vulnerabilities in our healthcare system, which must be addressed, especially as the threat of such attacks only

continues to rise,” Gilbert told the Senate Finance Committee.

“Moving forward, health plans, clearinghouses and other thirdparty vendors must have safeguards and contingency plans in place to better protect physician practices from cash flow and administrative impacts resulting from a cyber incident.

“Physician practices must continue to work to ensure they have adopted ironclad cybersecurity policies and procedures to best protect the data of their patients and their ability to provide highquality care. When contemplating the fallout, we urge against establishing penalties, or conditioning relief funds, for medical groups in response to cyberattacks perpetuated against other healthcare actors.

There are a multitude of security and data privacy regulations governing medical groups; introducing barriers to future relief would work against supporting medical groups’ ability to operate in the face of considerable interruption.”

Says Dr. Hungate, “Overall, to protect against future cyber incidents, it is important for the healthcare industry to continue to remain educated on, and aware of, cyber threats. Additionally, being resilient and having the ability to respond swiftly is critical. By fostering a culture of adaptability, and remaining vigilant, healthcare teams can mitigate risks and maintain trust in an evolving healthcare landscape.

“This incident affected basically every doctor in the United States. That forces all of us to ask, ‘What do we do next time?’ We will offer technology outreach and help our customers understand what they need to do to survive. Those customers who are most engaged with our reps come out on top of this.”

of reps still prefer reading Repertoire in print.

Here are a few r shows eason to cov up in m s why er. I’d y mail : be les box, I s incli alway ned to s read “ Gives m seek a it cove link an e an in r d read tentio imme .” nal br rse m e y a s k e I like t lf in a to dis o turn h conne i g h -quali the pa ct and ty pub ges an l ication d see “ Online b . indust ecom r y ads. es a b ” lur, pr int sti cks lo nger. “ I’m old s ” chool .”

“When it

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Contact Amy Cochran: 770-263-5279 acochran@sharemovingmedia.com

*April 2024 April Readex Research Study

Trends

Cybersecurity Issues Threaten, Test Healthcare Supply Chain Partnering with IT helps to construct digital rampart around transactional data.

By R. Dana Barlow Editor’s note: The following article first appeared in The Journal of Healthcare Contracting, a sister publication of

August 2024

Repertoire Magazine.

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 Burgeoning cyberattacks against healthcare provider organizations, payers, suppliers, vendors

and retail corporations continue to make headlines and tax both the defensive and offensive playbooks of the victims, no matter how many resources – financial, operational, technological or workforce – they erect to fortify and shore up IT infrastructure.

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Fortress of certitude Supply chain executives at some of the leading integrated delivery networks (IDNs) across the country express confidence in their cybersecurity playbooks for both defensive (protective) and offensive (preventive) measures. They acknowledge the need for comprehensive and ongoing risk assessments linked with information security executives like never before.

Category Management, Supply Chain, who oversees third-party risk management for the Rochester, Minnesota-based organization.

“The TPRM process is managed by our Supply Chain, but actual risks and their severity are defined by our IT, cybersecurity, compliance, and other areas. As risks are identified, risk management tasks – mainly related to contract language and obligations – are

As risks are identified, risk management tasks – mainly related to contract language and obligations – are defined. Higher risks that are outside norms are escalated to the appropriate oversite committee.

In the past, supply chain largely relied on inventory management systems, materials management information systems or supply chain modules of enterprise resource planning (ERP) systems, but nowadays the software spread extends to a variety of integrated business intelligence tools that include contract and customer relationship management, demand management, lifecycle costing and warehouse management specialties that can incorporate robotic process automation (RPA) and internet of things (IoT)/machine-to-machine (M2M) communications with external equipment.

One of supply chain’s fundamental tactics involves working with IT and collaborating on a business partner assessment questionnaire.

“Mayo Clinic has a comprehensive intake and lifecycle third-party risk management process,” said Bruce Goff, senior director,

defined. Higher risks that are outside norms are escalated to the appropriate oversite committee.

After an agreement is executed, there is an implementation assurance process before go-live.

Finally, during the course of the contract, we also conduct lifecycle management activities on a one-, two-, or three-year cycle depending on the level of risk or if the vendor has a security incident.”

Joe Dudas, division chair, Supply Chain Management Innovation and Planning at Mayo, emphasizes supply chain’s handson involvement in this process as opposed to shifting accountability and responsibility to IT alone.

“Our most senior leadership is engaged in this as is our Chief Supply Chain Officer (Jim Francis) who governs the process and oversees the results,” Dudas noted. “Supply Chain is the active manager of our TPRM processes – meaning all Repertoire

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August 2024

In fact, a wealth of studies and surveys hearkening back to the pre-pandemic years show that healthcare organizations are still playing catch-up in a desperate but perpetual chase toward cybersecurity throughout the enterprise.

The digital realm in which healthcare supply chain operates comprises networks and clouds accessed internally by large groups of staffers and contractors as well as externally by remote versions of the same, a trend accelerated by the global pandemic.

Much of the media coverage on cyberattacks in the U.S. healthcare sector centers on breaches for financial and patient data rather than on product and service strategic sourcing, contracting and transactions, but this doesn’t lure supply chain executives into a false sense of security.

Whether hackers electronically reach into contracting catalogues, email systems, product and purchasing databases all linked with clinical, financial and patient systems, hackers and hacktivists (from thrill-seeking enthusiasts to hired contractual goons or corporate stooges) know how to navigate their way through the complex web of confidential, private and heretofore thought-to-be-secure information via data breaches, phishing scams and ransomware attacks.

Factor in artificial intelligence (AI) either as a new defensive or offensive weapon, and depending on your intent, the digital fortress under which you operate that is designed to protect servers, desktops, laptops, tablets, mobile smartphones, likely no longer feels impenetrable. It’s enough to motivate a yearning for those analog days of fax machines, land lines, pagers and sticky notes.

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our supplier relationships – and built into our procurement and supplier relationship processes.

While we understand the basic requirements and standards associated with cybersecurity, our IT Security Team – and consultants under management of IT – conduct the assessments, determine risk and work with the supplier to ensure appropriate mitigation is put in place per the risk. This is comprehensive, not limited to supply chain systems.”

turnaround metrics in place that are sized for your organization.

