REP-Sept.25

Stocked, Ready, and Connected

How distributor reps can help practices successfully navigate respiratory season.

Stocked, Ready, and Connected

The Engine that Powers Healthcare

When we talk about what makes healthcare in the U.S. work, most people think of doctors, nurses, and hospitals. But behind the scenes, there’s a force that keeps everything running quietly, efficiently, and often without recognition. That force is you the medical distribution sales rep.

Medical distribution is the engine that powers the U.S. healthcare supply chain. It connects thousands of manufacturers to tens of thousands of healthcare facilities every day. From physician offices to ambulatory surgery centers, from long-term care facilities to major hospital systems, the U.S. healthcare ecosystem depends on the timely, accurate, and consistent delivery of supplies. And none of that happens without the people who make connections like you.

You are more than just a sales rep. You are a trusted partner to your clinicians. When they’re unsure about which diagnostic test is best suited for flu, RSV, or strep season you guide them. When a hospital needs a solution for supply standardization, you’re in the room with procurement and supply chain leadership helping them build a better path forward. When a manufacturer launches a new product or technology, you’re the one carrying that message to the end user educating, explaining, and helping them see how it fits into their workflow, benefits their practice, and improves patient care.

To our manufacturing partners: the value of the distribution sales force cannot be overstated. This field team is your voice, your strategy in action, and often your best feedback loop. They know the customer through years of relationships and favors. They know the environment. And they know how to move the needle.

Amid evolving regulations, increasing cost pressures, and ongoing labor challenges, it’s the distribution sales rep who shows up prepared, knowledgeable, and committed. And in an industry where patient care depends on everything being in the right place at the right time, that commitment means everything.

So this month, we tip our hat to you. Thank you to the distribution and sales professionals serving the U.S. healthcare market. You’re not just part of the system, you’re the link that holds it all together. And also thank you to the manufacturers advertising in Repertoire Magazine, showing your support of these amazing salespeople.

Keep going strong as we head towards Q4!

Dedicated to the Industry,

R. Scott Adams Publisher

editorial staff

editor Graham Garrison ggarrison@sharemovingmedia.com

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

Better Health Better Future

Hidden Dangers

Diagnosing silent infections before they turn serious.

 We all recognize the seriousness of infections we see right before us like influenza, strep, other respiratory and skin infections. While these acute infections are easy to identify – and for the most part self-limiting or easily treated – even the most obvious infections can lead to severe morbidity and long-term complications.

In addition, our customers recognize the differences in treatment programs posed by bacterial rather than viral infections. It is widely recognized that even these common seasonal infections can bring serious complications. While influenza is viral and antibacterials have no effect on it, group A strep is bacterial and can be effectively treated with antibacterials. Untreated group A strep respiratory infections can also lead to rheumatic fever and even rheumatic heart disease. Group A strep can also proceed to become

By Jim Poggi

invasive leading to very serious complications including streptococcal toxic shock syndrome and flesh-eating disease (necrotizing fasciitis). Influenza infections particularly in the elder population can lead to pneumonia and death. So, what’s my point? In this column I plan to explore initial diagnoses of the obvious infections we usually think of, consider careful follow up of these infections to avoid serious complications, and then discuss the next level of “silent infections,” ones that usually remain asymptomatic until they become

very serious. As valued consultants to our customers, we need to stay on top of the issues they encounter daily, and infectious diseases, obvious or occult (not obvious) are a part of their daily lives. Let’s come up to speed on these infections and the diagnostic tools we offer.

What we already know

The following are statistics on easy-to-identify infections:

` Influenza. There were 38 million cases of influenza reported to the Centers for Disease Control and Prevention (CDC) in 2019 resulting in 18 million healthcare visits, 405,000 hospitalization and 22,000 deaths.

` Strep. In that same time frame, strep resulted in over 5.2 million outpatient visits. Invasive strep with the most serious risk of complications resulted in an estimated 10,000 deaths annually and the incidence of invasive strep is rising.

` RSV. These infections lead to about 120,000 hospitalizations annually, equally divided between children under five and adults over 65.

What “silent infections” are out there?

We need to be aware of the dangers of “silent infections,” diseases that are infectious, spread quietly and quickly from one person to another with limited symptoms. From casual contact in large public gatherings to intimate contact between sexual partners there is a substantial list of infections we often think of as isolated, and not necessarily part of the big picture of infectious disease. But they are out there, and they create a serious risk to the public health daily.

What is the incidence of “silent infections” in the U.S.?

In 2019, the most recent year for which I have data, other infectious diseases accounted for 10.2 million physician office visits, 4.7 million hospital visits and 790,000 deaths. Given that there are about 230,000 primary care physicians, this data means they are seeing an average of one patient with a non-respiratory infection each week. And remember, many of these infections present without obvious symptoms.

But what do we offer for the “silent” infections? First, for diagnosis of silent infections to occur, there needs to be a trusting relationship between the patient and the care giver and, in some cases, careful history and physical, asking the right questions about lifestyle and carefully looking for signs of skin lesions and jaundice. Beyond that, lab tests become the fundamental tools to establish the initial diagnosis and to follow up post treatment to assure a return to health.

In my experience, many clinicians, particularly those with stable patient populations in more affluent areas believe STIs “can’t or don’t happen here.”

Quick quiz: name the top five infectious non-respiratory diseases in the U.S. As an added bonus, name the next three (at least one was a big surprise to me). The top five in order are chlamydia, gonorrhea, syphilis, salmonellosis, and Lyme disease.

Some data sources also list E. coli, staph, herpes and norovirus in the top 10. The top five non-respiratory infectious diseases cause over 2.6 million cases annually and the incidence is growing. The next three infectious diseases: hepatitis A, pertussis (whooping cough) and tuberculosis.

As we think about the challenges our customers experience, many of these infections, not including the GI disorders, present with few symptoms. We are all familiar with our respiratory tests and we know that they are critical to our customer diagnostic programs in the fall and winter.

cannot beat the complete blood count (CBC). While most CBC tests are CLIA moderate complexity, the type and amount of data they provide makes the CBC the first choice when laboratories are trying to identify an infection. Elevated white count is an immediate red flag indicating the presence of an infection.

In addition, the white blood cell differential (WBC diff) takes this information to the next level, and can point to a bacterial or viral source of the infection.

Which screening lab tests are

we talking about here?

From a perspective of screening for an infection if the history and vital signs (physical exam) indicates a need, there are several pathways to take. C-reactive protein can confirm the presence of an infection but is non-specific and not often used as a first line screen. Some CRP tests are CLIA waived.

Another diagnostic consideration, more often used in hospitals than primary care practices, is erythrocyte sedimentation rate (ESR). This also indicates an infection but has the same drawback as CRP; it is not specific and leads to one or more additional tests to confirm the infection and work to pinpoint its source. Some ESR tests are also CLIA waived.

For first-line determination of an infection and subsequent determination of whether it is viral or bacterial in nature, you

Typically, an increase in neutrophils, the most common WBCs, indicates a bacterial infection. An increase in lymphocytes more often points to a viral infection. An increase in eosinophils can point to an allergy and lead to a different path to diagnosis. While infections can be complicated, the CBC is not. In a minute or less the lab receives at least 11 different parameters that can point to general health concerns (hemoglobin and hematocrit are examples that may indicate anemia or a bleeding disorder) or an infection, with the WBC differential well established as the gold standard for initial screen for an infection. Just as important, once a treatment program has begun, follow up with a CBC can demonstrate the effectiveness of the treatment.

Which lab tests make sense to identify a “silent infection”?

This is where things get complicated and the skills of the clinician in drawing out information of the patient come into play. Respiratory infections and most staph infections are readily diagnosed during the vital signs exam. But, there is an increasing

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incidence of sexually transmitted illnesses (STIs) and while the conversation between the clinician and the patient can become somewhat awkward, it is important for the clinician to understand the recent (and in the case of syphilis) past history of the patient’s sexual behavior.

It is in the best interests of the clinician, the patient, their close contacts and ultimately the healthcare system to have an open, candid discussion to help rule out one of the major causes of STIs. If the clinician has a concern that the patient may be harboring an STI, there are several excellent choices, some of them waived, for STI assays.

Be sure to stay in close contact with your key lab manufacturers who can provide you with information regarding the STI assays they have available and their CLIA status. They can also help you develop conversational cues to make your discussion with your key customers productive, rather than uncomfortable. In my experience, many clinicians, particularly those with stable patient populations in more affluent areas, believe STIs “can’t or don’t happen here.”

The data indicates otherwise, and it is in the best interests of the experienced distribution account manager to offer the full range of testing possibilities, from initial diagnosis of infection to definitive diagnosis options.

My research has uncovered information indicating that over 33,000 curable STIs are contracted in the U.S. daily. More surprisingly to me, the CDC reports that there are 68 million Americans with an STI. That’s 1 in 5 Americans. Think it can’t happen here? Think

again. Both syphilis and tuberculosis are increasing in incidence. Your trusted lab manufacturer should be able to provide you with data and talking points to help your customers understand that it can happen here. In the case of tuberculosis, the broad range of medications that deliberately lower immune response to help treat arthritis and other autoimmune diseases is often associated with this increase in incidence.

provided you a list and some food for thought regarding the next level of more difficult to identify infections. As you can see from the data, there are a lot of patient visits for these less obvious sources of infection.

I have also reinforced the outstanding value of the CBC in getting to the heart of the matter: does the patient have an infection? If so, is it viral or bacterial? That answer clarifies the decision

My research has uncovered information indicating that over 33,000 curable STIs are contracted in the U.S. daily. More surprisingly to me, the CDC reports that there are 68 million Americans with an STI. That’s 1 in 5 Americans. Think it can’t happen here? Think again.

Careful vital signs examination along with history questions focused on whether the patient has traveled to an area where tuberculosis is more common or whether they are taking a newer arthritis medication would be critical to early diagnosis of tuberculosis. There are numerous new TB assays available, most of them are molecular. Your trusted lab manufacturer is the best source of information about assay choices and ways to open up the discussion with your customers. TB is another classic “does not happen here” disease, but changes in available medications are also part of the big picture regarding the increase in incidence of TB in the general population.

What’s the bottom line?

In addition to obvious respiratory and skin infections, I have

to administer antibiotics and helps with antibiotic stewardship, an initiative we all get value from. I hope I have given you a bit of insight on the less obvious “silent infections” and how to work with your trusted lab manufacturers to deliver the story.

In my experience, even a polished rookie can tell the respiratory testing story effectively. The proof of a well-established and well-respected lab consultant is just how far you can take the discussions on infections and the solutions you have to offer. The best lab consultant can discuss the “silent infections” nearly as easily as they can respiratory infections. I am confident that, with the help of your trusted lab manufacturers, you can increase your skills and add additional customer value to your list of credentials.

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‡For SARS-CoV-2 & FLU A+B: In the USA, the BD Veritor™ System for Rapid Detection of SARS-CoV-2 has not been FDA cleared or approved but has been authorized by the FDA under an Emergency Use Authorization for use by authorized laboratories; use by laboratories certified under the CLIA, 42 U.S.C. §263a, that meet requirements to perform moderate, high, or waived complexity tests. The product is authorized for use at the Point of Care (POC), i.e., in patient care settings operating under a CLIA Certificate of Waiver, Certificate of Compliance, or Certificate of Accreditation.

This product has been authorized only for the detection of proteins from SARS-CoV-2, not for any other viruses or pathogens; and, in the USA, the emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. §360bbb-3(b)(1), unless the declaration is terminated or authorization is revoked sooner.

BD, the BD Logo and Veritor are trademarks of Becton, Dickinson and Company or its affiliates. © 2025 BD. All rights reserved. (BD-145178)

Accelerating Excellence

A look at McKesson Medical-Surgical’s transformative approach to the U.S. healthcare supply chain.

 As the healthcare landscape continues to evolve at a rapid pace, suppliers must do more than keep up – they must lead. With that in mind, McKesson Medical-Surgical recently launched its Accelerated Supply Chain Excellence initiative – known internally as ASCE or simply “Ace” – a sweeping strategy that blends cutting-edge automation, expanded infrastructure, and a renewed commitment to both customers and employees.

In the following interview, Repertoire Magazine sat down with Jeremy Maron, Operations, McKesson Medical-Surgical, to explore the “why” behind ASCE, how it’s redefining the distribution network, and what it means for the people who make

it all happen. From enhancing regulatory excellence and expanding capacity to reimagining the employee experience, Maron shares how McKesson is setting the pace for what a modern healthcare supply chain should be.

Repertoire: What were some of the reasons behind McKesson Medical-Surgical’s Accelerated Supply Chain Excellence initiative?

Jeremy Maron: As we stepped back and looked at how our business is evolving, and how our

customer base continues to grow and diversify, we recognized a real opportunity to make a strategic investment in our distribution network. That’s really what inspired us to launch what we call Accelerated Supply Chain Excellence or ASCE, which we pronounce ‘Ace.’ It’s a name that fits, because this initiative is all about staying ahead and continuing to lead the healthcare supply chain into the future.

ASCE is more than just a capital investment – it’s a strategic transformation of our distribution network, technology and services. We’re building new, stateof-the-art distribution centers, implementing advanced automation, and upgrading our systems to enhance efficiency, quality and throughput. But just as important, we’re investing in our people –creating safer, more appealing workplaces and investing in the services that matter most to our customers. It’s about making sure we’re not only ready for what’s next, but that we’re setting the pace.

Repertoire: Why is improving the employee experience an important facet of ASCE?

Maron: I’m really glad you brought that up. You’ve probably heard the saying, ‘Take care of your employees, and they’ll take care of your customers – and the rest will follow.’ It’s a simple idea, but one we really believe in as we strive to be the best place to work in healthcare.

Our employees take a lot of pride in the work they do to get critical medical supplies and medications to providers and their patients. With ASCE, we saw an opportunity to not only bring in the latest technology, but also to make the employee’s experience

even better. Safety and well-being were top of mind from the start. We’re introducing things like robotic picking systems and quieter conveyors that help reduce physical work and create a safer, more efficient environment. But we didn’t stop there. We’re also rethinking the spaces themselves by adding more natural light, open breakrooms and areas where teams can relax and connect with large LED televisions. Our newest distribution centers even have outdoor spaces, game tables, and larger locker

rooms. It’s not unusual to see teammates enjoying a quick game of pool or foosball during a break. At the end of the day, we believe that when our employees feel supported and energized, it shows in the service we deliver.

Repertoire: ASCE has several key areas. Can you provide a few more details on what each will look like?

Maron: ASCE is built around five core pillars, each designed to strengthen a different part

of our supply chain and ultimately deliver more value to our customers. We’re confident these investments will not only strengthen our leadership in the industry today but also position us for long-term success as a standalone company.

