Physicians Squeezed for Time - Amazon Web...

vol.23 no.3 • March 2015 repertoiremag.com

Bringing value, aligning one’s sales approach with the physician’s objectives,

are keys to overcoming diminishing face time

Physicians Squeezed for Time

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MARCH 2015 • VOLUME 23 • ISSUE 3

repertoire magazine (ISSN 1520-7587) is published monthly by Medical Distribution Solutions Inc., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2015 by Medical Distribution Solutions Inc. All rights reserved. Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Repertoire, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.

The Time Crunch ............................................................6

PUBLISHER’S LETTER

HIDA Health Reform Update ............................ 16

HIDA

IMCO Today and TomorrowNew President Bill McLaughlin Jr. speaks about the opportunities for IMCO and its members ....... 10

DISTRIBUTION

18

More Time With Patients,Fewer Mundane Chores –What Could Possibly Go Wrong? .......................8

PRACTICE POINTS

With Trust Comes SuccessFor Teresa Dail, chief supply chain officer at Vanderbilt University Medical Center, building relationships is key to being an effective leader. .... 18

IDN OPPORTUNITIES

10

Bringing value, aligning one’s sales approach with the physician’s objectives, are keys to overcoming diminishing face time

TELEHEALTH

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Welch Allyn calls new venture ‘mobile vital signs monitoring,’ or mVSM ............................ 38

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MARCH 2015 • VOLUME 23 • ISSUE 3

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What’s on Your Plate?Sound nutrition can mean a healthier – and perhaps even happier – you. ................................. 50

HEALTHY REPS

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PUBLISHER’S LETTER

The Time Crunch

Scott Adams

editorial staffeditor

Mark [email protected]

managing editorGraham [email protected]

senior editorLaura Thill

[email protected]

associate editorAlan Cherry

[email protected]

art directorBrent Cashman

[email protected]

publisherScott Adams [email protected]

(800) 536.5312 x5256

director of business developmentMicah McGlinchey [email protected](800) 536.5312 x5268

director of business developmentKatie [email protected] (800) 536.5312 x5255

founder

Brian Taylor [email protected]

circulation

Laura [email protected]

Wai Bun [email protected]

Product and

Marketing Manager

Alicia O’[email protected]

Subscriptionswww.repertoiremag.com/

subscribe.aspor (800) 536-5312 x5259

2015 editorial boardTracy Howard : Cardinal Health

Bill McLaughlin Jr. : IMCO

Bob Miller : Gericare Medical Supply

Linda Rouse O’Neill : HIDA

Jim Poggi : McKesson Medical Surgical

Brad Thompson : NDC

Chris Verhulst : Henry Schein

repertoire is published monthly by mdsi 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043, Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: [email protected]; www.medicaldistribution.com

“All our research shows that the doctor buys the rep first, the brand second, and the

product third”. It is imperative for the rep – particularly if face time is shrinking – to build trust and maintain it. This quote by John Boyens, a consultant and sales productivity expert, can be found in this month’s cover story by Mark Thill. Boyens provides 5 key things every rep needs to do to build trust and maintain it.

This year’s overriding theme in Repertoire is “Year of the Distribution Sales Rep.” This theme is driven home through the words of Mark Thill in our cover story. The amount of time given to reps is becoming more and more limited. For example, 15 years ago a doctor could see 21 patients a day and have a success-ful practice. In order to keep status quo today, that same doctor needs to see 30 to 40 patients.

If face time is shrinking and the trust factor is becoming more important to garner the doctor’s attention, it behooves suppliers to covet the distribution sales rep. All indications point to distribution

reps continuing to play a key role in the supply chain. It also means the distribution sales rep needs to be ready to preform when they get the doctor’s time.

The sales rep, has to stay focused on his or her customer’s success. “And it has to be truly felt, not manipulative’. “We have to become providers of solutions,” says Camille Steele, profitability and equipment specialist, Henry Schein Medical. There’s one more thing implicit in the discussion, adds Steele: Successful selling today calls for different, new skills – but perhaps above all, passion. “If you’re not passionate, you won’t make it, because that’s what really keeps you going to navigate through these times.”

The best salespeople I have been around in my career understood one key to growing relationships that were full of trust. “Time” manufacturer reps don’t get to spend time with doctors regularly like a distribution rep. Time builds commitment. As the rep calling on the providers regularly and building trust through solutions, increasing their productivity, you continue to be the most valuable link in the chain. As Camille stated, be full of passion as you call on these accounts and realize the overall value you bring them as well as the manufacturers you represent.

Be sure to read the cover story this month to learn or be reminded of the keys to success when you get “Face Time” with the doctor.

Dedicated to Distribution,R. Scott Adams

PS: Don’t for get to scan the Repertoire calendar this month with your LAYAR app.

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By Laurie Morgan, Capko & Morgan

Editor’s note: Welcome to Practice Points, by physician practice management experts Capko & Morgan. It is their belief – and ours too – that the more education sales reps receive on the issues facing their customers, the better prepared they are to provide solutions. Their emphasis is on helping physicians build patient-centered strategies and valuing staff’s contributions.

PRACTICE POINTS

I think the trend is driven largely by the emergence of cloud-based, integrated EHR and billing systems. Many of these systems are dramati-cally superior to the ones they re-placed, and their reliable remote access capabilities have made third-party medical billing (AKA revenue cycle management) much more efficient and appealing for practices. In turn, sources like the Black Book (www.blackbookmarketresearch.com) now report that the majority of med-ical practices are at least considering outsourcing their billing.

With a critical function like bill-ing becoming easier to outsource successfully, it’s not surprising that physicians would look to outsource other business functions – and that vendors would quickly emerge to provide more options. It is a pow-erfully attractive idea: let some-one else take care of all the ‘grunt

work,’ and providers can focus on their patients. It’s especially tanta-lizing to owners of smaller prac-tices, who still wonder if they’ll be able to stay independent.

In fact, many commenters seem convinced that outsourcing is the key to small medical practice survival. But I’m not sure it’s right for every practice or every ‘mun-dane’ function. In my experience, outsourcing done well can be a godsend for a resource-constrained practice. But ‘done well’ is the key. Outsourcing is not without pitfalls of its own, and if physicians and managers are not aware of them, they can be very hard to spot be-fore significant damage is done.

For example, it is tempting to assume “that’s off my plate” after outsourcing. But this often leads to problems when the external resources aren’t managed closely. Sometimes, physicians and their owners are even intimidated by the expertise of the firm they’ve hired, and are reluctant to ask important questions.

Choosing which tasks to offload is another delicate area. One out-sourcing option generating a lot of interest is inbound call-handling. But

More Time With Patients, Fewer Mundane Chores –

What Could Possibly Go Wrong?In the little corner of the Internet that I spend most of my time in – the blogs, feeds, groups and pages of physician practice owners and managers, and the vendors and consultants who serve them – outsourcing has reemerged as a hot topic.

we’ve already seen how wrong this can go with the experiences of big technology company call centers – customer frustration with them is a business cli-ché. It goes without saying that the patient-practice relationship is even more delicate and easily damaged than a typical consumer one.

Similarly, practices that lack social media experi-ence are often eager to outsource rather than scale the steep learning curve. But social media has be-come a primary platform of interpersonal relation-ships – and an external ‘expert’ may understand the medium better, but not necessarily the messages that need to be sent and received.

I’m most leery of outsourcing functions like these that involve significant patient contact. Out-sourcing office cleaning, IT network support, and payroll processing may be easier decisions (although there are still risks there, too – think HIPAA and theft as two examples). Outsourcing things like so-cial media or billing are more complicated. Although few practices know they can consider it, sometimes the best approach is a hybrid. For example, a prac-tice can temporarily engage a social media expert to perform the function while also training staff. Or, rather than outsourcing, sometimes two practices can share an employee. This way, both practices will worry less about being “just another client” of an outsourcing firm while also avoiding overcommit-ting on staffing.

Outsourcing things like social media

or billing are more complicated. Although few

practices know they can consider it, sometimes the best approach is a hybrid.

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DISTRIBUTION

Growing up as the son of IMCO’s long-time president, Bill Sr., “I knew from an early age it was something I one day wanted to be a part of,” says McLaughlin.

McLaughlin received an undergradu-ate marketing degree as well as a masters in business administration from Stetson University in DeLand, Fla. At Stetson, he played golf, and after graduation, pursued a professional golf career for two and a half years. “I quickly learned that there are a lot of really good players out there, and if you don’t make almost every putt inside six feet, you aren’t going to make enough money to make it on your own,” he says. As his sponsorship ran out, he pursued jobs in the healthcare industry.

In June 2004, he accepted a position with Midmark Corp. as lower Midwest sales rep, covering Kansas, Missouri, Iowa and Nebraska. His boss – and mentor – was Phil Childrey (who later became IM-CO’s corporate sales trainer and director of equipment development).

“Midmark was a tremendous compa-ny to work for,” says McLaughlin. “Anne Eiting Klamar provided a perfect example of a family-owned business, treating every employee as if they were family.”

Though he had studied and learned about sales and marketing in school, being in the field was an eye-opener. “Until you ac-tually experience sales calls, you never know what they’re like,” he says. “It hits you in the face – learning how to work smart, covering a big territory, balancing your time, making sure you’re as organized as possible.”

IMCO Today and Tomorrow

New President Bill McLaughlin Jr. speaks about the opportunities for IMCO and its members

Independent distributors have much to offer healthcare providers and manufacturers. And Bill McLaughlin Jr. intends to make sure that IMCO members will continue to do so for years to come. McLaughlin Jr. was named president of the Daytona Beach, Fla.-based co-op in January.

Bill McLaughlin Jr.


DISTRIBUTION

Working for Midmark also gave him a perspective on distributors that he might not otherwise have gotten. “I was extremely proud to work with independents,” he says. “I learned they could really influence things quickly for me. They will go that extra mile to work with you. If you give them time, they make it worth your while.”

While working at Midmark, he met his wife-to-be, Ashleigh. “Ironically, we met at an IMCO convention, where she was managing an IMCO distributor,” he says. The two were married in 2008 and now have two daugh-ters, Alexis and Olivia, with a third expected in April.

In 2009, McLaughlin joined IMCO to focus on build-ing its private label program and equipment business, and to manage new projects and build the resource vendor business. “We have grown as a company through our in-

credible partnerships with our loyal members and vendor partners,” he says. “It is our job to fight every day to keep our independent businesses independent and thriving in an always competitive market, facing changes and con-solidation each year as the ACA takes a stronger hold of our industry.”

