Healthcare Global January 2016

w w w. h e al t h c ar e gl o b al.c o m • Jan u ar y 2 016

TOP 10 Healthcare

Companies to Follow on Social Media

LEADERSHIP

Proven Facility & Real Estate approaches that Cut Costs

Healthcare

TECH

The Biggest Trends for 2016

EDITOR’S COMMENT

A S W E S E T F O R T H on our journey into the

New Year, the January issue of Healthcare Global looks ahead to what we can expect to see in the next 12 months.

Although I don’t listen to much country music, I came across an interesting quote from country musician Brad Paisley: “Tomorrow is the first blank page of a 365-page book. Write a good one.”

As you begin writing your story for 2016, our top feature revolves around leadership strategies.

Michelle Mader, the director of strategy at healthcare consultinganddesignfirmFreemanWhite,describes how to plan and design strategies to optimize the space allocation/revenue stream relationship, ways to standardize design and layout, as well as how to adapt existing space for new users.

Next, we’ll look at the top technology trends for the upcoming year, and the growing role of IoT in the healthcare sector. We wrap up the first issue of the New Year with the top 10 companies to follow on social media, as well as intriguing company reports on Jewish General Hospital and Antibióticos do Brazil (ABL).

So what’s your New Year’s resolution?

Eric Harding Healthcare Global Editor eric.harding@businessreviewaustralia.com

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CONTENTS

6

TECHNOLOGY IoT Trends for 2016 LEADERSHIP Proven Facility & Real Estate Strategies that Cut Costs

12 TOP 10 Healthcare Companies on Social Media

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January 2016

20

Company Profiles BRAZIL

CANADA

The Jewish General Hospital

AMERICA LATINA

30

40 52

Antibi贸ticos do Brasil Ltda.

Stryker LATAM

TECHNOLOGY

IoT Trends for 2016 With new healthcare innovations coming to fruition left and right, we can thank the Internet of Things Written by: Eric Harding

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January 2016

SENSORS, mobile devices and related technologies are presenting new opportunities and risks for businesses in all sectors. Collectively known as the Internet of Things (IoT), this broad terms covers all non-computer and non-phone Internet connected devices.

Many in the business community view IoT devices as interesting consumer gadgets, like the Fitbit or the Apple Watch. However, IoT devices are coming into their own for business and industrial use, and in the process are reinventing industries such as healthcare.

These trends suggest that the first wave of IoT technology has arrived in the form of consumer adoption.

Here are some other healthcare trends to watch out for in 2016: Wearables As several million Americans have already begun carrying IoT devices in their daily life, it’s an exciting trend with much potential for firms that produce IoT products and services.

The future of health gadgets seems pretty stable, with 20 percent of Americans owning at least one wearable device. Will wireless 7

TECHNOLOGY medical devices and cloud solutions change the landscape of the industry, improving the quality of life for patients with diabetes, asthma and heart diseases, or will the trend eventually die out?

2016 will also mark a new inflection point in the pace with which healthcare organizations move to value-based reimbursement models. CMS, the largest buyer of healthcare services, has set a goal of tying 30 percent of traditional Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.

Bundled payments require providers across the care settings to coordinate more effectively. Instead of a payer separately reimbursing for each healthcare service, a bundled payment makes one payment that includes the initial hospitalization and

all related services within 90 days following the hospital discharge.

CMS got everyone’s attention when they recently announced starting in January, they will require hospitals in 75 Medicare Service Areas (MSA) to accept a single bundled payment for Comprehensive Care for Joint Replacements (CCJR).

Others are quickly following suit.

Health systems are proactively engaging with payers to design new bundled payment reimbursement models across a broad range of procedures and conditions, including chronic conditions, such as Heart Failure, COPD, and procedures, such as Labor & Delivery. In 2016, bundled payments will move from pilots to mainstream.

Cloud-based Electronic Health Records Expect to see a continued trend of cloud-based EHR adoption because they are more agile, adaptable, and flexible for both consumers

‘IoT devices are coming into their own for business and industrial use, and in the process are reinventing industries such as healthcare.’

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January 2016

IOT TRENDS FOR 2016

and providers of healthcare.

Traditional software implementations are just not capable of pushing seamless updates in near real-time like cloud-based EHRs can. Further, some cloud-based EHR providers also wrap ancillary business- and information-services around the software, enabling doctors to concentrate more on what they do best: practice medicine and improve the quality of life for patients.