Regulatory Excellence: This is about making sure we’re not just compliant but a leader in quality and safety. We’re enhancing and consolidating select distribution centers to optimize our network, and we’re investing in cold chain capabilities to protect product integrity and ensure patient safety, especially for those temperaturesensitive items that are a growing part of our business and our customers’ business.

complete, about 90% of all order volume will be touched by some sort of automation.

Greater Capacity: As demand grows, we’re expanding our footprint. We’ve already opened new distribution centers in Ohio; Colorado; Florida, and Washington state, with more on the way in Arizona, Georgia, Massachusetts, and Missouri. These facilities are larger, more automated, and better equipped to handle future growth.

More Services: We’re designing our new DCs to support expanded customer-facing service like value-added packaging, home delivery support and other capabilities that help our customers serve their patients more effectively.

Maximum Efficiency: We’re bringing in advanced automation and smarter systems to streamline operations and lower our cost to serve.

That includes robotic picking, automated packaging, and modern conveyor systems, all of which help us move faster and more accurately. Once our ASCE initiative is

Better Employee Experience: We know that great customer experience starts with great employee experience. That’s why we’re creating a safer, more engaging workplace with natural light, open breakrooms including amenities like game tables, outdoor spaces, and ergonomics

centered design in work areas. It’s all part of making McKesson Medical-Surgical the best place to work in healthcare.

Repertoire: How are the needs of today’s U.S. healthcare providers changing?

How does ASCE position McKesson to better serve its customers in an increasingly competitive and complex healthcare environment?

Maron: Healthcare providers are navigating an increasingly complex landscape – rising patient expectations, tighter margins, workforce shortages, and the need to deliver care across more settings, from hospitals and clinics to homes and virtual platforms. They need partners who offer more than just products – they need reliability, flexibility, and innovation. That’s exactly where McKesson Medical-Surgical is focused.

We’re evolving alongside our customers by investing in technology, expanding our distribution capabilities, and designing services that reflect the realities providers face every day. It’s not just about having a strong distribution network or being a single-source supplier – though we are. It’s about combining that scale with smart tools like McKesson Business Analytics and SupplyManager SM , which help providers manage inventory, control costs, and make informed decisions.

And behind all of that is our dedicated support team – field and inside sales reps who are with our customers every step of the way. Ultimately, everything we do is about helping providers deliver better care, wherever it happens.

The 3 Types of Ghosting…

and what to do about each

By Brian Sullivan, CSP – PRECISE Selling

 You had a great call. They loved the product. You high-fived your manager. And then … nothing. No reply. No callback. No next step.

Welcome to ghosting. Not the Halloween kind – the sales kind. And let’s face it, it haunts everyone in this industry. But not all ghosting is the same. And if you don’t know what kind of ghosting you’re dealing with, your follow-up will either fall flat or come off desperate. Let’s break it down.

Ghost Type No. 1: The Polite Ghost

They liked you. They meant to follow up. But they’re swamped.

This is the classic medical office or department manager who says, “We need this,” then disappears into a tornado of credentialing, staffing gaps, and nine other vendor projects.

Symptoms:

` Positive tone in last conversation

` Asked relevant questions

` Said things like, “Let me talk to my team” or “Circle back next week.”

What to do: Stop asking if they’re still interested. They are – but they’re overwhelmed.

Send short, helpful messages with value reminders.

“Quick one: I know you’re slammed. Just sent a 2-min video recap with how XYZ can cut 15 minutes per shift. Might help when you come up for air.”

Be the one rep who makes their job easier, not heavier. Pro tip? Sometimes mailing a physical one-pager or handwritten card can cut through the noise. You’ll stand out simply by not being another blinking light in their inbox.

One rep I coached sent a short checklist laminated with a Sharpie tied to it and a note that said, “Thought this might help your team until we can talk again.” Not only did she get a

reply, the buyer shared it with her entire team.

Ghost Type No. 2: The Political Ghost

They can’t move forward, because someone above them is blocking it.

In hospitals and large offices, even the champion you win over might not control the purse or policy.

Symptoms:

` You nailed the call, but they said things like “I’ll run this up the chain”

` Weeks go by with vague check-ins or silence

` You sense they liked it but aren’t the final say

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What to do: You’re not being ghosted. You’re being diluted.

Offer ammunition they can send upstream:

“Want me to draft a short ROI summary or a 3-slide deck you can share with your director?”

Or suggest a joint meeting:

“Happy to join a quick call with your team to answer questions directly if that’s easier.”

I once worked with a rep who brought in a third-party consultant to a second meeting – not to pitch, but to validate the financial case. The result? The champion forwarded that clip to the CFO, and the CFO asked for a meeting.

When your champion is out of arrows, hand them one that flies farther.

Ghost Type No. 3: The Panic Ghost

They were never ready to buy, and now they’re embarrassed.

This is the rep or manager who got excited in the moment but didn’t have the internal buyin, budget, or process to back it up. Now they’re dodging you.

Symptoms:

` They seemed overly enthusiastic

` Pushed for a demo quickly

` Went radio silent right after talking “next steps”

What to do: They don’t need pressure. They need permission to be honest.

Try this message: “Totally get it if the timing shifted or things changed. No pressure from me. Just wanted to know where it stands so I don’t keep bothering you unnecessarily.”

This relieves guilt and often gets a reply like, “Yeah, here’s the deal…”

Sometimes, they’ll even thank you for the nudge. Ghosting isn’t always intentional – it’s often fueled by shame, awkwardness, or fear of disappointing you.

Final Thought: Ghosting Isn’t About You

Most reps take silence personally. Don’t.

Ghosting usually says more about the buyer’s world than yours.

So pause before you hit send on that seventh “Just checking in” message. Instead, ask:

` What type of ghost is this?

` What do they need – relief, resources, or room to breathe?

Then be the rep who responds with empathy, not ego. Sales success doesn’t come from chasing people harder. It comes from understanding what’s really getting in their way, and showing up in a way that’s hard to ignore.

That’s how you turn silence into strategy.

Brian Sullivan, CSP, is the founder of PRECISE Selling, a training and consulting firm that helps medical sales professionals master the art of prospecting, presenting, and closing in complex environments. He’s the author of 20 Days to the Top and a trusted advisor to leading healthcare manufacturers and distributors. Learn more at preciseselling.com

Enhanced Detection

University of Pittsburgh scientists developed new technology to stop hospital outbreaks before they start.

 Hospital-acquired infections (HAIs), infections that patients get when receiving treatment in the hospital for another condition, are a serious threat to patient safety and a leading cause of increased costs and patient mortality in hospitals, according to the Centers for Disease Control (CDC).

Now, a new technology that can detect outbreaks before they spread may help physicians better address HAIs.

The Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT) system, an infectious diseases detection platform, developed by University of Pittsburgh scientists working with UPMC infection preventionists, proved over a two-year trial that it stops outbreaks, saves lives and cuts costs.

“We saved lives while saving money. This isn’t theoretical – this happened in a real hospital with real patients,” said lead author Alexander Sundermann, Dr.P.H., assistant professor of infectious diseases in Pitt’s School of Medicine. “This technology could easily be scaled. The more hospitals implement this practice, the more everyone benefits, not just by stopping previously undetected outbreaks within the walls of the hospital, but by finding medical device or medication-linked outbreaks sweeping the nation.”

The study was conducted from November 2021 through October 2023 at UPMC Presbyterian Hospital. The results are published in the journal Clinical Infectious Diseases , making the case for adoption in hospitals

nationwide and the development of a national early outbreak detection database.

The power of genomic sequencing

The EDS-HAT transmission system uses genomic sequencing to analyze infectious disease samples from patients. If two or more patients have near-identical strains of an infection, the platform

flags the results for the infection prevention team to find the commonality and halt transmission.

Patients with the same type of infection who don’t have an obvious link – such as staying in the same hospital unit – may unknowingly spread the infection, leading to an outbreak growing significantly before it is detected.

“Addressing outbreaks in hospitals was the main purpose

of the Pitt program is to start doing genetic sequencing on everything moving forward,” said Dr. Sundermann. “In this case study specifically, our research lab would work with our clinical lab every week to collect patient infections that were potentially acquired at the hospital and sequence them, review the data, and find if outbreaks were occurring in the hospital.”

Without tools like the EDS-HAT, infection preventionists may spend time and resources trying to avert a nonexistent outbreak when patients happen to have the same type of infection, but the transmission is found to be from unrelated sources.

of the EDS-HAT, as this technology is much more effective compared to the current method of disease detection in hospitals, where a nurse or clinician is needed to detect disease in each patient,” said Dr. Sundermann. “Then, when more than one patient has a certain type of infection, the infection control department is called in to investigate. Oftentimes, through that lengthy process of reactive sequencing, what we find is that it’s usually not an outbreak like the clinician initially thought it was.”

Without genomic sequencing, hospital infection preventionists have no way of knowing if two hospitalized patients coincidentally have the same infection, or if one of them was infected by another.

“Instead of waiting to find an outbreak to sequence when a patient has symptoms, the basis

“We would then figure out where in the hospital the outbreak was occurring and then we would work to stop it through further investigation, staff education, and cleaning and sterilization,” said Dr. Sundermann. “This program showed that EDS-HAT was effective at preventing outbreaks that go undetected at hospitals without this program.”

Geonomic analysis

Algorithms used in the EDS-HAT technology included bioinformatics, also known as genomics analysis, which works by analyzing patient DNA using publicly available bioinformatics tools, a well-established methodology that helps researchers build an analysis pipeline and determine if one patient’s infection is the same as another’s, said Dr. Sundermann.

“For this study we looked at common bacterial pathogens that are seen in hospitals

and prioritized the ones where patients that had been in the hospital for more than two days or had recently been discharged from the hospital within the prior 30 days, to prioritize infections that were more likely to be acquired in the hospital and therefore more likely to cause an outbreak,” said Dr. Sundermann. “We have found that through genomic sequencing, we can address these infections faster with earlier intervention.”

patient’s infection is prevented, you’re freeing up a lot of money.”

Without tools like the EDSHAT, infection preventionists may spend time and resources trying to avert a nonexistent outbreak when patients happen to have the same type of infection, but the transmission is found to be from unrelated sources.

“It is very clear that hospitals will save money, reduce length of stay in hospitals and improve patient outcomes with this technology.

We intentionally use publicly available bioinformatics tools to build our analysis pipeline, as we call it, and we publish it extensively, so that other healthcare facilities can download the exact same tools we’re using and follow the exact same process we’re using, and it’s pretty well established.”

Saving hospitals money

During the time of the study, analysis showed that EDS-HAT prevented 62 infections and five deaths, compared to if the system had not been running. The project, through UPMC’s academic partnership with Pitt, netted savings of nearly $700,000 in infection treatment costs, which is a 3.2-fold return on investment.

“A hospital acquired infection increases a patient’s length of stay by nearly eight hospital days. The main metrics that we were looking for in this study were infections prevented, deaths prevented, and cost savings,” said Dr. Sundermann. “It costs about $90 to sequence a patient infection using our methodology. A typical infection, on average, can be about $20,000 to treat, so if one

Our hope is that the more that we share this with hospital leadership at other facilities, the more people are going to want to sign off,” said Dr. Sundermann. “It’s a true winwin for the hospital and patients, and so we are hoping that this will scale, and more people will adopt it.”

Expanding genomic sequencing to scale

The healthcare field is in general agreement that this technology works at preventing infections, said Dr. Sundermann. The next question, then, is how to expand the technology to scale.

“The evidence on cost savings for genomic sequencing technology is there and everything is moving in the right direction,” said Dr. Sundermann. “We must have discussions with hospital

leadership about this, and when other hospitals realize that this is a new approach works, I believe they’ll make investments in it.”

Dr. Sundermann and his research team hope to implement EDS-HAT at more healthcare facilities nationwide and wants the findings to contribute to ongoing conversations among U.S. health care leadership, payors and policymakers about the benefits of genomic surveillance as standard practice in health care.

If health care facilities across the U.S. adopt EDS-HAT, a nationwide outbreak system could be developed, similar to PulseNet, the U.S. CDC’s network for detecting multistate outbreaks of foodborne illness, said Dr. Sundermann.

“We intentionally use publicly available bioinformatics tools to build our analysis pipeline, as we call it, and we publish it extensively, so that other healthcare facilities can download the exact same tools we’re using and follow the exact same process we’re using, and it’s pretty well established,” he said.

Dr. Sundermann and colleagues previously found that, had such a system existed, a 2023 outbreak of deadly bacteria linked to contaminated eye drops could have been stopped far earlier.

“This was a great example that shows that when more hospitals are taking advantage of this approach to infection prevention, and that we can share that data, the more benefit we’re going to get,” said Dr. Sundermann. “We must encourage public health involvement, because in order to share this data across institutions, it will require public health or federal involvement.”

Stocked, Ready, and Connected

How distributor reps can help practices successfully navigate respiratory season.

Are you ready?

As respiratory season ramps up, physician offices will rely on their distributor reps to ensure they have rapid, reliable access to test kits, vaccines, and other critical supplies when demand spikes suddenly. Distributors not only help maintain adequate stock levels but also provide timely communication, product education, and logistical support so practices can respond quickly to surges in patient volume without disrupting care.

Indeed, demand for respiratory tests can spike suddenly during outbreaks, making preparedness and well-stocked inventory essential, said several key manufacturers whom Repertoire Magazine spoke to for this issue. Coordinated, well-planned sales calls –especially during high-demand seasons – are key to quickly meeting end-user needs and securing orders.

Healthcare providers we spoke to report that recent respiratory seasons have brought shifting patterns in dominant viruses, with simultaneous surges of flu, COVID-19, RSV, and other illnesses straining hospitals. Improved access to rapid testing and vaccines has helped mitigate severe cases, though gaps in routine immunizations and fluctuating community immunity continue to fuel outbreaks.

Also, Families Fighting Flu shares powerful real-life stories of children severely affected or lost to influenza to emphasize that the virus is far more dangerous than many realize. Through advocacy, education, and community partnerships, the nonprofit works to increase vaccination rates, dispel flu myths, and prevent future tragedies.

Empowering Customers with Data-Driven Diagnostics

Abbott’s Julie Shaw shares how to make respiratory testing a year-round priority.

For Abbott RSM Julie Shaw and her team, respiratory testing is a focus each and every month. “We see the greatest success when we begin laying the groundwork early in the calendar year to ensure strong momentum going into Q3, so we can support customers proactively ahead of the season,” she said.

Each year brings unique dynamics due to shifts in seasonality, prevalence, and circulation patterns. In recent years, patients have become more informed on seasonality and the type of testing that is available. They now expect rapid, accurate testing, which has reshaped the landscape of respiratory diagnostics.

