Repertoire November 2023 by BOC design Inc

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vol.31 no.11 • November 2023

The Best of Equipment Sales The tips, tricks, and insights into a pivotal product category for distributor reps.

Trixie

Streppy Henri P. Lori

Smooch

Beverly

Sniff

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CONTENTS NOVEMBER 2023 • VOLUME 31 • ISSUE 11

The Best of Equipment Sales The tips, tricks, and insights into a pivotal product category for distributor reps.

 p. 26

PUBLISHER’S LETTER

MARKETING MINUTE

IDN INSIGHTS

The Ride Day....................................................2

The 4 Ps of Marketing........................... 39

Supply Chain Leader Spotlight

PHYSICIAN OFFICE LAB

INFECTION PREVENTION

Examining Inflammation

Breaking the Chain of Infection

Innovations in the lab could revolutionize the diagnosis and treatment of chronic inflammatory conditions.................. 4

DISTRIBUTION Find Your Focus

How Supreme Medical is committed to servicing customers in the home care market............................................ 8

From Standalone to Standing Together

How Concordance Healthcare Solutions’ Surgence Platform aims to unify and optimize the healthcare supply chain industry.................................... 16

A Supply Chain Renaissance

Through an ambitious modernization plan, Cardinal Health has big changes in store to improve facilities and the work experience of its employees........................ 18

SALES Uplifting Service

Taking an extra step for customer service........................................... 32

The Sales Tightrope

Prospecting vs. nurturing existing accounts........................................... 36

Prevention strategies for influenza in healthcare settings.................................... 40

Bill Kellar, VP, Strategic Sourcing, HCA...... 53

Supply Chain Leader Spotlight

Shireen Ahmad, Interim Vice President, GPO Business, Financial Insights, and Analytics, CommonSpirit Health®......... 55

TRENDS

TECH TALK

Direct-to-Consumer

Infection Prevention and Instrument Processing Workflows

DTC devices and tests can complement the professional market........ 42

HIDA HIDA, ASPR Launch Playbook To Monitor Medical Supply Chain.......................... 45

TRENDS Urgent Care Rollup

More urgent care chains have a triple-digit number of locations than ever before.......... 46

COMMERCIAL HEALTHCARE PROVIDERS Walgreens Seeks Footing in Healthcare Disruptor Race

The pharmacy retail giant appointed healthcare leadership veteran Tim Wentworth as CEO in October............ 50

Primary Care News................................ 52

The importance of having facility-wide standardized systems for instrument processing.............................. 56

HEALTH NEWS Healthy and Efficient Homes campaign

To maintain long-term health, monitoring air quality in indoor spaces is crucial............. 58

Pancreatic Cancer Awareness

The month of November sheds light on pancreatic cancer’s prevalence, and the research underway to combat it.............. 60

Google Health

Tech giant brings technological innovation to an ever-changing industry...... 62

NEWS Industry News........................................... 64

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PUBLISHER’S LETTER

The Ride Day Over the course of my career, I’ve done hundreds

of ride days with distribution sales reps. Back when I was a young Healthlink rep, I’d walk into a practice with a bottle of AloeGuard and ask the nurse to put her hand out to fill it with soap. I’m not sure 52-year-old Scott would have the nerve to do that today. I only got smacked once and yelled at a few times during those demos, but we sure sold some soap on those ride days. The best part was the look on a PSS rep’s face when I would do it the first time. When we walked back to the car, they’d always ask, “Are you gonna do that in every account?” I would reply, “Why yes, I am. And you’re going to make 37% margin on reoccurring soap business the rest of your career because of it.” From lotions and potions to demoing latex gloves. I am sure you are asking yourself how on earth do you demo a latex exam glove? Billy Harris would pull one over his head and then blow it up. I never did that, but I did put a glove on the nurse’s hand and stretch it from the cuff all the way up to the shoulder. Or I would step on the glove’s fingers and stretch it waist high without ripping. I started using this technique after accidentally punching a lady when the glove ripped on me. At one point, we put the entire alternate site team through clown training. They were taught how to do magic and tie balloon animals. We then challenged them to ride days dressed as clowns with latex gloves blown up with helium and go tie balloon animals in pediatric offices. We looked like idiots, but we closed a lot of business. More important than the business we closed on those ride days with distribution reps were the lifelong relationships we gained. I still keep in touch with many of those reps. They supported me and I supported them. Ride days provide you with time to really get to know someone. I believe those days launched my career and allowed me to show empathy towards the reps, because what they do isn’t easy. Ride Day Etiquette

ʯ Show up on time ʯ Have a pre call to discuss the day and how you will approach each meeting ʯ Never push an account so hard that you embarrass the distribution rep ʯ Never quote a price if the rep hasn’t given you permission ʯ If you end up at an account a competitive rep has already brought you to, tell the rep you’re with – they may not like it, but they will respect and trust you going forward ʯ If you have follow-up from the day, make sure you do it Since COVID, it seems like we’ve lost the art of doing ride days. If you haven’t done ride days in a while, go have some fun and get to know each other while closing business. Who knows, you may actually realize how much you enjoy doing them. Happy Thanksgiving, R. Scott Adams, Publisher

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Mark Thill mthill@sharemovingmedia.com managing editor

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

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senior sales executive

Amy Cochran (West Coast) acochran@sharemovingmedia.com (800) 536.5312 x5279 sales executive

Aili Casey (East Coast) acasey@sharemovingmedia.com (404) 625-9156 publisher

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PHYSICIAN OFFICE LAB Today, the information I’m proposing is just supposition, but much of it is based upon our evolving understanding of several clinical conditions. Is the evidence there yet to prove that inflammation underlies an increasing number of clinical conditions? No. But many associated findings of inflammation linkages to chronic disease states are being uncovered. Do we know if some seemingly unrelated clinical problems share the same inflammatory cause? No. But we are investigating and learning rapidly. Let’s explore this dreamscape together, remembering that medical science advances sometimes happen slowly and over time, and sometimes advances are the result of a rapid unforeseen breakthrough. Antibiotics, X-ray technology and automation of lab testing were all advances in medical technology that would have seemed impossible just a few years before they became mainstream and changed the practice of medicine forever.

Our understanding of infectious diseases

Examining Inflammation Innovations in the lab could revolutionize the diagnosis and treatment of chronic inflammatory conditions. A mosquito, a bee and a tick go into a bar. The bar-

tender asks, “Can I get you a drink?” The mosquito replies, “Nope. Just here for a bite.” We’re all familiar with insect bites and the obvious inflammation they cause. But how familiar are we with the broad and growing range of clinical conditions that are associated with inflammation that is NOT obvious? 4

By Jim Poggi

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To start with, consider the development of understanding of infectious diseases and initial screening tests to uncover them. Throughout most of human history, there was no way to understand the role of infectious agents in disease and consequently no way to diagnose them or prevent their spread. While there are writings as early as the sixth century BC proposing “seeds of disease,” these findings were not widely understood and there was no way to bridge between the academic theories of the cause of the disease to effective early diagnosis and treatment. Over the centuries, plagues came and went, resulting in serious health threats to humanity.

But, until the germ theory of disease became widely accepted in the 18th century, the fact that multiple diseases were related to infectious agents such as bacteria and viruses was not mainstream medical science. Even once the germ theory took hold and the cause of infectious diseases was apparent, there was no way to screen for infected individuals as well as carriers of disease. From the bubonic plague to Ebola, SARS and most recently COVID, infectious agents have severely impacted the health of millions with death rates ranging from 30% to over 90%. From a lab perspective, early diagnosis of diseases, particularly tuberculosis and others caused by infectious agents, has been considered a cornerstone of rapid effective management of the patient, and a key factor in slowing or preventing the contagious agent from spreading. Fast forward to modern times and there is a substantial number of effective screening tests for infectious diseases we sell daily, including group A strep, influenza and COVID to name some of the most important ones. COVID tests went from the R&D stage to fully developed antigen, antibody and molecular tests for the RNA of the virus in a matter of months, due to the pressing need for rapid diagnosis. At the same time, complete blood counts (CBC) provide a fast, accurate way to assess an infection and can differentiate viral versus bacterial infections. New CBC markers including monocyte distribution width and immature granulocytes provide more specific information, but more work is needed here as well. So, it is true that we now have a firm grip on how to develop tests for infectious agents. But, most infectious agents cause acute illness, and, as we know, most

of the leading causes of morbidity and mortality are due to chronic diseases, where an initial inflammatory process MAY be an underlying cause or at least a key associative factor. Other than COVID and influenza, the ten leading causes of morbidity and mortality are dominated by chronic illnesses. Where are we in the process of associating inflammatory processes with chronic diseases today? Still in the exploratory phase as I see it.

cause an increase in sedimentation rate. So, while ESR has been around for quite some time and points to a general inflammatory process, it lacks the specificity to point to the location and nature of the inflammation and what is needed to cure it. This takes us to C-reactive protein (CRP). CRP was initially discovered in the 1930s and its association to the inflammatory process was more clearly established than ESR.

New CBC markers including monocyte distribution width and immature granulocytes provide more specific information, but more work is needed here as well. So, it is true that we now have a firm grip on how to develop tests for infectious agents. Two key tests that uncover inflammation early include erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP). ESR was first used in the late 19th century but became widely adopted in the 1920s as a way to measure the disease outcome of tuberculosis by Dr. Alf Westergren. While the specific mechanism of action behind the difference in red blood cell sedimentation was largely unknown, it rapidly became clear that the rate of sedimentation correlated with the presence and severity of an inflammatory process. Increased sedimentation rates are indicative of inflammation and are still used today as an initial screening test for inflammation and an indication of an infection. However, like many non-specific biological markers, ESR has its limits. Advanced age, pregnancy, kidney and thyroid issues unrelated to an underlying infection can also

The cascade of immune system responses to a foreign agent (real or perceived due to an autoimmune reaction) begins with identification of the agent by the immune system and secretion of various proteins and messenger substances by white blood cells. CRP is secreted in response to these chemical messengers and eventually results in synthesis of substances that remove the foreign substance, reducing inflammation and preventing a wide scale infection. It is important to know that CRP is secreted in response to both acute and chronic sources of inflammation. However, CRP assays by their very nature are similar to ESR in that while sensitive, they are not specific. Even the newer high sensitivity CRP assays improve sensitivity resulting in an earlier indication of an inflammation but do not improve its specificity and cannot identify precisely what is wrong and what to do about it.

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PHYSICIAN OFFICE LAB Identifying triggers Yes, I’ve thrown quite a bit more lab science at us this month. What’s the point? As I see it, there is an increasing body of knowledge that inflammation is at least associated with several chronic diseases. Inflammation is associated with such seemingly unrelated medical conditions as dental plaque, atherosclerosis, arthritis, type 2 diabetes, multiple sclerosis,

and others. Inflammation persists at a relatively low level, just enough to create small and seemingly insignificant increases in CRP and ESR. So what’s the problem? The problem is the persistence of the inflammatory process and the likelihood that its persistence causes unrecognized progression of the disease. As a result, these chronic diseases and their associated inflammation

I see some of the next generation of lab tests as being developed to have the capability to identify these immune system triggers.

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remain resident long enough to create more significant disease progression and comorbidities. As lab diagnosis has advanced over the years, giving us new tumor marker assays, next generation sequencing, cell free DNA analysis and others, we still lack inflammation assays SPECIFIC enough to clearly point out the root cause. If we can eventually learn the root cause, which is likely to identify the specific trigger in the immune system and what is causing it, we should be able to find ways to deactivate the trigger through pharmaceutical agents. Recent examples of progress in this area include medicines for arthritis and psoriasis that selectively switch off parts of the immune system and then reduce the inflammatory process, reducing the disease progression itself. I see some of the next generation of lab tests as being developed to have the capability to identify these immune system triggers. As a specific side benefit, it is likely that we could then learn whether some of these disease processes are mediated by the same root cause, leading to more effective systemic medications to treat them. Ultimately, I believe these advances in lab medicine could improve quality of life as well as longevity. We aren’t as far off from making substantial progress in this area as you may think. Keep an eye out for development in this area. If I am right, they are likely to make substantial improvements in diagnosis and treatment of chronic inflammatory conditions. The tick turns to the bartender “I’m just itching to learn more about inflammation and chronic diseases. I think the three of us already know how it works in acute conditions. I think I DO need a drink. Can I get a ‘bloody appendage?’”

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DISTRIBUTION

Find Your Focus How Supreme Medical is committed to servicing customers in the home care market. Colton Mason’s official job title with Supreme Medical is senior vice president. But he prefers to use another term

when describing his day-to-day responsibilities – sales leader. “‘Don’t worry about the horse, load the wagon.’ That’s a quote I grew up hearing constantly from my hero – my father, Tony Mason,” he said. “My job is to keep loading the wagon every day. Working with our customers, our manufacturer reps, and our industry associations to keep Supreme Medical in front of everyone in the market for our products and services.”

As an independent distributor and IMCO member, Supreme Medical approaches the market in several unique ways. First, over 90% of their business is shipped to a front porch. Supreme’s business model is homed in on home care. “The home is going to be the care setting of the future,” Mason said. “We decided a long time ago that we’d rather carve out a key focus and do one thing extremely well. We’re laser-focused on serving the home care market.” In an in-depth interview with Repertoire Magazine, Mason shares how independent distributors can stand out in the marketplace, why home care will be front and center in the healthcare continuum of care, and why participating in advocacy efforts at the state and national level is so important. Repertoire: Can you talk a little bit about your home care centric business model?