The power of independentsIndependent distributors – like their national counter-parts – face a bundle of challenges, says McLaughlin. But with challenges come opportunities. He believes that in-dependents are in a unique position to capitalize on them, especially if they are part of IMCO.

“IDNs will continue to acquire physicians’ groups for the revenue and protection they can bring to a sys-tem, but many IDNs are still allowing these groups to operate separately,” he says. The emergence of very large physician “supergroups” presents opportunities. “But our

members must work even harder and smarter to ensure these accounts understand the benefits of working with an independent distributor.”

Prior to becoming supergroups, many of these practices used independent local distributors and have a certain expectation of service and support, says McLaughlin. “Our members will still be there to provide that service, because they are part of IMCO, where we can help them get the pricing they need to compete. It has also been our experience with IDNs as well as with ‘supergroups’ that sole sourcing is not as favorable as they once thought. They don’t want all of their eggs in one basket, and our members have a tremendous opportunity in the physician market to be the solution these accounts need.”

The attributes independents have enjoyed in years past – e.g., their ability to quickly adapt to changing market conditions – will serve them well in the future.

“In the ever faster changing world of healthcare, it is more im-portant now to be nimble and re-spond quickly to changing needs,” he says. “Both are keys to survival, because doing things the same old way will not work in today’s chang-ing market. IMCO members will continue to have a lower cost of

doing business compared to our national competi-tors. [This] provides them the opportunity to balance a commitment by the customer of more volume with a lower customer’s cost on products and services, while still remaining profitable.”

IMCO members enjoy many competitive advantages, he continues, including:

• Outstanding local service from a local source. (People buy from people they know and trust.)

• Dedication to their customers’ business. (Both parties are dependent on the other’s success, meaning goals are aligned.)

• Low cost of doing business. (Lower overhead with fewer levels of management.)

• Ability to be flexible for the customers’ needs. (Quick, local and immediate decisions and response time to changing needs.)

“ It is our job to fight every day to keep our independent businesses independent and thriving in an always competitive market, facing changes and consolidation each year as the ACA takes a stronger hold of our industry.”

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DISTRIBUTION

IMCO members also cover the major multiple mar-kets that mirror the current changes in healthcare – acute care, physicians, long-term care and home care. “This al-lows us to adapt and make changes very quickly, because we will experience trends in one market and make adjust-ments as they happen in the next market,” he says. “We also utilize our member board of advisors and market advisory groups to help provide IMCO tactical support and direction along with sharing successes across all mar-kets as they deal with the changes. These advisory groups along with our board meet twice a year with IMCO and are a vital part of our success.”

Message to vendorsMcLaughlin believes IMCO’s competitive advantages ex-tend to its members’ relationships with manufacturers and group purchasing organizations. By minimizing competi-tion among members – even to the point of turning down prospective members – IMCO has ensured direct access to key vendor partners, consis-tent growth, and very little turnover of members or vendors over the years, he says. “We intentionally limit our number of vendors to ensure a true partnership and focus on grow-ing our business together,” he adds.

“Our message to our vendor part-ners for 2015 is that we are a very vi-able, cost-effective option for them to expand their businesses and grow their market share through our members,” who cover not only the major medical markets, but dental, veterinary, safety, EMS, government, industrial, phar-macy, physical therapy and dialysis, he says. “We also make it easy to do business with us by having one point of contact for all markets to ensure a consistent message to every member. We are a marketing services organization as well, to ensure our members have all of the tools they need in the field to promote our vendor partners.”

McLaughlin is proud of members’ participation in the IMCO National Convention. For over 30 years, the co-op has averaged 93 percent member participation – 94 percent in 2014. “We sold out booth spaces at our 2015 show by November last year, so we are unfortunately

putting vendors on a wait list to see if we can fit in any more booths.

“Finally, with the additions of both Bob McCart, vice president of national accounts/GPOs, and Rich-ard Bigham, director of primary care, and their experi-ences in the market, we will continue to build momen-tum for our independent distributors as we move into 2015 and beyond.”

InitiativesKey initiatives for IMCO include:

• The private label program• New lab product lines• Expanded member incentive programs

IMCO’s private label business has more than dou-bled since 2010, reports McLaughlin. Margins have mul-

tiplied as well. “We will continue to add more products to our portfolio, as we have added Richard Bigham, who previously managed over $600 million in private brand business at a national company. We fully antici-pate that our overall private brand will continue to grow, because it is a great tool for our members to use in competitive situations.

“However, we are also sup-portive of our members who want to develop their own private label brand where the volume is large enough. Lastly, as the private label world grows and looks overseas for savings, we will continue to partner with our key domestic vendors on producing high-quality products at competitive, yet profitable, cost.”

Regarding lab, IMCO has added vendor partners Clarity Diagnostics, PTS Diagnostics and BioSys Laboratories, McLaughlin reports. The ability for providers to get test results and start treatment quickly can lead to better outcomes, he says.

Meanwhile, IMCO continues to build its member in-centive programs as well as its Sales Emphasis Lines pro-gram, announced at the 2014 convention. “The SEL pro-gram highlights many of our key vendor partners who want to provide extra support and programs for our members,”

“It has also been our

experience with IDNs as well as with

‘supergroups’ that sole

sourcing is not as favorable as they once

thought.”


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he says. Regarding IMCO’s member incentive program, he adds, “It’s been great for us to continue to enhance these incentive programs with all of our vendor partners as well.”

FutureIMCO members have every reason to be optimistic about the future, says McLaughlin. “Small businesses are the glue that keeps this country moving, and they usually lead the way with innovative products and ser-vices. Our members are constantly working on offering their customers better solutions, service, support, and personal relationships.

“Our members have the ability to change a pro-gram, adjust a shipment, de-liver a product after hours and go that extra mile that they need to, whereas most national competitors have multiple levels of manage-ment to work through in order to get approval.

“Every market that our members cover is different, but each one has new opportunities,” he adds. “We believe each market will continue to change and evolve as the payment system changes from fee-for-service to fee-for-performance, for cost reductions and for customer satisfaction.

“This is an exciting time in healthcare. Many pieces of the business are changing, from call points to pay structure to the vol-ume of business the Affordable Care Act is hoping to bring to the market. We are and will continue to look for new opportunities for our members, create a stronger portfolio of products that address today’s healthcare provider’s needs, offer multiple options for small units of measure of major branded products, have a database of information on all relevant top-ics in healthcare, and continue to unite our members while never missing an opportunity to tell our small-business story.”

“Small businesses are the glue that keeps this country moving, and they usually lead the way with innovative products and services.”


HIDA HEALTH REFORM UPDATE

HIDA has been right in the middle of these discus-sions, but the process is far from over. The key is getting meaningful legislation passed this year before Congress becomes even more political with a shift in focus to the 2016 presidential election.

Medical device tax repeal gets seriousIn early January, HIDA and its industry partners sent a coalition letter to House and Senate leadership urg-ing an immediate repeal of the 2.3 percent excise tax on medical devices. Although the tax is estimated to

collect approximately $25 billion in revenues, the letter cited adverse impacts on patient care and innovation, and compromised patient access to cutting-edge medical technologies as primary reasons for repeal.

The letter was sent as support to the repeal efforts in the House and Senate – the House bipartisan repeal bill has garnered more than 260 cosponsors and the Senate reintroduced its version of bipartisan legislation to repeal the tax in late January. HIDA and its constituents applaud

HIDA Health Reform UpdateCongress kicks off 2015 with bipartisan, bicameral collaboration

the broad congressional support and collaborative effort to repeal this tax, which recent surveys estimate could end up costing the U.S. economy at least 195,000 jobs.

21st Century Cures bill includes important medical device languageIn another significant development for distributor sales reps, the House Energy and Commerce Commit-tee recently released a draft version of its 21st Century Cures bill. The bill includes several forward looking proposals to improve the FDA’s medical device review

process, healthcare IT, and bio-medical innovation.

The bill also includes language secured by HIDA that standard-izes licensure requirements for all medical device wholesale distribu-tors and implements uniform li-censing criteria across all 50 states to strengthen the supply chain. This is substantial progress for dis-tributors, because it will ultimately

do away with a confusing patchwork of state licensure requirements and provide a uniform, secure way of do-ing business in multiple states.

The committee is currently looking for industry stake-holder feedback as it finalizes the bill, and we will be keep-ing a close eye on any further developments as they occur. As always, if you or your customers have additional ques-tions about licensure requirements or the medical device tax, please contact us at [email protected].

By Linda Rouse O’Neill, Vice President, Government Affairs, HIDA

You’re probably used to hearing on the news all the ways that Congress is unable to work together and make progress toward legislative goals. On healthcare, however, the 114th Con-gress has started the year on a positive note, introducing bills with input from both sides of the aisle, and both sides of the Capitol, that include provisions affecting medical products distributors.

In early January, HIDA and its industry partners sent a coalition letter to House and Senate leadership urging an immediate repeal of the 2.3 percent excise tax on medical devices.

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IDN OPPORTUNITIES

Teresa Dail is well aware that, without the support of

her physicians, it can be next to impossible to mobilize supply chain protocols. To a large extent, she credits her clinical background for her ability to engage Vanderbilt’s physicians and clinicians in the IDN’s contracting and stan-dardization strategies. Long before joining the ranks of contracting executives, she worked as an ICU registered nurse for 15 years, followed by positions as a nursing leader in intensive care, step-down and cardiac. It wasn’t until she joined a large private practice as a clinical practice adminis-trator that she was exposed to vendor/physician relation-ships and the dynamics between private practice physicians and hospital administration.

“I started in supply chain in a clinical resource management role, and then became the corporate di-rector of materials management at Orlando Health – a seven-hospital system at the time,” says Dail. “I believe strongly that it is my back-ground that has allowed me to build relationships and be effective in my role as a supply chain leader. In fact, I was originally recruited into the clinical resource manager role to build and foster relationships that did not exist during the early 2000’s between physicians/clinicians and materials management. Today, I be-lieve – and try to instill in my team – that supply chain needs to be a strong partner with the operational and clinical leaders; that with these relationships come trust; and that, with trust, comes success.”

Her ability to leverage such relationships has enabled Dail to mobilize key protocols at Vanderbilt, such as its Supply Chain Services program, which has enabled the IDN to work with non-owned hospitals and systems; and her current agenda – to engage supply chain in the IDN’s patient care centers and their bundled initiatives.

