Rep may18

vol.26 no.5 • May 2018

The Pursuit of Excellence

repertoiremag.com

MACRA Quality Measure Number: CMS146v5 A p p r o p r i a t e Te s t i n g f o r C h i l d r e n w i t h P h a r y n g i t i s

value-based

rapid tests

The OSOM ® Strep A Test provides specific, accurate results to help improve patient care supporting your MACRA quality measures.

Sekisui Diagnostics IS your partner in healthcare.

Call your rep today at 800-332-1042. www.sekisuidiagnostics.com MADE IN THE USA

© 2018 Sekisui Diagnostics, LLC. All rights reserved. OSOM® is a registered U.S. trademark of Sekisui Diagnostics, LLC. Because every result matters™ is a trademark of Sekisui Diagnostics, LLC.

MAY 2018 • VOLUME 26 • ISSUE 5

PUBLISHER’S LETTER To Those Who Carry A Bag.......................................6

PHYSICIAN OFFICE LAB Proficiency Testing

OMG it’s PT...................................................................................8

CONTRACTING EXECUTIVE PROFILE

The Pursuit of Excellence The Medical/ Dental Clinic

16

Joe Colonna; Vice president; supply chain and real estate; Piedmont Healthcare; Atlanta, Georgia............................................. 12

TRENDS

As the two disciplines draw closer together, is the medical/ dental clinic far behind?

28

Caught in the A1c Crossfire

34

page

repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2018 by Share Moving Media. All rights reserved.

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

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

www.repertoiremag.com

•

May 2018

3

MAY 2018 • VOLUME 26 • ISSUE 5

HEALTH FOCUS: IMAGING

HEALTHY REPS

Right Image, Right Time Resource for doctors facilitates high-value imaging Health news and notes.......................................................... 42

WINDSHIELD TIME Automotive-related news.................................... 44

HIDA GOVERNMENT AFFAIRS UPDATE Medical Device Tax Win Underscores the Value of Advocacy............ 48

SMART SELLING

38

In Today’s Healthcare Environment, Less Really is More........................ 49

REP CORNER

Ultimate Insider Kim Soler is smart on the phone

QUICKBYTES

Technology news

46

4

May 2018

•

www.repertoiremag.com

50 INDUSTRY NEWS News........................................................................................... 54

NEW

2,000mL

BOTTLE

THE LARGEST VOLUME EVACUATED DRAINAGE BOTTLE IS NOW AVAILABLE IT’S A BIG DEAL

With Automatic Fluid/Air Stop Valve and Automatic Needle Safety Shield

ACCEL® Evacuated Drainage Bottles 600mL, 1,000mL and 2,000mL Clear, Shatterproof, Plastic

ACCEL® Valved Safety Centesis Catheter with Introcan Safety™ Technology

ACCELerating Safe and Efficient Percutaneous Fluid Drainage Distributed by: B. Braun Interventional Systems Inc. | Bethlehem PA | USA 877-836-2228 | www.bisusa.org Refer to the Instructions for Use for complete indications, relevant warnings, precautions, complications, and contraindications.

Rx only CV-9036 7/17 ©2017 B. Braun Interventional Systems Inc.

PUBLISHER’S LETTER

To Those Who Carry A Bag As we head into “National Sales Meeting” season, I am reminded of the gratitude our

industry owes the men and women in the field – the ones who carry a bag. They also carry our message, and our future. Those brave reps that knock on doors and make cold calls grow not just their own business, but our industry’s as well.

Last month, during our Medical Distribution Hall of Fame dinner, we celebrated an individual who carried a bag. In this issue, we honor two sales reps that were nominated by their peers to win the Repertoire / HIDA Excellence in Sales Award. These two individuals show us all what it means to be professional. If you are a new rep, I encourage you to read their stories and learn from their experiences. If you are a veteran, please read these articles to remind yourselves why you are in this industry. I believe it’s the greatest industry in the world.

This year’s Hall of Fame inductee, Paul Julian, knew the value of every rep in our industry, because he knew what it meant to go out and make a sales call.

Can you imagine our industry without you, the distributor rep? I for one cannot, and there is no way I ever want to see it controlled by online buying. You, the Repertoire reader, the distribution sales representative, are one of over 6,000 men and women that make up the backbone of our industry. Thank you for everything you do on a daily bases. Thank you for taking care of the providers, suppliers, and your families by making sales calls that grow sales and save lives.

To our Excellence in Sales winners, Dianna and Mike, I would like to personally congratulate you both for your nominations, as well as thank you for the example you both are to us all.

Scott Adams

Dedicated to Distribution, R. Scott Adams

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

editorial staff editor

Mark Thill lthill@sharemovingmedia.com managing editor

Graham Garrison ggarrison@sharemovingmedia.com editor-in-chief, Dail-eNews

Alan Cherry acherry@sharemovingmedia.com art director

Brent Cashman bcashman@sharemovingmedia.com

6

May 2018

•

www.repertoiremag.com

vice president of sales

Jessica McKeever

jmckeever@sharemovingmedia.com (800) 536.5312 x5271 director of business development

Alicia O’Donnell

aodonnell@sharemovingmedia.com (800) 536.5312 x5261 sales executive

Tyler Moss

tmoss@sharemovingmedia.com (800) 536.5312 x5279 sales executive

Lizette Anthonijs Lizette@sharemovingmedia.com (800) 536.5312 x5266

publisher

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

Brian Taylor

Subscriptions

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

2018 editorial board Richard Bigham: IMCO

Eddie Dienes: McKesson Medical-Surgical

btaylor@ sharemovingmedia.com

Joan Eliasek: McKesson Medical-Surgical

circulation

Doug Harper: NDC Homecare

Ty Ford: Henry Schein

Laura Gantert

Mark Kline: NDC

lgantert@ sharemovingmedia.com

Bob Ortiz: Medline Pam Wedow: Independent consultant

THE WHOLE STORY. 2018 Procedures Chair Promotion

Your customers can SAVE HUNDREDS on best-in-class procedures chairs, but time is running out! This offer ends May 31, 2018.

Get all the details at: midmark.com/wholestoryREPmay 1-800-MIDMARK

© 2018 Midmark Corporation, Dayton, OH.

PHYSICIAN OFFICE LAB

Proficiency Testing OMG it’s PT

By Jim Poggi So, the boss called and said you need to increase your

lab sales – NOW. With flu kit season over, it’s time to get back to selling.

Sound familiar? It does to me. I heard it pretty much every year for a decade or so.

So, what do you do? Where is the low hanging fruit?

Inevitably it always starts with selling more product to current customers. They know and trust you and are familiar with your product lines, delivery schedules and ways you do business. So, they are natural candidates.

Last month, we covered LIS systems, which, with careful planning, are an excellent customer penetration strategy. Hopefully, I gave you some thoughts to help you take a step or two in the direction of looking at opportunities to sell LIS to current customers and, more likely, with new lab instrument sales as well.

Now it’s time to look at proficiency testing as an opportunity. Proficiency testing has been dominated by direct companies in the past, and remains one product category where distribution has truly not flexed its muscles yet. There is no point in naming direct company

8

May 2018

•

www.repertoiremag.com

names, but the “big brands” in proficiency testing hold the lion’s share of market in primary care and the hospital business as well.

The importance of PT to customers and their one big misconception Proficiency testing is not just a regulatory requirement.

It is an important element of managing a well-run lab.

But, in this case, it is usually customers that are warier than the account manager.

What I hear most often is: “We do not like folks looking over our shoulder” and “they might fail our lab.”

Both of these statements probably stem from insecurity and miss the point. It’s worth your time to remind your customers that proficiency testing and QC testing are the only tests that are not patient results. From that perspective, they are not a threat, but truly a safety check for your customers. To the extent you can convey that message, you are half way to the sale.

The reality is, whether your CLIA moderate complexity customers like it or not, they need to run proficiency testing.

MAYBE YOU NEED A BETTER TEST FOR NEXT FLU SEASON

Were you able to confidently diagnose and treat your patients during one of the most challenging flu seasons on record?1 Recent data shows that traditional rapid testing methods have only 50-70% sensitivity, which may lead to more false negatives when influenza activity is high.2 With 100% sensitivity for Flu A/B, the CLIA-waived cobas® Liat® PCR system can help you better detect flu and treat with confidence and speed, when it matters most.3

Visit go.roche.com/betterequipped for more information.

1 CDC Weekly U.S. Influenza Surveillance Report. Available at: https://www.cdc.gov/flu/weekly/. Accessed on March 12, 2018.

2 Rapid diagnostic testing for influenza: Information for health care professionals. Centers for Disease Control and Prevention website. http://www.cdc.gov/flu/professionals/diagnosis/rapidclin.htm#table Accessed March 12, 2018.

3 Roche cobas® Liat® Influenza A/B Package Insert COBAS and COBAS LIAT are trademarks of Roche Diagnostics. © 2018 Roche. PP-US-13376-0318

PHYSICIAN OFFICE LAB So, how does PT fit into your lab product portfolio and customer value? What are the pitfalls? What do I suggest you do? Let’s take this one question at a time.

PT and your product portfolio There are certain products and services that make account managers (and customers) cringe. PT is one.

LIS is another. But, a well-run lab needs more than just instruments and reagents. It needs the right PT service, a good LIS system and a range of other products and services designed to keep the lab efficient, accurate, productive and profitable. Your CLIA moderate complexity customers need PT, and it’s in your best interests to carefully consider how to incorporate it into your sales time in front of customers.

PT pitfalls PT is one of the hardest sales you will make.

Direct competition owns the lion’s share of the market, partly due to focus and expertise, and partly due to the established reputation of one of the services in the pathology community.

And, they are good at it.

They make it easy for customers to order online and with some services offering direct submission of PT results to the service provider, who grades their results and sends them back electronically. Finally, PT suppliers have program-to-program variance with different tests in their “program challenges,” so it is critical for the distributor account manager to know which tests their customer needs PT for and communicates it effectively to their PT provider.

10

May 2018

•

You will find your PT supplier willing to get on a call with you for your largest customers.

Close on the spot for enrollment to avoid having the direct competition come in and under cut your pricing or offer special deals.

www.repertoiremag.com

PT enrollment (subscribing to the program for the coming year) is typically seasonal, with most customers placing their orders for the coming year in the October to December time frame. This is right during the flu, strep, etc., season when more account managers are up to their eye balls in selling respiratory tests. So, there is a lot of distraction during that time of year. Finally, established direct PT suppliers bird dog their customer base carefully and keep a close eye on renewals. They will push back with discounts and other tactics to keep their client base.

PT suggestions Selling PT calls for a targeted approach. The first thing to do is get acquainted with the PT program(s) your company offers in early summer. Learn the catalog and find the person in the organization who is motivated to help you cross reference the direct competition’s programs to the ones you offer. Find out which sales tools including cross references and specialized PT programs your supplier offers that the direct companies do not. Yes, there are some out there. PT/INR is one.

The next step would be to make a list of your 15-20 largest moderate complexity customers (and high complexity microbiology or toxicology customers) as the targets. Have your story ready: “Consolidate your PT testing with the source of your lab instruments, reagents and other services from the distributor you trust: me. Our supplier offers unique advantages such as solid technical support, lower program cost, a convenient sample shipping schedule, etc.”

Then, meet with three customers a week to learn which programs they are in, whether they have enrolled in the coming year yet, and propose your solution. You will find your PT supplier willing to get on a call with you for your largest customers. Close on the spot for enrollment to avoid having the direct competition come in and under cut your pricing or offer special deals. Don’t expect miracles. A 10-20 percent close rate your first year is a good start. As a side bonus, selling PT really sharpens your sales skills.

Finally, keep follow up in view and check in with your customer every couple of months to assure they are satisfied with the service you have offered them. This follow up offers you the advantage of conducting a broad-ranging discussion of their lab and strategy for the future. It helps assure you will be at the front of the line when they are thinking about new tests, products and services.

