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vol.28 no.11 • November 2020

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Flu Season Brings Diagnostic Challenges We Have Solutions!

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vol.28 no.11 • November 2020

The Excellent Patient Experience In medical equipment, physicians seek convenience, patient privacy, infection prevention and confidence.

repertoiremag.com

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Sekisui Diagnostics delivers four point-of-care platforms dealing you a winning hand with flexibility, performance, quality, and value.

OSOM® Ultra Plus Flu A&B Test produces results equivalent to or exceeding the performance of reader devices, without the need for an instrument. Truly hard to beat.

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SEKISUI DIAGNOSTICS IS YOUR PARTNER IN HEALTHCARE / 800-332-1042 / WWW.SEKISUIDIAGNOSTICS.COM © 2020 Sekisui Diagnostics, LLC. All rights reserved. OSOM® and Silaris® are registered trademarks of Sekisui Diagnostics, LLC. Acucy™ and Because every result matters™ are trademarks of Sekisui Diagnostics, LLC. FastPack® is a registered trademark of Qualigen Inc.

NOVEMBER 2020 • VOLUME 28 • ISSUE 11

PUBLISHER’S LETTER Pause and Reflect.............................4

PHYSICIAN OFFICE LAB What We are Learning from COVID-19 The response to the COVID-19 pandemic proves just how creative, resilient, and effective the worldwide healthcare community can be.................... 6

IDN OPPORTUNITIES

The Excellent Patient Experience In medical equipment, physicians seek convenience, patient privacy, infection prevention and confidence.

16

Robert Wiehe

Contracting Executive Profile Robert Wiehe, Senior Vice President, Chief Supply Chain and Logistics Officer, UC Health, Cincinnati, Ohio......12

TRENDS Caring for People with Diabetes Biological information is essential, as it can lead to more precise therapeutic targeting. But incorporating sociological and anthropological principles is just as important.....................................32

What Can Drones Do For You? Drone technology and the healthcare supply chain...........................38

SALES Finishing Well 10 effective strategies for closing the year strong............................42

Trends

Value-Based Care Challenges the ‘Profitability of Sickness’ Will COVID-19 hasten the demise of fee-for-service medicine?

24

repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2020 by Share Moving Media. All rights reserved.

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

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

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NOVEMBER 2020 • VOLUME 28 • ISSUE 11

Rep Corner

Staying the Course For Beth Majure, her customers have always been her priority.

50

SMART SELLING Leveraging Technology with a Personal Touch Take your sales meeting to the next level......................................52

Healthy Reps

Health news and notes

46

Quick Bytes

Technology news

54

NEWS AMA releases the 2021 Current Procedural Terminology (CPT) code set..... 58 Industry news................................... 59 2

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Windshield Time

Automotive-related news

56

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PUBLISHER’S LETTER

Pause and Reflect As most of you know, the July and November Publisher’s Letters are my favorites. July

because I am so proud and thankful for America. We are all truly blessed to live here and raise our families in this country. November because it always gives us a time to reflect on the things that are important and that we need to be thankful for.

More than likely everyone reading this has said this year, “I’m ready for 2020 to be over.” I say it at least once a week. Given the year we’ve had, it may be difficult to think about the things that we should be thankful for and remember. Here are a few of mine: 1. I am thankful for the health of my family.

Scott Adams

2. I am thankful that I was able to shelter in place for a few months with my youngest son Nicolas. As much of a pain as it was being stuck at home, those few months with him will be with me forever.

3. I am thankful our business has survived the most difficult year in its 27 years of existence, and we are starting to thrive again thanks to you!

4. I am so very thankful for how our industry has come together and been a shining star in providing the

medical products our caregivers need.

As a someone sitting on the outside looking in and reporting on the industry, you’re all heroes and should be proud of what you do for a living.

5. I am thankful this crazy election is almost OVER! 6. And yes, I am thankful 2020 is coming to a close, and the “BLACKJACK” year 2021 is near.

Currently we are in our selling season here at Repertoire due to suppliers on the calendar year being in budget season. I am happy to report 2021 contracts are almost all up over 2020. and we have several new clients coming on board. I share this news with you to simply say we believe next year is going to be an amazing year full of hope.

Happy Thanksgiving Month, R. Scott Adams

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

editorial staff editor

Mark Thill

acochran@sharemovingmedia.com (800) 536.5312 x5279

mthill@sharemovingmedia.com managing editor

vice president of sales

Graham Garrison

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Katie Educate

editor-in-chief, Dail-eNews

keducate@sharemovingmedia.com (800) 536.5312 x5271

Alan Cherry

acherry@sharemovingmedia.com art director

publisher

Scott Adams

Brent Cashman

sadams@sharemovingmedia.com (800) 536.5312 x5256

circulation

founder

bcashman@sharemovingmedia.com

Laura Gantert

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sales executive

Amy Cochran

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Brian Taylor

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Subscriptions

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2020 editorial board Richard Bigham: IMCO Eddie Dienes: McKesson Medical-Surgical Joan Eliasek: McKesson Medical-Surgical Ty Ford: Henry Schein Doug Harper: NDC Homecare Mark Kline: NDC Bob Ortiz: Medline Keith Boivin: IMCO Home Care

Ethicon Wound Closure products

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Together, we will meet your customers’ needs by delivering best-in-class products with the expertise to match.

Reach out to your MTMC partner or Ethicon Inside Sales for more information.

Ethicon Inside Sales email: EthiconInsideSales@its.jnj.com Phone: 888-534-9413

+ Winning Together

©2020 Ethicon US, LLC. All rights reserved.

PHYSICIAN OFFICE LAB

What We are Learning from COVID-19 The response to the COVID-19 pandemic proves just how creative, resilient, and effective the worldwide healthcare community can be.

The current COVID-19 pandemic has shaped current events, the global economy, the medical-

By Jim Poggi

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surgical supply chain, social practices, and lab testing in ways we could scarcely imagine before it occurred. It has been over 100 years since the tragic flu pandemic of 1918, and COVID-19 is the most dramatic and far-reaching public health crisis in recent history. While it has challenged us individually and as a society in many ways, it has also created remarkable opportunities for learning. In this article I plan to explore things we are learning for the first time, and learnings being reinforced by COVID-19.

It is a formidable list! www.repertoiremag.com

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PHYSICIAN OFFICE LAB Our vocabulary is expanding along with our testing and treatment options Emergency Use Authorization, social distancing, contact tracing, antibody testing, and pandemic are all words we have had some familiarity with over the years. But, this is the first time that I can remember using them all on a daily basis.

What’s the scoop on EUA approvals as of mid September?

Emergency Use Authorization (EUA) has been the gateway for a flood of COVID-19 test products in particular. It is used instead of the more rigorous 510(k) clearance process more typical in the lab business to speed availability of testing products. As of mid-September,

are learning that each sample type has different uses and characteristics. It is becoming clear that stool samples show SARS CoV-2 antigen longer than blood or saliva, which could indicate that clearance of the virus from the gastrointestinal system is the final hurdle to systemic clearance of the virus.

Debate on whether RT-PCR is too sensitive for detection of SARS CoV-2 is ongoing One of the fundamental benefits of RT-PCR has always been the fact that it can take a very low titer of the nucleic acid of interest and amplify it to make it detectible. But, there is a school of thought that it is too sensitive when used as a proxy for whether a patient is still infectious to others. Some scientists suggest reporting the number of thermocycles required to detect the virus as a means to understand the viral load. Others suggest that the variability of methods and lack of specific standardization of RTPCR methods makes this impractical. My personal view is that there is a clear need for sensitivity for differential diagnosis of SARS CoV-2 from other infectious agents, especially as we approach the height of the typical respiratory infection season. It remains to be seen whether there will be a uniform way to use RT-PCR cycle counts as a proxy for infectivity. I don’t believe it is practical this season.

There is a wealth of test kits available. This is not only due to the use of EUA, but also due to powerful R&D organizations galvanizing their resources to provide needed assays rapidly.

In the process, we have also seen new types of assays and new indications for use emerge. over 200 test kit products have received EUA approval.

This includes 163 molecular diagnostic assays, 46 antibody test methods, 4 antigen detection assays and one kit specific for patient management, an assay for IL-6, which is elevated in patients who will likely suffer serious complications from COVID-19 and experience the “cytokine storm” most often associated with sepsis. Just knowing that the cytokine storm is a serious complication of a COVID19 infection is an important learning from the pandemic.

Ultimately, it will help lead to more effective diagnosis and treatment modalities for COVID-19 and sepsis.

In addition to the number of EUA approvals, it is interesting to note the remarkable range of assay formats and sample types represented for diagnosis. RT-PCR, ELISA and lateral flow assay formats all have a place in the portfolio. Sample types include venous and capillary blood, saliva and more recently stool samples. We 8

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Proficiency Testing for COVID-19 assays is here PT and QC have been two of the most important tools to understand relative method performance and individual lab and technologist performance. No where could this be more important than for assays for critical disease pandemics, especially when EUA has lessened the burden of performance data needed to enter the market. My research indicates a wealth of PT methods are available from the usual commercial sources and the College of American Pathologists. RT-PCR methods are well represented and antibody methods are becoming available quickly as well. It is also worth noting that Health and Human Services requires labs conducting COVID-19 tests to report results, irrespective of their CLIA license.

HHS released specific guidance to laboratories specifying the needed data and reporting requirement in June, 2020.

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The supplier community and distributors have proven time and time again that they have the agility, creativity, and supply chain connections to do the amazing on short notice.

We can break the speed limit to respond to a pandemic The supplier community and distributors have proven time and time again that they have the agility, creativity, and supply chain connections to do the amazing on short notice. COVID-19 has shone a light on just how remarkable these efforts can be and also has demonstrated some needs for improvement in manufacturing diversity, raw material, and logistical planning.

The ability for the supply chain to deal with the extraordinary demand for PPE products, in particular, has been outstanding. While some items like gloves remain in short supply, masks, face shields and gowns have all recovered nicely from the initial shock of demand. Legacy suppliers have stepped up, new sources of supply have emerged and some companies have shifted focus from their core product portfolio to begin manufacturing and distributing needed PPE supplies.

As noted earlier, there is a wealth of test kits available. This is not only due to the use of EUA, but also due to powerful R&D organizations galvanizing their resources to provide needed assays rapidly. In the process, 10

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we have also seen new types of assays and new indications for use emerge.

Progress has been impressive and dramatic. On the therapeutic side of things, I must admit I was skeptical of whether Operation Warp Speed was a buzz phrase or whether it could truly produce vaccines and antibody treatments at record speed, due to the need to demonstrate safety and efficacy. There are currently more than 150 COVID-19 vaccines in development, and a large number of other therapeutic agents including antibody therapeutics. It may to too early to predict precisely when the first vaccines will be available, but it is clear that the speed of vaccine development and deployment against COVID-19 will be a record pace.

It is true that adversity leads to opportunity and the worldwide response to the COVID-19 pandemic proves just how creative, resilient, and effective the worldwide healthcare community can be when challenged. What we learn from COVID-19 will benefit us in countless ways from supply chain improvements, new assay development, and advances in how to treat infectious diseases and prevent complications. We live in remarkable times.