Mason: We do things much differently than a physician, nursing home or hospital distributor. Case in point – a huge percentage of our business is low unit of measure fulfillment where we’re shipping medical supplies to a patient’s home on behalf of a provider that’s billing their insurance. 8

Colton Mason

For example, let’s take one of our top product categories, urologicals. Our best-selling catheter brand comes packaged from the manufacturer in cases of 300. The problem our customers face is that every patient requires a different quantity

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of catheters and ancillary items depending on their medical needs and insurance coverage. As you can imagine, the normal distribution model of shipping boxes or cases just doesn’t work when you get down to the individual patient level. That’s

where our home delivery program comes in. We break every item down to the “EACH” and handle the pick, pack, and ship for the provider. This allows them to use our warehouse as their own and drop ship direct-topatient in exact payor allowables. We even go a step further by customizing the packing slip with their company name and contact information so that when the box arrives on the patient’s doorstep, it’s as if the provider delivered the order. You can almost think of us as the Uber Eats for disposable medical supplies. Another innovative program we offer is tailored towards wound care telehealth, which has become our fastest growing customer segment. The demand for telehealth ties into the huge nursing shortage occurring right now in our country. More and more health plans and providers are starting to rely on outsourced clinical expertise to help manage patients dealing with chronic wounds at home. The problem that telehealth providers faced was not getting the wound care supplies to the home – our home delivery program met that need – it was the issue of what happens once the order gets there. You have a patient or caregiver that opens a box and sees a bunch of wound care supplies that they have no idea what to do with. So, we did what is always the smartest thing to do when you’re in sales. We went to our largest telehealth customer and asked a whole bunch of questions and listened to their answers. We found out the huge need was the ability to put step-by-step guidelines inside the box that walked the caregiver through exactly what to do, how often to do it, and in what order to apply the products. They also stressed that all this needed to happen in real-time, as the patients their

Colton Mason at HIDA.

wound nurses were assessing in the morning needed orders to ship that afternoon. So, we took their wish list and went to work to develop a solution for connecting the dots between supply distribution and telehealth wound management. What came out of that is something that we’re super proud of and is a real differentiator to Supreme in the market. Let’s say a patient is seen by a telehealth wound care certified nurse at 10 a.m.. That nurse looks at pictures of the wound bed and writes clinical care protocols (CCPs) that determine the supplies that are needed for optimal healing, and outlines directions for the caregiver on how to apply and change the dressings. Within the hour, that order has been picked and packed in our distribution center and heads down the shipping rollers. When the barcode on the pick ticket is scanned, our system prints the CCPs alongside the packing slip and shipping label.

Now when the package arrives on the patient’s doorstep a day or two later, the caregiver has notes from the wound care nurse on exactly what to do. Everyone talks about thinking outside the box. We think the bigger idea is to think inside the box. How can we make the experience better for the caregiver once that package arrives on the doorstep? That’s what we think will be the catalyst for our continued growth as more and more healthcare happens in the home. Repertoire: Why do you believe home care is the care setting of the future?

Mason: I think for three main reasons, which I like to call the trifecta of home care. The biggest of which is it’s where the patients want to be. If you’ve ever had to be in the hospital for a few days, everybody’s commonality is the thought of, “I just want to get home. I want to be

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DISTRIBUTION in my own bed.” That’s where people want to receive care. Nobody wants to die in a facility. They want to be surrounded by their loved ones, their things, their pets. They want to be at home. The second factor is infection rates. The home is the care setting with the lowest rate of infection, because you’re not in a room with a bunch of other sick people. Compare that to the waiting room of an urgent care clinic, or the dining hall of a nursing home, and common sense tells you that you’re at a much lower risk of being exposed to a virus or bacteria by receiving healthcare in your home. We’ve known that for years, COVID of course only reinforced this principle. That’s why you’re seeing an explosion of nursing home at-home and hospital-at-home programs becoming so big right now, because controlling infection and the spread of illness is such a hot topic in the industry. And finally, the home is the lowest cost to the payors. On average it

costs about $50 a day to take care of a patient at home. In comparison, a nursing home is 15 times more expensive ($750) and a hospital is 70 times more ($3,500) per day. We like to use those numbers to stress to policy makers that they should invest more in home care to spend less on health care. Repertoire: What are keys to success for independent distributors in today’s marketplace?

Mason: It’s important to find a focus for your company. Some people will call that a niche, something you do extremely well that solves a problem or offers a better solution than what is currently available. You should be able to sit down with your customers and say, “Out of all the other choices in the market, this is what makes us better. This is what makes us unique. This is what makes us different. This is why you should choose to work with us instead of our competition.” For us as an independent distributor, we see a big opportunity in B2B

e-commerce. As much as we talk about technology in healthcare, there is a huge gap right now as it relates to delivering a frictionless buying experience to a healthcare provider. Simply put, it should not be harder to order from a medical supply distributor than from Amazon. The individuals that are now responsible for making purchasing decisions don’t understand why they have to pick up the phone and call a sales rep or a customer service department to make a return, or to find out if there’s a quantity discount available, or to get an account set up for their business. They don’t understand because they come from the generation of being able to pull an iPhone out of their pocket and access information with the tap of a finger. That’s what customers want today. They want the same buying experience they enjoy in their personal lives. They want a platform that’s easy to do product research on, easy to order from, and hassle-free with zero friction. They expect you to pick up the phone when they have a problem, but that’s not where they want to start. We’re really focused on getting that right. We see a ton of opportunity to capture market share by delivering a better online experience to healthcare providers. Healthcare is complicated enough; buying shouldn’t be. Repertoire: You served as a HIDA chairman and then as an advisory board member to IMCO. Why have those industry commitments been important for you?

Colton Mason and industry colleagues at an IMCO event.

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Mason: I’ve met some of my best friends from industry events over the years. That’s where you build up your networks of folks that are always in your corner. I wouldn’t have that without groups like HIDA or IMCO.

DISTRIBUTION Specifically for HIDA, Matt Rowan and Kelly Taft stopped me at an event, probably six or seven years ago. They told me HIDA was interested in home care because they were getting so many requests from their members about that market. They didn’t have any resources for home care built out yet, and asked if I would help them. So, alongside my mentor – Doug Harper – we founded a Home Care Advisory Council for HIDA that I chaired for four and a half years. We built that from zero to what has become their largest council, in kind of a unique situation. It was the first advisory council where they had manufacturers and distributors working together. That concept worked so well that it has now been implemented for all HIDA markets. We quickly started bringing in provider customers too, so we had all three of us at the table. We could talk through issues, what was working, what wasn’t, and what everybody needed help with. Those sessions were always packed, because you’ve got all these manufacturers in legacy markets like acute care that see the writing on the wall that they have to get their products to follow the patient home from the hospital. Founding the HIDA Home Care Advisory Council was one of the highlights of my career so far. Brent Poythress (Vice President, HME Corporate Accounts McKesson Medical-Surgical) and Matt Boarman (Homecare and Managed Care, Team Leader First Quality Products) have taken up the torch as the new co-chairs and are doing some great work coalescing distributors and manufacturers around the concept of using value-based care to help providers have meaningful conversations with payors. 12

Mason family

As it relates to IMCO, as your manufacturer audience knows, IMCO does not have its own warehouse. They’re not placing purchase orders with manufacturers. It’s a direct relationship buying group that connects independent distributors with manufacturer contracts. They rely on their advisory boards to give them feedback on what new vendors and new programs are needed for the membership in each market segment. We have a Power Meeting every January in Daytona Beach

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and spend three days meeting with IMCO leadership and key manufacturer partners to outline a plan for success in the coming year. To give you one big win we had recently, last year, Supreme and IMCO did a pilot program with Nestle Nutrition where it was specifically built around home care. The issue we were running into with Nestle is it’s historically a hospital and nursing home-driven product line. So, it’s got these huge minimums of 350 cases of formula per PO. Which makes

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DISTRIBUTION sense for those other markets, as the distributors that supply acute care and long-term care are delivering bulk pallets and hundreds of cases at a time to their customers. We explained the big difference with home care customers is that we’re not delivering truckloads of products to a facility. We’re shipping 3 cases to a patient’s home on behalf of a pharmacy. We’re also doing a lot of specialized pediatric nutrition, peptide-based and organic plantbased formula for kids at home that’s covered by Medicaid. This is a growing new category, but with anything that’s new it’s hard to anticipate stock levels. We would order 350 cases and the next day be backordered on something because an order for a child with a specific medical need came through. We knew there must be a better way, so we asked IMCO for help. They worked with Nestle to reduce our minimum order requirement to 125 cases for a year to help us build up our volume and understand what products in these new emerging categories were going to be the most utilized. We committed to 20% growth for them annually and shook hands. That program just ended in July, and I’m proud to say we achieved 111% growth and increased our purchases by over $250,000 with Nestle. That’s just one example of where a buying group, a distributor and a manufacturer can sit down together and say, “We need this from you, what can we do for you?” and make it where it’s a win-win-win. Repertoire: Going back to the home care market, what are some of the main challenges for providers?

Mason: The biggest one for providers that bill insurance is stagnant 14

reimbursement rates. They’ve experienced cost-of-goods increases several times in the last few years, but their reimbursement rates are not being lifted enough to offset any of that. You’ll always have people on Medicare and Medicaid who need those services, but I am a firm believer that the largest payor in healthcare in the coming decade will be adult children taking care of mom and dad with their credit cards. We’re getting past the generation that came up with the mentality of “my insurance should cover that”. People in their 30s, 40s, and 50s, are used to saying, “What do mom and dad need?” and then pulling out their phone and placing an order. Boom, easy. They don’t want to deal with insurance paperwork, high co-pays, or waiting on hold to speak to a representative. They want a self-checkout line for medical supplies and equipment. So, we’re investing a ton of time and resources into making sure Supreme Medical is there to service this new customer in the way they want to do business. This year, we met with our 20 largest manufacturer partners and took a deep dive into developing a curated formulary of medical supplies and home medical equipment for seniors, caregivers, disabled individuals, and those managing chronic conditions or recovering from surgery or an injury in the comfort of their homes. Our website has been enhanced to display beautifully on a mobile device and now features consumer buying options such as Subscribe & Save and Buy Now, Pay Later which allows you to schedule automatic deliveries to your home, or take advantage of payment plans where you can take up to 12 months to pay off a purchase.

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

These are not options you see offered by the nationals. We want to take full advantage of the fact that we can turn-on-a-dime and be the distributor that helps our manufacturer partners tap into this emerging customer base. As we enter our 27th year in business, I can say without a shadow of a doubt that we’re very excited about the future and the opportunities that lie ahead of us. Repertoire: What motivates you to get better as a leader? Mason: I come from a small family business. I started working at Supreme part-time as a teenager during high school. My first job was breaking down boxes with a pocketknife in the warehouse (because my Dad didn’t trust me with a box cutter yet). I’ve counted inventory, driven a van to deliver orders to customers, and carried a bag in the field. The folks here are what drive me to make sure that I’m making the best decisions that move us forward. I think and keep them in mind all the time; Jeff Powell, our GM; Shawn Griffin, our warehouse leader; Tanya Pasquill, our customer service leader – all three have been here over 20 years. Countless others over 10 years. That motivates me to not get complacent, and to always be working on the next big idea, because a lot of families depend on this company for their livelihood. I think the other driving force behind me are the two most important people in my life. I’m a son who just wants to make his mom and dad proud. I would not be where I am today without my parents. I want to make sure that what they broke their backs to build, I do a good job with and that it only gets better as we go. I love you Mom and Dad, thank you for everything.

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DISTRIBUTION

From Standalone to Standing Together How Concordance Healthcare Solutions’ Surgence Platform aims to unify and optimize the healthcare supply chain industry. Success within the healthcare supply chain industry means efficiently developing, manufacturing and distrib-

uting medical and surgical products to ensure that providers have the products needed for delivering optimal patient care. As the pandemic showed, staying connected across the dynamic healthcare supply chain network is fraught with challenges.

The healthcare supply chain faces numerous challenges including a lack of visibility, inefficiencies, and continuous, but hard to predict disruptions. There is also a lack of realtime visibility to consumption and forecasting between trading partners 16

within the industry, according to Concordance. This is due to a lack of solutions that can connect disparate systems and identify aspects of the supply chain such as variability of supply, inventory strategies, and unpredictable consumption rates.

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

This causes an inability to truly forecast supply needs. In 2022, Concordance commissioned a market assessment to validate the need and found that hospitals and health systems are very interested in a platform that centralizes all

aspects of their organization’s supply chain, while simultaneously bringing insights from their trading partners throughout the supply chain to proactively signal and address challenges such as supply constraints. “The lack of comprehensive third-party solutions and offerings in the industry was highlighted by COVID-19,” Concordance Healthcare officials said. “The same market assessment stressed the supplier and distributor interest in inventory and allocation management, and efficient customer demand planning and forecasting, especially in a solution that is fully connected to providers.” To that end, Concordance Healthcare Solutions recently announced the launch of a revolutionary technological solution, Surgence™, a healthcare supply chain “ecosystem.” It was designed with the intent to fully connect providers, distributors, and suppliers by bringing visibility to healthcare network supply and demand information. Concordance partnered with Palantir Technologies Inc., a leading builder of operating systems for the modern enterprise, to create Surgence.

Impacting enhanced patient care through connectivity Surgence is designed to provide “unprecedented visibility” into the demand of medical supplies in real time, ensuring a seamless flow of products and ultimately enhancing overall patient care in the process, Concordance officials said. The platform aims to improve the accuracy of decisions and outlook of the future utilizing a variation of AI technologies. Industry partners can obtain a better overall picture of the state of their supply chain, solve challenges faster and proactively plan for the future.

Surgence is a first-of-its-kind platform that integrates all the strengths of the other platforms into one, allowing for a wider range of connectivity across the supply chain, Concordance officials said. Individual data governance allows each organization to share information within the Surgence platform and allows each organization to collaborate with their supply chain partners in a way that allows them to be in ultimate control of their data. “By giving real-time visibility to product demand signals up and down the supply chain, Surgence establishes a new world of informed, proactive supply chain decision-making. This

of the supply chain, and Surgence aims to maximize the existing technologies, integrate them, and streamline the information into one comprehensive platform. “By coming together as an industry to face the challenges of the supply chain, we can utilize the power of Surgence to bring value to each connected member individually and together. Many organizations are working on individual solutions, but these standalone technologies are challenging to connect to industry partners. Surgence solves this by being an agnostic solution for the entire industry,” according to Concordance officials.