PT: Not EZ, but OK4U. Good luck!

C

LI A

W AI

VE

Get the NEW GeneXpert® Xpress for your territory.

Front-line Access & Control. Everywhere

You Need It.

Ask your Cepheid Rep about our NEW Placement Agreement

Xpert® Xpress Flu Reliable • CLIA waived molecular RT-PCR results • Internal QC in each test cartridge

Simple • Easy 3-step procedure • Add sample & go!

Efficient • Run more than 1 test at a time • Accurate results as soon as 20 minutes** * For in vitro diagnostic use.

A better way.

** For positive Flu only. Results from negative specimens are reported in approximately 30 minutes.

904 Caribbean Drive | Sunnyvale, CA 94089 USA | TOLL FREE +1.888.336.2743 | PHONE +1.408.541.4191 | FAX +1.408.541.4192 | www.cepheid.com

D *

IDN OPPORTUNITIES

Contracting Executive Profile Joe Colonna; Vice president; supply chain and real estate; Piedmont Healthcare; Atlanta, Georgia

Joe Colonna

Editor’s note: Joe Colonna was selected as one of the “Ten People to Watch in Healthcare Contracting” by the Journal of Healthcare Contracting, a sister publication of Repertoire.

Piedmont Healthcare is a private, not-for-profit orga-

nization serving nearly 2 million patients across Georgia.

Today, more than 110 years since it was founded, Piedmont is known as a leading health system in cancer care, treatment of heart disease and organ transplantation, with 11 hospitals and multiple urgent care centers and physician practice locations.

Since July 2008, Joe Colonna has served as vice president of supply chain. In 2016, real estate and construction

12

May 2018

•

www.repertoiremag.com

were added to his responsibilities. Prior to Piedmont, he was a principle in Appleseed Healthcare, a supply chain and leadership consultancy. Colonna started his supply chain career with the United States Air Force, and has enjoyed a blend of healthcare experiences for over 30 years in different aspects of the healthcare supply chain, including roles in provider, consulting, distribution and group purchasing organizations. At Piedmont, he has worked closely with Piedmont’s executives, clinicians,

business partners and one of the industry’s best supply chain teams to completely reorganize how Supply Chain is viewed by the organization. “I am proud to say that Supply Chain now plays a significant role in the strategic plans of the organization, and has been recognized nationally for the team’s role in supporting Piedmont’s mission,” he says.

At Piedmont, Colonna leads a team of professionals who are responsible for real estate, construction, corporate and local supply chain, biomedical and diagnostic imaging acquisition and maintenance, print services, and a value analysis process that focuses on all non-labor activities, including clinical and non-clinical devices, and which includes purchased services contracting. From a centralized service center, Colonna and his team provide lowunit-of-measure supply distribution, print services, biomedical and diagnostic imaging repair, courier services (third party) and IT central distribution for equipment. Piedmont has also centralized its front-office services, contracting, purchasing, materials management information and more.

belief that we should always be good stewards of the funding we are given as a non-profit. This means that our team in both Supply Chain and Real Estate and Construction are often involved in helping grow the mission while remaining fiscally wise. I really enjoy that partnership and I am very proud of our role.

JHC: In what way(s) have you improved the way you approach your job or profession in the last 5-10 years?

Colonna: In recent years it has become apparent to many of us in the industry that supporting the mission of our facilities will be less about lower prices and more and more about lowering the total cost of ownership. This will mean creating greater efficiencies. These changes will

The industry needs to be more agile and willing to change. Even change things that have been successful in the past.

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

Colonna: The changing role of and dependency on technology, mergers and acquisitions, and, in general, a raising of the bar for our industry. The most challenging and rewarding thing for us has been the creation of an internal team that is focused both on the day-to-day needs of the organization as well as the more strategic elements of supporting Piedmont Healthcare’s mission and vision.

We are professionals serving professionals, and for our team, that is not just a focus on saving money or stocking shelves (which is still very important), but also helping create business partnerships and relationships around quality, safety and service.

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

Colonna: Piedmont Healthcare continues to grow both in geographical size and our services to the community.

We are doing this while still remaining true to our CEO’s

require our team members and our business partners to embrace different and better ways of doing business. As always, this will be enabled by people, process and technology. None of this can happen if we do not improve the way we (as an industry) handle and respect the impact of data. In the past five to 10 years I have really grown to appreciate the impact of data on everything else we are trying to do in this industry. Not to the exclusion of the need for people or process, but instead, I think I have a better understanding of the rate-limiting impact of bad data on people and process improvement.

JHC: What do you need/want to do to become a better supply chain executive in the coming year(s)?

Colonna: Patience. The industry needs to be more agile and willing to change. Even change things that have been successful in the past. I am so proud of my industry and our team here at Piedmont Healthcare. I know what we are capable of doing, and sometimes I forget that we cannot do it all at once. I am very comfortable with change but change, even with the best of intent, must be balanced with patience … I am working on it.

www.repertoiremag.com

•

May 2018

13

Sofia Lyme: Results in minutes, not days.

Diagnosing Lyme disease is hard. Symptoms are broad and generic, mimicking many other conditions. Patients feel horrible and want answers. It doesn’t help that current testing methods may take hours or days for results. Not anymore! Sofia Lyme FIA provides objective and automated results in only 10 minutes, getting doctor and patient on a path to treatment much sooner.

Sofia Lyme FIA is the only rapid, near-patient testing solution that provides IgM and IgG differentiated results in a single test. It has demonstrated accuracy on par with current testing methods — all with less than 1 minute hands-on-time in near-patient moderately complex labs. And as you’ve come to expect from Sofia, our Lyme assay functions in WALK AWAY and READ NOW modes, providing flexible workflow options based on lab needs.

To have your customer's moderately-complex lab ready for Lyme season with Sofia Lyme FIA, contact your Quidel Account Manager at 800.874.1517

quidel.com AD2029801EN00 (03/18)

The Pursuit of Excellence E

xcellence is all around, if we look for it. Certainly it is exemplified in the manner in which Mike McGoldrick and Dianna Hundl practice their craft of medical sales. Honesty, service, education, attention to the little things (that aren’t so little to the customer) are some of the things that came to mind as we share stories about this year’s recipients of the Repertoire/HIDA Excellence in Sales Award.

Excellence in Sales 2018 2017 2016 2015 2014 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000

16

May 2018

•

Distributor

Manufacturer

Mike McGoldrick, Henry Schein Victor Bakkar, McKesson Medical-Surgical Mike Ludwig, Henry Schein Todd Matthews, McKesson Medical-Surgical Chuck Ryan, McKesson Medical-Surgical Paul Lilly, McKesson Medical-Surgical KC Meleski, Claflin Equipment Steve Marshall, Cardinal Health Rich Bilz, Henry Schein Tom Jacob, McKesson Medical-Surgical Dick Daley, Affiliated Healthcare Systems Mike Leva, Claflin Company Marty McCurdy, PSS Denise Hassler, Caligor James Barnes, Cardinal Health Jim Wheeler, Seneca Medical Linda Phillip, McKesson Extended Care Brad Jacob, McKessonHBOC

Dianna Hundl, Quidel Patrick Thombs, Clorox Healthcare Chris Huppert, Midmark Nick Riordan, Welch Allyn Nate Williams, Midmark Louis Cupo, Cardiac Science Mimi Hobson, Terumo Mike Paige, Med Care Associates Tommy Whitehead, Midmark Denny Monnin, Midmark Bob Chaldu, TIDI Products Jack Moran, Med Care Associates Steve Bakalar, Welch Allyn Jeff Daner, Midmark

www.repertoiremag.com

The Pursuit of Excellence

Mike McJet Mike McGoldrick is loyal to customers, manufacturers, colleagues… and the New York Jets

H

Mike McGoldrick

e says he’s no whiz-bang. In fact, he probably is. The thing about Mike McGoldrick is, he keeps things simple. No ostentation, no uber-aggressiveness. Just honesty, loyalty and hard work. In return, he earns the trust of his customers and manufacturer partners, and plenty of business.

Mike McGoldrick – or Mike McJet, as many people call him (he’s a fanatic New York Jets fan) – is territory manager in Connecticut for Henry Schein, and the recipient of this year’s Excellence in Sales Award for a distributor.

“Mike has core values that make him successful professionally,” says Arthur Lubniewski, district manager, New England, Upstate New York, eastern Canada, for Integra/Miltex. “He holds himself accountable in making sure every minute with a vendor is utilized appropriately. His level of respect toward his professional network is above and beyond most.

Finally, his high level of integrity is what sets him above everyone else and helps him build loyalty with his customers and peers.”

Garett Roberts, sales representative for Midmark Corp. in southern New England, says, “Mike is just a solid person all the way around. He prides himself on not doing anything too fancy. He simply puts his head down and works hard. His customers have the utmost respect for him, and they know they can count on him to always deliver. Most important, Mike is a family man – husband, father of four. He has his priorities perfectly aligned.”

18

May 2018

•

www.repertoiremag.com

Mike McGoldrick is the type of guy who, given the choice between lobster tail or beef stew, would probably go for the stew, says Frank Rivas, Northeast Zone general manager, Henry Schein. “He’s funny as hell, but at the same time, a little reserved in crowds. His demeanor is not that of an aggressive salesperson. It’s more like, ‘I’m here to help you and your practice.’ And people see that.”

Two life choices Born and raised in Connecticut, McGoldrick made two important life choices by the age of 17. The first was his commitment to the New York Jets, made in Shea Stadium at his first Jets game – with Namath quarterbacking – when he was in second grade. The second was his decision, at the age of 17, to enlist in the Navy rather than go straight to college after high school.

“Right out of high school, I didn’t have the grades, the money or the maturity to have any sort of college future,” he says. (That’s his honesty speaking.) “Enlisting in the Navy was almost an easy decision to make. It would provide me a safe place and time to mature. And we all know that serving your country is an honorable thing to do.”

Q2 2018 Rebate Offer

THE BIG

3

Use promo code REP2018 for an add'l. $50 manufacturer's rebate

1 BEST 2 WARRANTY LARGEST SELECTION

• 2 Year Parts & Labor Warranty* • 10 Year Chamber Warranty

3

BIGGEST CHAMBER SIZES

*Fully automatic units only

*

Designed to meet the most current sterilization standards ANSI/AAMI ST55

DID YOU KNOW ?

Our EZPlus models offer a closed-door drying system.

WHY IS THIS IMPORTANT ?

This ensures the door remains closed throughout the dry cycle to maintain sterility and efficient drying of packs and pouches.

Buy any new EZPlus, EZ or Elara11 from April 1 thru June 30, 2018 and get your choice of a $450.00 manufacturer’s rebate or a FREE 1 gallon Water Distiller

$450 or Manufacturer’s Rebate

FREE Water Distiller

A $ 71 Reta 4 Valu il e

To redeem, the end user must visit www.tuttnauerUSA.com/Q2-2018-rebate, upload the dealer invoice dated April 1 thru June 30, 2018 (with doctor’s and/or practice/ facility name and date purchased), complete the information required on the form (which includes the serial number of the autoclave), and select “Submit”. All information will be verified by Tuttnauer USA upon submission. A confirmation email will be sent for your records. Keep the confirmation until goods or rebate are received. Redemption deadline is July 31, 2018. Please allow 4 weeks for receipt of rebate or shipment of free goods. Excludes reconditioned and scratch and dent machines.

CANNOT BE COMBINED WITH ANY OTHER MANUFACTURER OFFERS OR PROMOTIONS.

Tel: (800) 624 5836, (631) 737 4850 Email: info@tuttnauerUSA.com, www.tuttnauerUSA.com

The Pursuit of Excellence While serving, he took advantage of a Navy program that contributed two dollars for every dollar the enlisted person set aside for an education fund. Upon his discharge, he enrolled at Southern Connecticut State University in New Haven. Yes, it was a little strange sharing class with fellow freshmen 17 years of age. But McGoldrick set his own course.

