REP-June.25

Addressing the Overdose Crisis

Recent American Medical Association report highlights drug overdose epidemic challenges and solutions.

Overdose Crisis

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Healthcare organizations try to forecast impact of new trade rules

Global, national economic shifts may take toll on sourcing options.

44 Tariffs Put Pressure on U.S. Healthcare Supply Chain

Tariff impact and uncertainty is a growing crisis for U.S. healthcare providers, industry collaborative says.

46 Healthcare Workforce Well-being and Better Safety Outcomes

Recent AHA report links workplace safety measures to a better patient experience.

 INFECTION

‘Urgent Threat’

Emerging fungus has healthcare providers on alert.

MultiCare

Technology in Post-Acute How technology is changing the way post-acute care is delivered.

Supply Chain Leader Spotlight

Jessica Carrillo, Director, Consolidated Services Center, Supply Chain Services for Banner Health

57 Supply Chain Leader Spotlight

Jose Flores, SPSM, Sr. Contract Administrator, Supply Chain Management, Tower Health

HEALTH NEWS

60 More Than “Just a Headache” June is Migraine and Headache

Awareness Month, shedding light on the symptoms and treatment options for headache and migraine.

Halfway Home

June marks the midpoint of the year. It’s time to pause, take a deep breath, and ask ourselves two critical questions:

 Where are we compared to plan?

 What’s it going to take to finish strong?

For those of us in medical distribution, 2025 has already delivered its share of change. Whether you serve hospitals, physician offices, long-term care, labs, or ambulatory surgery centers, the conversations we’re having today with our customers are more complex, more strategic, and more urgent than ever. Labor shortages, new care delivery models, margin pressure, and ever-tightening budgets all weigh heavily on the providers we serve. Not to mention all the changes we are seeing in distribution itself.

In May, many of us came off the road after attending our national sales meetings – McKesson, IMCO, NDC, and others wrapped up meeting season. These gatherings remind us of the strength and reach of our industry. They also reveal the rapid pace of transformation: new leadership, new strategies, and in some cases, new go-to-market models, and NewCo’s. Change is here – and it’s not slowing down.

But in the face of all that, our mission hasn’t changed. Every day, we show up for our customers. We listen. We educate. We solve problems. We get product where it needs to be. And we do it while chasing our number, managing territories, building trust, and pushing ourselves to hit the next milestone.

So what do the next six months hold? That depends on how focused we stay. It’s easy to get distracted by everything that’s evolving around us. But the reps who will finish the year on top are the ones who stay close to their customers, take care of the basics, and execute consistently. It’s not flashy – but it works.

As we look ahead, let’s not lose sight of what we’ve already accomplished – and let’s remember to celebrate the people who continue to shape this industry for the better.

This spring, we had the honor of inducting three outstanding professionals into the Medical Distribution Hall of Fame: Brad Thompson of NDC, Jonathan Overbey of Sekisui Diagnostics, and Lisa Wikstrom of Abbott. Their careers are a testament to what’s possible when service, leadership, and relationships are placed at the center of the work.

Thank you to all our Hall of Fame sponsors this year, and thank you to every one of you in the field, in the warehouse, and in the office. Keep your eyes on your plan, your customers, and your goals. We’re halfway home – let’s finish the year strong.

Dedicated to the Industry, R.

Scott Adams Publisher

editorial staff

editor Graham Garrison ggarrison@sharemovingmedia.com

editor-in-chief, Dail-eNews Jenna Hughes jhughes@sharemovingmedia.com

content creator Pete Mercer pmercer@sharemovingmedia.com

art director Brent Cashman bcashman@sharemovingmedia.com

circulation Laura Gantert lgantert@sharemovingmedia.com

sales executive Aili Casey acasey@sharemovingmedia.com (404) 625-9156

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

founder Brian Taylor btaylor@sharemovingmedia.com

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Repertoire is published monthly by Share Moving Media 350 Town Center Ave, Ste 201 Suwanee, GA 30024-6914 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia.com; www.sharemovingmedia.com

Accurate and early infection detection

The American College of Obstetricians and Gynecologists (ACOG) highlights that syphilis screening is crucial for pregnant women to prevent the transmission of congenital syphilis, which can pose significant prenatal risks. The Vitros Syphilis Assay helps clinicians accurately detect infections early to treat and prevent the spread of the disease.

Now available on the Vitros ® 3600 Immunodiagnostic System and Vitros ® 5600 and Vitros ® XT 7600 Integrated Systems in the U.S.

Managing Diabetes

Despite the rising incidence of diabetes in the U.S., we have never been in a better position to use the tools at our disposal to effectively screen the population for diabetes.

 Did you ever wonder: if lab testing impacts about 70% of all medical decisions, and if diabetes has been a known disease entity for over 3,500 years, and glucose testing has been a key element of our diagnostic arsenal for over 50 years, then why is diabetes incidence continuing to increase in the U.S.?

At the same time, it is right to ask “Are recent advances in treatment for type 2 diabetes going to help? Is our battle with diabetes at a pivot point? Have we moved on from treatment programs that put responsibility for management of type 2 diabetes (reduce carbohydrate intake, get more exercise and measure their glucose level as frequently as directed by the physician) on the patient who is likely resistant to needed life changes? Are there newer diagnostic and therapeutic tools that will assure a higher level of success in diabetic management?”

By Jim Poggi, Principal, Tested Insights

In this column, I intend to explore some of the history of diabetes, how we got where we are today and some speculation regarding where diagnosis and treatment of diabetes may go over the next few years. Spoiler alert: I do believe we are approaching a pivot point where diagnostics, treatment and patient compliance are all heading in the direction we need to reduce the incidence, cost and complications of this difficult-to-treat disease.

Back in the day

Despite being first recognized as a disease by the Egyptians in about 1500 BCE, diabetes has had a confounding history in terms of both definitive diagnosis and treatment. Early medical writings from Egypt, the Middle East, China and Rome all identified diabetes in various ways, but typically by recognizing the sweet smell of the urine characteristic of diabetes. Excessive thirst, patients losing body mass and longer-term complications such as blindness and damage to extremities were known morbidities of diabetes, but there was no effective diagnosis to identify diabetics, much less any way to treat the disease.

Little more was known about treatment until foundational work was done to isolate insulin deficiency as a cause of diabetes about 100 years ago. The synthesis of insulin and its availability as a treatment made a difference for some but not all persons with diabetes. Not until the late 1930s was the difference between type 1 (insulin deficient) and type 2 (insulin resistant) diabetes known. Insulin injections have been the first line treatment of type 1 diabetics since then. Several oral

antiglycemic medications were developed and have made a difference in the treatment of type 2 diabetes, but there has not been a real breakthrough in treatment of type 2 diabetes until recently.

It took centuries to go from noting the sweet smell of diabetic

glucose tests replaced older methods and eliminated issues with specificity. In parallel, glucose meters that came to market in the 1970s had improved speed, result quality and customer acceptance, making home glucose testing a practical reality.

Diabetes has been a long-term problem in the U.S. It has eluded diagnosis since it remains asymptomatic until it is often too late to effectively reverse. Patients have often been unmotivated since they feel well and see no real need to change life habits.

urine to even determining what the cause of the smell was, glucose in the urine. From a diagnostic perspective, developing fast, accurate and convenient glucose testing has also been a challenge. Beginning in the mid 19th century, the first crude glucose methods were developed, but they were neither reliable nor widely available. Before the American Diabetes Association was founded in 1940 and the first reasonably reliable urine glucose methods were brought to market, there was no real thought for screening and little advocacy for the diabetic patient. Improved urine glucose methods were developed in the late 1940s and 1950s. But even these early urine testing methods still lacked the specificity to be the high-quality screening tools expected for a disease with such a high incidence.

Until the 1970s, there was no highly accurate and precise method of glucose testing on blood or urine. Between the 1960s and 1970s, improved laboratory methods for blood

By the 1990s, glucose testing by glucose meter methods and in the laboratory added further improvements that made confident measurement of glucose in laboratory and home settings a reality. At the same time, recognizing the need to understand the average glucose concentration over time, hemoglobin A1C methods were developed. Providing a way to measure glucose concentrations over a 60- to 90-day period (as a function of how much glucose was bound to red blood cells) enabled physicians to understand the extent to which diet and exercise treatment programs were adhered to and how much of a difference they made. Hemoglobin A1C testing represented the first tool available to clinicians to truly understand patient compliance with their treatment program. No longer could non-compliant patients adjust their eating habits for a few days and attain a reasonable glucose level, appearing to their physician to be complying with their treatment program

while they were not. This level of noncompliance and avoidance behavior has led to severe longterm comorbidities for these patients, including blindness and amputation.

Incidence of diabetes in the U.S. today

What is the current incidence of diabetes in the U.S. now, and is the rate of incidence decreasing or increasing? Sadly, now,

The advent of better diagnostic tests, and particularly hemoglobin A1C to help distinguish patients working hard to engage in healthy life habits from those “hoping no one will notice,” improves the physician’s ability to properly coach their patients. And, some patients have embraced healthy living habits willingly, eating better and exercising more frequently. But, unfortunately, the “unworried unwell” still prevail in the diabetic population, as evidenced by the data.

diabetes is winning. Data from the Centers for Disease Control and Prevention (CDC) shows that there are presently 30 million Americans diagnosed with diabetes and a staggering 98 million prediabetics. Diabetes affects nearly 50% of the U.S. adult population.

How about the trend in incidence? This is also not a good story. Despite heart disease, cancer and lower respiratory diseases all declining in incidence between 2019 and 2020, diabetes is pulling ahead. With an increase of 14.8% it remains the eighth leading cause of morbidity and mortality and is implicated in heart disease, stroke and kidney disease that are all represented in the top 10. Equally disappointing, its increase in incidence is second only to unintentional injuries.

What is blocking progress?

The advent of better diagnostic tests, and particularly hemoglobin A1C to help distinguish patients working hard to engage in healthy life habits from those “hoping no one will notice,” improves the physician’s ability to properly coach their patients. And, some patients have embraced healthy living habits willingly, eating better and exercising more frequently. But, unfortunately, the “unworried unwell” still prevail in the diabetic population, as evidenced by the data. The fact that diabetes is a tough disease to conquer, coupled with the “unworried unwell” either deciding that change in not worth their time or that they feel OK and do not need to make any adjustments in their life are, are probably the dominant reasons that diabetes is so stubborn in the U.S.

Can we screen the “unworried unwell”?

We have never been in a better position to use the tools at our disposal to effectively screen the U.S. population for diabetes and prediabetes. With the substantial number of undiagnosed prediabetics (who most likely are also asymptomatic and therefore unaware of the need to act) by implementing large scale diabetes screening we could dramatically reduce the future incidence of diabetes and re-shape the leading causes of morbidity and mortality.

In the year for which I have the most recent data (2017), over 20 million patients with diabetes visited a primary care practice. That’s less than 16% of the total U.S. diabetic population. Do we have the resources, funding and reach to diagnose a significant percentage of the 98 million undiagnosed diabetics in the U.S.? Unlikely. To do so would require a massive focus in time, personnel and budget to get to the enormous number of undiagnosed diabetics in the U.S. It is also unlikely that there are enough primary care physicians to screen and evaluate that large of a patient base. Communicating with such a large cohort of patients itself is a daunting task.

But what if the target goal was to reach 10% of the undiagnosed diabetic population, or just under 10 million patients? If there was a concerted effort to do so, I consider it within the realm of possibility. With the current primary care practitioner base, reaching this number of patients would increase the visit load per practitioner by 37 visits per year, just under one a week. And this assumes that every

undiagnosed patient is a new patient, which is very unlikely. While a heavy lift, I do not consider it impossible if control of diabetes were to be prioritized in the current U.S. healthcare environment which seeks to manage chronic conditions.

Why am I proposing such a “blue sky” scenario? Because I believe both the diagnostic and treatment tools are at the point where early diagnosis and intervention can positively impact the lives of the U.S. prediabetic population and reduce the overall morbidity and mortality rate associated with diabetes and its comorbidities. Administrative action and prioritization from the Department of Health and

Human Services is certainly the most direct way to create needed focus. The new administration is actively prioritizing chronic diseases, but it is not presently clear where diabetes fits in. But as trusted consultants to our customers, we have the communication channel and the diagnostic and treatment tools to discuss the possibilities with them and gauge their interest in acting. We can start dialogue and see where it takes us. Every distribution account manager needs to think about how this strategy would work for them and work with their management to decide how to proceed and to what extent. But you must admit it is an intriguing idea.

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Your diagnostic and treatment tools

From a diagnostic viewpoint, we are in an excellent position. The greatest need is to get patients in front of the diagnostic tools. Hemoglobin A1C has proven its worth as an excellent way to diagnose prediabetics. There are several peer reviewed articles attesting to the success rates of this diagnostic tool. Ask your

but the difference in glucose levels at two hours is significant between normal patients and those with diabetes. The data I have seen shows about an 80-90 mg/dL difference between these two groups. It is significant enough to be easy to identify.

Consult with your trusted quantitative glucose manufacturer to get the facts and help you be able to offer this option. At the

Now with better-than-ever diagnostic tools and new-and-improved treatment choices, I believe we finally have a chance to take diabetes on with the prospect of reducing its incidence and impact on the health of Americans. The question remains: what will it take to do it? Can we exercise our skills and abilities as respected consultants to ask our key customers to put more focus on diagnosis of diabetes?

trusted lab product manufacturer to help you understand the information and provide you with the value proposition and qualifying questions to discuss this option with your key customers.

There is a range of CLIA waived and moderate complexity options to present to your customers. Be sure to confirm that the options you are proposing are cleared for diagnosis, as well as monitoring of hemoglobin A1C levels. In addition, there is renewed emphasis on “two-hour post prandial” glucose measurements. Granted, assuring the right time between the initial glucose meal, the start of fasting and measurement of glucose needs to be carefully controlled,

same time, changes in technology and availability of technology have made continuous glucose monitoring a reality for patients post diagnosis. There are multiple options available today and your lab category team, colleagues and manager can point you to the leading options. Why is this important? Because ready availability of this information can help patients manage compliance and make life changes needed to control their glucose levels. This is not an easy change, and this tool provides needed feedback showing progress.

Treatment options have also undergone significant changes in the past few years, taking away the clinician objection of “I can

diagnose diabetes, but I may not be able to treat it effectively.”

There is now a simple, fast and effective way to diagnose changes in retinal blood flow to help detect changes before diabetic retinopathy occurs, preserving eyesight for the diabetic patient.