Patient-Centric Devices Along with wearables, biosensors are advancing to the point at which, within the next five years, they will not only become incorporated into clothing but actually inside our bodies. Imagine a diabetic’s biochip detecting blood glucose levels within personalized parameters, and then initiating appropriate, immediate, remedial and automatic action such as insulin-dosing. Soon, sensors will 9

TECHNOLOGY

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January 2016

IOT TRENDS FOR 2016

provide doctors valuable feedback for a range of chronic conditions: a pacemakers’ use in heart arrhythmias, efficacy (or side effects) of prescribed medications, and dosing compliance, including chemotherapy.

Imagine a diabetic’s biochip detecting blood glucose levels within personalized parameters, and then initiating appropriate, immediate, remedial and automatic action such as insulin-dosing.

Big Data Analytics and Patient Access Analytics will provide valuable insights in operations and, more importantly, at the point of care. But analytics alone won’t be the solution unless organizations and providers must also have more robust patient access tools.

Instead, analytics become important when organizations act on those insights.

Currently, many of the big data analytics and insights revolve just around operations. It is there that administrators revise, improve, and streamline workflows to reduce costs, deliver higher quality care, and reduce 30-day readmissions, garnering higher levels of patient satisfaction.

‘Along with wearables, biosensors are advancing to the point at which within the next five years, they will not only become incorporated into clothing, but actually inside our bodies.’

For providers, the end result of big data analytics will be at the point of care through data-enrichment, whereby algorithms and other powerful digital technologies become an essential tool in the doctor’s toolkit. Operationally, leveraging health insights and pivoting this knowledge into targeted patient outreach and access is what makes analytics so powerful.

There is no doubt companies and startups in the healthcare analytics space will change the way healthcare is delivered and practiced. It’s an exciting time be in the industry and we should look forward to seeing how these technology trends continue to impact the goal of reducing costs and increasing quality.

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LEADERSHIP

Proven Facility & Real Estate Strategies that Cut Costs Planning and design strategies that optimize the space allocation and revenue stream relationship, adapt existing space as well as standardize design and layout W r i t t e n B y : M I C H E LLE M A D E R 13

LEADERSHIP THE HEALTHCARE INDUSTRY is learning how increased pressure from payers, smaller healthcare networks and the Affordable Care Act (ACA) has combined to force a redesign of the nation’s healthcare system.

The industry must figure out how to provide value-based services at lower costs. This redesign must be undertaken quickly because revenues are expected to go downward to the tune of about $230 million from current revenues.

The bottom line? The healthcare industry must implement effective cost-cutting initiatives while

developing policies and procedures for managing the future costs of the emerging healthcare system.

Healthcare organizations are expected to invest in the provision of new services and increasingly advanced technologies. To make the most cost-effective decisions about these investments, providers must remain flexible enough to adapt quickly to a changing market.

Optimizing Space Allocation and Revenue Stream: Making Every Square Foot Count Planning and design strategies that

P R O V E N FA C I L I T Y A N D R E A L E S TAT E S T R AT E G I E S

optimize the space allocation and revenue stream relationship of existing space can be applied to decrease costs and increase revenue.

An adaptive re-use of an existing non-revenue-generating space for a different function generates revenue and lowers operating costs faster because it takes less time — and often less money — than building a new space.

When one finds inefficient space in healthcare facilities, the challenge is to make it more efficient — not by curtailing services or reducing the size of the space, but by changing operations or reallocating the space to serve a function that generates more revenue.

Otherwise it remains a cost center.

By necessity, critical access hospitals (CAH) have optimized the space allocation/revenue relationship.

Typically located in rural communities with no other healthcare facility for 30 miles in any direction, a CAH not only provides scarce services, but also experiences difficulty recruiting and retaining physicians and staff.

The bottom line? Identifying ways to use facility space and real estate to cut costs requires a 180-degree turn

in perspective — it takes the mindset of real estate developers, who do not build a property unless they can do it cost-effectively and generate revenue from virtually every square foot of it.

Designing for Adaptation: Avoiding Present and Future Costs Planning and design strategies that are used to adapt existing space over time rather than building new space also decrease costs.

These strategies enable an organization to use existing space more efficiently to deliver existing or new services while avoiding the additional present and future costs of new construction, which entails costly site work, shell-and-core construction, and a long timeline. Time is of the essence based on “speed to market” — the longer it takes to build, the greater the market opportunity cost.

A caveat is that the project logistics must be favorable to creating an open chair that enables the contractor to renovate a space with a more cost-effective, flexible solution on a short timeline — not a multi-phase project, which can actually be more time-consuming 15

LEADERSHIP

and costly than new construction.