Shaw believes thorough pre-call planning and clear communication can mitigate any reservations or issues that may arise with customer discussions. “Aligning on shared goals with our distribution partners before customer visits helps ensure productive engagements,” she said. A focused, strategic approach – especially considering post-pandemic preferences for virtual meetings – helps both the distributor and manufacturer rep connect with the right stakeholders and advance the sales process effectively.

Effective ride-days are also built on strong pre-call planning

The Abbott team tailors their respiratory testing strategy based on regional CDC data and seasonal trends. Outbreaks and promotions often guide their timing and messaging to ensure relevance and urgency.

“It’s important that we focus on providing diagnostic solutions for our customers that can flex to meet their testing needs based on what is circulating,” Shaw said. “The ID NOW rapid molecular platform provides flexibility and allows customers to quickly pivot based on what’s circulating in their community –making it easier to respond effectively and efficiently.”

and ongoing collaboration. Establishing clear next steps for each customer interaction and aligning on follow-up cadence ensures continuity. This not only drives deal closure but also helps identify new opportunities, resulting in a win-win for both the manufacturer and distributor.

“Building trust and maintaining a steady cadence of communication post-ride-day can significantly

accelerate deal closure and uncover additional opportunities.”

Shaw and her team track shared performance metrics and celebrate wins across teams to reinforce best practices. “This helps us continuously refine our approach and drive both sales and engagement.”

During peak respiratory season, customers may experience “respiratory fatigue.” However, strong distributor credibility can open the door for early, proactive conversations, encouraging customers to prepare ahead of spikes rather than react to them. “With respiratory season quickly approaching, we want to make sure our customers are prepared with tests on hand, so we have assay promotions running until the end of September that include: COVID-19, Flu A&B, Strep A and RSV.”

The Abbott team tailors their respiratory testing strategy based on regional CDC data and seasonal trends. Outbreaks and promotions often guide their timing and messaging to ensure relevance and urgency.

“The powerful insights provided by POC Link (a connectivity tool within ID NOW) enable us to analyze regional and customer-specific prevalence trends,” Shaw said. “We can then share these insights directly with customers, empowering them to leverage data to better prepare and serve their communities.”

Inside the Respiratory Season Playbook

BD territory managers share how to deliver when it counts most.

As respiratory season ramps up, frontline sales professionals like Damacio Ulibarri and LaRae Abney, Point of Care Territory Managers for BD, know that success isn’t just about selling products – it’s about strategy, adaptability, and trust. With rising flu and COVID cases triggering a sense of urgency across the healthcare space, selling during this critical time demands more than just timing. It demands best-in-class execution. The following are several best practices the two BD territory managers recommend.

1 Start early, stay proactive

While most customers begin inquiring about flu and COVID testing in June, BD’s strong distributor relationships often ignite conversations well before that. “Distributors need to stay ahead of the curve, especially in a competitive market where many companies are going direct with low-cost alternatives,” Ulibarri and Abney said. “Because of this dynamic, our distribution partners rely on us for early and accurate communication regarding BD Veritor updates and promotions. Having insights into upcoming promotions before the season gives our distributor reps a strategic advantage that they’re able to engage proactively with customers and retain business before competitors enter the conversation.”

2 Plan the ride-day with purpose

Both BD territory managers emphasized the importance of structure. “It is very important to establish clear daily objectives,” they said. Begin each day with a well-defined understanding of your goals and priorities. Once you have that, the next step is to plan your joint target account engagements. Identify specific accounts to focus on and outline the desired outcomes for each interaction.

impact. First and most important is high-quality lead generation.

“To achieve this, we need focused efforts on identifying and cultivating strong, qualified prospects,” they noted.

Secondly, what are the opportunities for future engagement?

“For success we need to strategically build relationships that support long-term growth and pipeline development.”

Finally, the closed business objectives. “Driving toward

Respiratory season creates a clear sense of urgency for customers.

3 Stay agile during outbreaks

Flu outbreaks, RSV spikes, or COVID surges often demand last-minute pivots. During the pandemic, BD’s team quickly transitioned to virtual platforms to maintain momentum. But as restrictions eased, BD’s team were some of the first to return to the field, showing up in-person where others were still remote. That willingness to adapt and prioritize support – whether in hospitals or parking lots – demonstrated BD’s commitment to being a reliable partner under pressure.

4 Evaluate success beyond the sale

The BD territory managers said there are several ways to measure

clearly defined sales goals and measurable outcomes.”

5 Reliability is paramount

Respiratory season creates a clear sense of urgency for customers.

“As flu and COVID cases rise, they need to trust that we can deliver reliable, high-quality testing products without delay,” they said.

“During peak seasons or outbreaks, such as during the early COVID epidemic, BD’s consistent supply and clinical accuracy made us the go-to choice, even as competitors faced backorders. Increased urgency during this time means distributor reps and customers lean heavily on us to deliver solutions fast and with confidence.”

Selling for Respiratory Season

A strategic, team-driven approach at Cepheid

At Cepheid, the ramp-up for respiratory season is a wellcoordinated and relationshipdriven effort that begins months in advance. Connie Bermingham, Regional Sales Director – West for Alternate Site & Channel Sales at Cepheid, sat down with Repertoire Magazine to share how her team prepares to meet seasonal demand and why strong distributor relationships are the key to success.

“We always say respiratory season starts August 1, but the preparation begins well before that,” Bermingham said. “By May or June, we’re already mentally, physically, and strategically getting ready. That includes everything from inventory planning

to aligning with our distributor partners on goals and strategies.”

This unified approach extends to Cepheid’s ride days with distributor reps – an essential part of relationship building. Rather than focusing solely on sales tactics, these joint field visits are about understanding the people behind the partnerships.

“It’s like a first date,” Bermingham laughs. “There can be some initial awkwardness, but it’s about getting to know what drives your partner – what their goals are, what motivates them, how they’re compensated. That understanding helps us align and sell better together.”

One example of this longterm strategy paying off is in

the Pacific Northwest. A rep in that region invested years into cultivating distributor relationships, and now those efforts are paying dividends.

“When I visited, the distributor leaders said, ‘We trust your rep completely. He’s educated us, supported us, and has always been honest. So now, we lead with Cepheid,’” says Bermingham. “That territory is not only thriving – it’s also the easiest for me to manage. That’s what every sales manager wants: high performance with minimal friction.”

As September hits, the market shifts. Experienced customers, anticipating the seasonal surge in respiratory illnesses, place large orders to ensure they’re ready. Cepheid supports this proactive behavior with strategic promotions and a strong emphasis on training and product knowledge.

“For new hires, we run refreshers. For experienced reps, we double down on focus,” Bermingham says. “We remind everyone: for the next few months, it’s all about respiratory.”

Despite the planning, some customers will inevitably be caught off guard. “You start to hear the ‘oh no’ calls in September –requests for emergency installs and staff training. Luckily, our systems are simple, and we move fast. But those situations reinforce why it’s better to prepare early.”

For Bermingham, the real measure of success during respiratory season isn’t just the sales numbers – it’s the relationships that endure long after the season ends. “When someone speaks highly of you and your product when you’re not in the room, that’s the true win. That’s what we work for.”

More Viruses, New Peaks

Doctors navigate the unpredictable nature of respiratory season.

If there is one thing to expect during respiratory season, it’s that it will have its own ebbs and flows compared to previous years. Indeed, healthcare providers who spoke to Repertoire Magazine said they have seen changes to which viruses are dominant during the last several respiratory seasons.

“Yes, we’ve seen some notable shifts,” said Dr. Laura Arline, chief quality officer and an internal medicine specialist at Florida-based BayCare Health System. “For example, flu has had

Dr. Laura Arline

“While vaccines for flu and COVID don’t eliminate the risk of transmission, they significantly reduce the risk of severe illness, hospitalization or death.”

a double peak in past seasons. COVID continues to circulate, but we didn’t see the winter peak we usually expect, and the dominant strain continues to change. We’ve also seen an increase in pertussis, which hasn’t been as prevalent in previous years.”

Based in Nashville, Tennessee, Vanderbilt University Medical Center’s Dr. Parul M Goyal said their health system is seeing an increased mix of COVID virus, RSV, and enterovirus a lot more than five years ago during the respiratory season.

Everything from environmental conditions like temperature and humidity to human

behavior such as travel, masking or vaccination can contribute to the rise or fall of respiratory infections, said Dr. Arline. Even shifts in school schedules or large gatherings can affect how viruses spread. “We’re also seeing that the previous year’s exposure – or lack of it – affects community immunity.”

Respiratory season always puts added pressure on emergency departments and inpatient units, both physicians said. “It’s something we prepare for systemwide,” Dr. Arline said. The strain is greater when multiple respiratory viruses peak at the same time – like flu, COVID and RSV.

Severity

Dr. Goyal said healthcare providers are seeing more severe cases in older adults primarily because of their age and underlying co-morbid illness. “They are also more prone to get severe RSV infections,” he said.

BayCare physicians are seeing a mix of mild and more complex cases. Among children, there’s been a noticeable increase in flu, partly due to a drop in routine vaccinations. “We’re also seeing more pertussis in both children and adults,” Dr. Arline said. “When immunity wanes, more people get sick, and some may experience more severe illness.”

Both healthcare providers noted that testing has become much more accessible – especially for COVID. “A few years ago, you could only get tested in a medical office, or your test would be sent to a lab with results returning days later,” Dr. Arline said. “Now, home tests are available for COVID – and even flu. This allows for faster treatment, better isolation practices and quicker reassurance for patients. Telemedicine has also improved access to care, letting people see a provider from home.”

Dr. Goyal believes the availability of rapid testing has eased the load on health systems. Patients are able to get diagnosed and treated early on and preferably in the outpatient setting, thereby obviating the need for the ED visit.

“[The rapid tests] might not catch everything,” he said. “However, the specificity is there, which means a positive test means it is positive.”

Vaccinations

Based on the latest CDC report of vaccinations, Dr. Goyal said the uptake is there for the available vaccines; “however, we can definitely aim for getting a much higher uptake.” He recommends that patients gather the vaccine related data and make an informed decision after discussion with their health care providers.

Dr. Arline said they are seeing some gaps in routine childhood

immunizations. On the adult side, there’s been encouraging uptake of the new RSV vaccine since its approval. “While vaccines for flu and COVID don’t eliminate the risk of transmission, they significantly reduce the risk of severe illness, hospitalization or death.”

Vaccine utilization

` According to the CDC, as of April 2025, only 1 in 5 adults over 18 and fewer than 1 in 10 children had received the updated 2024–25 COVID-19 vaccine.

` Just under half of adults and 2 in 5 children received a 2024–25 flu vaccine.

` Coverage is highest among adults 65 and older, with about 2 in 5 receiving the COVID-19 vaccine.

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From Prep to Peak

Keys to effective ride-days for respiratory season.

Ride-days before and during respiratory season are vital opportunities to strengthen customer relationships and drive product growth. According to a QuidelOrtho salesperson, success during these days hinges on one core principle: alignment.

“Goal alignment is probably the top challenge I face,” the salesperson shared with Repertoire Magazine. “I might have a different idea of what could be a qualified account for our product than my distributor does, so the ideal accounts don’t get targeted or there’s a mismatch in customer needs to our offerings. Sometimes it’s just not catching the right people to talk to in accounts.”

To overcome this, pre-planning is essential. The QuidelOrtho salesperson emphasized that

preparing for each ride-day with account-specific knowledge and clear objectives ensures both reps show up equipped to have impactful conversations. “A good discussion ahead of time to make sure goals are aligned is key.”

Measuring ride-day impact goes beyond just immediate sales. While aligned goals can lead to quick conversions – sometimes even sameday wins – the longer-term value lies in education and relationshipbuilding. “Anytime you can get out in the field with reps you’re planting seeds for future sales success. The more reps can see what your products can do and hear you talk about them the more they can better look for opportunities that match what you carry and talk about them on your behalf in their daily conversations with their customers.”

One memorable ride-day illustrated this perfectly. What began as a casual lunch with a distributor rep led to a breakthrough. They went over QuidelOrtho’s tests as a refresher, and one really clicked for the distributor rep based on issues in a few of his accounts. “We went by, and he confidently announced to his folks that he had the answer to their problems and turned it over to me – they agreed, and we had an easy placement. That led to several other successful ride-days and deal closes as well as several other wins with our products that he secured on his own without my help.”

Ride-days also shift with the seasons. Respiratory season, which ramps up in September and peaks from December through February, brings both opportunity and urgency. “Some customers are eager to hear about solutions, especially if they’ve been having issues,” the QuidelOrtho rep explained. “Others might be overwhelmed and delay decisions. That’s why it’s important to start conversations early.”

Staying informed is another key to success. Trends like flu outbreaks or RSV spikes can influence how a salesperson approaches customer visits. “Any new insights, data, or studies we can share are appreciated by customers and help build credibility,” the salesperson noted.

While recent years have brought uncertainty – especially during the height of COVID –things are starting to normalize. “We’re seeing flu, COVID, and RSV begin to follow more familiar patterns. But each year is still a little different, and staying adaptable is essential.”

Selling Respiratory Kits in Unpredictable Seasons

Sekisui Diagnostics’ William West on why pre-call strategy and planning matter more than ever.

Every July 1, William West, Account Executive Distribution and Alternate Care, Sekisui Diagnostics marks his calendar. It’s the unofficial time for respiratory products, when order and interest typically ramp up. It’s also when they run their end user promotion and distribution rep spiffs.

But the case load for physician offices often “starts on a dime,” he said. “Out of the blue, end users will suddenly see a huge uptick of sick patients and realize they need to order multiples of respiratory kits – Flu, COVID, Strep, RSV, etc. They will need them ‘yesterday,’ so we try to make sure distribution warehouses are well stocked with our kits.”

Every year is different, depending on the severity of the COVID/Flu season. For example, 2024-2025 was fairly harsh, but 2023-2024 was fairly mild. “Test kit sales are much higher, obviously, in severe years vs. mild years,” West said.

West knows distributor reps these days are super busy and hard to pin down. Pre pandemic, ride-days were quite common. “Post pandemic, not so much.”

West suggests that the ride-day experience would be most effective if distributor and manufacturer reps coordinated ahead of time by scheduling targeted appointments with the account decision-makers. He recommends distributor reps

text the address to their manufacturer counterpart to meet at the account, but they each drive separate cars to the next appointment.

The pre-call work is critical, and often the difference between a confirmed sale or an indecisive shrug. For example, a recent successful ride-day involved upgrading an existing customer from an antigen-based test to a new molecular COVID/Flu combo kit.