Finally, who has not seen the television ads for new diabetic treatment choices from a new class of drugs called GLP-1 agonists? This new category of treatment involves giving the patient a drug that mimics what “glucagon like peptides” do in the normal patient: regulate insulin levels and carbohydrate metabolism. Their mechanism of action is broad based and while regulating insulin availability, they also regulate appetite and work to restore a more normal metabolic balance in patients with type 2 diabetes.

While understanding their mechanism of action is complicated, the results are impressive. There are multiple options on the market today and results in controlling type 2 diabetes and triggering weight loss have been well documented. While they do not restore the normal metabolic balance and must be administered on an ongoing basis, there is no doubt that they provide an effective, new means of controlling the metabolic factors involved in type 2 diabetes. Expect even more advanced therapeutic choices as pharmaceutical companies analyze the results of patient treatment and look for ways to create even more sophisticated and long-lasting treatment options.

Diabetes: Can we beat it?

Diabetes has been a long-term problem in the U.S. It has eluded

diagnosis since it remains asymptomatic until it is often too late to effectively reverse. Patients have often been unmotivated since they feel well and see no real need to change life habits.

At the same time, while diagnostic tools have been available, the number of undiagnosed diabetics in the U.S. has risen to nearly 100 million showing diabetes has resisted our efforts to control it. And treatment options for type 2 diabetes have shown modest effectiveness unless coupled with patients willing to take charge of changing their eating and exercise habits.

Now with better-than-ever diagnostic tools and new-andimproved treatment choices, I believe we finally have a chance to take diabetes on with the prospect of reducing its incidence and impact on the health of Americans. The question remains: what will it take to do it? Can we exercise our skills and abilities as respected consultants to ask our key customers to put more focus on diagnosis of diabetes? Can public health clinics step and help work to improve reach in diagnosis? I believe we have the tools.

I do not expect a new U.S. healthcare focus on diabetes with the intent to radically drive

down incidence. We likely could not effectively manage that scale of an initiative. But, what if, as trusted consultants, we led grass roots activities – community screening programs, health fair days, support for community healthcare clinics and messaging to our key customers on actively screening for diabetes. I believe that is where we can provide guidance, effective consultation and could make a difference.

What’s the old saying?

“Think globally but act locally?” I believe that is where each of us can make a difference, and our combined efforts can make a substantial difference.

Achieving Unprecedented Sales Success

A guide to overcoming obstacles and achieving sales career development.

By Jenna Hughes

 Feeling stuck in your career journey isn’t necessarily a sign that you’re failing. In fact, it may be a sign that you’re ready for more, according to Laura Gassner Otting, an author, catalyst, and executive coach.

Gassner Otting spent 20 years leading executive searches. Along the way, she helped many people navigate vulnerable moments in their career.

“My journey has been anything but linear – it’s been a series of pivots, leaps of faith, and moments of both confidence and uncertainty,” said Gassner Otting, author of the Wall Street Journal best-selling book “Limitless.”

Gassner Otting started her career in politics, working in the Clinton White House, where she helped shape national service programs. Then, she spent two decades in executive search, helping mission-driven organizations find their leadership. “That experience showed me firsthand the difference between those who succeed on paper and those who thrive.”

During her own personal career journey, Gassner Otting found that the most profitable, fulfilled, and productive individuals in companies weren’t always those who worked harder, but those who knew how to connect their work to their passions.

Gassner Otting recently spoke to Repertoire Magazine on how sales reps can achieve long-term success.

Finding personal fulfillment

If you feel like you’ve hit a ceiling, it may be time to take a step back and reassess, said Gassner Otting.

“The question isn’t whether you’re good enough. The best

salespeople don’t sell – they help,” asserts Gassner Otting. “Are you proactively deepening relationships rather than just responding to what’s in front of you? Are you solving bigger problems? Are you

Laura Gassner Otting

positioning yourself as a trusted advisor rather than just a salesperson? When you shift your mindset from transactions to transformation, success follows.”

An integral part of success in sales comes from our own internal motivators. Finding confidence and voice can help salespeople to overcome obstacles, and, by pushing past internal limiting beliefs, salespeople can achieve more in their career than they ever thought possible.

Considering pointed, specific goals and desired outcomes before interacting with customers allows for preparedness in sales meetings, allowing you to connect with the customer, know your product, and drive results.

“Confidence doesn’t come from knowing you’ll never fail – it comes from knowing that failure won’t break you,” said Gassner Otting. “The best salespeople don’t have some innate, unshakable self-assurance. They build their confidence through action, resilience, and relentless curiosity.”

Generating voice and confidence

Start by identifying your own distinctive purpose as a sales rep. Is it forging trusting relationships with customers? Providing lifesaving products across the industry? A work-life balance to spend much needed family time? Your purpose, one or many, guides you; you cannot be fulfilled by someone else’s goals.

Sales reps must therefore match what they do to who they are, also known as consonance, which requires creating one’s own definition of success. Consonance can be reached through

the four elements of calling, connection, contribution, and control, as described in Gassner Otting’s book ‘Limitless:’

1 Calling: A gravitational pull toward a goal larger than yourself.

2 Connection: Gives an individual an understanding of how their everyday work serves their calling.

3 Contribution: An understanding of how your job, paycheck, company, etc. contributes to the person you want to be.

4 Control: Reflects how you influence your connection to your ultimate calling (such as in the assignment of projects, deadlines, and clients; offering input into shared goals, and doing work that contributes to your career trajectory).

Until you can control how connection and contribution are influenced by calling in your career, you will continue to be limited in confidence to make choices and take chances.

Once you begin the process of focusing on the four elements of consonance, Gassner Otting’s overarching piece of advice for a successful lifelong career in sales is to stay “relentlessly curious.”

“The people who thrive over the long haul are the ones who never stop learning, adapting and growing,” said Gassner Otting. “Your career is not a fixed identity; it’s a series of choices that you get to make. Keep asking yourself: ‘What excites me? Where can I add the most value? What do I need to learn next?’ If you keep pushing your own boundaries, your career will never stagnate – it will always expand to meet the size of your ambition.”

A guide to a lifelong career

Finding your own sense of purpose, or reason for which you do something, is key to success, which encompasses your career, company, personal life, and beyond.

“Everything I teach comes from what I’ve lived. I’ve had moments where I thought I was at the top, only to realize I was deeply unfulfilled,” said Gassner Otting. “I’ve had to reinvent myself multiple times and embrace the unknown.”

Stepping into discomfort can allow you to find new paths and opportunities, and may ultimately lead you to discover a more fitting, fulfilling career and personal journey.

“Eventually, through experience, I realized my true calling: helping people see their own potential and build lives that align with their greatest ambitions. That led me to write books, speak on stages around the world, and coach high achievers to get out of their own way.”

Success isn’t always about finding the perfect path – instead, it’s about making bold moves, learning along the way, and giving yourself permission to evolve.

“Often, we spend so much time climbing the ladder that we forget to ask if it’s leaning against the right wall. Too often, we chase the version of success that society, our industry, or even our past selves told us we should want – only to get there and realize it doesn’t feel the way we thought it would,” said Gassner Otting. “Real fulfillment doesn’t come from external validation; it comes from alignment. If success doesn’t feel satisfying, it’s a sign that you need to redefine it on your own terms.”

Reframe the Game

What to do when they say “too expensive.”

By Brian Sullivan, CSP – PRECISE Selling

 Let’s be honest – there’s nothing quite like putting together a killer presentation, mapping out the solution, maybe even showing up with warm donuts, and then hearing the words:

“Yeah, but your price is just too high.”

Cue the internal scream.

Price sensitivity is the new national pastime. With tariffs climbing, budgets shrinking, and procurement departments auditioning for Shark Tank, it’s easy to feel like you’re constantly on the defensive. But here’s the good news:

The best reps don’t play defense. They reframe the game.

If you’re tired of getting squeezed, ghosted, or hit with last-minute price objections, I’m going to give you the playbook for flipping the script – and becoming that rep buyers remember.

First, stop apologizing for price

Look, I get it. We all want to be liked. But unless you’re planning on handing out coupons with

your quotes, it’s time to ditch the apologetic tone.

“Yeah, our price is a little higher but –”

No. Stop. You lost me at “little.”

Instead, try this:

“I know you’re under pressure to reduce spend. The real question is – what would a delay in this product line cost your team, your patients, or your reputation?”

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Boom. You just shifted the conversation from price to impact. From transaction to trust.

Your real job? Risk manager, not product pusher

If you’re still selling features and hoping someone notices the ROI on page four of your brochure, you’re playing checkers in a chess match.

Top reps – the ones who own the room – know that the cost of the wrong decision is far greater than the cost of their product.

 Let them imagine the fire drill. You don’t need to scare them, just be the one holding the extinguisher.

3 “What would this cost you in patient care, staff time, or lost trust if it doesn’t perform?”

 Ding ding ding. Now they’re thinking beyond the invoice.

Tell a freakin’ story (Preferably one that happened to you)

You could say:

“We have a 98.7% fill rate.”

“ This market’s unpredictable. That’s why we’ve doubled down on U.S.-based fulfillment, emergency inventory, and partner accountability. You don’t just need a supplier. You need a backstop.”

Want to test it? Next time someone says a competitor is “cheaper,” ask: “How’d that cheaper option work out the last time?”

(Spoiler: it didn’t.)

Use these 3 “price flippers” in your next call

These questions don’t just redirect the conversation – they elevate it.

1 “What are you hoping to accomplish with a switch?”

 Translation: Are you chasing short-term savings or solving long-term pain?

2 “What happens if this product fails – or doesn’t arrive on time?”

Or you could say:

“We had a client last month who tried to save a few bucks with an offshore brand. Two weeks later, their materials were stuck in customs and they had nothing for the morning cases. We got them back on track in 24 hours. Guess who they’re still ordering from?”

Or here’s one from my own playbook: Years ago, I had a hospital buyer who nearly passed on our IV start kits over 11 cents per unit. Procurement was pushing them hard to cut, so they went with another supplier. Four weeks later, they called me back after three kits in a row failed – one mid-procedure. Nurses were

fuming. I didn’t say “I told you so,” but let’s just say … I’ve been their go-to ever since. Stories sell. Stats yawn.

Let’s talk tariffs (Without whining)

Everyone knows costs are up. But if all you do is echo what the client already knows – “Yeah, those tariffs are brutal” – you’re adding zero value.

Instead, frame the current chaos as proof of why they need you. You’re not just a vendor, you’re their supply chain therapist.

“This market’s unpredictable. That’s why we’ve doubled down on U.S.-based fulfillment, emergency inventory, and partner accountability. You don’t just need a supplier. You need a backstop.” Now that’s a partner worth paying for.

Value isn’t a line item

Your buyer isn’t just buying a product. They’re buying:

 Confidence that it’ll show up on time

 Peace of mind that their reputation is safe

 A partner who will answer the phone when things go sideways

So, when they say, “This is too expensive,” don’t cave.

Smile.

Ask the right questions. And remind them what’s really at stake.

Because if you’ve done your job right? They’ll realize… You’re not the expensive rep. You’re the smart one.

Brian

From Competence to Capability

The evolving landscape of leadership.

 Over the past decade, we’ve witnessed a profound shift in the nature of effective leadership. What once revolved around competence – defined by a reliable set of skills like planning, decision-making, and team development – has now evolved into something deeper and more dynamic: capability.

Randy Chittum

Historically we have paid attention to outward things like planning, decision making, developing others, leading a team, and so forth. Capability is more of the “inner game” way of thinking about leadership, said Randy Chittum, PhD., a leadership consultant.

When senior executives are surveyed, a great number of them refer to increasing complexity

as a major challenge for their organization. When things are truly complex (unpredictable), all the old leadership lessons are insufficient. “In this world, we need leaders who are present to emergence, who are adaptable, and can shift as things evolve,” Dr. Chittum said.

However, doing this requires that leaders can see what they might not have seen before.

Further, leaders in this world need to understand how their own internal sense-making keeps them seeing what they are used to seeing.

Repertoire Magazine spoke to Dr. Chittum about how leaders can move more into the inner way of thinking.

New ways of fostering trust

The most obvious area of change for leaders over the last five years is in managing remote workers and teams. Less obvious but connected is leading culture and having staff feel “a part of” the organization even within the remote framework, Dr. Chittum

said. “In many places, staff have been reduced to a metaphorical ‘pair of hands’ with less energy and commitment to the purpose and the cause,” he said.

But the challenges go beyond remote work. “I suspect that many people changed their feeling about, and relationship to, our institutions in general,” Dr. Chittum said. “This includes work. The nature of the pandemic likely shifted our values to more family and personal well-being.”

Remote work environments mean leaders must think about fostering trust and communication in new ways. Dr. Chittum said some client organizations,

and leaders, do this better than others. “I think it is easy to lose sight of the fact that in most cases, leaders and employees enter into this new world in the context of a pre-existing relationship. If I already had trust and good communication with my leader, it seems easier to hold on to that, even as context shifts. The opposite is also true.”

More practically, Dr. Chittum has seen a lot of well-managed organizations take tactical approaches to helping people be in the same space at the same time more often. Those seem to include some days when everyone is in the office and some

meetings (typically offsite) where bigger issues are tackled. “In many ways, this is not unlike what we did before.”

Again, the bigger challenge for many is that the changing work dynamics have made us accustomed to new ways of being together. “Like always – it is hard to help people shift out of what they know and expect.”

Empathy and compassion in the modern workplace

People need and want more empathy from their peers and leaders. Given how much meaning we get from our work (at least in the U.S.), having people appreciate us feels critical. And it feels much harder to do in a remote world.

“If empathy is basically defined as the ability to see the world through my eyes, that gets much harder when there is a whole part of your work life (at home, with family, etc) that I don’t have access to,” Dr. Chittum said.

To that end, compassion might be a more important characteristic than empathy. Can leaders have grace for their employees and assume the best of intentions? The counter to this is companies that do things like monitor the number of times your computer mouse moves in an hour. “That kind of transactional thinking quickly destroys trust and empathy, and compassion,” said Dr. Chittum.

The next decade

How to adapt to constant change and uncertainty in the marketplace is the question of the next decade for leaders. Dr. Chittum said adding to the challenge is that the new political eco-system

One underutilized skill

Dr. Chittum believes one of the most underutilized skills for today’s leaders is quitting. Behavioral economists have a smart way of thinking about quitting, he said. “It happens when the combination of sunk cost combines with opportunity cost. If the sunk cost doesn’t outweigh the opportunity cost, we should quit. This is a more practical approach to emergence and again, requires constant care and attention to what is shifting around us.”

is a great cause of uncertainty and change.

“The mistake most of us make is we love our certainty and are thus prone to create ‘false’ certainty even when none exists,” he said. “We do this for psychological reasons but with real life impact. Part of

the reason we love our certainty is that our lazy brains can stop thinking. Certainty equals a clear path forward in our minds. Michael Bloomberg said, ‘we are more certain than ever, but less informed, and far less thoughtful.’ I think that sums up the challenge pretty nicely.”