Try to document decisions so that over time you have more objectives – think playbooks – for faster and more consistent decision making. That is doable at all-sized organizations.”

Mayo Clinic’s assessments are multi-dimensional and are based on the criticality of the system, the information contained and transmitted and the vulnerability per architectural, security, finance

August 2024

“ The bottom line is that almost anything we buy that’s not a disposable product and that touches a patient in some way or form tries to collect [operating and patient] data and connect to our network.”

Any organization, regardless of location, size or type, can and should apply this logic to their own processes, according to Goff. “[Mayo Clinic] has a very integrated and clinically driven supply chain function,” Goff said. “We work across all categories of supply – direct, indirect, purchased services. So, we already occupy a key position. For organizations not as integrated, the function needs to be located and empowered to facilitate these issues based upon your culture.

It also requires a strong internal customer service attitude so that things stay moving.

“The bottom line is that no department gets a pass or can throw it over the cube wall,” he continued. “Design a process that takes in various data points so they can review through their risk lens. Put some reasonable

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and historical risks, etc., Dudas insisted. “We would not purchase a system or enable it if risks were high and not mitigated,” he added.

Goff cited the use of “offshore services” as one example “where we have less control and less information to analyze the risk.”

Parallel pathways At BJC HealthCare, St. Louis, supply chain and IT mutually embrace their respective expertise when it comes to assessing third-party risk.

“Supply chain’s role is to assess risk and engage IT security to determine organizational risk and actions required of a supplier to do business with our company,” said Tom Harvieux, BJC’s Chief Supply Chain Officer. Harvieux’s team worked with IT security to develop an assessment questionnaire that

suppliers and vendors must complete prior to any contract signing or product purchasing.

“The bottom line is that almost anything we buy that’s not a disposable product and that touches a patient in some way or form tries to collect [operating and patient] data and connect to our network. For example, a knee implant now will have a sensor in it to see how the knee is performing, and that’s looking to connect to the internet. That’s how far this is going. Every device you buy – whether it be minor equipment, capital, blood pressure cuffs, IV pumps, compression sleeves – everything is connecting to the internet so you can integrate it with your network.”

Harvieux acknowledges that any piece of capital equipment not only connects online to the manufacturer for maintenance and technology upgrading but also to the electronic health or medical record of the patient.

“That’s why we make sure our IT security looks at our agreements with the understanding that these products are both online and inside our network,” he added.

“That’s the norm now.”

Milwaukee-based Froedtert ThedaCare Health Inc.’s supply chain team operates with similar caution and preparation.

“We work closely with our IT department to ensure that our supply chain systems are monitored frequently and remain secure,” assured Jacob Groenewold, vice president and Chief Supply Chain Officer. “We also work closely with our ERP provider to maintain a secure environment and provide regular updates to maintain up to date software platforms across our

criteria and standards of expectations of the partnership upfront, negotiating and being super clear on cybersecurity criteria/role is important,” Chawla said. “Setting that clear expectation of what we directly control and what the supplier controls is essential.

A ‘team sport’ Such efforts should offer mutual value, according to Mike Mucha, Stanford’s Chief Information Security Officer.

“Giving your partner a heads up about a problem you’re seeing should be presented and received

“ You have to put in layers of protection no matter what system you have. If you get too fragmented it gives you more systems you must monitor, more systems you have to fortify, more systems you have to pay attention to versus trying to do your best to leverage larger applications that can do many things.”

“For supplier cyber risks, you have to pick where the line is between what you’ll direct versus what you demand your suppliers take care of,” she continued.

“Where do you focus your teams, investments and controls versus legal shifting of risk to suppliers?

You can invest in active auditing of your supplier’s remote operations, but there’s always some point at which you have to rely on them to meet their contract obligations to keep their services functioning.

Once you know where you’ll draw the line, you can establish technical and process controls to detect problems. For example, your cyber monitoring and business process monitoring should link to each other so that cyber issues like phishing are detected and your organization can realize and react to phishing coming from your supply chain. It could be a sign your supplier is under larger attack that could affect their ability to service customers.”

as helpful,” he added. “We’re all in this together!”

For Coral Gables, Floridabased Baptist Health South Florida, cybersecurity remains a team sport, notes George Godfrey, Chief Supply Chain Officer and corporate vice president, Financial Shared Services.

“We are joined at the hip with our IT partners on an ongoing basis for any new technology we’re sourcing,” he said. “We’re doing technical reviews so if it’s a new technology that we’ve never deployed or even when we go to replace a technology, we’re also making sure that there’s no other connection points that we’re not aware of that changes the game. That’s an ongoing, dayto-day process that two groups manage because we will not issue a PO until those reviews are completed and until the group is satisfied that we have minimized the risk to the system.

“The clinical partners can push for something really quick, Repertoire

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enterprise. Our IT department has a very robust cyber security program, which includes frequent testing of employees and regular education to keep us informed of current threats in the market.

‘Phishing’ emails are constantly attacking us, and our IT team does a good job of working to educate us on the ever-increasing threat to our systems.”

Froedtert’s supply chain team relies on an IT assessment, too.

“Each of our vendors must go through third-party risk assessments to ensure they meet our standards for security,” indicated Jack Koczela, director, Sourcing & Transformation, Supply Chain. “In partnership with IT, we re-evaluate our vendors on a regular basis depending on the level of risk they bring to our organization.”

The cybersecurity assessment also includes teeth to close doors.

“We have had a few vendors that were unable to meet our security standards for the [software-as-a-service] solution they were hosting,” Koczela noted. “We followed our standard IT security vetting process, and they were unable to demonstrate full compliance with our requirements. After numerous conversations with the vendor, we agreed to remove the problematic function from the contract and proceed with the rest.”

At Stanford (CA) Medicine, the supply chain team invokes its risk detection and management procedures before contracting and onboarding of a supplier, according to Amanda Chawla, MHA, FACHE, CMRP, senior vice president and Chief Supply Chain Officer.

“At this foundation layer, it is essential to have clear vetting

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and we will honor that, but we will make sure we don’t move superfast and make a mistake that could [affect] the system,” he added.