A collaborationDail joined Vanderbilt in 2007 as administrative di-rector of supply chain. Three years later, she was as-signed to serve as interim administrative director for perioperative services, with oversight for daily clini-cal operations while the IDN recruited a permanent

replacement to fill the position. “I was actually asked to do this because of the collaborative re-lationship I had been able to de-velop with the perioperative team during a major initiative between our two areas that I was the proj-ect manager for,” she explains.

“I had the privilege of being named the chief supply chain officer at Vanderbilt in June of 2012,” Dail continues. “We had several changes in leadership in the months leading up to that. While there were a num-ber of opportunities that I could have pursued at the time, I had a vi-sion of where I wanted to take the supply chain at Vanderbilt, so it made my decision to pursue the CSCO po-sition a very easy one. Having spent the previous five years building a solid, fundamentally strong foundation,

By Laura Thill

With Trust Comes Success

For Teresa Dail, chief supply chain officer at Vanderbilt University Medical Center, building relationships is key to being an effective leader.

Editor’s note: The following is a profile of The Journal of Healthcare Contracting’s Contracting Professional of the Year.

Teresa Dail

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IDN OPPORTUNITIES

I wanted the opportunity to maximize our position as a health system, while begin-ning to explore externally how we could drive additional value for ourselves and others in the effort to better position all of us for the challenges we are facing.”

Today, she oversees all areas of opera-tions related to Vanderbilt’s supply chain, including four hospitals, 151 employed physician clinics and some joint ventures. “This [requires] a strong self-contracting model; procurement; GPO oversight; capital acquisition and data base develop-ment; asset management; distribution and logistics for just-in-time delivery; an LUM model with over 400 ship to’s on- and off-

site; materials system maintenance, which includes point-of-use technology in every clinical department; equipment manage-ment; post office; copy center; and clinical engineering,” she says. “I also have supply chain responsibility for a 50,000-square-foot off-site case cart operation center, which does all of the case picks for our adult hospital (including 76 operating rooms following expansion planned in 2014). I see the entire clinical enterprise as our customer, and have worked to instill the impact of the value of the work we do with our team members as it relates to direct patient care.

“It is a huge compliment that when someone needs to find a solution or to get something done, our phone rings,”

Dail continues. In addition to the above responsibilities, she is the executive chair of the medical economic outcome com-mittees, which is a paired leadership model with Vanderbilt’s physicians and clinicians charged with managing the in-troduction of new products and technol-ogy into the system.

Driving valueThe past seven years have kept Dail busy. “There have been multiple projects that have touched every aspect of sup-ply chain,” she says. “We are constantly evaluating our performance and how we can drive value for the organization

through the use of technology, clinical engagement, internal and external benchmarking, and peer best practice modeling.” A recent project involved the launch of the Vanderbilt Sup-ply Chain Services (VSCS) pro-gram, which enables the IDN to work with non-owned hospitals or systems. “We currently have 11 hospitals in the program, with a focused growth plan to add participants,” she explains.

“Our goal is multi-faceted. We know that we can bring value to these entities through the self-contracting model that we have in place and our ability to drive compliance. By working on behalf of these organizations, it is our goal to help them improve their margins so that they can continue to provide services within their communities.

“With the changes occurring today in healthcare, we have to find a way to allow these small-to-medium-size com-munity hospitals to keep their doors open,” Dail continues. “We hope the program we have put in place, which will require ongoing support by our industry partners, will help. We will also work to share best practice and innovative

Vanderbilt University Medical Center, Nashville, Tenn.

• Four hospitals.

• 151 employed physician clinics, as well as miscellaneous joint ventures.

• 1065 beds.

• $500 million supply chain spend.

“ With the changes occurring today in healthcare, we have to find a way to allow these small-to-medium-size community hospitals to keep their doors open.”

– Teresa Dail


approaches to [facilitate the] management of complex sup-ply chain issues. Our goal is to position the supply chain within any organization to be a strong, integrated member of the healthcare team in the effort to drive quality and re-duce cost. And, if requested, [we will] offer our services and expertise to supplement or support a given process within an organization.”

The pace in the coming year shows no hint of slowing down. “We have a very robust new product and technology program that embraces physi-cian and clinician leadership and engagement, which has been in place for six years,” says Dail. “While the committees have been very successful in support-ing standardization, centralized contracting, cost reductions and new technology assessment/ac-quisition, we realize that we need to evolve beyond that. Internally, we are working closely with our senior leadership team to understand how the committees – and supply chain in gen-eral – can help support the Patient Care Centers as they become more engaged in episode-of-care (bundled) initiatives, fo-cused growth and centers of excellence. “This collaboration, where everyone is evaluating cost, quality and outcomes to drive value, is critical for organizations go-ing forward,” she says.

“While we work to take our com-mittees to this next level, we would like to help those entities working with us under the Vanderbilt Supply Chain Ser-vices (VSCS) program to implement a version of the model that makes sense for them,” she says. “This can be done in a community-based setting or an

academic environment, with or without employed physicians. Ulti-mately, as the VSCS evolves and matures, I would love to see a col-laborative forum that allows physicians and clinicians, no matter at what institution they practice within our network, to be engaged in subcommittee work, helping to make contracting decisions on behalf of the participants that can be incorporated into best practice care models. This is not an insignificant endeavor, as it is going to require a completely different mindset by both the physicians and their respec-tive hospital leadership teams.

“Evidence can and should drive decision making,” she continues. “I equate this to when I was asked to take my first nurse manager role in a step-down unit. I had a very prominent physician tell me that the unit couldn’t be fixed and that he would never admit his patients there. I asked him to give me six months and then [we could] talk again. Before that six months passed, he was admitting his patients to my unit. Things that are worth doing require a lot of work, but you shouldn’t shy away from trying, simply because some many believe it can’t be done.”

“ While we work to take our committees to this next level, we would like to help those entities working with us under the Vanderbilt Supply Chain Services (VSCS) program to implement a version of the model that makes sense for them.”

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Simply stated.

Similarly, in today’s healthcare environment, physicians are busier than ever, and many reps are finding face time more difficult to obtain. How should reps re-spond? “Sell better.” That was the consensus of those with whom Repertoire spoke.

“When you get that elusive face time with the doctor, you must be pre-pared,” say Sergio Bustamante and Luis Hernandez, account managers for American Medical Supplies. “You cannot wing it on the spot. Make the most of your time with the doctor. Have a purpose, a plan and a product to speak about. Work on your presentation. There is nothing worse in sales than to ad lib and fumble through a presentation. Your customer will be grateful for your appreciation of his/her time.”

Bringing value, aligning one’s sales approach with the physician’s objectives, are keys to

overcoming diminishing face time


“I am a little old school when it comes to seeing customers,” says Bob Miller, vice president of sales, Gericare Medical Supply. “Face time has always been at a premium, in my opinion. The good ones go out and make it happen. The others talk about why they can’t. It seems to me you just need to prioritize more and stop making excuses.”

In 2006, Chicago White Sox Manager Ozzie Guillen managed the American League All Star team. In the days and weeks prior to the game, Guillen came under attack for overlooking some talented

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COVER STORY

Are docs busier?Data is hard to come by, but physicians seem to be busier than ever – and that isn’t likely to change. The population is aging. The Affordable Care Act has extended insurance to about 10 million Americans (with more to come, in all likelihood). And the physician workforce isn’t getting any younger either.

In a recent survey of 21,000 physicians across the United States, conducted on behalf of The Physicians Foundation by Merritt Hawkins, 81 percent of physicians described themselves as either overextended or at full ca-pacity, up from 75 percent in 2012 and 76 percent in 2008. (See December Repertoire.) Only 19 percent said they have time to see more patients. What’s more, 44 percent of physicians said they plan to take one or more steps that would reduce patient access to their services, such as

seeing fewer patients, retiring, working part-time, closing their practice to new patients or seeking a non-clinical job, leading to the potential loss of tens of thousands of full-time-equivalents.

It’s true that nurse practitioners, physician assistants and others are taking up some of the slack. But all signs point to a more harried physician workforce. Because of that, practices are taking steps to increase their ef-ficiency. Sales reps who can help them achieve that goal will be rewarded.

Time crunch“It’s hard for me to find time to see a sales representa-tive,” says Wanda Filer, MD, MBA, a family physician in York, Pa., and president-elect of the American Academy of Family Physicians. Physicians such as Filer are see-ing more new patients. “Superimpose on that our pretty

intense flu and cold season, and our schedules are pretty packed,” she says.

Last July, the AAFP asked its members in a survey, “Since January 2014, have you seen an increase or de-crease in patients seeking appointments?” Forty-four percent responded that they had seen an increase, but 41 percent had not seen it yet.

Many practices are migrating toward a team-based approach to caring for patients, as a way to improve pa-tient care and improve the efficiency of their practices, says Filer. And those teams are broadly spread. “People tend to think of [team members] only as nurse practi-tioners, physician assistants or doctors. But they can also include LPNs, medical assistants, perhaps a diabetes educator, behavioral health counselor or social worker.” Many practices now have more than one office, so they

can share resources across several sites, she adds. This new approach to care helps spread the workload – and presents more entry points for sales reps. “If I’m not available, the repre-sentative might see a nurse practitio-ner, physician assistant or one of the LPNs on our team.”

Robert Tennant, senior poli-cy advisor, Medical Group Man-agement Association, notes that “there’s no new money in health-care. Reimbursement rates are not likely to increase.” Even so, many

practice owners resist the notion of expanding physician hours or decreasing the amount of time doctors spend with their patients. So the only ways to improve the bot-tom line are to be more efficient, save money, or look for other avenues of revenue within the practice, such as operating an in-office dispensary, offering new services such as physical therapy or imaging, or subletting office space and equipment to specialists, he says. Gastroenter-ology is a common specialty that partners with primary care to share space and resources. “Everybody wins,” says Tennant. The gastroenterologist avoids the need to finance the infrastructure of an office, the practice gets additional revenue, and the patient gets convenient, high-quality care.

Leveraging electronic data interchange can help improve the efficiency of the practice, including the claims revenue cycle, he adds. For example,

“ Physicians are looking for relationships with people who can help them solve the challenges they are facing.”

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COVER STORY

electronically verifying insurance eligibility by us-ing the HIPAA “270/271” transactions allows prac-tices to speedily receive information about a patient’s healthcare eligibility and benefits. “These new tools are absolutely critical, especially with today’s high-deductible health plans.” Practices can receive the pa-tient co-pay and deductible amounts from the payer within 20 seconds. Better to capture these payments upfront at the time of service rather than chase mon-ey after the patient leaves the office, he says.