Over time, additions can incrementally be added to this facility in order to provide higher acuity services, like outpatient surgery, avoiding the need to build a separate outpatient surgery facility. Space can still be shared; for example, the primary care exam room can also be used as a pre-op or PACU overflow for the surgical suites. During off-peak hours, the waiting room can be used for group meetings, 16

January 2016

nutrition counseling and other health education presentations.

Shared ambulatory spaces require a flexible scheduling approach, so multi-use spaces must be large enough to accommodate several different functions. While the initial cost of such spaces might be higher, it will still be less costly to build fewer multi-use spaces than to build more single-use spaces.

Another reason to build larger multipurpose rooms is the greater ease

P R O V E N FA C I L I T Y A N D R E A L E S TAT E S T R AT E G I E S

with which they can be adapted for different uses as healthcare trends change over time. Nurse stations and bathrooms can be shared among functions. Individual offices can and should be eliminated, with providers, including physicians, sharing a desk area designed like an airport lounge.

The bottom line? Understand where the revenue is generated.

Build a business case in the planning phase. Identify opportunities for shared spaces and multiple

revenue-generating uses.

Standardization: Avoiding Costly Variations Facilities and real estate also decrease costs when leaders adopt planning and design strategies that standardize the design and layout of similar spaces. This approach reduces the costs of planning, design and construction, enhances the physicians’ and staffs’ willingness to share space, and 17

LEADERSHIP enables cost-effective “plug-andplay” modifications in the future.

A standardized medical office building is a prime example. If the size, layout, and stationary equipment and furnishings of the exam rooms are standardized, then each exam room can be used for a variety of providers from a family practitioner to an Ob/Gyn. With every room at 105 square feet, providers are more willing to share — rather than vying for a few larger exam rooms.

Because healthcare is by the people and for the people,

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everyone is unique in his or her preferences, including providers.

When leaders standardize the universal components and create protocols around providers’ preferences, then it is a win-win.

The most advantageous way to encourage behavioral and preference modification is to relate it to cost: Show the space, infrastructure and cost savings that accrue from standardization. When the physicians own the surgical center, they directly realize the benefits as increased revenue. At the hospital, the case

P R O V E N FA C I L I T Y A N D R E A L E S TAT E S T R AT E G I E S

for standardization is more difficult to make because the incentive is often intangible and non-personal.

The bottom line? Healthcare is a service industry; it does not make products. The conversation around standardization is different for healthcare than it is for other industries, largely because hospitals are dependent upon providers whom they may or may not employ.

Healthcare relies upon relationships — physicians’ relationships with patients, the hospital’s relationship with payers, and so forth. The way standardization is approached is unique, but there are always opportunities to get the low-hanging fruit, such as standardized exam rooms. And the more that end users and leaders work at it together, the more cost savings they will achieve.

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TOP 10

TOP10

Healthcare Companies on Social Media With social networking taking over today’s digital age, these are the best companies to follow Written by: Eric Harding

Since it is such a regulated industry, the majority of healthcare organizations have avoided the realm of social media.

However, some healthcare providers are now starting to realize the opportunities to build awareness and promote their brand all while still serving the public, patients and physicians.

Many consumers in today’s digital age use social media platforms to make important health decisions, such as selecting their doctor, hospital and different types of treatment available.

Although social media helps healthcare professionals to communicate and improve health outcomes, the legal and risks of non-compliance with rules and regulations have skyrocketed as the industry begins to embrace it.

So for Healthcare Global’s first Top-10 feature of 2016, let’s take a look at the top healthcare companies on social media.

TOP 10

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JOHNSON & JOHNSON

With a corporate site that has over 650,000 Facebook fans focusing heavily on mothers and children, as well as areas it has prescription drug therapies such as asthma and teenage depression. In addition, J&J has used social media well during crisis management situations during its product recalls.

10

MERCK & CO.

Since launching its social media accounts on Twitter and Facebook in 2011, Merck has used social media as a way to reshape its image. In addition, the company’s segmenttargeted “Merck for Mothers” Facebook and Twitter pages have sparked much more conversation in recent years.

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H E A LT H C A R E C O M PA N I E S O N S O C I A L M E D I A

07

BAYER HEALTHCARE

With over 75,000 Twitter followers, Bayer Healthcare has generated interest through adopting a fresh strategic approach. Many of its tweets revolve around promotion and awareness days, which Bayer also markets its annual Grants4Apps healthcare incubator program on both Twitter and Vine.