Much depends on the size and type of an organization’s IT system as well, according to Godfrey. He says that larger platforms – including ERPs, business intelligence tools and contract management systems – may offer different levels of security than smaller niche systems.

“When you’re building a fortress, you have to be pure,” he noted. “You have to put in layers of protection no matter what system you have. If you get too fragmented it gives you more systems you must monitor, more systems you have to fortify, more systems you have to pay attention to versus trying to do your best to leverage larger applications that can do many things. You try to implement technology that you can leverage over multiple applications.” In short, larger organizations tend to use larger systems with more sophisticated technologies.

Godfrey admits the challenges in assessing data access and transmission risks among the myriad suppliers, vendors and

service companies that providers use, including online exchanges, pharmaceutical distributors and wholesalers, product manufacturers and distributors, transportation services and payment services.

“The challenge is how to ensure external suppliers are well protected from a cybersecurity standpoint,” he said. “It’s very difficult and expensive for a single healthcare provider to assess the many suppliers – even when having a supplier fill out a multi-page risk assessment form. Hopefully, we’re doing enough and that it’s providing value.

“We’re typically requiring this for any medical device that will connect to our system,” Godfrey continued. “It’s not that we’re

requiring a multi-form security review for a vendor that’s supplying snacks in vending machine. But if I’m connecting a [magnetic resonance imaging] unit or a [computed tomography] scanner, any type of major medical equipment that could have patient information, we’re going through a lot of due diligence to ensure that the manufacturer has followed strict guidelines that are stated by the FDA, and then there’s guidelines about what firewalls we’re going to have and what firewalls they’re going to have and how we’re going to connect.”

The breach of UnitedHealthcare’s Change Healthcare system admittedly gives Godfrey pause about the effectiveness of provider assessment efforts. “This was a major clearinghouse where you could have given them a survey and they could have provided a long list of steps they take to prevent cybersecurity issues,” he observed. “But at the end of the day, whatever they did didn’t work.” Per an “AMA Update” report, Change Healthcare isolated its systems to prevent the cyberattack from affecting the connected systems of UnitedHealthcare, UnitedHealth Group and Optum.

Back in March, the “AMA Update” cited a Cisco Talos Intelligence Group report that found healthcare as the industry most targeted by cybercriminals during the first half of 2023. In fact, in nearly half of the attacks, hackers “exploited public-facing applications to establish initial access.” Healthcare slipped off Cisco Talos’ “top targeted” list in the third quarter, according to the “AMA Update,” but finished the year as No. 3 behind manufacturing and education.

August 2024

Per the “AMA Update,” the Department of Health and Human Services Office for Civil Rights reported 733 large data breaches involving nearly 134.8 million people in 2023, compared with 55.9 million people affected by breaches reported in 2022.

See ocrportal.hhs.gov/ocr/breach/breach_report.jsf.

For the 13th consecutive year, the United States held the title for the highest data breach costs in the world with an average total cost of $9.48 million, according to IBM Security’s report titled, “Cost of a Data Breach Report 2023.”

See www.ibm.com/downloads/cas/E3G5JMBP. Within the healthcare sector alone the average cost of a studied breach approached $11 million in 2023, a 53% increase since 2020, according to the report.

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IDN Insights

The Ongoing Effort to Retain Nurses Hackensack Meridian Health shares initiatives that their health system has taken to support and retain nursing staff.

 Filling nursing job vacancies is an ongoing issue for hospitals and health systems. As employees

August 2024

on the front lines of healthcare continue to face post-COVID workplace challenges, many hospitals have witnessed high rates of nurse turnover. Hospitals, as a result, are increasingly looking for ways to market their health systems’ opportunities and appeal to nurses seeking positions in healthcare. The ability for hospitals to retain qualified nurses impacts not only its patients but also the overall profitability of the health system.

Nurses are increasingly requesting workplace changes that reflect a post-pandemic healthcare industry, including better pay, flexible schedules, a workplace focus on mental and emotional well-being, and opportunities for continuing education and career development.

Hackensack Meridian Health, a network of healthcare providers, acute care facilities, and research hospitals located in New Jersey, has responded to industry changes by investing time and funding into building a strong system-wide nursing culture.

Hackensack aims to ensure that nurses feel safe in the workplace and can conduct patient care autonomously. The overarching goal is for nurses to feel supported and that they become more likely to spend their entire career at the health system.

“We are one of the most recognized health systems in the country for nursing excellence with eight Magnet designations, and our hospitals have been Magnet designated for nearly 30 years;

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said Regina Foley, executive vice president, chief nurse executive and chief clinical transformation and integration officer for Hackensack Meridian Health, “less than 10% of U.S. hospitals have earned this recognition.”

The Magnet Recognition Program was developed by the ANCC in 1990 to recognize healthcare organizations that go above and beyond to support their nurses. The designation is based off creating a hospital work

Education and leadership Providing continuing education, in-school shadowing, and internship positions for current and aspiring nurses allows them to be brought up in their career and feel supported within the workplace. These programs have been shown to make it more likely that nurses will stick with the career of nursing. Hackensack Meridian has invested in strong relationships with higher education programs, allowing nursing students to have a consistent experience at each nursing site. Positive exposure to the profession early on encourages nurses to consider Hackensack’s health system as a place to work even before they officially begin their careers.

As the healthcare industry continues to look for ways to strengthen the current and future nursing workforce, more health systems have invested in developing both the current nursing

workforce, as well as encouraging and supporting future generations of nurses. Hackensack has invested in an enhanced education framework, with the goal of contributing to the ongoing professional development and growth of its nursing team.

“Through the integration of our three schools of nursing (Hackensack Meridian Health School of Nursing and Wellness at Georgian Court; JFK Muhlenberg and Snyder School of Nursing; Middlesex College Nursing Program) and the new Hackensack Meridian Health Sheila Cancro Institute for Nursing Leadership and Practice Excellence, a host of programs and initiatives have been advanced,” said Foley.

“These programs serve to support and further educate both current and aspiring nurses.”

to nurses, and Hackensack’s Lecture Development Series offers nursing leaders professional development opportunities.