A C LO S E R LO O K AT A FI N I O N™ 2 A N A LY Z E R The Afinion™ 2 Analyzer enables fast and easy quantitative determinations of hemoglobin A1c (HbA1c) and albumin-creatinine ratio (ACR). With its compact size and short test times, the Afinion™ 2 System is ideal for any of your customers that are managing patients with diabetes.

FACTORY CALIBRATED Each Afinion 2 Analyzer is carefully calibrated during manufacturing and a self-check is automatically performed when the instrument is turned on.

No calibration check devices or cumbersome and costly operator calibration is required.

GUIDED TEST PROCEDURE The analyzer’s simple, 3-step procedure includes a touch display with icons and short messages that guide the operator.

NO MAINTENANCE The analyzer has no parts requiring periodic replacement.

Recent studies comparing the Afinion™ HbA1c assay to routine and reference laboratory methods have consistently shown a bias close to zero and a coefficient of variation (CV) below 2% (NGSP units).1-5 Test results can be printed or transferred to electronic medical records.

1. Nathan DM, Griffin A, Perez FM, et al. Accuracy of a Point-of-Care Hemoglobin A1c Assay. J Diabetes Sci Technol. 2019;13(6):1149-1153. https://journals.sagepub.com/doi/abs/10.1177/1932296819836101.

2. Arnold WD, Kupfer K, Little RR, et al. Accuracy and Precision of a Point-of-Care HbA1c Test. J Diabetes Sci Technol. March 10, 2019. https://journals.sagepub.com/doi/pdf/10.1177/1932296819831292.

3. Arnold WD, Kupfer K, Swensen MH, et al. Fingerstick Precision and Total Error of a Point-of-Care HbA1c Test. J Diabetes Sci Technol. March 6, 2019. https://journals.sagepub.com/doi/ pdf/10.1177/1932296819831273.

4. Lenters-Westra E, English E. Evaluation of Four HbA1c Point-of-Care Devices Using International Quality Targets: Are They Fit for the Purpose? J Diabetes Sci Technol. 2018;12(4):762-770. https://journals.sagepub.com/doi/pdf/10.1177/1932296818785612.

5. Sobolesky PM, Smith BE, Saenger AK, et al. Multicenter assessment of a hemoglobin A1c point-of-care device for diagnosis of diabetes mellitus. Clin Biochem. 2018;61(4):18-22. https://www.sciencedirect.com/journal/clinical-biochemistry/vol/61/suppl/C. © 2020 Abbott. All rights reserved. All trademarks referenced are trademarks of either the Abbott group of companies or their respective owners. Any photos displayed are for illustrative purposes only.

10005910-01 08/20

IDN OPPORTUNITIES

Contracting Executive Profile Robert Wiehe, Senior Vice President, Chief Supply Chain and Logistics Officer, UC Health, Cincinnati, Ohio Born in Cincinnati, Ohio, Robert Wiehe received his undergraduate degree in manufacturing engineering from

Miami University in Oxford, Ohio, and his master’s in business administration from The University of Cincinnati.

Gamble and Wal-Mart. He has served on national boards of directors in the industry, and currently serves as an adjunct professor at Miami University where he teaches operations and supply chain management.

At UC Health, Wiehe is the senior vice president, chief supply chain and logistics officer working as an integral leader in the operations team. Since assuming the role in June 2015, his responsibilities have expanded beyond Supply Chain to include managing Sterile Processing, Clinical Engineering and the Project Management Office.

Recently, he has been assigned as the operations and logistics lead on a Perioperative Leadership Team tasked with improving Operating Room utilization and expanding capacity across the health system.

About UC Health:

Robert Wiehe

He began his career in the automotive industry as a project engineer and advanced through various leadership positions in the consumer goods industry, primarily focused on operations management and supply chain. He is certified in change management and is a six sigma lean black belt.

Over the course of his career, Wiehe has managed global supply chains and numerous manufacturing facilities, serving as a supplier to companies such as Procter & 12

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UC Health is an integrated academic health system serving the Greater Cincinnati and northern Kentucky region. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching – a combination that provides patients with options for even the most complex situations.

Members of UC Health include: University of Cincinnati Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians (includes nearly 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute; UC Cancer Institute; and UC Heart, Lung & Vascular Institute.

Many UC Health locations have received national recognition for outstanding quality and patient satisfaction.

With more than 12,000 employees, it is one of the largest employers in Greater Cincinnati. And during the 2019 fiscal year, UC Health had 2 million visits and admissions from patients from all 50 states. UC Medical Center

IDN OPPORTUNITIES is also the region’s only level I trauma center for adults, and saw more than 121,000 Emergency Department & Trauma visits last year. Learn more at uchealth.com.

Repertoire: What is the most challenging/rewarding project you have worked on in the last 12-18 months?

Robert Wiehe: I would have to say that my current role on the Perioperative Leadership Team has been the most challenging project I have encountered in my five-plus years in healthcare. The role has dictated that I immerse myself with the perioperative team and quickly learn from the subject matter experts the issues that we are facing as a system.

It has been rewarding in the sense that I have been able to learn from front-line staff, leverage the strong relationships that I have with our clinical chairs/physician group and bring a different skill set to the team to help lead improvement efforts in both efficiency and quality.

In many ways, we are using similar methodologies to what we use in Supply Chain by applying data and lean principles to develop interventions and solutions to problems. While the work is still underway, we have already started to improve utilization and expand OR capacity to help UC Health live into its purpose to advance healing and reduce suffering.

Repertoire: What project or initiative are you looking forward to working on?

Wiehe: Over the past two years, Supply Chain has worked hard to align with our physician partners and become “physician led and supply chain supported.” The integration between supply chain and our physician partners is one of the most important projects that we continue to evolve and grow. It is important that our front-line clinical staff views supply chain as a strategic partner who shares a common vision that focuses on our patients.

At the core of this project is lean principals, clinical informatics and relationships. We have invested heavily in the necessary resources to provide and use data to drive better decisions and focus on clinical quality and safety. Through transparency of data and inclusion in strategy development, we have built a strong foundation for the future.

We have had strong support from both the Chief Medical Officer and Chief Operating Officer; and continue to build trust and develop physician champions through our various initiatives. I am truly excited to see our collaboration and partnerships continue to grow and to see the benefits to our system and patients.

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Repertoire: How are you better at practicing your profession than you were 5-10 years ago?

Wiehe: In addition to continual self-development and pushing myself to take on new challenges, I have a deeper understanding today of how diversity and inclusion can drive better results. As I have grown older, I have become more aware of the importance of deeply understanding and listening to various perspectives and how this can effectively drive performance improvement regardless of the project.

I also have a better understanding today of the importance of analyzing a situation and being flexible on what approach I may take. I am more comfortable today with being either a leader or sometimes a teammate based on what the situation dictates.

We have had strong support from both the Chief Medical Officer and Chief Operating Officer; and continue to build trust and develop physician champions through our various initiatives.

Repertoire: What lesson or lessons do you think supply chain leaders will take from the COVID-19 pandemic?

Wiehe: I think there are several takeaways that Supply Chain leaders will learn from this pandemic: 1. Collaboration and communication with clinicians are critical to Supply Chain operations 2. A deep understanding of clinical usage and patient population is necessary to improve demand planning 3. Strategic partner communication about upstream supply risks is vital 4. Community collaboration and coordination needs to be a part of the new normal I’m proud to work for UC Health because as the region’s academic health system, we are a source of hope for all people, regardless of how complex the health challenge – especially during the COVID-19 pandemic.

The Excellent Patient Experience In medical equipment, physicians seek convenience, patient privacy, infection prevention and confidence.

At the height of COVID-19, physicians might have had more immediate concerns on their minds than exploring

new equipment options. Since then, patient volumes and revenues have risen, and some of the urgency has been lifted.

Still, Repertoire readers who sell medical equipment will have to ask – and answer – some tough questions in the months ahead. Will their physician customers hesitate to explore new equipment opportunities? How will trends that predated the pandemic – such as competition from urgent care and retail clinics – affect equipment decisions?

How can suppliers help their physician customers create an excellent patient experience?

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“As recovery continues, the current disruption in workflows and how caregivers engage patients has significantly challenged traditional clinic environments, including the people, processes and equipment in them,” says Brian Vierra, director of sales, Medical Division, Midmark Corp. As virtual care, infection prevention and efficient care are increasingly top of mind, new equipment and technology will have to be adapted to the next normal of healthcare delivery.

THE SOLUTION IS IN SIGHT Up to 24,000 Americans will go blind from diabetic retinopathy each year.1 But the solution is in sight.

With early detection, 95% of vision loss due to diabetic retinopathy can be prevented.2 On World Diabetes Day, join Hillrom in our mission to help the millions of people living with diabetes and make sure your customers are doing all they can to save their patients’ sight.

Visit retinavue.com to learn how the Welch Allyn® RetinaVue® care delivery model can help primary care organizations offer simple and affordable teleretinal exams to their patients during routine primary care visits.

Centers for Disease Control and Prevention. Vision Health Initiative (VHI) 2017. https://www.cdc.gov/ visionhealth/projects/economic_studies.htm. Accessed January 31, 2018

1

National Eye Institute. Diabetic Retinopathy. https://nei.nih.gov/health/diabetic/retinopathy.

Accessed March 9, 2017.

2

© 2020 Welch Allyn, Inc. ALL RIGHTS RESERVED. APR140406 Rev 1 01-OCT-2020 ENG-US

The Excellent Patient Experience ‘Meaningful connections’ Physicians in Texas – as elsewhere – have little appetite for new equipment at the moment, Yvonne Mounkhoune, quality consultant to TMA PracticeEdge, told Repertoire in September. “Many practices are hanging on by a thread due to the significant loss in revenue.” (Created by the Texas Medical Association, TMA PracticeEdge creates and supports physician-owned accountable care organizations.)

The few independent physicians who are opening practices are taking advantage of the liquidation of equipment occurring with the closing of others, she added.

Equipment-buying may pick up post-pandemic, but slowly, “and it will likely be dependent on unemployment and the economic recovery.”

post-COVID, concerns about infection prevention and patient privacy may cause some practices to place scales and other equipment in exam rooms. That will put the onus on manufacturers to offer equipment that improves workflow and is also economical.