The distributor rep set the appointment, West met her at the account, and after presenting information on the new product, the user secured an order for one kit and two readers.

“It succeeded because the distributor rep had proper pre-call

planning, knew where to go, who to see, what to discuss, and asked for the sale after presenting,” West said. “Textbook sales call!”

End users will typically only stock kits as needed, so it’s important for reps to be prepared for the fluctuations. For example, during summer when it’s blazing hot outside and there is low COVID/Flu circulating, physician offices may see little need to have a bunch of respiratory kits on hand.

“But once a COVID/Flu/ Strep/RSV outbreak occurs, ride-days and direct calls to end user requests increase greatly,” West said, “and it’s all we can do to keep up.”

From Grief to Action

Parents turn flu tragedies into lifesaving campaigns.

For many families, the flu is seen as a temporary inconvenience –a fever, a few days off school, maybe some rest on the couch with soup and cartoons. But for the families of children like Kaden, the flu has left permanent scars – physically, emotionally, and economically.

In December 2022, 7-year-old Kaden’s mom thought he had a cold. Like so many parents, she wasn’t alarmed at first. But when his condition worsened, she rushed him to the ER just after Christmas. Within hours, Kaden

was airlifted to a children’s hospital where he later underwent a double amputation due to complications from the flu. In the same hospital, a 5-year-old boy fighting the same virus did not survive. Kaden, now almost 10, continues to face ongoing surgeries and challenges as he grows – reminders of a virus many underestimate.

Then there’s the story of a healthy 12-year-old girl who got her physical in the summer but fell ill with the flu that fall. Her journey included 93 days in three

different hospitals. At one point, doctors gave her just a 1% chance of survival. She beat those odds, but not without lifelong consequences, including the loss of part of her lung and a need for ongoing medication.

These are not isolated incidents. These are the real stories Families Fighting Flu shares – not to spread fear, but to raise awareness.

“The majority, if not all, of our family members didn’t skip the flu vaccine because they didn’t believe in it,” said Michele Slafkosky, executive director,

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Families Fighting Flu. “They simply didn’t think the flu was serious enough to make getting vaccinated a priority.”

Families Fighting Flu (FFF) was established in 2004 by a group of parents who had each experienced the unthinkable: losing a child under the age of five to influenza – at a time when flu vaccination was not yet recommended for healthy children that age. These grieving families came together to support one another and to advocate for change. They shared their stories

Awareness

Today, FFF remains a national nonprofit advocacy organization guided by its mission “to save lives and reduce hospitalizations by protecting children, families, and communities against influenza.” Their work centers on raising awareness about the seriousness of the flu through personal family stories, public education campaigns like Stay in the Game™ and Keep Flu Out of School, and partnerships with healthcare professionals and community groups. FFF offers

Over the past five years, vaccination rates have steadily declined and reversing that trend is a top priority. The organization is focused on advocating, educating, and collaborating with partners to boost immunization efforts ahead of the next flu season.

with the Advisory Committee on Immunization Practices (ACIP) and pushed for expanded flu vaccine guidelines. Their efforts played a pivotal role in the CDC’s 2010 decision to recommend annual flu vaccination for all individuals six months and older, marking a significant shift in public health policy.

“What united the [founding members] was disbelief – none of them could fathom that the flu had taken their child’s life,” Slafkosky said. “Their grief turned into purpose as they came together to raise awareness about the seriousness of the flu and to ensure other families wouldn’t have to endure the same tragedy.”

Their message was simple but urgent: it’s not “just the flu.”

free educational materials, hosts grassroots advocacy programs, and honors the families impacted by flu-related complications or loss. By emphasizing evidencebased information and sharing heartfelt experiences, they aim to make annual flu vaccination a priority and, ultimately, prevent future tragedies.

“We’re often known as the face of flu because of the powerful stories we share,” Slafkosky said. “Our mission is to educate and raise awareness – but we do it through storytelling. That’s what sets us apart.”

This past flu season, there were over 265 pediatric flu deaths – the highest number in a nonpandemic year since the CDC began reporting them. In total,

more than 26,000 people died from the flu during the 2024-2025 season alone.

But those numbers don’t tell the whole story. Over 610,000 individuals were hospitalized due to the flu. Many of them were previously healthy, yet left the hospital with life-altering complications – some with chronic conditions, others even facing amputations. These stories often go unheard.

Outreach

FFF works closely with healthcare providers, schools, and community organizations by offering a wide range of educational resources. These include print and digital materials such as videos, posters, postcards, coloring books, comic books, and social media graphics – many of which feature real family stories. FFF partners with hospitals, pediatrician offices, and school nurses to provide tools that encourage flu vaccination, often speaking to healthcare residents or incorporating stories into newsletters and outreach efforts. Their storytelling approach helps humanize the impact of the flu and motivates providers and communities to take preventative action.

In addition to traditional partnerships, FFF has expanded into more unconventional outreach methods. They have partnered with organizations like USA Boxing to host flu clinics at boxing events and have participated in state fairs, health festivals, and wellness events. While they don’t administer vaccines themselves, they are present with branded materials and educational tools to support vaccination efforts. These partnerships help FFF reach

diverse audiences and contribute to increasing vaccination rates, especially in community-based or non-clinical settings.

FFF also collaborates with “trusted messengers,” often family members directly impacted by flu-related tragedies, who now lead flu clinics in their communities. For example, a schoolteacher and mother who lost her 16-year-old son to the flu now coordinates mobile clinics at schools in her area. Another board member in Iowa has organized multiple annual clinics in memory of her daughter. FFF also supports largescale public health efforts, such as their work with the Rhode Island Department of Health, which runs more than 250 onsite school flu clinics. These grassroots and institutional partnerships highlight FFF’s dedication to increasing awareness and vaccination access nationwide.

In the short term, Families Fighting Flu aims to increase flu vaccination rates, especially as current surveillance shows rising flu-related illnesses, hospitalizations, and deaths. Over the past five years, vaccination rates have steadily declined and reversing that trend is a top priority. The organization is focused on advocating, educating, and collaborating with partners to boost immunization efforts ahead of the next flu season. While the overall goal remains simple – increasing vaccination and reducing flu’s impact – the current public health climate is challenging. That’s why the organization is committed to staying flexible, adjusting its messaging, and being creative in its outreach to meet the evolving needs of different audiences.

Long-term, the goal is to build consistent year-over-year improvements in vaccination rates and, ultimately, prevent more flu-related tragedies. A key part of this strategy involves crafting culturally relevant and trustworthy messaging.

For example, FFF developed an indigenous-focused campaign featuring the story of Amiah Morningstar Houseman, a young girl who died from the flu, ensuring that the content reflected the values and preferences of that community. Similarly, they’ve found that certain campaign

Common myths

formats – like simple, relatable posts with links to trusted sources – are often more effective than polished video reels, depending on the audience. The broader objective is to rebuild public trust, especially among those who are vaccine-hesitant or fatigued, and to move them toward making informed decisions about flu prevention.

“We share these stories to show just how serious the flu can be and why prevention and awareness are so critical,” Slafkosky said.

Some of the biggest misconceptions from the general public about the flu include:

1 “The flu vaccine can give you the flu.”

The flu vaccine cannot give you the flu. The injectable flu vaccine contains inactivated virus or pieces of the virus that cannot cause illness. Some people may experience mild side effects, such as a sore arm or low-grade fever, but this is not the flu – it’s a sign that the body is building protection.

2 “It’s just a bad cold.”

Many people confuse the flu with the common cold, but influenza is a serious respiratory illness that can lead to severe complications, hospitalizations, and even death – especially among young children, the elderly, pregnant individuals, and those with underlying health conditions. Unlike a cold, the flu often comes on suddenly with high fever, body aches, fatigue, and respiratory symptoms.

3 “Healthy people don’t need the flu vaccine.”

A major misconception is that only people with weakened immune systems need to be vaccinated. In reality, healthy individuals –including children, teens, and young adults – can get severely ill from the flu. Vaccination not only protects the individual but also helps protect others in the community, including those who can’t be vaccinated.

Addressing these misconceptions is crucial to improving flu vaccination rates and saving lives, FFF noted.

Red Flags in Children’s Health

Screen time, chronic conditions, and missed care all contribute to the health decline in U.S. children, study says.

 A new research study has found that the health of U.S. children has declined significantly since 2007. In the U.S. specifically, children were found to be 15% to 20% more likely to have a chronic condition in 2023 than in 2011.

In particular, the prevalence of depression, anxiety, sleep apnea and obesity in children all increased during the “Trends in US Children’s Mortality, Chronic Conditions, Obesity, Functional Status, and Symptoms” study period (2007-2023), as did rates of autism, behavioral problems, developmental delays and attention-deficit hyperactivity disorder.

To foster better health outcomes for children, the basics of good nutrition, proper sleep and adequate exercise remain essential.

Recently, however, the rising use of cell phones, the internet and social media among younger generations have been contributing factors to a decline in mental and behavioral health for children.

“The past decade has been uniquely impacted by the ubiquitous presence of hand-held electronic devices and nearly unfettered internet access for almost all children in the developed world regardless of race or socio-economic status,” said Dr. Michael Artigues, president of the American College of Pediatricians (ACPeds).

In the past five years, internet access and social media use have been a significant trend affecting children’s health. A 2019 report found that 8-to 12-year old’s experience almost five hours of screen exposure each day, and teens view screens for an average of nearly seven and a half hours each day, excluding screen time for completing schoolwork.

Excessive exposure to screens at a young age is associated with lower academic performance, sleep disturbances, obesity, attention deficit, increased aggression, lower self-esteem, depression,

and increased rates of highrisk behaviors among children, according to ACPeds.

“This includes social media and the challenges it presents, particularly in mental health, interpersonal relationships and the previously mentioned need for proper sleep/exercise,” said Dr. Artigues.

Getting regular checkups

Regular pediatric checkups can help identify and address childhood health issues. The most common conditions detected during routine annual pediatric visits include developmental issues, vision and hearing problems, and developmental disorders such as autism and attention-deficit/ hyperactivity disorder.

health issues such as obesity and anxiety and/or depression,” said Dr. Artigues.

Regular well-child visits provide the opportunity for pediatricians to answer parents’ and caregivers’ questions and to provide age-appropriate guidance on an individual basis, promoting positive long-term health outcomes for children.

“When diagnosed and addressed early on, problems diagnosed during checkups are more likely to be successfully addressed as the underlying causes are often initially treated with basic measures such as changes in diet, screen use and sleep hygiene,” said Dr. Artigues.

Pediatricians are often frontline providers for children and

The ACPeds “Benefits of the Family Table” abstract reinforces the importance of regularly eating together as a family as a way to improve family well-being, and encourages pediatricians to communicate with parents to make every effort to regularly gather around the “Family Table” for meals.

At a child’s well visit, a pediatrician checks vision and hearing, evaluates mental health or recent changes in mental health, provides immunizations for childhood diseases, gets to know a child’s sleeping, nutrition, and physical activity habits and assesses if a child is meeting agebased developmental milestones.

“General annual exams with the typical associated screening tools are often able to pick up problems with vision, blood pressure and common physical/mental

are instrumental in addressing the rise in mental health issues for children and adolescents. These providers play a key role screening children, providing early intervention, and referring children and their families to the appropriate medical professionals.

“The first step of any problem is its diagnosis,” said Dr. Artigues. “From there, decreases in risk factors and, when needed, active treatment or referral to mental health professionals can be initiated.”

ACPeds recommends that all adolescents be screened for depression and treated appropriately. ACPeds also encourages adolescents and families to develop habits that support mental health and decrease the likelihood of developing depression.

Healthy habits include improving family connections – such as eating meals together, volunteering together, and participating in religious activities as a family. Keeping a gratitude journal and limiting social media use may help both in preventing and mitigating depressive symptoms in children, according to ACPeds.

Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccinepreventable disease outbreaks and epidemics, especially among children, according to a National Library of Medicine study titled “Vaccine Hesitancy.”

While there has always been a small but significant subset of parents who desire to either make personal adjustments to the recommended vaccine schedule or forego preventive vaccination altogether, the study noted many pediatric offices have seen an increase in such vaccine hesitancy following the pandemic and its

that screen time be avoided for all children younger than 18 months and limited to one hour per day for children two to five years of age.

To address growing concerns around technology use, in the “Media Use and Screen Time— Its Impact on Children, Adolescents, and Families,” abstract, ACPeds encourages parents to become media literate and limit screen time for their children. ACPeds also affirms limiting children’s exposure to screen time due to the negative effects of excessive use and its long-term impacts on the health of young children and adolescents.

Excessive exposure to screens at a young age is associated with lower academic performance, sleep disturbances, obesity, attention deficit, increased aggression, lower self-esteem, depression, and increased rates of high-risk behaviors among children, according to ACPeds.

The ACPeds “Benefits of the Family Table” abstract reinforces the importance of regularly eating together as a family as a way to improve family well-being, and encourages pediatricians to communicate with parents to make every effort to regularly gather around the “Family Table” for meals.

Childhood vaccination

Annual checkups and well-being visits for children also have an important role in keeping children on track with vaccinations and preventing transmissible diseases.

“Since most vaccines cannot be given to feverish or seriously ill children, the best time to review and address vaccination needs is during a well visit,” Dr. Artigues.

emphasis on the Covid vaccine for the general population.

The National Institutes of Health continues to recommend immunizations as a safe and effective way to protect children from disease. Regular vaccination at children’s well visits not only safeguards each child but also plays a crucial role in preventing outbreaks and promoting public health.

Reducing screen time

Technology – particularly visual media – has become increasingly influential in shaping the lives and health outcomes of children, adolescents and families in the United States.

The American Academy of Pediatrics guidelines recommend

ACPeds also asserts that parents must lead by example and restrict their own personal screen time to foster a healthy relationship with their children. The organization encourages pediatricians to regularly warn families about the negative impacts of media during wellchild visits, and calls upon the media industry, sponsors, educators and policymakers to act responsibly to protect the physical and emotional health of children and families.

Facing barriers to care access

Many children in the U.S. often face significant barriers to accessing care, similar to those experienced by adults, and these obstacles

can be more detrimental during a child’s developmental years.

Barriers to healthcare access for children include financial concerns and caretaker inability to access care, provider shortages, and/or previous negative experiences, less family-centered communication, lower trust, and less partnership between families and providers, increased rates of adverse events and provider bias, according to the National Institutes of Health.

In fact, nearly half of U.S. children with a treatable mental health disorder did not receive treatment from a mental health professional

distribution of resources may also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions for children.