He worked his schedule so that in his sophomore, junior and senior years, he would go to class on Tuesdays and Thursdays from 8 am to 8 pm, then work (at a landscape company) on Mondays, Wednesdays and Fridays. “I wasn’t the greatest student, but I did well enough to earn money and pay rent. And after four years, I walked out with a business degree.”

After graduation, he took a full-time job with the landscaper and became the company’s first outside salesperson. “We targeted a lot of corporate properties around our area,” including golf courses, he recalls. He learned a lot, calling on superintendents of golf courses, talking about redoing bunkers. “One of the downsides to that job was that once we would sell a bunch of work, I would end up in the field with a pick and shovel in my hand.

That was not what I wanted to do.”

After a year or two of selling and digging, he took a sales position with Caligor Physician and Hospital Supply (now Henry Schein Medical) in 1993. “The medical field was always of interest to me,” he says. “Both of my sisters were nurses, and I knew some friends who had taken jobs in the medical field.”

20

May 2018

•

www.repertoiremag.com

Learning from the best McGoldrick says he was fortunate to learn from a Connecticut sales legend, Harry Glass, who retired from Caligor a few years after McGoldrick began his career there.

But he credits much of his success in sales to Frank Rivas. He had first met Rivas when Rivas was a manufacturer rep for Boehringer Mannheim. Shortly thereafter, Rivas joined Caligor and became McGoldrick’s sales manager.

“He’s one of the best people I know in the business and in life in general,” says McGoldrick, speaking of Rivas. “He always treats everybody equally, whether he’s talking to the checkout person in the convenience store or [Henry Schein Chairman and CEO] Stan Bergman.” Rivas modernized Caligor’s sales organization, and he also helped McGoldrick navigate his early years in medical sales. “Here I am, 25 years later, thanking my lucky stars to be part of distribution.” Here’s why: First, supplying physician practices with all they need to care for patients is gratifying, he says. When he finds a product or process that one customer is implementing with success, he shares the story with others, so they can benefit too.

Second, “in medical distribution sales, the relationships you build with your customers can last decades,” he continues. “You live and work in the same area, and you put down roots.”

Third, “the opportunity to work amongst medical professionals and healthcare executives provides for a challenging and stimulating workplace. This allows for continual learning, as new technologies and treatments emerge.”

Fourth, “the medical industry is of utmost importance in our society, affecting all of us equally,” he continues. “We operate in a very meaningful and impactful environment.

And fifth, “given its importance to our quality of life, medicine sees constant investment and innovation, thus providing ample opportunity for establishing a lucrative career in sales.”

Manufacturers are important allies for successful sales, adds McGoldrick. He believes reps should make every effort to break away from the daily routine and customer

Delivering front line solutions that Delivering front line solutions will help eliminate some of thethat will helpcauses eliminate some of the leading of preventable leading causes of preventable blindness in children and adults. blindness in children and adults.

Welch Allyn Welch Spot™Allyn Vision Screener

Spot™ Screener Instrument Vision based vision screening technology that can detect six common Instrument based vision screening risk factors that that can impact children’s vision technology detect six common health and development. risk factors that impact children’s vision health and development.

Welch Allyn Welch Allyn Network RetinaVue™

RetinaVue™ Network Help improve the management of patients with diabetes by providing Help improve the management of diabetic retinal exams in primary patients with diabetes by providing care while helping customers achieve diabetic retinal exams in primary up to 90% patient compliance.¹ care while helping customers achieve up to 90% patient compliance.¹

Contact your Welch Allyn representative to learn more today.

Contact your Welch Allyn representative to learn more today. ¹ Mansberger, et al., Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial ¹ Mansberger, et al., Comparing the Effectiveness of Telemedicine and Traditional Surveillance ©in2018 WelchDiabetic Allyn MC14875 Providing Retinopathy Screening Examinations: A Randomized Controlled Trial © 2018 Welch Allyn

MC14875

The Pursuit of Excellence demands, and meet with and learn from manufacturer reps.

“By affording manufacturers the opportunity to present their products and/or solutions to our customers, we build camaraderie, which can lead to mutually beneficial relationships,” he says.

“Working with Mike as a vendor was always awesome,” says Rivas, referring to Rivas’ years at Boehringer Mannheim (now Roche Diagnostics). “Mike gave you accessibility. And he is such a down-to-earth person. He never had a big ego, which can get in the way of working together. I was new in sales, so for me, it was, ‘This guy is giving me a chance.’ And you don’t forget people like that.”

Garett Roberts of Midmark says, “Mike has great relationships with his customers because he is an honest, dependable, and caring business partner. He realizes that relationships alone will not secure long-term loyalty from his customers, nor will they – by themselves – exceed the growth expectations that we all have in sales. Thus, Mike’s ability to understand today’s changing market, and how these changes are impacting his customers, puts him in position to adapt his sales approach to best benefit his customer and to secure that very loyalty we all look to acquire.

“As a manufacturing partner, one of my goals is to collaborate with our distribution channel in order to increase sales and help our mutual customers provide better care,” continues Roberts. “McJet embraces this and includes his manufacturer reps in his sales process.

“We are always looking for ways to differentiate ourselves in the market. Some focus on price, some on relationships. Mike is focused on utilizing his partners, like Midmark, to teach customers new ways to improve their work. By focusing on the end user and – Arthur Lubniewski their objectives, Mike shifts his customers’ perception of him away from being a supplier of products, to a trusted advisor who provides market insights, navigates alternative solutions, and ultimately improves their ability to provide quality healthcare.”

One more thing about McGoldrick, says Roberts: “He is as loyal as they come. The fact that he has stuck by his New York Jets through the Richard Todd [quarterback] era, the butt fumble [referring to a disastrous Thanksgiving 2012 fumble, when quarterback Mark Sanchez ran into the rear end of teammate Brandon Moore], many 4-12 seasons along with so many heartbreaking losses, continues to prove how loyal he is. He never gives up on his team.”

Speaking of teams, McGoldrick’s loyalty lies not only with the Jets, but with all things UConn, as well as the Pirates, which is the men’s hockey league team on which he plays. (About playing hockey he says, “It’s a ton of fun. The games typically start at 8:30 to 10:30 at night, so the only thing you give up is sleep.”) And he tries his best to attend any and all events in which his children are participating.

McGoldrick and his wife, Julie, have four children.

“ Mike bundles meetings and inservices to make sure the day is full. Even if an appointment gets canceled or pushed back, he has a plan up his sleeve to prospect or visit another customer.”

Nor has McGoldrick changed his approach with manufacturers over the years, adds Rivas. “He’s openminded; he doesn’t pre-judge products. He gives manufacturer reps an opportunity to visit his accounts, to make a day of it.”

Loyalty counts Says Arthur Lubniewski, “Mike’s customers genuinely trust him because of his loyalty to them, and vice versa. This makes it a pleasure to meet with them from a vendor’s standpoint, as they are all ears to hear how we can help streamline their procedures and at the same time provide better patient care and revenue.”

(Lubniewski himself was a distributor sales rep with McKesson Medical-Surgical/Moore Medical prior to joining Integra in October 2013.)

“Mike bundles meetings and inservices to make sure the day is full. Even if an appointment gets canceled or pushed back, he has a plan up his sleeve to prospect or visit another customer.”

22

May 2018

•

www.repertoiremag.com

The New GAMMEX® PI Glove-in-Glove System™ PRE-DONNED GLOVE-IN-GLOVE, READY FOR DOUBLE GLOVING Experience double gloving convenience like never before. Ansell’s new GAMMEX®PI Glove-in-Glove System™ delivers a world first: pre-donned outer and inner synthetic surgical gloves ready for double gloving in just one don.

Don in half the time. Don once and you’re done! It‘s that simple and it takes just seconds from un-wrapping to donning.

Reduces environmental impact. By combining the glove-in-glove pairs in one poly-pouch and one inner-wrap, there is 50% less inner packaging waste, decreasing your carbon footprint.

For samples or more information, please visit Ansell.com/gloveinglove or contact Customer Service at 1-800-952-9916.

The Pursuit of Excellence

Dianna Hundl: Driven

P

retty much everybody in Houston knew Hurricane Harvey was going to hit the city hard. And it did, on Aug. 25, 2017.

The house in which Dianna Hundl – hospital account manager for Quidel in Houston – and her family were living was rendered uninhabitable. So was the new house – still under construction – that the family was building, and to which they had hoped to move shortly. So the family of four moved to her parents’ house, then to a small apartment.

Dianna Hundl

“Quidel was good enough to let me take off as much time as I needed to get things settled,” recalls Hundl. “But I couldn’t stop. I worked on emails, trying to do everything I could.” She took to waking up hours before dawn, in order to get an early start on her day, so that she could be home with her family at night.

An outstanding work ethic is just one reason Hundl is the recipient of this year’s Repertoire/HIDA Excellence in Sales Award for a manufacturer rep.

“Dianna goes above and beyond for her customers, including our distribution partners,” says Brandi Mayhall, regional sales director, Southeast region, Quidel. “She has worked evening, weekends, and even on vacation, whether it is helping customers solve an issue or achieving a go-live goal for a new platform. She seeks a solution that

24

May 2018

•

www.repertoiremag.com

is best for the customer, while balancing the interests of Quidel. On co-travels with Dianna, I saw first-hand how invested she is in the lives of our customers.”

It’s genetic Hundl’s work ethic is one she owes to her parents, Rosa and Jose Cantu, owners of a contracting business in Houston, where she was born and raised. “They always said, ‘Work hard, and it will pay off.’ They both love to work and are very competitive. I fit right in.”

Graduating from high school at the age of 16, Hundl wasn’t sure of her career path, but she did know one thing: She wanted to help people. So she enrolled in a nursing program and ended up working in the special care unit at Children’s Memorial Hermann Hospital in Houston.

“It was one of the hardest things I have ever done,” she recalls. For her, caring for kids from zero years old to 18 was heartbreaking. “I quickly learned I was not going to make it as a nurse,” she says, adding, “I will always be thankful for working at such an extraordinary facility and patients who will never be forgotten.”

Knocking at the door Hundl returned to school to pursue a bachelor’s degree in science. In her last semester, she had an internship at a research lab at Rice University.

“When you work in a research lab, reps frequently knock on the door, asking if everything’s OK and if you need anything. I noticed, there were so many of them.” Her mentor, Jerome Saltarrelli, explained how sales worked, and that there were distributor reps and manufacturer reps.

Sales sounded appealing to Hundl. “I think I can do that,” she thought at the time.

So Saltarrelli asked around, and ultimately got Hundl in touch with Lanette Woodward, a sales rep for VWR. “We went to lunch and she explained the life of a sales rep. I joined her on a few calls the rest of the day. I instantly knew I was going to be a sales rep.” She joined VWR in October 2009, calling on the educational and research markets.

Hundl was right about one thing: She could do it. And she enjoyed it. “From the beginning, I wanted to help people, and this was my way,” she says. “Working for VWR International, I met amazing researchers who dedicate their entire careers in hopes of making a difference, trying to find a cure, uncovering something that will benefit us all.”

In 2015 she joined Quidel, and today calls on integrated delivery networks in Houston. Call points vary from IDN to IDN, but she most often meets with vice presidents of laboratory services, medical directors, pathologists, lab directors and supply chain executives.

“I was sad leaving VWR,” she says. “I was worried about losing the relationships I had with my customers; they weren’t just customers to me, but people who depended on

me.” But she found she could establish and maintain relationships with her new IDN customers.

Because equipment purchases frequently make their way to the C-suite, sales cycles are longer, she says. “It takes a couple of more calls and better follow-up to move the contract along.”

Here’s where her work ethic kicks in.