“Hackensack continuously invests in our team and their education to ensure our nurses are empowered and that we have an environment that supports the highest quality of patient care,” said Foley.

Hackensack Meridian spends ample time developing the next generation of nursing leaders, giving them many opportunities to expand their skills. The health system additionally offers nurses education reimbursements, including tuition for employees that want to advance their careers.

Nurses are also reimbursed for national certification participation and for participating in professional development activities,

Hackensack Meridian has invested in strong relationships with higher education programs, allowing nursing students to have a consistent experience at each nursing site.

Examples of these programs include NSPIRE, an apprentice program to support newly graduated, pre-NCLEX nurses in their transition to work, The New Grad Residency Program, which develops professionalism and independence among recently graduated students.

Nurses within this program provide delivery of nursing practices using the outcome-based practice model by demonstrating competency in clinical judgment, technical skills and an appropriate knowledge base. Finally, the 2023 Beyond the Residency Program, developed in 2023, offers mentorship

including Hackensack’s RNClinical Advancement Program, a clinical ladder program.

Fostering safety and emotional well-being During the COVID-19 pandemic, patient volume within hospitals significantly increased, and the continued impacts and changes to the healthcare industry have left nurses in great need of safe and emotionally supportive workplaces.

Hackensack Meridian ensures the safety of both their nursing staff and patients through their commitment to providing a safe Repertoire

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environment that is conducive to attracting and retaining well-qualified nurses. According to research from the American Nurses Credentialing Center (ANCC), only 378 of the more than 6,000 U.S. healthcare organizations have received a Magnet designation credential for nursing.

Magnet designation has been shown to increase RN retention, decrease vacancy turnover rates, and improve patient care and satisfaction, according to Hackensack. As a result, the health system has intentionally created a Magnet culture focused on “nursing leadership, professional development, full scope of license, evidence-based practice, and interprofessional collaboration,” said Foley.

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and healthy workplace environment. Hackensack lives by the “One Team for Safety” adage, which outlines the obligation for staff to look out for each other in the workplace.

“Safety in the workplace starts with a fair and just culture,” said Foley. “By creating and nurturing a fair and just culture consistently throughout the health system, we have built trust within our organization, creating an environment where everyone feels comfortable and is encouraged to address safety and quality issues.”

they are human, technical or system-induced errors. Our team feels supported and encouraged to identify, report and address issues or concerns.”

Some additional examples of well-being and safety initiatives the health system has taken includes a complete redesign of the ID badges for patient-facing team members in acute care hospitals.

The ID badges now display the name of each nurse using the first initial of their last name, instead of their full name. This change serves to protect each nurses’ identity

August 2024

Algorithms are already being deployed across many clinical departments at Hackensack to speed up some of the daily processes for clinicians related to the supply chain. These initiatives save nurses time and increase job satisfaction, leading to a better quality of care provided to patients.

Leaders within the health system actively encourage staff to speak up for personal and team safety, emphasizing that staff members have the full support of leadership if they do.

This fosters a culture of trust and mutual respect among nurses and their supervisors.

“As part of our safety commitment, Hackensack has built trust within our organization through the implementation of a just culture, where every team member is treated justly and consistently when reporting errors or missteps,” said Foley.

“We recognize that protecting team members and making advances in patient safety depends on our collective ability to learn from mistakes whether

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while they are interacting one-onone with patients.

The health system also implemented a new electronic hand hygiene system that allows nursing and physician teams to track each employee’s hand washing practices, reducing and preventing the spread of hospital-related infections.

“The nursing practice at Hackensack Meridian is built around Watson’s Theory of Human Caring, which reflects our deeply rooted commitment to providing holistic care, and our shared belief that fully embracing self-care is essential to human caring,” said Foley.

“Research shows that the Theory of Human Caring improves patient care while reducing staff burn out.”

All these mental health, safety, and well-being practices

are organized around Watson’s Theory of Human Caring, a system of outlining four major concepts: human being, health, environment or society, and nursing. Watson’s Theory of Human Caring aims to ensure that nurses are working in an environment where they are fully supported and prepared to foster a culture of self-care for themselves, so that they can provide a healing environment for patients.

Nurses and the supply chain/ medical devices The medical device and healthcare supply industry significantly impacts nursing staff, and if improperly managed, can be a contributing factor in nurse turnover rates. Health systems have begun to address supply issues by implementing new technologies and more efficient patient care systems, ensuring that nurses have an easier time at work managing healthcare supplies.

“Hackensack continues to explore ways to enhance the efficiency and safety of the supply chain process, including the use of handheld barcode or RFID scanning tools in place of traditional supply chain management,” said Foley.

Hackensack has been transitioning to the use of artificial intelligence to streamline processes and tools related to the supply chain and medical device transfer. The health system already has several pilots in place including using AI-driven chatbots to enhance the patient experience and AI solutions to help detect chronic disease earlier on.

Algorithms are already being deployed across many clinical

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IDN Insights

departments at Hackensack to speed up some of the daily processes for clinicians related to the supply chain. These initiatives save nurses time and increase job satisfaction, leading to a better quality of care provided to patients.

“As we shift into different care settings, such as our Hospital at Home program, our health system will have different supply chain needs from medication

management to diagnostics,” said Foley. “I view that as an opportunity for the supply chain to work with us to help ensure the safety of our nurses and our patients in every healthcare setting.”

The nursing profession continues to be dynamic and variable, and it is up to health systems and healthcare leaders to foster safe, emotionally supportive workplaces with more efficient workflows.

Investing in the safety, wellbeing, and continuing education of nurses allows Hackensack and other health systems to retain nursing talent in a dynamic industry. These initiatives also encourage nurses to remain employed at a hospital for their entire career journey, supporting strong and profitable health systems and serving to reduce nurse turnover rates.

Hackensack Meridian Hackensack University Medical Center first in New Jersey to achieve Magnet Designation seven consecutive times Hackensack University Medical Center was the first hospital in New Jersey and second in the nation to achieve Magnet® designation from the American Nurses Credentialing Center (ANCC) for the seventh consecutive time, the IDN announced in February.

The distinguished Magnet® Recognition Program® is recognized as the gold standard of nursing excellence, with just 9.4% of hospitals in the United States receiving this designation.