08

HIMSS

A cause-based non-profit, Healthcare Information and Management Systems Society (HIMSS) provides thought leadership, community building, professional development, public policy and events to it social media followers. It also keeps industry analysts informed of the best uses of health IT to improve global health.

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TOP 10

05

06

CLEVELAND CLINIC

The Clinic’s content-driven social media strategy has proven to be successful across the full spectrum of online platforms. With over 553,000 Twitter followers, the company strives to find a way to become a meaningful part of people’s everyday lives even when they aren’t sick or need healthcare service. Cleveland Clinic approaches it as if it’s a part of consumer’s lives when healthy, people will consider going to it when they need care.

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January 2016

AMERICAN MEDICAL ASSOCIATION

The AMA promotes the art and science of medicine and the betterment of public health. It’s goal is to improve the health of the nation, enhance the delivery of care and enable physicians and health teams to partner with patients to achieve better health for all. With over 560,000 Twitter followers, the AMA regularly promotes events and links to inform citizens of the latest healthcare news.

H E A LT H C A R E C O M PA N I E S O N S O C I A L M E D I A

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04

NOVARTIS

BOEHRINGER INGELHEIM

Despite having a smallerthan-average community, pharmaceutical company Boehringer Ingelheim excels on social media behind a small group of loyal retweeters. With a social media strategy that is broad and engaged, Boehringer is exceptionally active on Pintrest, Vine and Instagram. Its social networks are also featured on the company’s home page and are cross-linked with one another.

In addition, Boehringer is the first pharma company to fully engage with social media and the concept of digital health.

With very active accounts on Twitter, Facebook and YouTube, Novartis is among the fastestgrowing companies on social media. The pharma company uses different Twitter tactics to engage consumers, such as interviews conducted on Twitter dubbed “twitterviews,” as well as “tweetchats.”

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TOP 10

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H E A LT H C A R E C O M PA N I E S O N S O C I A L M E D I A

02

PHILIPS HEALTHCARE

After facing concerns that it wasn’t being seen by its peers as a leader in healthcare innovation, Philips Healthcare set out to increase the credibility of its products through a series of LinkedIn groups. Through high-quality debates as well as polls and other engagement features, Philips attracted over 73,000 followers to its group.

Also, by actively managing and promoting its LinkedIn company page, Philips has lured over 250,000 company subscribers.

With new status updates every few days, this has caused a constant flow of engagement and new subscribers.

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TOP 10

01

MAYO CLINIC

The Mayo Clinic has been able to leverage and enhance its reputation as a trusted source of information through its large online presence and expansive social media platforms.

The company created the Mayo Clinic Center for Social Media in 2010 to coordinate and focus the clinic’s several social media programs and initiatives. The company uses social media to get patients to become better advocates for their own care.

Mayo Clinic’s social media philosophy is individuals have the right and responsibility to advocate for their own health, and it is the company’s responsibility to help them use social media tools to get the best information, connect with providers and with each other, and inspire healthy choices.

Behind strong brand recognition, putting social media at the forefront of its mission, understanding the importance of social media engagement, support from its leadership as well as a love for innovation, the Mayo Clinic is the top healthcare company on social media.

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January 2016

H E A LT H C A R E C O M PA N I E S O N S O C I A L M E D I A

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The Jewish General Hospital

Advancing innovation

Dr. Lawrence Rosenberg, President and CEO of West Central Montreal Health, discusses challenges and innovations at the Jewish General Hospital in Montreal Written by: Sasha Orman

Produced by: Andy Turner

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T H E J E W I S H G E N E R A L H O S P I TA L

E

stablished in 1934, the Jewish General Hospital was built by Montreal’s Jewish community and stands today as a leading healthcare provider within its region. Since its inception, the hospital has held fast to values of integrity and accountability.

“The hospital has always strived to deliver world-class care and to be a magnet for talent,” says Dr. Lawrence Rosenberg, President and CEO of West-Central Montreal Health. “It has a legacy and heritage of entrepreneurship, which persists to this day. The hospital has always set impossible goals for itself, which 32

January 2016

have always been met.”

As a magnet hospital and a centre of innovation, the Jewish General Hospital continues its legacy through today’s innovations and modern challenges.