“From the very first meeting, I’m hands-on all the way. I like doing my installs and training. And I think my numbers speak to my persistence. I don’t stop. I don’t want to get behind or let my customers down.”

“ I know the importance of a timely response, and I make sure that neither the customer nor my distribution partners wait.”

Two perspectives Her experience on the distribution and manufacturer sides of sales has made her a better salesperson, says Hundl.

“In distribution, we tend to own the relationship with the customer. We know and understand the customer’s wants and needs, and the customer truly wants our honest opinion. In most cases, distribution managers have thousands of products that they sell. We need to know which manufacturer reps we can count on. They need to always be helpful, fast and efficient. It’s important that we provide the customer with the best solution before the competitor does.

“Learning these skills when I was in distribution has played a significant role in my success as a manufacturer rep,” she continues. “Being helpful, fast and efficient are the skills that I take pride in. I know the importance of a timely response, and I make sure that neither the customer nor my distribution partners wait.

“I know that if I provide the distributor or my customer the information they request, everyone’s job is

www.repertoiremag.com

•

May 2018

25

The Pursuit of Excellence Always getting better Hundl believes that a number of factors have contributed to her becoming a better rep over the years.

“I take positive criticism very well and learn from it. I’ve learned to truly listen to my customers’ needs.

They are the best teachers; they share current regulations and upcoming changes,” which she, in turn, shares with other customers.

“I learn from every experience, whether good, bad or awkward.

Quidel is an exceptional company, with a team that will go above and beyond to make sure our customers are satisfied.”

much easier. Even though I’m the manufacturer rep, I still have the relationship with the customer and make sure that I provide them with the best possible service. Regardless of what side of the fence you are on, it’s a team effort.”

Theresa Freeman, senior account executive with Fisher HealthCare, part of ThermoFisher Scientific, would agree.

“Whenever I ask Dianna to follow up with a request from me or our customer, it always gets done, typically within 24 hours – max. In my fast-paced, busy role, it is so helpful when you only have to ask once and it gets done. When I give her a qualified lead, her close rate must be really close to 100 percent. She never gives up.

“When working with Dianna in our shared accounts, we communicate openly to collaborate on what our next steps are with our customer, either to progress a sales cycle or address a customer question or concern. She understands the business, her products and our customers.”

Medical sales is a career Hundl would urge anyone to consider, because it offers the opportunity to: • Provide safe and efficient products for patient care.

“This is extremely important, because I sell to all the hospitals that my family has been to or that I might need to go to. Knowing that the hospitals have great products makes it that much better of a facility.”

• Help drive company profits while maintaining excellent service to the customer. “I enjoy being a part of my customer implementation plan; aiding in any possible way makes my job very rewarding.”

• Work hard. “When you work hard, it’s very rewarding – mentally, physically and financially,” she says.

“Quidel was good enough to let me take off as much time as I needed to get things settled. But I couldn’t stop.”

26

May 2018

•

www.repertoiremag.com

“The more you work, the more it will impact your goals and help you grow, not only as a sales professional, but as a person.”

tr 92

Mobile Protection?

oC yrtsudnI tseW 001 11 kroY weN kraP reeD moc.yarxflow.www 9279-653-008

The Clear Lead Mobile Barrier provides a full-body shield for one or two doctors or radiology technologists, and can be easily repositioned or moved from room to room.

The optically clear, lead plastic viewing panel rests on an opaque lower panel, and provides exceptional visibility with 0.5mm or 1.0mm lead-equivalent protection.

The shatter resistance and durability of Clear Lead ensures long life under heavy use.

56610

56603-W

56600-W 23111

CLEAR LEAD BARRIER SPECIFICATIONS Overall Size: 75” Hx 31” W x 25” D PB 56603-W Lead Plastic Panel: 24H x 30W 56606-W Lead Plastic Panel: 48H x 30W 56604-W Lead Plastic Panel: 54.5H x 30W

0.5MM 0.5 MM 0.5MM

Overall Size: 75”H x 49”W x 25”D PB 56600-W Lead Plastic Panel: 30H x 48 W 56605-W Lead Plastic Panel: 36H x 48W 56603-W Special Lead Panel: 24H x 30W

0.5MM 1.0MM 1.0MM

Lead Vinyl Adjustable Mobile Barrier 23111 48” H (open) x 33” H (closed) x 26.75” W x 18”D (at base) 0.5MM

Mobile Adjustable Height Clear-Pb Barrier 56610 74” H (open) x 45.25” H (closed) x28”W x 31”D (at base) 0.5MM

56604-W

56606-W

100 West Industry Court Deer Park, New York 11729

www.wolfxray.com

800-356-9729

wolfxray

X-RAY CORPORATION

TRENDS

The Medical/Dental Clinic As the two disciplines draw closer together, is the medical/dental clinic far behind?

28

Mason visits the Kaiser Permanente Northwest Cedar

Paths converging

Hills Dental and Medical Office in Portland, Oregon, for a routine exam. Checking his medical records, his pediatric dentist sees that he is due for some vaccinations. An onsite licensed practical nurse administers the vaccinations then and there.

Ronald, an adult patient, comes into the clinic with a tooth that is bothering him. The dentist recommends dental surgery, but after taking Ronald’s blood pressure, decides the numbers are too high to proceed with the surgery. So the dental assistant takes Ronald down the hallway to see the primary care physician, who checks the patient’s medical records, reviews his blood pressure history, and talks with him about how he is managing his medications. They come up with a plan to control the hypertension, which will allow them to proceed with the dental surgery once his numbers have stabilized.

Julie, another adult dental patient comes in, and the Kaiser Permanente dental team notices that a medication she is taking could affect her jaw. Her dentist knows to look for certain things during the exam based on this information.

After a century and a half, the pathways of medicine and oral health appear to be converging, driven by a growing awareness of the connection between oral health and overall, systemic health. The Cedar Hills Dental and Medical Office – where these real-life scenarios took place – is one example.

Whether they are physically co-located or virtually connected, this coming together of oral health and medicine could have an impact on Repertoire readers as well as their customers.

“The importance of oral health as part of overall health has been in literature, research and on the minds of prominent health professionals and health executives for decades,” says Steve Kess, vice president, global professional relations, Henry Schein. “For almost 20 years, Henry Schein has closely followed the growing recognition and innovative healthcare model, especially in the community health care sector, where physicians and dentists have collaborated on improving patient care and outcomes across the country.

May 2018

•

www.repertoiremag.com

When it comes to exam room safety, sooner or later you realize we’re all in this together.

We all talk about safety.

But nobody delivers it like Brewer.

Patient falls and provider injuries cost health systems millions every year. Brewer tables help your clients avoid these costly events in the exam room with: • Exclusive auto-stop safety switch design, taking patients and providers out of harms way • Solid, market-leading 700-lb. patient weight capacity, adding security for hard to manage and high-risk patients • Three stable contact points – back, safety grab bars, and seat – enabling safe lateral patient transfers from wheelchairs • Industry-leading three-year power table and five-year fixed height table warranties

Our reps make it easy for you to deliver the highest standard of safety for your clients and their patients.

Contact Brewer sales at 262-293-7121 today for details, to get a quote or arrange a demo. Or, visit brewercompany.com

TRENDS “We have supported interprofessional education among the health professions, including the Harvard School of Dental Medicine Initiative to Integrate Oral Health and Medicine and The Santa Fe Group, which reports on the importance of good oral health – especially good periodontal health – as a way to improve health outcomes, reduce cost and improve quality of life for patients with non-communicable diseases.

“We also continue to champion the important role electronic health records will play to enhance health care professionals’ awareness of patients’ total health as reported by physicians to dentists and dentists to physicians,” says Kess.

“We are optimistic that this increasing trend of interprofessional care – coupled with costChristian Stohler saving solutions – will advance over the next few years in both the public and private sectors.”

No longer a pilot Kaiser Permanente opened its integrated medical-dental clinic as a pilot in January 2017. At the time, KenKenneth Wright neth R. Wright, DMD, MPH, vice president of dental services for Kaiser Foundation Health Plan of the Northwest, called it an “innovation site where we will pilot new ways to combine dental and medical care that maximize convenience for our memQuinn Dufurrena bers and ensure their visits address their total health.”

One and a half years later, the clinic is well past the pilot stage.

“It’s been an incredible journey, a transformation,” says Wright. Since opening, the clinic has added four dental operatories and now has five general dentists, one

30

May 2018

•

www.repertoiremag.com

pediatric dentist, four dental hygienists, 11 dental assistants, three front-office staff, a family practice physician, a physician assistant and three LPNs. “Because we have integrated health records [using the Epic system], we consult the member’s record in advance of the visit and identify opportunities to close the care gap,” says Wright. A patient who comes in for a routine dental cleaning, for example, might need an A1c test or a well-child exam. Wright estimates that 15 percent to 35 percent of the clinic’s dental patients receive some medical attention as well.

Wright believes that integrating the two disciplines “is truly the essence of care.” Patients welcome it, he adds.

“Once they have a chance to meet the staff, they say, ‘Why haven’t we done this before?’

“ We can’t see inside a person’s intestinal system as easily as we can inside his or her mouth, to determine whether an inflammatory component is present.”

– Christian Stohler, DMD, DrMedDent

“It’s unique and a pleasant surprise,” he continues.

“Maybe some of the kids aren’t too happy” to get treated by a doctor and a dentist during the same visit. “But it does save mom and dad time. They don’t have to miss so much work, and ultimately, it’s beneficial to the member and his or her family.”

Precision medicine The Columbia University College of Dental Medicine is pointing its students toward a future in integrated care. In December, the College dedicated its Center for Precision Dental Medicine, comprising 48 new dental operatories outfitted with technology to help the students learn how to deliver truly personalized care.

Electronic dental records will be tied in to medical records to enable dentists and other providers to treat patients based on comprehensive health information rather than just oral disease, according to the College.

B E YO N D A B E T T E R B OX

TM

INNOVATIVE INTEGRATION ACROSS THE CARE CONTINUUM CBC testing solutions for physician office labs

SYSMEX RANKED #27 XN-L SERIES

www.sysmex.com/us

XP-300+M

Visit RepConnect to contact your Sysmex Regional Distribution Manager for additional information and promotions.

© 2017 Sysmex America Inc.

XP-XNL_RepertoireAd_FINAL.indd 1

Using Epic electronic health records, dental and medical information will be shared with clinicians at Columbia University Medical Center, New York-Presbyterian and Weill Cornell Medicine.

“The College of Dental Medicine was founded 100 years ago with the disruptive idea that dentistry should be taught and practiced within the context of the whole body,” Christian S. Stohler, DMD, DrMedDent, dean of the College of Dental Medicine and senior vice president for Columbia University Irving Medical Center, said at the time of the center’s opening. “The Center for Precision Dental Medicine gives us the capacity to realize this founding vision in the information age.”

The time is right, he believes.

Since 1990, Americans’ average lifespan has increased, but quality of life – particularly in the later years – has not, he says. In fact, increased lifespan often means more years of ill health, not well-being. “If this continues, and as the numbers of the elderly keep growing, the burden of disease – particularly, chronic disease – may not be sustainable,” either from a quality-of-life perspective or an economic one. Incorporating oral health and medicine may provide at least part of the solution.

That’s because many of chronic diseases affecting the elderly today share an underlying physiological mechanism

11/30/17 11:27 AM

– inflammation, says Stohler. Dentistry is a key factor in identifying and addressing inflammation, he adds.

“In dentistry, for the past 150 years, we have focused on cutting out the ‘piece’ that is bad and replacing it with something that will hold for a number of years before requiring replacement,” he says. It is time for dentists to do more, e.g., examining a patient for oral disease and treating its underlying cause rather than removing diseased tissue. “We can’t see inside a person’s intestinal system as easily as we can inside his or her mouth, to determine whether an inflammatory component is present,” he says. “We should take advantage of it.