“ All organizations will receive value by connecting to Surgence, as more organizations connect, each organization will receive exponential value. The industry response to Surgence has been extremely positive.” includes the ability to immediately communicate consumption changes and alert all related parties to these changes,” according to Concordance. “Today, there is a lag in realizing consumption pattern changes downstream which leads to inventory and supply issues upstream. By unifying the supply chain with one source of truth, everyone will be moving in the same direction to provide exceptional patient care.”

Future of supply chain connection Within the healthcare supply chain industry, companies are being challenged to do more with less resources. There are technologies that currently exist to connect specific components

Looking forward, Concordance is aiming to unify the industry by continuously onboarding providers, distributors, and manufacturers. “All organizations will receive value by connecting to Surgence, as more organizations connect, each organization will receive exponential value. The industry response to Surgence has been extremely positive,” officials said, with many stakeholders stating that the technology is a much-needed solution for the industry. Favorable reviews from manufacturers, distributors and providers alike are driving the commercialization and adoption of the solution. To learn more about the Surgence platform or to schedule a demo, visit wearesurgence.com.

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

DISTRIBUTION

A Supply Chain Renaissance Through an ambitious modernization plan, Cardinal Health has big changes in store to improve facilities and the work experience of its employees. When a chief supply chain officer for a hospital or health system awards business to Cardinal Health, the gravity

of that decision isn’t lost on James Sembrot, the company’s SVP, Supply Chain for U.S. Medical Products & Distribution. “They’re in essence turning over their supply chain to us,” said Sembrot. “You don’t want to disappoint your customers in any industry, but particularly when your industry is as meaningful to the world as ours.” 18

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

chain resiliency with increased inventory and expanded physical infrastructure. The company said these investments will also enable the team to integrate automation and more modern technologies; improve safety, service, quality and cost; and be more efficient in managing variations in volume and labor availability.

Infrastructure and technology

Unfortunately, the pandemic served as a great disruptor to U.S. healthcare providers and the businesses who served them. Service levels weren’t being met, and resiliency became top-of-mind for an economic sector that may have taken it for granted in the past. For its part, Cardinal Health used the pandemic as a trigger point in launching a multi-year warehousing and modernization plan. The goal of this ambitious effort is to increase service levels and supply

The investments include a new, nearly 600,000-square-foot distribution center that opened in early 2023 in Central Ohio, as well as a $50 million inventory management project that, when completed, will collectively add nearly 1.5 million square feet to Cardinal’s replenishment center network. Cardinal Health looked at not just square footage, but the cube footage of its facilities, to see if they were maximizing the space they had. Could they build storage and shelf space up? Or, did they need to build more modern facilities that were taller than current distribution centers? “Where it made sense, we made investments in growing our ability to hold inventory on behalf of our customers,” Sembrot said. At the same time, the distributor (and manufacturer) has deployed several new technology systems to improve efficiencies with how it transports and tracks goods. For instance, through FourKites, a visibility solution, Cardinal Health is creating connectivity with all carriers across the supply chain, “from large national carriers to couriers in the final mile,” the organization said in a release. “When an item is ordered, where is it in the supply chain?” Sembrot said. “We’re pretty good at knowing within a facility, is the product there or not? What we’re not always

James Sembrot

good at historically has been knowing where it is in the manufacturing cycle. If it’s a shipment from overseas, which ship is it on? Which port is it in? Which carrier is it on during transit? So, this is connecting, from a visibility perspective, where all our customers’ orders are and where our inventory is throughout the supply chain.” Advanced planning software products like Kinaxis® enable Cardinal Health to enhance its supply chain through concurrent planning and end-to-end network visibility. “With Kinaxis®, we can factor in seasonality and balance demand and supply while accounting for capacity safeguards,” the company said. “And we can more easily simulate various product supply scenarios to create best-fit solutions for customers.” And then there are the autonomous mobile robots (AMRs). Cardinal Health has partnered with Locus Robotics to implement AMRs working in a complementary way with operations team members. The robots are integrated with a facility’s warehouse management system, receive picking instructions, are loaded with plastic totes by employees, and, using sophisticated artificial

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

DISTRIBUTION intelligence (AI) and optimization algorithms, determine the most efficient routes for traveling from one pick to the next to optimally satisfy the customer order. The pictures displayed on touchscreen devices help employees accurately identify the correct products in the requested quantities. Employees scan the items into the robot’s digital system, then place the products into the robot’s totes. Once the totes are fully packed, the robot moves them to a staging area for loading onto delivery trucks. With the AMRs, Cardinal Health has seen a marked improvement in defects per million opportunities, or DPMOs, a key performance indicator the organization tracks. “It doesn’t seem like much to move from a 4.1 to a 4.3 sigma, but it’s almost 1,500 defects per million opportunity improvement,” Sembrot said. “Things like that move the needle

and allow us to do what we do even better.” Safety has also improved. Rather than team members pushing around 400-pound carts, the AMRs are coming to the team members at pack stations. Approximately 400 robots have been deployed across eight U.S. distribution centers supporting the medical product business, with plans to continue optimizing the benefits of the technology.

Allaying concerns But what would team members think working in tandem with these robots? When discussing the deployment of AMRs in their distribution centers, Cardinal Health leaders knew that acceptance from team members would be key. The first step would be to discuss the initial rollout and allay any fears the workers had related to safety and job security.

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

“That was a concern, absolutely,” Sembrot said. “It takes communication, transparency and then providing reasons why the organization is adopting the new technology.” These proof points can come from within the industry or how the technology is used in other companies. Sembrot described the visual of a run chart: this is what the world was like before there was an event, and then this was how the world was after. Is it better, or worse? Timing was another consideration. The introduction of the AMR technology has come as suppliers across industries are experiencing higher turnover rates in shipping facilities, mainly due to overtime hours. “Overtime is expensive, but more than the expense, it’s disruptive to our employees’ schedules and our organization’s timelines,” Sembrot said. Cardinal Health leaders met

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DISTRIBUTION with its facilities teams and walked them through how the assistance of the AMRs could actually cut down on overtime hours, particularly with the second shift.

Making transportation top of mind Sembrot doesn’t mind the complexities and scope of the modernization plan. If anything, the veteran supply chain leader said it’s confirmation that he has one of the best roles in the industry. “The largest segment of GDP devoted in our economy is to healthcare,” he said. “The second largest is transportation distribution. I get to work in both. It’s fantastic, and meaningful.” With such a critical role, it’s important for supply chain leaders to stay up to date on several aspects related to how they receive and ship products. Sembrot listed several: ` “Resiliency is a big deal,” he said. A few months back, a lot of people in supply chain watched with worry as one of our country’s largest package delivery service providers negotiated with its drivers to avoid a strike. While the organization and its team members worked out an agreement, supply chain leaders were having flashbacks to the pandemic and disruptions caused in receiving and shipping products.

Whether it’s drone delivery, new modes of transportation, or new market entries, transportation leaders have to keep an eye on the latest developments.

` Predictability is increasingly

important to businesses. A couple years ago, companies were paying $25,000 per container to get something from Asia to the United States, about ten times what it was pre-pandemic. Fortunately, freight cost has significantly dropped back down to pre-pandemic levels. “Being predictable isn’t just your load showing up on time – there’s

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

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DISTRIBUTION

a predictability to your financials,” Sembrot said. “The CEO and CFO want to know that you’re going to be resilient, have backup plans so that you don’t have a shock to the financials like many companies experience when transportation capacity really tightens up.”

` Visibility is something consumers

and companies want more of into the supply chain. “Customers across

industries don’t want to just know when a truck is arriving. They want to know when their item that happens to be on the truck is arriving.”

` New capabilities are happening

at a rapid rate. Whether it’s drone delivery, new modes of transportation, or new market entries, transportation leaders have to keep an eye on the latest developments. One example is Uber Freight.

Innovation lab The new distribution center in Central Ohio is home to a major investment in future innovations for Cardinal Health. The facility houses a 4,000-square-foot innovation lab, where team members can develop and test solutions, while building and evaluating new capabilities in a real-world environment. Cardinal team members experiment with everything from handhelds like scan guns, to other robots that have different capabilities than the Locus AMRs, Sembrot said. “We’re looking at other technologies where goods actually come to the person,” he said. “Locus AMRs are great at moving little items that can be put in a tote, but we also move pallets. We’re picking layers for customers and exploring other technologies that help us achieve those with multiple pilots.”

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

“The company didn’t exist 15 years ago and now they’re delivering everything.” Another example is the U.S. Postal Service. The massive supply chain and transportation organization has seen their business change due to email and other market entrants. “So, what are they doing? They’re refocusing. They’re transforming. They’ve launched a new product called Ground Advantage where they’re trying to compete with UPS and FedEx.” At the end of the day, Sembrot said what he loves most about working in healthcare and the transportation of goods is how people-focused the work is. “Many times, it is the driver that’s the face of Cardinal Health to our customers,” he said. “They are who our customers know. So, it’s really important that we are cognizant of it, and that it informs our strategy of how we approach transportation. This is just a super exciting industry to work in.”

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November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

The Best of Equipment Sales The tips, tricks, and insights into a pivotal product category for distributor reps.

When speaking to Repertoire last year about the link

between equipment and patient care, Tom Schwieterman, M.D., MBA, chief medical officer and vice president of clinical affairs for Midmark, said to visualize a Broadway show. The equipment manufacturer (in this case Midmark) would be the theater owner, not the show itself. “Our role is not script, orchestra music or cast. However, we would design the seating, orchestra pit and stage, lighting, concessions and the means for staging between acts. To create the perfect setting for the production, we would need to know the storyline and setting intimately. “Within the theater, we would ensure that all critical elements were received by the audience in their fullest extent and are enjoyed in a comfortable and engaging manner. We would design the theater seats to avoid any barriers to a view of the stage so the cast can develop intimacy with the audience. “If these things are not done well, the show will ultimately fail no matter how well the cast performs a Tony award-winning story.” Through the years, industry veterans have provided a myriad of useful tips, insights and illustrations regarding equipment sales. We’ve compiled some of the best in the following article. www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

The Best of Equipment Sales

Problem-solvers “Knowing how to uncover hidden problems and providing solutions is key to selling equipment,” says CME Corp.’s Cindy Juhas. Many customers don’t even know they have a problem. Asking questions and knowing how to sell solutions to potential problems is the only way to sell equipment. “You need to know the customer’s goals when trying to uncover their problems, so the sales rep has to be knowledgeable about the customer,” she says. For example, some accounts may be more focused on patient satisfaction than others. The successful equipment salesperson knows which products in his or her bag will help them meet their goals. “That’s where good interviewing skills cross with great product knowledge.”

Things are changing so rapidly, that if the equipment salesperson asks his or her customers to articulate their challenges and needs, “by the time you present, things could have changed.”

that will aid them with their long-term financial goals,” says Meleski. “When a health system partners with a distributor equipment salesperson, they typically choose to do so because of the variety of products and solutions that they can offer. As such, it is imperative that you maintain a firm understanding of the benefits and features of the product lines you carry, so you can provide advice and guidance to your customer.”

Finding the best fit Successful distributor equipment reps are more like consultants than salespeople, says sales leader Larry Dawson. “The doctor tells the consultant, ‘This is what I do, this is how I practice, this is what I need,’ and the equipment rep says, ‘This will probably work best to fit your needs, this is the company, and this is the reason why you want to work with this company.’” Just as consumers look to knowledgeable, confident experts for guidance when making significant purchasing decisions, so too do doctors look to their sales reps for guidance on equipment decisions, continues Dawson. “The dealer rep can look that doctor in the eye and say, ‘Doctor, I’ve worked with this vendor before; we’ve sold their products for many years; if there’s an issue, you will be taken care of.’”

Learn your customer’s objectives CME Corp.’s K.C. Meleski says, “The act of procuring equipment is complex, and as a customer, you will naturally gravitate to salespeople who can lessen that complexity for you. As our clients continue to consolidate, they are facing unique challenges with both the purchasing and deployment of their medical equipment. Our clients are concerned with maintaining system clinical standards, following their organizations’ branding strategies, adhering to contractual obligations, and the logistics of how their equipment will be installed.” The effective equipment salesperson can help his or her clients with all these concerns. Equipment sales reps can bring additional value to clients by understanding how the equipment purchase may affect clinical outcomes as well as patients’ perceptions of the practice (as measured by the HCAHPS survey, or Hospital Consumer Assessment of Healthcare Providers and Systems), he says. “You must be able to take on a consultative role with your clients and help them identify and specify products 28

Says Midmark’s Matt Bourne, it is a rep’s ability to solve their customers’ problems that separates the high achievers from the rest of the pack. “They think in a way that allows their customers to invest in products and services that are going to benefit their environment – the caregivers, the patients and the bottom line. “To sell equipment in today’s healthcare, you can’t just present features and benefits,” he continues. “You can’t just present equipment in terms of return on investment. You need to learn as much as you can about your customer’s objectives; you must understand it deeply; you have to be embedded in what they’re going to need to do in the next three to five years to drive the measures they have put in place. “A ‘deep dive’ has to take place to understand the customer’s environment before presenting solutions,” says Bourne. Things are changing so rapidly, that if the equipment salesperson asks his or her customers to articulate their challenges and needs, “by the time you present, things could have changed.”