Responding to the changing shape of Quebec healthcare In early 2015, the National Assembly passed Bill 10, a health care law aimed at transforming the organization and delivery of health care and social services by eliminating regional health authorities (i.e. The Agencies), while unifying individual institutions

H E A LT H C A R E

into new territory-based networks of integrated care. Towards the end of the year, Quebec saw further healthcare legislation with the passage of Bill 20, which aims to increase access to family physicians for Quebec residents and to improve productivity of specialists. The Jewish General Hospital is one of many that are working to streamline and restructure in response to these new laws.

“With the implementation of Bill 10, the hospital has become part of an integrated healthcare and social services university network,” says Rosenberg, noting that the restructuring has presented the hospital with opportunities to work with partners to find ways to improve patient access and quality of care, and to find efficiencies and better control hospital costs.

“We will have to compete on being the best—the highest quality and lowest cost provider. We are more than up to the challenge” – Dr. Lawrence Rosenberg, President and CEO

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C O M PA N Y N A M E

It is too soon to really know what the consequences will be for the hospital, but needless to say, anything that promotes better use of resources and improved access will certainly benefit the population,� he adds. “I do not believe that either legislation will negatively impact our plans for future growth. The hospital has been preparing for this for the 34

January 2016

past two years, and we are ready to play a formative role.�

Corporate responsibility and patient-centric care Above all, a hospital is judged by the level of care it is able to provide to its patients. The Jewish General Hospital understands this, and works to increase its level of care

SECTOR

through higher accountability to the public.

“Corporate responsibility is extremely important to us—we take our stewardship role of the system very seriously,” says Rosenberg.

“With the current pace of change, one of our challenges is actually accountability as we redefine roles and responsibilities within the new

corporate structures.”

Efficiencies and cost savings are vital in any sector, and healthcare is no different. But at the Jewish General Hospital, a critical part its corporate accountability strategy has been a shift of priorities from its professionals to its patients, ensuring that high quality care comes before all other w w w. j g h . c a

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T H E J E W I S H G E N E R A L H O S P I TA L considerations.

“We are stewards of the public healthcare system and our primary stakeholders are our patients,” Rosenberg adds. “Accordingly, we are rethinking how we organize by putting the patient at the centre of all our decision-making. As I say to my colleagues, everything should pass the ‘if this were your mother...’ test.”

and the Jewish General Hospital stays on the vanguard as the industry and its capabilities rapidly evolve. “Given our culture of innovation and entrepreneurship, we are always looking for opportunities to partner with industry to prove the benefit of new technologies,” says Rosenberg, explaining that the hospital boasts a rich clinical research program as well as a Building in an era of accelerated commitment to acquiring cutting change edge equipment like the Da Vinci Technology is always advancing, robotic surgical system to improve

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the patient experience.

“The hospital’s surgical program is largely predicated on minimally invasive techniques, including selective use of the Da Vinci. This has permitted us to drastically reduce length of stay and complications,” says Rosenberg. Another recent acquisition, the first equipment of its kind in North America, utilizes high intensity focused ultrasound (HIFU) to target and treat prostate cancer. Rosenberg estimates that the machine What motivates me is the sense should reduce surgical prostatectomies by as of adventure that I feel at the prospect of accomplishing much as 20 per cent. something new in the medical The hospital is anticipating a more widespread field. Each day offers fresh to strive towards evolution of the healthcare industry. “I believe we opportunities new horizons, to innovate, to are in an era of accelerated change, in part driven improve, to inspire. by technology,” says Rosenberg. “Interventions that could previously only have been conducted in a medical centre are moving out to community “We put the patient hospitals, clinics, physician offices, and into the at the centre of home as well. Moreover, as the standards for all our decisioncredentialing of nurses and other allied healthcare professionals have risen, care previously provided making. As I say by specialists and general practitioners will be to my colleagues, provided by these other professionals.” everything should While these advances will improve access pass the ‘if this and reduce cost for patients, they also require a rethinking of the best way to administer care in a were your mother...’ hospital setting. Once again, the solution comes test.” back to the idea of patient-centered treatment.

– Dr. Lawrence Rosenberg, “Given this rapidly unfolding environment, the President and CEO hospital will have to become more focused on w w w. j g h . c a

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T H E J E W I S H G E N E R A L H O S P I TA L

what its redefined mission will be,” says Rosenberg. “We must move from a volume-based to a valuebased organization that is patientcentered, as opposed to being physician-centered. We cannot do everything and we will have to compete on being the best—the highest quality and lowest cost provider. We are more than up to the challenge.”

Meeting current challenges In the spirit of innovation, the Jewish General Hospital currently 38

January 2016

has several projects underway to expand and increase its abilities.