Comfort with emergence is a key leadership capacity for our times. This requires intense presence to what is truly happening and constantly reassessing that reality. It sounds simple, but requires a different energy and focus than many leaders are used to. “I recently asked a team of executives to individually write a response to this question – ‘what is true now,’” Dr. Chittum noted. “Unsurprisingly, there was very little agreement on something so fundamental.”

The further challenge is to embrace presence and emergence with a sense of optimism and possibility. Noticing is a key capability and responding to what is noticed is a key leadership competence. “If we ruminate rather than reflect, we get drug down an emotional intelligence hole, from which we are incapable of leading anything.”

A delicate balance

In the book “Good to Great,” author Jim Collins talks about how successful companies have an enduring purpose, stimulated by big goals (what Collins called BHAGs – Big Hairy Audacious Goals). “I suspect companies today still need both of those things, and the ability to shift out of either or both as new reality comes online.”

Given that both are good and useful AND that either or both can be over-used (in relationship to the other) – a set of early warning signs could be valuable. “How will we know if we’re over-playing one of these against the other?”

What looks like innovation is often a response to emergent thinking. “Those who can see what others cannot (and see it sooner) are more likely to seem innovative. And good innovation often protects the core,” Dr. Chittum said. “One of my favorite ‘both/ands’ is to honor the past and innovate for the future.”

Randy Chittum, Ph.D. has spent his 25-year career working with leaders and executives worldwide in a variety of organizational settings. He works at all levels of the organization, specializing in leadership development (individual and team coaching, leadership workshops covering emotional intelligence, coaching for managers, managing change and transition, and branding and personal presence), and organization development (team and system level interventions) including strategy development and learning to collectively think differently to support sustainable change. Learn more at still-leading.com

People at the Center

How human-centered leadership can transform your organization.

By Pete Mercer

 In the last few years, we have seen several major movements happen in the workforce. During the height of COVID, employees across all major industries resigned en masse due to a variety of reasons – pay stagnation, inflexible working environments (aggravated even more so by the pandemic), and an overall job dissatisfaction.

This was called The Great Resignation, and it reflected an overwhelming lack of engagement from the American workforce. The fact that the pandemic was a catalyst for this movement is merely circumstantial – this was a workforce that felt undervalued by the leaders and the organizations that they worked for. This is exactly what a human-centered work environment is designed to avoid.

Repertoire Magazine recently sat down with Ryan Estis, keynote speaker and author of Prepare for Impact: Driving Growth and Serving Others through the Principles of Human-Centered Leadership , to discuss what human-centered leadership looks like and how leaders can use it to change their growth strategies.

What does humancentered mean?

So, what is a human-centered organization? Estis described it as an organization “that embraces a philosophy that prioritizes people. They become the center of decision-making, strategy and culture – the way into that is prioritizing people and leading with empathy, trust, mission and outcomes.”

A human-centered organization is led by a leadership team that cares about its people, largely placing people over

profit. Leaders at human-centered organizations understand that the priority is to help other people become the best possible version of themselves. This approach stems from a servant leader mindset.

These organizations are highly collaborative environments that allow for creativity and are constantly looking to improve their processes to allow for that collaboration and creativity. Estis said, “From an enterprise perspective, it’s one that prioritizes people over process, or deeply considers the impact and outcomes around people. It includes an organization that was purposedriven, with a very clear thesis on the impact and vision of the organization that people could align with and support.”

Address the employee engagement crisis

It’s important for leaders to understand the changing dynamics of the workplace. There are greater expectations for how an organization and its leadership team should operate and employee engagement is at the forefront of the conversation.

Employee engagement is at an all-time low these days.

Ryan Estis

Gallup’s 2024 State of the Workforce Report found that only 23% of employees across the world are thriving at work today. With those kinds of engagement numbers, it’s bound to affect customer relationships at one point or another. Think of it as a trickle-down effect – when your team is not actively engaged with their work, the customers will feel it.

“The way customers feel about doing business with you is very often informed by how employees feel about coming to work,” Estis said. “Those two things are interdependent, and we’re seeing a sea change in both employee attitude and expectations and customer requirements in real time right now.”

Estis said that one of the most meaningful things a leader can do is have one conversation a week with each of their employees, but there are a variety of factors that prevent that kind of connection from happening on a regular basis.

“I think fundamentally, people want to be seen, heard, understood and valued. Leaders need to invest the time to build those high-trust relationships to nurture, care and develop people and put them in a position to be successful. That’s our responsibility, but it takes time and competency to do it.”

Balancing driving results with a healthy culture

As with all things, operating with a human-centered mindset requires a certain amount of balance to maintain results and a healthy culture. Culture should never be sacrificed at the altar of results, but you can’t run a company without results – balance is key.

“If you’re going to be a leader and earn fellowship, you have to take care of people, love people, value people, and invest in people. One of the most loving, kind things you can do for people is to hold them accountable to very high standards of excellence,” Estis said.

The most important component in the results-culture equation is honesty. Without honesty, your team is much more likely to flounder without making much progress. Open, honest and consistent feedback is essential for these environments. For Estis, the best leaders for these environments are coaches.

integrate into our daily processes and improve efficiency, but it can be tempting to overly rely on these tools.

Your customers are smart enough to tell the difference between human-generated communications and communications that are pushed by CRM software. Estis said, “That isn’t what people respond to the best. They respond much better when we make an effort and a commitment to understand them personally. The right way to think about technology automation is that they are tools that can create more efficiency to empower us to do the things that only humans can do.”

“The way customers feel about doing business with you is very often informed by how employees feel about coming to work,” Estis said. “Those two things are interdependent, and we’re seeing a sea change in both employee attitude and expectations and customer requirements in real time right now.”

“The best, human-centered leaders hold that balance very closely. They prioritize people, but it isn’t a soft skill. Finding that balance is one of the hardest things we can do. But the leaders that get that right are the ones that I think are putting both their individual contributors and their teams in a position to be innovative and successful.”

Integrating automation and AI

As the world continues to shift towards AI and automation, it’s important to understand their utility in the workspace. These are incredible tools that can seamlessly

All it takes is to find a natural way to integrate these tools with your existing workflows to improve efficiency without replacing the human element that makes your organization so special. More than ever, people are looking for connection at every touchpoint – by operating with a humancentered lens, your team will be more equipped to meet the needs of your customers.

“People can solve incredible problems in innovative ways for customers, but we have to create the right culture, structure and processes for that human potential to be unleashed in the right direction.”

PWH and the PWH Leadership Summit are Rooted in Leadership

By Rachel Bailey, Editor, PWH Connect Journal

 The Professional Women in Healthcare ® (PWH) organization held its seventh annual PWH Leadership Summit in Frisco, Texas, March 31 to April 2, 2025. The three-day event is the industry’s only conference dedicated to enriched leadership development. This year, with a theme of “rooted,” the event drew 230 executives and aspiring leaders.

Sessions offered attendees plenty of twenty-first century fertilizer to grow their roots, from learning how to apply AI tools and design thinking to speed mentoring and leadership support.

Vizient sponsored the event’s opening keynote speaker, Erin Diehl. Presenting on empathic leadership, Diehl encouraged attendees to “discover a newfound sense of self-love, empathy, and inner peace” to advance “positive relational energy.”

Ashlee Gerrie, Marketing and Communications Manager for Premier, attended Diehl’s session. “I loved the opportunity to attend many great sessions, especially the

one with Erin Diehl, changing our scarcity mindset to an abundance mindset, from ‘am I enough?’ to ‘I AM ENOUGH!’

After the event, Gerrie, who also serves as Vice Chair of the PWH CID Committee shared on social media, “I am incredibly grateful for the opportunity to attend#PWHSummit2025, where I had an amazing experience that significantly contributed to my professional and personal growth. The Summit provided a fantastic platform for networking and enhancing my skills, and I am thankful for the support and encouragement from my Premier Inc. family*.”

Ashleigh McLaughlin, PWH Chair and Chief Financial Officer of IMCO Inc., explained to attendees the meaning behind the event’s theme during the opening session on day two. “Our theme of ‘rooted’ honors the “women who have paved the way for us, whose passion, commitment, and influence created the PWH community that we know and cherish today. Their vision laid the foundation for an organization rooted in the belief in an industry equally led by women.”

One of those women is PWH Past Chair and PWH Board Advisor Julee Prefer who helped plan the inaugural Summit in 2018. Prefer helped coin the term “Leadership Insights” for the Summit’s signature session that features five industry leaders who inspire attendees with unique 15-minute TED-style talks on a variety of industry and leadership issues.

This year’s set of Leadership Insights was sponsored by Midmark. Attendees heard from:

 Matt Bourne, Chief Commercial Officer for Midmark

 Jenny Collopy, Vice President and Chief Marketing & Communications Officer for The Christ Hospital Health Network

The PWH Board is comprised of voluntary and active PWH members who also serve as members of the PWH Executive Committee, as Chairs or Vice Chairs of the organization’s nine other committees, and as Board Advisors.

 Lamont Robinson, Leader of Small Business Development

 Rachelle Ferrara, Senior Vice President of Enterprise Account Management for ModivCare

 Jack Stephens, President and CEO of NDC Inc.

 Ashley Vertuno, Chief Executive Officer of HCA Florida JFK North Hospital

An event unique to this year’s Summit was the Special Executive Leadership Roundtable. C-Suite executives from PWH Corporate Partners were invited to be part of a collaborative conversation intended to help shape the future leadership of the industry. Participants discussed how to deploy practical strategies to amplify the influence of women leaders, build stronger leadership pipelines, and foster a culture of sponsorship and advocacy that embraces diverse perspectives.

The 2025 PWH Leadership Summit wrapped up with a leadership panel sponsored by B. Braun and moderated by John Pritchard, Publisher of the Journal of Healthcare Contracting and President of Share Moving Media. The session was entitled “Ring of Honor: Rooted in Leadership.”

Sarah Charai, Executive Director of Supply Chain Operations for Cleveland Clinic; Andrea Harrison, Senior Vice President of Product & Solutions for Owens & Minor, and Clinton Hazziez, Vice President Supply Chain & Sourcing for Baylor Scott & White shared stories of resilience, risk, and growth.

Michele Rodriguez, Revenue Cycle Manager for Byrum Healthcare was especially inspired by the closing panel. “Our last day! It always goes so fast. I am truly blessed that I was able to attend for my fourth year. These summits are

very much needed and appreciated. Thank you to everyone who was a part of putting this together. Our panel discussion inspired us to get rooted in leadership and included our very own Andrea Harrison.”

After the event, PWH Chair Ashleigh McLaughlin thanked the team of PWH members who put on the 2025 Summit. “I’m riding such an incredible high today and feeling so lucky to be part of such an inspiring group. Your leadership and commitment continue to shape the future of PWH in powerful ways, and this Summit was no

exception. I’m proud of what we accomplished together and even more excited for what’s ahead.”

The PWH organization is grateful for Summit sponsorship from 18 industry-leading organizations and for the generous support of 24 corporate partners. Thanks also goes to the PWH Leadership Summit Committee, chaired by April Shomper, Sr. Director, Events Strategy & Planning, Vizient.

The 2026 PWH Leadership Summit will be held in West Palm Beach, Florida, May 18-20, 2026. For more information visit mypwh.org

Honoring our Roots with PWH Awards

Four PWH members received the following PWH awards at the 2025 PWH Leadership Summit

1. Shellene Baines, PWH Mentoring Committee Chair received the 2025 Sandra Parker Leadership Scholarship with funding from Graham-Field.

2. Mary Poffenbarger, Supply Chain Information Systems - Security Reports & Analytics for Nebraska Methodist Health System, MBA, received the 2025 GHX Leadership Scholarship.

3. Khaki Weber, Past PWH Mentoring Committee Chair and Partner at Weber and Associates Consulting received the 2025 Jana Quinn Inspirational Award.

4. Cindy Juhas, PWH Founding Member, PWH Past Chair, and PWH Board Advisor received the 2025 Anne Eiting Klamar Leadership Award of Distinction.

During the Summit’s speed mentoring event, attendees had fun networking in a brief, informal, speed-dating like setting.

Contribute 2025

Concordance Healthcare Solutions strengthens connections, strategy and culture.

Courtesy of Concordance Healthcare Solutions

 The Contribute 2025 event, hosted by Concordance Healthcare Solutions in Columbus, Ohio, gathered over 150 Concordance team members and more than 100 supplier partners and exhibitors for an impactful, intimate experience centered around resilience, innovation and laying the groundwork for a stronger future.

Held at the Hyatt Regency Downtown, the event offered a unique opportunity to deepen collaboration and reflect on what it means to work together in today’s healthcare landscape. From breakout sessions to supplier exhibits, the focus was on connection –trust, communication and shared purpose – emphasizing that relationships drive real results.

Legacy and leadership in the spotlight

A profoundly moving moment came with the dedication of the first-ever “Bill Black Memorial Award,” honoring the late Bill Black, former Director of Supplier Relations, who passed away in September 2024. His children, Adam and Jocelyn, accepted the award in his memory.

“Bill was greatly missed as we gathered together,” said CEO Lisa Hohman. “He played such a big role in the industry. His influence is still felt in the way our team and partners approach relationshipbuilding. I have no doubt we’re making him proud.”

Innovation front and center

This year’s meeting also highlighted key strategic initiatives. Presentations from

Panelists shared how the platform –found at WeAreSurgence.com – is driving smarter supply chain decision-making and improving visibility across the healthcare supply chain.

the leadership team – including Hohman, CFO Sean Spraley and CIO/COO Keith Price – focused on Concordance’s cultural foundation, the continued evolution of its go-to-market strategy and the drive toward execution excellence.

A standout session was the Surgence lunch panel, featuring representatives from Cleveland Clinic and Cook Medical, alongside Surgence leadership. Panelists shared how the platform – found at WeAreSurgence. com – is driving smarter supply chain decision-making and improving visibility across the healthcare supply chain. Their insights reinforced the real-world value Surgence brings to both providers and suppliers, sparking meaningful conversations around

how unlocking visibility enables operational efficiencies, resiliency and value creation.

Inspiration, collaboration and forward momentum

The event also featured Sean Swarner as keynote speaker, whose extraordinary story of perseverance inspired attendees to push boundaries and lead with purpose. Insights from the MMCAP Infuse team added further depth to conversations around partnership and value. Contribute 2025 wrapped with renewed energy, deeper alignment and a clear sense of purpose. As Hohman noted, “We strengthened our strategies – but more importantly, we strengthened our relationships. That’s how we succeed – together.”