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

He puts his comments in context. In some instances, the distributor will be asked by the customer to present several alternatives for a piece of equipment to put out to bid. “It’s easy for the distributor to say, ‘No problem; here are your A, B and C companies and the different price points,’ then walk away and hopefully pick the order up at a later date. “It’s much more difficult to say, ‘We can do that, but let’s bring these manufacturers together so you can experience how they are different and are going to enhance your environment based on how I understand the organizational vision to be.’” By asking the customer to pause and then offering a different perspective, the sales rep challenges the status quo and looks to become a problem-solver. Says Medical Resources’ Randy Reichenbauch, “You have to understand what the particular physician does or is trying to do. You have to understand clinical outcomes. You have to figure out his problem and whether you have a solution for it.

Remember, the financial presentation is as important as a good clinical presentation, so you need to master it. The best time to deliver that financial presentation is NOW. When possible, don’t tell them you are going to get back to them with a proposal. “In the past, you would say, ‘This is the CPT code, and you’ll make this amount of money [with the equipment], and this is how it will benefit you,’” he says. “But today, it’s a matter of, ‘How will this affect that customer on a long-term basis? Will it have the impact on the practice they want, with accountable care networks?’” Customers are also looking at the impact of equipment on patient satisfaction, he adds. Says longtime manufacturer sales leader Rob Saron, “The most effective question that I’ve heard is, ‘Doctor, if you could replace one piece of equipment in your office, what would it be?’” He cites the example of one

rep who asked that question of every OB/GYN professional on which he called. The consistent answer was “my colposcope.” Having gotten that question answered, the rep would continue, “Are you happy with your LEEP system? Is it up to today’s standards? Is it safe? Reliable? And if it breaks, what happens then?” A logical line of questioning results in sales, he says.

Brian Sullivan’s Five Steps of Equipment PRIDE Prospect:

So, whose job is it to prospect for new business? The answer is EVERYBODY. That means both manufacturer reps and distributor reps. To do it well, you need to focus on a select number of products each month (3-5). Rep Communication:

If you are in distribution, take time in your office before the end of the year to determine which manufacturers you should be partnering with. Remember, not all manufacturers and reps are created equal. Look for well-known brands or cool new technologies that also have great sales reps to support you. By teaming up with the right partners, you will find that together you will create more leads, more meetings/demos, and more sales. In the Call:

When manufacturer and distributor reps do a joint call or product demo together, it’s important that they discuss specific roles during that call. If they don’t, the risk is that they will be talking over each other, and the communication/meeting will be disjointed. Take a few minutes before you walk in (or turn on your Zoom camera) and split up duties. Decision-Time:

Once you receive buying signals and buying noises (like hmm, interesting, I like it), somebody needs to control the call. Remember, the financial presentation is as important as a good clinical presentation, so you need to master it. The best time to deliver that financial presentation is NOW. When possible, don’t tell them you are going to get back to them with a proposal. Have three different product/pricing options available and present them immediately after you have built the emotional momentum. This means you need to prepare the financials before you ever attend that demo/meeting.

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

The Best of Equipment Sales

“Capital equipment can be a solution for many needs, from patient care, patient satisfaction, or financial benefits.” Explore:

The best time to explore for additional capital equipment opportunities is immediately after a prospect says “yes” to the capital equipment opportunity you just presented. Too many salespeople are so elated to sell something that they’re afraid they will sound too pushy by bringing up another piece of equipment.

It’s not easy No one said selling equipment is easy. Mistakes will be made. “Probably the biggest mistake made by distributor reps is not focusing on solving the customers’ needs or problems,” says one former industry sales leader. “Capital equipment can be a solution for many needs, from patient care, patient satisfaction, or financial benefits. Equipment can serve all of these needs, but addressing

the most salient needs makes it easier for the customer to make the purchase decision.” Longtime manufacturer sales leader Dick Moorman believes that selling categories of products can take the distributor’s focus away from the customer’s true equipment needs. “Distributor salespeople have been trained to sell categories of products,” he says. “Virtually all of distribution has category managers, who are responsible for various manufacturers’ product lines. “The reason for category management is certainly understood, and it is not an easy job for a distributor category manager to manage multiple manufacturers. That being said, what a distributor brings to a customer should be the best possible solutions with a manufacturer who truly understands the medical space they play in. One who can really deliver to the end user the solutions they need.”

The value of time Distributors shouldn’t miss the opportunity to demonstrate to clinicians how digital capabilities can enhance their practice, Michael Suits, senior marketing specialist, physical assessment, for Baxter told Repertoire. “Communication with digital images – and being able to send them directly to the EMR and other providers – is a significant step forward in physical exams. In addition, it has been demonstrated that a single digital image of the tympanic membrane obtained by a smartphone-enabled otoscope resulted in correct diagnosis of 96% normal tympanic membranes and 100% abnormal tympanic membranes. This provides assurance that quality care is being delivered to patients, likely resulting in improved patient and clinician experience.”

November 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

We’re thankful. We appreciate all of our loyal readers and advertisers. As our Share Moving Media family prepares to celebrate our 30th anniversary in the upcoming December issue, we would like to take a moment to express our sincere thanks for your loyalty and support over the years. We are truly thankful for the wonderful industry we have the privilege to serve.

C E L E B R AT I N G 3 0 Y E A R S

repertoiremag.com

SALES

Uplifting Service Taking an extra step for customer service. By Pete Mercer

What does customer service look like to you? You could likely poll 100 different people and get 100 different

answers based on their varying needs and expectations. The interesting thing with a question like that is that there aren’t really any wrong answers – it’s all about meeting the needs of the customer.

That idea of meeting the customer’s needs is succinctly defined in Wes Anderson’s colorful 2014 film, The Grand Budapest Hotel. The film’s protagonist M. Gustave is speaking to his new concierge, saying, “A lobby boy anticipates the client’s needs before the needs are needed.” While we may never be able to fully nail every need and expectation that the customer has, we can work towards a greater understanding of their potential needs. Repertoire Magazine recently spoke to customer experience guru Ron Kaufman about what customer service looks like and how we can take an extra step to accommodate our customer’s needs. Backed by his extensive experience in creating strong customer service teams, Kaufman has an innate sensibility for what winning customer service should look like.

What is uplifting service? Kaufman’s uplifting service is a customer service concept that takes an extra step from what traditional customer service might accomplish. The idea is that through uplifting service, your organization can create deeper emotional connections with your customers. Kaufman said, “Service is about taking action to create value. That 32

action can be over the phone, it can be in person, it can be online, it can be proactive, it can be reactive – but it’s only service if someone else values it. Uplifting Service is taking the next action to create more value for the person you serve.” He uses an example in a restaurant setting – if a customer requests extra sugar for their coffee, the act

October 2023 • Repertoire | Celebrating 30 Years • www.repertoiremag.com

of getting that sugar for them is customer service. What if the waiter offers them options, saying, “White sugar, brown sugar, or honey?” That’s a perfect example of uplifting service, which creates a little more value for the customer. Uplifting Service has different components that make it successful. Not only does it uplift the service

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SALES experience for the customer, but it also uplifts the service provider by putting them in a position to really consider what the customer needs and how you can address those needs. These extra steps you take with your customer base can range from asking an extra set of questions to better understand their situation to offering training and workshops designed to help them better utilize the product that your organization is selling.

has opened up to a new way of thinking about where, when, and how we can serve our patients and their family members better or differently than we have in the past. How can we enable them to experience what really matters to them?” In this new setting, it’s vital to provide uplifting service for your healthcare customers. The medical devices and equipment you sell must be understood and used correctly to provide

“ Today, patients are walking in better informed than ever before, and that can be challenging for doctors. Customer experience has opened up to a new way of thinking about where, when, and how we can serve our patients and their family members better or differently than we have in the past.” How has customer service changed? Part of the challenge with providing consistent excellent service for your customers is that the landscape of customer service looks so different than how it used to. The internet has changed everything, especially when it comes to dealing with customers. The buyer is much more informed than they used to be, which changes the way that sales reps approach customer experiences. In the healthcare industry, medical sales reps are now thinking not only about their customers (hospitals, doctors and physicians) but about the customer’s customers (patients and their family members). Kaufman said, “Today, patients are walking in better informed than ever before, and that can be challenging for doctors. Customer experience 34

adequate patient care. For Kaufman, customer experience now includes the larger context of a patient’s overall experience, and not just the immediate moments of action. He said, “Service now lives in a longer horizon including before the moment of action and beyond to after the sale.” Which is where uplifting service comes in for medical sales reps by asking questions like; “Are your staff learning how to use the product? Would you like us to come in and run some workshops for them?”

The difference between compliance and creativity Another challenge with selling in the healthcare space is navigating areas where compliance and creativity may clash. The medical industry requires compliance and regulations to protect

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healthcare organizations and individuals practicing medicine, as well as the individuals receiving care. These are designed to benefit everyone involved, but it can be restricting for those trying to take extra steps to provide uplifting service. “Uplifting service is taking the next action to create more value, which means you need people to think outside of the box and come up with new ideas,” Kaufman said. “But not every idea is going to be a good idea, so you’ve got to teach your team to brainstorm new and creative ideas – then evaluate and let go of the unworkable ideas – and finding a way to make the remaining ideas even better.” For Kaufman, companies get their approach to customer service right when the culture helps them facilitate and cultivate new ideas for reaching and serving their customers. When your employees are encouraged to take that next action of uplifting service, this inevitably creates more value for customers, and for your organization. That shift in culture starts from the top and trickles down through feedback, communications, training and workshops for your teams. Traditional metrics for sales look at dollar signs for the data. With uplifting service, the leading metrics are the number of new ideas the team has generated, evaluated, prioritized, improved, and put into action. “Of all our new ideas, how many did we try? How many did we improve, consolidate, and embed into our systems and processes? These metrics are the leading indicators that drive your financial measures. If you want to build a culture of uplifting service, you must be proactive and drive your leading metrics, too,” Kaufman said.

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SALES

The Sales Tightrope Prospecting vs. nurturing existing accounts. By Brian Sullivan

In the ever-evolving world of sales, reps often grapple with a challenge as old as the profession itself – finding the perfect balance between dedicating time to prospect for new business and nurturing existing customer relationships. This balancing act is more than just a mere juggling act; it’s a complex, dynamic dance that requires meticulous planning, a disciplined approach, and an unwavering commitment to excellence. The prevailing misconception among many salespeople is that prospecting can be deferred until there’s an opportune moment in the daily grind. Yet, more often than not, that elusive “free time” never materializes, and existing customers, like demanding sirens, continue to beckon. In this article, we’ll delve into six key strategies to help you master the art of maintaining this delicate balance between prospecting for new opportunities and tending to the needs of your valued existing accounts. No. 1: Prioritize and calendarize your prospect schedule After a recent seminar I delivered, a seasoned salesperson approached

me and said, “Sully, I like your concepts on cold prospecting to find new clients, but frankly, I just don’t have time, because my existing clients require too much out of me.” My response was, “Give me some examples of things they require of you.” He then spewed out a laundry list of low-value activities that he would perform within those accounts that, while important, were either things he could have deferred to internal resources or perhaps not needed to do at all. In short, this rep was mistaking activity for progress. The truth was, just because he was busy, it didn’t necessarily mean he was being productive. 36

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Imagine your sales calendar as a wellorchestrated symphony, with each note representing a specific task or activity. To create a harmonious melody, it’s essential to prioritize prospecting by scheduling dedicated time for it. Start by allocating blocks of time in your calendar exclusively for prospecting activities. These

pockets of focus can range from a mere 30 minutes to a full hour, depending on your schedule and preferences. The key is to treat this commitment to yourself as sacrosanct, unwavering in the face of competing demands. The more consistently you honor this schedule, the more you’ll witness the transformation of sporadic prospecting into a habitual practice that drives your long-term success. No. 2: Establish clear and respectful boundaries with existing customers

No doubt, existing customers are important. They trust your offerings, rely on your expertise, and expect nothing but top-tier service. However,

maintaining their trust doesn’t require sacrificing your potential for growth through prospecting. To strike a balance, establish clear boundaries with your existing customer base. While it’s tempting to respond instantly to every customer request, doing so can inadvertently send the message that you’re perpetually available. During your designated prospecting time, consider allowing non-urgent calls from existing customers to wait momentarily. Communicate politely that you’ll address their needs but that it may take a bit of time. Most customers will understand and even appreciate the professionalism of a busy expert who sets expectations concisely.

No. 3: Harness the power of internal resources

In many sales organizations, a wealth of internal resources is available to support customer requests. These might include subject matter experts, dedicated customer support teams, or knowledgeable colleagues who can provide assistance. Don’t hesitate to delegate tasks when it’s feasible and beneficial. And for you that perhaps own your own manufacturer rep firm or perhaps act like a solopreneur within your business as a 1099 employee, there are options to tap into external expertise. Platforms like Upwork and other outsourcing websites offer access to skilled professionals who can take on

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SALES tasks that would otherwise consume your precious prospecting time. Effectively leveraging both internal and external resources can help you meet customer demands efficiently without sacrificing your growth prospects. No. 4: Steer clear of overcommitment A common pitfall in the realm of sales is the temptation to overcommit to existing customers. When you promise more than you can reasonably deliver, you risk becoming overwhelmed by servicing existing accounts, leaving minimal room for prospecting and business expansion. To navigate this challenge successfully, establish realistic expectations, both for yourself and your customers. Make it a cardinal rule not to overextend your commitments. By providing clear timelines and managing expectations prudently, you create a win-win situation. Your customers will appreciate your honesty, and you’ll gain the breathing space needed to allocate time for prospecting effectively. No. 5: Allocate dedicated time for existing customers

Maintaining healthy, mutually beneficial relationships with existing customers is undeniably crucial. To ensure that your existing accounts receive the attention they deserve without compromising your prospecting efforts, allocate specific time blocks for them. These designated time slots on your calendar should be dedicated

exclusively to servicing and communicating with your existing accounts. By structuring your tasks within these predefined windows, you can fulfill your obligations to existing customers efficiently, preventing tasks from spilling over and disrupting your prospecting activities. This proactive time management approach ensures that you can nurture existing relationships while also creating room for cultivating new opportunities.

but always maintain a respectful demeanor. This approach sends a powerful message: you are a professional who values and respects your existing customers, but you also value your time and have the discipline to manage it effectively. In short, the sometimes-difficult dance of balancing prospecting for new business and nurturing existing customer relationships is a fundamental aspect of achieving success in

Every sales professional encounters highmaintenance customers at some point in their journey. Effectively managing such customers requires a balanced approach that accommodates their needs while maintaining control over your schedule. It’s a delicate art of diplomacy. No. 6: Strive for firm, yet respectful interaction with existing customers

Every sales professional encounters high-maintenance customers at some point in their journey. Effectively managing such customers requires a balanced approach that accommodates their needs while maintaining control over your schedule. It’s a delicate art of diplomacy. From the outset, set clear boundaries and expectations with these high-maintenance customers. While expressing gratitude for their loyalty, emphasize that you cannot let their demands dominate your entire schedule. Be firm in your commitments

sales. By proactively prioritizing prospecting, establishing clear boundaries with existing customers, leveraging available resources, avoiding overcommitment, allocating dedicated time for existing accounts, and maintaining a firm yet respectful stance, you can master this delicate equilibrium. Remember, time is one of your most valuable resources, and how you allocate it can significantly impact your sales performance. By incorporating these strategies and making a concerted effort to strike a harmonious balance, you’ll position yourself for sustained growth and lasting success. See you at the Top!