In January 2016 the hospital plans to launch its new critical care pavilion (Pavilion K), which will henceforth house 60 per cent of hospital activity. “It is a magnificent structure,” says Rosenberg. “This will definitely be a defining moment with respect to the future of the hospital.”

The hospital is in the process of helping to put in place a new management team as part of its integration into Quebec’s new health

H E A LT H C A R E

care and social services university network.

Additionally, the hospital team and its new network partners are developing a framework to establish a “continuum of care” for citizens that will focus on preventative care and aftercare for a healthier region, plus a Patient/Client Experience Program for better service overall.

“As our healthcare and social services network takes form, we will play a critical role in establishing trajectories of care that will follow a continuum from the hospital,” says Rosenberg.

“We hope to contribute to the creation of a more robust system of home care that will keep patients away from the hospital.”

Company Information INDUSTRY

Hospital HEADQUARTERS

3755 Côte-SainteCatherine Road Montréal, Quebec Canada H3T 1E2 FOUNDED

Making a difference with innovation and entrepreneurship From government mandates to growing populations, the Jewish General Hospital has plenty of challenges ahead. But with advanced resources and a spirit of progress, the hospital is dedicated to meeting and exceeding those challenges as they come.

“I believe what sets us apart is our culture of entrepreneurship and innovation, our history of caring for all, aspiring to provide the highest quality care, and our dogged persistence and resilience,” says Rosenberg. “The hospital has historically been a survivor—we have always discovered a creative way through the challenges that have been put before us.”

1934 EMPLOYEES

5142 REVENUE

$350,000,000

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TECH

comp

HNOLOGY SERVING HEALTHCARE Accredited by the most demanding markets in the world, the

pany stands out as one of the leaders in the hospital segment Written by: Flรกvia Brancato | Produced by: Karla Sohn

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ANTIBIĂ&#x201C;TICOS DO BRASIL

W

ith a mission to manufacture and sell pharmaceuticals and raw materials for the domestic and export market, Antibiotics do Brazil Ltda. (ABL) uses world-class manufacturing practices to ensure the highest standards of quality and safety within the pharmaceutical industry.

ABL was founded in 2003, the same year it became part of the Italian group ACS Dobfar, which specializes in raw - material as well as finished product antibiotics manufacturing and marketing.

Complementing its line of products, in 2011 the company acquired the Beker, a producer of parenteral solutions operating in Brazil for more than 30 years. A third pharmacy unit, MEQ Corporation, completes the union, specializing in custom parenteral nutrition and chemotherapeutic drugs.

With products in 34 countries worldwide, ABL is the only company in Latin America to have international authorization to produce cephalosporanic for the U.S., Europe and Japan. With offices in the city of SĂŁo Paulo, the

Industrial complex

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January 2016

BRAZIL

ABL products

pharmaceutical production plant is located in the Cosmopolis, São Paulo state.

Production With a diversified line of dozens of reference and generic medications, including renowned products such as Keflin, Kefazol, Dobutrex, Vancocina and Tobramina, the company stands out as a major player in the hospital segment, combining products and services

of high quality standards and competitive prices.

“We started in 2003, 12 years after we reached a profit of more than 10 times of that obtained in our first year. We started with a factory focused on the Brazilian market, and a few years later we are in different countries, with three plants operating in Brazil,” says the commercial director of ABL, Antonio Ianchello.

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BRAZIL

Management strategy The development of professionals in the company is achieved through periodical training, required by national and international regulatory standards, as well as through external courses on subjects of interest in each area. “ABL believes that the company’s success depends directly on the training of professional, so it works on attracting young talent and on the development and retention of its employees,” explains Ianchello.

The company offers various benefits aimed at its employees

well-being. In addition to medical and dental care, transportation and educational training programs, employees also have agreements with shops and pharmacies to assist in purchasing prescription medications.

The director also emphasizes the importance of the production cycle by focusing on a specific market segment, antibiotics. “We dominate the cycles from the production of raw materials to the final finished product, becoming experts in what we do.”

SUPPLIER PROFILE

Industry: Logistics Employees: 1360 Established: 1975 Services: Transport and storage Management: Telma Santoro, Commercial director Pedro Pierini, General Manager Website: www.luft.com.br

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ANTIBIÓTICOS DO BRASIL

Quality and Safety Following the most strict quality standards, ABL has FDA certification as well as two certificates of Good Manufacturing Practices issued by ANVISA (the Brazilian National Health Surveillance Agency), both for medicines and for pharmaceutical chemicals. Accredited in the most demanding markets, U.S. and Europe, the company is qualified with the Certificate of Suitability - Certificate of Compliance with the European Pharmacopoeia (for ceftazidime buffered input).