Helping physicians ‘outserve’ the competition

“‘Pandemic preparedness’ will no longer be something that smart planners can ignore or place in the ‘highly unlikely’ category,” predicts Mike Abney, senior vice president, North American sales and distribution, Quidel Corp. Physicians want to be ready to test consistently in order to keep their practices open, and they want enough equipment to accommodate new customers from practices that were forced to close. “ As recovery continues, the current What won’t change for physician practices is competition from drugdisruption in workflows and how store chains, retail chains, urgent caregivers engage patients has care centers and others, says Abney. significantly challenged traditional clinic Given that these competing models aim to offer faster and more conenvironments, including the people, venient transactions with patients, processes and equipment in them.” physician practices will need to dif— Brian Vierra, director of sales, Medical Division, Midmark Corp ferentiate themselves by offering two distinct types of services: 1) quick, in-and-out, less-than 30-minute visAs fall settled in, many physician members of Provista its, and 2) longer and more consultative visits, which drug– a GPO primarily for non-acute-care facilities – were stores and retail groups cannot match, he says. This will reluctant to invest in new equipment without understandrequire smart equipment investments by physicians so ing what the new normal looks like, said Kathryn French, they can continue to “outservice” their competitors. associate vice president for marketing. “Equipment that Convenient care will win can help with cleaning or social distancing, or other patient Because of COVID-19, physicians are focusing on and caregiver safety equipment, will be desirable.” improving patient flow, eliminating waiting rooms, miniPatient comfort and confidence mizing contact between patients, incorporating virtual In the coming months, distributor reps will need to help visits, building capabilities for contact tracing, and prophysicians re-examine how they use equipment, says Ken viding spaces more conducive to infection prevention, Harris, executive vice president of sales and marketing says Vierra. for Health o meter® Professional Scales/Pelstar, LLC. “In the end, convenient quality care is likely to win,” “Patients want to know they are safe, and that the prohe says. To compete effectively against new competitors, fessionals in the office are paying attention to their wellphysician practices will need to drive increased effibeing. They will notice things in the practice are different ciency and standardization in their clinical processes than they were before COVID-19, especially in terms of and environments. “This will certainly shape their how they share common spaces.” equipment decisions, as new technology, equipment For example, prior to COVID-19, practices were and connected workflows will be essential in enabling likely to weigh patients on a scale in a common area. But those goals.”

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Mobile Adjustable Height Lead Acrylic Window Barrier With the same great protection you get from a Wolf barrier, this model features the ability to position the clear lead at any level between 45.25” and 74” for the ultimate in patient and operational visibility.

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The Excellent Patient Experience A better patient experience Clinics will require space, equipment and technologies to accommodate patients’ demands for easy, accessible and safe (e.g., virtual) care, said Provista’s Kathryn French.

“During the pandemic many virtual interactions were ‘clunky’ given the speed of adoption. Permanent, high quality and reliable virtual solutions will soon become a high priority.”

“Excellent patient experiences will drive many consumer decisions, and I think physicians will continue to create better experiences than they already have,” says Ken Harris. “They will look for equipment that is easy to use, safe, accurate and affordable. Cost, reliability and local support will continue to be important.”

“ The winners of the future will match the needs of their physician practice customers with the best platforms to meet those needs, have their customer base ready to help the country get back to normal, and be prepared for any future pandemic event.”

— Mike Abney, senior vice president, North American sales and distribution, Quidel Corp.

ask them questions such as, “What is your vision of the future?” “What problems do you want to solve?” “How do you want to care for your patients?” “What is your desired workflow?” “What have you learned through the COVID experience?”

“Through unprecedented situations, such as the pandemic, our approach as an organization has been to position ourselves as solution providers,” says Sweeney.

“Working together, manufacturers and their distributor partners will have to learn how to present solutions to meet the needs of their customers.”

Says Mike Abney, “The 2020 pandemic and the urgency surrounding diagnostic testing has forced advancement of new and existing diagnostic platforms.

Our distribution partners need to study and be educated on all new tests and platforms at a greater rate than ever.

“The winners of the future will match the needs of their physician practice customers with the best platforms to meet those needs, have their customer base ready to help the country get back to normal, and be prepared for any future pandemic event.”

Takeaways ʯ The current disruption in workflows and how caregivers engage patients has significantly challenged traditional clinic environments.

ʯ Patients want to know they are safe, and that Distributor reps should make an effort to talk regularly with physician customers about equipment, he adds.

Working with the manufacturer’s local experts on salesand service-related issues will extend distributors’ reach.

“Successful reps rely on their network of support.”

Says Bill Sweeney, vice president of sales for primary care, Hillrom/Welch Allyn, “Consumers are looking for immediate access to healthcare, so the competition [from retail clinics, etc.] will continue. Physician practices will have to market or promote themselves. Just like any business, they can do so more effectively with updated equipment.”

Meanwhile, consolidation of physician practices – whether it be within healthcare systems or as larger physician groups – will continue, he says. Distributors will have to engage in conversations with physicians and 20

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the professionals in the office are paying attention to their well-being.

ʯ Pandemic preparedness will no longer be

something that smart planners can ignore or place in the ‘highly unlikely’ category.

ʯ In the end, convenient quality care is likely to win.

ʯ Physician practices will have to market or

promote themselves. Just like any business, they can do so more effectively with updated equipment.

ʯ Permanent, high quality and reliable virtual solutions will soon become a high priority.

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Value-Based Care Challenges the ‘Profitability of Sickness’ Will COVID-19 hasten the demise of fee-for-service medicine?

Repertoire readers know that COVID-19 has hurt their

physician practice customers. And the stats bear them out.

Practice revenues dropped 50% between March and May of this year, according to the American Medical Association.

Health Affairs reported on a study estimating that over the course of calendar year 2020, primary care practices could 24

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be expected to lose $67,774 in gross revenue per full-timeequivalent physician. And McKinsey’s Physician Survey, conducted in May, showed that 46% of respondents were concerned about their practices making it through the pandemic crisis and 43% expected to have fewer than 28 days cash on hand – an 85% increase since pre-COVID-19.

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TRENDS If there is a silver lining, it may be that the crisis has accelerated the push to drop fee-for-service medicine.

“It has underscored that doctors don’t get paid at all when they can’t see patients and bill piecemeal for care,” reported Kaiser Health News.

“The pandemic has exposed the flaws of our traditional, volume-based fee-for-service method, as patients cancelled or postponed visits,” a spokesperson for BlueCross BlueShield of North Carolina told Repertoire.

A survey of North Carolina primary care physicians in May showed that almost one in 10 were considering shutting their doors permanently.

‘ Fee-for-service was pretty good for 1890.

But it is woefully inadequate for 2021.’

Based on outcomes Value-based healthcare is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes instead of the amount of healthcare services delivered, according to a January 2017 report in NEJM Catalyst Innovations in Care Delivery. It rewards physicians for “helping patients

improve their health, reduce the effects and incidence of chronic disease, and live healthier lives in an evidencebased way. The ‘value’ in value-based healthcare is derived from measuring health outcomes against the cost of delivering the outcomes.”

Ideally, value-based care allows 1) patients to spend less money to achieve better health, 2) providers to achieve greater efficiencies and patient satisfaction, and 3) payers to control costs and reduce risk.

“In a word, it’s better care,” says Don Crane, president and CEO of America’s Physician Groups,

Proponents of value-based care say: ʯ The pandemic exposed the

flaws of our traditional, volumebased fee-for-service method, as patients cancelled or postponed visits.

ʯ Value-based care allows 1)

patients to spend less money to achieve better health, 2) providers to achieve greater efficiencies and patient satisfaction, and 3) payers to control costs and reduce risk.

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ʯ Chronic illness is a disease

burden best addressed through value-based care, in which physician groups take responsibility for the health of broad populations, conduct plenty of community outreach, and place heavy emphasis on prevention.

ʯ The ‘value’ in value-based health-

care is derived from measuring health outcomes against the cost of delivering the outcomes.

ʯ Primary care physicians paid

under global capitation – which pays a set amount per month per patient – achieve key quality metrics at higher rates than physicians paid under fee-for-service.

ʯ Providers are able to focus on

more proactive forms of preventive care with less administrative burden with all patients.

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TRENDS a national professional organization of 350 physician groups, all of whom are committed to valuebased care. “Today, 90% of the U.S. healthcare spend is on people with chronic and mental health conditions, and more than 80% of Medicare FFS spending is on the costliest 25% of Medicare beneficiaries, many of whom have multiple chronic conditions. It is a disease burden best addressed through value-based care, in which physician groups take responsibility for the health of broad populations, conduct plenty of community outreach, and place heavy emphasis on prevention.

“Fee-for-service was pretty good for 1890. But it is woefully inadequate for 2021.”

For years, the federal government and private payers have been nudging the industry toward value-based care. For example, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) instituted the Quality Payment Program, or QPP, and two payment options: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Private payers are increasingly attracted to the concept as well. In January 2019, BlueCross and Blue Shield of North Carolina (Blue Cross NC) launched

Physician practices ready to step away from fee-for-service and toward value-based care need three things above all, says Don Crane, president and CEO of America’s Physician Groups, a national professional organization of 350 physician groups, all of whom are committed to value-based care:

ʯ Leadership and commitment.

Practices making the transition to value-based care may need to develop new infrastructure and competencies, including analytics, better patient communications, and patient registries. “It takes leadership to say, ‘Let’s do this,’” says Crane.

ʯ An electronic medical records system. “EMRs drive some

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doctors crazy, while others love them. But from an administrative standpoint, they are absolutely necessary in order to aggregate data” and avoid unnecessary or improper tests or procedures.

ʯ A team. “Keeping people out of

the hospital, where costs are high and safety sometimes compromised, is key to value-based programs,” says Crane. “But you

need the personnel to do so.”

That includes hospitalists, to help avoid unnecessary admissions and facilitate timely discharges from the hospital; care managers, to keep care plans on course; and physician assistants and others to focus on the knotty problems of managing chronic disease. “It’s not rocket science,” says Crane. “You want the whole team working at the top of their capabilities.”

TRENDS Blue Premier, a value-based care program that holds Blue Cross NC and providers jointly accountable for meeting quality and cost measures, says a Blue Cross NC spokesperson. Eight of the state’s largest health systems, plus more than 200 independent primary care practices, are in Blue Premier.

In August 2020, UnitedHealth Group released a report showing that primary care physicians paid under global capitation – which pays a set amount per month per patient – achieve key quality metrics at higher rates than physicians paid under fee-for-service. The study showed that patients treated under global capitation: ʯ Were screened at higher rates for breast cancer (80% versus 74%) and colorectal cancer (82% versus 74%). ʯ Demonstrated higher controlled blood sugar levels (89% versus 80%) and were given more eye exams (84% versus 74%). ʯ Received higher rates of functional status assessment (96% versus 86%) and medication review (97% versus 92%).

Still, progress toward value-based care has been uneven. In 2018, 87% percent of physicians reported that their practice received payment through fee-for-service, making it by far the most commonly reported payment method, according to the American Medical Association.

That said, 63% reported payment through at least one of the four APMs of MACRA.

The COVID factor The question is, what impact will COVID-19 have on the evolution of fee-for-service to value-based care?

“Patients have been fearful of visiting their doctor, and the waiting rooms of many practices are empty,” says Crane. “But because our groups are prospectively paid, they continued to receive payment for doing the kind of things they do, such as conducting outreach, mining data to uncover those who might be vulnerable to the virus, and providing counseling when necessary – all while continuing to care for non-COVID patients, who still struggle with chronic conditions such as hypertension, diabetes or COPD.” In response to COVID-19, Blue Cross NC created its Accelerate to Value Program for Independent Primary Care to provide financial stability to primary care practices during COVID-19 and to serve as a pathway towards participation in a primary-care-provider capitation program starting in 2022. PCP capitation is a fixed 30

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payment for a set of core primary care services including office visits (E/M codes), wellness visits (preventive care codes) consults and physical exams.