Brian Sullivan, CSP, is the author of “20 Days to the Top” and a leading voice in the field of sales training and development. He believes in the potential of every salesperson to achieve their best and continually challenges sales professionals to reach new heights. To have Brian Sullivan or one of his stable of trainers and coaches help your team get to the top, visit him at www.preciseselling.com. 38

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MARKETING MINUTE

The 4 Ps of Marketing By Jenna Hughes

In the healthcare supply chain indus-

try, a successful marketing campaign can include a variety of techniques and strategies. The world of marketing is dynamic and always changing, and there isn’t a “one size fits all” way that works to promote all brands. It can be helpful when first developing a brand’s marketing strategy to have a framework, or outline, of what a brand hopes to accomplish through marketing efforts. This allows a brand to stay on track and successfully market its product or service. One example of a framework that can guide marketing efforts is the four “Ps” or a “marketing mix.” A marketing mix is the different campaign strategies that a brand employs to market their product or service.

The “marketing mix,” or the four “Ps” include product, price, place, and promotion. Strategies can include social media marketing, email campaigns, print marketing, and much more. Read on for a breakdown of each aspect of the four “Ps” marketing framework, and how businesses can integrate it into their business plans and campaign strategies. 1. Product Product is the goods or services that are being marketed by a brand to a specific audience. It is important for a company and its employees to have extensive knowledge and experience with the product or service in order to best represent it to customers in marketing campaigns.

2. Price Price is how much a product or service costs. Cost is a crucial aspect of the 4 Ps, as it determines who a brand’s audience is and the amount of profit a company can make from selling it to a specific audience. 3. Place Distributing or selling a product in a place that is easily accessible to consumers encompasses the third “P”. In the medical distribution industry especially, considering place is of utmost importance when selling products. Medical supply reps should have a thorough understanding of the needs of the hospitals or physician offices that they are working with, and how to best address those needs with certain products. 4. Promotion Advertising a brand’s product or service is the definition of promotion. Promotion includes print advertisements, TV commercials, and content marketing such as blogs, emails, and social media. The 4 Ps can guide a brand’s preliminary marketing strategy. If your brand could benefit from further assistance planning marketing strategies or developing content specific to the medical distribution industry, contact Scott Adams at sadams@sharemovingmedia.com to set up a brainstorming session. Share Moving Media has over 30 years of experience creating content for the medical supply chain industry and can assist your brand in developing creative healthcare marketing ideas.

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INFECTION PREVENTION

Breaking the Chain of Infection Prevention strategies for influenza in healthcare settings. By Paul Girouard It’s that time of year again. We’re heading into the cold and flu season. The season usually gets underway in

October and lasts through April. Timing varies from season to season; however, the peaks of each season generally occur December through February. Be prepared.

Preparation and planning are extremely important. A few great resources to use as barometers of flu activity are: ` FluView: www.cdc.gov/flu/ weekly/index.htm

` FluView Interactive:

www.cdc.gov/flu/weekly/ fluviewinteractive.htm 40

These sites help track weekly flu activity, trends, what types of viruses are circulating, and help track where they are occurring. To better prepare for the season, it is best to start off with how flu spreads. Flu viruses are spread person to person via aerosolized droplets

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when people sneeze or cough. The droplets usually travel up to six feet and come into contact either directly or indirectly with mucosal surfaces (eyes, nose, mouth, etc.). The droplets could be inhaled, land on another person, or a high touched surface. For reference, the

How many times did we have a bottleneck in the supply chain due to a key raw ingredient, packaging issues, geographical challenges, or manpower shortages. • Provide and encourage proper hand hygiene, and supply facemasks/tissues • Encourage respiratory hygiene and cough etiquette. ` Quick access to hand hygiene, hand sanitizer and hand soap throughout facility ` Use of PPE throughout the facility including gloves, masks, face shields, and gowns wherever an employee or patient may come into contact with pathogens or aerosolized droplets ` Frequent use of environmental infection control products on high touch areas throughout the facility

Lessons learned National Institutes of Health did a study that indicated we touch our faces 23 times per hour. Recommendations for healthcare professionals are to implement vaccination programs as well as the use of Universal Precautions to help break the chain of infection. Universal Precautions are considered the foundation of all infection prevention within a healthcare setting. Planning for your customers should include the following: ` Vaccination programs for employees and patients ` Minimize exposure • I f employees are sick, encourage them to stay home • For patients who are known to be ill, provide separate waiting areas and exam rooms from the general population

What did we learn during the pandemic that can help us during every flu season from a supply chain standpoint? Really get to know your suppliers. We are only as good as our supplier’s supplier. How many times did we

have a bottleneck in the supply chain due to a key raw ingredient, packaging issues, geographical challenges, or manpower shortages. The solution around this is to know your suppliers, have cross references, and have contingencies. It may mean that you expand your professional network. We thankfully learned that we all remain in a people/relationship business. If you invest time into understanding your suppliers’ products, programs, and people, it will come back to provide less challenges with our healthcare supply chain, and ultimately better service to our customers and their patients. Pandemics and bad flu seasons also reinforce the value of distribution. Distributors that plan can provide inventory management, better sourcing, quality products, and a consultative sales force to help through challenging times. Wash your hands.

Last flu season Last flu season started early in the United States, with activity increasing nationally at the beginning of October 2022 and peaking in early December 2022, according to the Centers for Disease Control and Prevention. CDC preliminary estimates are that during the 2022-2023 flu season, 31 million people got sick with flu, 14 million people visited a health care provider with flu, 360,000 people were hospitalized with flu, and 21,000 people died due to flu illness or related complications. Additionally, 176 flu related deaths in children were reported to CDC for this season. This is the third largest number of deaths in children reported during a seasonal flu epidemic since reporting began during the 2004-2005 flu season, CDC reported. Like many seasons, adults 65 years and older were hospitalized at the highest rate last season, followed by children younger than 5 years.

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TRENDS

Direct-to-Consumer DTC devices and tests can complement the professional market. Direct-to-consumer medical devices are what the market is demanding today. Educated, motivated, health-

conscious and busy consumers are attracted to almost anything online, including home blood pressure equipment, glucose meters, in vitro tests and diagnostic wearables. But distributors should view the DTC market as complementary to – not opposed to – the professional market in which they operate, according to those with whom Repertoire spoke.

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DTC and the FDA Over-the-counter (OTC) medical devices are those that may be offered for sale directly to the consumer. They do not require a prescription for sale. But they do require oversight. According to the FDA, consumers may have different physical, sensory (vision, hearing, tactile), cognitive, and emotional abilities than healthcare professionals, as well as different literacy levels and ability to process information. These capabilities and others may be relevant considerations in the design of an OTC device. In general, labeling for OTC medical devices should be simple, visible, concise, and easily understood by the lay person, with narratives or pictures where appropriate, says the FDA. Labeling should include contraindications and clear warnings of all hazards. In addition, the labeling should be accessible to users even when the device may become separated from the labeling, perhaps through a website or through calling the manufacturer.

Direct-to-consumer digital health is a growing industry that can address unmet patient needs by directly engaging patients, according to the authors of “Direct-to-consumer digital health,” which appeared in The Lancet Digital Health in 2020. “The direct-to-consumer approach might be particularly helpful for those without consistent access to care because of financial, social, cultural, or geographical barriers.” DTC is attractive to medical technology companies as well, because it offers them a large customer base and few regulatory barriers to entry, they said. “We believe that the availability of DTC medical devices will promote more active participation by patients in their own healthcare,” says Anna Ivashko, manager, sales and marketing lead – life sciences, at Clarkston Consulting. “As a result, patients leveraging DTC medical devices will be more engaged and likely to visit doctors’ offices more frequently, prepared to have more informed discussions. This should

Direct-to-consumer tests for non-medical, general wellness, or low-risk medical purposes are not generally reviewed by the FDA before they are offered. DTC tests for moderate to high-risk medical purposes, however, are reviewed to determine the validity of test claims. When reviewing tests, the FDA assesses:

` Whether a test can accurately and reliably measure what it claims to measure (analytical validity).

` Whether the measurement is predictive of a certain state of health (clinical validity).

` What a company says about its test and how well it works (claims).

The FDA also looks at whether the test offers accurate descriptive information that can be easily understood by a consumer without the involvement of a healthcare provider.

drive the utilization of monitoring devices in the physician’s office rather than reducing current utilization and sales.” Jonathan Overbey, head of corporate alliances and channel management, Sekisui Diagnostics, believes that educated consumers will drive more traffic to the physicians’ office. “As we have seen in the cases of pregnancy testing and

Opportunities for distributors Distributors should consider the short-term and long-term opportunities of interacting with the DTC medical device market, says Ivashko. Short-term opportunities include presenting educational seminars, while long-term opportunities include supporting data-sharing capabilities with physicians in the rise of telemedicine.

‘ Patients leveraging DTC medical devices will be more engaged and likely to visit doctors’ offices more frequently, prepared to have more informed discussions.’ glucose testing, most professionals test again as the patient presents in their practice to confirm their OTC results. In my opinion, the DTC market complements the professional one and, in some cases, drives more efficiencies in testing and patient management.”

“Under controlled conditions, manufacturer sales reps for prescription devices currently sponsor educational seminars for prospective patients of certain medical devices such as insulin pumps and continuous glucose monitors. Offering similar educational seminars to patients

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TRENDS using equivalent DTC devices under the physician’s care can promote disease management in that patient population and will be a value-add to the physician. This would differentiate the distributor as a partner to the professional practice. “The seminars would need to focus on disease state education, for example, why a DTC glucose meter is beneficial to the patient along with routine physician visits to better manage the disease,” she continues. “These offerings may make the professional more likely to purchase equipment from a sales representative who can help with the education of their patients on specific diseases. Any such educational offerings would need to be reviewed for promotional considerations to ensure regulatory standards are not violated as part of ongoing management controls.” Looking long-term, the rise of telemedicine will reduce office visits and therefore the utilization and sales of medical devices to the professional market, says Ivashko. In that case, “distributors may look to expand their portfolio to include equipment that lowers the barriers to informationsharing between patient and physician practice. These type of capabilities (typically considered a SaMD, i.e.,

filters and safeguards of healthcare systems, write the authors of the Lancet article. “The risk is that low value, or even harmful, products will inundate the commercial healthcare market.” Think Theranos, they say. “Even companies with good intentions are challenged to balance the rapid and iterative nature of technological development with the deliberative and cautious nature of medicine. As the direct-to-consumer digitalhealth industry grows, these risks must be carefully assessed.” By ensuring companies explicitly state the product’s purpose and

‘ The DTC market drives more efficiencies in testing and patient management.’ software as medical device) enable seamless sharing of monitoring data between physician and patient to support in-office appointments. Enabling this functionality would hinge on the ability to capture consent from the patient.”

Red flags As attractive as they are to consumers, DTC products bypass the typical

limitations, the US FDA will help to differentiate high-quality products from low-quality products, they add. “Just as nutrition labelling led to a healthy food revolution in the USA, a label of digital health facts could drive consumer demand towards products that are able to support explicit health claims and motivate companies to compete on quality and value.”

High-growth DTC categories It is true that direct-to-consumer medical devices have made it less attractive for physician offices to carry the same devices, says Meghna Eichelberger, partner and associate director and global leader of medtech marketing for Boston Consulting Group. That said, BCG foresees strong growth in a number of DTC areas, including:

` OTC hearing aids. ` Eye care. ` Cardiac monitors / wearables / patch devices. ` Continuous glucose/ketone monitors.

` Imaging screener tools / AI detection. ` Stool collection/gut biome. ` Saliva tests. ` Sleep detection/diagnostics.