Hackensack University Medical Center is one of the most recognized hospitals in the country for nursing

Research demonstrates that Magnet® recognition provides specific benefits to health care organizations and their communities. This includes: ` Higher patient satisfaction with nurse communication, availability of help and receipt of discharge information ` Lower risk of 30-day mortality and lower failure to rescue rates ` Higher job satisfaction among nurses ` Lower nurse reports of intentions to leave their positions “For nearly 30 years, Hackensack Meridian Health hospitals have been recognized for nursing excellence and transforming the way care is delivered,” said Robert C. Garrett, FACHE, CEO of Hackensack Meridian Health. “This designation is a testament to our world-class nursing team who provides high-quality, compassionate care each day.”

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excellence with seven Magnet designations from the ANCC. The ANCC Magnet Recognition Program distinguishes health care organizations that meet arduous standards for nursing excellence. The program focuses on advancing three goals within each Magnet organization: promoting quality in a setting that supports professional practice; identifying excellence in the delivery of nursing services to patients; and disseminating “best practices” in nursing services.

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IDN News

HSCA names Angie Boliver as President and CEO The Healthcare Supply Chain Association (HSCA) announced

that it has named GPO industry expert and public affairs veteran Angie Boliver as President and Chief Executive Officer (CEO).

The announcement follows the retirement of former President and CEO Todd Ebert, who led HSCA for seven years. Boliver joins HSCA from AB Communications Strategies, which she founded and led as President and Principal Consultant. Throughout her career, she has held a number of leadership positions at the forefront of public policy, law, public relations, and communications, including at a national GPO where she first served as Senior Legal Counsel and then Vice President of Strategic Communications, and Public Relations.

Boliver has also worked as an attorney for Jones Day. HealthTrust names Jocelyn Bradshaw Chief Operating Officer of GPO Operations HealthTrust Performance Group announced that Jocelyn Bradshaw, Senior Vice President of Strategic Sourcing, has been promoted to Chief Operating Officer of GPO Operations, effective June 1, 2024.

The role was held by Michael Berryhill who was elevated to President of GPO Operations in October 2023.

Bradshaw will be responsible for the operational activities of the GPO, member operations, and sourcing across the core, pharmacy, commercial, medical device, human resources and PBM portfolios.

Additionally, she will oversee the company’s Resource Optimization

& Innovation division, which serves members through Regard® Medical Supplies, Regard® Clinical Packaging Solutions, and ROi Supply Chain.

Intermountain Health plans for new pediatric Behavioral Health Center for children Leaders from Intermountain Health, the state of Utah, along with major Utah civic leaders have announced the new family-centered Intermountain Primary Children’s Hospital Behavioral Health Center that will offer vital behavioral health services, including a walk-in crisis center and Utah’s first dedicated space for mental health crisis care for youth with autism and neuro-diverse needs.

Intermountain Primary Children’s Hospital is constructing the new center earlier than anticipated thanks to a $25 million investment from the state of Utah and generous community support of Primary Promise, Intermountain Health’s historic campaign to build the nation’s model health system for children.

Intermountain leaders and clinicians will soon unveil renderings of the new center, talk about the vital and unique services that will be offered to patients, and outline how the center will help meet the needs of Utah children experiencing behavioral health issues, including those in crisis.

Nationally, one in five children ages 3 to 17 faces either a mental, emotional, developmental, or behavioral disorder. In Utah, suicide remains a leading cause of death for Utah youth.

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August 2024

Lifespan to become Brown University Health Amid ongoing headwinds facing the health care sector, Lifespan health system and Brown University have finalized terms on a set of expanded affiliation agreements to strengthen top-quality patient care, medical education and biomedical research in Rhode Island. As part of the agreements, Lifespan will change its name to Brown University Health later this year through a rebranding effort to be developed over the next several months, enhancing its ability to recruit and retain world-class physicians and reflecting a deeper alignment between Lifespan’s clinical care and Brown’s academic and research focus.

The agreements also include reciprocal financial investments between Lifespan and Brown, which will continue as separate, independent organizations after the implementation of the Lifespan rebrand to Brown University Health. A $15 million to $25 million annual investment from Brown to Lifespan, totaling $150 million over seven years, will be devoted to strengthening Lifespan’s financial capacity to sustain and advance the shared academic mission of the two organizations. Following that period, Lifespan will invest $15 million annually to support the Warren Alpert Medical School’s education and research efforts.

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Tech Talk

Improving Diagnostic Testing with Modern Technology  Diagnostic testing is a critical piece of the primary care puzzle, a process that gives primary care

physicians better insight into the health of their patients. These tests cover everything from blood samples, urine samples, imaging, endoscopy, and biopsy. The information that primary care physicians get from these tests is invaluable.

Repertoire Magazine recently spoke to Eric A. Reyer, DNP, ACNP, CCNS, Director of Medical Affairs / Patient Monitoring and Physical Exam & Diagnostics at Baxter, about the importance of ophthalmoscopy and otoscopy in a primary care visit. Primary care is the front line of the healthcare industry, and a timely diagnosis can make a huge impact on the patient.

Ensure that your primary care customers have the tools they need to perform these tests and take care of their patients so that they can improve their outcomes and patient care processes.

Ophthalmoscopy and otoscopy tests are clinical procedures designed to examine the structures of the eyes and ears, respectively.

These are routinely performed at most primary care offices, and they give a better picture of the total health of the patient.

Dr. Reyer said, “Ophthalmoscopy and otoscopy are fundamental parts of a patient’s visit because they are essential diagnostic tools for healthcare providers to assess the patient’s overall

health. Using these tools in a patient’s visit can help healthcare providers identify potential health issues early on, which can lead to more effective treatment and better patient outcomes.”

These exams are conducted to monitor the patient’s condition over time, giving providers an opportunity to track changes or progressions in their patients.

Many providers are looking at the total health of the patient, often using these tests to detect problems that are symptomatic of bigger issues.