In August 2020, following more than a year of collaboration and planning, Allina Health and Blue Cross and Blue Shield of Minnesota announced a six-year, value-based payment agreement. Allina Health performs more than 6 million patient visits per year, while approximately one in three residents in the state have coverage through Blue Cross. “We’ve lived in a volumebased healthcare world where the profitability of sickness is greater than the profitability of wellness,” Dr. Craig Samitt, president and chief executive officer at Blue Cross and Blue Shield of Minnesota, was quoted as saying.

“ The pandemic has exposed the flaws of our traditional, volume-based feefor-service method, as patients cancelled or postponed visits.”

“It is extremely important for Allina and Blue Cross that quality of care is improved – not diminished – by this agreement,” said an Allina spokesperson. Allina Health is committed to expanding its expertise on preventive care and new models-of-care delivery (to help reduce overall levels of care), and to share “appropriate, usable, real-time data to inform care delivery and enhance the patient experience.

“Ultimately, providers will be able to focus on more proactive forms of preventive care with less administrative burden with all patients. This means more time spent building patient relationships, streamlining the care delivery experience and reducing provider burnout.

The effect will be to encourage preventive care, which can keep patients healthier and reduce rates of debilitating chronic illness.”

How can you help distribution reps sell more while improving outcomes and taking care of the caregivers?

Share Moving Media is committed to providing the med/surg community with timely, important content to help reps thrive during a crucial point in the industry’s history.

Reps are turning to Share Moving Media platforms for content in record numbers. Consider the following:

Repertoire’s Web traffic is up 180% over 2019

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Share Moving Media is dedicated to providing our customers with the tools to increase their market-share through our publications, educational services and associations for providers, manufacturers and distributors in the business of healthcare.

TRENDS

Caring for People with Diabetes Biological information is essential, as it can lead to more precise therapeutic targeting.

But incorporating sociological and anthropological principles is just as important.

Why do so many people suffer the ill effects of type 2 diabetes, including eye disease, kidney disease and nerve

damage, despite the fact that so much is known about preventing and controlling it? Why doesn’t everybody just do what they’re supposed to do? There are many reasons – some of them physiological, but others more socioeconomic- and cultural-related. And healthcare providers are paying attention.

For example, people who live in a food desert may lack access to – or money to afford – adequate amounts of insulin, or fresh fruits and vegetables. It’s unlikely they have a gym membership, and they may not even feel safe going for extended walks in their neighborhood.

Practicing diabetes from a transcultural perspective doesn’t mean sacrificing science, according to proponents.

Excellence of care is excellence of care – for everybody.

No one, for example, would dispute the importance of monitoring blood glucose levels, eating healthily, watching one’s BMI or participating in vigorous physical activity. The job for physicians is helping people with type 2 diabetes from different cultures understand and achieve these goals. But it’s complicated.

The American Association of Clinical Endocrinologists deemed the topic important enough to publish a Position Statement on Transcultural Diabetes Care in the United States in July 2019.

Multicultural waiting rooms

In addition to socioeconomic factors are non-physical – cultural – ones. Perhaps strength training or vigorous exercise isn’t part of one’s culture. Perhaps we are talking about an Asian-American whose diet is heavy on white rice (high in carbs but low in nutrients), or an African-American patient who has difficulty trusting non-African-American doctors, or an Hispanic patient who has difficulty believing that an English-speaking doctor or nurse can understand the realities of their everyday lives and culture.

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Consider the challenges facing physicians whose patients come from multiple cultures, such as Jeffrey Mechanick, M.D., who practices endocrinology out of Mount Sinai Hospital in Manhattan.

“I see Latinos, African-Americans and Caucasians from the Upper East Side,” says Mechanick, who was chair of the AACE committee that published the transcultural care Position Statement. “We have a Jewish population, Asians, people from Africa, Latin America and Russia.

And the same is true for physicians practicing in any number of large cities as well as smaller cities and rural areas.

The ethnicity terrain is changing and multicultural.”

Mechanick has been studying transcultural diabetes care for some time. Ten years ago, he led a project to develop a transcultural diabetes nutrition algorithm.

In 2015, he helped organize the AACE Pan-American Workshop in Costa Rica for endocrinologists from Latin American countries. Three years later, he participated in

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TRENDS a series of “Diabetes Care Across America” summits in New York, Houston and Miami to examine cultural factors that influence diabetes care domestically.

On the evening before each of the one-day summits, organizers invited local community leaders to share their perspectives on diabetes care among their communities, he recalls. “We took notes and as a result were better informed on conference days,” recalls Mechanick.

“For example, we recognized that a good percentage of African-Americans are of Caribbean descent. Regarding Native Americans, we learned how important it is for them to feel that they matter and that we understand and acknowledge the trauma Native Americans have endured in Canada and the United States.”

‘ Even though you have different populations in different socioeconomic strata, there’s no excuse for different levels of excellent care.’

in order to help them adjust traditional eating patterns to more healthy options that are still acceptable to them, provide flexibility in lifestyle and medication recommendations that take into account cultural factors, and using communitybased resources to improve implementation.

Says Mechanick, “Even though you have different populations in different socioeconomic strata, there’s no excuse for different levels of excellent care. You may have to adapt it based on formularies or other resources, but that doesn’t excuse you from striving for that one standard of care.”

What factors affect diabetes care?

Physician (“human-made”) factors

ʯ Healthy food supply/availability

(stores, restaurants, schools, workplace).

ʯ Fitness resources (walking/running paths, gyms, school programs, parks).

ʯ Building design (stairs, elevators, walking distances, handicapped access).

ʯ Safety (surveillance, transportation, The 2019 Position Statement reflects many of the lesons learned. “Transculturalization is a necessary part of optimal endocrine care, with a specific attention to diabetes care,” the authors wrote. Biological information is essential, as it can lead to more precise therapeutic targeting, including lifestyle interventions and specific pharmaceuticals. But incorporating sociological and anthropological principles is just as important. “This approach facilitates effective health messaging for behavioral change on the part of both the patient and health care professional(s).”

Making the transition Some first steps to prepare a diabetes practice for an ethno-culturally diverse patient population include: ʯ Gaining experience with lifestyle and behavioral medicine, especially motivational interviewing. ʯ Creating a safe clinical environment. ʯ Incorporating translation services, wearable technologies, web-based resources and community engagement. ʯ Relying on clinical trial evidence that best reflects the ethno-cultural attributes of individual patients, 34

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city/community design, energy supply).

ʯ Pollution (water supply, endocrine disruptors, air, food chain).

Non-physical (transcultural) factors

ʯ Ethnicity (physical and nonphysical human factors).

ʯ Belief structures, behaviors, customs and

attitudes (toward food, physical activity, healthcare providers). ʯ Social factors (screen time, family structure, appearance in public). ʯ Economic factors (affordability of healthy – and dependence on unhealthy – lifestyle components). ʯ Political factors. ʯ Religious factors. ʯ Stress (crime, economic, personal; at work, at school, at home; sleep hygiene, comfort foods, food security). ʯ Disparities, discrimination, stigmatization (age, gender, race/ethnicity, economic class).

Source: Transcultural diabetes care in the United States – A position statement by the American Association of Clinical Endocrinologists, May 2019.

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Selling to the Government The federal government presents a massive opportunity for vendors.

It also presents a tremendous challenge. Companies will need the right partner to help capitalize on the opportunity, and MedPro is just the partner.

The U.S. federal government is the largest buyer of medical supplies globally. It presents a huge opportunity for

organizations to sell their products and services to military facilities, VA hospitals, prison systems and a myriad of assorted agencies and entities.

However, selling to the federal government isn’t easy.

Access, compliance, contracting and sales calls are all out of the norm when dealing with the government as a whole and at each of its numerous facilities.

In a recent podcast, Repertoire Publisher Scott Adams discussed the intricacies involved in doing business with the federal government with several industry veterans who have experience streamlining the process – Manny Losada, CEO of Optimal and president of MedPro; Pete Junge, vice president of government services for Optimal; and Tim Driver, national sales director of government care for MedPro. The following were some key takeaways from the conversation.

The federal government is made up of several different entities When selling medical supplies, the primary federal agencies involved are the U.S. Department of Veterans Affairs (VA) and the Department of Defense (DOD), which is the military health system. The VA has about 170 medical centers, and triple that as far as clinics. The DOD has 56 to 60 military treatment facilities, of which 27 of those would be considered major facilities.

The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The IHS provides a comprehensive www.repertoiremag.com

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November 2020

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SPONSORED

MEDPRO

health service delivery system for approximately 2.6 million American Indians and Alaska Natives who belong to 574 federally recognized tribes in 37 states.

There is also the Federal Bureau of Prisons (BOP), which has 120 different hospitals.

Different agencies, different ways to contract

The agencies want their medical centers to have a methodology of buying regularly-used items on an ongoing basis without having to go and do the due diligence to determine fair and reasonable pricing. In those instances, they’ll put schedules or contracts in place with vendors, and the vendors will pre-qualify the items and the pricing for all sorts of different things with either the Defense Logistics Agency (DLA) on the DOD side, or the National Acquisition Center (NAC) on the VA side.

Each of those entities contracts in different manners. “So the DOD will be contracting one way, the VA will be contracting another way, the IHS will be working in much the same way as the DOD and VA, but they’ll have subtle It’s both an art and a science to be able to find differences – and the same with the and zero in on the solicitations that the federal BOP,” said Junge. “And then you have government is looking for, said Junge. The the other governmental agencies like government will send out a solicitation saying the Centers for Disease Control and Prevention (CDC) and the National they are looking for certain types of things Institutes of Health (NIH).”

Calling on each location has its own challenges

and they’ll ask which vendors/companies are out there that can fulfill certain requirements.

It’s quite a different call point, said Driver. “It’s the one medical sales call point where you pull up and there’s a guard with an assault rifle at the welcome center. So, it can be a little intimidating.”

Each branch, and each base within that branch, usually has different requirements. For instance, at Fort Bragg, an army base in Fayetteville, North Carolina, as long as you have your car insurance and driver’s license and you can prove who you are, then you can come on base. At Navy facilities, usually you need to have an appointment set and a sponsor to let you through the guard gate. “So it can be a little intimidating, but our team is used to going through those steps needed to get on base,” said Driver.

When procuring medical supplies, the federal government is going to want to compete for every piece of business it does It’s both an art and a science to be able to find and zero in on the solicitations that the federal government is looking for, said Junge. The government will send out a solicitation saying they are looking for certain types of things and they’ll ask which vendors/companies are out there that can fulfill certain requirements. Then they’ll bid it out, and companies respond in the prescribed channel.