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HIDA

HIDA, ASPR Launch Playbook To Monitor Medical Supply Chain HIDA has long advocated for stronger public-

By Linda Rouse O’Neill, Senior Vice President for Supply Chain Policy, HIDA

private partnerships to strengthen the medical supply chain. A recently published Preparedness Playbook, developed in collaboration with the Administration for Strategic Preparedness and Response (ASPR), marks an important development in this process. At the first annual HIDA Preparedness Summit in June 2022, executives from medical product distributors and manufacturers met with federal agency partners and identified an opportunity to better coordinate how and when to ramp up and ramp down production for a more cohesive response in the future. This Preparedness Playbook is a tangible result of those discussions. This Playbook was produced in whole or in part with federal funds from the U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response under a cooperative agreement with HIDA. The Playbook provides insight and guidance for public and private supply chain partners on planning strategies and supports the national preparedness outlines the response framework. It creates a monitoring effort and sets a cadence of regular meetings between federal partners and medical product supply chain leaders. The collaborative process described in this Playbook identifies the key activities of the public-private partnership; the roles of each partner; the triggers for moving to a different phase in the process; a decision-making process to mitigate supply chain disruption, and how to rebalance the supply chain as it returns to normal operations. Criteria developed by public and private stakeholders are included in the Playbook to help federal agencies determine when the supply chain is in one of three conditions – Steady State

(Condition Green), Potential Disruptions (Condition Yellow), or Overwhelmed Supply Chain (Condition Red). Stakeholders would take such conditions into account to coordinate production and distribution decisions during a public health emergency. The Playbook will serve as a resource for federal, state, and local public health and emergency planners as well as commercial market medical product distributors and manufacturers. Additional audiences include healthcare providers, first responders, academia, and other supply chain stakeholders to inform their preparedness planning and response activities. Furthermore, the playbook will serve to inform training and tabletop exercises for public and private sectors. This playbook is a “living” document, is considered to be non-exhaustive and feedback and input from all audiences is always welcome to help inform future iterations of the playbook and add additional appendices. HIDA is pleased to facilitate public-private partnerships such as these. Our organization continues to cultivate relationships with federal agencies and seeks to convene events where public and private stakeholders can exchange ideas and best practices.

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TRENDS

Urgent Care Rollup More urgent care chains have a triple-digit number of locations than ever before The number of urgent care centers continues to rise. According to the Urgent Care Association, there are over

14,000 such centers in the U.S. (not including retail clinics), and the current growth rate for new ones is 7%. Over 78% of the U.S. population lives within a 10-minute drive of an urgent care center. As such, they represent a growing opportunity for distribution. And they’re getting bigger – through consolidation – all the time. 46

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Telemedicine and urgent care Urgent care centers’ usage of telemedicine is growing. In the Urgent Care Association’s 2018 Benchmarking Report, only a small fraction of respondents (2%) stated that they offered telehealth services. Just one year later, the 2019 Benchmarking Report released in January 2020 showed the percentage of healthcare centers providing telemedicine grew to 29%. The pandemic acted as a catalyst for the rapid adoption of telemedicine. In June 2020, 87% of healthcare

Urgent care bridges the gap between primary care and emergency care, providing evaluation and care for urgent, but not emergent, conditions, according to the UCA. This includes treating minor burns, scrapes and cuts, but also treating conditions such as allergic reactions, ear infections and strep throat. Care volume can be seasonal, typically spiking during late fall and winter, during the respiratory season, correlating to the intensity of the flu, COVID-19, RSV and other respiratory illnesses. Most centers stabilize and treat fractures and offer onsite X-ray, laboratory and lab services. Where allowed by state law, many centers

centers were offering telemedicine services. By 2022, 94% were still offering it as a service. Patients have come to expect this service, according to the association. It is offered not because it is profitable, but to meet patient expectations and stay competitive. The dramatic increase clearly demonstrates the transformative impact of the pandemic on the widespread adoption of telemedicine within the healthcare industry, says UCA.

‘ Inside sales is a great asset, but you also need the outside salesforce to provide service locally.’ dispense commonly prescribed prepackaged medications. They do not care for life- or limb-threatening situations but do stabilize patients while securing emergency transport. The majority of urgent care centers employ family practice and emergency medicine trained physicians, as well as licensed healthcare professionals, including physician assistants, nurse practitioners, registered nurses and radiology technicians.

Urgent care growth trends COVID introduced many patients to urgent care for the first time, according to the Urgent Care Association. Pre-COVID, a single center saw 32 patients per day, on average. From 2019 to 2020, centers across the United States saw a 60% increase in per-center patient visits. Post-COVID, patients continue to recognize the importance of urgent care, says UCA. The median number of daily visits to a center was 40 in 2022. In fact, year-over-year urgent care center growth continues, as it has since 2014:

` 2014: 7,220 centers. ` 2015: 7,983 centers. ` 2016: 8,676 centers. ` 2017: 9,553 centers. ` 2018: 10,484 centers.

` 2019: 11,481 centers. ` 2020: 12,392 centers. ` 2021: 13,306 centers. ` 2022: 14,075 centers. ` 2023: 14,382 centers.

Urgent care centers provide laboratory testing both onsite as well as those that can be sent out to regional or national laboratories, says UCA. Examples of available testing may include blood testing services such as Complete Blood Count, Comprehensive Metabolic Profile, diabetic testing (hemoglobin A1c, fingerstick glucose), urine pregnancy, urinalysis, rapid strep throat cultures, and rapid influenza testing. Centers also routinely offer tuberculosis testing; drug screens from urine, hair and saliva; and cultures for STIs and urinary tract infections.

Ownership trends The urgent care industry’s ownership mix is in a constant state of flux, says UCA. These centers emerged largely as a physician or physician group strategy. In 2008, 54% of centers were physicianowned while hospitals represented 25% of the total. By 2014, physician ownership had dropped to 40% and hospital ownership increased to 37% of respondents.

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TRENDS In 2022, ownership by a physician was reported at 27%, while hospital owned/joint venture centers made up 53%. Corporate entity (private equity, insurance companies or majority shareholder ownership) was at 15%. One year later, sole ownership increased to its levels of nearly 15 years ago, at 52%. Hospital owned/JV growth dropped sharply, from 52% in 2022 to 33% in 2023.

of urgent care centers that are part of a larger health system said they intended to use the same electronic health record system as the hospital, she adds.

For distributors Regardless of who owns them, urgent care centers share many of the same concerns, says Sarah Alasya, corporate accounts director for alternate sites,

The ‘megacompanies’ owning urgent care is a relatively new phenomenon.’ Consolidation is growing in urgent care. “The ‘megacompanies’ owning urgent care is a relatively new phenomenon,” says Samantha Wulff, communications director for UCA. “What made it all possible was private equity interest. Scaling up in the industry requires a degree of standardization – everything from clinic layouts to staffing levels, and even where various supplies are stored. But it is a trend, with more urgent care chains having a triple-digit number of locations than ever before.” As far as integration goes, according to a 2019 UCA survey, nearly 60%

Medline. “They all need product in a timely manner and at an acceptable price. They all want to take care of patients. And they want to stay open for business.” Each of those needs represents opportunity for distributors. At Medline, physician office reps are the ones to call on urgent care centers, she says. “They are already trained on the needs of this market. And many urgent care center owners and staff have previously worked in a hospital or ER, so they are comfortable with Medline as a company and with our products.” While inside

sales is a necessity for servicing all healthcare settings, it is critical for urgent care centers that span multiple states. “But while inside sales is a great asset, you also need the outside salesforce to provide service locally.” COVID brought with it a new interest in inventory control among urgent care center owners. “It’s another opportunity for the distributor and center to work together,” says Alasya. “Before the pandemic, many centers didn’t think much about it, but now they’re saying, ‘Can you help us?’ They know it’s in their best interest to control their inventory, but they don’t know where to start. We show them that formularies and inventory management systems will help.” During COVID, patient volume and revenues climbed, she points out. Today, in its aftermath, many centers are looking to add services, including moderately complex lab testing, sexual health testing, IV therapy treatment, occupational health and primary care services. “For the urgent care industry, there is a big opportunity for growth – in branding, marketing and establishing a successful footprint. As a distributor, we have to be a partner in that growth and an extension of their business.”

Urgent care and the primary care doctor Urgent care appears to be a young persons’ game, raising questions about the continuing role of primary care doctors in the health and well-being of Gen Z and Millennials. Use of urgent care centers is much higher among Gen Z and Millennial consumers vs. other generations, with approximately 36% of them reporting having used urgent care services in the past six months, according to the Urgent Care Association. In comparison, only 19% of Boomers and members of the Silent Generation used urgent care during the same period. Meanwhile,

Gen Z and Millennials have visited urgent care centers more frequently, with 56% and 45%, respectively, having visited more than three times in the prior 12 months, compared to only 26% and 22% of Boomers and Silent Gen. “The goal of urgent care is not to replace primary or other specialized care,” says the UCA. “Urgent care centers are a perfect complement to the [patientcentered-medical-home] model, and they support primary care practices as an extension of the patient’s clinical team.”

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COMMERCIAL HEALTHCARE PROVIDERS

Walgreens Seeks Footing in Healthcare Disruptor Race The pharmacy retail giant appointed healthcare leadership veteran Tim Wentworth as CEO in October.

Walgreens invested $5.2 billion and became the majority stake owner in VillageMD in October 2021 as part of a

broader effort to turn its stores into healthcare destinations. Competition between giant pharmacy retailers Walgreens and CVS Health, as well as Amazon, Walmart and Optum, has driven disruption in primary care in the U.S. through increased access, virtual care and value-based care.

In 2022, Walgreens’ VillageMD acquired Summit Health-CityMD for close to $9 billion. Today, there’s 680 VillageMD locations, including 200 clinics co-located with Walgreens, in 26 markets. Roz Brewer, former Walgreens Boots Alliance CEO, told an audience at the HLTH conference in November 2022, “as soon as we were looking at life beyond 50

the COVID-19 vaccination period and getting into this endemic role in our lives, it was important to think about what’s the next growth venture for this company because dispensing of pharmaceuticals is not going to be our long-term growth avenue.” She told the HLTH audience that Walgreens would be very aggressive to set up a healthcare continuum and

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deliver healthcare services through a brand everyone knows. Walgreens operates over 9,000 stores in the U.S. But as the giant pharmacy retailer prepared to move from acute-based care to more long-term care, a change in leadership was announced. The company, its board of directors and Brewer mutually agreed that Brewer would step down as CEO on Aug. 31.

Search for deep healthcare experience Walgreens appointed Tim Wentworth as its new CEO in October. Wentworth was previously CEO of pharmacy benefits manager (PBM) Express Scripts before Cigna acquired it and he served as CEO of Cigna’s health services unit before retiring in 2021. He brings nearly three decades of healthcare leadership experience to Walgreens. Stefano Pessina, Walgreens’ executive chairman, said the board and leadership team focused on a search for someone with deep healthcare experience. Walgreens’ shares were down almost 40% in 2023 before Wentworth was appointed as CEO. Consumers have shifted their habits for purchasing items like toothpaste and shampoo to Walmart and Amazon, and Walgreens also saw a drop in demand for COVID-19 testing and vaccines. In fiscal third-quarter earnings, the giant pharmacy retailer missed Wall Street projections for the first time since July 2020. Lisa Gill, an analyst for J.P. Morgan, said in a note that Wentworth’s strong track record in healthcare services should provide a solid base for understanding much of the nuance that Walgreens is navigating.

Pearl Health partnership strengthens commitment to healthcare To accelerate its expansion of value-based care, Walgreens teamed up with Pearl Health in September to collaborate with community-based primary care physicians. Walgreens provides complementary services, including prescription fulfillment, medication adherence, immunizations, care gap closure and diagnostic testing, and it also works with providers to help patients discharged from the hospital transition to home. “Walgreens is committed to being the partner of choice for providers and health systems looking to transition quickly and effectively to value-based care and improve outcomes in the communities they serve,” said John Driscoll, executive vice president and president, U.S. Healthcare, Walgreens Boots Alliance, in a statement. “Our partnership with Pearl Health allows us to reach more communities faster.”

COMMERCIAL HEALTHCARE PROVIDERS

Primary Care News CHP Oak Street Health opens first primary care center in Kansas Oak Street Health is now welcoming patients at the new Strawberry Hill center at 1200 N 7th St in Kansas City, Kansas. This is the first center for Oak Street Health in Kansas City and in the state. “We are thrilled to open our Strawberry Hill center in Kansas and begin delivering an unmatched patient experience and improving health outcomes for older adults in the community,” said Dr. Michele Mitchell, Executive Medical Director at Oak Street Health. The Oak Street Health integrated model incorporates behavioral healthcare and social determinants support and is easily accessible through a mix of in-center, in-home and telehealth appointments, as well as a 24⁄7 patient support line. The Company has reduced patient hospital admissions by approximately 51% compared to Medicare benchmarks and driven a 42% reduction in 30-day readmission rates and a 51% reduction in emergency department visits.

Marathon Health continues U.S. expansion with launch of new network health center in Michigan Marathon Health, a provider of direct primary care for employers, announced its expansion into Kalamazoo, Michigan, with the opening of its newest Network health center. Kalamazoo is now the eighth U.S. market where Marathon operates its Network model, offering accessible, 52

independent and personalized primary care to employers of all sizes. Marathon Health works with employers to build and operate onsite, Network and virtual health centers. With over 300 health centers in 43 states and over 1.2 million members, the health centers share the same focus: providing high-touch care for employees and their families, while reducing the overall cost of healthcare for both the employee and employer. Kalamazoo County Government is the first organization to partner with the new Marathon Health Network in the city, according to a release. The health center provides over 850 county employees and their families with fast, convenient and free access to primary care, sick care, screenings, blood work, medication management, behavioral health, physical therapy and health coaching, among several other services.

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Sesame announces new partnership with Costco Sesame, a healthcare marketplace that connects thousands of healthcare providers to consumers across the nation, and Costco, a membership warehouse club specializing in merchandise sales, have announced a partnership offering discount pricing to all Costco members on a range of outpatient care offered at Sesame. Costco members nationally receive virtual primary care, health check-ups, virtual mental health therapy, and a discount on all other Sesame services. The partnership is unique and comes at a time when many other retailers are expanding healthcare offerings. Through the Sesame partnership, Costco members will have access to care in a convenient setting and the ability to develop long-term doctor-patient relationships with a Sesame provider.