“In the future, you will need to manage diabetes and periodontal disease as a package, psoriasis and dental disease as a package, rheumatoid arthritis and dental disease as a package. That’s why the linkage [between oral health and medicine] is crucial.

Some barriers The wall between oral health and systemic health is longstanding, and will not crumble easily or quickly. The traditional, siloed manner in which insurers cover dental and medical care is one barrier to overcome.

“Many people receive dental insurance through their employer,” notes Jane Barrow, MS, associate dean for

www.repertoiremag.com

•

May 2018

31

TRENDS global and community health, and executive director of the Initiative to Integrate Oral Health and Medicine at the Harvard School of Dental Medicine. Then, when they turn 65, they lose access to dental insurance, unless they purchase it separately.

“Generally, this comes as a surprise to many people, and it happens at a time when they need more dental services than they ever did before.”

The Initiative convenes academics and leaders in the healthcare community to develop innovative ideas around the integration of oral health

“Maybe some of the kids aren’t too happy. But it does save mom and dad time.”

– Kenneth Wright, DMD, MPH

Integrating oral and medical records systems will facilitate care not only in clinics where dentists and MDs are co-located, but in virtual arrangements as well, notes Stohler.

Columbia’s Center for Precision Medicine, for example, will share records not only with Columbia University Medical Center, but New York-Presbyterian (with which it is affiliated) and Weill Cornell Medicine. “The marching order has been given, and work groups are already working on it,” he says.

“With the patient’s permission, anyone who treats you will be able to access your integrated health record,” he says. Patients will have access to their records as well.

“We are in an age of shared responsibility. Patients have access to what science is telling us today. We are entering an environment where the physician is their guide through the information jungle.”

Human element

and primary care. Activities undertaken include research, policy statements, conferences and seminars.

Electronic health records present another barrier – as well as opportunity. Connecting patients’ medical and dental electronic records is a sine qua non for true integration of oral health and medicine, according to those with whom Repertoire spoke.

“If a person visits his or her primary care physician, then is referred to a specialist in surgery or medicine, there’s communication back and forth, often using the same EHR,” says Barrow. “But if that patient is referred to a dentist, there’s no communication because, generally, those information systems don’t talk to each other. The Initiative is working on technology that will facilitate bidirectional communication.”

32

May 2018

•

www.repertoiremag.com

Technology issues – while formidable – aren’t the only hurdles to oral/ medical integration.

“One of the challenges is change management, that is, getting people to implement a new system,” says Wright. The learning curve comes with a predictable – but temporary – drop in productivity. “We saw some of that the first year, but by the end of the year, we were operating at peak efficiency.

It’s like learning to drive a new car.

“It has been incredible to see the tremendous transformation that has taken place among our team this past year. When two different groups of people come together, there’s some apprehension, some doubts about compatibility.”

An open mind erases most of that, he says. “Even though we had never worked like this before, our team embraced the mission. They collaborated in mind and spirit. They have huddles throughout the day; they are in active discussion about improving workflow and

The insurance angle Will we see combined medical/dental policies Medical and dental professionals understand the connection between oral health and systemic health. How about insurers?

“The plan for the future is to manage risk, and that means managing the heavy costs associated with comorbid conditions,” says Christian S. Stohler, DMD, DrMedDent, dean of the Columbia University College of Dental Medicine. “The only way American insurance will survive is to keep people healthy, as much as possible – managing their health appropriately, then measuring the risk. Dentistry needs to fit into that picture.”

Some in the insurance industry agree.

Empowered consumers “There’s plenty of research to indicate the connection between medicine and dentistry,” says Quinn Dufurrena, DDS, JD, chief dental officer, United Concordia Dental. “Bundling of medical and dental insurance makes sense, and I think we will see it.”

Dufurrena has a broad perspective on the topic – as a dentist, as an advisory board member

processes. Whatever silos existed before have been completely obliterated.

“I see a great deal of passion here. They are changing the world, transforming healthcare. There’s a certain amount of kinetic energy here. They realize this place is special.”

Tomorrow’s practitioners Working side by side may come more naturally to tomorrow’s dental health and medical professionals than it does to their older counterparts.

The Boston-based Center for Integration of Primary Care and Oral Health (CIPCOH) serves as a national resource for research on oral health integration into primary care training. Established in 2016 through a cooperative agreement with the U.S. Department of Health and Human Services Health Resources and

of the Harvard School of Dental Medicine Initiative to Integrate Oral Health and Medicine, and as an executive of United Concordia, a subsidiary of health insurer Highmark Inc. Barriers to the integration of the two disciplines exist, he concedes. For example, it’s difficult to quantify the impact of improved oral health on systemic health (though few would dispute that the two are closely associated).

The fact that dental professionals – unlike those in medicine – seldom use diagnostic codes for recordkeeping makes such studies that much more difficult. “And one of the biggest barriers is the fact that we use different practice management systems,” says Dufurrena. “It’s difficult for medicine and dentistry to communicate with each other.

Such barriers will be overcome, he predicts. Empowered consumers will come to insist on the convenience of co-located dental/ medical clinics, as well as the improved health outcomes co-location can bring. Combined medical and dental insurance may follow.

Services Administration (HRSA), the Center places special emphasis on training enhancements that will train primary care providers to deliver high quality, cost-effective, patient-centered care that promotes oral health, addresses oral health disparities and meets the unique needs of all communities. Demonstration practice sites are up and running.

Dental students and medical students at Columbia share their first 18 months of education, says Stohler.

“We have fertile ground on which to build that foundation. And if you have that foundation, you should take advantage of it.

“Our students appreciate the significance of genomics in driving personalized medicine. They know they may be practicing for 40 years. The world will change, and personalized medicine cannot be practiced without dentistry.”

www.repertoiremag.com

•

May 2018

33

TRENDS

Caught in the A1c Crossfire Few medical practitioners would dispute the impor-

tance of HbA1c tests for people with type 2 diabetes. But physician groups sparred publicly this spring over how doctors should respond to HbA1c test results.

One group – the American College of Physicians – came out in favor of relaxing blood sugar targets; others, led by the American Diabetes Association, loudly and publicly disagreed.

Diabetes mellitus is a leading cause of death in the United States and is associated with microvascular and macrovascular complications, according to the American College of Physicians. More than 29 million people, or 9.3 percent of the U.S. population, have type 2 diabetes.

The hemoglobin A1c (HbA1c) – also called glycosylated or glycated hemoglobin level – approximates average blood glucose control over about three months.

Markedly elevated glucose levels can result in subacute symptoms, such as polyuria (frequent urination),

34

May 2018

•

www.repertoiremag.com

polydipsia (excessive thirst), weight loss, and dehydration, points out the ACP. Over time, people with diabetes may suffer vision loss, painful neuropathy or sensory loss, foot ulcers, amputations, myocardial infarctions, strokes, and end-stage renal disease.

Lowering blood glucose may decrease risk for complications, but lowering strategies come with harms, patient burden and costs, says the ACP in its clinical guidelines, published March 6 in the Annals of Internal Medicine. Those harms include hypoglycemia.

Accordingly, the American College of Physicians recommends that clinicians aim to achieve an HbA1c level between 7 percent and 8 percent in most patients with type 2 diabetes (while conceding that clinicians should personalize goals for glycemic control depending on each patient’s circumstances). Furthermore, the organization recommends that clinicians ease up on pharmacologic therapy in patients with type 2 diabetes who achieve HbA1c levels less than 6.5 percent.

Grow your sales with OraSure Rapid testing Complement your infectious disease sales with our suite of products

Cryosurgery A market leader for 20 years with

FDA approved & CLIA waived

Substance abuse testing

Complementary POC products

$

Easy to sell Clinically proven Millions tested and treated* Patient friendly * Only applies to OraQuick products. Š 2018 OraSure Technologies, Inc. OTI0171 Rev. 03/18

Learn more at www.OraSure.com/smm1

Be sure with OraSure

TRENDS M.D., FFPM, FACE, medical director, PTS Diagnostics, which makes the A1CNow system.

Wrong, said the American Diabetes Association, the “People are individuals. Each individual is unique American Association of Clinical Endocrinologists, the in their medical history, current health conditions, lifeAmerican Association of Diabetes Educators and the style, socio-economic status, and quality of life desires.

Endocrine Society, in a statement issued March 9.

Each person requires an individualized treatment and “While there is agreement on individualization of monitoring plan. treatment based on patient-specific factors, with the “As healthcare professionals know, successful aim of protecting those at highest risk, the ACP’s rectreatment of diabetes is dependent upon the knowlommendation of blood glucose targets for A1C from edge and motivation of the person 7 to 8 percent could prevent many with diabetes. The degree of conpatients from receiving the full trol recommended by the healthbenefits of long-term glucose concare professional is determined by trol,” wrote the associations. the multiple factors listed above.

“We are also concerned the Increased knowledge leads to broad range suggested by ACP’s greater motivation. guidance is too large to apply to “I personally am a strong most patients with type 2 diabetes, believer in tighter HbA1c conand has the potential to do more trol where it can be accomplished harm than good for many patients safely, and with the informed for whom lower blood glucose agreement of the person with diatargets may be more appropriate, betes. It is unfortunate that many particularly given the increased risk reimbursement entities and qualof serious complications such as ity care systems limit HbA1c meacardiovascular disease, retinopasurements to twice a year. Pointthy, amputation and kidney disof-care testing (with immediate ease, which are the result of higher healthcare professional feedback) blood glucose (A1C) levels.

James Anderson, M.D. and A1c self-testing on a more “While ACP’s guidance is only frequent basis can add knowledge one additional percentage point, and increase motivation in people this may equate to a difference of with diabetes. nearly 30 points when blood glu“As treatment goals are relaxed, cose is measured in mg/dl. This some individuals may feel less need difference in the lower and higher to continue with treatment (pharA1Cs in the range ACP suggests macologic and lifestyle) goals that also has been shown to have clear are safely and effectively controldifferences in microvascular comling their diabetes and promotplications from large, multicenter ing their health,” says Anderson. randomized trials of patients newly “This is unfortunate. However, diagnosed with type 2 diabetes.” regardless of the treatment and A1c goals with which the person A believer in tighter controls with diabetes and their healthcare “Whether one believes that there are professional have agreed, regular two types of diabetes, or five types point-of-care and self-testing of (as Scandinavian researchers postuHbA1c remain a critical contribulate), all human diabetes occurs in tor to improved diabetes control people (not patients or diabetics),” and better health.” says James H. (Andy) Anderson, Jr., – James H. (Andy) Anderson, Jr.

A different point of view

“It is unfortunate that many reimbursement entities and quality care systems limit HbA1c measurements to twice a year.”

36

May 2018

•

www.repertoiremag.com

Passion and partnership are at the center of everything we do.

What is the DUKAL DNA? At DUKAL, we are dedicated to improving patients’ lives through our expanding product line, bringing even more solutions to the market and bundling them into an offering you can trust. www.dukal.com | 1-800-243-0741

HEALTH FOCUS: IMAGING

Right Image, Right Time Resource for doctors facilitates high-value imaging

Imaging is life-saving. But too much imaging leads to

unnecessary costs, not to mention the risk to patients of needless exposure to radiation.

Radiologists understand this. The American College of Radiology has been working to help its members, referring physicians and the public differentiate high-value (appropriate) imaging from low-value (unnecessary) imaging. ACR has done so through its participation in programs such as Choosing Wisely®, Image Gently® and Image Wisely®.

With the ACR’s R-SCAN™ program, radiologists are trying to get the message across to their referring physicians – that is, the primary care physicians whom Repertoire readers call on.