“There will always be financial barriers to recommended pediatric care, even in developed nations such as our own, including access to comprehensive health insurance, transportation needs and the lack of access to quality pediatric-specific healthcare providers,” said Dr. Antigues.

Despite these challenges, preventive health services and annual pediatrician visits are

a key role in facilitating access to these types of services, according to the NIH.

Parents provide the foundational role of support and guidance for their children, including the fundamental right to direct the child’s upbringing, according to ACPeds’ abstract on the “Roles, Responsibilities, and Rights of Parents.”

Ensuring the health and wellbeing of children consequently requires a multifaceted approach between parents, healthcare professionals, pediatricians and the community to prioritize and

Infection control

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From Sick Care to Well-Being

The importance of whole health in family medicine.

By Jenna Hughes

 When it comes to a patient’s health, clinical care is only one piece of the puzzle.

Indeed, only 16% of health outcomes are attributed to clinical care, according to the American Academy of Family Physicians (AAFP).

Nearly 34% of all health outcomes result from patients’ health behaviors outside of clinical settings, and 47% are attributed to patients’ socioeconomic factors such as where people live, work and play.

To fully support patients, primary care must extend beyond the clinical space to address broader health and lifestyle needs. A significant contributing factor to patients’ health outcomes are the behaviors, lifestyle, and choices they make on their own outside of healthcare facilities. Thus, healthcare providers must focus on addressing the remaining 84% of patients’ lifestyle outside of the physician’s office.

Family and primary care physicians play a critical role in guiding patients toward better health outcomes by addressing underlying behavioral and lifestyle factors that contribute to overall well-being.

The active role of the patient in their own healthcare and well-being, known as Whole Health Care, includes the social and structural determinants at the root of poor health, focusing on the priorities and goals of people and communities, centering on promoting resilience, preventing disease and restoring whole-person health, according to AAFP.

“Whole Health is about seeing the person behind the patient,” said Steve Furr, MD, FAAFP, Board Chair of the American Academy of Family Physicians. “It’s a framework that focuses not just on treating disease, but the underlying causes, their entire health history and what really matters most to the patients.”

A Whole Health approach encourages moving beyond symptom management to promote long term wellness.

“By addressing physical, emotional, social and behavioral health together, Whole Health

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Care shifts care from a reactive model to a proactive, patientcentered approach.”

Elements of Whole Health Care

The practice of Whole Health Care goes beyond in-person, clinical healthcare; rooted in patients having community support and a healing environment, a key element to improving overall health outcomes.

A people-centered care approach focuses on seeing a patient as a whole person – not just their symptoms or illness. Focusing on the individual considers a person’s life experiences and overall situation and relies on long-term, relationshipbased care to build patient and community trust.

Comprehensive and holistic care refers to addressing an individual’s health, with physicians

Physicians that are able connect and work closely with other specialists and community resources have a better chance of improving significant health factors that affect individuals and communities.

Whole Health Care employs both spiritual and mental dimensions to understand patient behavior and what matters to an individual, enabling patients to take an active role in maintaining their personal health. According to AAFP, when physicians approach care from a patientcentered perspective, patient experiences and reported outcomes are improved, patients have increased access to care, healthcare expenditures are lower, and patients see improvement for specific conditions such as chronic pain, mental health, traumatic brain injury and aging.

The Whole Health Care model consists of five elements:

` People-centered care,

` Comprehensive and holistic care

` Upstream focused care

` Equitable and accountable care

` Team well-being

working as a clinical team to find and treat the root causes of illness and bringing different health care providers together as a team to provide well-rounded care. Comprehensive care is what care is provided and includes regular medical treatments, but it assesses important factors like lifestyle, social needs and education. Holistic care describes how care is provided and focuses on caring for the whole person, their family and the community.

When a family physician builds a strong, trusted relationship with a patient, it serves to support other important factors that affect health and well-being, such as behavior, social, structural, economic and environmental factors, according to AAFP.

Physicians that are able connect and work closely with other specialists and community resources have a better chance

of improving significant health factors that affect individuals and communities.

Improving the social factors affecting health ensures that everyone has fair and accessible health care and is a key aspect of health equity, according to AAFP.

AAFP’s Health in All Policies, which addresses policy decisions made at the federal, state, and local levels directly affect community health by influencing the social and economic factors that drive the social determinants of health improve population health, promote sustainability and advance health equity. Physicians can advocate for environmental, policy and systemic changes in the communities where they live and work and promote equity and accountability for all.

Finally, team well-being is a foundational element of any whole health and lifestyle medicine approach, according to AAFP, with benefits for the interprofessional team and the patients they are providing care to by reducing burnout and promoting workplace-wide wellness.

Lifestyle medicine principles

Whole Health Care aligns closely with Lifestyle Medicine, an evidence-based field that leverages behavior-based interventions (nutrition, physical activity, sleep, etc.) to prevent, treat, and reverse chronic disease.

Implementing Lifestyle Medicine principles in primary care settings can provide a solid foundation for incorporating whole health approaches to patient care, according to AAFP.

The pillars of lifestyle medicine work together with whole health approaches to support

physicians looking to complement treatment-based care and emphasize behavioral and lifestyle factors that improve whole health outcomes.

Family physicians, according to AAFP, are uniquely positioned to integrate whole health and lifestyle medicine into their routine care.

“When care teams understand the full context of a patient’s life – including social drivers of health like housing, food access, and emotional well-being – they can tailor interventions that are more effective, sustainable, and aligned with each person’s unique circumstances,” said Dr. Furr.

“Family physicians are well positioned to incorporate these factors into care plans.”

The power of primary care

Patients are best served when their primary care needs are addressed by a physician-led, integrated care team and feature a trusted relationship with their physicians.

Trusted relationships and open dialogue with patients allow family physicians to align their care with the patient’s values and treatment goals, according to AAFP. Family physicians can also connect patients with other health professionals and specialists who promote whole health

care and wellness to support system-level changes.

“Family physicians are at the heart of their communities – and they often build relationships with patients that span years, even generations,” said Dr. Furr. “That continuity and trust make them ideally suited to lead the charge in whole health care.”

“They don’t just treat symptoms; they understand the bigger picture; they really listen to patients to understand what is most important to them,” said Dr. Furr. “Family physicians are trained to care for the whole person – across all ages, backgrounds, and conditions – and

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they know how to connect medical care with lifestyle, behavioral and social support that impact long-term health.”

In collaboration with the Ardmore Institute of Health, AAFP is working to give family physicians the tools and support they need to make lifestyle and behavioral health interventions an everyday part of their practice.

This includes resources that help physicians address the social drivers of health, implement whole-person care, and ensure their communities have access to healthy lifestyle support and scholarships for family medicine residents to attend the AAFP’s Lifestyle Medicine conference, which “equips the next generation of physicians to lead in promoting long-term, community-based health.”

AAFP is the recipient of grants from the Ardmore Institute of Health and the Healing Works Foundation that are amplifying the voices of family physicians and shaping a future centering care on health and wellness.

“Together, the organizations will explore how payment models and training programs must evolve to ensure that whole health strategies are scalable and sustainable for all primary care physicians and practices,” said Dr. Furr.

Whole Health Projects

The AAFP’s Whole Health pilot projects aim to examine how family and primary care physicians can increase their impact on community health and wellness through Whole Health Care.

The projects increase awareness for Whole Health approaches among the healthcare community by leveraging existing

materials and resources and providing support and technical assistance to family medicine practitioners. Each medical practitioner documents lessons learned and disseminated findings across public health, lifestyle medicine and family medicine audiences.

The anticipated outcomes of the Whole Health projects has been to increase the availability and access to technical assistance, products and other resources, increase awareness and understanding of whole health concepts among AAFP members, increase awareness of findings and available tools and strengthen the health care system infrastructure.

taking place in the U.S. cities of Springfield, MO, Phoenix, AZ and Columbia, MD to understand how family physicians can best impact the lives of patients outside the clinic.

Facilitating Whole Health

Dr. Julia Flax, of CoxHealth Medical Center in Springfield, partnered with Ozark Food Harvest and Umoja Food for Health to develop a Whole Health pilot project that incorporates lifestyle medicine and whole health approaches for individuals with food insecurity by supplying prescription food boxes to her practice’s patients.

“Our motivation for joining the AAFP’s Whole Health program was deeply rooted in the

“A key innovation is the direct-to-home shipping of these food boxes, which eliminates transportation barriers. Each box also includes a pre-paid debit card for fresh produce, empowering patients to choose their own healthy options and actively apply their lifestyle medicine education in their daily lives.”

AAFP aims to broaden the primary care community’s understanding of whole health and lifestyle medicine through the information and lessons learned in the pilot projects using the six pillars of lifestyle medicine as foundational knowledge for participating physicians. The whole health approach empowers patients, families and communities to focus on social determinants of health in addition to treating traditional risk factors for disease.

The first of AAFP Whole Health pilot projects are currently

program’s core objectives: integrating whole health approaches, focusing on lifestyle medicine, and addressing social determinants of health through community collaborations,” said Dr. Flax.

The prescription food boxes contain medically tailored meals customized by a registered dietician with nutritional guidelines for patients with diabetes and heart disease. Boxes are delivered directly to the patient’s home.

“A key innovation is the direct-to-home shipping of these food boxes, which eliminates

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transportation barriers,” said Dr. Flax. “Each box also includes a pre-paid debit card for fresh produce, empowering patients to choose their own healthy options and actively apply their lifestyle medicine education in their daily lives.”

Patients at CoxHealth are being informed and educated about the Whole Health approach through several integrated methods.

“Patients are identified for this project after assessing their needs through a health-related social needs assessment conducted by our population health care navigators,” said Dr. Flax. “It’s these care navigators who then inform patients about this program and guide them through the entire experience.”

the community with tailored prescription food boxes, in addition to comprehensive lifestyle medicine nutrition education, therefore improving the health outcomes of underserved patients.

“Our population health team was already proactively integrating whole-person care into patient services,” said Dr. Flax.

“This pilot perfectly aligned with our goals, offering a structured framework to directly address food insecurity among our underserved patients with diabetes and hypertension.”

Overcoming barriers

In the Phoenix Whole Health: Pilot Projects, Dr. Jose RodriguezGarcia at Spectrum Medical Care

“We have learned that strong partnerships and direct communication channels between health care workers and community organizations are crucial for streamlining processes and overcoming barriers when delivering Whole Health Care.”

The program’s emphasis on a holistic approach to care allowed CoxHealth to tackle a critical social determinant of health by focusing on nutrition, ultimately aiming to improve its patients’ overall health in a comprehensive way.

“As a direct result of the Whole Health pilot, we’ve significantly transformed aspects of patient care,” said Dr. Flax. “We’ve enhanced our integration of lifestyle medicine by leveraging a strong partnership with a local community organization.”

The collaboration with AAFP enables CoxHealth to provide

Center worked with the ‘Chicanos por la Causa’ and ‘one·n·ten’ outreach programs with a community aim to help prevent HIV transmission within the Phoenix LGBTQ+ community while improving social connection and stress management strategies among participants.

In Columbia, Dr. Lindiwe Greenwood of Total Renaissance Wellness partnered with ‘HopeWorks’, Healing House’ and ‘Edesiagurl’ to provide wellness programs integrating nutrition, physical activity, social connection and stress management for survivors of domestic and sexual violence.

Each of the AAFP pilot projects emphasized the importance of addressing social drivers for health through holistic care and leveraging community resources and partnerships to help meet patient’s needs.

“We also learned from the projects that strong partnerships and direct communication channels between health care workers and community organizations are crucial for streamlining processes and overcoming barriers when delivering Whole Health Care,” said Dr. Furr.

“This pilot has generated significant success stories and demonstrable impact, strongly evidenced by the profound feedback from our patients,” said Dr. Flax. “Their comments highlight a direct and positive shift in their ability to access and consume healthy foods, which is a critical outcome for addressing food insecurity. For instance, patients have shared that the boxes were ‘a game changer with how expensive healthy food has gotten’ and ‘really helping me get by’ when other assistance was cut.”

Beyond increased access to nutrition, the CoxHealth project has directly influenced healthier eating habits and culinary exploration for Dr. Flax’s patients. Of the 68 patients meeting the criteria to participate in the prescription food box program, 45 have enrolled, leading to a 66.2% engagement rate, according to AAFP data.

“Patients have reported ‘reaching for healthier items to cook and snack on,’ and discovering new food favorites. The convenience of the microwaveable meals in the boxes was also

greatly appreciated, with one participant noting, ‘The microwaveable meals have been surprisingly tasty and keeping me away from fast food while at work.’

Dr. Flax says that the project demonstrated the significant impact of addressing social determinants of health through a whole-person approach.

Using electronic health records and health-related social needs screening tools allowed Dr. Flax and her team to precisely identify patients with specific conditions such as diabetes mellitus and hypertension who experience food insecurity to address the nutrition pillar of lifestyle medicine.

“Moving forward, we are formalizing our measurement of both qualitative and quantitative impact. We are now conducting follow-up ‘Starting the Conversation’ surveys, in addition to collecting biometric readings and HgbA1c levels to more formally track the health outcomes and overall effectiveness of this vital program,” said Dr. Flax.

“The success of this pilot, strongly reinforced by patient experiences, has led us to now focus on scaling this model to ensure more patients receive the comprehensive care they deserve,” said Dr. Flax.

Dr. Furr says that hearing the real-world success stories from the pilot project initiatives can inspire other family physicians to implement similar programs in their own practices.

“These stories demonstrate the positive impact of integrating lifestyle medicine and community collaboration, fostering a collaborative, equitable, holistic healthcare environment,” said Dr. Furr.

Success in collaboration

A key component of effective primary care is recognizing that a patient’s life circumstances play a central role in their health outcomes.

AAFP continues to work to solidify primary care’s place in a health care system focused on achieving whole health rather than by solely treating disease. In practice, this means building relationships with community organizations, nonprofits, local organizations, and more to promote the health and well-being of the community.

“We have learned that strong partnerships and direct communication channels between health care workers and community organizations are crucial for streamlining processes and overcoming barriers when delivering Whole Health Care,” said Dr. Furr.

The AAFP Whole Health: Project Plan is designed to be replicated by any physician seeking to

develop or expand a partnership with a community organization. The project plan template from AAFP, a guide focusing on identifying outcome goals for project’s strategy, is designed to be used by any physician who wants to start or grow a partnership.

The addition of partnership impacts to the model helps physicians create a plan for working with and within community groups, according to AAFP.

AAFP has also compiled a list, known as the Whole Health Guide, of valuable resources and tools to help family physicians make collaboration successful, including case studies, research projects, personal health inventories, and more.

“With the right tools, training, and support, family physicians can bring Whole Health to life in their practices every day – helping patients thrive, not just survive,” said Dr. Furr.