Better Health Better Future

Addressing the Overdose Crisis

Recent American Medical Association report highlights drug overdose epidemic challenges and solutions.

By Jenna Hughes

Since the 1990s , overdose deaths in the U.S. have risen significantly, driven by the use of opioid medications and illegal drugs. For decades, the nation has continued to face a severe drug abuse and overdose crisis, calling attention to the urgent need for broader healthcare and public intervention strategies.

Despite ongoing efforts to combat drug abuse, the overdose epidemic has persisted, remaining a complex public health challenge. Most U.S. overdose deaths involve opioids, according to the National Institutes of Health (NIH) , a group of drugs that includes illegal substances like heroin and prescription pain medicines. In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a national public health emergency. Overdose deaths related to illicitly manufactured fentanyl, fentanyl analogs, methamphetamine and cocaine have also reached historic heights.

NIH data on drug use and overdose death rates reveal that the overdose epidemic has become extensive and national, affecting people of all racial and ethnic groups – in cities, suburbs, small towns, and rural areas, and that rates of drug overdose are rising among almost all groups.

To highlight the increasing need for solutions that address drug abuse, the American Medical Association’s (AMA) Substance Use and Pain Care Task Force released “The 2024 Overdose Epidemic Report”. The report emphasizes the need for better policies to address inequities and improve access to medications for opioid use disorders. Although there has been some progress, overdose deaths remain high, and outdated prescribing rules continue to harm patients in pain.

The impact of drug overdose

Drug overdose remains one of the leading causes of injury and death in adults in the U.S. Overdose rates have significantly increased over the past several decades, according to the Centers for Disease Control and Prevention (CDC), with the age-adjusted rate of drug overdose deaths nearly quadrupling from 8.2 in 2002 to 32.6 in 2022.

Since 2010, illegally made fentanyl and other synthetic opioids have also infiltrated the U.S. drug supply, according to the National Institute on Drug Abuse (NIDA). Fentanyl and related substances have been a significant contributing factor to the rise in overall drug overdose deaths across the nation.

Nearly 107,600 Americans died from a drug-related overdose in 2023, only a slight drop from 107,941 in 2022, according to the

CDC. Death figures did, however, continue to drop during 2024, with figures showing a 17% decline.

The collateral impact of the ongoing drug-related overdose and death epidemic, however, includes widespread economic damage, psychological trauma, moral injury, and more; with data from the AMA showing that more than 320,000 children across the nation have lost a parent due to overdose.

Reducing stigma and facilitating change

For more than a decade, policymakers have searched for the right combination of policies to reduce drug-related mortality and improve outcomes for individuals with substance use disorder, patients with pain and people who use drugs.

maintain that restrictions in opioid prescribing will result in improved care and reduced mortality, according to the AMA. Many states and national pharmacy chains continue to hold on to dose and quantity restrictions that have resulted in harm for certain patients.

“Half-measures and outdated policies [in regard to the overdose epidemic] are costing lives, and the American Medical Association urges policymakers to act,” said Dr. Bobby Mukkamala, AMA president-elect and chair of the AMA Substance Use and Pain Care Task Force.

Despite a recent decline in opioid prescribing by physicians, restrictive laws stigmatize and reduce access to medication for certain patients with pain who require opioid therapy for surgery,

Physicians are encouraged to prescribe naloxone or other opioid-overdose reversal agents to anyone at risk of an opioidrelated overdose, including to youth and adolescents.

Despite advancing some of these efforts, at least 39 states across the U.S. still have opioid prescribing restriction policies in place that interfere with patients being able to receive individualized pain care treatment options, according to the AMA. While opioid prescribing has decreased by more than 51.7% since 2012, many patients who utilize opioid therapy have been negatively impacted by laws from health insurers, pharmacy chains and pharmacy benefit managers.

These types of pharmacy companies have continued to

sickle cell disease, chronic pain, hospice and palliative care, cancer and other medical conditions, according to the AMA.

“With thousands of families and communities devastated by overdose deaths, the time for incremental change has passed,” said Dr. Mukkamala. “We need unwavering commitment to expand access to lifesaving medications, enforce parity laws, and address the glaring gaps in harm reduction. We cannot stand by as outdated policies and insurance barriers prevent patients from accessing evidence-based care.”

State policy and payers have also taken few actions that meaningfully increase access to non-opioid alternatives for patients, including important steps forward such as adopting the April 2024 Federation of State Medical Boards “Strategies for Prescribing Opioids for the Management of Pain.”

In the 2024 Overdose Epidemic Report, the AMA urges state legislatures, Medicaid agencies, health insurance companies, and pharmacy chains to adopt new protocols and to rescind outdated laws, policies, and protocols (based on the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain).

“This epidemic has caused harm across multiple generations,” said Dr. Bruce A. Scott, AMA president. “We need to employ every measure to increase access to care for individuals with a substance use disorder or pain – and do everything we can from a harm reduction standpoint to keep people alive and reduce their risks.”

Policy recommendations highlighted in the AMA report include the meaningful enforcement of state and federal mental health and substance use disorder parity laws, increased access to medications for opioid use disorder (MOUD), requiring payers to increase access to non-opioid

Almost half of states in the U.S. have decriminalized the use of fentanyl test strips, however, the AMA states that additional state-wide advocacy is needed to decriminalize these types of test strips and other drug checking supplies for emerging adulterants.

Organizations such as the CDC and the Federation of State Medical Boards (FSMB) have begun to address outdated practices by spreading messaging campaigns to make it clear that an oversimplified approach to prescribing guidelines can be detrimental to patients’ health.

Progress and policy change

In terms of progress toward a drug-free nation, evidence-based policy change must continue to guide patient care as the nation’s opioid crisis evolves into a more dangerous and complicated illicit drug overdose epidemic.

pain care options, increasing access to naloxone in pharmacies, schools, and public settings, and supporting efforts to fund and make other evidence-based harm reduction initiatives more widely available – including syringe services programs and overdose prevention centers.

FDA-approved medications for opioid use disorders (MOUD) include buprenorphine, methadone and naltrexone. Alternatively, the drug naloxone’s main purpose is to save lives from opioid-related overdose. Physicians are encouraged to prescribe naloxone or other opioid-overdose reversal

agents to anyone at risk of an opioid-related overdose, including to youth and adolescents.

The amount of naloxone dispensed from retail pharmacies has continued to grow, per the AMA report. From 2018 to 2023, naloxone prescriptions increased from about 555,000 to nearly 2.2 million prescriptions.

The amount of buprenorphine dispensed from retail pharmacies, on the other hand, appears to have plateaued, likely due to a variety of factors including longer prescriptions, pharmacy reluctance to stock the medication, and confusion and fear over DEA suspicious order requirements.

“The AMA strongly agrees that when pharmacists have questions about a prescription for buprenorphine for the treatment of OUD, it is essential for the pharmacist and physician to discuss the situation – and not automatically deny the patient access to the life-saving medication,” according to the AMA.

The AMA asserts that efforts such as removing outdated prior authorization dosage requirements for buprenorphine, authorizing methadone to be prescribed outside of Opioid Treatment Program settings, and removing buprenorphine from the DEA’s suspicious order reporting requirements can help reduce barriers to life-saving treatment.

Addressing substance use disorders

In recent years, the U.S. has witnessed positive actions from physicians in relation to the overdose epidemic, growth in harm reduction services and much-needed policy advancements. State-level decreases in opioid prescriptions

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from 2012-2023 ranged between 36% to 68%, according to the AMA report, and total opioid prescriptions dispensed decreased from 260.5 million in 2012 to 125.9 million in 2023.

Total dosage strength of certain medications, measured in morphine milligram equivalents, also decreased 63.1% from 2012 to 2023, with every U.S. state having seen a significant decrease, according to the AMA report. State prescription drug monitoring programs were also used more than 1.4 billion times in 2023, a significant increase since 2014 when they were used only 61 million times.

The AMA has urged the healthcare industry to combat the overdose epidemic by providing evidence-based care for patients with pain as part of a larger effort to address substance use disorder, including non-opioid interventions when appropriate and opioid therapy only when clinically necessary. The AMA also emphasizes that pain management should always be guided by evidence and

best practices for each patient, rather than relying on a one-sizefits-all approach.

“Two key actions every state can take to help patients with pain include supporting coverage for, access to, and payment of comprehensive, multidisciplinary, multimodal evidence-based treatment for patients with pain, a substance use disorder or mental illness,” according to the AMA Substance Use and Pain Care Task Force.

“Additionally, coverage, access and payment should directly address inequities as well as social determinants of health. Emphasis must be placed on individualized patient care decisions, protecting patients with pain, a substance use disorder or mental illness from continued stigma and addressing a lack of access to evidence-based care or accepted best practices.”

According to the AMA, tools such as drug checking equipment (DCE) helps detect fentanyl and other toxic materials in substances.

Preliminary research shows that drug checking services have a

Key data cited in the Overdose Epidemic Report

 Opioid prescriptions have decreased by 51.7% since 2012. State-level decreases from 2012-2023 ranged between 36% to 68%.

 State prescription drug monitoring programs were used more than 1.4 billion times in 2023, a staggering increase since 2014 when they were used only 61 million times.

 Buprenorphine dispensed from retail pharmacies appears to have plateaued, likely due to a variety of factors including longer prescriptions, pharmacy reluctance to stock the medication, and confusion/fear over DEA suspicious order requirements.

 Naloxone dispensed from retail pharmacies continues to grow.

From 2018 to 2023, naloxone prescriptions increased from about 555,000 to nearly 2.2 million prescriptions.

positive impact on individuals’ intended drug use behaviors, including making changes to their drug use practices such as keeping naloxone nearby to prevent fatal overdose, according to the AMA. Empowering individuals who use drugs with knowledge about the presence of harmful substances in the drug supply can reduce potential harm associated with drug use.

Almost half of states in the U.S. have decriminalized the use of fentanyl test strips, however, the AMA states that additional state-wide advocacy is needed to decriminalize these types of test strips and other drug checking supplies for emerging adulterants.

“The AMA strongly supports increasing access to fentanyl test strips and naloxone from pharmacies and other retailers,” according to the 2024 Overdose Epidemic Report. “These are common sense strategies to help prevent more people from dying.”

The AMA asserts that an end to the nation’s drug abuse epidemic requires improving care for patients with pain or substance use disorder, and that increasing access to harm reduction services requires commitment, collaboration, and partnership between stakeholders.

“The AMA, our Substance Use and Pain Care Task Force, and the nation’s physicians continue to urge policymakers, health insurance companies and other payers to once and for all remove barriers to evidence-based treatment for substance use disorders, pain care and harm reduction initiatives,” said Dr. Mukkamala. “Delays or denials of this care only results in increased suffering and death. Ending the epidemic is possible, but much more work must be done.”

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Emerging Trends in Drug Abuse and Product Development

As the landscape of drug abuse continues to evolve rapidly, healthcare and workplace testing solutions must keep pace with emerging substances and shifting usage patterns. In particular, the rise in synthetic opioid misuse and other prescription drugs is driving innovation in drug testing technology. Companies like Abbott are responding with advanced, easy-to-use testing solutions that meet the growing demand for speed, accuracy, and flexibility

across a range of settings, from clinical practices to workplace and law enforcement environments. In the following Q&A, Abbott shares insights into current drug abuse trends, evolving customer needs, technological advancements, and the future direction of substance misuse testing.

Repertoire: What emerging trends are you seeing in drug abuse, and how is that influencing the development of your products?

Abbott: There is a significant increase in the abuse of synthetic opioids, particularly Fentanyl, as well as prescription medications like Tramadol, which has driven the demand for CLIA waived testing solutions that can quickly and accurately detect these substances. In response, we have launched our CLIA waived 14 panel iScreen Dx Tox Cup, which includes Fentanyl, to meet market needs. Additionally, oral fluid drug testing is gaining traction

for employment screening due to the ease of collection and ability to detect recent drug use.

The Department of Transportation (DOT) approved oral fluid drug screening in 2023, and this method is currently being validated in several laboratories.

Commonly tested drugs and shifts over time

Repertoire: Which drugs of abuse are most commonly tested for, and how have those patterns shifted over time?

Abbott: The most commonly tested drugs of abuse include Amphetamine, Benzodiazepine, Buprenorphine, Cocaine, MDMA, Methamphetamine, Opiates, Oxycodone, and THC/ marijuana. Over time, there has been a noticeable shift towards testing for synthetic opioids like Fentanyl, reflecting the growing prevalence of these substances. Conversely, drugs such as Propoxyphene and Tricyclic antidepressants are less frequently requested by customers, indicating a shift in the patterns of drug abuse and testing priorities.

Evolution of technology in drug testing

Repertoire: How has the technology evolved over the last few years?

Abbott: Urine testing remains the gold standard in drug testing due to its reliability and the extensive range of FDA cleared and CLIA waived options available. However, oral fluid testing is emerging as a valuable alternative, particularly for its ease of use and recent advancements in detecting substances like THC. The adoption of oral fluid testing by the DOT further underscores its growing importance in the industry.

Primary customers and market segments

Repertoire : Who are your primary customers? Are your solutions used more in workplaces, healthcare settings, or law enforcement?

Abbott: Our primary customers in Clinical Toxicology include Physician Office Laboratories (POLs) such as Family Practice/ General Practice, OB/Gyn, Pediatrics, Internal Medicine, Pain Management, Community Health Centers (CHCs), and Hospitals. Our solutions are utilized across various markets, including workplaces, healthcare settings, and law enforcement. We offer CLIA-waived products for clinical use, oral fluid tests for workplace screening, and Forensic Use Only (FUO) tests for law enforcement. We have seen increased adoption in all these markets as customers recognize the benefits of rapid results, which facilitate timely treatment and efficient workflow management by sending only preliminary positives or unexpected results for lab confirmation.

Challenges in the drug testing industry

Repertoire: What are the biggest challenges in the drug testing industry today?

Abbott: One of the biggest challenges in the drug testing industry is the rapid change in drug abuse trends, which necessitates continuous updates to testing panels. Additionally, obtaining FDA clearance and CLIA waivers for new testing solutions can be a lengthy and complex process, and often delay the availability of products needed to address emerging trends.

Future of substance misuse testing

Repertoire: What do you see as the future of substance misuse testing in terms of both technology and societal impact?

Abbott: The future of substance misuse testing will likely be shaped by advancements in technology and evolving societal needs. Legislation for medication monitoring aims to ensure patients adhere to their prescriptions and prevent diversion while employment testing will continue to play a crucial role in creating safe work environments by mitigating substance and alcohol abuse.

Questions for distributor reps

Repertoire: What questions can distributor reps ask their customers in order to better serve their needs in this area?