MedPro’s system simplifies the process Even large companies are under-resourced when it comes to the federal opportunity with medical supplies. MedPro has simplified the process for manufacturers of all sizes to be able to reach out to one company and work through that one company to service all the branches of the federal government. “The process saves the manufacturer a ton of time and years of setup to work with these institutions to get their goods or services into military treatment facilities, VA med centers, or large organizations such as the CDC and NIH,” said Junge.

MedPro’s trained sales representatives know the nuances of getting access into the facilities, and the do’s and don’ts in that very unique environment to elevate awareness of their manufacturer partners’ products and make the clinicians aware of the value prop of those products. “And not just that, but then also allow the contracting folks and the purchasing folks to know that those items are on the proper contract to make it very easy for them to do,” said Junge. “So from a manufacturer standpoint, you can get your items onto the contracts and get a whole field sales team plugged in so you’ll be able to transact much, much quicker.”

To listen to the entire podcast, visit http://repertoiremag.com/want-to-sell-more-to-the-dod-and-u-s-government.html For more information on MedPro and Optimal, visit www.mproassociates.com or www.optimalmax.com.

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Gain Top Access Unlock the potential of GOVERNMENT CONTRACTS and GET ON BASE with the right industry partner MedPro’s Government Services Team takes the complexity out of contracting with the Federal Government.

The United States government is the largest purchaser of medical supplies and equipment. With established federal contracts in place, prime vendor distribution relationships established, and a national sales force trained and actively calling on federal medical centers, MedPro makes federal contracting simple.

MedPro’s Government Services Team:

Elevates product awareness at end-user level

Provides security requirements to access facilities

Moves new products through committees

Gets new products into purchasing formularies

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215-519-5916 • info@mproassociates.com

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TRENDS

What Can Drones Do For You? Drone technology and the healthcare supply chain The healthcare supply chain moves with a sense of urgency. Unfortunately, sometimes shipments are at the

mercy of ground transportation delays.

But what if there was a way to make critical deliveries without the worries of traffic jams or a shortage of vehicles?

What if hospitals and health systems could ship and receive lab samples at a quicker pace, thus receiving faster results?

What if sensitive cancer treatment supplies could be delivered without the worry of delay?

The technology already exists. Supply chain leaders need only look to the sky.

In March of 2019, UPS announced a groundbreaking new logistics service to deliver medical samples via unmanned drones through a collaboration with Matternet, a leader in autonomous drone technology. The program is taking place at WakeMed’s flagship hospital and campus in the Raleigh, N.C., metropolitan area, with oversight by the Federal Aviation Administration and North Carolina Department of Transportation.

The program will utilize Matternet’s M2 quadcopter, which is powered by a rechargeable lithium-ion battery, and can carry medical payloads weighing up to 4.4 pounds over distances of up to 12 miles.

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Throughout the drone delivery program, a medical professional will pack and secure a drone payload container with a medical sample or specimen – such as a blood sample – at one of WakeMed’s nearby facilities.

The medical professional hands the payload container to a UPS Flight Forward operator who weighs the box and carries it to a specially designated takeoff and landing location outside the facility. The drone will autonomously fly along a predetermined flight path, monitored by a specially trained Remote Pilot-inCommand (RPIC), to a fixed landing pad at WakeMed’s main hospital and central pathology lab. This will be an ongoing program at WakeMed, and UPS and Matternet will use the learnings to consider how drones can be applied to improve transport services at other hospitals and medical facilities across the U.S. The Journal of Healthcare Contracting, a sister publication of Repertoire, asked Kevin Wasik, head of business development, UPS Flight Forward, for insights into drone technology, its uses, and how it is entering the healthcare field.

The Journal of Healthcare Contracting: How did UPS get started in drone delivery? Why the decision to explore this technology?

Kevin Wasik: UPS has been testing and investing in drone delivery since 2016. We see tremendous potential

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Gender Partnership: Turning an “Aha!” Moment into Action

Mike Kaufmann

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A passionate advocate for diversity and inclusion, Mike cosponsors the Cardinal Health Diversity and Inclusion Council that brings forward perspectives and cultivates real change through connection, listening and action. He also created the African American and Black Racial Equity Cabinet that serves as advisors on racial equity issues. Previously, he served as executive sponsor of the Cardinal Health Women’s Initiative Network, an employee resource group fostering a culture of partnership that makes Cardinal Health a place where women want to work and grow their careers. His support of women leaders in healthcare earned him recognition from both the Healthcare Business Women’s Association and the Institute for Women’s Leadership.

Rachelle is a seasoned leader and Corporate Accounts Executive with over 20 years of expertise in the healthcare industry. Dedicated to achieving an industry equally led by women and men, she has been a passionate member of PWH for more than 13 years. In 2016, Rachelle was awarded the to thank We want everyday privilege to attend The FORTUNE Most Powerful Women warrior NEXT GEN Executive Program. During her tenure as PWH As DUKAL employees work t PPE products are reaching h Chair, she launched the Associate Member Program, creating of COVID-19, we want to tak opportunities for men to join as members, supporting the thank the essential workers w hours to keep organization’s Diversity and Inclusion goals, as well as itsour nation goi While it can feel like the world is stand overall Gender Partnership initiatives.

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TRENDS for UAS to disrupt the same-day delivery industry. To start, we are focused on urgent medical deliveries, where faster and more reliable transport of healthcare items can improve patient care.

Speed ʯ Overcome ground traffic and chronic parking issues ʯ Access hard-to-reach locations ʯ Improved turnaround time for urgent lab samples Efficiency ʯ Improve economics of final mile delivery ʯ Optimize workflow with smaller, more frequent deliveries ʯ Battery powered aircraft are energy efficient and better for the environment Accuracy ʯ Greater predictability for time- and temperature-sensitive payloads ʯ Preprogrammed flight for precision takeoff and landings within tight footprints ʯ Flight status alerts and progress delivery maps JHC: What is your personal interest in drone technology?

Wasik: Drone technology has been around for decades.

Now, the FAA is leading a pilot program designed to integrate UAS into National Air Space. UPS Flight Forward is a fully certified drone airline working with the FAA to test and develop the right solutions to scale drone delivery services.

My focus is on solving problems for the healthcare community with present day capabilities. It’s very common for hospital networks to physically connect a web of decentralized facilities with same-day ground couriers. Couriers run daily bus routes to pick up and drop off from the same locations, multiple times per day.

Ground vehicles are regularly hampered by ground traffic and limited by total number of vehicles.

Drones are different. They are available on-demand – virtually anywhere – and can be used to increase the speed of delivery. This is really important within the healthcare industry. For example, ensuring urgent lab samples are tested sooner or personalized cancer treatments that are time- and temperature-sensitive are rapidly delivered to the patient’s point of care.

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JHC: Please tell us about your work with WakeMed Hospital in Raleigh. What is UPS able to provide through UPS Flight Forward?

Wasik: UPS Flight Forward operates Monday through Friday, eight hours per day. Prior to the drone program, lab specimens were transported from WakeMed’s outpatient clinic to the hospital’s central lab via a ground courier. The courier would make eight scheduled trips per day and occasionally return for an unplanned STAT delivery.

Today, WakeMed hospital is using a drone to increase the frequency and speed of specimen transport. The lab is receiving more specimens in smaller batches throughout the day – increasing the efficiency of lab. Doctors have an opportunity to diagnose patients sooner. And, since the program started in March, 2019 – WakeMed has yet to call on a ground courier for a STAT delivery.

JHC: Why is this needed in healthcare today?

Wasik: Physical access to healthcare is a real problem within the United States. “Rural America” makes up at least 15 to 20% of the U.S. population. This population faces inequities that result in worse healthcare than that of urban and suburban residents. Drone delivery represents a unique opportunity to physically connect rural America to healthcare providers.

JHC: What are other upcoming initiatives related to the program?

Wasik: UPS Flight Forward seeks to optimize how we operate. We are focused on delivering high-impact enhancements that will allow more complex operations.

For example, longer distance flights, heavier payloads, and increasing the capacity of total deliveries per hour.

JHC: Can you talk about UPS’s COVID-19 response?

How has it affected business operations? What are some unique ways in which UPS has responded?

Wasik: UPS Flight Forward teamed up with the nation’s largest pharmacy to deliver prescriptions ondemand from a pharmacy in Florida, to a nearby retirement community called The Villages, home to the largest retirement community in the United States. This drone operation helps a high-risk demographic remain healthy at home. Instead of visiting the pharmacy, patients have the option to receive their prescription in as little as 30 minutes. UPSFF is proud to run a drone operation that supports social distancing to prevent the spread of COVID-19.

SALES

Finishing Well 10 effective strategies for closing the year strong

By Sandler Systems, Inc.

It’s hard to believe, but the end of an unusual year is almost here. How’s your year been so far? Maybe it’s been

understandably disappointing and you’re looking to improve what you can while you can. Or maybe you’ve thrived in the recovery and rebounded into a terrific year and simply want the momentum to continue.

Whatever your situation, here are 10 tried-and-true strategies for finishing the year strong and positioning yourself for a profitable and productive 2021.

No. 1: Actively engage in account planning An account plan isn’t something you create in January and forget about; it’s a living, nimble document that sales teams should consistently utilize, update and share collaboratively in a team selling environment. Account plans act as strategic and tactical guides to help move future revenues into the present, based on clear understanding of client needs and pains.

No. 2: Identify and segregate your accounts All accounts are not created equal, as Sandler’s KARE tool reminds us. KARE is an acronym for the four critical 42

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objectives that drive our interactions with established and prospective buyers: KEEP, ATTAIN, RECAPTURE, or EXPAND. These are four very different strategic priorities. Salespeople must learn to ask: which of these four groups makes the most strategic sense for me to focus on right now – and why?*

No. 3: Devise a 2021 mid-year strategy Another strategic element to keep in mind is to revisit opportunities from earlier in the year that may have lost funding or were dropped by the customer. Remember, funding can be restored based on client need changes or the brightening of a financial outlook. Your understanding of client environments increases your competitive advantage and positions you to win deals that your adversaries have dropped from their radar.

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SALES No. 4: Understand customer financing in late Q4

No. 7: Be ready to make “close the file” calls

While this is a complex topic, one thing you can do pretty easily is to identify excess budget in your customer’s organization through your understanding of their historical spending. This foresight can lead to pre-billing for services yet to be rendered and, in essence, warehousing money for the client to spend in the next year – with you! In many situations for clients, it’s “use it or lose it!” Make sure you clearly understand your client’s financial calendar and fiscal year. Remember – it’s not about you!

Don’t be afraid to get a “no.” If a customer has gone dark on you, make a call and say, “Since I haven’t heard back from you, I get the feeling that you’ve gone in a different direction.” Prospects who’ve moved on but never told you so will allow you to close the file. On the other hand, those who simply became distracted will often move forward with a deal after you’ve reconnected with them in this way. With time a precious commodity in your efforts to close the year strong, you can’t afford to be in the dark.

Whether you close the file or identify something new that will help you win the deal, you’ve been given a gift!