IDN INSIGHTS

Supply Chain Leader Spotlight Bill Kellar, VP, Strategic Sourcing, HCA

Bill Kellar has been with HCA Healthcare for 14 years and has been Vice President of Strategic Sourcing since July

2022. His role encompasses all spend within HCA, including $14 billion in purchased services and another $7 billion in supply spend. His team represents HCA within HealthTrust for all contracts voted on and ensures contracts are in place for all categories that its GPO does not cover.

Kellar worked for Ardent Health Services in between his two stints with HCA, returning to HCA in 2011 as the Supply Chain CEO for its TriStar division, where he was responsible for all supply chain operations for that division. There’s been so much complexity and chaos in the supply chain in the last few years. How do you tackle strategic sourcing in an era of so much disruption?

It certainly has presented some challenges for us that we took for granted. The question is, when is it going to stop? Everybody would like to know the answer to that, but there’s just so much uncertainty. As a result of these supply disruptions, we’ve looked to source from different suppliers if there’s been a failure to supply or prices have increased beyond a level of tolerance for us. With the size of HCA, that’s not an easy task. Suppliers, oftentimes, want to have contracts with us, but I don’t think they really appreciate the scale of our organization. It’s the dog that finally caught the car concept. Be careful what you ask for. Being the largest healthcare system in the world, we have different

Bill Kellar

With all the pressure on commodities right now, the price increases are more than anybody’s seen who’s been doing this for more than 10 years. We’ve had to look at other categories for savings to offset these increases we’re seeing.

expectations of our suppliers based on our supply chain model and the scope and scale of what we utilize on a daily, weekly, monthly and annual basis. You have to be able to take on that volume. And sometimes that compromises their relationships with their other customers. Sometimes we can’t move the business and to offset price increases we have to look at different ways to manage utilization if there is a limited supply of the product. That requires us to continue partnering with our clinicians or we take on price increases that we normally would not consider, especially if it is a category where they have a significant market share and there’s not a lot of alternatives in the marketplace. These are things we haven’t had to deal with a lot before COVID-19. But what is has done is forced us to understand where products are sourced and manufactured. There was a lot of conversation during COVID-19 about near shoring. In my opinion that’s something that is going to take a long time to accomplish and a strategy that continues to be important to the entire U.S. health system. It’s just going to take a while for that to be a reality. Now that COVID-19 is over, I think the emphasis on that strategy is

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

IDN INSIGHTS getting weaker. We tend to have short memories until it happens again. I think some health systems are going back to old strategies because of the cost pressures, and they are sourcing some products from overseas at a better price point once again. What projects have you been able to implement successfully at your size and scale?

for us in the range of $8 million to $12 million per year. Trauma is another category where we worked with our contract suppliers and generated another $14 million to $20 million in savings opportunities. With drug eluting stents we also renegotiated pricing that resulted in another $7.5 million in savings. We have also renewed our efforts in the purchased services category to identify and realize cost savings. Even though many of our purchased services categories are not necessarily supply cost savings, it still represents cost savings that impacts the bottom line. For example, we expect to see some big savings in managed print

Even in this digital age, we still have a lot of paper documents and medical records. You’d be surprised how much it costs to categorize, or what we call index, and then store those documents based state or federal document retention laws around maintaining those documents for a period of time. purchased services and medical devices. The GPO has some contract coverage in the medical device spend categories, but not necessarily all of them. We have had success in reducing cost in the medical device categories of primary total joints, trauma implants, and drug eluting stents for a few examples. Right out of COVID-19, we did what we call a refresh of our total joint category – hips and knees – and we were able to successfully achieve a price decrease that resulted in savings 54

services. This represents traditional copiers (multifunctional units) and desktop printing. We’ve recently partnered with a supplier that has been able to demonstrate some significant savings between 20% and 50%. Based on our scale, that represents quite a bit of opportunity. Also, production print. I’d say most health systems today have outsourced high production print and we have as well. We use a third party but still keep it within our operation. We recently negotiated an

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agreement on behalf of the entire company that is going to generate savings in the $13 million range by restructuring the agreement and how we manage it. We probably have another 10 to 12 categories we’re still looking at. Take document destruction, for example. Even in this digital age, we still have a lot of paper documents and medical records. You’d be surprised how much it costs to categorize, or what we call index, and then store those documents based state or federal document retention laws around maintaining those documents for a period of time. Document destruction costs money, but so does document storage each month. So, that’s another category that we’re taking a really hard look at. What upcoming projects are you looking forward to working on?

We’re looking at a hip fracture program within the total joint space and we’re still working on a few other categories within the implant space. Total shoulders is a category that’s growing. The technology has dramatically improved and we’re seeing more of these procedures being done. The current cost of a total shoulder is typically two to three times the cost of a total hip or a total knee and they are reimbursed at the same rate. It’s important we take a look at this category if we have the desire to promote service line growth. Then, thoracic fixation is another one. Historically, open heart surgeons would use cabling to bring the sternum back together after they saw through the middle of it. Clinical data suggest that patient outcomes are better and so we’re seeing a trend where surgeons are using more plates and screws versus cabling.

IDN INSIGHTS

Supply Chain Leader Spotlight Shireen Ahmad, Interim Vice President, GPO Business, Financial Insights, and Analytics, CommonSpirit Health® Shireen Ahmad serves as the Interim Vice President of GPO Business, Financial Insights and Analytics at

CommonSpirit Health, a faith-based, nonprofit health system operating in 22 states across the country. She helps the organization devise strategies for bringing as much spend under management to help their operating divisions optimize savings opportunities and capture as much value as possible.

Any recent stories of wins/successful supply chain projects you can share?

We recently onboarded a hospital that had entered a management agreement with our organization. After five years of negative margins, they have seen three months of successive profit after a number of revenue enhancing and cost cutting measures that my team has actively engaged in. Helping turn this hospital around that provides vital healthcare in an underserved area has been extremely fulfilling and I view it as a big win.

What’s the biggest takeaway for you as a supply chain leader over the last few years of marketplace disruptions?

Shireen Ahmad

What about upcoming initiatives you are excited to be working on?

I am most excited about the relaunch of our wholly owned GPO which is focused on filling a gap that we see in the marketplace. Our National GPO covers a large number of items, but doesn’t necessarily cover niche or specialty products. Our wholly owned GPO is bolstered by strong relationships with key vendors in physician preference items and we’ve been able to leverage that successfully on behalf of our members. How do you measure the success of your team and its impact on the organization as a whole?

Each team is given a set of goals and objectives that have either a positive impact or create efficiencies for the department or organization. The measurements and determinants of success often vary from year to year based on what we set out to achieve. Completion of the goals set is not the only expected outcome, we also gauge it through stakeholder satisfaction, whether it is a Division CFO that is able to take away actionable insights from our financial reporting or a member that is able to see a true decrease in their supply expense through their income statements.

You have to be nimble enough to mobilize quickly when a disruption is imminent and have relationships established with key vendors. You have to constantly survey the environment for disruptions and shortages, develop contingency plans quickly and execute on them. We were fortunate to have great relationships with reputable vendors and manufacturers that helped sustain us through the pandemic that helped us avoid many of the challenges felt by other health systems. What are the keys to a successful provider/supplier relationship?

Communicating early and often is key. Disruptions in the marketplace require providers and suppliers to have even stronger relationships. Providers need clearer upstream visibility into the supply chain to be able to anticipate issues as they arise from raw material sourcing to production impacts. And providers also need to communicate shifting needs so that suppliers can anticipate and plan accordingly.

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

TECH TALK

Infection Prevention and Instrument Processing Workflows The importance of having facility-wide standardized systems for instrument processing.

The pandemic highlighted for healthcare organizations that proper preventive measures and safety protocols

are imperative to prevent disease transmission. Healthcare practices are increasingly obtaining accreditation for their facilities to establish a standardized and safe workplace environment. When it comes to compliance, there are several key guidelines and regulations that healthcare industry workers should be aware of.

The Joint Commission provides health facility accreditation based on certain best practice recommendations and health standards, or regulations provided by organizations such as The Food 56

and Drug Administration (FDA), Centers for Disease Control (CDC), The Association of Medical Instrumentation (AAMI, and The Occupational Safety and Health Administration (OSHA).

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When looking to gain accreditation for a healthcare facility, it is important to assess the current state of its infection prevention standards. A broad, holistic approach to infection prevention ensures all bases are

covered and positions instrument processing spaces to have a successful accreditation survey visit. “When combined with diligent self-assessments, accreditation gives organizations confidence to know that they are meeting requirements and regulations. This can give both the organization, and the patient population it serves, confidence in the safety and sterility of reusable instruments,” according to Ben Hill, Marketing Manager, Midmark Corporation.

Holistic approach to infection prevention In both acute and non-acute healthcare centers, infection prevention should be a key focus to keep healthcare workers and patients safe. Increased disease transmission associated with the COVID-19 pandemic reiterated that infection prevention is a crucial priority for healthcare facilities. Healthcare staff have continued to reassess infection prevention methods that were set in place during the pandemic. Now, as the healthcare world moves forward from the pandemic, organizations should consider if more evolved infection prevention tactics are necessary. A comprehensive approach to infection prevention consists of five components: facility design, equipment design, data analytics, instrument processing areas, and access to sterilizers. Patient-centered workflow designs allow physicians to limit patient interaction and manage the process of work, reducing the potential for transmission. “It is vital to implement an efficient, repeatable workflow in healthcare settings. Reducing the burden

on staff and improving turnaround time for instruments should be top of mind. Monitoring (documentation) is a key aspect of the process and can help staff ensure that the proper workflow is being followed every time,” according to Hill. According to Midmark, examples of facility design from a holistic approach perspective include the collaborative care model, which centralizes and consolidates the patient visit as much as possible, the selfrooming model that eliminates the need for a waiting room, and the onstage/off-stage model that provides separate, dedicated corridors for caregivers and patients.

then inspected and wrapped, to maintain sterility. Then, in the sterilization area, there should be space for loading, unloading, and cooling of sterilizers. Finally, there should be an area where sterilization data is recorded and documented. The CDC recommends that for each sterilization cycle, staff should record the type of sterilizer and cycle used, the load identification number, load contents, exposure parameters (such as time and temperature), and the results of mechanical, chemical, and biological monitoring. Storage areas should be covered and contain space for disposable and sterile items.

A comprehensive approach to infection prevention consists of five components: facility design, equipment design, data analytics, instrument processing areas, and access to sterilizers. Five-step compliant workflow There are five critical steps to standardizing instrument processing workflows according to the CDC. The first step includes receiving, cleaning, and decontamination. Reusable instruments should be placed in appropriate containers at the point of use, and then all items should be sorted, cleaned, and decontaminated of both macro and microscopic debris in a dedicated section of the processing area. Second, cleaned items should be rinsed and dried thoroughly, and

Organizing an instrument processing workflow through these steps allows staff to easily reproduce the process and ensure the safety and wellbeing of staff and patients. According to Hill, “The five critical steps, as outlined by the CDC, are best practices. These should be followed in conjunction with guidelines laid out by others such as AAMI and FDA. The five steps are critical because they set the foundation for an efficient and effective instrument processing workflow.”

Editor’s note: Repertoire would like to thank Midmark for its contribution to this article. Learn more about instrument processing

workflow at midmark.com or call a Midmark representative today.

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

HEALTH NEWS

Healthy and Efficient Homes campaign To maintain long-term health, monitoring air quality in indoor spaces is crucial. During the pandemic, disease prevention initiatives such as working-from-home, online school, and quarantine

required long hours to be spent inside at home. Shelter-in-place mandates increased the amount of time people spent in indoor spaces, making it necessary to reconsider the quality of indoor air.

Indoor air quality is defined as the quality of the air within indoor environments such as homes, schools, and offices. According to the American Lung Association (ALA), pollutants such as cleaning products, mold, moisture, and household appliance emissions can cause indoor air pollution levels that are two to five times higher than outdoor concentrations. On average, Americans spend 90 percent of their time indoors, 58

according to the Environmental Protection Agency (EPA). With how much time people spend inside, the health impacts of prolonged exposure to indoor air are important to recognize. To address the health impacts of poor air quality, in 2023, the Lung Association introduced the “Healthy and Efficient Homes Campaign,” which works to make indoor spaces safer by advancing solutions that improve indoor air quality.

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Katherine Pruitt, National Senior Director for the American Lung Association, has worked with a wide range of education and policy perspectives on indoor air quality within the organization for almost 30 years. In her position, she addresses indoor and outdoor air quality and its link to respiratory health. Pruitt is the lead author and editor of the “State of the Air Report,” an annual national report on outdoor air pollution.

“The Lung Association has realized that there is increasing evidence that a key source of indoor air pollution is combustion appliances in the home. After a conducted review of the scientific literature, we now know that pollutants that are released from burning fuel in your home do create conditions that are hazardous to lung health,” according to Pruitt.

The health impact of indoor air pollution Maintaining healthy indoor air quality is crucial to an individual’s overall health. Various factors can impact indoor air quality such as the use of household cleaning products, mold, moisture, and pests, which can all release dangerous pollutants throughout the home. Appliances such as water heaters and stoves also emit compounds such as nitrogen dioxide, benzene, and carbon monoxide that can be extremely harmful to health. Exposure to indoor air pollutants is especially dangerous for children and older adults, because these age groups are at higher risk for respiratory issues such as asthma attacks, respiratory tract infections, lung disease, and other harmful diseases. “There are many types of indoor air pollutants including radon, a naturally occurring radioactive gas that causes lung cancer. The health impacts of each indoor air pollutant vary depending on the source,” said Pruitt. “Health effects include asthma, which is triggered by mold, pests, and allergens, and lung cancer, triggered by exposure to radon. Neurological damage and other potential cancers can also be caused by the volatile organic compounds in cleaning supplies and other products.”