Launched in September 2015, R-SCAN brings together radiologists and referring clinicians to improve imaging appropriateness based upon a list of imagingrelated Choosing Wisely topics. (Choosing Wisely is an initiative of the ABIM Foundation that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures.) Today, nearly 100 referring practices representing 4,000 referring physicians from a variety of medical specialties are teaming up with radiologists on R-SCAN projects, reports the ACR. R-SCAN offers radiologists and referring physicians tools to study image ordering practices, institute educational

38

May 2018

•

www.repertoiremag.com

interventions to improve ordering, and conduct post-intervention analyses. Among these tools is a web-based clinical decision support (CDS) system, CareSelect Imaging™, which provides access to the ACR Appropriateness Criteria® (AC), evidence-based guidelines to optimize image ordering and reduce unnecessary imaging exams.

Radiology and referring clinician practices participating in the CMS Merit-based Incentive Payment System (MIPS) can fulfill “Improvement Activity” credit requirements by using R-SCAN.

Harris Health and Baylor In a case study on its website, R-SCAN describes how radiologists at Baylor College of Medicine worked with Harris Health System in Harris County, Texas, in 2016 to reduce the number of MRIs being ordered for patients with low back pain (one of the Choosing Wisely topics).

The project helped the health system reduce MRIs by nearly 38 percent and increase the appropriateness rating for such orders 23 percent.

Christie M. Malayil Lincoln, M.D., assistant professor of radiology and neuroradiology and faculty senator at Baylor College of Medicine, and Melissa M. Chen, M.D., who was a neuroradiology fellow at Baylor College of Medicine at the time, led Baylor’s effort to reduce inappropriate

HEALTH FOCUS: IMAGING imaging for low back pain. They selected the topic after noticing that two of Harris Health System’s high-volume family practice clinics were ordering more imaging studies for low back pain than were probably necessary.

Lincoln and Chen approached Brian C. Reed, M.D., director of disease control and clinical prevention at Harris County Public Health, who at the beginning of the project was the vice chair of community health in the Department of Family & Community Medicine. Reed introduced the two to Samuel Willis, M.D., and Luu Phong, M.D., the directors of the two Harris Health clinics with the highest incidence of inappropriate image ordering for low back pain. Both clinicians were receptive to using R-SCAN, and they recommended a third clinic that also struggled with appropriate image ordering.

With the referring clinicians on board, Lincoln and Chen partnered with three other members of the radiology group. Together, the radiologists reviewed the 300 MRIs that referring clinicians from the three clinics ordered for patients experiencing low back pain during a 10-month period. The team determined whether the MRIs ordered met the ACR Appropriateness Criteria by using the web-based clinical-decision-support tool through the R-SCAN portal.

The review process confirmed that the referrers were in fact ordering a significant number of lumbar spine MRIs inappropriately based on the evidence-based guidelines.

In response, the radiologists attended the monthly continuing medical education (CME) luncheons at each of the three health clinics and taught referring providers, nurse practitioners and physician assistants about appropriate image ordering for lumbar spine, explains the ACR in the case study.

In the 10 months following the educational intervention, clinicians from the three clinics ordered a combined 187 MRIs for low back pain, down from the 300 orders made during the pre-intervention period. In addition, the appropriateness of the exams ordered increased by 23 percent over the pre-intervention period.

These results indicated that the educational intervention led to improved image ordering, according to the R-SCAN team. The results also indicate that referring clinicians are now looking for other ways to treat lower back pain before turning to advanced imaging.

What’s more, as Reed had hoped, the reduction in unnecessary imaging also seems to have reduced wait times for patients who urgently needed MRIs. The Baylor team is working to measure this reduction in patient wait times for MRI as part of the next iteration of the project.

Refer your physician customers to www.rscan.org, or email rscaninfo@acr.org, to learn more about R-SCAN.

Image gently, image wisely Image Gently® and Image Wisely® are two programs – both supported by the American College of Surgeons – designed to reduce patient’s unnecessary exposure to radiation.

The Image Gently campaign was launched in 2008 to raise awareness about methods to reduce radiation dose during pediatric medical imaging exams. The campaign is an initiative of the Alliance for Radiation Safety in Pediatric Imaging, a coalition founded by the Society for Pediatric Radiology, the American Society of Radiologic Technologists, the American College of Radiology and the American Association of Physicists in Medicine. The Alliance has now grown to more than 40 organizations.

40

May 2018

•

www.repertoiremag.com

Image Wisely focuses on radiation safety in adult medical imaging. The American College of Radiology and the Radiological Society of North America formed the Joint Task Force on Adult Radiation Protection to address concerns about the surge of public exposure to ionizing radiation from medical imaging. The Joint Task Force collaborated with the American Association of Physicists in Medicine and the American Society of Radiologic Technologists to create the Image Wisely campaign.

Image Wisely (www.imagewisely.org) offers resources and information to radiologists, medical physicists, other imaging practitioners, and patients.

Choosing Wisely An R-SCAN project begins with the physician practice and radiologists selecting a Choosing Wisely® topic to tackle. Following are imagingrelated topics and recommendations.

Abdominal imaging • Avoid ordering CT of the abdomen and pelvis in otherwise health emergencydepartment patients (age <50) with known histories of kidney stones, or urolithiasis, presenting with symptoms consistent with acute uncomplicated renal colic. (Recommended by the American College of Emergency Physicians.)

Cardiac imaging • Don’t routinely order coronary CT angiography for screening asymptomatic individuals.

(Recommended by the Society of Cardiovascular Computed Tomography.)

Chest imaging • Avoid admission or preoperative chest X-rays for ambulatory patients with unremarkable history and physical exam.

(Recommended by the American College of Emergency Physicians and the American College of Surgeons.)

• Do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay. (Recommended by the American College of Physicians, the American College of Chest Physicians, the American Thoracic Society and the American College of Radiology.)

Genitourinary imaging • Do not recommend follow-up imaging for clinically inconsequential adnexal cysts.

(Recommended by the American College of Radiology.)

• Don’t perform PET, CT, and radionuclide bone scans in the staging of early prostate cancer at

low risk for metastasis. (Recommended by the American College of Radiology.)

Musculoskeletal imaging • Avoid imaging for low back pain within the first six weeks, unless red flags are present.

(Recommended by the North American Spine Society, the American College of Physicians, and the American Academy of Family Physicians.)

Neuroimaging • Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis. (Recommended by the American Academy of Allergy, Asthma, & Immunology, the American Academy of Otolaryngology – Head and Neck Surgery Foundation) • Don’t do imaging for uncomplicated headache. (Recommended by the American College of Radiology.)

• CT scans are not necessary in the immediate evaluation of minor pediatric head injuries. Clinical observation/Pediatric Emergency Care Applied Research Network criteria should be used to determine whether imaging is indicated. (Recommended by the American Academy of Pediatrics.)

• Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure. (Recommended by the American Academy of Pediatrics.)

• For adult minor head trauma, avoid CT scans of the head in emergency department patients who are at low risk based on validated decision rules. (Recommended by American College of Emergency Physicians.)

Choosing Wisely is an initiative of the ABIM Foundation that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. The initiative now has more than 540 specialty society recommendations. For more information go to www.choosingwisely.org

www.repertoiremag.com

•

May 2018

41

HEALTHY REPS

Health news and notes Get some sleep Getting insufficient sleep and working while fatigued have become commonplace in the modern 24/7 workforce, with more than 37 percent of workers sleepdeprived, according to the National Healthy Sleep Awareness Project. Sleepiness not only throws you off your game with customers, but it doesn’t mix well with driving.

The National Transportation Safety Board estimates that fatigue has been a contributing factor in 20 percent of its investigations over the last two decades. And in February, the AAA Foundation for Traffic Safety released a research brief estimating that drowsy driving is involved in up to

9.5 percent of all motor vehicle crashes. Projections from the AAA Foundation indicate that drowsy driving causes an average of 328,000 motor vehicle accidents in the U.S. each year, including 6,400 fatal crashes.

Meditative lighting Speaking of sleep, iHome says its Zenergy – a bedside sleep therapy machine – can help you sleep restfully and wake energized, reports Tribune News Service. The $100 device is designed with flame-free candles to deliver meditative lighting and sound therapy, like the natural sounds of the ocean, nature and storms.

Workout headphones After testing 143 sets of headphones and considering an additional 90, Wirecutter calls the JLab Epic Sport the best pair of wireless workout headphones for most people. They are said to sound good, fit comfortably, stay out of your way during rigorous workouts, and offer 12-hour battery life. Wirecutter’s testing showed that these earbuds should withstand abuse, sweat, and moisture when used properly, plus they’re backed by a one-year warranty and responsive customer service.

Pelvic floor disorders Experts estimate that one of every three women in the United States has a pelvic floor condition, which can lead to problems with bladder or bowel control, according to the National Institutes of Health. But because so many women don’t tell their doctor, the condition is probably much more common. Treatment options may include dietary changes, physical therapy, medications, medical devices, or surgery. NIH is funding studies to

42

May 2018

•

www.repertoiremag.com

develop new and improved treatments. Lower your risk of pelvic floor issues by: 1) maintaining a healthy weight; 2) avoiding constipation and straining by getting enough fiber and fluids in your diet; 3) avoid tobacco smoke and triggers of a long-term cough; 4) do Kegel exercises regularly to keep pelvic floor muscles toned. Men can benefit from Kegel exercises as well.

AEDs work Victims of cardiac arrest have a greater likelihood of survival when a bystander used an automated external defibrillator (67percent) rather than wait for emergency medical services to shock the heart (43 percent), according to an NIH-funded study published in Circulation. In addition, people were more likely to survive with minimal disability after cardiac arrest (57 percent for AED from a bystander versus 33 percent for AED initiated by emergency medical services). The more time that elapsed before emergency medical services arrived, the larger the benefit of bystanders using an AED. “We estimate that about 1,700 lives are saved in the United States per year by bystanders using an AED,” Dr. Myron Weisfeldt of Johns Hopkins University is quoted as saying.

A previous analysis of 2005 to 2009 data by the team found that about 500 additional lives could be saved each year in the U.S. and Canada if bystanders used AEDs. Because of increased availability of AEDs and their increased use by bystanders, an estimated 3,459 people having a cardiac arrest could be saved each year by bystander AED use.

60 will get a transplant, ideally from a closely matched sibling. The remaining participants for whom a suitable donor can’t be identified will go into a comparison group and receive the current standard of care for two years. The trial seeks to determine if bone marrow transplantation leads to better outcomes for older sickle cell patients. Approximately 100,000 Americans have the disease, according to NIH. Most are of African ancestry or identify themselves as black. About one in every 365 black children is born with sickle cell disease.

Diet quality, not quantity A study published in the Journal of the American Medical Association found that people who cut back on added

Victims of cardiac arrest have a greater likelihood of survival when a bystander used an automated external defibrillator (67percent) rather than wait for emergency medical services to shock the heart (43 percent), according to an NIHfunded study published in Circulation.

Sickle cell investigation Forty sites are participating in a National Institutes of Health-funded trial investigating a potential cure for sickle cell disease, reports the Atlanta Journal-Constitution. During a bone marrow transplantation procedure, which has proved successful with younger patients, the recipient undergoes chemotherapy to destroy their own bone marrow and ward off rejection. That’s then replaced intravenously with closely matched marrow from a healthy donor. The trial will enroll 200 patients between the ages of 15 and 40. About

sugar, refined grains and highly processed foods while concentrating on eating plenty of vegetables and whole foods – without worrying about counting calories or limiting portion sizes – lost significant amounts of weight over the course of a year, reports The New York Times. The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on their DNA makeup or on their tolerance for carbs or fat. The research lends strong support to the notion that diet quality, not quantity, is what helps people lose and manage their weight most easily in the long run.

www.repertoiremag.com

•

May 2018

43

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

Automotive-related news

44

Arizona accident

Dunkin’ Donuts mobile ordering

The death in March of a pedestrian hit by a self-driving car in Arizona “is a sad reminder of the dangers of overreliance on autonomous and semi-autonomous vehicle technology,” said Dr. Richard Harkness, CEO of ADEPT Driver, a developer of crash-avoidance training programs. “In this heartbreaking case, a driver was behind the wheel, but did not override the technology that missed seeing the pedestrian who was killed.” ADEPT Driver offers neuro-cognitive training that allows the driver to quickly scan the driving environment and identify hazards, he said. “When operating autonomous or semi-autonomous vehicles, the driver must be ready to quickly and without warning scan, detect hazards and take control of the vehicle. If your brain is not trained to do this specific task, chances are the crash will happen before you recognize it.”