Improving Health Equity Through Pulse Oximetry

 One of the biggest challenges in healthcare today is ensuring that all patients receive quality care, despite their skin color, race, gender, or sexual orientation. There are plenty of factors that play into health equity, both biological and structural. Unfortunately, cognitive bias plays a role as well, leading providers to use presuppositions and flawed judgements to make a bad call regarding a diagnosis. These kinds of things happen all the time, contributing to this chasm of health equity amongst differing patient demographics.

One area that is improving in regard to health equity is pulse oximetry. Pulse oximeters are non-invasive devices that use sensors to shine a light through the patient’s finger to determine how well oxygen is being delivered through the body. This has come to be known as the fifth vital sign, along with heart rate, blood pressure, temperature, and respiration, acting as an excellent, non-invasive way to monitor patients. But even while it’s improving health equity, it certainly isn’t perfect.

Health equity through pulse oximetry

Pulse oximeters play an invaluable role in healthcare, especially during the height of COVID-19, as a way to manage care for patients based on their blood oxygen levels. But when those numbers are inaccurate, it can create a dangerous environment for treating patients.

The FDA released new draft guidance in January 2025 on pulse oximeters after evidence showed that these devices can have socalled “blind spots” for patients with darker skin pigmentation. Because melanin absorbs the

Is your pulse oximeter treating all patients equally?

Is your pulse oximeter treating all patients equally?

Is your pulse oximeter treating all patients equally?

A review of the evidence from a recent prospective study enrolling healthy volunteers evaluating the effects of skin pigmentation and perfusion index on pulse oximeter accuracy.†,‡

A review of the evidence from a recent prospective study enrolling healthy volunteers evaluating the effects of skin pigmentation and perfusion index on pulse oximeter accuracy.†,‡

Nellcor™ pulse oximetry

A review of the evidence from a recent prospective study enrolling healthy volunteers evaluating the effects of skin pigmentation and perfusion index on pulse oximeter accuracy.†,‡

Missed hypoxemic events in subjects with dark skin and low perfusion.

Missed hypoxemic events in subjects with dark skin and low perfusion.

Nellcor™ pulse oximetry

Nellcor™ pulse oximetry

Masimo SET ™* pulse oximetry

Masimo SET ™* pulse oximetry Missed hypoxemic events in subjects with dark skin and low perfusion.

Medtronic is working to close the inequity gaps

Medtronic is working to close the inequity gaps

Medtronic is working to close the inequity gaps

We are collaborating with regulators, academics, and clinicians to enhance guidelines and standards.

We are collaborating with regulators, academics, and clinicians to enhance guidelines and standards. We are expanding education on Nellcor™ technology use to enable clinicians to serve all patients.

We are expanding education on Nellcor™ technology use to enable clinicians to serve all patients.

We are collaborating with regulators, academics, and clinicians to enhance guidelines and standards. We are expanding education on Nellcor™ technology use to enable clinicians to serve all patients. We are including 40% enrollees with dark skin in future testing to ensure performance for all patients. We are investing in science and innovation to improve our pulse oximetry portfolio.

We are including 40% enrollees with dark skin in future testing to ensure performance for all patients. We are investing in science and innovation to improve our pulse oximetry portfolio.

We are including 40% enrollees with dark skin in future testing to ensure performance for all patients. We are investing in science and innovation to improve our pulse oximetry portfolio.

Scan the QR code for more information

†Oxygen saturation accuracy can be affected by certain environmental, equipment, and patient physiologic conditions that influence readings of SpO2. Please consult the instructions for use and manual for full safety information.

†Oxygen

Nellcor™ pulse oximetry missed

Nellcor™ pulse oximetry missed fewer hypoxemic events for subjects with dark skin and low perfusion than Masimo SET ™ * pulse oximetry.1

74%

74%

74%

fewer hypoxemic events for subjects with dark skin and low perfusion than Masimo SET ™ * pulse oximetry.1

Nellcor™ pulse oximetry missed fewer hypoxemic events for subjects with dark skin and low perfusion than Masimo SET ™ * pulse oximetry.1

‡The study enrolled 146 healthy subjects and examined the Nellcor N-595 and Masimo Radical-7™* pulse oximeters. The study enrolled 146 healthy subjects in the 92%-96% saturation range and examined the Nellcor N-595 and the Massimo Radical 7 pulse oximeters 1Gudelunas MK, Lipnick M, Hendrickson C, et al. Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024;138(3):552561. doi:10.1213/ANE.0000000000006755. Scan the QR code for more information

‡The

enrolled 146 healthy subjects and examined the Nellcor N-595 and Masimo Radical-7™* pulse oximeters. The study enrolled 146 healthy subjects in the 92%-96% saturation range and examined the Nellcor N-595 and the Massimo Radical 7 pulse oximeters 1Gudelunas MK, Lipnick M, Hendrickson C, et al. Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study. Anesth Analg. 2024;138(3):552561. doi:10.1213/ANE.0000000000006755.

© 2024 Medtronic. All rights reserved. Medtronic, Medtronic logo and Engineering the Extraordinary are trademarks of Medtronic. ™* Third party brands are trademarks of their respective owners. All other brands are trademarks of a Medtronic company. medtronic.com 6135 Gunbarrel Avenue, Boulder CO 80301

© 2024 Medtronic. All rights reserved. Medtronic, Medtronic logo and Engineering the Extraordinary are trademarks of Medtronic. ™* Third party brands are trademarks of their respective owners. All other brands are trademarks of a Medtronic company. medtronic.com 6135 Gunbarrel Avenue, Boulder CO 80301

the Extraordinary are trademarks of Medtronic. ™* Third party brands are trademarks of their respective owners. All other brands are trademarks of a Medtronic company. medtronic.com 6135 Gunbarrel Avenue, Boulder CO 80301

red and infrared light from the oximeter, it can cause the device to provide inaccurate oxygen saturation levels in people with darker skin tones. This can lead to higher rates of occult hypoxemia, a condition where a person’s blood oxygen level is dangerously low, though it won’t be picked up by pulse oximeters.

A study published by PubMed documented the racial disparity in oxygen saturation measurements by pulse oximetry, saying, “Overestimation of oxygen saturation in patients with dark skin tones has serious clinical implications, as these patients may receive insufficiently rigorous medical when pulse oximeter measurements suggest that their oxygen saturation is higher than the true value.”

Another study published by JAMA Internal Medicine found that in a group of patients with COVID-19, the oxygen saturation levels in Asian, black, and Hispanic patients were overestimated by pulse oximeters compared to white patients. According to the results of this study, the inaccurate oxygen saturation levels in those groups contributed to either “unrecognized or delayed recognition of eligibility to receive COVID-19 therapies.”

When oxygen saturation levels are inaccurate, it can seriously compromise patient safety – without the total picture of the patient’s health, how can providers accurately give a diagnosis? Even beyond the immediate ways to address those concerns, like supplying oxygen, it can result in dangerous conditions slipping through the cracks.

Bridging the gap

Understanding how pulse oximetry limitations can impact

patient care is crucial for helping providers to make clinical and diagnostic decisions, especially in the fast-paced environment of an ambulatory surgery center. As ASCs continue to handle a growing volume of outpatient procedures involving anesthesia and sedation, ensuring patient safety through continuous and accurate monitoring has never been more important.

Pulse oximeters like Nellcor from Medtronic are designed

moment-to-moment readings that are generated from arterial signals.

Jason Case, VP of R&D for Acute Care & Monitoring at Medtronic, told Modern Healthcare , “Think of it like trying to find a signal in a fog. Our AI is trained to recognize even faint pulses, no matter how thick the ‘fog’— whether it’s caused by pigmentation, low perfusion or a weak signal. It tells us exactly when to take a measurement, improving accuracy when patients need it most.”

When oxygen saturation levels are inaccurate, it can seriously compromise patient safety – without the total picture of the patient’s health, how can providers accurately give a diagnosis?

to help bridge the health equity gap. While there are plenty of pulse oximeters on the market, Medtronic has taken a unique approach to integrating modern technology that simplifies a technology that’s already accessible. The pulse is identified through artificial intelligence –by focusing on the pulse as the foundation, the oximeter allows providers to track and monitor the patient during their time at the ASC.

Once the pulse has been identified, the signal is scrubbed to clean up any noise or interference, due to motion or low perfusion. OxiMax technology, a digital memory chip designed to enable higher accuracy and improved performance, is used to calibrate the signal. From there, the entirety of the Nellcor OxiMax system is used to deliver accurate,

For a fast-paced setting like an ASC, tools like this greatly improve efficiency and quality of care for the whole facility. By bridging that health equity gap, providers can ensure that all of the patients are receiving the care that they need, based on accurate monitoring results.

“We want to design technologies with all patients in mind from day one, not retrofit them later,” Case said to Modern Healthcare . “That’s why we’re investing early in diverse patient cohorts, including collaborations around the world, like in India, to ensure we're capturing a wide range of physiologic characteristics. Innovation is not just about advancing technology. It’s about making sure that innovation reaches everyone – and works for everyone.”

Tracking Clinical Data in an Ambulatory Surgery Center

How ASCs can turn clinical data into better patient care.

By Pete Mercer

Editor’s note: This is part two of a two-part series

 As the demand for high-quality, cost-effective surgical care continues to grow, ambulatory surgery centers (ASCs) are playing a more prominent role in the healthcare landscape. But building a successful ASC isn’t just about bricks and mortar – it requires a strategic approach grounded in culture, compliance and clinical performance.

To better understand how ASCs can use clinical data to not only meet regulatory standards but also drive measurable improvements in patient outcomes, Repertoire Magazine sat down with Lisa Austin, a senior consultant with Avanza Strategies. With more than four decades of healthcare experience – and 35 of those focused specifically on developing and operating ASCs – Austin brings insight into what it takes to launch and sustain a high-performing surgery center. From setting the tone during early planning stages to tracking the right metrics for Medicare certification and accreditation, Austin emphasizes that data isn’t just a requirement – it’s a tool for transformation.

In our conversation, Austin shared how ASCs can build a culture of safety from the ground up, leverage clinical data to make informed decisions, and adapt to a changing healthcare environment where private equity, hospital partnerships, and technology all play key roles.

Launching ambulatory surgery centers

Austin has spent the last 35 years of her career operating and developing surgery centers. She started consulting with Avanza in 2020, bringing her extensive ASC knowledge and expertise to its clients. A lot of them come through hospital systems, and they often engage with Avanza in the early stages of the development process to get a better understanding of what it takes to build and run a successful ASC, and even whether they should or shouldn’t do one at all.

She said, “I like the process of when it’s someone else’s idea:

bringing it to fruition for state licensing and Medicare certification, and then accreditation through one of the accrediting organizations.” According to Austin, this is a process that involves a little bit of everything – helping the organization get legal involved to form their LLCs, opening bank accounts, overseeing construction design, procuring the necessary equipment, hiring staff, and implementing any policies and procedures to go through state licensure, certification, and accreditation.

One of the first steps to establishing an ASC is to start conversations about what the culture is going to be. This is especially important in the hiring stages while the leadership team is setting the foundations and expectations for the entire organization. “We want to ensure that, overall, it’s a culture of safety, from every aspect of the experience: from the surgeon on to the patient’s pre-op experience, during the procedure, their recovery, and then their postop care,” Austin said.

From there, Austin will conduct performance reviews because she knows what accreditation organizations are expecting for demonstration of improved performance, even in the early stages of an ASC’s operations. Quality improvement opportunities can come from anywhere, even something as simple as where the supplies are and should be located in the facility. It’s all about finding the rougher spots of the operation and smoothing those out.

Tracking and leveraging clinical data

Most clinical care quality factors can be measured through quality

measures, many of which are standardized (especially for those ASCs certified through Medicare). These measures are designed to ensure the safety of each patient as they come through the facility, as well as measure how well surgeons and staff are performing at their jobs.

Austin said that Medicarecertified surgery centers have to electronically submit all the required information about each measure. This includes things like patient falls, patient burns, hospital transfers, and any admissions (regardless of whether it had to do with surgery or not). Additionally, anything that goes wrong during surgery is measured – wrong site, wrong side, wrong patient, wrong procedure, wrong implant.

The ASC Quality Collaboration (ASCQC) is an organization that exclusively and specifically collects benchmarking data about ASC quality measures and performance.

“They work with organizations like Regent Surgical, SCA, and USPI – the larger ASC management companies that would provide higher amounts of data to track things like patient safety, patient outcomes, and operational efficiencies,” Austin said. While most of what the ASCQC does is similar to what Medicare requires for reporting, Austin said that they help ASCs track the metrics and publish benchmarking data and a range of helpful resources for ASCs to access.

In addition to all the standardized Medicare quality measures, ASC quality control efforts should include tracking and measuring things like operating room turnover, case

volumes, staffing levels, financial performance, overall revenue, and cash collections.

Prioritizing the right data

In order to maintain their Medicare certification, ASCs may undergo surveys (i.e., inspections) from accrediting organizations that verify whether ASCs are taking appropriate steps to ensure patient safety and quality of care. ASC accrediting organizations like Accreditation Association for Ambulatory Health Care, Accreditation Commission for Health Care, The Joint Commission, and QUAD A go to great lengths to ensure that their standards meet and build upon those set by the federal and state governments.

board is informed and making decisions based on data presented on an ongoing basis.” They’re looking to understand an ASC’s processes and where information gets captured and then reported, and then what is done because of that information.”

How ASCs have changed over the years

With Austin’s 40+ years of experience in healthcare, she has seen how the ASC landscape has changed over the years. From an operational perspective, she’s seen how many more hospitals are including ASCs and joint ventures with physicians in their strategic planning. At one point, hospitals largely viewed ASCs as the competition – they

Quality improvement opportunities can come from anywhere, even something as simple as where the supplies are and should be located in the facility. It’s all about finding the rougher spots of the operation and smoothing those out.

Austin said, “When an accrediting organization comes in and they know you’re a Medicarecertified facility, they are going to make sure that you are reporting on all the CMS-required measures. They will look through everything, including things like patient satisfaction, records of patient infections, admissions to the hospital and demonstration of clinical leadership.”

In recent years, Austin has found these organizations have become even more thorough in their surveys, going so far as to ensure the governance of the

were losing some of their best surgeons to ASCs, which offered physicians the opportunity to become business owners, gain greater control over their surgical environment and experience, and deliver high-quality care at a lower cost.

“What I’m seeing right now is a lot of mergers and acquisitions affecting ASCs, and a lot more private equity getting involved with surgery centers,” Austin said. “The private equity aspect is particularly interesting, because private equity groups tend to have a short game in mind – they want

to get in and require all these benchmarks to be made, like adding new surgeon partners and cases, and then they want to flip it and sell it for a profit.”