“Sales representatives have to keep in mind not only that physicians and administrators are taxed for time, but they’re looking for solutions that meet their needs – that can free up time, make their processes more ef-ficient, and can add some ancillary income to the prac-tice,” says Tennant.

Comes down to valueToday’s physicians are more stressed than ever, says Ca-mille Steele, profitability and equipment specialist, Henry Schein Medical. “I don’t care who you are, there are only 24 hours in the day; no one has figured out how to get more; every minute is precious.

“Even in the smallest practices, there has been a shift in their routine, but most of all, in their attitude,” con-tinues Steele, who calls on practices in the Chicago area. “They’re not looking for one more conversation unless they can trust and perceive its value.

“Most physicians are more aware today of what needs to be done to run a successful practice,” she says. “They’re looking for business partners who are capable of knowing how to help them achieve that success. They may know where they need to go, but not how to get there.”

The sales rep, then, has to stay focused on his or her customer’s success. “And it has to be truly felt, not

manipulative,” she says. “We have to become providers of solutions.”

Given the demands being made on physicians today, sales reps will have difficulty maintaining the same kind of relationships with customers as they had in the past, says Andy Rice, national training and development manager, Henry Schein Medical. “Phy-sicians are looking for relationships with people who can help them solve the challenges they are facing.” There’s little time for small talk. What’s more, if the physician practice is owned by an IDN or other entity, the doctors may have limited leeway in the products they use in the office.

Nevertheless, sales reps can continue to provide value to their customers by keeping in mind what Henry Schein calls the 5 Ps:

• Patients• Profit• People (i.e., the doctor’s staff)• Process (i.e., the practice’s operations)• Penalties (e.g., OSHA and HIPAA)

Implicit in all this? The sales rep’s ability and willing-ness to listen. “If you can get the customer to talk to you and tell you what’s on their mind, they are more likely to have a conversation with you,” says Rice. “You might find out that what you’ve been talking to them about has been the wrong thing.”

There’s one more thing implicit in the discussion, adds Steele: Successful selling today calls for differ-ent, new skills – but perhaps above all, passion. “If you’re not passionate, you won’t make it, because that’s what really keeps you going to navigate through these times.”

“Sales representatives have to keep in mind not only that physicians and administrators are taxed for time, but they’re looking for solutions that meet their needs – that

can free up time, make their processes more efficient, and can add some ancillary income to the practice.”

– Robert Tennant

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COVER STORY

Face time crunch: From the field

Is face time becoming a scarcer commodity? And if so, how does the sales rep continue to build and maintain relationships, and introduce new products and services

to the busy physician? Repertoire asked several readers for their opinion, including:

• Read Patterson, CEO, Sound Medical.• Bill Muich, Midwestern regional sales manager,

MMS – A Medical Supply Company.• Cheryl Carman Fischer, account manager,

McKesson Medical-Surgical, Primary Care.

Repertoire: Are sales reps finding it more difficult to get face time with doctors today than, say, five or 10 years ago?Read Patterson: Yes. Physicians are experiencing the new landscape of healthcare. Their revenues are declin-ing, and their costs to operate their business are rising.

To make ends meet, today’s doctor has to massively in-crease patient volumes. For example, a primary care doc-tor who was profitable at 21 patients per day 15 years ago, now has to see 30 to 40 patients per day to maintain status quo. In between the stress and the dizzying pace, there seems to be less tolerance for medical sales reps. But as it is with any change or new frontier, amongst the chaos is opportunity.

Bill Muich: It is harder to get face time with physicians than 10 years ago. With more physicians being employed by hospitals and IDNs, more of the contact is through procurement offices, business managers or regional direc-tors, who are responsible for primary care decisions for the clinics. Face time is still achieved, but may take longer and go through more decision-makers to finally get to the doctor. The doctors who are independent have relegated

With face time shrinking, sales reps should con-sider shifting their focus to providing value-add to their physician customers, says John Boyens,

Nashville, Tenn.-based consultant and sales productivity expert. Perhaps the rep can share clinical studies, a white paper or blog post that addresses a topic of interest or con-cern to the doctor.

“If every time I see some-one, he or she teaches me some-thing new or shares some best practice, that’s the person I want to see – not the person who brings donuts to my office staff,” says Boyens, speaking of physi-cians. “Think how much easier a distributor rep’s life would be if the physician actually looked for-ward to you coming in.”

The key is to focus on what the doctor is buying, and why – not on what the rep is selling, adds

Boyens. Resist the temptation to flood the doctor and his or her staff with marketing materials. And when sending materials, be sure to vary the message, the medium and the frequency, he adds.

“Doctors are concerned with things like patient satis-faction, increasing revenues for the practice, lowering costs, minimizing risk,” says Boyens. The opportunity for the sales rep is to focus on how the products he or she represents can help the physician address those things.

“All our research shows that the doctor buys the rep first, the brand second, and the product third,” he says. It is imperative for the rep – particularly if face time is shrink-ing – to build trust and maintain it. They can do so in five basic ways, says Boyens:

• Do what you said you’d do.• Show up on time. Be prepared.• Listen more than talk.• Focus on what the doctor is buying vs.

what you are selling.• Provide professional and timely follow-up.

“ If every time I see someone, he or she teaches me something new or shares some best practice, that’s the person I want to see.”

– John Boyens

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COVER STORY

the business decisions to the business manager/office manager. The independent doctors, though, do want to be a part of decisions in regards to equipment and still want to know about new technologies and products that will help them provide better care to their patients and provide a better outcome for their patients, either clini-cally or through having a better experience in their office.

Cheryl Carman Fischer: Today’s healthcare environment is so much more complicated and demanding of physi-cian’s time than even two years ago. They are having to learn new technologies, insurance requirements and pro-cess changes just to take care of the same patient for often less reimbursement. Time is more valuable than ever for the physician, and under-standing their demands can assist you in maintaining a relationship that they value.

Repertoire: What tools or skills are distributor reps employing to maintain their relationship with doctors and to introduce new products to them?Patterson: I have always held the opinion that the buying decisions are mov-ing away from the clinical operators to the business/administrative personnel. Doctors used to be able to make decisions based on relationships and pref-erences, but today, they have to focus more on the clinical aspects of the busi-ness and trust their administration to make intelligent business decisions. We focus on creating massive effi-ciencies that decrease the total cost of ownership. That is what today’s physicians need and want.

Moving a customer’s formulary from thousands of items to hundreds of items is the first step in creating large scale efficiencies. This seems obvious, but in reality, it can be a challenge to get a customer to truly standardize. True standardization allows for less moving parts, which equates to efficiencies in time, delivery, accounting, etc. It

really impacts the customer’s entire business. We offer a solution where we manage our customer’s inventory based on predetermined par levels across a standardized formulary. We do this through innovative technologies and the relational prowess of the sales reps. Once imple-mented, the supply chain functions are eliminated from the customer’s operations. This large-scale efficiency al-lows our customers to focus on the clinical aspects of their business, whereas they can reallocate lost labor back to revenue producing activities. This is a great ex-ample of helping our customers to decrease costs, and increase revenues.

In our industry, it isn’t only about the cost of medical supplies. We train our reps to think at a high level, which will impact the customer’s entire enterprise. If we can first prove our value as a true partner, then our access to physicians becomes available. We train our reps to continue to clearly establish alignment with the physician’s objectives. In today’s market, albeit it is simple, the objectives are to deliver higher quality care at a lower cost. Any solution that correlates with this mission will gain the interest of the physicians, because they, too, are compensated along these lines.

Muich: The tools used are technology, e.g., using a tablet device to show a doctor a new product in an effective, concise manner, and being able to send that information to them and the business manager electronically. The skills are to keep updated on new technology and products that can bring real value to the doctor’s practice. Understand-ing the practice by asking probing questions of the staff and business manager, so when you ask for time with the doctor, you are not wasting their TIME! Being a source of knowledge that you can bring to the office staff will get you the time to speak with the doctor.

Fischer: Physicians are interested in products or services that, first, save them time or bring efficiencies to their daily process, and second, offer additional revenues for their practice. I hear again and again, “If this will save my staff time, I would like to evaluate it.” The greatest skill a distributor rep can bring is knowledge of the cur-rent healthcare regulations, such as the Affordable Care Act, ICD-10 and Medicare reimbursement rate changes. Understanding these concerns will greatly increase your ability to show your interest in their business and how your product or service may bring value in a constantly changing environment.

“ In between the stress and the dizzying pace, there seems to be less tolerance for medical sales reps. But as it is with any change or new frontier, amongst the chaos is opportunity.”

– Read Patterson

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COVER STORY

Electronic medical records are supposed to help the physician and his or her staff work more efficient-ly, and eliminate paper, redundant work, fumbling

through medical records to find pertinent data, etc. The federal government is so sold on the opportunity that EMR represents to improve care and cut costs, that it is incentivizing practices that are “meaningfully using” EMR, and penalizing those that don’t.

But many physicians aren’t happy. In a recent survey of 21,000 physicians across the United States, conducted on behalf of The Phy-sicians Foundation by Merritt Hawkins, 85 percent of physicians reported adopting electronic medi-cal records systems, up from 69 per-cent in 2012. However, 46 percent said EMR has detracted from their efficiency, while only 24 percent said it has improved efficiency.

In September 2014, the Ameri-can Medical Association took up the cause, calling for a “design overhaul” of EMR systems.

“Physician experiences docu-mented by the AMA and RAND Corp. demonstrate that most elec-tronic health record systems fail to support efficient and effective clinical work,” AMA President-elect Steven J. Stack, MD, was quoted as saying in September. “This has resulted in physicians feeling increasingly demoralized by technology that in-terferes with their ability to provide first-rate medical care to their patients.”

AMA/RAND findings show physicians generally ex-pressed no desire to return to paper record-keeping, ac-cording to the AMA. But physicians are concerned that EHR technology requires too much time-consuming data entry, leaving less time for patients.

“I am on the fourth EMR of my career,” Wanda Filer, MD, MBA, a family physician in York, Pa., and president-elect of the American Academy of Family Physicians, told Repertoire. “Some systems work reasonably well; some are atrocious.”

One reason for the difficulties is that many sys-tems were built for the billing side rather than the clini-cal side, so they fail to add efficiencies to the medical

records process, she says. “You spend a lot of time clicking boxes. And if I do a hospital follow-up visit with a patient who had been in the emergency department, what I used to see in two or three pag-es now comes to me in 25 pages.” It is difficult to tease out the rel-evant information amidst the clut-ter. “EMR should be a tool, not a means to an end,” she says. “My focus needs to be on the patient.”