Your family physician may tell you not to overdo the donuts, but when you have no options for a quick breakfast before a call, there’s always Dunkin’ Donuts. Dunkin’s On-the-Go Mobile Ordering is now available through the Google Assistant, on iPhones and Android phones. DD Perks® Rewards members can use the Google Assistant, Google’s voice assistant technology, on their iPhones and Android phones to place a mobile order for coffee, beverages, baked goods and breakfast sandwiches, and then speed past the line in store for pick-up. Guests who have a DD Perks account and a Google account can link both, with all ordering and payments happening within Dunkin’ Donuts’ mobile platform. Guests can order from saved Favorites and items previously ordered via the Dunkin’ Mobile® App. To get started, guests need simply say, “Hey Google, talk to Dunkin’ Donuts.”

May 2018

•

www.repertoiremag.com

Who’s driving?

Roughly a third of recent high school graduates have ridden in a motor vehicle with a substance-impaired driver, according to a study by researchers at the National Institutes of Health and other institutions. The study found that during the first two years after high school graduation, 23 percent of young adults had ridden with a marijuana-impaired driver at least once, while 20 percent had ridden with an alcohol-impaired driver, and 6 percent had ridden with a driver impaired by glue or solvents or harder, illicit drugs, such as amphetamines, opioids or cocaine. The authors noted that having ridden with an impaired driver in the past was linked to a higher risk of driving while impaired and of riding with an impaired driver in the future. Other factors that increased the risk for riding with an impaired driver were living alone and not attending a four-year college. For young adults in the study who attended a four-year college, living on campus increased their risk of riding with an impaired driver. The authors called for enhancements to informational programs that educate young people on the risks of riding with impaired drivers.

earlier research has shown that playing action video games improves spatial cognition.

Sunroof regulations coming?

A dozen years ago, 18-year-old Liza Hankins was thrown through the closed sunroof of her sport-utility vehicle during a crash and paralyzed, according to a recent article in the New York Times. Her family sued the truck’s maker, Ford, claiming it had failed to live up to its safety responsibilities. Ford won the case after it pointed out that no government regulations required a sunroof – even a closed one – to keep someone inside a vehicle in a crash. Twelve years later, no such regulations exist, even as more buyers are opting for the sunroof option and more carmakers are introducing larger, panoramic sunroofs, reports the newspaper. Some automakers have taken steps to make sunroofs safer by using laminated safety glass, while gadgets now in the works could help limit sunroof ejections during rollovers. And a new test created by researchers at the National Highway Traffic Safety Administration could mean the federal government is laying the groundwork for regulations governing sunroofs.

New drivers’ skills A UCLA researcher asked instructors from a Los Angeles driving school to rate students’ driving skills on a scale of 1 to 4, and the researchers analyzed the results based on several variables. Among males, the older the student, the worse his driving skills score. There was a similar trend among female drivers, but it was not as significant. A history of playing any kind of organized sport was linked to better driving skills among both men and women. Men and women who played sports scored 2.66 and 2.43, respectively, while men and women who had not played organized sports had average scores of 1.94 and 1.60.

Previous studies have shown that participating in organized sports improves spatial perception. Meanwhile, playing video games showed no relationship to driving abilities. The authors expected the opposite, because

Remote control drivers While major technology and car companies are teaching cars to drive themselves, Phantom Auto in Mountain View, Calif., is working on remote control systems, often referred to as teleoperation, reports the New York Times. In one demonstration, Ben Shukman, a software engineer for Phantom Auto, sat in front of a phalanx of video screens in Mountain View, Calif. Using a live, two-way video connection along with the kind of steering wheel and pedals usually reserved for video games, he was driving a Lincoln MKZ in Las Vegas, hundreds of miles away. Many see teleoperation as a necessary safety feature for the autonomous cars of the future. California was scheduled to allow companies to test autonomous vehicles without a safety driver – as long as the car can be operated remotely – starting in April.

Some automakers have taken steps to make sunroofs safer by using laminated safety glass, while gadgets now in the works could help limit sunroof ejections during rollovers. www.repertoiremag.com

•

May 2018

45

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

Technology news One word: Encryption When your laptop is stolen, your personal information is accessible to anyone, even if you have a password, reports the New York Times. But you can protect your data with encryption. And it’s pretty easy, even for techno-Neanderthals.

Some Windows 10 devices come with encryption turned on by default. If your Windows laptop doesn’t support Device Encryption, use Windows’ other built-in encryption tool, BitLocker. All modern Macs (since about 2003) have a feature called FileVault, which encrypts your entire system drive. But don’t lose the key you create. If bad guys can’t get into your computer without the key, you can’t either.

Controlling hand tremors For people with hand tremors and irregular hand movements caused by Parkinson’s disease, essential tremor, spinal cord injuries, or just old age, using utensils can turn an enjoyable meal into a frustrating experience, reports Medgadget. Liftware (part of Alphabet’s life sciences research division) hopes to resolve that frustration. The company’s two products – Liftware Steady and Liftware Level – are both specialized eating utensils consisting of a handle and a detachable utensil head (available in soup spoon, normal spoon, fork, or spork options). Liftware Steady’s handle has an on-board computer that detects tremors and then

46

May 2018

•

www.repertoiremag.com

adjusts the utensil head to move in the opposite direction, while Liftware Level has internal motors that can adjust its position to accommodate larger movements such as hand or arm twists. As a result, both devices keep their utensil heads level in the face of unintentional movements. Liftware was founded in 2010 and was acquired by Verily, Alphabet Inc.’s life sciences research division, in 2014.

Hands-free camera This could get creepy, but if you’re a parent with young kids or grandkids, you might really go for it. Google introduced Google Clips ($250), a pretty tiny, hands-free camera designed to help you capture more spontaneous moments of kids, pets and others around you. That’s because the camera takes pictures on its own. That’s right, you don’t have to click a button (though you can if you want). Rather, you set the camera down; point it at, say, your two kids putting together Legos; and the camera decides when the scene gets interesting enough – or adorable enough – to capture in a short clip.

Clips syncs wirelessly and in seconds from the camera to the Google Clips app for Android or iOS. Swipe to save or delete your clips, or choose an individual frame to save as a high-resolution still photo. Clips is said work best at home with family and friends, as the camera learns to recognize the faces of people that matter to you and snaps accordingly.

Smart Deadbolt’s existing compatibility with Amazon Alexa®.

Alternatively, users may choose to set up the Schlage Sense deadbolt with Apple HomeKit™ and use Siri® to command the deadbolt on their iPhone®, iPad® or iPod touch®.

The smallest, slimmest charger WAFR – said to be the world’s smallest and slimmest wireless power bank and AC charger – uses Nano SD technology and interchangeable AC plug modules to charge users phones anywhere in the world. Compatible with all iPhones and Android devices, the device was expected to be sold at most major retail box stores and carriers this spring, including Apple, Best Buy, Target, Walmart, Costco, Verizon, AT&T, Sprint, T-Mobile, and US Cellular. The device is said to be ultra-slim (7mm) and can fit in a user’s shirt pocket.

What’s the weather?

A suitable smartphone You can spend $700 or $1000 on an Apple or Samsung smartphone, and you’ll get a great camera, vibrant display, frequent updates, maybe even facial recognition. But if you’re cheap, you can get a good phone for as low as $200, according to Wirecutter, a product review website owned by the New York Times. Wirecutter’s top budget phone is Motorola’s Moto G5 Plus ($230), which has a high-quality camera, a good 5.2-inch screen, a fast fingerprint sensor and plenty of storage. Huawei’s $200 Honor 7X has a better camera and bigger screen than the Moto G5 Plus, but it runs on an older version of the Android operating system, called Nougat. And if you’ve just gotta have an iPhone, Apple still sells the iPhone 6, which it introduced in 2015, for $450 (if through Apple).

Smart deadbolts Door hardware maker Schlage® said that its Schlage Sense Smart Deadbolt was expected to work with Google Assistant this spring. With the Google Assistant on Google Home, users will be able to lock the door or check if the door is locked by saying, “OK Google, lock my door,” or “OK Google, is my door locked?” Beyond Google Home, users can also ask Google Assistant on an iOS or Android™ smartphone.

This integration will come as an addition to the Schlage Sense

AccuWeather for the Google Assistant is a new app said to make it easy to access weather forecasts as well as warnings using natural language commands. The app allows people to ask simple weather- and forecast-related questions, such as “Do I need an umbrella?” or “When will the snow stop?” It is available on all Google Assistant-enabled devices, including speakers like With the Google Google Home, Android phones, through the Google Assistant Assistant on iPhone app, Apple TV, headGoogle Home, users will be able phones, and more.

to lock the door or check if the door is locked by saying, “OK Google, lock my door,” or “OK Google, is my door locked?”

Custom athletes

Medical technology firm Hologic is teaming up with the University of Minnesota to help coaches and professional trainers tailor athletes’ bodies to their specific sport or position, reports the Worcester Business Journal. The agreement has Hologic as the exclusive provider of Dexalytics, a Minnesota company borne out of research from the University of Minnesota, which offers cloud-based software to provide measurements beyond traditional data of body fat. Together with Hologic’s Horizon DXA system, the companies hope to be able to compare the body composition of athletes against predetermined sport and position-specific standards, helping trainers and medical professionals target their work and identify baseline body types when returning from injuries and understand how the human body changes over the course of a sports season.

www.repertoiremag.com

•

May 2018

47

HIDA GOVERNMENT AFFAIRS UPDATE

Medical Device Tax Win

Underscores the Value of Advocacy Earlier this year, distributors and manufacturers scored a major victory when Con-

By Linda Rouse O’Neill, Vice President, Government Affairs, HIDA key topics such as the value of diagnostics, competitive bidding, progress on traceability and unique device identification implementation, and the impact of marketplace proposals for government procurement on the healthcare supply chain.

Of particular note this year is emergency preparedness, which is discussed in more detail below.

gress reinstated the moratorium on the medical device tax for two years as part of the deal to fund the government. These organizations were able to effectively communicate to lawmakers how they would be affected if the tax was allowed to take effect and were ultimately successful in getting it delayed. This is one example of the power of advocacy and, more specifically, grassroots advocacy. Members of Congress pay attention to letters and calls they get from their constituents back home, and in one week, HIDA members generated over 100 letters to Congress about the medical device tax.

Meeting members of Congress and their staff in person is also very effective, and there is no better opportunity to do so than during the HIDA Washington Summit. Summit attendees have the opportunity to educate government policy decision makers on

During the Washington Summit, HIDA members will meet with the legislative and federal agency leaders who are working on the PAHPA reauthorization.

Emergency/Pandemic Preparedness 2018 is a vital year for pandemic and emergency preparedness. As we discussed in last month’s column, the Pandemic and All-Hazards Preparedness Act (PAHPA) is up for its third reauthorization this fall. The legislation shapes the way public health agencies respond to disease outbreaks and natural disasters. In partnership with the Healthcare Products Coalition, HIDA has developed a set of principles that will strengthen government agencies’ ability to draw on distributors’ and manufacturers’ expertise.

During the Washington Summit, HIDA members will meet with the legislative and federal agency leaders who are working on the PAHPA reauthorization. Participants will seek to educate government leaders on how this law impacts the industry’s ability to respond to demand spikes for necessary

48

May 2018

•

www.repertoiremag.com

products like personal protective equipment, diagnostic tests, and devices used to administer vital therapies.