Abbott: Distributor reps can ask the following questions to better understand and serve their customers’ needs:

1. Current Screening Practices: Are you currently conducting any drug screening? Are you collecting samples and sending them to a lab?

2. Clinical Efficiency: Would you be interested in a solution that provides results in 5 minutes to improve patient treatment and workflow efficiency?

3. Employment Efficiency: Would you like a solution that delivers results in 5 minutes, allowing you to rule out negatives for employee testing and send only preliminary positives to the lab for confirmation? This approach can significantly improve workflow efficiency by reducing the time spent tracking lab results.

Premier Argues for Balanced Approach to Tariffs

Healthcare organizations try to forecast impact of new trade rules.

By Daniel Beaird

 Healthcare organizations from medical device manufacturers to hospitals and health systems have a keen eye on the Trump administration’s tariffs on foreign products and are asking for a balanced approach. In a March letter to the office of the U.S. Trade Representative (USTR), Premier aimed to highlight ways to adopt that approach to implementing tariffs that could impact the U.S. healthcare supply chain.

Premier’s comments centered around clearly defining which healthcare products are subject to tariffs and urged gradual implementation to allow manufacturers and providers time to adjust. It also suggested considering U.S. Food and Drug Administration (FDA) approval timelines when shifting supply sources and increasing supply chain transparency with public reporting on the country of origin for federally purchased healthcare products.

“As a provider, you are looking for what could be the potential forecast and financial impact of the volume of spend to have on site,” said Kyle MacKinnon, senior director of operational excellence for Premier. “Understanding where tariffs might make an impact is an extremely complex issue. There isn’t one number out there that captures the full effect because each supplier is unique.”

Mexico, Canada and China are the three largest trading partners for the U.S. with established medical device and pharmaceutical supply chains. They play a pivotal role in APIs, key starting materials, subcomponents, sub-assemblies and other inputs that are a part of tiers two and three for manufacturers. But they could be subject to tariffs depending on where they are imported from and that’s been difficult to identify and estimate.

Encouraging domestic manufacturing

Premier called for a multi-pronged approach with tax incentives to encourage domestic manufacturing investments, trusted trade partnerships to diversify sourcing for critical medical products and expedited FDA approvals that prioritize domestically manufactured medical supplies.

“The FDA is the gold standard from a regulatory approval perspective, but it’s getting to that approval that can be really difficult,” said Mark Hendrickson, director of supply chain policy for Premier. “So, if we’re talking about bringing some manufacturing onshore, that involves changing current manufacturing volume and capacity and changing manufacturing lines. All of those require regulatory scrutiny, and regulatory changes can take a long time.”

Accelerating FDA approval processes will help prioritize inspections and regulatory approvals for critical medical supplies and drugs that are manufactured domestically, according to Premier. It will also improve responsiveness to public health needs, especially in times of crisis.

FDA review and approval timelines can be anywhere from

six to 18 months. Premier asked the USTR to consider FDA approval timelines within the timeline for tariffs while providing a sufficient glidepath for manufacturers and healthcare providers to ensure both have time to respond and adapt to new tariffs.

Premier also suggested differential reimbursement to incentivize hospitals to purchase U.S.-made medical supplies and government purchasing mandates to strengthen “Buy American” requirements for critical healthcare products.

partners to diversify sourcing for medical devices and pharmaceuticals and enable timely access to the vital supplies providers need to care for patients during a public health crisis or national security threat. It would authorize the President to enter into trade agreements for the reciprocal elimination of duties and import restrictions on medical goods.

According to its letter to USTR, Premier believes trusted trade partnerships in healthcare would create new trade and investment

Premier asked the USTR to consider FDA approval timelines within the timeline for tariffs while providing a sufficient glidepath for manufacturers and healthcare providers to ensure both have time to respond and adapt to new tariffs.

“It goes back to ensuring there’s price parity across the category or the product mix,” MacKinnon said. “There are all of these other cost pressures on healthcare organizations to stay above the line in terms of their operating margins. We want to be resilient, but we also have to keep the doors open.”

MacKinnon says a targeted list could be created for critical devices and pharmaceuticals that are in short supply. The industry could set up competitive organizations or domestic factories for the right product mix.

Working with Congress

Premier supported legislation reintroduced in the 119th Congress, the Medical Supply Chain Resiliency Act, which would permit the establishment of trusted trade

opportunities abroad as well as generate growth and investment in domestic manufacturing and services, insulating some of the most critical supply chains from disruption.

“The stated purpose of tariffs is to boost domestic manufacturing and bring some of that manufacturing back and make it more resilient,” Hendrickson added. “That’s what we want to do as well, but also understanding that not all manufacturing will come back onshore.”

He asked, “How do we incentivize organizations that are already domestic? We don’t want to penalize them for something they’ve already done and want to encourage in the future.”

Hendrickson says one idea is to provide a tax credit on income generated from the sale of domestically manufactured goods. Premier suggested other

policy options such as redefining requirements for government purchasers like the Department of Defense (DoD) and the Department of Veterans Affairs (VA) to purchase domestically manufactured critical medical supplies and pharmaceuticals.

The Buy American Act requires federal agencies to purchase domestically manufactured products unless an exception applies. As of 2024, at least 65% of the product components purchased must be sourced from the U.S. That is set to increase to 75% in 2029.

turers, distributors and suppliers, are looking at tariffs and how they will affect their supply chains. They’re asking where they will be taxed and if there are other options to avoid tariffs. For providers, it’s a focus on cost.

“Just like pressure testing and budgeting for inflation and labor costs, this is another factor,” Hendrickson said. “But it’s been hard to plan for with the on-again, offagain nature of the tariffs.”

He says each organization has to look at the factors important to them and those change depend-

The Buy American Act requires federal agencies to purchase domestically manufactured products unless an exception applies. As of 2024, at least 65% of the product components purchased must be sourced from the U.S. That is set to increase to 75% in 2029.

Premier suggested accelerating these timelines, exempting critical medical devices and drugs from purchase cost requirements and incorporating applicability to medical devices for the VA, DoD’s Defense Health Agency, Federal Emergency Management Agency (FEMA), Government Services Administration (GSA) and Department of Health and Human Services (HHS).

“Where American products are available, those should be first up, but specifically critical medical supplies,” Hendrickson said.

Assessing tariffs in each organization

Healthcare organizations, from providers and GPOs to manufac -

ing on an organization’s size and where it’s located. Everyone has a unique challenge in this space.

He asked, “In a lot of ways, tariffs are the stick, so where’s the carrot? What’s going to help get those products to the patient? We want to make sure everyone has a level playing field, we incentivize the right behaviors, and we bring manufacturing back where we can and where it makes sense.”

According to Premier, other steps that need to be taken include real-time inventory management to improve supply chain tracking for emergency preparedness and the reauthorization of the Pandemic and All-Hazards Preparedness Act to ensure readiness for future public health crises.

“API is only good for so long,” Hendrickson noted. “I think plastic and aluminum for devices and other products can be kept on hand for a while if an organization has space for it. But on the provider level, there’s much less ability to stockpile because there’s less capital and thinner margins.”

Averting disruptions or supply shortages

Premier’s comments to USTR reflect its efforts to shield healthcare providers and patients from price increases and shortages as a result of any tariff actions. It says a well-designed and implemented tariff policy represents one leg of a stool to help strengthen the U.S. healthcare supply chain, but additional investments and actions are necessary to create a comprehensive approach.

“Our focus is on the holistic market and supply chain continuity and resiliency,” MacKinnon said. That includes trusted trade partnerships, tax incentives and appropriate reimbursement as additional legs to make the stool whole and create a comprehensive multi-pronged approach.

As the Trump administration announced its tariff plan in April, Premier’s Soumi Saha, senior vice president of government affairs, added that a strong, sustainable supply chain is the foundation of high-quality, affordable and accessible healthcare for all Americans. She says targeted and thoughtful tariffs on healthcare products can offer a chance to bolster supply resilience and ensure access to critical medical supplies, but they can’t live in a vacuum.

They must be put to work, funding innovation that ensures long-term stability and a stronger, more resilient U.S. supply chain.

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Adapting to Tariff Realities

Global, national economic shifts may take toll on sourcing options.

By R. Dana Barlow

Editor’s note: The following column originally ran in the May-June 2025 issue of The Journal of Healthcare Contracting.

 Ever since the global COVID-19 pandemic detonated the long-running healthcare supply chain strategy of larger, rigid, standardized, single- and dual-vendor contracting with just-in-time and/ our stockless distribution, providers have scrambled to embrace demand forecasting and more flexible contract sourcing that enabled options from alternative vendors.

This year’s tariff-induced trade war threatens to pummel those prospects, too, leaving so many questions unanswered by providers and suppliers alike, with group purchasing organizations (GPOs) caught in the middle as if they’re holding the net between the fiscal volleys.

“It is too early to say with certainty how tariffs will impact sourcing, but HSCA expects that the supply chain will need time to adapt to the shifting economic landscape in the short-term future,” acknowledged Angie Boliver, president and CEO, Healthcare Supply Chain Association (HSCA), the national trade organization representing the GPO industry segment in healthcare.

“Given the natural lag between these policy actions and the targeted outcomes, there will likely be gaps in supply as manufacturers work to ramp up domestic capacity. Meanwhile, our reliance on foreign sources to meet the needs of the healthcare ecosystem will remain in effect. GPOs will play a critical role in helping members

navigate the supply chain during this transition period.”

Dan Kistner, senior vice president and general manager of category management and strategic programs, concurs about the lingering and looming uncertainty.

“Given the dynamic nature we presently are experiencing, it is difficult to estimate the totality of the impact,” Kistner observed.

“While the discussion and focus on tariffs is warranted, they are not the only potential disruptors of the healthcare supply chain. In

order to more effectively manage disruptions, we need greater transparency, including where items are sourced, manufactured and their quality throughout all of those processes.”

Tracking, tracing and transparency about country of origin for all products – from raw materials to finished goods – remains paramount.

“Historically, our efforts to improve the quality and reliability of the supply chain have been hampered by limited insight into the origination and/or

manufacturing point,” Kistner insisted. “Industry stakeholders should have visibility to where all products are made and where all critical components are sourced. That is the only way to understand the impact of disruptions, whether they be tariffs or hurricanes, and to help ensure a more reliable supply chain.”

Provider organizations should work with their GPOs to map their potential vulnerability points and factor in various duration scenarios, according to Andy Brailo, Chief Customer Officer, Premier. Brailo grants the industry a modicum of credit having emerged from the pandemic.

“We think that those suppliers that learned lessons during the pandemic about having backstock and multiple manufacturers with some near-shore and on-shore will have implemented some different options and may show a little more flexibility they go forward,” he said. “They’re going to have to pivot.

“But the challenge is that we don’t know how long something will last,” Brailo continued. “We’re pretty sure China is going to be challenged with tariffs for a while, but what about the other countries? Those companies that didn’t make this production shift had a dry run for this during the pandemic. We know about what happened, even with the challenges we faced with friendly trading partners. Healthcare has such a broad machine production capacity. We have to encourage that we’ve got the right time frame for the hospitals and the suppliers to be able to make those pivots if they haven’t done so. But those that have will clearly be in a more advantageous position.”

Brailo fully agrees that while the pandemic may be in the rear-view mirror, the industry cannot return to any type of prepandemic status quo nor rest on whatever emerged post-pandemic as a new status quo.

“Smart organizations have figured that out,” he insisted. This involves identifying supplier locations, geographic concentrations and countries of origin as well as product utilization. Working with domestic manufacturers and sharing information as transparently as possible between trading partners remain two key tactics worth implementing. Through investment and collaboration, they are addressing global challenges domestically and directly, he adds.

products are coming from, and if they will be impacted by a tariff. Other than steel and aluminum, there have not been any other tariffs imposed on products at this point. [ Editor’s Note: At press time, the Trump administration’s broadly sweeping tariff declaration in early April had not yet occurred. ] Beware of suppliers positioning for price increases before you know the extent of a tariff, and what countries are going to be impacted. It is important to remember that you are not paying a tariff until you actually purchase the goods. Alternative products may not be subject to a tariff and you can avoid the tariff by making strategic product changes.

It is important to remember that you are not paying a tariff until you actually purchase the goods. Alternative products may not be subject to a tariff and you can avoid the tariff by making strategic product changes.

Providers and suppliers just need to keep a clear head and eyes open, according to John Strong, a veteran healthcare supply chain consultant with extensive experience leading two different GPOs and who currently serves as co-founder, Access Strategy Partners Inc.

“While the volleys back and forth can be frightening, it is important to remember that many of them are negotiating tactics – and no one may be affected at all by a threatened tariff,” he said. “Sourcing needs to continue, and contractors need to better understand where

“You want proof that a tariff is going to impact a product, along with what country(ies) will be impacted by a tariff and the extent to which any products are impacted,” Strong continued. “Remember that everyone across the healthcare supply chain should be working in the customer’s interest to mitigate the impact of tariffs. This includes manufacturers, distributors and GPOs. If they are not or cannot assist you now, perhaps it is time to start shopping. Trade associations have already started lobbying the federal government for exemptions to tariffs for healthcare products.”

Tariffs, trade war intentions send mixed signals to healthcare in quest for stability

One of the apparent motivations behind Washington’s use of tariffs around the world is to convince, encourage or force American companies to return their manufacturing operations to domestic facilities and to lure foreign companies to invest in domestic production of their products here. Historically, it’s no secret that many American companies moved their manufacturing to other countries for access to cheaper labor and production facilities as well as closer proximity to raw materials and other resources. Distribution and transportation costs may be higher in this scenario, but apparently

not enough to negatively affect their return on investment – revenue and net profit. Returning production to domestic channels may reduce distribution and transportation costs, but they likely would be offset by higher labor, production and quality regulation costs. This debate represents an economic and political conundrum.

Short of reaching some semblance of balance, healthcare providers and suppliers with group purchasing organizations (GPOs) in the middle are being stretched between the pros and cons of consolidating domestically vs. diversifying globally still.

“HSCA supports efforts to strengthen domestic capacity in the supply chain and our member GPOs often work with manufacturers to promote domestic and near-shore manufacturing, which is vital to ensuring access to essential products. However, shortages due to manufacturing issues or natural disasters drive home the importance of having a multifaceted approach to sourcing. In 2024, for example, rainfall due to Hurricane Helene shut down IV fluid production at Baxter International’s North

Cove facility in North Carolina, leading to shortages of several critical parenteral products. The emergency prompted Baxter and the FDA to designate a number of temporary foreign importation sources to meet hospital demand. In emergency events like Hurricane Helene, geographical diversification and redundancy can help avoid shortages and save hospitals money in the long run.”