From a clinical care perspective, not much has changed from how patients are moved from pre-op to surgery to post-op.

While that has stayed fairly consistent over time, what Austin has seen change is the ability to capture data to better understand and tell the story of a patient’s journey. This is largely possible because of the assistance of national organizations like the Ambulatory Surgery Center Association (ASCA) and ASCQC and state ASC organizations. For Austin, this has had two primary benefits. “One, the public is more aware of ASCs. Two, we’re able to better negotiate contracts with insurance companies. They rarely want to raise reimbursement rates and pay surgery centers more, so we have to have a good patient outcomes story to tell and we have to have good data to support that story.”

Because of technology available today, like electronic health record and analytics solutions, ASCs are able to collect better data than ever before, which greatly impacts the industry.

“What I think that does is allow us to do our jobs better. We can track the number of post-op infections and even hospital admissions 24 hours after the surgeries. From there, we can better understand how to prevent those kinds of incidents. We’re motivated to keep improving not only because adverse events are a burden on the healthcare system, but more importantly, they are a burden on patients.”

HonorHealth’s Local Roots

How the Arizona IDN grows its local spend, onboards three hospitals and focuses on utilization.

By Daniel Beaird

 The Phoenix area is one of the fastest growing metro areas in the country, adding over 600,000 people from 2010 to 2020 for a total of almost 5 million residents. And in the winter, snowbirds from the U.S. and Canada travel to Arizona and effectively double the population of cities like Scottsdale, where HonorHealth is headquartered.

Many of those Canadians like to get their medical procedures done in Arizona too, making HonorHealth, one of Arizona’s largest nonprofit health systems, very busy. The Arizona IDN fluctuates between

$120 million and $160 million a year in capital projects. Its vision is simple – to be the partner of choice in transforming healthcare for its communities, driven by its values and a commitment to delivering the

best experiences and services to its patients and communities.

Supplier diversity program takes off Mark Dozier and his strategic sourcing and engagement team

at HonorHealth handle about $1.6 billion in spend annually. They launched their own supplier diversity program in 2022 with a clear objective to increase partnerships with Minority Business Enterprises (MBEs) and keep some of its spend in state.

“We wanted to help local businesses, strengthen them and help the communities of Phoenix,” said Dozier. “So many diverse minority business enterprises are local. They’re in your state.”

it. We’ve been chipping away at it organically and it’s been going well. We’re pleased with the progress we’ve made.”

HonorHealth benchmarks best practices for supplier diversity from other IDNs, increases its diverse spending each year and provides information to suppliers on supplier diversity when requested. A baseline was set in 2022 and a policy procedure rolled out in 2023.

“We didn’t want it to be a flash in the pan,” Dozier

“ We have three to five utilization projects this year. We really think it’s a bigger bang for the buck than just price at the pump. If your preference cards are correct and up to date in surgery, the impact on reducing waste is big.”

Two years later, HonorHealth was named Large Corporation of the Year by the Healthcare Supplier Diversity Alliance and Owens & Minor for its efforts in advancing supplier diversity. It’s a crucial initiative toward inclusivity and community engagement in healthcare.

“I love our culture at Honor,” Dozier said. “Our slogan is honor above all, and integrity is so important in what we do. It’s a together mindset.”

HonorHealth has boosted its supplier diversity program and has grown its MBE contracting spend from $37 million to $70 million in just three years.

“We set up an easy way for diversifiers to interact with us on our website, to share their story and their catalog,” he said. “We didn’t hire additional staff for

explained. “We want it to be significant 10 years from now and that’s ingrained in the processes.”

Dozier rolled out a similar program at a clinic in Minnesota

for his previous employer, so he understood it needed to be methodical to make sure it’s sustainable. He attended a conference and workshop on supplier diversity held by Detroit-based Henry Ford Health, and also drew inspiration from Pittsburgh-based UPMC’s program.

“You have to really understand it and believe in it,” he said. “Why is it important? Why should we do it? How does it impact local vendors?”

He says for every $100 spent locally, $45 is recirculated locally. If that same $100 is spent with a national company, only $13 remains in state. “That statistic is a game changer,” he said. “Of course, with stents, hips and knees, you have to have all that to run the hospital and that’s from Fortune 500 companies. But there are a lot of products and services you can buy local and recirculate spend in your communities.”

It takes patience. Local vendors aren’t a machine like their larger counterparts. They don’t have the resources or legal processes to help them with the RFP journey. But that’s part of not rushing the process, Dozier says.

“Don’t try to do too much too soon but just keep chipping away,” he advised. “We’re adding diverse suppliers every year and growing the number of vendors. It just requires patience.”

Onboarding three Steward hospitals

HonorHealth recently purchased three hospitals and a free-standing ED in the Phoenix Valley from Steward, stemming from its bankruptcy. The hospitals come from a for-profit culture and

Mark Dozier

HonorHealth is transitioning them to its contracts and systems.

“It will take months to get them acclimated to our clinical value analysis processes and how we make decisions on technology,” Dozier said. “We have different technology councils and capital process. They had to move to Epic, our electronic medical record, and that’s a massive change for these hospitals.”

There are over 100 HonorHealth employees bringing these hospitals up to speed and Dozier says it’s been both stressful and exciting.

“Their old culture didn’t offer a lot of choice or input on product decisions,” he said. “So, on exam gloves, they got one option. On surgery gloves, one option. Drug balloons, one option. One hip and knee option.”

HonorHealth has more cardiology manufacturers, orthopedic vendors and usually more of everything. That makes physicians and clinicians excited.

“At Honor, we’re more open to providing additional products of choice for our surgeons. That’s one way we get them to come work for us,” Dozier said. “We’re bringing the nurses and staff from Steward into our process. Our value analysis team meets monthly, and these three hospitals are excited to have a voice now, to be a part of the decision-making process.”

Utilization is the future

Part of that process is utilization. Dozier says it’s the future at HonorHealth and the key to change with so much focus on price.

“There’s a bigger opportunity with utilization but it takes more partnership,” he said. “You

can have a double-digit impact, 10-12%, on your expenses.”

For price, supply chain just works with the vendor. But for utilization, it works with frontline users in the OR, ED, Cardiology and Nursing. This relies on good data and HonorHealth internally benchmarks its 10 hospitals on product usage or service.

“We have three to five utilization projects this year,” Dozier explained. “We really think it’s a bigger bang for the buck than just price at the pump. If your preference cards are correct and up to date in surgery, the impact on reducing waste is big.”

But like most others in healthcare, staff turnover affects HonorHealth and that can hurt implementation time. Having an adequately trained staff in clinical and the capacity to work on utilization is a challenge.

“It’s extra time to think, look at the data, have meetings, come back with fresh data and show that we really want to partner with service lines on utilization,” Dozier said.

That’s where HonorHealth’s value analysis teams help. The peri-op value analysis team has 25 OR nurses on it, for example, and is a great resource. And HonorHealth asks major suppliers to help with utilization too.

“We talk to our top suppliers and ask how we can utilize their product per OR procedure, per OR room, and per patient bed. There are many denominators you can use to slice and dice,” he said. “How do we compare to other IDNs?”

Dozier says they ask that in quarterly business reviews, but manufacturers rarely have that

information. And that’s information that HonorHealth would like to have. It would help to utilize products and have the right mix.

“We’re pushing for that information. They can blind it. They can say, here are three IDNs and here is their utilization usage of drug- eluting stents or whatever it is,” he said. “We’re going to keep knocking on that door until we get some manufacturers to work with us on that.”

Measuring the team’s success and appreciation

Each value analysis team at HonorHealth has a financial target for the year and presents it to senior leadership. They present two times a year and Dozier thinks it’s important.

“They get to show their work, why it’s important, and they feel valued by our senior executives,” Dozier said.

HonorHealth’s total value scorecard tracks the department’s value to the organization, measuring savings from conversions, savings from new contracts and additional rebates. Last year, it marked $34 million on the total value scorecard.

Beyond the financials, HonorHealth’s Strategic Sourcing & Engagement team builds what Dozier calls stickiness through its fun squad and team-building events like socials, potluck lunches, pie contests, celebrating birthdays, and other competitions.

“When you have a great team, you want to keep them,” he said. “You want to make it more fun working together. Our Fun Squad’s activities keep our team looser, connected, and happier. The impact has been significant.”

University Health set to acquire former CHRISTUS Santa Rosa Medical Center

University Health has agreed to purchase the 45 acre CHRISTUS Santa Rosa Hospital – Medical Center campus – including a 236,000 sq ft hospital and two medical office buildings – for $71 million, with an additional $20 million earmarked for renovations and equipment, according to a report. This move enables University Health to rapidly expand its footprint and relieve capacity pressures at its flagship facility amidst surging patient demand.

CHRISTUS Health closed the Medical Center location in April 2025 as part of a consolidation strategy, shifting services to nearby expanded campuses at Westover Hills and Alamo Heights, supported by over $300 million in recent investments. The sale ensures the facility continues to serve the community under University Health, preserving its mission-driven care model.

University Health’s planned takeover will help “decompress” the strain by offering additional inpatient and ambulatory care services, including emergency, cardiology, transplant, and rehabilitation – all aimed at reducing wait times and improving system efficiency.

Notably, the acquisition will be funded through existing resources without any tax rate increase, making it a strategic expansion that respects taxpayer constraints.

IDN News

UNC Health Rex, Brasseler Surgical form partnership

UNC Health Rex Hospital, based in Raleigh, N.C., recently formed a partnership with Brasseler Surgical in an effort to cut costs across the system. This strategic partnership was formed because of Brasseler Surgical’s high quality orthopedic cutting accessories, which met the high standards of quality and performance for orthopedic procedures while also cutting costs.

According to a news release, partnerships like the UNC Health Rex-Brassler Initiative shows the value of finding solutions that can benefit both parties, emphasizing things like engaging frontline staff and clinicians in cost-saving discussions, partnering with suppliers to identify value-driven solutions, and recognizing and celebrating achievements to inspire further innovation.

BayCare taps Northwestern Medicine in academic health system push

BayCare & Northwestern Medicine announced a strategic collaboration this summer.

BayCare, one of Florida’s leading not-for-profit health systems, and Northwestern Medicine, Chicago’s premier integrated academic health system, are embarking on a strategic collaboration to expand access to advanced medical treatments, enhance clinical research, and improve training and education

for current and future physicians in West Central Florida, according to a release.

By joining forces with Northwestern Medicine, BayCare gains enhanced capacity for advanced medical treatments and clinical research in the region. This bolsters patient access to cuttingedge therapies locally.

New data show better outcomes for hospitalized surgical patients

Patients in the hospital for surgeries had better outcomes in 2024 than they did in 2019, according to a new report released by the American Hospital Association and Vizient ®

The significant improvement aligned not only with better performance on patient safety metrics – such as reductions in infections and falls – but also with marked declines in three major surgical patient safety indicators: severe bleeding, sepsis and respiratory failure.

The new findings build on a report AHA released in collaboration with Vizient last year showing that hospitals and health systems performed better on key patient safety and quality measures in the first quarter of 2024 than they did before the COVID-19 pandemic. In fact, hospitals’ efforts to improve safety led to 200,000 Americans hospitalized between April 2023 and March 2024 surviving episodes of care they wouldn’t have in 2019.

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer. HELO - HORIBA Evolutive Laboratory Organization Yumizen H2500

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Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Yumizen H2500

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HELO - HORIBA Evolutive Laboratory Organization

HELO - HORIBA Evolutive Laboratory Organization

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Shaping New Dimensions in Hematology

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

Shaping New Dimensions in Hematology

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep. © 2025 HORIBA, Ltd. All rights reserved.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

Yumizen H2500

Yumizen H2500

Yumizen H2500 with SPS

Yumizen H2500 with SPS

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer.

HELO - HORIBA Evolutive Laboratory Organization

- HORIBA Evolutive Laboratory Organization

Yumizen H2500

Yumizen H2500

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Yumizen H2500 with SPS

Yumizen H2500 with SPS

Yumizen H2500 with SPS

Yumizen H2500 with SPS

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

HELO - HORIBA Evolutive Laboratory Organization

Supporting patient care through Innovation, E f ficienc and Quality with the Yumizen H2500 Hematology Analyzer.

Supporting patient care through Innovation, E f ficiency, and Quality with the Yumizen H2500 Hematology Analyzer. HELO - HORIBA Evolutive Laboratory Organization Yumizen H2500 Yumizen H2500 with SPS

HELO - HORIBA Evolutive Laboratory Organization

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

HELO - HORIBA Evolutive Laboratory Organization

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

For more information, visit horiba.com/usa/healthcare or scan the QR code to contact your HORIBA Sales Rep.

The Simplicity Shift

Using the art of simplicity as a strategic tool.

By Pete Mercer

 There are plenty of different ways to drive change, but it usually involves creating products or processes to be the catalyst. We rarely choose reduction in the pursuit of change, but it might be the secret weapon that your company needs.

The power of simplicity is often underestimated as a downgrade – it’s rarely considered flashy to take a minimalist approach to anything, but simplicity can be a refreshing antidote for a culture that’s addicted to life in the fast lane.

Repertoire Magazine sat down with Lisa Bodell to discuss how the power of simplification can be a catalyst for change. Bodell is the founder and CEO of FutureThink, a company that uses simple techniques to help organizations embrace change and increase their capability for innovation, and an award-winning author of Why Simple Wins and Kill the Company . She named her organization FutureThink because she wants to help people look towards the future. “We’re taught history, but we’re never taught about the future.”

Why simplicity is innovative

Simplicity is often misunderstood in the work environment. Our days are filled with busy work that eats up a significant amount of time, but does it really accomplish anything? Bodell argues that when your team has the time and space for priorities, they are much more efficient and effective with the work that actually matters.

“The first thing to know about simplicity is that it isn’t only meant to drive productivity and efficiency. That will happen, but the bigger thing about simplicity is it’s a strategic advantage because it means that people can move faster, they can focus, and they have time to think.”

It can be easy to fall into the trap of looking to innovate by adding ideas and processes to the workflow, but simplicity is

Lisa Bodell

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really about scaling back to the essentials. Your employees need the space to shed meaningless tasks and focus on more meaningful work that will have greater impacts on things like revenue, productivity, and the bottom line.

For example, managers at pharmaceutical giant Sanofi implemented a technique called Stop It, which is an effort to remove tasks that aren’t meaningful for the company.

Bodell said, “We spend so much time having people tell us what more they’re going to do, but we never ask them what they’re going to stop doing. I like what Sanofi does – subtraction is just as important as addition, just like weeding the garden so it can grow. When they do their strategic planning, they say, ‘Give us your top five priorities that you’re going to accomplish and then tell us the top five you’re going to stop doing to make that happen.’ You can’t just keep piling on more, you have to make space for priorities.”