“We are producing sterile drugs using procedures developed under sterile practices in clean rooms. We

work in controlled environments from beginning to end during production in order to maintain sterilization,” adds Ianchello. The area of sterile crystallization, in addition to producing raw materials for domestic consumption, enables ABL to export active input ingredients, such as cefepime and cefalotin to the U.S. and other places in the world.

When it comes to environmental policy, the company has one of the few plants with computerized incinerator that can meet its own demands and also provide services to third parties. Constantly committed to the current and future well-being of the people, ABL

“If we can speed up the process of product registration, we can contribute greatly to the development of pharmaceutical manufacturing in Brazil.”

– Commercial director of ABL, Antonio Ianchello

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January 2016

Quality control

Laboratory

considers aspects related to health, safety, environment, quality and specially regarding to correct social ethics.

To implement this principle, the 48

January 2016

company is committed to meet the international standard SA 8000 as follows: Promote education and safety of workers

.

. Do not practice, accepting or condoning any type of forced labor, including child labor Maintain a safe and healthy working environment

.

. Respect the rights of employees and collaborators to associations and collective negotiations Do not practice or tolerate discrimination of any kind

.

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ANTIBIĂ&#x201C;TICOS DO BRASIL

Production line

. Do not practice or tolerate abusive disciplinary actions, coercion, threat or exploitation among employees and associates Comply with legislation and collective agreements on working hours and pay, ensuring adequate conditions of employees and collaborators Abide by all national legislation, related regulations and international labor conventions

. .

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January 2016

. Continuously improve the Social Responsibility Management System, involving other stakeholders where applicable Growth and expansion Expanding the reach of raw materials and finished products exports to all of Latin America is one of the main objectives of the ABL. â&#x20AC;&#x153;For this, the company is constantly seeking to expand the production

BRAZIL

Company Information NAME

Antibióticos do Brasil Ltda INDUSTRY

Pharmaceutical HEADQUARTERS

Cosmópolis, SP - Brazil E S TA B L I S H E D

2003 EMPLOYEES

400

capacity and is opening a new plant, located in Sumaré, São Paulo state,” says the director.

In 2015, investments of around 2 million targeted development and new product registration and professional training. As for revenue, the director says there was an increase of over 20 percent compared to last year and concludes, “If we can speed up the process of product registration, we can contribute greatly to the development of pharmaceutical manufacturing in Brazil.”

PRODUCTS / SERVICES

Specialized in manufacturing and marketing of antibiotics (raw material and finished products)

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STRYKER:

LATAMâ&#x20AC;&#x2122;s access to innov medical equipment & in

Healthcare in Latin America counts Stryker as a reliable ally, able to bring first-rate healthcare technology to the region Written by: Mateo Rafael Tablado Produced by: Lucy Verde Interviewee: Fabrizio Signorin, President for Stryker LATAM

vative nstruments

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I LATAM’s private and public healthcare providers rely on a first-class ally: Stryker

Workshops, special trainings and conferences... Standard activitiesorganized by Stryker for both its own staff and its clients’ 54

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n 1941, Dr. Homer Stryker, an orthopedic surgeon in Kalamazoo, Mich., created his own brand for medical instruments and equipment to better meet his patients’ wellness needs.

With more than 70 years of medical innovation, the Stryker corporation holds multiple patents, ranging from the turning frame, the cast walking heel and the cast cutter to sophisticated equipment and software for monitoring and imaging, as well as cameras for endoscopies and other instruments used in complex surgical procedures. Stryker products and services benefit orthopedics, surgical, and neurological specialties.

The company’s international ventures began in 1972 when exports to Canada and overseas first took place. Afterwards, offices in Germany and Australia – among many other countries – were opened. Stryker Latin America, headquartered in Miami, opened in 1992. Currently, Stryker products are used in more than 100 countries.

Its LATAM division has established affiliates in Argentina, Brazil, Colombia, Chile and Mexico, with its management organization reporting directly to Fabrizio Signorin, President of Stryker LATAM. Signorin was named to this position in May 2015. His previous experience in the sector includes his tenure at Philips Healthcare. He also worked for different companies belonging to the FIAT group. He graduated as an engineer from the Milan Polytechnic and took postgraduate studies

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at HEC Paris and at the Kellogg School of Management of the Northwestern University (Chicago).