“The promise of EHR technol-ogy was there,” says Robert Tennant, senior policy advisor, Medical Group Management Association, speaking of EHR. But the implementation challenges have been formidable. The first challenge has proven to be the technology itself, which, in many cases, fails to fully meet the practice’s clinical and administrative needs. The second has been the reliance –

or over-reliance – on the government’s “meaningful use” program as the driver for the technology. Just as software developers were improving their systems through use of a robust, private-sector certification program, “meaningful use” hit the streets, he says.

The government’s incentive program “was positive in the sense that it freed up capital for physicians to pur-chase these systems,” he says. Unfortunately, the urgency of implementing the systems short-circuited efforts to

EMR: Is time on the doctor’s side?

“Physician experiences

documented by the AMA and

RAND Corp. demonstrate that most electronic health record systems fail to

support efficient and effective clinical work.”

– Steven Stack, M.D.

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COVER STORY

1. Enhance physicians’ ability to provide high-quality patient care. “Effective communication and engage-ment between patients and physicians should be of central importance in EHR design,” says the AMA. “The EHR should fit seamlessly into the practice and not distract physicians from patients.”

2. Support team-based care. “EHR design and configu-

ration must: 1) facilitate clinical staff to perform work as necessary and to the extent their licensure and priv-ileges permit, and 2) allow physicians to dynamically allocate and delegate work to appropriate members of the care team as permitted by institutional policies.”

How to make EMR more usable: AMA

To leverage the power of EHRs for enhancing patient care, improving

productivity, and reducing administrative costs, the American Medical Association has identified what it says are eight “usability priorities.”

improve their usability. “So you may have had a vendor whose system was certified for ‘meaningful use,’ but also was abysmal to use in the real world of seeing patients,” he says. These issues have only been exacerbated as the feds have ramped up the more onerous Stage 2 of “mean-ingful use” requirements.

“We have to find ways to make these tools really work effectively within the parameters of the physician work-flow,” he says. “The goal is to have the physician leverage technology to improve care and efficiency, not to stumble through or lose time. The only way we will move forward with [health information technology] is to make it usable for the end user.”

‘Kicking and screaming’“EHR systems have been lacking in a number of things – content, support and taking care of what the doctor needs,” says Michael Paquin, MDP Group, Los Angeles, and EMR consultant. And that’s true for a number of reasons, he says.

For one, the Affordable Care Act and “meaningful use” provisions pushed doctors to implement EHR. “But they weren’t ready; they didn’t have time. You’re talking

about doctors not only going to an EHR, but updating their practice management systems too.” Throw in ICD-10 and accountable care organizations. “We have all these things throwing the doctor’s office in turmoil.” What’s more, buying an EHR is more complex than buying most medical products and equipment. “A lot of due diligence should be taking place,” he says. No wonder doctors are kicking and screaming.

But things are changing. “Many vendors are redo-ing their products, and making them simpler and easier to use,” says Paquin. Most have managed to successfully combine their practice management and medical records components, so they work well together.

Doctors are responding. “Doctors who are imple-menting these systems are starting to be enabled and to see how they can work,” says Paquin. “That’s positive. The disconnect in the past were those doctors who bought a system, started to use it but then stopped. That didn’t do anyone any good.”

There are no perfect systems out there, he says. So it is the doctor’s responsibility to select a system that is best for them, and make it work. Reps who can provide some guidance along those lines will be appreciated.


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3. Promote care coordination. “EHRs should have enhanced ability to automatically track referrals and consultations as well as ensure that the referring physician is able to follow the patient’s progress/ activity throughout the continuum of care.”

4. Offer product modularity and configurability. “Modularity of technology will result in EHRs that offer flexibility to meet individual practice require-ments,” says the AMA. “Application program interfaces (APIs) can be an important contributor to this modularity.”

5. Reduce cognitive workload. “EHRs should sup-port medical decision-making by providing concise, context-sensitive and real-time data uncluttered by extraneous information. EHRs should manage information flow and adjust for context, environ-ment and user preferences.”

6. Promote data liquidity. “EHRs should facilitate connected health care – interoperability across different venues, such as hospitals, ambulatory care settings, laboratories, pharmacies and post-acute and long-term-care settings. This means not only being able to export data, but also to properly incorporate external data from other systems into the longitudinal patient record. Data sharing and open architecture must address EHR data ‘lock in.’”

7. Facilitate digital and mobile patient engagement. “Whether for health and wellness and/or the management of chronic illnesses, interoperability between a patient’s mobile technology and the EHR will be an asset.”

8. Expedite user input into product design and post-implementation feedback. “An essential step to user-centered design is incorporating end-user feedback into the design and improvement of a product. EHR technology should facilitate this feedback.”

Source: “Improving Care: Priorities to Improve Electronic Health Record Usability,” American Medical Association, ©2014


TELEHEALTH

“This is another area that we are actively exploring with great interest, including how our strong distributor partnerships can poten-tially add value in selling scenarios that are, in many cases, new for Welch Allyn and perhaps many of our partners,” said Welch Allyn Se-nior Vice President of New Health-care Delivery Solutions Scott Guc-ciardi, responding to a question about the impact of telehealth on distributors’ selling opportunities. “The mVSM [mobile vital-signs-monitoring] solution will very much be a strategic sale, and we recognize that many of our channel partners are working hard on specialty stra-tegic selling teams, so there may in fact be an opportunity to work to-gether beyond just devices.”

Wireless patient monitoringHealthInterlink’s telehealth offering integrates wireless patient monitor-ing devices with smartphones or tab-lets, so that patients’ vital signs data can be transmitted to a HIPAA-com-pliant web portal for management by healthcare professionals. The tech-nology – which gained FDA 510(k) clearance in March 2014 – is also

designed to support communication between patients and their caregivers to answer the patient’s care or health status questions.

The standard HealthInterlink offering – which has been called Beacon – comes with a Bluetooth wireless blood pressure monitoring unit, a weight scale and a pulse ox-imeter. The company says that Blue-tooth wireless thermometers, blood glucose monitors and spirometers are also available.

“We intend to take the ap-proach of integrating wireless medi-cal devices into the solution that are the best overall fit with the needs of patients and providers, with con-sideration for performance, qual-ity, accuracy, and, of course, value vs. cost,” says Gucciardi. “In some cases, it will make sense to include Welch Allyn devices in the remote patient monitoring kits, but not in all cases.

“On a related note, we intend to discontinue the use of the Beacon brand name in favor of Welch Allyn branding accompanied by new no-menclature for the solution – Mobile Vital Signs Monitoring, or mVSM for short.”

Remote controlWelch Allyn calls new venture ‘mobile vital signs monitoring,’ or mVSM

“The spirit of where healthcare

delivery is headed includes

managing some patient conditions, at least in part,

without having to bring them in to

the office or clinic for every part of their care plan.”

– Scott Gucciardi

Telemedicine moved one step closer to Repertoire readers following Welch Allyn’s acquisition in November of the assets of telehealth company HealthInterlink LLC from pri-vate investment firm Prairie Ventures. Though distribution’s role was not clearly defined at press time, the door to new selling opportunities appeared to be open.


Helping physicians remotely monitor chronic hypertension patients will be an important focus for Welch Allyn, but not the only one, says Gucciardi. “The mVSM solution can be used to help manage all the major chronic disease states, and is espe-cially useful for helping with complex chronic patients having multiple conditions. Those same patients tend to be the ‘fre-quent flyers,’ meaning they utilize a great amount of healthcare resources, including hospital ER visits, inpatient admissions, and physician/clinic visits.

“The move to care co-ordination across the contin-uum – from acute, to post-acute, ambulatory, long term care and ultimately, to care in the home – will drive new requirements for our mVSM solutions, and we plan to meet those needs.”

Impact on office visitsA big question for Repertoire readers and diagnostics manufacturers is this: What impact will tele-health have on office vis-its and sales to physician practices? The answer may be a little cloudy, but the industry appears commit-ted to pushing ahead with mobile solutions.

“The spirit of where healthcare delivery is head-ed includes managing some patient conditions, at least in part, without having to bring them in to the office or clinic for every part of their care plan,” says Guc-ciardi. “If we are going to continue to be able to afford high quality healthcare in the United States, it will have to include utilization of at least some aspects of home telehealth and related approaches.

“The trends, dynamics, and new demands on the delivery sys-tem – from changing payer incentives and penalties, to the aging demographic and growing prevalence of chronic diseases, to the push toward managed care and population health – will make these new approaches a necessity.”

‘Telemedicine’ defined

The American Medical Association offers these

three categories of telemedicine technologies:

Store-and-forward telemedicine in-volves the transmittal of medical data (such as medical images and bio signals) to a physi-cian or medical specialist for assessment. It does not require the presence of both parties at the same time and has thus become popu-lar with specialties such as dermatology, radi-ology and pathology, which can be conducive to asynchronous telemedicine.

Remote monitoring, or self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is typical-ly used to manage chronic diseases or specific conditions (e.g., heart disease, diabetes mel-litus or asthma) with devices that can be used by patients at home to capture such health indicators as blood pressure, glucose levels, ECG and weight.

Interactive telemedicine services pro-vide real-time, face-to-face interaction be-tween patient and provider (e.g., online por-tal communications). Telemedicine, where the patient and provider are connected through real-time audio and video technol-ogy (generally a requirement for payment), has been used as an alternative to traditional in-person care delivery, and in certain cir-cumstances can be used to deliver such care as the diagnosis, consultation, treatment, education, care management and self-man-agement of patients.

Source: “Coverage of and Payment for Telemedicine,” © 2014 American Medical Association

“ The trends, dynamics, and new demands on the delivery system – from changing payer incentives and penalties, to the aging demographic and growing prevalence of chronic diseases, to the push toward managed care and population health – will make these new approaches a necessity.”

– Scott Gucciardi


TELEHEALTH

The Dexcom Share Direct Secondary Displays system’s data-sharing capability is said to allow caregivers to a person with diabetes to monitor that individual’s blood sugar levels remotely through a de-vice available on mobile devices. De-vices such as the Dexcom Share were previously available through open source efforts, but were not in com-pliance with regulatory requirements, according to the FDA. The Dexcom Share system is the first of its kind to offer a legally marketed solution for real-time remote monitoring of a patient’s CGM data. Using Dexcom Share’s mobile medical app, the user can designate people (“followers”) with whom to share their CGM data.