Angie

Boliver, president and CEO, Healthcare Supply Chain Association (HSCA), Washington

Angie Boliver

“As we have seen over several decades, supply disruptions come in all shapes and sizes. Taking actions to limit tariff exposure does not protect against the other events that could disrupt supply and/or increase product prices. Therefore, implementing multiple strategies, which may include diversification of suppliers, is likely needed to increase the overall resiliency and reliability of the healthcare supply chain.”

Dan Kistner, senior vice president and general manager of category management and strategic programs, Vizient Inc., Irving, TX

“No one really knows yet how wide and vast the tariffs could be, but the president has been clear that he wants to eliminate ‘product gateways’ whereby China ships goods to Mexico for example, and then they become ‘Mexican imports’ into the U. S. It appears that some of the tariffs are designed to stop this. The U. S. should be looking at re-onshoring the manufacture of goods for many reasons, including our health and security. While ‘bringing back manufacturing’ to our shores may bring about short-term pain, this is a solid strategy for many supply chains, including healthcare. Healthcare procurement needs to look at longterm value and cost strategies and stop pandering to the lowest price for goods at a single point in time. Stability of the supply chain is key in times like this, and as an industry we are probably not well prepared.”

John Strong, consultant, co-founder, Access Strategy Partners Inc. and former GPO executive, Fontana, WI

“ I live in Atlanta, but I grew up in the Northeast where manufacturing lifted up the blue-collar workforce.

When I was living in that area, I saw factories move and I saw the bluecollar workforce get diminished there. Now that personal passion is shared by our CEO Mike Alkire and by our company. We’ve been a strong advocate for diversity in manufacturing and what I mean by that is hedging to some degree and not having it all concentrated in one part of the globe. Domestic production is critical. We firmly believe that true supply chain resiliency necessitates a strategy to have domestic production.

“I think that tariffs on any healthcare items should be reinvested into this domestic supply chain to provide tax incentives to boost domestic manufacturing. Authorized trusted trade partnerships can use [tariffs] to explore some of the things that have hindered domestic manufacturing. For example, there are certain things that are really difficult to manufacture here because of our environmental rules, which isn’t a bad thing, but how can that impact new innovations? How do we reinvest into the science of manufacturing? We’ve got to expedite the FDA approval process for domestic supplies. There should be differentiated reimbursement for manufacturing supplies domestically. The government should be purchasing domestic healthcare supplies for the VA.

“We also really do need realtime inventory data management systems so that we can all have transparency on country of origin and raw material sourcing.

“Finally, true resiliency is not accidental. It’s stakeholders along the way making concerted actionable efforts to focus on not just the short-term, but what impact does the short-term have on the interme-

diate and the long-term? We’ve got to be thinking that way. We’ve got to be thinking about what’s going to happen two years from now, five years from now, and how do we get there? We have to make incremental steps. We need to focus on those incremental steps that are going to solve the longterm challenges. That’s the key to this.”

Andy Brailo, Chief Customer Officer, Premier Inc., Charlotte, NC

Andy Brailo

John Strong

Dan Kistner

Tariffs Put Pressure on U.S. Healthcare Supply Chain

Tariff impact and uncertainty is a growing crisis for U.S. healthcare providers, industry collaborative says.

 In the vast and complex landscape of the U.S. healthcare system, a new vulnerability has surfaced – one that could disrupt and increase uncertainty in the global supply chain. For years, hospitals and healthcare providers have relied upon a complex and global system of supply chains that deliver essential medical goods to their doors. While Tier 1 suppliers are visible, what lay beyond – where critical processing steps are performed, where subcomponents are manufactured – are equally integral. This lack of visibility increases risk.

Disruptions to these supply chains have grown increasingly concerning, especially as the healthcare industry grapples with its deep dependencies on China, according to the Healthcare Industry Resilience Collaborative (HIRC). “From active pharmaceutical ingredients (APIs) to personal protective equipment

and critical medical devices, a significant portion of the U.S. healthcare lifeline runs through Chinese manufacturing facilities,” HIRC said.

Now, with escalating tariffs between the U.S. and China, and possible global tariffs on pharmaceuticals and medical device inputs, HIRC members believe

that lifeline is under threat. Uncertainty looms over whether the added costs will apply only to finished goods or also to the subcomponents that cross borders multiple times before becoming a usable product. The potential for cumulative tariffs raises alarm bells – not just about pricing, but about availability itself.

“Healthcare systems across the country are growing more anxious, particularly in the face of rising geopolitical tensions,” HIRC told Repertoire Magazine. “With no clear answers on how tariffs will be implemented, many providers are scrambling to assess their exposure. They’re reaching out to suppliers, requesting country-of-origin data in hopes of mapping the true risk. Yet this information, at best, offers only an indirect estimate.”

Behind the scenes, healthcare trading partners are poring over their contracts, asking difficult questions: Would tariffs trigger force majeure clauses? Can current price guarantees still hold?

The financial stakes are high. Nearly half of U.S. hospitals already operate at a negative or near-zero margin, HIRC noted. The system simply does not have the cushion to absorb significant cost increases.

“And amid this growing pressure, another unknown lingers –how, or if, the Centers for Medicare & Medicaid Services (CMS) will adjust reimbursement rates to reflect these surging supply costs,” HIRC said. “For now, there is little clarity, only a shared urgency among providers to brace for impact in a global system where disruption feels less like an ‘if,’ and more like a ‘when.’”

The tariff situation is changing rapidly, emphasizing the need for close monitoring and enterprise-wide scenario planning. The healthcare industry, both hospitals and suppliers, need to lean in to face these pressures together, HIRC advised.

Suppliers who have committed to understanding their resiliency improvements through the extensive diagnostic offered by

the HIRC Resiliency Badging program, are better able to predict, prevent, and recover from disruption. Resiliency will be the key differentiator for companies who can navigate this uncertain economic and policy environment.

Pressure mounting

The level of tariff pressure facing U.S. companies has not been seen since the 1930s. During a recent poll of HIRCs members, nearly half anticipate organizational annual cost increases of $50M or more. Half of respondents believe tariffs are a moderate long-term threat. With limited protective levers to pull, two-thirds of HIRC members are actively seeking to diversify their supplier base.

accept price adjustments from our suppliers related to recent tariff announcement without further due diligence. We will require full visibility to the multi-tier Bill of Material, to include associated price breakdowns, to understand country of origin and duty impact appropriately. We are first and foremost committed to fulfilling our caring mission. We continue to value our partnerships and trust that suppliers will work with us to find mutually beneficial solutions during these uncertain times.”

Providers in the HIRC community are willing to have candid discussion on the impacts of tariffs, but not without transparency and clear rational. Partners of HIRC including Clarium are

Suppliers who have committed to understanding their resiliency improvements through the extensive diagnostic offered by the HIRC Resiliency Badging program, are better able to predict, prevent, and recover from disruption.

While the tariff impacts unfold in the marketplace, Allina Health has taken a clear stance on how it will behave with suppliers who intend to pass tariff charges at some point over the coming weeks and months. “We have placed specific safeguards within our Shared Services Team responsible for procure to pay and data management procedures at this time.” said Tom Lubotsky, Vice President, Chief Supply Chain Officer and Chair of HIRC. “Allina Health expects our suppliers to honor their existing pricing agreements that have been negotiated in good faith and will not

offering HIRC members tariff impact risk assessments using the power of AI, HIRC reported. “These insights are fully unlocked when the underlying data is available, some of which only the supplier can provide.”

Transparency for the end-toend supply chain is not only critical to understanding the potential cost implications of tariffs, it’s vital to protecting the lifeline of essential medical goods from any and all disruptive forces. Transparency builds trust, enables proactive planning, and places trading partners in a better position to face challenges together.

Healthcare Workforce Well-being and Better Safety Outcomes

Recent AHA report links workplace safety measures to a better patient experience.

 Physicians, nurses and healthcare staff are the foundation of the healthcare system, and delivering the best care starts with prioritizing the individuals who provide it.

Positive patient outcomes rely heavily on an investment in the safety and well-being of healthcare staff themselves, as supporting their health directly impacts quality of patient care.

A recent report from the American Hospital Association

“Improvement in Safety Culture Linked to Better Patient and Staff Outcomes” highlights that hospitals and health systems fostering a culture of safety in their facilities also reported increased positive healthcare experiences for patients.

The AHA, along with data from the Press Ganey National Database of Nursing Quality Indicators (NDNQI) dataset from 2025, compiles statistics into a report from 25,652 units and 2,430 inpatient acute care hospitals across the nation.

Since the release of a previous September 2024 AHA report, developed in collaboration with Vizient, notable improvements have been observed across patient care, healthcare workforce experience, patient safety measures and overall hospital safety culture.

In 2025, 13 million patients and nearly 2 million members of the health care workforce reported improvements in safety, care quality and resilience. Alongside improvements in safety culture and patient and employee experience, this year’s report emphasizes that a positive work environment for healthcare staff fostering communication, safety, and job satisfaction has been linked to higher rates of patient satisfaction.

People caring for people

Patient safety, patient experience, workforce experience and wellbeing are all tied together by a

hospital or health system’s culture of safety, according to the AHA report. Across clinical settings, the single largest driver of a patient’s reported experience of care has been shown to be how well care team members work together.

The cornerstone of healthcare involves people caring for other people, the AHA noted, highlighting the importance of supporting the well-being of healthcare workforce within the context of better patient health outcomes.

As the strain of the COVID-19 pandemic recedes, the healthcare workforce itself is beginning to rebound as well. Hospitals are performing at or better than prepandemic levels on multiple measures of quality and patient safety that reflect more efficient work led by nurses to care for patients. Press Ganey data from more than 1 million members of the health care workforce show a rebound from pandemic decreases in engagement, resilience and safety culture.

Mortality and healthcareassociated infections rates are also improving while hospitals care for more patients with increasingly significant health care needs.

Analysis of key measures in data related to catheter-associated urinary tract infection (CAUTI), central line associated bloodstream infection (CLABSI), falls and pressure injuries, reveal that the incidence of all measures have declined since their pandemic peaks, and nearly all measures across all units are back to or better than pre-pandemic levels.

A culture of safety

Patients themselves have reported increased attentiveness to team dynamics and interpersonal capabilities within clinical settings. Press

Ganey data showed that when patients were asked about their confidence in the care they received and their willingness to recommend a hospital to others, individuals across care settings ranked hospitals higher when they perceived the hospital team to be working well together and were attentive to the patients’ needs and questions, according to the AHA report.

Better patient outcomes

Better teamwork among healthcare workers has been shown to drive better patient outcomes. According to the AHA, an energized and engaged workforce improves the overall quality of care provided to patients, the physical and psychological well-being of patients, and patient perception of the healthcare workforce’s ability to keep them safe.

Results show hospitals and health systems are on the path to returning to pre-pandemic levels of safety.

A critical factor in generating both better patient outcomes and care team engagement at work is a strong safety culture. A culture of safety is one where both physicians and patients experience effective teamwork and communication, where everyone can speak up and feel confident that improvements occur when issues are reported, and that any issues that arise are dealt with fairly.

Hospitals that were top performers in engagement also were shown to have a strong culture of safety, with 51.5% of hospitals with a high safety culture score being shown to have a 95 percentile rank difference in employee engagement from those that had a low safety culture score, according to the AHA.

A strong culture of safety serves to support clinical teams through the demanding tasks associated with care delivery. When staff feel supported and safe at work, it results in a notable difference in how patients experience their care, thus leading to safer care and a more resilient care delivery system.

Steady gains in patient perceptions have been shown both in relation to experience of care and safety of care, up after a drop due to the COVID-19 pandemic. Results show hospitals and health systems are on the path to returning to pre-pandemic levels of safety. Patients who perceived that their care was safe were 2.5 to 3 times more likely to recommend their hospital to others.

Improvement is an ongoing effort, according to the AHA, and hospitals must remain committed to advancing the safety and quality of care, the way in which patients experience care, and the well-being of their care teams through increased workplace safety measures.

Through the work of the American Hospital Association’s Patient Safety Initiative – which focuses on hospital safety culture, identifying and addressing disparities in healthcare outcomes, and the well-being of the workforce – hospitals and health systems are continuing to use proven safety improvement strategies across their health system to advance their work with patients.

‘Urgent Threat’

Emerging fungus has healthcare providers on alert.

 An emerging fungus first reported in 2016 has risen to the level of “urgent threat” in healthcare facilities in less than a decade.

Candida auris is a yeast that can lead to serious infections, including bloodstream, wound, and ear infections, particularly in healthcare settings, according to the Centers for Disease Control and Prevention (CDC).

Many strains of C. auris are resistant to common antifungal treatments, making infections harder to treat.

C. auris spreads easily between patients in hospitals and other healthcare facilities, especially on surfaces and medical equipment. People can have C. auris on their skin and other body sites without

having symptoms, the CDC notes. Healthcare providers refer to this as ‘colonization.’ People who are colonized can spread C. auris onto surfaces and objects around them and to other patients.

Cases of C. auris have been on the rise in recent years. The CDC reported 4,514 new clinical cases in the United States in 2023, marking a continued increase since the first case was identified in 2016. The Los Angeles Times reported that during this same period, California reported 1,566 infections, more than any other state.

The CDC declared C. auris an “urgent threat” in a 2023 public safety announcement because of how resistant it is to many antifungal drugs, and how rapidly it can spread in healthcare settings.

It mainly affects individuals with severe underlying health conditions or those who use invasive medical devices, like catheters or feeding tubes. Healthy people are typically not at risk.

Prevention

Healthcare workers should be aware of several key strategies to prevent the spread of C. auris in healthcare settings:

1 Hand hygiene. Frequent hand cleaning with alcohol-based hand sanitizers (ABHS) or soap and water if hands are soiled is crucial.

2 Infection control measures. Patients with C. auris, whether infected or colonized, should be isolated in a separate room. Gloves, gowns and frequent cleaning of the patient’s room with special disinfectants are essential.

3 Screening: Regular screening for C. auris colonization helps identify asymptomatic carriers who could spread the infection.

4 Precautions when transferring patients. Notify receiving healthcare facilities if a patient has tested positive for C. auris or has been in an outbreak area to prevent transmission.

“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Dr. Meghan Lyman.

SCAN ME

Kootenai, MultiCare Health partner on ASC

 Kootenai Health and MultiCare Health System recently announced the development of a new multi-phase, 30-acre medical campus in Post Falls. The new location, named the Prairie Medical Campus, represents one of the largest recent medical investments in northern Idaho.

According to a press release, the 30-acre Prairie Medical Campus will house a micro-hospital, an ASC, clinic offices and lab services, with the goal to expand in the future.