No. 5: Set more aggressive behavioral plans and actionable goals

No. 8: Practice strong pre-call planning and have clear next steps

Here’s a sales leader’s rule of thumb for a year that none of us expected: in 2021, our salesforce should execute behaviors that support business development at a level that is at least 30% higher than what they were doing prior to the outbreak of the pandemic. That’s what we are seeing among teams that are bouncing back – and note that this higher level of behavior is what’s necessary just to break even. A truly aggressive behavioral plan needs to be the starting point for each salesperson in Q4, and it needs to be set up in two different categories: behaviors that drive revenue into your organization over the next 90 days; and prospecting behaviors designed to set up the salesperson for a strong 2021.*

Every call you make should have a clear purpose. As a manager and salesperson you should always be able to answer this question: “Where am I in this deal and what will it take to progress to the next step?” If the scenario is ambiguous for you, it is for your buyer, too. Clarity is key!

No. 6: Optimize your team

No. 10: Look beyond the big deal

Sales managers, now is the time to take action on chronic underperformers while there’s still time to salvage opportunity and revenue from their territories. It’s also time to onboard new, quality sales representatives to take you through the end of the year. Even without quality replacement candidates ready, tolerating consistently poor performers sends a very negative message throughout your organization. You never hear sales managers lamenting, “I moved too quickly on releasing Tom.” It’s always the opposite.

The sales teams who are turning the corner on this year’s challenges are the ones planting lots and lots of seeds.

They’re setting up large numbers of low-budget trial programs and pilot programs, also know as “monkey’s paws,” that can expand over time. A monkey’s paw is a smallersized deal that a buyer can say yes to quickly. You can enjoy a very successful year if you initiate lots of relationships – or strengthen an existing relationship – and close 2020 as strongly as possible, while laying the groundwork for an even stronger 2021.

No. 9: Have client review meetings Now’s the time for face-to-face meetings with customers who present an opportunity for expanded business. Figure out who they are and what new products or services you could be providing to them. Use your client knowledge from account planning to identify these situations with the most potential for current business, and avoid sessions focused on the “status quo.” The clock, of course, is ticking.

* To schedule a complimentary 30-minute advisory session on account planning, goal-setting, or sales management, for yourself or your sales team, send your request and contact information to SalesTips@repertoiremag.com with “30-minute free consultation” in the subject line.

About Sandler Training With over 250 local training centers around the globe, Sandler is the worldwide leader for sales, management, and customer service training. We help individuals and teams from Fortune 500 companies to independent producers dramatically improve sales, while reducing operational and leadership friction. ©Sandler Systems, Inc. All rights reserved.

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HEALTHY REPS

Health news and notes Being mindful Mindfulness is a simple self-care tactic that can reduce stress, help you be less reactive, and assist you in finding a path to greater calm. Utah-based Intermountain Healthcare announced in September it was offering free online classes to help people comfortably work toward achieving better emotional wellness.

Many people who practice mindfulness report: Increased ʯ Capability to relax ʯ Energy and enthusiasm for life ʯ Self-esteem and self-compassion ʯ Ability to cope with discomfort Decreased: ʯ Physical and psychological symptoms ʯ Acute and chronic stress ʯ Perception of pain Indeed, practicing mindfulness meditation for even a few minutes a day has been shown to help improve overall health and well-being and can be useful in managing stress.

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For more information, visit: https://intermountainhealthcare.org/blogs/topics/ covid-19/2020/09/free-online-mindfulness-classes.

Wildfires, COVID pose dual threat As wildfires raged across the entire west coast this fall, the air quality had the potential to reach extremely unhealthy levels. The Washington State Department of Health released information aimed at helping citizens to stay safe from smoke and fire, while preventing the spread of COVID-19.

Breathing in wildfire smoke can cause symptoms that are relatively minor, such as eye, nose, and throat irritation, and also more dangerous symptoms like wheezing, coughing, and shortness of breath. The best way to protect yourself from smoky air is to stay inside and keep your indoor air clean by improving filtration and creating a clean air room in your home. To reduce the intake of smoke into your home, the DOH recommended: ʯ Close windows and doors when it’s smoky outside, and open windows to let in fresh air during times when there’s better air quality outside. ʯ Set air conditioners to re-circulate.

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HEALTHY REPS ʯ Avoid burning candles/incense, smoking, broiling/frying foods, and vacuuming, as these can add to indoor pollution. ʯ Use a portable air cleaner with a HEPA filter Air Cleaner Information for Consumers California Air Resources Board. ʯ Build your own box fan filter.

“This wildfire season is especially challenging during the COVID-19 pandemic,” the DOH said in a release. “If you’re considering leaving the area to escape smoke or fire, consider the COVID-19 restrictions in the county you are traveling to, and the people you are visiting. This is especially important if they are at high risk for severe COVID-19. For those taking in people trying to escape fire or smoky conditions: please keep your circles small, wear masks indoors, and continue washing your hands often.”

“ If we are going to have kids play sports, we need to really strongly encourage a lot of those social safety measures: social distancing, hand hygiene, masking when possible.”

– Dr. David Soma, pediatrician, Mayo Clinic

These steps alone are not enough to protect you from COVID-19: Wearing cloth face coverings to protect yourself and others is still critical. “Cloth face coverings generally do not provide much protection from wildfire smoke, but they are still crucial in a pandemic,” said Secretary of Health John Wiesman. “We want people to continue to wear cloth face coverings to slow spread of COVID-19.”

Youth sports amid a pandemic In a recent blog post for the Mayo Clinic, Jason Howland examined how youth sports have changed in 2020, and what safety measures should be put in place.

“Sports do require oftentimes close contact, sharing of equipment and other things that do pose risks. How do we do that in the safest way possible I think is the million-dollar question,” says Dr. David Soma, a Mayo Clinic pediatrician who specializes in sports medicine.

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Dr. Soma says sports provide valuable mental and physical benefits for kids, but the COVID-19 pandemic is a whole new ballgame. “If we are going to have kids play sports, we need to really strongly encourage a lot of those social safety measures: social distancing, hand hygiene, masking when possible.” He also recommends screening athletes for COVID-19 symptoms before practices and games.

Study: Positive effects of metabolic surgery may be independent of weight loss A Cleveland Clinic study shows that 5% to 10% of surgically induced weight loss is associated with improved life expectancy and cardiovascular health. In comparison, about 20% weight loss is necessary to observe similar benefits with a non-surgical treatment. The findings also show that metabolic surgery may contribute health benefits that are independent of weight loss. The study is published in the October issue of Annals of Surgery.

This large observational study looked at 7,201 Cleveland Clinic patients: 1,223 patients with obesity and type 2 diabetes who underwent metabolic surgery (bariatric or weight loss surgery) were matched to 5,978 patients who received usual medical care. About 80% of the patients had hypertension, 74% had dyslipidemia (elevated triglycerides and cholesterol), and 31% were taking insulin to treat their diabetes.

Using different statistical models, the effects of weight loss were studied to identify the minimum weight loss needed to decrease the risk of death and of experiencing major adverse cardiovascular events, such as coronary artery events, cerebrovascular events, heart failure, kidney disease, and atrial fibrillation.

“Following metabolic surgery, the risk of death and major heart complications appears to decrease after about 5% and 10% weight loss, respectively. Whereas, in the nonsurgical group, both the risk of death and major cardiovascular complications decreased after losing approximately 20% of body weight,” said Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute, and lead author of the study.

“This study suggests greater heart disease benefits are achieved with less weight loss following metabolic surgery than medical weight loss using lifestyle interventions. The study findings suggest that there are important benefits of metabolic surgery independent of the weight loss achieved,” said Steven Nissen, M.D., Chief Academic Officer of the Heart, Vascular & Thoracic Institute at Cleveland Clinic, and the study’s senior author.

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REP CORNER

Staying the Course For Beth Majure, her customers have always been her priority.

By Laura Thill

From order takers to sales consultants, medical products salespeople have leapt multiple hurdles over the years

to ensure their customers are equipped to offer the best possible patient care. Today, however, it’s not only about meeting the customers’ needs, but also helping them know what those needs are, according to Beth Majure, a longtime sales consultant at Gericare Medical Supply.

Particularly given the toll the coronavirus pandemic has taken on staff and residents at long-term care facilities, “we need to ask the right questions to know exactly what will benefit them,” she points out. “I want ensure my customers are happy with the products I offer, and that they trust me – and Gericare Medical Supply – to take care of them.” Indeed, this longtime investment in relationships with her customers has helped her weather the pandemic storm as successfully as possible.

A new home Majure joined the medical products industry in 1990, when she and her husband moved to Mobile, Alabama.

“I saw the medical industry as a unique opportunity to make a positive impact Beth Majure on people’s health and well-being,” she says. She interviewed with Ross, then a division of Abbott, and joined their team as a sales rep with a focus on med/surg and nutritional products. “I especially enjoyed this focus and felt I was making a difference in people’s lives,” she notes.

After six years, however, Abbott realigned its territories, causing Majure to lose both her territory and her job.

During her tenure with Abbott, Majure cultivated a close relationship with Gericare. “Gericare was my biggest customer,” she recalls. “It was an awful shock to lose my job, but within a few days, Gericare called.

They had just formed their sister company, Progressive Therapy, and wanted to hire me as their first salesperson. Joining Gericare turned out to be the best possible move for me! They were extremely supportive 50

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and offered the perfect transition. Within two years, I was selling for both Progressive Therapy and Gericare.

Between the two companies, we can meet all long-term care needs.” Gericare has been her home ever since.

The biggest change yet Majure has witnessed – and helped her customers adapt to – plenty of changes in the medical products/longterm care industry these past 30 years.

“The onset of DRGs meant a huge learning curve, both for salespeople and their customers,” she recalls.

“Because payment rates were based on DRGs, we all had to change our focus and approach.” The same was true in addressing OBRA, she adds.

“With the onset of OBRA, we had to focus on products that not only aided long-term care residents, but also supported the facilities’ programs.”

By far, however, the biggest change – and greatest challenge – to date has been the immediate and ongoing need to weather the COVID-19 pandemic. Within a few weeks last spring, medical salespeople, caregivers and patients found their lives upended, and those in the longterm care sector were in the eye of the storm. It was bad enough for residents who were suddenly isolated in their rooms; those on the outside found themselves challenged as well.

Salespeople can read their customers much better in person, according to Majure. As the world quickly discovered, Zoom calls and parking lot visits were a poor substitution, albeit the best possible solution. Indeed, for

medical products/long-term care salespeople, their customers depended on them more than ever. “Today, I drop off samples and sometimes lunch in my customers’ parking lots,” she says. “I bring them information and updates as often as I can. I never imagined I’d be communicating primarily through Zoom calls and emails.”

An investment that pays off For 30 years, Majure has placed a premium on her relationships, both with her customers and the manufacturer reps who make it possible to keep her customers happy.

Today, these relationships have become more important than ever before, she points out, particularly as – months into the pandemic – distributors continue to face a limited source of supplies. True, the situation is improving.