A CGM is a device that includes a small, wire-like sensor inserted just under the skin, which provides a steady stream of information about glucose levels in the fluid around the cells (interstitial fluid), according to the FDA. CGMs are worn externally, and continuously display an estimate of blood glucose levels, and the di-rection and rate of change of these estimates. When used along with a blood glucose meter, CGM informa-tion can help people with diabetes detect when blood glucose values are approaching dangerously high and dangerously low levels.

The Dexcom Share system is not intended to replace real-time continuous glucose monitoring or standard home blood glucose moni-toring, according to the FDA. It is also not intended to be used by the patient in place of a primary display device. Additionally, CGM values alone are not approved to determine dosing of diabetes medi-cations. CGMs must be calibrated by blood glucose meters; treatment decisions, such as insulin dosing, should be based on readings from a blood glucose meter.

The technology may find special use among caregivers of children with diabetes who want to monitor their glucose levels remotely according to the FDA.

Remote glucose monitoring app cleared by FDA

The U.S. Food and Drug Administration in January allowed marketing of the first set of mobile medical apps that allow people with diabetes to automatically and securely share data from a continuous glucose monitor (CGM) with other people in real-time using an Apple mobile device such as an iPhone. The technology may find special use among caregivers of children with diabetes who want to monitor their glucose levels remotely according to the FDA.

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TELEHEALTH

Physician practices aren’t the only healthcare provid-

ers using telehealth. Hospitals and hospital systems are do-ing so as well.

In January, the American Hospital Association published “TrendWatch: The Promise of Telehealth for Hospitals, Health Systems and Their Communi-ties.” In it, the AHA reports that the technology holds promise to increase access and patient satisfaction, and to reduce readmissions and costs. But it also faces operational challenges.

In 2013, 52 percent of hospitals used telehealth, and an-other 10 percent were beginning the process of imple-menting telehealth services, according to AHA. Recent studies on the use of telehealth services have shown that:

• 74 percent of U.S. consumers would use telehealth services.

• 76 percent of patients prioritize access to care over the need for human interactions with healthcare providers.

• 70 percent of patients are comfortable communi-cating with their healthcare provid-ers via text, email or video, in lieu of seeing them in person.

• 30 percent of patients already use computers or mobile de-vices to check for medical or diagnostic information.

For several years, the Veter-ans Health Administration (VHA) has used telehealth for home health monitoring to track vital signs and conditions for patients with chronic diseases or who have been released recently from the hospital, reports the AHA. The VHA reported that telehealth services in its post-cardi-ac-arrest-care program resulted in a 51 percent reduction in hospital readmissions for heart failure and a 44 percent reduction in readmissions for other illnesses.

Coverage and paymentCoverage and payment issues pres-ent some of the greatest challenges for providers seeking to implement telehealth, notes the AHA.

Coverage and payment issues present some of the greatest challenges for providers seeking to implement telehealth, notes the AHA.

Hospitals and telehealth: Promises, challenges


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“On the public payer front, inconsistencies exist. For example, Medicare’s policies for coverage and payment for telehealth services lag far behind other payers due to its re-strictive statutes and regulations. Many state Medicaid pro-grams cover telehealth services to some extent, although the criteria for coverage vary widely from state to state. On the private payer side, by contrast, there has been significant ex-pansion, with many states passing laws requiring private pay-ers to provide coverage for telehealth services.” The Ameri-can Telemedicine Association reports that 20 states and the District of Columbia have enacted so-called “parity” laws, requiring insurers to pay for telehealth services the same way they would cover services provided in-person.

Heart failure programGeisinger Health Plan, a managed care organization serv-ing patients primarily in rural central Pennsylvania, has operated a heart-failure telemonitoring program since March 2008, according to the AHA. Geisinger gives pa-tients Advanced Monitored Caregiving Bluetooth scales with an Interactive Voice Response (IVR) system, which is used with landline or cellular phone service to transmit weight measurements and to take the IVR calls.

Geisinger researchers reviewed claims data for patients enrolled in the program from January 2007 through October 2012. In a given month of the study, patients enrolled in the program were 23 percent less likely to experience a hospital admission. The odds of experiencing a 30-day readmission were 44 percent lower, and the odds of experiencing a 90-day readmis-sion were 38 percent lower than patients not enrolled in the telemonitoring program. Also, the program was associated with approximately 11 percent cost savings during the study period.

Healthcare reform and telehealthGiven the Affordable Care Act’s emphasis on clinically integrated care models, telehealth should only grow in its usage, says the AHA. In a proposed rule published in December 2014, for example, the Centers for Medi-care & Medicaid Services proposed requiring accountable care organizations (ACOs) to describe in their applica-tions how they will encourage and promote the use of technologies such as telehealth services to improve care coordination for Medicare beneficiaries.

Source: “TrendWatch: The Promise of Telehealth for Hospitals, Health Systems and Their Communities.” ©2015 American Hospital Association


Outbreaks of Hepatitis B virus and Hepatitis C virus have occurred in outpatient settings – including long-term care facilities – primarily as a result of unsafe injection practices, and reuse of needles, fingerstick de-vices and syringes, according to the Centers for Disease Control and Prevention (CDC). In fact, unbeknownst to some, Hepatitis C virus is the most common chronic bloodborne infection in the United States. Approxi-mately 3.2 million individuals countrywide are chroni-cally infected with the virus, which is often transmitted through large or repeated percutaneous exposure to in-fected blood, according to the CDC.

Infection control is keyIn the past, healthcare workers in long-term care facili-ties have been known to re-use blood glucose monitoring equipment, such as fingerstick devices, from one patient to the next, increasing the risk of transmitting viral hepa-titis and other bloodborne pathogens. For this reason, the CDC offers the following infection control recommenda-tions in long-term care settings:• When treating diabetic patients:

• Single-patient insulin pens and insulin cartridges should not be used to administer medication to multiple patients.

• Medications, such as insulin, should be prepared in a centralized medica-tion area, and multiple-dose insulin vials should be assigned to individual patients and labeled appropriately.

• Surfaces and equipment, such as glucometers, should be decontami-nated regularly, or whenever they are contaminated with blood and body fluids.

• Trays and carts used to deliver medication/supplies should re-main outside patient rooms.

• Nurses/healthcare workers should not carry supplies and medication in their pockets.

• Unused supplies and medication taken to one patient’s bedside should not be used for another patient.

• Glucometers should be assigned to individual patients and used appropriately.

LONG-TERM CARE

Playing it SafeHepatits B and Hepatitis C can be a risk in long-term care settings.

For many long-term care providers and patients, Hepatitis B and Hepatitis C may not be at the forefront of their concerns. But, the reality is, many of your customers – as well as those they care for – are at risk of contracting these diseases, much the same as their counterparts in hospitals and other healthcare settings.


• Glucose test meters approved for use with more than one patient should be cleaned and disinfected after each use.

• Needles, lancets and syringes should NEVER be reused.• Use of fingerstick capillary blood sampling devices

should be restricted to individual patients. • Healthcare workers should only use single-use

lancets that permanently retract upon puncture.• Fingerstick devices and lancets should be disposed

of at point of use, in an approved sharps container.• Used and unused equipment and supplies should

be stored separately.

• Gloves should be:• Worn whenever the procedure involves finger-

sticks, needle sticks or potential exposure to blood and body fluids.

• Changed between patient contact.• Changed after touching potentially blood-contaminated

objects or fingerstick wounds before touching clean surfaces.

• Discarded in appropriate receptacles following every procedure involving potential exposure to blood or body fluids.

• Hand hygiene:• Should be performed (e.g., handwashing with soap

and water or the use of an alcohol-based hand rub) immediately following glove removal and be-fore touching other medical supplies intended for use on other patients.

The CDC recommends that long-term care administra-tors provide their healthcare practitioners, workers and staff with a full Hepatitis B vaccination series. In addition, adminis-trators should establish oversight for infection-control activities and compliance. Attention to details up front can mean peace of mind for your long-term-care customers in the future.

Outbreaks of Hepatitis B virus and Hepatitis C virus have occurred in outpatient settings – including long-term care facilities – primarily

as a result of unsafe injection practices, and reuse of needles, fingerstick devices and syringes, according to the CDC


TRENDS

As our healthcare system evolves

from “fee for service” to “fee for out-comes,” many moving parts are chang-ing – insurance, accountable care organi-zations, reimbursements, access, and a shift in accountability.

Outcomes are more important than ever, but healthcare providers, manufac-turers and distributors know that they can only do so much to affect them. The costs associated with healthcare out-comes can be driven as much by patients’ actions as they are by the clinical team treating those patients. An under-valued component in the new healthcare deliv-ery and payment model is the patient’s

behavior. The ability to predict which patients will follow his or her prescribed treatment plan and which one can’t – or won’t – is the potential innovation.

The premise of personal account-ability is based on individual life habits, patterns and behaviors. Doctors, ACOs and hospitals should not be penalized for patients who don’t have the stamina,

fortitude or desire to follow a treatment protocol. This is quickly becoming the ‘patient vortex,’ that is, the place where the science of healthcare collides with human nature and economics.

Some might suggest that patients be monitored throughout their recovery, utilizing technology. They believe that tracking each movement or noncom-pliance during recovery is the only way to facilitate treatment compliance. The question is, what type of monitoring is most useful? Wristbands? Apps? Much of this capability exists today, and inno-vative technology is on the horizon. Of-ten it is being put to great use in tracking

clinical components, such as heart rates, blood pres-sure, glucose and the like.

Patient predictability profileBut what if a patient con-tinues risky pretreatment behaviors during recovery, such as smoking, drinking, or failing to take medica-

tions as prescribed? Wouldn’t it be easier and more cost-effective to develop a pa-tient predictability profile, which would indicate the behavioral risks for treating a patient before he or she enters the sys-tem? Many partners in the current health-care model already have behavioral and transactional data that can be structured in such a way as to assess how certain

Predicting Patient Behavior

Predicting the behavior of recovering patients could be the next frontier in healthcare.

By Bruce Stanley

“ The costs associated with healthcare outcomes can be driven as much by patients’ actions as they are by the clinical team treating those patients.”


types of patients will respond based on predictive behaviors. The blend-ing of useful data and analysis with technology could help patients re-cover faster, and help doctors and clinicians treat with greater reliability.

The ability to predict how a pa-tient will act based on past behavior could provide clinicians and insur-ers with the confidence required for making certain treatment options available to certain patients and not others. Additionally, products and processes could be designed and delivered by the key players in the healthcare system that more effectively treat patients based on behavioral analysis. Is this segre-gating care? I hardly think so. Is it segmenting care? Yes, indeed; it be-comes customized care. The good news is that predictive analysis is based on scientific and mathemati-cal principles grounded in reliable characteristics of human nature. Predicting the behavioral capability of recovering patients could be the next frontier in healthcare.