“The Prairie Medical Campus in Post Falls is a transformational investment in the future of our region’s health care,” said Jamie Smith, CEO of Kootenai Health. “It is our mission to serve this rapidly growing part of our community. We are excited to partner with MultiCare; working together allows us to build on the strengths of both organizations for the benefit of our patients. It allows us to create something bigger, faster and better in the Post Falls to Liberty Lake corridor than either of us could alone.”

The micro-hospital will include a 12-room emergency department, MRI capabilities, CT scanners, ultrasound machines and X-ray machines.

Work on the project will begin in 2025 with a targeted opening in 24 to 36 months. The new building is part of a joint venture between the systems.

Since 2020, Kootenai and MultiCare have collaborated on several projects, including an Epic implementation and two urgent care locations.

“MultiCare is pleased to collaborate with Kootenai Health on this forward-thinking initiative,” said Bill Robertson, CEO of MultiCare Health System. “Together,

we are building a health care infrastructure that will support our communities for decades to come and ensure residents have timely access to the best possible care.”

MultiCare is Washington state’s largest community-based, locally governed, nonprofit health system. Consistent with its mission of partnering for healing and a healthy future, MultiCare is committed to working collaboratively with likeminded organizations to expand access to care and services.

Kootenai Health is the thirdlargest health system in Idaho and is independent, non-profit and locally governed. It is known for exceptional, compassionate care that has helped it earn numerous prestigious designations and certifications.

Sutter Health signs deal for new California ASC

Skanska, a Swedish real estate developer, has signed a contract with Sutter Health to convert a 60,000-squarefoot office building into an ASC and specialty clinic space.

The new ASC will total 20,000 square feet and the specialty clinic will total 40,000. The facility will have four OR’s, three procedure rooms, a full sterile processing department, and spaces for multiple programs including orthopedics, podiatry and ENT.

Construction on the new facility is expected to wrap up in 2026.

Infirmary Health breaks ground on Alabama ASC

Infirmary Health Center has broken ground on an ASC and medical office building in Malbis, Alabama.

This two-story facility will span 94,000 square feet, which will include an ASC, an imaging center, linear accelerator, women’s imaging and physician offices.

Revolutionizing Access

With new standards for medical diagnostic equipment in place, are your physician office customers equipped and compliant?

Small details can have a profound effect on enhancing patient access and care. Take medical diagnostic equipment. In 2017, the US Access Board released standards for accessible medical equipment, but one key area—low seat height—remained flexible, allowing a range from 17 to 19 inches. The federal agency’s 2024 ruling finalized this by setting the low seat height requirement to 17 inches or lower. It marked a major step in improving healthcare accessibility, according to August Boehnlein, Associate Marketing Manager for Midmark Corporation.

“The US Access Board found that at a low seat height of 17 inches, you are providing access and accessible care for 96% of patients who utilize a wheelchair,” Boehnlein explained to Repertoire Magazine Publisher Scott Adams in a recent podcast. “By implementing the 17-inch low-seat-height requirement, among the other standards, they’re truly revolutionizing accessibility.”

This May, Midmark launched the first and only procedure chair fully compliant with the new 2024 accessibility standards. The 631 Procedure Chair features a low seat height of 17 inches, making it accessible to 96% of wheelchair users.1

Beyond the low seat height, the chair includes:

 A 39-inch high-seat-height allowing providers to work

1.

In short, the 631 Procedure Chair meets all the current accessibility requirements, making it the most accessible and compliant procedure chair on the market.

The 631 Procedure Chair also complements the Midmark 626 Exam Chair. The 626 Exam Chair is fully compliant and highly accessible, with an even lower seat height of 15.5 inches, while maintaining a 37-inch high seat height for working with proper ergonomics while seated or standing.

with proper ergonomics (standing or seated)

 Transfer surface that is 28 or 32 inches wide

 A base less than 26 inches wide, compatible with patient lifts

 Patient Support Rails that feature a continuous 1.25-inch gripping surface, aiding independent transfers and stability

 Articulating Knee Crutches that support a patient’s thigh, knee and calf during lower body procedures.

“The Midmark mission statement is around improving the experience between the patient and the caregiver,” Boehnlein said. “We felt that if we were truly going to accomplish that mission, we needed to be a leader in accessibility. And that’s not just in the exam space, but also in the procedure space.”

Distributor reps have a real opportunity to emphasize that investing in both chairs helps facilities meet rising accessibility demands, enhances patient comfort, and ensures provider efficiency—all while staying compliant with evolving standards.

The population of Americans aged 65 and older is projected to surpass 80 million by 2050. 2 In addition, over 70 million Americans reported having a disability in 2022. 3 As a result, patients are not only aging but are also facing a growing number of medical conditions. The need for accessibility isn’t diminishing—it’s becoming increasingly important.

www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html 3.

www.cdc.gov/media/releases/2024/s0716-Adult-disability.html#:~:text=

Technology in Post-Acute

How technology is changing the way post-acute care is delivered.

 The healthcare landscape is continuing to evolve to meet the needs of patients within medical facilities and beyond the hospital setting.

Technological advancements such as AI, telehealth, remote patient monitoring and more have transformed post-acute and at-home care by enhancing accessibility of care, improving efficiency, and enabling personalized patient support.

“Many people, even those with complex care needs, can be cared for at home after a hospital stay thanks to emerging technologies,” said Dr. Steven Landers, CEO of the National Alliance for Care at Home. “It is also less costly to the system than unnecessary hospital days and nursing home care.”

The Alliance, comprised of more than 1,500 members from all 50 states, is an organization of home health, hospice, home care, palliative care, and other care-at-home service providers that are driving forward the home care movement. The Alliance’s partners include technology companies, consulting firms and other organizations committed to patients having access to highquality healthcare at home.

“One of the things top of mind for patients and families when they are hospitalized is how they can safely return home after their inpatient care,” said Dr. Landers. “Post-acute care athome offers an opportunity for continued recovery, rehabilitation

and disease management in a comfortable environment.”

Advanced technology, such as artificial intelligence (AI) has become an integral part of the healthcare experience today. It has revolutionized physician communication, driven better patient outcomes, and has largely reshaped the way care has been traditionally delivered.

“New AI and analytics tools are helping physicians with risk stratification, triage, and quality gap analysis and closure,” said Dr. Landers. “I’ve been impressed with the role of some of the risk

stratification and triage tools used specifically in post-acute healthcare. For example, the company Medalogix has a software product on the market that has helped home health providers identify patients who have poor survival prognosis and may benefit from conversations about hospice and palliative care. This tool has likely helped hundreds of thousands of patients receive more patientcentered care based on their goals and circumstances.”

Technology has also changed the way post-acute care providers handle administrative tasks and aspects of patient care, making standard processes more streamlined and efficient.

“The nature of clinical documentation is changing. The backoffice billing and administrative functions are being assisted by new AI tools,” said Dr. Landers. “Remote monitoring and telehealth tools are more frequently supporting more seamless access in between visits and physician/ provider certification visits.”

Potential of tech in post-acute care

The promise and opportunity of telehealth in post-acute care has not yet been fully realized. While telehealth and technology has transformed many areas of healthcare, its integration into

post-acute and at-home care remains uneven.

“While improvements in physician certification tasks, management of urgent situations to avoid preventable hospitalization, and ongoing monitoring have grown, regulatory limitations and lack of clarity on some compliance and reimbursement restrictions are limiting the full potential of AI and other technologies,” said Dr. Landers.

Though tech solutions have been a growing area of investment across the nation for hospitals and health systems; skilled nursing facilities (SNFs) and other post-acute providers have largely been excluded and/or delayed in benefitting from the past decade of substantial public and private-sector investment in information technology (IT), according to the NIH.

To realize telemedicine’s full potential across the industry, collaboration among the healthcare and technology sectors is imperative. Through remote consultations, monitoring, and diagnosis facilitated by technology, according to the NIH, tech-based healthcare can extend its reach to remote and underserved areas and healthcare sectors while enhancing accessibility.

To continue advancing the goal of technologically integrated post-acute care facilities, the NIH asserts in its “Progress Toward Digital Transformation in an Evolving Post-Acute Landscape” report a need to expand efforts to identify and address design, implementation, and use issues that continue to impede progress toward optimal IT-enabled care.

Technology tackles challenges

Technology has certainly played a role in assisting post-acute care

providers, but it has a ways to go in terms of fully addressing the overwhelming and persistent challenges facing the industry.

Staffing shortages exacerbated by the COVID-19 pandemic are an ongoing issue across the healthcare sector, which Landers says has continued to be a significant obstacle impacting physicians’ ability to provide quality, patient-centered post-acute care.

to meet the growing demand for quality care across post-acute care.

The future of post-acute care technology

Looking forward, Dr. Landers said that the rapid growth of the 85 and older population, the falling caregiver support ratios and workforce constraints, the preference for care at home, the cost pressures on Medicare, and

“ Many communities are facing nursing other health professional shortages, and these providers are in competition with hospitals and facilities for a finite number of workers. We need a range of solutions to improve the situation.”

“Many communities are facing nursing other health professional shortages, and these providers are in competition with hospitals and facilities for a finite number of workers. We need a range of solutions to improve the situation,” said Dr. Landers. “Technology that supports logistics, reduced documentation time, care coordination, point of care decisions, remote monitoring, and more are all helping with workforce shortage challenges, but we still need more caregivers.”

While Dr. Landers stresses that technology has helped to address physician and caretaker shortages, the healthcare workforce is still under an immense amount of stress.

Addressing the staffing crisis will require not only innovative technology and tools, but also strategic investments in training, recruitment, and retention to ensure the health industry is able

technological and care model innovation opportunities will dominate ongoing conversations within the post-acute care industry.

To successfully navigate these shifts, the post-acute care industry must take a multifaceted approach to progress that includes policy changes, workforce investments, financial reforms and the continued adoption of technology.

Efforts such as these, coordinated across groups such as healthcare providers, policymakers, and technology companies can help to ensure more effective and long-term access to technology solutions for post-acute care physicians and their patients.

“The healthcare industry must be working hand-in-hand with each other on advocacy efforts to help educate policymakers on opportunities to strengthen tech-enabled post-acute care,” Dr. Landers said.

Supply Chain Leader Spotlight

Jessica Carrillo, Director, Consolidated Services Center, Supply Chain Services for Banner Health

 As Director, Consolidated Services Center, Supply Chain Services for Banner Health, Jessica Carrillo’s role entails overseeing both the IDN’s consolidated services center as well as an offsite distribution building.

What’s unique about running Banner Health’s self-distribution center and logistics center?

With Banner being the largest healthcare provider in Arizona, we support 17 hospitals utilizing our Arizona based warehouses. We also support our hospitals outside of Arizona when their normal distribution channels through a national distributor or direct orders with a supplier are disrupted. We have the leverage to reach out and support them.

Something else unique in my role is the partnership with Banner’s contracting and clinical teams at a corporate level. We work together frequently whether through disruptions that arise or a contract negotiation to really capture contracting expertise, the clinical side of our business as well as operations. My team not only oversee operations and workflows from receiving into the warehouse, storage and outbound, we also work at the corporate level, focused on the vision and strategy of our senior leaders.

Jessica Carrillo

We have seen a flawless accuracy in our order fill rate; always above 99% daily. That is where a picker can go to a location and fulfill 99% of the orders that come through. Our inventory accuracy rates have also drastically improved.

What have the last few years been like working with disruptions in the supply chain?

It has been constant. I would say that for Banner, we’ve been able to strategize on a lot of critical supplies and ensuring that we have a safety stock or healthy inventory so that if there is a disruption, whether it be a few weeks or even a month or two, we often have strong inventory so that we have time to plan not only contractually where we go to look for alternate supplies, but also clinically to vet and review alternatives. The disruptions have been constant, but we are continuously looking to grow what type of products we stock, ensuring the most critical are being assessed.

Looking at your career to date, is there anything that you consider your first big win, either at Banner Health or supply chain in general? Within supply chain, focus is around disruption and how to respond. We spend a lot of energy there, but what has been exciting for me was a project implementing a warehouse management system.

During the COVID years, we also had a long-term initiative to improve our technology

within the distribution center, going from our paper-based manual processes to systembased through a warehouse management system. In 2023, towards the end of the year, we implemented the new technology. And, over a four-day period, we lifted our team off paper picking where they were filling orders off manual pick sheets to electronicbased handheld devices.

While implementation was four-days, it took us eight to nine months of planning and thorough process review and development. For me that was one of the most successful projects because not only as a team did we succeed in change management, really pulling together to focus on that end goal, but we have been reaping the benefits ever since. We have seen a flawless accuracy in our order fill rate; always above 99% daily. That is where a picker can go to a location and fulfill 99% of the orders that come through. Our inventory accuracy rates have also drastically improved.

Having that visibility in your hands, especially with inventory in multiple facilities, knowing exactly where everything is – the quantities, the expiry dates – has been a huge leverage for our operation to plan better, to maintain

inventory and better rotate safety stock. WMS has given us the transparency and control necessary to ensure scalability and stability for our operation.

What do you see as the biggest stress points for the U.S. healthcare system?

How supply chain can find solutions to help?

There are two primary areas that we focus on to relieve the burden in supply chain. One is the continued focus on cost savings with low margin. To eliminate that concern we try to focus on less complexity in the variety of supplies. In other words, standardization.

With the self-distribution center, we focus on resiliency by having enough resources in our warehouse, whether that’s 60 or 90 days of supply. But we also want to focus on formulary items, something that every hospital is using or that is critical when a patient presents themselves through our emergency department.

The second area is the overall disruptions that we continue to face. That is why we are focused on our vision of growth and trying to be as resilient as possible and be able to support the most critical items.

Supply Chain Leader Spotlight

Jose Flores, SPSM, Sr. Contract Administrator, Supply Chain

Please tell us about your role and responsibilities.

I am the Senior Contract and Sourcing Lead supporting the Tower Health Supply Chain Department in the Purchased Services & Goods for the Maintenance, Repair, and Operations category for all Facilities Management Departments under Tower Health. These facilities include Reading Hospital, Reading Hospital School of Health Sciences, Drexel University College of Medicine at Tower Health, Pottstown Hospital, Phoenixville Hospital, St. Christopher’s Hospital for Children, TowerDIRECT, Tower Health at Home, multiple Tower Health Urgent Care sites, and multiple Tower Health Medical Group sites. I manage a Book of Business with an estimated 400 reoccurring annual contracts. This number does not include the annual contract requests that are submitted for one-time purchases of services and goods and capital purchases.