Leveraging these skills to improve patient care By leveraging the fundamental skills of ophthalmology, providers can improve patient care through accurate diagnoses because of this sort of testing. Dr. Reyer said, “Ophthalmoscopy enables healthcare providers to examine the fundus of the eye, including the retina and optic disc, to diagnose conditions such as diabetic retinopathy, age-related macular degeneration, and retinal detachment. If these conditions are identified early on, they can be

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What are ophthalmoscopy and otoscopy tests and why are they important?

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Implementing new technology Medical manufacturers like Baxter are working to introduce new pieces of technology to the market that will make conducting these

tests easier, while improving the diagnostic results. Traditional methods have a certain margin for error built in, making them more difficult to use and prone to error compared to the modern technological counterparts. Newer pieces of technology like Welch Allyn’s MacroView Plus Otoscope and the PanOptic Plus Ophthalmoscope are designed to improve workflows and deliver better results.

Dr. Reyer said, “This new technology has several advantages over traditional methods, including increased accuracy, improved patient experience, enhanced visualization leading to early detection and treatment, reduced healthcare costs, and improved patient outcomes. High resolution digital technology provides detailed images allowing for more accurate diagnosis and treatment.”

As the digital age continues to sweep in and change so many of our analog tools, it can transform traditional ophthalmoscopy and otoscopy by providing real-time

imaging, a wider field of view, higher resolutions, cost savings, remote consultation, advanced image analysis, and even telemedicine. These digital tools are also helpful when it comes to tracking and monitoring progress with the patients. For example, physicians can track the previous test results for patients coming into the office for a follow-up appointment.

Armed with this capability, primary care physicians can compare results to the last time these tests were done.

“Digital imaging also provides a means of objective comparison to previous exams which was not possible with traditional exams,” Dr. Reyer said. “Patients and caregivers are now able to see exactly what the problem is through a high-resolution image so that they better understand the diagnosis and why certain treatment options may be preferable over others, instilling confidence and trust with both the provider and the plan of care.”

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August 2024

more effectively managed through progression tracking leading to timely interventions and adjustments to treatment plans over time.”

Preventative care can make such a significant difference in the life of the patient, making these tests more important for primary care environments. However, these fundamental ophthalmological skills are often not prioritized due to time constraints, inadequate training, limited resources, and misunderstanding of the importance of these exams.

About these challenges, Dr. Reyer said, “Healthcare providers are often under pressure to see a high volume of patients within a limited time frame which can lead to a rushed exam and lack of focus on these essential skills.

Others may not have received adequate training in ophthalmoscopy and otoscopy, which can make it difficult for them to perform these exams proficiently.

Some settings may not even have the equipment or resources to perform these essential services.”

In these scenarios, it amplifies the risk for missing or delayed diagnoses in patients. Prioritizing these exams can result in vision loss, hearing loss, increased risk of health complications, decreased quality of life, increase in healthcare costs, and legal implications for the provider. When providers take the time to prioritize these processes, patients can receive timely and accurate diagnoses with the appropriate treatment.

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Health News

Health News

Focusing on heart health: cardiovascular trends

August 2024

Nearly 61% of U.S. adults will be diagnosed with cardiovascular disease by 2050, as predicted by new research from the American Heart Association (AHA). The biggest driver of cardiovascular disease trends is a result of the increasing number of people in the U.S. who already have or will develop high blood pressure.

High blood pressure results in individuals being much more likely to develop life-threatening health issues including heart attacks, arrhythmias, atrial fibrillation, heart failure and congenital heart disease.

Despite treatment innovations, heart disease has been a leading cause of death among Americans for decades, and it

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is responsible for more than 800,000 deaths every year.

The AHA also predicts that 45 million adults will have some form of cardiovascular disease or will have a stroke (excluding high blood pressure) stroke in 2050, which is up from 28 million in 2020. Though cardiovascular disease is a leading cause of death in America, it can be prevented through certain lifestyle changes, according to Mayo Clinic. Not smoking or using tobacco, engaging in 30 to 60 minutes of exercise or physical activity, eating a nutritious diet, maintaining a healthy weight, reducing life stressors, and getting regular health screening tests can help reduce an individual’s risk of cardiovascular disease.

Inflammatory bowel syndrome (IBS) is a variety of symptoms that affect the digestive system.

Symptoms include abdominal pain, cramps, constipation, diarrhea, or a combination of each.

IBS is the most common disease that gastroenterologists diagnose, with experts estimating that about 10-15 percent of adults in the U.S. have IBS, according to Cleveland Clinic.

A portion of the immune system that researchers have discovered are associated with IBS are within white blood cells called macrophages, according to BBC. These macrophages flood the linings of the intestines where they release chemicals, called cytokines, that lead to inflammation.

Inflammation is part of the body’s normal response to infection, but if it goes on for long periods of time, can have drastic health consequences.

A group of researchers at the Francis Crick Institute and University College London performed a genetic analysis to determine the cause of IBS. Researchers discovered a section of genetic code, or DNA, that turns out to be the macrophage’s “master regulator” of inflammation, according to BBC. The gene identified controls the suite of inflammatory chemicals the macrophages release. Some people are born with a version of the gene that make their body prone to responding excessively. Research breakthroughs such as this one allow researchers to better understand and develop more effective treatment options for patients living with IBS.

Long Covid’s impact on the healthcare system The National Academies of Sciences, Engineering, and Medicine have released a report recognizing the seriousness of long Covid on the healthcare industry. The condition, which is developed by patients after a Covid-19 infection, is persistent and impactful for millions of Americans. Long Covid often affects a patient’s ability to function, according to the National Academies of Sciences, Engineering and Medicine, afflicting people of all ages.

The National Academies report highlighted data from 2022 that showed nearly 18 million adults and nearly a million children in the U.S. had long Covid at some point. The year that the survey was conducted, about 8.9 million adults and 362,000 children had the condition. The National Academies have identified more than 200 symptoms associated with long Covid, and the disease

has been found to impact nearly every organ in the body.

The ongoing symptoms of the disease are both difficult to treat and costly to the U.S. healthcare system, as there is not yet a standardized way to diagnose or treat the variety of ways long Covid presents in patients.

Troublesome symptoms can prevent patients from living their everyday life, causing them to be unable to attend work, school, or perform daily responsibilities.