ChallengesHealthcare clinicians can be equipped with data that helps them determine what individual patient behaviors look like even before specific treatments begin. Based on that profile, they can modify the rigor of a particular treatment or cease it. While predictive analysis could have significant benefit in developing a patient treatment profile, it also raises potential ethical concerns, which would have to be addressed.

Using predictability profiles to guide treatment de-cisions is not allocating care, but rather, adding a cus-tomized behavioral component to it. At the end of the

day, all participants in the system win: patients, physi-cians, manufacturers, hospitals, insurers, and the gov-ernment. With this tool, delivering care can be a better balanced and effective process from product innova-tion to patient consumption.

Predictive analytics can’t guarantee favorable out-comes for patients, but it can help caregivers deliver the right care in the right behavioral context. In the end, it is only a tool, but one that may benefit the entire healthcare system.

Bruce Stanley is a supply chain and contracting operations consultant with over 30 years in the healthcare industry, and an adjunct professor at Endicott College’s MBA program, teaching global supply chain, contracting and healthcare informatics and regulations. He served as senior director, contracting operations, for Becton Dickinson. He is a former chairman of the AdvaMed working group focused on vendor access-credentialing, and has collaborated with MassMedic and AdvaMed on legislative initiatives related to this topic. In 2011, he co-founded The Stanley East Consulting Group, in Ipswich, Mass., a global consulting practice specializing in supply chain, contracting, order fulfillment and project management for small and medium-sized companies, startups, and companies in transition or divestiture.

“ The ability to predict how a patient will act based on past behavior could provide clinicians and insurers with the confidence required for making certain treatment options available to certain patients and not others.”


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Cardiometabolic Syndrome Identifying cardiometabolic syndrome can help your physician customers effectively treat diabetes and cardiovascular disease.

Cardiometabolic syndrome is a cluster of conditions – including high blood pressure, high blood sugar levels, high cholesterol, high triglyceride levels, low HDL cho-lesterol levels, and excess body fat around your waist – which occur together.

If an individual has at least three of these conditions, the patient likely has metabolic syndrome, and the risk of developing cardiovascular disease or diabetes is greatly in-creased. That means an increased risk of complications, including loss of eyesight and kidney failure from diabetes, and heart attack and stroke from cardiovascular disease.

“With diabetes, we know that you can control the blood sugar and get it back to normal,” says James Anderson, MD, PTS Diagnostics’ Medical Officer. “But those people still have an increased risk of developing cardiovascular complications. Likewise, we know that people with lipid disease have high tri-glycerides and high cholesterol, and that actually causes insulin resistance, which can be a factor in causing the development of diabetes. So diabetes makes cardiovascular disease worse, and cardiovascular disease makes diabetes worse.”

However, diagnosis and treatment of diabetes and cardio-vascular complications have typically been segmented. “You look at the world of medicine and you have diabetologists who

deal with diabetes, and you have cardiovascular physicians who deal with heart disease,” says Anderson. “They really ought to be working together very closely. You cannot really separate the two diseases and treat them independently.”

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“Our CardioChek analyzer measures lipids in as little as 90 seconds. The A1CNow+ system provides a result in five min-utes. The major advantage is that because you can get the tests done so rapidly, the physician can actually counsel the patient while the patient is still in the exam room,” says Anderson. “The ability to do that has a much greater impact than the patient get-ting a letter in the mail a few days or a week following the visit saying ‘Your cholesterol or glucose was elevated, you should speak with your physician the next time you see them.’ The im-pact of immediate counseling is much more forceful and much more effective in dealing with the patient than a delayed educa-tion.”

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1) http://www.diabetes.org/diabetes-basics/statistics. Accessed November12, 2014. 2) Hemoglobin A1C Monitoring A Global Strategic Business Report, page 17. Global Industry Analysts, Inc. February, 2014. Data on file.

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Statistics show that 83 million Americans suffer from cardiovascular disease. Also according to statistics, more than 29

million Americans have diabetes, and one in three Americans may have signs of pre-diabetes. Your physician customers are no doubt aware of those issues within their patient base. What they may not realize is effective treatment with either disease state can best be realized by testing and monitoring for both through recognizing the signs of cardiometabolic syndrome.

1) http://www.diabetes.org/diabetes-basics/statistics. Accessed November 12, 2014.2) Hemoglobin A1C Monitoring A Global Strategic Business Report, page 17. Global Industry Analysts, Inc. February, 2014. Data on � le.

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HEALTHY REPS

For starters, the organization recom-mends the following:

• Eat breakfast. You’ve heard it before: Breakfast is an important meal. But, it’s especially so when it includes lean protein, whole grains, fruits and vegetables.

• Make half your plate fruits and vegetables. The Academy of Nutrition and Dietetics recommends eating two cups of fruit and 2 ½ cups of vegetables daily.

• Portion control. If half of the plate is designated to fruits and vegetables, the other half should contain grains, lean meat, seafood or beans – all within recommended portion sizes.

• Exercise. The Academy of Nutrition and Dietetics recommends adults get at least 2 ½ hours of exercise each week.

• Healthy snacking. Low-fat yogurt with fruit, or whole grain crackers with low-fat cheese are

two suggestions. (For more, visit www.eatright.org.)

• Read food labels. • When in doubt, consult a

registered dietician about diet and food choices.

• Follow food safety guidelines. Each year, the Centers for Disease Control and Prevention estimates that nearly one in six Americans get sick from foodborne disease each year, according to the Academy of Nutrition and Dietetics.

• Learn to cook. Cooking at home can be healthy and cost-effective.

• When dining out, plan ahead in order to stick to healthy eating habits.

• Make mealtime about family. Research has shown that family meals promote healthier eating.

• Spice up a boring brown bag lunch. For ideas, visit http://homefoodsafety.org.

• Drink more water. The body depends on water to regulate temperature, transport nutrients and oxygen to cells, carry away waste products and more.

• Explore new foods. A little variety is good for everyone!

What’s on Your Plate? Sound nutrition can mean a healthier – and perhaps even happier – you.

Eating fruits and vegetables needn’t be a chore.Fruits and vegetables can add flavor, color, texture and vita-mins, minerals and fiber to one’s plate. The Academy of Nutrition and Dietetics offers the follow-ing suggestions:

• Use broccoli, spinach, green peppers, tomatoes, mushrooms and zucchini as pizza toppers.

• Make a breakfast smoothie using low-fat milk, strawberries and bananas.

• Swap chips with crunchy vegetables and dip or dressing.

• Fill a whole-wheat tortilla with roasted vegetables and low-fat cheese.

• Stuff an omelet with veggies.

• Add grated and chopped vegetables to meat loaf.

• Puree fruits for pancake toppings.

For more ideas, visit www.eatright.org.

Feeling guilty about those faded New Year’s resolutions for a healthy

2015? Take heart. Spring is officially on the calendar this month – a great time for sales reps and their customers to jumpstart healthy habits. The Academy of Nutrition and Dietetics has designated March National Nutrition Month ®, and of-fers a range of tips for healthy eating and maintaining sound nutrition.

Feeling guilty about those faded New Year’s resolutions for a healthy 2015? Take heart. Spring is officially on the calendar

this month – a great time for sales reps and their customers to jumpstart healthy habits. The Academy of Nutrition and Dietetics

has designated March National Nutrition Month®, and offers a range of tips for healthy eating and maintaining sound nutrition.

HMMC Spring 2015 Executive ConferenceNashville Hilton Downtown

April 14-16, 2015

SAVE THE DATE

HMMC’s Conference in Nashville promises to be another exciting event where leaders from our manufacturing community come together to gain insight in industry, become better leaders and to network with peers. An exciting and talented group of speakers and panel discussions will address

timely and pertinent issues that every manufacturer of medical devices must deal with today.

www.hmmc.com


WINDSHIELD TIME

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

Automotive-related newsDeducting your milesThe Internal Revenue Service (IRS) has announced the 2015 national optional business mileage deduction rate of 57.5 cents for U.S. business drivers, effective January 1, 2015, reflecting a 1½ cent per mile increase. To establish the rate, the IRS worked closely with Runzheimer Inter-national, the company that has provided annual vehicle cost data to the IRS since 1980. U.S. taxpayers will be able to deduct the new rate for vehicle expenses on a 2015 tax return for recorded business miles.

Better safe…Rear View Safety, a manufacturer of camera systems and accessories, has introduced new road safety features for commercial vehicles. The G-Series Replacement Mirror Monitor with Bluetooth capability, for instance, provides drivers with hands-free control for mobile devices. The integrated Bluetooth function is designed to allow driv-ers to easily connect their smart device, as well as answer or make calls through the mirror. Drivers can also play music through the connec-tion, and it features voice recognition by pressing the monitor’s microphone but-ton. The company also of-fers a Two Channel Dash Camera, a rear-view camera system featuring dual cam-eras, with a four-inch touch screen that allows drivers to see both cameras. Each of the featured cameras on this product offer full features for HD record-ing, and can be viewed si-multaneously. This backup camera system also comes with integrated Wi-Fi, per-mitting mobile devices to be connected.

Eyes on the roadiBOLT has introduced the iPro2 Car Dock, an MFi-approved car dock with an integrated lightning connector designed to fit iPhone 5, 5s, 6, and 6 Plus. The iPro2 Car Dock provides users with a reportedly secure and versatile connectivity and charging solution when on the road. Upon inserting the iPhone in the iPro2 Car Dock, users can launch the iBOLT Dock’n Drive app to access favorite contacts as well as music and navigation apps. The iPro2 Car Dock features 360-degree viewing angles, as well as:

• Sliding adjustable latch• Accessibility to AUX-out port and all buttons on

the iPhone• Open camera view• Ball joint for easy turning and mounting options• Two-meter lightning cable for flexible placement

options, including the left side of the steering wheel.