“Lately, I can get 99% of what I need,” she says. But, there’s often a hitch. Manufacturers continue to encounter difficulties procuring raw materials, sometimes making it difficult to fill orders for PPE and gloves. For Majure, that means having to call around in search of product substitutions. “I must reassure my customers that even though they may not be used to using a new brand, the product will work well and get the job done.”

Through it all, prices have increased, she adds. If not for the years she invested in building her customers’ trust and partnering with her manufacturer reps, the process likely would have been a lot bumpier. “I have no doubt these relationships have paid off,” she says. “My manufacturer reps truly care about my customers. They do an excellent job of communicating with me. Whenever there’s a situation to address, they are here for me!”

Her customers, too, have demonstrated patience with the new normal and appreciation for Majure’s efforts. “I’ve stayed in constant contact with them,” she says. Whether she is helping them address new regulations or procuring a specific type of gown, she must be certain to ask the right questions and narrow down their exact needs. And, those needs are constantly changing, she adds. “Residents who are sick with coronavirus may require respirators, while the staff (and residents) continue to need PPE, sanitizers, soap and more. It’s imperative that the staff remain healthy so that they can go home to their families at the end of their shift.

“My customers are my friends,” she continues. “They, too, are susceptible to coronavirus and it’s extremely difficult to discover that someone you’ve known for so many years has passed away. On one hand, they need my compassion and support more than ever, but of course I can’t pop in to see them.”

The bottom line is, pandemic or not, her customers must rest assured that “when they pick up the phone, I’ll be there to take care of them,” says Majure. “Long-term care administrators can easily purchase products online.

I need my customers to trust that I’ll make sure they are purchasing the right products. Regulations constantly change, especially given the pandemic. My customers have a lot on their plate. They need me not only to be a sounding board, but to ensure they are prepared to meet any challenge that arises.” It’s still as important today as it was 30 years ago for customers to see a face and know who they are working with, she adds.

Mobile Area DON Association Early on in her sales career, Gericare sales consultant Beth Majure recognized that long-term care directors of nursing (DONs) could benefit from an ongoing opportunity to connect with one another and share their experiences and concerns. So, about 25 years ago, she started Mobile Area DON Association, a group designed to bring

together DONs from facilities across southern Alabama.

“We meet once a month at different long-term care facilities,” says Majure. “The DONs (some who drive as long as 1 ½ hours to attend meetings) discuss various issues and learn how others deal with different situations. This has become a great sounding board – something DONs

really need.” It’s also an opportunity for manufacturer reps to attend meetings, bring breakfast and introduce or demo new products, she adds. And, for the past 15 years, Majure has also organized annual banquets to recognize CNAs at the facilities, as well.

“It’s cost-free to participate in our monthly meetings,” says Majure. “For the DONs, their payment is their time.”

Laura Thill is a contributing writer to Repertoire.

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SMART SELLING

Leveraging Technology with a Personal Touch Take your sales meeting to the next level

By Sharon Cohen, HIDA Communications Director In early 2020, we all started to hunker down in

our home offices while healthcare facilities pivoted to take on the tsunami of COVID-19. The routine day of a sales rep was turned upside down when travel stopped and onsite client visits disappeared.

Sales reps often feel like customers are family, but suddenly there was a disconnection when “home” wasn’t accessible. Thankfully, six months or so into our brave new world, there are bright spots. Technology combined with sales rep savvy has not only come to the rescue – it’s taken many relationships to the next level.

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In a session at HIDA’s virtual Streamlining Healthcare Expo & Business Exchange, four top supply chain sales experts talked about how they have learned to leverage technology to communicate and build relationships amid the pandemic. Here are some of their lessons learned: Make sure your sales teams are comfortable on their meeting platform such as Zoom, WebEx, or Microsoft Teams. “If we’re not fully sold on communicating through this platform ourselves, how can we expect our customers to be,” says Account Executive Tim Morris, McKesson Medical-Surgical. Don’t think of a virtual meeting as a sorry second chance, but as an opportunity to make an even stronger connection. “You can see into people’s home offices and their lives – ask questions that put people at ease and get customers into their comfort zone,” advises Claflin VP Alex Caldwell. Morris places a guitar he made with his young daughters in the background as a conversation starter.

Use social distancing to bring together decision makers – virtually. There’s an opportunity as a sales rep to bring together top people more easily. “We’re seeing an opportunity to service customers from a team approach,” says Stephen Milton, Sales & Training Development Director, PDI. “We can get a group of people together more effectively and easier than before by leveraging technology – and be more productive.”

provide backup on every real sales call with the slide deck.

That way, if he loses video or audio, his partner can jump in. “If the clinical science liaison is on the call, I also make sure they have a copy of the slide deck so they can pick up if I drop off. It’s just providing good customer service,” he says.

Kevin Dixon, Senior Director, Commercial Contracting, Medtronic, noted that his company has made sure his team has the tools they need to reach out to customers digitally during this unprecedented time.

Caldwell says it’s important to explore product topics with your clinical team before pitching a meeting with a customer. “We’re trying to be in a lot more opportunities to our customers in addition to PPE.”

“ By ending my meeting invitation with questions, I’m addressing things that can easily derail a meeting before the meeting actually happens.

It’s extremely important to set expectations.”

Be prepared. When Morris schedules a video meeting, he puts a couple of “teaser questions” in the meeting invite, asking that they be answered before the meeting.

For example, “how are your PPE needs right now?” can be addressed prior to the conversation. “By ending my meeting invitation with questions, I’m addressing things that can easily derail a meeting before the meeting actually happens. It’s extremely important to set expectations,” he advises.

Caldwell agrees that you can’t “just request a meeting,” but need to offer content that will pique curiosity.

“It’s really important to prep ahead of time.”

Milton’s team conducts mock sales calls designed to have connectivity problems. He recommends that a colleague

– Tim Morris, Account Executive, McKesson Medical-Surgical

Be a resource. Customers ask a lot of questions about what’s going in other parts of the country, notes Dixon, and “I can give them some insight on that.” Additionally, sales reps are supplied with educational materials that can help customers. For example, with the dramatic reduction in elective surgeries during the spring, offer clients tips and tools for how to help get patients back into a client’s care settings.

Embrace levity. Embrace the awkward. Even if you can’t connect in-person, show your personality by changing up your video settings with a fun background option like a beach scene. It may bring a smile to someone’s face.

And if your dog is barking in the background, ask who’s a dog lover. “Sometimes you just have to embrace the awkward,” Morris says. www.repertoiremag.com

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

Technology news Customize your company’s voice Google recently launched a few updates to its Contact Center AI product. Among them is Custom Voice, available in beta, a new capability for CCAI and Text-to-Speech API that lets you create a unique voice to represent your brand across all your customer touchpoints, instead of using a common voice shared with other organizations. By taking advantage of the custom Text-to-Speech model created with Custom Voice, you can define and choose the voice profile that suits your business and adjust to changes without scheduling studio time with voice actors to record new phrases.

How could this new feature be used? Tech Crunch provided one example: Maybe your company has a wellknown spokesperson for example, but it would be pretty arduous to have them record every sentence in an automated response system or bring them back to the studio whenever you launch a new product or procedure. With 54

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Custom Voice, businesses can bring in their voice talent to the studio and have them record a script provided by Google. The company will then take those recordings and train its speech models based on them.

Improving your work-from-home experience When it comes to computer monitors, seeing is believing.

The editors at Wired included the best computer monitors for home offices in a recent work from home gear guide.

Among the top recommendations: ʯ Acer SB220Q Bi 22-Inch Full HD monitor for $90 (“This simple 1080p monitor will do the job for most people and it’s about as affordable as monitors get.”) ʯ HP 24F 24-Inch Full HD Monitor for $180 (“It can’t be mounted, but it’s ultrathin and shouldn’t take up much space on your desk.”)

ʯ Asus VA24EHE 24-Inch Full HD monitor for $110 (“It’s well built, looks sleek, and the screen is sharp and gets incredibly bright. It’s plenty colorful, too.”) ʯ LG 24-Inch Full HD monitor for $130 (“Like the Asus, this is another good option if you want to mount your monitor.”) ʯ Dell S2719DM 27-Inch QHD monitor for $380 (“This monitor is bigger, has a very slim profile, a higher 1440p pixel resolution, can be mounted, and even supports HDR for better colors in supported apps.”) ʯ LG 34-Inch ultrawide monitor for $377 (“If you’re frequently in front of a monitor and find yourself craving more screen, consider an ultrawide.”)

triggers and 3D Audio, and an all-new generation of incredible PlayStation® games.

Samsung launches Galaxy Watch3 Titanium Samsung Electronics Co., Ltd. announced the launch of Titanium model of Galaxy Watch3. “Galaxy Watch3 boasts all the craftsmanship of a high-end timepiece, built with premium materials and a stunning signature rotating bezel,” the company said in a release. “And now, for the first time, Samsung is offering a titanium smartwatch model: elegant and lightweight, yet built to last. With military-grade durability and water resistance, your watch is fit for any setting – whether you’re running through the backwoods or meeting in the boardroom.”

Read the full gear guide at: www.wired.com/story/ work-from-home-home-office-gear-guide/#intcid=_ wired-homepage-right-rail_2db1b67a-7d68-42ab-8557212f46352dc7_popular4-1.

End of an era According to The Verge, game console manufacturer Nintendo has discontinued the 3DS nearly 10 years after its release. Nintendo’s focus is now fully on the Switch, with the console’s hybrid nature removing the need for a dedicated handheld system. The 3DS received several revisions throughout its life: the larger 3DS XL, the improved New 3DS, the cut-price 2DS, and finally the sleek 2DS XL. In total, Nintendo shipped more than 75 million 3DS consoles worldwide – fewer than half as many of its predecessor, the phenomenally popular DS, The Verge reported. “But overall, the system can be seen as a success, and helped steer the company through the rocky Wii U years with more than 384 million games sold.”

The company has shipped more than 61 million Switch consoles as of the end of June – a figure that is likely to overtake the 3DS this holiday season.

Game on Speaking of game consoles, Sony’s PlayStation 5 is set to debut this month. The electronics company announced it will launch the PS5 in the United States on Nov. 12. A digital edition of the PS5 will sell for $399.99 while the standard model will sell for $499.99.

Sony is touting the console will come with lightningfast loading with an ultra-high speed SSD, a deeper immersion with support for haptic feedback, adaptive

The Galaxy Watch3 is packed with advanced monitoring features that offer valuable insights into your fitness and wellness. On-demand SpO2 measurements can track how well your heart is pumping oxygen, while VO2 max readings can evaluate overall endurance during training. To help you smash your fitness goals, enhanced sensors ensure that you stay within your target zone during workouts, home training programs allow you to exercise from home, and new sleep management tools maximize recovery. Starting at $599.99, Galaxy Watch3 Titanium will be available this fall at Samsung.com and major retailers. www.repertoiremag.com

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

Automotive-related news

Silvercar by Audi

Silvercar by Audi Audi of America recently announced the expansion of the brand’s U.S. mobility solutions with the availability of Silvercar by Audi at Audi dealerships. Customers will now have access to Silvercar by Audi at participating dealerships in several markets to rent from an exclusive Audi fleet and enjoy the customer satisfaction and premium Silvercar by Audi experience.