Individuals that had more severe Covid symptoms during the initial infection were more likely to develop long Covid, according to the National Academices report, however, anyone who was infected with Covid previously were at risk of experiencing the persistent symptoms associated with long Covid. Because long Covid varies so widely from person to person and affects so many body systems, each case must be approached individually by healthcare professionals.

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August 2024

Inflammatory Bowel Disease breakthrough

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By The Numbers

Psoriasis The month of August sheds light on individuals living with psoriasis and psoriatic arthritis, along with prevention and treatment options for the disease.

4

COMMON SYMPTOMS

Symptoms of psoriasis can vary from person to person, according to NIAMS. The four most common symptoms of psoriasis include patches of thick, red skin with silvery-white scales that itch or burn, dry, cracked skin that itches or bleeds, thick, ridged nail beds, and poor sleep quality.

8

million

¼

Nearly one quarter of people with psoriasis have cases that are considered moderate to severe, according to The National Psoriasis Foundation. Psoriasis treatments vary by individual needs. The variety of treatment options for psoriasis patients is positive, as it allows healthcare providers to assist patients in finding effective treatments specific to the individual. Treatments that are available for both psoriasis and PsA include relieving pain through medication and therapy, reducing swelling, helping keep joints working properly, and preventing joint damage.

August 2024

More than 8 million people in the United States are currently diagnosed with psoriasis. Psoriasis is not just a cosmetic/skin issue. Almost 60% of people living with psoriasis reported to The National Psoriasis Foundation that the disease had a significant, negative impact on their daily lives, with a greater impact being reported among younger patients and women.

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30

%

PsA can begin at any age and may also impact children. The disease most often occurs between ages 30 and 50, according to The National Psoriasis Foundation, and for many individuals PsA begins about 10 years after psoriasis develops. Some patients can develop PsA without noticing or developing psoriasis first.

1.5% vs. 3.6%

Psoriasis prevalence in African Americans is 1.5% compared to 3.6% in Caucasians, according to The National Psoriasis Foundation. Psoriasis is likely underdiagnosed among individuals with skin of color due to differences in clinical presentation. A growing body of research aims to better define the prevalence of psoriasis among racial and ethnic groups and to shed light on disease-related disparities in the United States, according to The National Psoriasis Foundation.

125

million

Psoriasis is the result of a dysfunctional immune system, meaning it is both cosmetic and an internal immune disease. With psoriasis, an overactive immune system causes a rapid increase in skin cell production, leading to raised, scaly patches on the skin. According to The National Psoriasis Foundation and the World Psoriasis Consortium, 125 million people worldwide (2-3%) of the total population have some form of psoriasis.

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August 2024

30to50

Already having been diagnosed with psoriasis carries the risk of getting other serious conditions (comorbidity), according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). An estimated 30% of people with psoriasis also develop psoriatic arthritis (PsA), according to The National Psoriasis Foundation. PsA is a chronic, inflammatory disease of the joints, tendons, and ligaments. Other serious conditions associated with psoriasis include mental health issues, cancer, Crohn’s disease, cardiovascular events (stroke and heart attacks), and more.

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HIDA

From Warehouse to Washington Ten years of HIDA advocacy.

 Ten years is a long time in lobbying.

Ten years ago, HIDA launched its first Washington Summit and Fly-In. The idea was to bring representatives of the medical supply chain – both distributors and their manufacturer partners – to Capitol Hill.

This year, more than 80 HIDA member executives flew into Washington D.C. to ask Congressional leaders to support legislation to strengthen the medical supply chain. ` Participants met with key staff members in the offices of 75 Senators and Representatives from 35 states. Of these meetings, 48 were with the House of Representatives and with 27 Senate offices. ` HIDA members met with a bipartisan spectrum of elected officials, including 40 Republicans, 34 Democrats and 1 Independent.

By Wyeth Ruthven, Director of Congressional Relations and Public Relations, Health Industry Distributors Association

August 2024

Many of these meetings were with members on committees with jurisdiction over the medical supply chain, including the Senate Health, Education, Labor and Pensions (HELP) Committee, House Energy and Commerce Committee, House Transportation and Infrastructure Committee, and Senate Commerce, Science and Transportation Committee.

Keynote speaker Senator Susan Collins (R-ME) emphasized the need for a more resilient medical supply chain, and expressed her support for ongoing funding for domestic manufacturing and supply chain resiliency initiatives. Senator Collins was instrumental in passage of the PREVENT Pandemics Act, HIDA’s top priority in 2022. Senator Collins authored provisions to make the medical supply chain more resilient, strengthen the Public Health Workforce through student loan relief, and professional development for HHS employees through fellowships and leadership exchange programs.

In Hill meetings, HIDA members stressed several key issues essential to strengthening the medical supply chain: ` Getting Critical Medical Supplies To Patients And Providers. H.R. 6140, the Facilitating Access to Swiftly Transport Goods during a Publicly Announced State of Emergency Situation (FAST PASS) is a

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bipartisan bill directing Secretary of Transportation to examine efforts to expedite the movement of critical cargo through ports.

` Preparing For the Next Public Health Emergency. HIDA supports reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA).

The federal government uses its authority under PAHPA to assist healthcare providers responding to infectious disease outbreaks and global pandemics, including Ebola, Zika, and COVID-19. It has also supported hospitals following natural disasters such as hurricanes, tornadoes, wildfires and floods.

` Building Resiliency Into The Medical Supply Chain. HIDA

shared with Congress the findings of its recently published Supply Chain Resiliency Road Map, which articulated five pillars to support domestic manufacturing of medical supplies and maintain robust stockpiles.

Executives advocated for a strategic blend of domestic, near-shored, and global production in order to maintain a resilient supply chain that can surge to meet the demand of future emergencies.

HIDA’s Washington Summit highlighted the critical need for legislative support to enhance the resilience of the healthcare supply chain. The combined efforts of the summit participants have laid a strong foundation for ongoing legislative action to secure and strengthen the medical supply chain.

News

BD surpasses greenhouse gas reduction milestones for FY 2023 BD announced it has surpassed its Scope 1 and 2 science-based greenhouse gas (GHG) emissions reduction targets for FY 2023 by 5 percentage points and received approval for near and long-term science-based emissions reduction targets from the Science Based Target initiative (SBTi)[1]. This furthers the company’s progress toward its goal to reach net zero GHG emissions across its value chain by FY 2050.