Even if you can’t come to Washington, you can still advocate for our industry. Make sure your representatives know how PAHPA affects your business, and that distributors have deep knowledge that can strengthen federal responses during a crisis. Options for educating your representatives include: • Writing letters.

• Participating in local advocacy events.

• Hosting representatives at your facility.

These steps are simple and effective ways to help lawmakers understand your business and learn what federal agencies can from your perspective.

Get involved These are just some of the issues that HIDA members will discuss at the 2018 Washington Summit, June 7-8. This is a key opportunity to put a human face on the healthcare distribution industry, and to inform policymakers about the industry and the healthcare customers and patients we serve.

Whether you are able to attend the Washington Summit or not, educating your elected leaders on the value of distribution and the healthcare supply chain is important to our work in Washington on behalf of the industry. If you would like to learn more or get involved in HIDA Advocacy, please email us at HIDAGovAffairs@HIDA.org.

DISTRIBUTOR SALES STRATEGIES FROM HIDA

SMART SELLING

In Today’s Healthcare

Environment, Less Really is More Salespeople naturally tend to want to sell

more. It’s hard to make your quota by selling less!

But when selling to today’s healthcare supply chain managers, showing them how they can buy less can help them achieve their savings targets while bolstering the value of your solutions.

Leading healthcare providers have realized that getting suppliers to take a few cents off each widget won’t get them to the total savings they need as reimbursements decline. So, they’re targeting product utilization (consumption). That means evaluating not just what they use, but how many and in what circumstances.

Imagine that you’re trying to reduce your family’s grocery budget. You could switch grocery stores or use more coupons to get a slightly better price on the items you buy.

But you might save more by looking at what you’re buying (for example, cheap paper towels that require you to use twice as many) and what you’re throwing out (for example, the bananas or sour cream that went bad before you could use them). You might even identify items that you don’t need to buy at all – for instance, maybe you’re wasting money on disposable utensils.

The same concepts apply to healthcare, many times over. You can probably think of many opportunities to help your customers rightsize their utilization, but here are a few ideas: • Products that require fewer units to do the same job.

• Examples: Incontinence briefs that require fewer changes; gloves that are thick enough to eliminate the need for double-gloving.

•P roducts that eliminate the need for other procedures.

• Examples: A rapid diagnostic test that’s accurate enough to eliminate the need for a culture to confirm the results; a treatment that doesn’t need to be injected, eliminating needle use and needlestick risks.

By Elizabeth Hilla, Senior Vice President, HIDA

• Strategies for reducing product waste.

• Examples: Helping a hospital customer identify items on a procedure tray that aren’t being used and can be eliminated; identifying products that are often dropped or contaminated before usage (such as gloves that are difficult to get out of the box); adjusting order quantities to reduce waste due to product expirations.

• Opportunities to reduce unwarranted variation.

• Examples: Showing a customer that they’re using two different strep tests with slightly different procedures, and that by standardizing to one product they can reduce mistakes (and possibly improve pricing as well).

• Simpler, less expensive products that meet but don’t exceed basic requirements.

• Examples: Showing the customer that certain wound closure procedures don’t require a more expensive suture. (In some cases, standardization isn’t the best strategy.)

Chances are, you are well aware of opportunities like this and you point to these benefits in your sales presentations.

Keep it up! Read articles on utilization management, pay attention to what your customers are doing, and share their successes with other customers. Helping your customers improve utilization management can move conversations away from price alone to instead focus on true value, and will position you as a trusted resource.

www.repertoiremag.com

•

May 2018

49

corner

Ultimate Insider Kim Soler is smart on the phone

As a student at Kean University in Union, New Jersey, Kimberly Soler had a goal – to be a journalist and start a

magazine, perhaps one focused on urban hip-hop. Public relations was another option. Either way, she wanted a future in communications.

As it turns out, she eventually got it, though not in the way she had expected. As HME inside sales lead for McKesson Medical-Surgical, Soler spends the better part of everyday speaking and problemsolving with providers of home medical equipment and home health agencies.

Born and raised in Sicklerville, New Jersey, Soler is the youngest child of Robert and Stephanie Kirby. Her father is a three-tour Vietnam vet and retired postal worker, and her mother retired from Rowan University as the executive assistant for the alumni department.

“They raised both my sister, Nicole, and I to be leaders – never to follow,” she says. “They did so by making sure we excelled at school.

We were on the path to college success by middle school. Their main interest was for us both to have more success and achieve financial stability sooner in life than they did.

“They worked incredibly hard for us, and we didn’t need for anything.

50

May 2018

•

www.repertoiremag.com

Kimberly Soler

“They raised both my sister, Nicole, and I to be leaders – never to follow.”

The push wasn’t overwhelming. It was motivating, and that’s why I’ve been able to fulfill many of my goals today.”

After graduating, Soler – then living in South Jersey – got a job as a senior sales specialist for computer-maker Dell. “I really excelled at it,” she says. “It didn’t feel like work; it was just a natural process for me.

“I love to talk and to socialize, and that was my job. I loved digging down and getting to know my clients. I enjoyed talking with them, making them comfortable. And I got the sale! It was easy for me to uncover what they really wanted.”

At Dell, she learned that to be successful in sales, you have to know what you are selling – its benefits and advantages, all the details.

And you have to know the competition. The experience taught her that the three most important traits of a successful inside rep are persistence, perseverance and drive.

In 2010, Soler began applying those characteristics as a sales administrator for McKesson MedicalSurgical, supporting the long-termcare and home-care sales teams. She became inside sales account manager, homecare, in 2012; and last year, was named HME inside sales lead.

EVENT DATES AND LOCATIONS

JUNE 19 IRVINE, CA

JUNE 21 DALLAS, TX

JUNE 26 CHICAGO, IL

JUNE 28 GREATER NEW YORK

EVENTS SPONSORED BY:

Manufacturer Sponsorships are available!

FOR MORE INFORMATION CONTACT:

ANNA MCCORMICK EVENT COORDINATOR 770-263-5280 AMCCORMICK@SHAREMOVINGMEDIA.COM

• This is an evening of networking with regional distribution reps and educational content.

• Drinks and hors d’oeuvres will be provided.

• These events will be hosted at a local brewery.

corner Customers’ challenges HME providers and home care agencies face plenty of challenges – challenges that McKesson Medical-Surgical can help them meet, says Soler.

“The biggest challenge facing providers today is finding a way to increase revenue year after year, when reimbursement is declining even faster. The second biggest

discuss the needs of patients or their loved ones.” But they are facing stiff competition from big-box retailers and online suppliers.

To meet that competition, successful HME providers are modernizing their stores to attract customers, adding storage and floor space, as well as plenty of windows and lighting. Many are trying to connect with their communities by working with local charities, assisted-living or long-term-care facilities, even schools.

Inside account managers can help providers diversify and streamline everyday processes, says Soler.

By offering tools such as electronic ordering and online visibility to purchase history and inventory, “we help them keep their costs down and profits up, allowing them more time to focus on patient care and outreach.”

Soler and her husband, Frank, a contractor, live in Philadelphia. They like to travel, and later this year, hope to make it back to Jamaica. When she’s not working or traveling, she might be cooking. “I love Latin food. I make what they call pernil – which is slow-cooked roast pork to die for.

“And I’m only getting better at it.”

“ I loved digging down and getting to know my clients. I enjoyed talking with them, making them comfortable. And I got the sale!” challenge is reinventing their businesses. What worked for providers seven years ago, five years ago, even three years ago, will not work today.

“In the past, the brick-and-mortar HME provider was the No. 1 place in the community to get home care products,” she says. “In my opinion, they still are. They are knowledgeable, hands-on and always available to

Hip hop insights Editor’s note: As a college kid majoring in communications, Kimberly Soler thought about starting an urban hip hop magazine. Her career took a turn, but her enthusiasm about hip hop, and her ability to write about it, remained strong. Repertoire asked Soler to write a btrief review of the person she considers to be the most exciting hip-hop artist today. Here’s what she wrote.

Rapper Casanova hit the music scene in 2016, catching the attention of Memphis Bleek (former Roc-A-Fela artist), and music mogul Jay-Z. Managed under Jay-Z’s Roc Nation management company, Casanova is making quite a name for himself.

With a tone similar to Busta Rhymes combined with the rawness of 50 Cent, Casanova is catching the ear of the older hip hop generation with his new school “Trap” flow.

52

May 2018

•

www.repertoiremag.com

Though his style is intriguing, it’s his past that makes him more exciting. Casanova lived his youth as a gangster until it cost him eight years in Riker’s Island. There is no excitement in incarceration, but I admire anyone that takes advantage when given a second chance at life. Using his past as a foundation, it stimulates authentic rap lyrics that provide realism through his rhymes.

Though his story is not original, it is motivating when one can turn a life of negativity into success.

Industry news Cardinal Health survey finds 40% of providers have canceled surgical cases due to lack of supplies According to a new Cardinal Health (Dublin, OH) survey of surgical staff and hospital supply chain decisionmakers, the OR needs better supply chain management systems and analytics to help reduce costs and support patient safety. Nearly half (40%) of respondents revealed they’ve actually canceled a case, and more than two-thirds (69%) have delayed a case because of missing supplies.

Furthermore, 27% have seen or heard of an expired product being used on a patient, and 23% have seen or heard of a patient harmed due to a lack of supplies

Bovie Medical names new director of clinical education, market development Bovie Medical Corporation (Clearwater, FL) appointed Scott R. Sanders as director of clinical education and market development. Prior to joining Bovie Medical, Sanders worked for Olympus Corporation and Gyrus ACMI.

54

including: Total Rewards (Compensation & Benefits), HR Operations (HRIS and Payroll), Talent Acquisition, Talent Management, Organizational Effectiveness and Leadership Development, and teammate relations. Neal joins Owens & Minor from Becton Dickinson, where she most recently was SVP, human resources, with oversight of the Life Sciences. Additionally, Neal led the organization and talent integration of several large acquisitions for Becton Dickinson.

HHS taps CVS Caremark VP to oversee drug pricing effort HHS Secretary Alex Azar selected CVS Caremark VP Daniel Best to lead the agency’s push to curb drug prices, a source familiar with the matter told Politico. As leader of HHS’ effort to lower drug costs, Best will manage daily tasks associated with the initiative. He currently oversees industry relations for CVS’ Medicare Part D arm. He joined the company in 2011 when CVS acquired Universal American’s Part D business.

Owens & Minor names new SVP and chief human resources officer

John Bardis leaves cybersecurity post at HHS

Owens & Minor Inc (Richmond, VA) appointed Shana Neal as SVP and chief human resources officer, effective March 26, 2018. In her new role, Neal will serve as an officer of the company, and will be responsible for all global human resources functions of the company,

John Bardis announced he will leave his role as HHS assistant secretary for administration, effective April 5. Bardis, founder and former CEO of MedAssets, was appointed last year by former HHS Secretary Tom Price. Bardis said he always planned on serving only one year

May 2018

•

www.repertoiremag.com

better patient positioning

better BP

TM

better care

Be the first to offer your customers a fully integrated point-of-care workflow designed by Midmark to promote proper positioning for a more accurate blood pressure measurement. Introducing the NEW generation of Barrier-FreeÂŽ exam chairs.

Learn more: midmark.com/betterBPREPmay 1-800-MIDMARK

Š 2018 Midmark Corporation, Dayton, OH.

Rad-97 Pulse CO-Oximeter ™

®

With Noninvasive Blood Pressure Monitoring

Optional Roll Stand

Not Your Ordinary Patient Monitor

Advanced Connectivity Solutions

For more information, visit www.masimo.com Rad-97 is not licensed for sale in Canada.

Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, and precautions. © 2018 Masimo. All rights reserved.

Upgradeable rainbow SET ™ Technology

PLLT-10432A

Configurable Patient Profiles

PLCO-001648/PLMM-10746A-0218

Customizable Multi-touch Screen Display