Key Peole

STRYKER globally: • 18 sales offices • 38 R&D / manufacturing facilities • 26,000-plus employees • Almost 60,000 products • Available in more than 100 countries

Solid presence around the region through sales and interaction The Stryker brand is a recognized as one of the major players in orthopedics and healthcare, with its presence in Latin America supporting its global status as a premier supplier.

Both private and public hospitals benefit from Stryker, whose success results from locating key areas that the company’s products and overall presence are able to improve the value of healthcare services.

Fabrizio Signorin President for Stryker LATAM Signorin graduated from the Milan Polytechnic in Management Engineering, with a specialty in logistics and production. He also earned an MBA in HEC Paris business school, among other postgraduate studies.

Signorin has also worked for IVECO and CNH industrial vehicle manufacturers, both companies of the FIAT group. In healthcare, Signorin has worked for Philips Electronic as global product manager and for Philips Healthcare as market development manager, and as director for patient’s care in Latin America.

He was appointed as president for Stryker LATAM in May 2015.

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“Solid relationships w us to find out what reg be addr

– Fabrizio Signorin, Pres

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with our clients allow gional necessity must ressedâ&#x20AC;?

sident for Stryker LATAM

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S T R Y K E R L ATA M Cutting-edge technology ambassadors

Stryker LATAM offers complete systems for cardiac monitoring

Stryker LATAM’s network provides the entire region with innovative medical products and devices, developed with the most advanced technology for use in surgery, rehabilitation, monitoring and hospitalization.

One of Stryker LATAM’s most efficient strategies consists of having dedicated local employees closely involved in day-today activities in each market, helping customers deliver optimal care for their patients. Each regional representative’s role is crucial to new strategy evaluation at the company’s

Endoscopies become a less complicated procedure with help from Stryker’s cameras and other instruments 58

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headquarters in the U.S. “The diversity of these operations allows us to better understand local needs and to build strong working relationships with our customers,” Signorin explained.

Providing the goods and the knowledge to use them Stryker’s presence in the region is far from being only a business venture. Aside from producing products and instruments, the company also provides workshops for healthcare professionals on subjects such as proper use for new products and new surgical procedure techniques. Stryker also works also with colleges and other medical institutions.

iSuite: a complete monitoring system for surgery rooms

Strict control of the supply chain In order to manufacture its great products, Stryker counts on suppliers that can provide the best materials and components. Most of the company’s R&D facilities and plants are located in the U.S. and Europe and subsequently distributed to their destination regions.

Humerus inner cover

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Triathlon System for knee, Stryker CEO Kevin Lobo is seen in the background

In order to have inventory close to its customers, Stryker has a few large central distribution centers and warehouses in countries where the brand has a presence.

The company builds strong relationships with local and regional suppliers, especially third party logistics providers, for product transportation and warehousing.

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“Reliability is the key. Our suppliers must be reliable. They must operate with the highest quality standards and must be willing to collaborate with our company and our customers,” the executive said.

Tech and innovation-driven endeavors Stryker LATAM is driven to make healthcare better. At the end of the supply chain there is always a patient; therefore, avoiding disruptions and being able to adapt to changing client needs is extremely important. Every new development is directed to assist patients into leading a more active and satisfactory lifestyle through orthopedics, surgery, and neurology.

Stryker Brazil receives a Great Place to Work award

Already a “Great Place to Work” The staff at Stryker LATAM delivers based on core values such as integrity, reliability, and performance. In response, the company acknowledges the importance of attracting, retaining and developing great employees.

Stryker Mexico and Brazil have been certified by the Great Place to Work global survey.

“These values are part of our DNA and are fundamental to how we execute our mission,” Signorin said.

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Knowledge Experience Commitment ARGENTINA

www.alfarolaw.com

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Short term projections

Company Information

In 2016, Stryker hopes to introdu ce a series of new products in the region in expanded clinical segments such as joint care and endoscopy.

The regionâ&#x20AC;&#x2122;s historical macroeconomic and political scenarios are challenging for a company that has recorded 35 straight years of positive figures, with total sales of more than $9.7 billion.

Stryker is able to sustain this 18 percent growth rate by developing high quality innovative products and operational excellence.

NAME

Stryker LATAM INDUSTRY

Medical equipment and instruments for surgery, rehabilitation and hospitalization HEADQUARTERS

Davie, Florida, United States of America FOUNDED

1992, parent company in 1940 EMPLOYEES

250 REVENUE

US $200 million WEBSITE www.stryker.com/latm/index.htm

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