Take action against poor air quality The focus on reduction of indoor air pollution increased during the asthma epidemic in the 90s, according to a National Library of Medicine. Widespread focus on the issue increased again during the COVID19 pandemic, when people started to consider the impact of indoor air quality because of increased time spent indoors.

Lung Association. Make sure that all gas appliances within the home work properly. For households that use wood burning for heat and cooking, air cleaning devices that use HEPA filtration can provide some protection from soot and smoke. “The first thing to do to take action toward better air quality is to be aware of the air in your home. Think about what you are bringing into your home, such as the types of chemicals

Exposure to indoor air pollutants is especially dangerous for children and older adults, because these age groups are at higher risk for respiratory issues such as asthma attacks, respiratory tract infections, lung disease, and other harmful diseases. “Having worked on indoor air quality for many years, we saw a big uptick in interest in the topic early in the 1990s and 2000s as the asthma epidemic was peaking. During the COVID-19 pandemic, people started to think about indoor air quality again because it had us all at home all the time and considering what was circulating in the air we were breathing,” said Pruitt. To protect yourself and your family from the health impacts of indoor air pollution, it is important to take precautions to reduce indoor air pollutants. Actions that can be taken to reduce indoor air contaminants include installing carbon monoxide detectors in the home, avoiding unnecessary wood burning inside, using a vent hood, or opening a window when cooking on a gas stove, and transitioning to healthier and efficient electric appliances, according to the

you are using and what scents and fragrances you’re introducing. Make sure you have a source of fresh air inside the home,” said Pruitt. Federal, state, and local government agencies can also contribute to improving indoor air quality. Air quality legislation can address issues by introducing appliance safety standards, establishing building codes for ventilation, and transitioning to healthy, all-electric construction in new buildings. “It’s important to do what we can to improve ventilation in buildings, which can be accomplished by making sure that our building codes are up to date, and that buildings have appliance safety standards,” said Pruitt. “Indoor air quality is key to maintaining public health, and the Lung Association has a wide range of resources available to help families and the public improve indoor air quality.”

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

HEALTH NEWS

Pancreatic Cancer Awareness The month of November sheds light on pancreatic cancer’s prevalence, and the research underway to combat it.

Pancreatic cancer month, along with World Pancreatic Cancer Day, observed on November 16, brings greater attention to the disease, raises research funds, and aims to support patients while working toward better health outcomes for a disease that was previously under-researched, according to the Hirshberg Foundation for Pancreatic Cancer Research.

November is pancreatic cancer awareness month; a time of empower-

Prevalence and diagnosis

ment, education, and inspiration for the public and for individuals that have been affected by the disease. The month sheds light on pancreatic cancer awareness, management, and research on treatments, aiming overall to better inform the public on the disease. Symptoms of pancreatic cancer often do not present until after the disease has spread to other organs within the body, making it difficult to catch in the early stages when the chance of curing it is greatest, according to the Mayo Clinic.

Pancreatic cancer begins in the cells of the pancreas, a leaf-shaped organ in the body’s abdomen and near the lower part of the stomach. The pancreas functions to make enzymes that aid digestion, regulate blood sugar, and make hormones such as insulin.

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There are two forms of pancreatic cancer, exocrine pancreatic cancer (95% of all cases) and endocrine/ pancreatic neuroendocrine tumors, also referred to as islet cell tumors. Risk factors such as being overweight, having diabetes, chronic pancreatitis, and certain hereditary conditions increase the chance of developing pancreatic cancer, according to the American Association for Cancer Research (AACR). Pancreatic cancer is the third leading cause of cancer death in America, and The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program estimates that 64,050 people will be diagnosed with pancreatic cancer in the U.S in 2023 and that approximately 50,550 deaths will occur. Symptoms of pancreatic cancer may initially be difficult to diagnose, according to the Pancreatic Cancer Action Network. The signs of pancreatic cancer may include pain in the lower abdomen or back, weight loss, jaundice, loss of appetite, nausea, pancreatitis, and recent-onset diabetes. If a patient is experiencing one or more of these symptoms, it is important for the individual to visit a healthcare professional. To diagnose a patient, physicians will perform a physical exam to check for pancreas changes, and possibly order blood, urine, and stool tests. A patient may also undergo an imaging study, such as a CT scan or an MRI, or a biopsy to detect cancer cells and determine if cancer has spread to nearby organs. According to data published in a journal from the AACR, pancreatic cancer is projected to become the leading cause of cancer-related death in the U.S. by 2030, behind lung cancer. It is critical in the prevention of pancreatic cancer for individuals and

communities to be informed on the symptoms of the disease as well as the lifestyle changes that may decrease the risk of developing pancreatic cancer.

Treatment Supportive care for those diagnosed with pancreatic cancer focuses on comfort, quality of life, and patient well-being during and after cancerfighting treatments. Standard treatments include surgery, chemotherapy, and radiation. Disease treatment varies depending on a patient’s health and the progression of the cancer and its size and location.

to identify gaps in the current understanding of pancreatic cancer and to stimulate further disease research. The incidence of pancreatic cancer is rising, and according to the National Library of Medicine, lifestyle habits can be modified to reduce the risk of developing the disease. Individuals can reduce their risk by maintaining a healthy weight, exercising regularly, and avoiding processed or highsugar foods, according to the American Cancer Society. There are many initiatives that currently fund pancreatic cancer research. For example, the Pancreatic

Pancreatic cancer is the third leading cause of cancer death in America, and The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program estimates that 64,050 people will be diagnosed with pancreatic cancer in the U.S in 2023. The U.S. Food and Drug Administration has also approved a targeted therapy drug for pancreatic cancer, and one immunotherapy for a small group of eligible pancreatic cancer patients. However, the treatments have not yet begun to be widely used. World Pancreatic Cancer Day on November 16 and Pancreatic Cancer Month are two ways that people, organizations, and communities can get involved to make a difference toward disease awareness. Both observances shed a light on the disease and encourage the support of disease research. Pancreatic cancer is a “understudied malignancy,” according to a 2018 pancreatic cancer study conducted by the National Library of Medicine. The study was conducted

Cancer Action Network has a research grants program, which includes information about clinical trials that those diagnosed with pancreatic cancer may be able to participate in, as well as early detection initiative studies, data research platforms, a patient registry, and a “Know Your Tumor” precision medicine research program. To make an impact, individuals can donate to organizations such as The Pancreatic Cancer Action Network, participate in a nationwide walk for fundraising, create their own fundraiser, or share their personal journey with cancer to support others. Participants can also share facts about pancreatic cancer on social media and donate to make an impact toward further pancreatic cancer awareness.

www.repertoiremag.com • Repertoire | Celebrating 30 Years • November 2023

HEALTH NEWS

Google Health Tech giant brings technological innovation to an ever-changing industry. Technological advancements are

revolutionizing the way clinicians deliver patient care. Changing patient expectations within the healthcare industry has resulted in nuanced business models and increased technological innovation, exemplified by healthcare entrant companies such as CVS Health, Oak Street Health, Amazon, and Google. Google, a multinational technology company, drives innovation in the world of healthcare through its Google Health sector. Google Health is committed to “helping everyone, everywhere be healthier through products and services that bring meaningful health information,” according to the company’s mission statement. Google has designed technology and products that empower both physicians and the public with access to health information. Google Health also develops technology-based solutions for the industry, such as the use of artificial intelligence technology in healthcare, to assist clinicians in the accurate diagnosis of diseases. Google Health has web resources for consumers, including information on health and fitness motivation, health research participation, access to health information and care, and a wealth of knowledge and information. The company also has resources for clinicians and caregivers that empower them to transform care daily and integrate AI into their practices. For communities, Google Health provides tools for data-driven insights, assists researchers and scientists, and shares critical information. Through 62

the company’s technology, researchers can improve the accuracy of genomic analyses, find assistance with AI-enabled tools, and share research findings to collaboratively advance healthcare.

Google Health’s partnerships Collaboration with established healthcare organizations is key to success for technology companies in the healthcare industry. According to Google Health, working with clinical, public health, and academic organizations as partners integrates the company’s emerging technologies with its technological expertise, transforming the industry. One partnership includes iCAD Inc., a global medical technology company. According to a press release from August of 2023, the partnership between Google Health and iCAD Inc. allows iCAD to integrate Google AI technology into the company’s ProFound Breast Health Suite

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for 2D Mammography. ProFound Detection is a cancer detection solution proven to improve detection for radiologists reading mammography and has been used throughout the U.S. as an independent reader for breast cancer screenings. The iCAD partnership with Google Health aims to enhance and expand the diagnostic technology to millions of women and providers worldwide. According to Google Health, partnerships with Ascension Health, Northwestern Medicine, and Mayo Clinic have also led the way for healthcare industry innovation. Through Ascension Health, a U.S. health system with 2,700 care sites, Google Health is employing technological solutions focused on transforming the clinician experience and improving patient care, according to Google Health. Google Health also collaborates with Northwestern Medicine on clinical research that optimizes and increases the accuracy of early lung cancer and breast cancer screening processes and enables earlier intervention and treatment. Mayo Clinic is also taking advantage of Google Health’s AI and advanced cloud computing to research and equip healthcare providers with the best tools and resources in healthcare.

Health research In addition to its health system partnerships, Google Health collaborates with researchers and international organizations. Google Health entered a multi-year collaboration agreement with the World Health Organization

(WHO) that allows the companies to provide credible health-related information online that helps physicians around the world respond to emerging and future health crises. Examples of health-related information Google Health provides includes alerts to inform individuals about possible disease transmission in their area, YouTube policies debunking medical misinformation, dropdown menu “Knowledge Panels,” and more. Google and the WHO aim to increase access to trustworthy health information online through its online Knowledge Panels, or informative online drop-down menus. With the WHO, Google plans to add health conditions such as COPD, hypertension,

type 2 diabetes, Mpox, Ebola, depressive disorder, malaria, and more diseases to the dropdown menus, in multiple languages, to better inform the public on proper disease management. The collaboration will also accelerate digital care in underresourced communities and connect people to accurate WHO health information by providing funding for Google Search and Ad Grants. Google Health additionally supports research efforts, for example, with the first draft of the human pangenome, announced as a reference in Nature, and Google Health researchers assisted with the studies. The new human pangenome combines assembled genomes from 47 people from diverse ancestries around

the world. Unlike the current human reference genome, which represents data from just one person at each point along the DNA, the pangenome reference includes data from many individuals at each position. This revolutionary finding creates a new resource developed through technological innovation that better represents human genetic diversity, allowing scientists and doctors to more accurately diagnose and treat diseases and develop new therapeutics. Google Health’s partnerships, collaborations, and technological advancements within healthcare represent how new entrants in the industry are introducing groundbreaking innovation into patient care that improves health outcomes.

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NEWS

Industry News Midmark clinical education program nationally recognized for excellence Midmark Corp., a leading medical solutions provider focused on the design of the clinical environment to improve the delivery of care, announced that the Clinical Education Diagnostic Curriculum has earned a 2023 Brandon Hall Group Silver award for excellence. The curriculum is designed to help improve efficiency, comfort and safety when using Midmark equipment in clinical care settings. Midmark’s multi-tiered curriculum addresses the education needs of Midmark clinical educators, patient care staff at clinical facilities, and even patients to further drive positive health outcomes. The curriculum includes e-learning modules, quick reference guides, eBooks, toolkits and other materials covering Midmark diagnostic products. Midmark has evolved its Clinical Education Diagnostic Program to share its expertise and knowledge more easily with customers to help them understand how best to integrate Midmark offerings into their facilities and workflows to ensure a better care experience and improve patient outcomes. The Midmark clinical education team is led by professional clinical educators who specialize in proper device use and workflow efficiency in non-acute facilities.

HIDA welcomes Patrick Jones To HIDA Board of Directors The Health Industry Distributors Association (HIDA) welcomed to its Board of Directors Patrick Jones, President of Fisher Healthcare, a part of Thermo Fisher Scientific. 64

Patrick has more than 25 years of healthcare experience. He joined Fisher Healthcare in January of 2023 and is focused on providing customers with innovative products and automated solutions to make laboratories more efficient so patients can begin their healthcare journey faster. Prior to this role, he was the Vice President and General Manager of

Thermo Fisher’s Nucleic Acid Therapeutics business. Previously, Patrick held progressively responsible general management roles at BD since 2010. His last position was VP/GM focusing on medical devices for the pharmaceutical & biotech segments. He has also held various sales, marketing and operations roles at General Electric, Siemens and Abbott Laboratories.

Avera Health, Owens & Minor to open new Integrated Service Center in 2025

Avera Health, and Owens & Minor, Inc., announced plans for a 330,000 square foot commercial building for supply distribution and other integrated services. The building will be constructed at Foundation Park in north Sioux Falls. Owens & Minor is expanding its presence in the region and will remain Avera’s primary distributor of essential medical/surgical supplies. Owens & Minor will use the new Integrated Service Center as a hub to service Avera and leading health care organizations in the region. Avera’s Integrated Service Center will house numerous Avera services including centralized pharmacy services, supply chain serving as central distribution for medical supplies for Avera hospitals, clinics and long-term care centers, a print shop, biomedical engineering, home medical equipment distribution center, courier operations, and more.

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Experience the value of automated vital signs capture. The Midmark® Digital Vital Signs Device brings automation to the point of care. Simplify vital signs and weight capture using INTERESTED? SCAN HERE.

one screen to capture and import data directly into the patient record from a single, centralized location. The device now comes equipped with an Exergen® TemporalScanner®. Temporal temperature is preferred for its accuracy, speed, hygiene and cost-effectiveness.1

Contact your Midmark Representative to start the conversation or visit: midmark.com/mdvsd

Exergen and TemporalScanner are registered trademarks of Exergen Corporation. 1

https://www.exergen.com/wp-content/uploads/2023/02/Exergen-ClinicalStudies-03222023.pdf

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