Kill the Company

Part of what Bodell does in her work is encourage leaders to think like their competitors to identify and confront any vulnerabilities within their own organization. This exercise is called Kill the Company, and it puts business leaders in position to look at their own companies as the competition and find ways to put themselves out of business.

“The purpose of it is proactive obsolescence,” she said. “How do you identify your weak spots and fix them before your competitors make them a problem? Because you don’t want to react to change, you want to drive it – the only way to do that is constantly

Leaders who are looking to reignite the curiosity of their team members need to be able to demonstrate it themselves by providing a safe space to ask open-ended questions.

look at your weaknesses with honesty and fix them.”

This process gives business leaders free reign to take an objective look at their own weaknesses in a safe and constructive environment. Bodell even likens it to a kind of business therapy session for some people, allowing them to say whatever they want. From there, it gives them an opportunity to take these “bad things” and “impossibles” and turn them into opportunities and solutions. This exercise is designed to be performed by executive and leadership teams right before strategic planning starts, so that time can be spent prioritizing the things that need to be fixed. Bodell said, “What’s cool about it is that you discover new fixes that are

actually a competitive advantage that now make you turn those strengths onto your competitors. It’s cathartic.”

Reigniting curiosity and other power skills

As artificial intelligence continues to evolve and saturate the market, it’s more important than ever for your employees to flex their skillsets, especially the power skills. Bodell has advocated for replacing the oft used (and perhaps under-appreciated) term soft skills with power skills, or as she put it in an article for Forbes, skills that “make us human.”

“AI is going to take care of a lot of automated tasks, but that’s going to free us up to be more human and we’re not used to

it. We’re used to processes, but we need more ability to creatively solve problems, to innovate, to think, to be curious, to have empathy. Those are things machines can’t do yet, so we call those power skills.”

For Bodell, the greatest of these skills is curiosity. “Curiosity drives action. It hijacks your brain. If I can ask you enough questions, I can get you on my side from a sales perspective very quickly. If we teach people how to ask better questions, we’re going to get better innovations.”

Curiosity is also one of those traits that can die out if we don’t provide the right kind of kindling

to keep the fire going. Leaders who are looking to reignite the curiosity of their team members need to be able to demonstrate it themselves by providing a safe space to ask open-ended questions.

Bodell also advocates for other power skills like agility, resilience, creative problem solving, and leading through change. She argues that agility often gets put in the wrong bucket as a result of misunderstanding why leaders want their teams to be agile. “You don’t want people to be agile just to respond to change. You want people to be agile so they can drive change. That’s different.”

It’s all about framework, which is why her trainers at

FutureThink implement improv exercises that are popular at improv training grounds like Second City, The Groundlings, and Upright Citizens Brigade to look for a solution in the positive and the negative. One of these is called “That’s Great” and it uses scenarios where someone is confronted with bad news and has to come up with a “that’s great” kind of opportunity from the news.

“It teaches muscle memory to look for the positive and negative aspects in the problems we need to solve. There are always ways to solve problems if you have the right mindset.”

Managing Cholesterol: A Healthy Circulatory System

The CDC educates the public on preventing high cholesterol and reducing chronic disease risk during National Cholesterol Education Month in September.

 At a physician’s visit, one of the most dreaded phrases for many patients is: ‘high cholesterol.”

Cholesterol often gets a bad reputation, but not all cholesterol is bad; some types are essential for good health.

Cholesterol is a waxy, fat-like substance carried throughout the bloodstream. The body needs cholesterol to make hormones and build cells, according to the Centers for Disease Control and Prevention (CDC).

Two types of cholesterol travel through the body on proteins called lipoproteins; low-density lipoprotein (LDL), sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol, according to the CDC.

HDL carries cholesterol back to the liver, and the liver flushes it from the body. When the body has levels of LDL cholesterol that are too high, it can build up in the walls of blood vessels (known as plaque) and prevent the proper flow of blood. LDL cholesterol is a major risk factor for cardiovascular disease (CVD).

As the blood vessels build up more plaque over time, the inside of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from the heart and other organs. When blood flow to the heart is blocked, it can cause serious health issues including heart

disease, angina (chest pain), heart attack and stroke.

From 2017 to 2020, nearly 86.4 million U.S. adults aged 20 or older had high or borderline high cholesterol (a total cholesterol level greater than or equal to 200 mg/dL), according to the CDC.

An optimal cholesterol reading, according to the CDC, is around about 150 mg/dL.

Understanding and preventing high cholesterol

There are usually no warning signs when a person has high

cholesterol. Many people do not know that their cholesterol levels are too high until they have a heart attack or stroke.

For this reason, it is very important to take the necessary steps to manage cholesterol levels before it is too late.

Fortunately, there are numerous preventative measures and lifestyle changes that can be made to maintain a healthy cholesterol level.

One significant way for people to manage cholesterol is through proper nutrition and diet modifications. Foods with a lot of cholesterol usually also have high levels of saturated fat, and saturated fats can make cholesterol levels higher. Specifically, food that is made from animals, including red meat, butter and cheese often has a lot of saturated fat.

To prevent the buildup of cholesterol, those at risk should aim to eat foods with plenty of fiber, such as oatmeal and beans, and healthy unsaturated fats, such as avocados, olive oil, and nuts. Being active everyday also can help to lower cholesterol levels. The Physical Activity Guidelines for Americans, from the U.S. Department of Health and Human Services, recommends that adults get 150 to 300 minutes of moderate physical activity each week.

Keeping up with cholesterol levels

The only way to know for sure whether you have a high level of cholesterol is to get it checked at a physician’s office. A cholesterol test is a blood test measuring the amount of cholesterol and triglycerides (type of fat) in the blood.

The CDC recommends that healthy adults get their cholesterol

level checked at least every three to five years. People who have heart disease, diabetes, or a family history of high cholesterol should ensure they get their cholesterol checked more often.

Children should also be aware of their cholesterol levels, as early monitoring can prevent more serious future health issues. About 1 in 5 adolescents had an unhealthy cholesterol measurement from 2009 to 2016, according to the CDC.

Children should have their cholesterol checked at least once between ages 9 and 11, and adolescents should have their cholesterol checked between ages 17 and 21. Children who have obesity or diabetes may need to be screened for high cholesterol more often.

Patients should know their family history of cardiovascular disease and talk with a healthcare team about ways to manage cholesterol, according to the CDC. The 2018 American College of Cardiology/American Heart Association Guidelines recommend that cholesterol management be based on a person’s lifetime cardiovascular risk, whether a person is 45 to 75 years of age, has diabetes, or if other health factors may impact risk.

Healthcare professionals can calculate a person's lifetime cardiovascular risk by considering comorbidities, whether a person is being treated for high blood pressure, whether a person smokes and more.

High cholesterol awareness

In some cases, elevated cholesterol isn’t just the result of diet or lifestyle, it also may be inherited.

As many as 1 in 212 U.S. adults may have a genetic condition called

familial hypercholesterolemia (FH), an inherited disorder that causes the liver to have problems metabolizing and removing excess LDL cholesterol, resulting in very high LDL levels, according to Million Heart’s Cholesterol Management page.

Some people, including those with FH, need medicine, called statins, to manage their cholesterol. Statins work in the body by reducing the production of cholesterol in the liver. Data from 2013–2014 indicate that only about half (54.5%) of U.S. adults (over age 21) who might benefit from statin use are taking them, according to Million Hearts.

Statins, when used as indicated for most patients, can dramatically reduce a person’s risk of having a heart attack or stroke, according to the Million Hearts Initiative. It is essential that if patients are given statins to manage cholesterol that they take them exactly as prescribed to ensure the best outcome.

To raise awareness about the importance of the proper management of cholesterol, The CDC recognizes National Cholesterol Education Month in September to educate the public.

The CDC’s website has social media and graphics available to the public, physicians and healthcare organizations to help spread the word about what cholesterol is and why managing it is important to reducing cardiovascular disease.

With the support of health professionals, CDC’s Division for Heart Disease and Stroke Prevention (DHDSP) also educates the public about cholesterol management through the Cholesterol Communications Toolkit.

Putting the Medical Supply Chain to the Test

 Imagine being able to assess the health of the U.S. medical supply chain with a single glance. That’s the idea behind HIDA’s Traffic Protocol Partnership, a joint effort with federal agencies to develop a color-coded system (green, yellow, and red) that signals the operating status of the medical supply chain.

This “supply chain traffic light” was put through its paces at HIDA’s recent Resilience and Preparedness Summit, where healthcare industry leaders and federal officials participated in a series of tabletop exercises simulating real-world disruptions. The scenarios were designed to stress-test the protocol across multiple types of supply chain shocks: a hurricane impacting East Coast ports, cybersecurity attacks on the West Coast, and retaliatory tariffs imposed mid-crisis.

The exercise proved the value of the protocol – but also highlighted areas for improvement. Participants walked away with a shared understanding that while the framework shows promise, fine-tuning is needed to make it a reliable, shared decision-making tool during times of crisis.

Three takeaways emerged:

Build consensus on terminology

Participants noted that alignment on key terms is essential for consistent situational awareness. A major example: the term “allocation” means different things to different organizations. Without a shared definition, stakeholders had difficulty agreeing on when the protocol should shift from green (normal operations) to yellow (moderate disruption). Establishing a common language across public and private sectors is a necessary next step.

Disaggregate supply chain stressors

One of the most valuable aspects of

the exercise was the ability to isolate different types of stress. Participants agreed on the importance of distinguishing among demand shocks (such as a surge in PPE use during the COVID-19 pandemic), supply shocks (like manufacturing disruptions from hurricanes), and logistical shocks (including port closures, cyberattacks, and labor actions). Understanding how each type of disruption affects the broader supply chain enables better mitigation strategies and more targeted responses.

Keep the conversation going

HIDA’s strong relationships with federal partners were a key strength during the exercise. Participants drew on real-world experiences to shape their decisions, emphasizing the need for ongoing collaboration. The protocol is not a static tool – it will evolve. HIDA plans to refine it with continued input from both industry and government, including at the upcoming 2026 MedSupplyChain Conference, where the next iteration will be put to the test.

In today’s complex and interconnected healthcare ecosystem, having a shared framework to assess and communicate the state of the medical supply chain isn’t just helpful – it’s essential. With continued input and collaboration, the Traffic Protocol Partnership has the potential to become a vital tool for readiness and response.

By Christina Lavoie, Director of Supply Chain Policy, HIDA

The Hidden Cost of Drug Shortages

Vizient survey reveals drug shortages continue to cause significant strain on U.S. healthcare nationwide.

 Vizient announced an updated analysis of the financial impact of drug shortages for hospitals’ workforce and budgets. The 2024 Vizient survey, “Beyond the Shortage: The Hidden Cost of Drug Supply Chain Disruptions, reveals that drug shortages continue to disrupt healthcare nationwide, having intensified since the 2019 survey. The survey responses came from hospitals, clinics, and other healthcare facilities that monitored an average of 43 drug shortages and a maximum of 70 over the course of 2023.

All facilities reported experiencing disruptions to patient care due to drug shortages. Shortages impacted a variety of clinical areas, with outpatient infusion services experiencing the most significant disruptions to patient care with a staggering 41% of all cases impacted or delayed. Over

the next 10 years, the number of patients using ambulatory service lines will increase by 17%. This alarming trend shows the serious effects of shortages on patient care, according to Vizient.

The Vizient analysis revealed that in 2023, hospitals across the U.S. spent roughly 20 million hours

managing a range of drug shortages, which translates to nearly $900 million annually in labor costs – more than double the labor costs reported of just under $360 million in the 2019 survey.

The 2024 survey results additionally show the continuing financial problems caused by drug shortages, such as increased hospital budgets and labor costs. Approximately 74% of facilities reported budget overruns – nearly the same as the 75% reported in Vizient’s 2019 survey, with Vizient stating that there has been no measurable economic improvement. Among respondents, 74% exceeded their pharmacy budgets as a direct impact of monitoring and managing drug shortages.

There was a significant increase in labor costs related to managing drug shortages in 2024, rising from $359 million to $894 million between 2019 and 2024, according to Vizient. Pediatric facilities have faced the greatest financial and labor strain.

Time that hospitals and health systems spent managing drug shortages increased from 8.6 million hours to 20.2 million hours from 2019 to 2024. Communication gaps were identified as a significant challenge in managing drug shortages, with numerous respondents emphasizing the need for earlier and more transparent notifications and more accurate product release dates.

Relying on secondary distributors for essential medications has led to an average price increase of about 214% compared to primary distributors, which greatly increases the financial burden of drug shortages, according to Vizient.

Industry News

Tracy Timmerman promoted to Director of Marketing – Medical at Midmark Corporation

Tracy Timmerman, PMP®, EDAC ®, has been promoted to Director of Marketing – Medical at Midmark Corporation. An accomplished marketing leader with 15 years in the MedTech industry, Tracy brings strong leadership and strategic insight and a rare combination of crossfunctional experience spanning marketing, operations, purchasing, engineering sourcing, and project management. Tracy also brings an in-depth understanding of the medical industry with strong knowledge of our customers and channel partners.

Her credentials as a certified Project Management Professional (PMP) and holder of the Evidencebased Design Accreditation and Certification (EDAC) reflect her commitment to strategic execution, clinical insight, and design thinking. Her new role underscores the commitment at Midmark to visionary leadership –grounded in practical experience and a deep understanding of the healthcare environment.

Tracy is an active member of both Professional Women in Healthcare (PWH) and the Healthcare Manufacturers Network (HMN), where she con-

tributes to the advancement of industry knowledge, leadership development, and diversity in healthcare. As a champion for inclusive leadership and forwardthinking innovation, she provided strategic insight that led the successful launch of the USAB-compliant Midmark® 631 Procedure Chair – advancing accessibility in clinical design. In her new role, Tracy will shape go-to-market strategies that connect meaningful product innovation with customer value, helping distribution partners drive success in an evolving healthcare landscape.

SEKISUI Diagnostics awarded silver rating by Ecovadis

SEKISUI Diagnostics is pleased to announce that the company has been awarded a silver rating by Ecovadis, a globally-recognized provider of business sustainability ratings and assessments. EcoVadis is the world’s largest provider of business sustainability ratings. Their sustainability assessment evaluates how well a company has integrated the principles of Sustainability and Corporate Social Responsibility into its business and management system. It is based on international sustainability standards, such as Global Reporting Initiative (GRI), United Nations Global Compact (UNGC), and ISO 26000.

Tracy Timmerman

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