Gaining approval of near- and long-term targets and net-zero target from SBTi supports BD’s sustainability journey by ensuring that its climate actions are sciencebased, transparent and aligned with global efforts to combat climate change. In FY 2023, the company reported an 18 percent reduction of Scope 1 and Scope 2 GHG emissions (from a FY 2019 baseline), surpassing its target of 13 percent for the year. Additionally, BD doubled the number of sites that are now using Green Electric Power and on-site renewables (solar power) since FY 2019.

To further underscore the company’s commitment to achieving emissions reduction across all scopes, BD signed the White House HHS Health Sector Climate Pledge and committed to reduce its Scope 1 and 2 GHG reduction target by 50 percent by 2030 (from a 2019 baseline, absolute).

BD’s emissions reduction goals, as well as other achievements

across the company’s 2030+ corporate sustainability goals, are reported in the Fiscal Year 2023 Together We Advance Corporate Sustainability Report.

Sysmex America announces Dan Zortman as new CEO Sysmex America, Inc. announced that longtime healthcare executive Dan Zortman has been named the company’s new CEO. Andy Hay, who has served as CEO since 2021, will continue to serve as Chairman and President of Sysmex America with a focus on the company’s emerging hinotori Surgical Robotic System business. Dan is a diagnostics industry executive with more than 33 years of experience. He has worked at Roche for the last 24 years, most recently as senior vice president of commercial operations, successfully leading the company to achieve its number one position in the U.S. market.

Dan has also held several global sales and marketing leadership positions and served as national director of sales and marketing for Roche Canada and as a regional business manager in the northeast territory. Before joining Roche, he worked in sales at Pharmacia Dx, Sanofi (now part of Beckman), Bio-Rad and Chiron (now part of Siemens).

Cepheid receives FDA Authorization with CLIA Waiver for Xpert® HCV Cepheid announced that it has received FDA De Novo marketing

authorization and Clinical Laboratory Improvement Amendments (CLIA) Waiver approval for Xpert® HCV, the only molecular test in the U.S. to detect hepatitis C virus RNA directly from a human capillary whole blood (fingerstick) sample. The Xpert HCV test is performed on the GeneXpert Xpress System.

In the United States, 2.4 million people are estimated to be living with hepatitis C and more than half of the people with HCV do not know that they have the virus. An HCV RNA test at the point of care can simplify testing algorithms, increase diagnosis rates, and support timely linkage to care and treatment.

The Viral Hepatitis National Strategic Plan for the United States calls for greater than 80% of people with hepatitis C to achieve viral clearance by 2030. Currently, the clinical care pathway for detection of hepatitis C faces many barriers, including complicated multi-step diagnostic algorithms based on antibody screening and RNA confirmation. These algorithms require centralized testing technologies that may result in treatment delays and loss-to-follow up and could discourage at-risk populations from accessing testing and receiving care. Xpert® HCV can accurately detect active HCV infection from individuals at risk and/or with signs and symptoms of HCV infection with or without antibodies to HCV from a capillary blood sample.

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August 2024

Industry News

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The Cure

Being Your Best Where You Are Great leaders develop their skills on the job.

 While the leadership journey may look different from person to person, there are some basic needs for the skills that can make all leaders successful in their careers. Specifically, good leaders understand the need for consistency and balance.

In a recent episode of The Cure with Scotty and Sully, Brian Sullivan and Scott Adams spoke to Maria Barditch, the National Vice President of Sales for Cardinal Health at-Home, a market-leading home medical supply provider serving over 4 million customers.

They discuss her advice for people looking to move into a leadership role and how to find and maintain a work-life balance.

Advice for leadership

August 2024

Great leaders understand that their time and energy is best spent wherever they are currently serving. Effective leaders know that they need to be good at what they’re doing now in order to be great at what they want to do in the future.

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Barditch said, “People ask me that question often, what do I have to do to get that other job? My first response is, you’ve got to be great at the one you’re in. Knock it out of the park in whatever your current responsibility you have, whether you love it or not.

Be great at that.”

Planting your feet in your current position is one of the best things that you can do for yourself, your team, and your organization. Create a village of people around you that can trust you to do your job well; while also giving you the feedback you need to grow and develop into the person that best fits that next role.

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Finding and maintaining a work-life balance Striking the balance between your busy work schedule and your busy life schedule is never easy, and will need revising as your life changes. For example, when you start to have kids and build a family, your balance needs are going to look much different than they did before. This is a fluid process, so it’s important to give it the space to breathe.

Barditch said that she’s boiled it down to two consistent parts – be where your feet are at and find your bookends. Balance is all about being present in the moment: if you’re at work, be at work. If you’re at home, you need to be present at home. “Where am I standing? Who needs my attention and who is getting it?”

Bookends are consistent ways that you are starting and finishing your days. Find a way that you’d like to start and finish your day so that you can draw a line and set a boundary. She said, “We’re always talking about showing up as the best version of yourself, but guess what? After hours, the folks that you interact with need the best version of yourself as well. Be in tune with what you need in your time off.”

01

The Next Generation of Midmark® Steam Sterilizers 02

Midmark Steam Sterilizers are designed inside and out to make instrument processing as easy and as automated as possible.

01 Navigate cycle setup and other processes with

a clear, fingerprint-resistant 5-inch touchscreen you can utilize while wearing gloves.

02 Determine cycle status—cycle in progress, cycle

complete and cycle error—from a distance with a progressing color-coded LED light bar, large cycle countdown clock and audible cues.

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authentication, unlimited storage of routine care events for the life of the sterilizer, and automated cycle recordkeeping.

See what makes them different at: midmark.com/nextgen

03

Scan to view the 2-Minute Drill on RepConnect.

© 2024 Midmark Corporation, Versailles, Ohio USA

Baxter has more than 100 years of innovation, 268,000 customers nationwide, and 100 configurable Welch Allyn products.

The numbers tell our story. With a broad portfolio spanning patient monitoring, diagnostic cardiology, vision screening, and physical exam tools there are always inspiring opportunities to discuss with customers.

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