My responsibilities include but are not limited to performing analytical tasks in support of securing savings and streamlining processes; providing data driven recommendations and best industry practices that support internal business decisions related to costs, risk management, contract terms

and conditions, vendor selection, SOWs, and RFPs; strategic sourcing and system-wide contract standardization with an emphasis on co-terminating contracts; keeping an open business mind to solve complex problems as there are many solutions, ideas, and compromises that can be

used to achieve a resolution; managing the entire life cycle of contract administration from the solicitation of bids and proposals to vendor negotiation and contract execution; work closely with Value Analysis, Risk Management, Legal and IT Departments when a contract requires their input,

Jose Flores

approval or in preparation of an RFP; monitor and evaluate vendor performance and continually engage with vendors to build upon a professional business relationship.

How did you get started in supply chain?

I began my career in supply chain while serving in the United States Marine Corps as a Contract Specialist. While being a Marine was very challenging with multiple moves up and down the East Coast and two overseas middle east deployments during Operation Iraqi Freedom and Operation Enduring Freedom, professionally it was very rewarding. I knew that I most certainly found a career that I could enjoy until I retired.

What is a recent project that really stretched you and your team?

Recently, the Supply Chain Department changed their Contract Management System. The prior system used was based off multiple management systems. Although the previous system was effective, it was time to utilize a more efficient contract management tool that integrated the multiple systems we were using. The IT Department worked with the Supply Chain Department to revamp a system already in use by IT that could be revamped into a Contract Management tool with very little increase in cost. This innovative thinking not only brought about significant savings, it brought the Supply Chain team together to collectively share ideas and process improvements for the new system. The IT Department and the consultants used the information provided to build upon the existing system

that was technically not meant to be used as a contract management tool. Within a few months, the team successfully created a contract management tool tailored to the needs of our Supply Chain Department.

From this experience, I learned that you don’t have to be the smartest person in the room. Your ideas for process improvement and efficiency are just as important as those of the individual next to you. We all had a common goal and worked together to share our ideas and create conversations around what would work best. It was like a scientific experiment where all our ideas were utilized in some way or another to create the contract management tool we are using today.

What about now? Is there a current or upcoming initiative you are excited to be working on?

I was recently assigned to be the sole contract administrator for the entire book of business for all Facilities Management contracts. The significance of mentioning this is at one time, this book of business was handled by four contract administrators. Around the time Tower Health sold a few hospitals and Urgent Care facilities, the contract administrators went from four to two. During a recent realignment of Supply Chain personnel, Supply Chain Leadership selected me to manage all Facilities Management contracts by myself. While challenging, this initiative led me to reevaluate my work process and to find ways to be more efficient. This is exciting because I’ve been empowered and entrusted to effectively

manage my own contract portfolio. In time, I will self-evaluate my progress and create my own case study to show what worked, what didn’t work, and what I could have done better.

Is there a source of motivation for the work you do in the healthcare supply chain?

I was raised in the projects less than one mile away from Reading Hospital. Three of my sisters were born in Reading Hospital. My dad and I would walk from the projects to Reading Hospital to visit my mom after the birth of my first sister and thereafter with each sister, we would walk to visit my mom and the newborn sister. I vividly remember how nice the nurses were and that was my first introduction to doing what you love and the sense of gratitude of serving your community.

At the time, I didn’t know what doing what you love or what a sense of gratitude meant, but I knew I was treated in a way that made me feel good. Little did I know I would one day have the opportunity to work at Reading Hospital doing something that I love and feeling the sense of gratitude for serving my community. There is something about providing a service behind the scenes that impacts the lives of thousands of patients and their family members that motivates me in my role today. I was recently promoted to a Senior Contract and Sourcing Lead. The promotion made me feel like my contributions matter. Serving my community and making sure that I do not fail them is what motivates me in my role today.

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More Than “Just a Headache”

June is Migraine and Headache Awareness Month, shedding light on the symptoms and treatment options for headache and migraine.

 Migraines and other headache disorders affect more than 40 million Americans, according to the National Headache Foundation (NHF), yet they remain among the most misunderstood and underdiagnosed neurological conditions. As the healthcare industry and the field of neurology continue to evolve, raising awareness and improving care for those affected by headaches and migraines has become more urgent than ever.

Nine out of ten people with a migraine reported they could not “function normally” during the days on which a migraine strikes, according to the NHF. Nearly 3 in 10 people require bedrest during a migraine attack.

Many people are misled to believe that a migraine is a bout of “bad headaches,” and that they are psychological or easily

treated by drinking enough water, diet changes or medication. A migraine is a type of headache disorder that can be a highly debilitating health condition, often requiring treatment from a healthcare provider.

“The truth is that migraine is a complex neurological condition with various contributing factors or triggers. Most people

require a multifaceted, personalized approach to management,” according to Susan Stone, CEO and executive director of the National Headache Foundation.

The NHF started National Headache Week over 35 years ago in 1989 to provide information and promote advocacy on headache disorders, migraine disease and facial pain. In 2011, the Awareness Week became an Awareness Month with the theme of “It’s More Than Just a Headache” to promote advocacy and awareness of each condition.

Since 2018, the NHF has been collaborating with the Coalition of Headache and Migraine Patients (CHAMP) during June of each year for Migraine and Headache Awareness Month (MHAM).

The impact of migraine disease

Migraine is a health condition that significantly impacts patients’ daily lives. The symptoms of a migraine are different from person to person. One of the most common symptoms of a migraine attack is moderate to severe throbbing pain that usually happens on one side of the head.

Migraine is a chronic neurologic disease believed to result from a combination of genetic, environmental and neurological factors, said Stone. “As a primary headache disorder, migraine is one of the most prevalent and disabling neurological diseases, with 1 in 4 households impacted across the nation.”

“Migraine tends to run in families, with a reported risk of 40% if one parent has a history of migraines, which increases to 75% when both parents have a migraine history and are affected,” said Stone.

Symptoms of migraine may include nausea, vomiting, changes in mood, extreme tiredness, and sensitivity to light, noise, and smells. Migraine attacks may last from hours to days and make it hard for an individual to do everyday activities.

“When a patient visits a healthcare provider for their symptoms, a physical examination helps rule out other potential causes of headache,” said Stone. The healthcare provider evaluates a patient to see if they meet specific diagnostic criteria for migraine or other headache types set by the International Classification of Headache Disorders Third Edition (ICHD-3) – and determines if the cause is primary headache (migraine, tensiontype headache, etc.), secondary headache (headache attributed to trauma, infection, etc.) or neuropathies and facial pains.

Several factors may contribute to a patient experiencing migraine symptoms, according to the Centers for Disease Control and Prevention (CDC), including environmental factors like sudden changes in weather, sleep disruption, strong smells or fumes, physical and mental stress, and more.

“Lifestyle changes can also impact patient outcomes,” said Stone. “Behaviors like getting consistent sleep, eating a more balanced diet, and exercising regularly can help some patients reduce attack frequency and intensity.”

The National Institute of Neurological Disorders (NINDS), a component of the National Institutes of Health (NIH), has researched headaches and migraines to look at things like using different colored room lighting, and adding dietary changes like omega-3

polyunsaturated fatty acids to see if they work for treating migraine.

Treatment options for migraines

Treatment options for migraines include a combination of therapies tailored to a patient’s personal goals.

“The most effective treatment is the one that works for that specific individual,” said Stone. “Headache specialists approach each patient as an individual and partner based on the person’s needs and preferences to develop and implement an aligned treatment plan.”

A personalized treatment plan, according to Stone, includes both acute and preventive treatments. Acute treatments aim to stop an attack once it has already started, such as over-the-counter pain relievers, prescription medications, neuromodulators, and other therapies such as CBT, cold or heat packs, resting in a dark room, and relaxation techniques. Preventive treatment focuses on reducing the frequency and severity of attacks before they begin through lifestyle modifications, prescription medications, neuromodulators, supplements, and nerve blocks.

“Educating patients and care partners about the nature of migraine and identifying individual contributing factors and triggers is essential for effective management and self-advocacy,” said Stone. “A personalized plan can help patients manage their condition more effectively.”

Advocacy for migraine patients

According to the NHF, steps to facilitate migraine care include scheduling a dedicated appointment to see a healthcare provider, tracking and sharing symptoms at the appointment, getting a correct

diagnosis, finding treatments that meet a patient’s personal goals, and requesting a specialist referral when needed.

“By actively communicating your symptoms and experiences to demonstrate the impact and disability that migraine disease has on your daily life, you can help ensure that your condition is acknowledged and treated with the urgency it deserves,” said Stone. “Remember that your health is paramount. Use all available resources to ensure you receive the attention and care you need for better outcomes.”

Stone also emphasizes the importance of managing the stigma associated with migraines to reduce barriers to care and allowing impacted patients better access to the healthcare resources that they need and deserve.

“The attacks are real, are misunderstood by many, can happen without warning, and are very inconvenient to patients’ lives,” according to Stone. “Connecting patients and care partners with support and resources can help them cope with the challenges of living with migraine.”

This June, NHF’s campaign for Migraine and Headache Awareness Month includes a social media campaign based around the themes “Invisible Disease. Real Symptoms.”, “Headache. Not Just Head Pain,” and “Your Path to Better Days,” which aim to shed light on the reality of living with migraine, so everyone that needs care, gets timely access to effective diagnosis and treatment.

To learn more or get involved, visit headaches.org and follow NHF’s #MHAM2025 campaign on social media.

Health Report

Cleveland Clinic survey reveals insights into women’s health

A new national survey of women in the U.S. by Cleveland Clinic, in collaboration with YouGov, highlights knowledge gaps, barriers to care, and growing interest among women in clinical research participation. The results come ahead of National Women’s Health Awareness month, which is May.

The survey revealed that many women are not aware of how certain health conditions impact women and men differently. For example, despite nearly two-thirds of Alzheimer’s disease diagnoses being in women, 32% of women believe it affects both sexes equally. Similarly, 31% of women believe stroke affects women and men equally, even though it’s more common and fatal for women. In addition, even though heart disease is the leading cause of death in both men and women in the United States, 62% of women don’t realize it impacts women and men at similar rates.

Annual report: Cancer deaths continue to decline

The annual cancer statistics report from the National Cancer Institute (NCI), published in the journal Cancer in April, shows some signs of progress in America’s fight against the disease. Overall, rates of new cancer diagnoses and cancer-related deaths have declined. Between 2018 and 2022, cancer death rates have decreased by 1.7%

each year for men and 1.3% for women, the report stated.

Measles jumps borders in North America with outbreaks in Canada, Mexico and U.S.

North America’s three biggest measles outbreaks continue to increase, with more than 2,500 known cases; three people have died in the U.S. and one in Mexico,

according to AP News. Mexican and U.S. officials also say the genetic strains of measles spreading in Canada match the other large outbreaks. Recent World Health Organization report said measles activity in the Americas region is up elevenfold from the same time last year and that the risk level is “high” compared to the rest of the world’s “moderate” level, according to AP News.

Study finds social factors explain poorer cardiovascular health in rural areas

A study published by the National Institutes of Health found that adults living in rural areas have worse cardiovascular health than those in urban communities due to social factors such as income, education, having enough food and owning a home. The agency found that those living in rural rather than urban areas were more likely to have heart disease (7% vs. 4%), high blood pressure (37% vs. 31%), high cholesterol (29% vs. 27%), obesity (41% vs. 30%) and diabetes (11% vs. 10%).

Industry News

McKesson spins off med-surg segment

McKesson Corporation announced its intention to separate its Medical-Surgical Solutions segment into an independent company (“NewCo”).

McKesson believes a separation will “further enhance the strategic opportunity and operational focus of both companies and unlock value for McKesson shareholders,” the company said. “The separation would advance McKesson and NewCo’s ability to create value for customers, partners, patients, and shareholders.”

McKesson will focus on opportunities that best align with its long-term enterprise strategies, advancing McKesson’s portfolio to focus investment on higher growth, higher margin opportunities in Oncology and Biopharma Solutions.

SMI welcomes new leadership: Lisa Hohman as Board Chair, Steve Mason and Amanda Chawla to Board of Directors

SMI® has appointed Lisa Hohman, CEO of Concordance as Board Chair; and Steve Mason, CEO, Global Medical Products and Distribution at Cardinal Health; and Amanda Chawla, Chief Supply Chain Officer and

SVP for Stanford Medicine to its board of directors.

Hohman has been a member of SMI since 2010 and a board member since 2020. She said, “It is an honor to be board chair for an organization known for its commitment to the healthcare supply chain industry. I am committed to upholding SMI’s mission to make impactful and transformational change while serving the SMI community, alongside many of my peers and colleagues.”

“I look forward to collaborating with my fellow board members as we work together to understand and anticipate the evolving needs of our members and industry,” Mason said. “The mission of SMI is in deep alignment with our efforts at Cardinal Health and I appreciate the opportunity to contribute to the advancement of the healthcare supply chain in my new role on the board of directors.”

Since its inception in 2004, the SMI Board of Directors sets the strategy for SMI and the work of its members. The Board includes twelve members, 6 provider partners and 6 industry partners to ensure a balanced representation of its membership which consists of leaders from large integrated delivery networks (IDNs) as

well as suppliers, manufacturers, distributors, technology, and service organizations.

Sports

organization

MotoAmerica first to use Abbott’s rapid blood test for concussion evaluation on-site at races

Abbott and MotoAmerica, the premier motorcycle road racing series in North America, announced that MotoAmerica is the first professional sports organization worldwide to use Abbott’s groundbreaking blood test to help assess suspected concussions for riders in the on-site medical facilities at all races.

Abbott’s test, the i-STAT TBI test cartridge, is used to evaluate patients 18 years of age and older who present with suspected mild traumatic brain injury (mTBI). It provides results in 15 minutes and may be used up to 24 hours after injury to help determine the need for a CT scan of the head.

In 2024, Abbott’s i-STAT TBI test received clearance from the U.S. Food and Drug Administration (FDA) to be used with whole blood, allowing doctors to quickly assess patients with suspected mTBI on the handheld i- STAT Alinityanalyzer at the patient’s side.

Midmark is the first and only manufacturer in the market to have both a procedure chair and an examination chair that comply with the US Access Board Standard.

Getting to know the standard

01 Seat Height: 17" or lower and 25" or higher

02 Transfer Surface: 21" wide and 17" deep

03 Base Clearance: 26" wide or less

04 Transfer Supports: Compliant to the US Access Board Standard

05 Leg Supports: Support the patient’s thigh, knee and calf

Learn more at: midmark.com/reachnewheights

Source: US Access Board. (2024, July 25). Standards for accessible medical diagnostic equipment. Federal Register, 89(143), 47823-47839. https://www.federalregister.gov/documents/2024/07/25/2024-16266/standards-for-accessible-medical-diagnostic-equipment

Let’s partner together to show your customers how the latest Welch Allyn exam tool technology is changing views for the eye and ear exam.1

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