Additionally, Audi at Your Door – launched in May at participating dealers – offers customers a new online premium vehicle purchase and service experience. The expanded offerings continue the brand’s efforts to meet and adapt to consumers’ evolving mobility needs. Customers can rent, purchase and get on the road the way they want to in an Audi.

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The Silvercar by Audi operations update will allow new and existing customers to rent an Audi at participating Audi dealerships, providing another entry point for customers. Silvercar will continue to offer an exclusive Audi fleet with premium standard features through the Silvercar mobile app and Silvercar website, including service provided by a Silvercar Mobility Specialist on location to assist customers when needed. The newly launched Contactless Rental will also be available at participating dealerships, making renting with Silvercar by Audi a worry-free and consumer friendly experience.

“We’ve seen and heard from customers that their mobility needs are changing as transportation habits evolve,” said Stephan Zeh, head of Audi Mobility Services. “The addition of Silvercar rentals at dealerships

provides a new, convenient way for new and existing customers to enjoy the premium Audi experience in their neighborhood.”

The automaker said this new accessibility to Silvercar by Audi addresses the growing demand from new and existing customers for local rental options to accommodate regional transportation, longer test drives, flexible short-term transportation and lease bridges. It allows Audi to meet both short-term and long-term consumer demands and expectations during today’s rapidly changing travel environment. For example, urbandwelling customers are showing increased favorability toward auto travel due to the uncertainties currently surrounding air travel.

Circle K to deploy more EV stations According to Automobile News, Circle K owner Alimentation Couche-Tard Inc. is taking its electric car strategy to North America after learning from consumer habits in northern Europe. The Laval, Quebec-based convenience store giant will add charging stations at locations on the west coast of the U.S. and Canada and in its home province, CEO Brian Hannasch said in an interview. Longer term, the company wants to expand into at-home vehicle charging in North America, as it’s doing in Norway.

“We’ll have chargers deploying in the next 12 months in Canada and in the U.S.,” said Hannasch, whose company has outlets in 48 of the 50 states. “Our goal will be to follow the path we’re on in Norway.” The company, which counts more than 14,350 locations worldwide, has been experimenting with chargers and stations for years in the Scandinavian nation, where subsidies for electric cars helped speed up their adoption.

NHTSA launches SaferCar App The United States Department of Transportation announced the launch of a redesigned mobile app, SaferCar, by the National Highway Traffic Safety Administration with an emphasis on safety and convenience for the public. Available for both iOS and Android, it allows users to save their vehicles, car seats, equipment, or tires in a virtual garage on their smartphone. The app automatically checks, in the background, whether a recall is issued and alerts users when a recall occurs.

“In today’s world, smartphones are the tool of choice for many tasks – and the updated SaferCar app is a new safety tool at the public’s disposal,” said NHTSA Deputy Administrator James Owens. “The SaferCar app allows you to store your information locally on your device and

then the app goes to work to inform you of recalls as they occur – and owners can more quickly get their free recall repairs scheduled.”

Because each user’s information is stored only on their device, no personal information can be shared with NHTSA – ensuring a safe and private user experience.

Once the user sets up their virtual garage, the app checks for safety recalls every day, and will notify the user if an issue requires their attention.

For more detailed information on the SaferCar app and to download it, visit NHTSA.gov/app.

“ In today’s world, smartphones are the tool of choice for many tasks – and the updated SaferCar app is a new safety tool at the public’s disposal.”

James Owens, NHTSA Deputy Administrator

Used cars more in demand Car and Driver reported that as the coronavirus pandemic continues, used cars are in demand because new-car supplies are low and people are choosing car ownership over public transit and ride sharing. Used-car prices are up and inventory is down.

The first signs of the used-car boom came in May and June, following the overall economic downturn the U.S. saw in March and April following the first wave of stay-at-home orders caused by the coronavirus here. J.D. Power calculated that auto dealers sold 2.1 million used vehicles in May and June, 9% more than they did in those same two months in 2019.

In fact, Edmunds found franchised car dealers sold 1.2 million used cars and trucks in June, which was more than in any month since 2007. According to Cox Automotive, people kept buying more used cars in July, with the 2.2 million used-vehicle stockpile at U.S. dealerships that month representing a 22% drop compared to July 2019. www.repertoiremag.com

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NEWS

AMA releases the 2021 Current Procedural Terminology (CPT) code set The American Medical Association (AMA) has released the 2021 Current Procedural Terminology (CPT) code set.

The updated code set is “the first major overhaul in more than 25 years to the codes and guidelines for office and other outpatient evaluation and management (E/M) services,” the AMA says.

Among the additions to the 2021 code set are new medical testing services sparked by the public health response to the COVID-19 pandemic. The CPT code set has been modified with several code additions and revisions that have been approved for immediate use and published for the 2021 CPT code set.

Among the additions to the 2021 code set are new medical testing services sparked by the public health response to the COVID-19 pandemic. The CPT code set has been modified with several code additions and revisions that have been approved for immediate use and published for the 2021 CPT code set.

The changes to CPT codes ranging from 99201-99215 are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. 1, 2021. The Association says that the foundational modifications were designed to make E/M office visit coding and documentation simpler and more flexible, freeing physicians and care teams from clinically irrelevant administrative burdens that led to time-wasting note bloat and box checking.

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The revised E/M office visit codes are among 329 editorial changes in the 2021 CPT code set, including: ʯ 206 new codes ʯ 54 deletions ʯ 69 revisions The majority (63%) of new codes this year involving new technology services described in Category III CPT codes and the continued expansion of the Proprietary Laboratory Analyses (PLA) section of the CPT code set.

The AMA highlighted the following specific changes: The addition of code 92229 for retinal imaging with automated point-of-care, and revision of codes 92227 and 92228, better support the screening of patients for diabetic retinopathy and increase early detection and incorporation of findings into diabetes care.

The augmented intelligence technology described by new code 92229 has the potential to improve access for atrisk patient populations by bringing retinal imaging capabilities into the primary care setting.

Technological advances in the field of continuous cardiac monitoring and detection have prompted the addition of codes 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248, along with associated guideline revisions. These codes will replace Category III codes 0295T, 0296T, 0297T and 0298T, which were deleted. These new codes utilize an innovative algorithmic technology that works in concert with a patch that is much easier to wear for patients and provides more accurate and complete data for physician interpretation.

Industry News Midmark names new VP, corporate strategy Midmark Corp. (Dayton, OH) announced Beth Walters was promoted to VP, corporate strategy.

In this new role, Walters will be responsible for leading the development and maintenance of Midmark’s corporate strategy while collaborating to ensure alignment of functional strategies across all three of Midmark’s business units – medical, dental and animal health.

She will also be responsible for leading the organization to embrace new business areas and ensure the successful integration of these areas into core business processes.

Since joining Midmark in December 2014, Walters has led a series of strategic implementations for the company.

She led the renewal of Midmark’s corporate strategy in 2016, as well as led cross-functional teams to design and recommend the path forward in the areas of customer education and digital transformation.

Owens & Minor elects Mark Beck as chair of the board of directors Owens & Minor, Inc. (Richmond, VA) announced the implementation of a succession plan within its board of directors. Mark Beck was elected by the board to succeed Robert Sledd as chair of the board, effective September 22. Beck, who currently serves as CEO of B-Square Precision, LLC and previously held executive positions with JELD-WEN Holdings, Inc., Danaher Corporation, and Corning Incorporation, has been an independent director of the company since August 2019.

Sledd has been a director since 2007 and board chair since 2018, and served as interim CEO & president of the company from November 2018 until March 2019. He will remain on the board of directors for the remainder of his current term, which culminates with the company’s 2021 annual meeting of shareholders.

Thermo Fisher opens new Bioprocessing Collaboration Center Thermo Fisher Scientific Inc. (Waltham, MA) announced the opening of its new Bioprocessing Collaboration Center (BCC) in St. Louis, Missouri. The facility is adjacent to the company’s biologics manufacturing facility, which recently doubled production capacity with a $50 million expansion. The company

say that the combined expertise from Thermo Fisher’s bioproduction and pharma services businesses will accelerate innovation and enhance productivity for biopharma companies, enabling them to meet the growing need for more flexible, scalable biologics development and manufacturing solutions.

“The BCC will bring together the company’s leadership in GMP biologics manufacturing with its deep expertise in bioprocessing technologies including bioreactors, cell culture media, chromatography and analytical tools, among others. This collaboration will deliver new singleuse bioprocessing technologies as well as drive critical process, data management and quality improvements that enable scale-up solutions for biopharma customers,” Thermo Fisher said.

Sheri Edison joins Cardinal Health board of directors Cardinal Health (Dublin, OH) announced that its board of directors elected Sheri Edison as an independent director, effective September 1. Edison joins the board with extensive experience as a senior legal executive in the medical device and packaging industries.

Edison currently is EVP and genSheri Edison eral counsel for Amcor plc, a global leader in packaging for products spanning the food, beverage, pharmaceutical, medical, home and personal care sectors, with approximately 50,000 employees across more than 40 countries. She previously held the role of SVP, chief administrative officer of the medical device company Hill-Rom Holdings, Inc.

BD donates $1M to support launch of world’s largest NGO hospital ship BD (Becton, Dickinson and Company) (Franklin Lakes, NJ) is celebrating its 25 year of philanthropic partnership with the global nonprofit, Mercy Ships, by announcing its donation of $1 million in cash and product to support the construction and launch of the world’s largest non-governmental organization (NGO) hospital ship, which plans to sail to Africa in late 2021 under the name, Global Mercy. www.repertoiremag.com

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NEWS Over the course of the 25-year partnership, BD has donated more than $1.5 million in cash and products to support Mercy Ships in its charitable mission of providing free surgical care to those in need. Today’s announcement brings BD’s total philanthropic investment in Mercy Ships to $2.5 million.

The organization’s new, custom-built hospital ship, Global Mercy, features six operating rooms, state-ofthe-art technology, the highly-trained medical talent of a modern hospital, and the capacity to house more than 600 volunteers.

Medtronic to acquire Avenu Medical Medtronic plc (Dublin, Ireland) announced the planned acquisition of Avenu Medical (San Juan Capistrano, CA),

a privately held medical device company focused on the endovascular (minimally invasive) creation of arteriovenous (AV) fistulae for patients with end-stage renal disease (ESRD) undergoing dialysis.

Avenu Medical’s Ellipsys Vascular Access System is a single-catheter, ultrasound-guided device that inserts a catheter percutaneously (through the skin) into the arm to create a durable AV fistula. The procedure can be performed in the hospital outpatient department, ambulatory surgery center (ASC), or physician’s office.

The Ellipsys Vascular Access System has been approved by the FDA and is CE Marked for distribution in the European Union. It is indicated in both geographies for the creation of a proximal radial artery to perforating vein anastomosis for percutaneous creation of an AV fistula.

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