Women have control of the wheel – literally ReportLinker, a market research group, reports that women are set to form a larger and more influential consumer segment than men, driving OEMs to launch specific models targeting women. In 2012, women comprised the majority of drivers, ac-cording to ReportLinker. As such, U.S. OEMs, such as Fiat, Re-nault, Jaguar and Porsche, have been aiming key vehicle models at women. At one point, smaller city cars started the trend, but today luxury and SUV models are following. The dominance of female customers will drive changes in the retail space and many stores are predicted to become more lifestyle oriented, hire more female staff, and emphasize consultative selling. New business models are believed to attract women by offering lon-ger warranty periods, pay-as-you-drive, and car-as-a-service. Dealers, car brokers, leasing companies, and insurers will win competitive advantage by marketing specifically to women, ac-cording to ReportLinker. According to the report, women will drive the following design trends in years to come:

• Interior spaciousness • High visibility• Environmental friendliness• Intuitive controls• Personalized options

Women are set to form a larger and

more influential consumer

segment than men, according

to research, driving car companies to launch

specific models targeting women.


Further, whereas past vehicles have been heavy and without assist functions, features such as park assist and sensorised doors are becoming standard.

New or used?Consumers appear to be increasingly interested in purchasing used cars, accord-ing to the NADA Used Car Guide. At the same time, fewer cars are being sold at wholesale auctions. As a result, vehicles sitting in used car lots have managed to retain more of their value over the past couple of months. Still, the new vehicle market has remained strong, particularly toward the end of 2014.

Kites, lasers and sunshine – oh my!Driving may become much more environmentally friendly, sooner than one might expect. Although there are no imminent changes for mainstream con-sumers, thousands of Unmanned Aerial Vehicles (UAVs) will be deployed in the next few years for both civil and military missions, with a focus on smart structural components and intelligent motors with integral gearing. Cars are expected to follow suit in years to come, note experts. Currently, UAVs are powered by electric motors said to provide maximum torque from stationary, with virtually no noise or gaseous emissions. There is also work on unmanned aircraft harvesting power from winds at altitude using kites and beaming it to earth. Other UAVs are held aloft by lasers, while another project will result in upper atmosphere UAVs that stay aloft for five years on sunshine.

Honda going greenLooking to buy a new car? How important is green when it comes to choosing a dealer? To help auto dealers adopt more environmentally responsible business practices, while also reducing costs, Honda recently released the Honda Green Dealer Guide. The 93-page energy efficiency roadmap is geared specifically to-ward dealerships and similar commercial buildings with high-energy loads. The company is encouraging auto dealers across all brands to download the Guide and reduce their environmental footprint. To date, the program has reportedly helped 45 Honda and Acura dealers collectively reduce their annual CO2 emissions by ap-proximately 5,000 tons – the equivalent annual footprint of the electricity needed to power more than 600 U.S. homes. In addition, dealers have cut their cumulative annual operating costs by more than $800,000. If all 17,000 automotive dealerships across the country were to reduce their electricity consumption by 10 percent, nearly 800,000 tons of CO2 emissions would be eliminated annually, says Honda.

Zero-emission fuel cellHyundai Motor introduced its zero-emission fuel cell, reportedly the first avail-able mass-produced fuel cell electric vehicle. The fuel cell is designed to re-place the battery pack used in an electric vehicle by generating electricity from hydrogen through an electrochemical process, which does not involve hydro-gen combustion, with no moving parts within the fuel cell stack. The Tucson fuel cell maintains the day-to-day flexibility of the gasoline-powered Tucson so that its driver is able to immediately enjoy the next generation of electric vehicles, without regard to range or recharge-time.

57.5The IRS has announced the 2015 national optional business mileage deduction rate of 57.5 cents for U.S. business drivers, effective Jan. 1, 2015, reflecting a 1½ cent per mile increase.


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

QUICK BYTES

Technology newsA new dimension for videoconferencingThe next generations of PCs are likely to come with three-dimensional cameras – or so the experts say. Chi-cago-based Personify has developed software (also called Personify), which Intel plans to include in Windows com-puters outfitted with the Intel RealSense 3D camera, ac-cording to the Chicago Tribune. The software employs data from 3D cameras to measure depth of field, separating the user from his or her environment, and then remov-ing the background. Users have the ability to share their screens one at a time, permitting them to collaborate. The result: Companies will be able to hold background-delet-ed videoconferences, rather than broadcasts from a single user, says the Tribune.

Coffee with a chargeStarbucks is known for giving its customers a charge – both caffeine and the hefty fee associated with its coffee. But, now the coffee chain offers one more kick: Power-mat wireless charging. Currently, wireless charging is of-fered in about 200 San Francisco Bay Starbucks stores, with a promise to extend this service throughout its U.S. locations within the year.

Stores in the San Francisco Bay area are now equipped with ‘Powermat Spots’ – designated areas on tables and counters where customers can place their compatible device and charge wirelessly. In addi-tion, Starbucks stores are offering Duracell Powermat “Rings” for purchase or loan that instantly upgrade any phone to wireless charging compatibility. The rings are being offered for in-store purchase at $9.99 and can al-ternately be borrowed and returned on a per-visit basis. Powermat Spots comply with the open standard set by Power Matters Alliance, whose members include AT&T, BlackBerry, HTC, Huawei, LG, Microsoft, Qualcomm, Samsung, TI and ZTE, ensuring that these compa-nies’ devices and accessories can charge seamlessly in Starbucks. Customers who are interested in locating a Powermat-enabled store can visit www.powermat.com to find their nearest location.

It begins with a kissKeyssa has introduced Kiss Connectivity, a connector designed to transmit huge amounts of data and video rapidly between devices in close proximity, and report-edly with virtually no battery drain. The coffee bean-sized connector uses extremely high frequency (EHF) signals to transmit information securely, using standard protocols. When built into tablets, laptops, smartphones or docks, it is said to save space and free product design-ers to create sleeker rugged devices. It also offers con-sumers a new way to securely share, sync, and store their content, without wireless networks that can be hacked.

Starbucks will extend its Powermat service throughout U.S. locations within the year


The connector is reportedly solid state, preventing RFI/EMI signal interference and eliminating metal contacts, which are prone to wear-and-tear from repeatedly con-necting cables or pins. It supports standard protocols, and requires no programming overhead or software drivers, according to the manufacturer. It also co-exists with all wireless power standards and will have configu-rations that integrate wired power. Users can operate at transfer rates of up to 6Gbits per second, meaning that when supporting protocols like USB 3.0, DisplayPort, SATA and PCIe, Kiss Connectivity can download a 1GB movie in as little as two seconds. In addition to permit-ting users to share content in seconds, Kiss Connectivity is said to enable mobile devices to:

• Dock seamlessly to other mobile devices, and add keyboard, monitors and storage, as well as sync data, songs and movies.

• Kiosk to download movies in seconds.• Display to stream 4K video.

Touch sensitiveSamsung has introduced a fingerprint sensor in its product. The Galaxy S5 home button presents a fingerprint sensor with PCB technology for capacitive sensing of ridge peaks and ridge valleys of a fingerprint on a swiped finger. The technology senses the speed of the finger as it is swiped across the image sensor and recognizes the fingerprint im-age. Located above the home button, the 17.5×5.5 mm sensor is incorporated within a rectangular shaped housing composed of an aluminum ring and a stainless steel base, and is protected by a white plastic cover.

Device happySurprise! United States consumers are becoming increasingly obsessed with their devices, according to a recent Deloitte survey on mobile consumer trends. The survey offers insight into consumer behaviors and trends in the United States, with a focus on mo-bile devices, existing servic-es, and emerging technolo-gies. Nearly 90 percent of people check their phone in the first hour after wak-ing up, and 23 percent look at their device up to 50 times a day, according to the survey. About 55 percent of those surveyed expressed interest in a connected-home solution. Survey results also indicate that in-store mobile payment technol-ogy (e.g., mPayments) is underutilized by U.S. consumers, which could change given recent market developments. Other key findings include:

• The average consumer uses more than a gigabyte of data per month, with the majority allocated towards video. Of those surveyed, 19 percent reported stream-ing television or film more frequently than in 2013.

• Interest in price grows. Consumers are becoming savvier about pricing, both in terms of mobile devices and service plans.

• Consumers intend to purchase new devices at the same rate of frequency over the next five years.

Nearly 90 percent of people check their phone in the first hour after waking up, and 23 percent look at their device up to 50 times a day, according to a survey.


corner

Down to the wireLast summer, heart surgery was imminent for Dana, a baby girl living in El Salvador. Gift of Life Los Angeles – a non-profit organization dedicated to saving the lives of chil-dren with congenital heart disease around the world – was intent on making that happen. But without a monitoring device and heart medication that was no longer available in El Salvador, the organization could not follow through. That’s when they reached out to Henry Schein Medical.

On Aug. 27, 2014, Melissa Deitz, a Minnesota-based special account service rep, received an email from Brenda Small, assistant to the executive director of Gift of Life. “Brenda first emailed Alan Feldman, a Henry Schein field rep, and received his out-of-office reply,” Deitz recalls. “Alan would not be returning until September 2nd.” As it turned out, Deitz was Feldman’s backup. “I was cover-ing his territory in his absence,” she explains. “Alan and I have been working together since he joined Henry Schein in 2004.” Small had called to inquire whether Henry Schein carried the monitoring device Gift of Life required, and if so, how much it cost, she notes. “We exchanged multiple emails that day to ensure we could help health happen for those in need.”

Rob Raylman, executive director of Gift of Life, was scheduled to fly from New York to El Salvador four days later, says Deitz, and he needed the monitoring device before he left the country. “Understanding the gravity of the situation and the impact we could make, Brenda asked that I order the product and have it delivered the following day,” she says. “With help from our reliable and trusted vendors, the product would be shipped Friday for Saturday delivery to ensure help was on the way when needed.

“Brenda also helped ensure that the proper medica-tion would be delivered on Saturday, August 30,” Deitz continues. “Because this medication was already stocked in our Indianapolis facility, I was able to work with my colleague, Wendy Klein, who could help process this order onsite. We knew this medication would require a physician license to be compliant, and with Rob and Bren-da’s help, we obtained the necessary documentation.”

Klein is a Nevada-based medical sales support team rep. “Our team assists medical field sales representatives in placing orders, tracking orders and troubleshooting situ-ations on accounts and orders,” she says. She, along with other customer care representatives, assist field sales rep-resentatives. “We are their back-up and assist them with

A Gift of Life

Quick thinking and immediate action on the part of Team Schein Medical are credited with saving the life of an infant in El Salvador.

By Laura Thill

Behind every good sales rep stands a team: a fine-tuned, well-coordi-nated group of support reps and service reps who step in whenever necessary to ensure that promises are met, and important products are shipped and received. It’s an important role – one that, on occasion, has been known to save a life.


behind-the-scenes work by calling vendors, looking into the status of orders, tracking down orders and [overseeing] various other responsi-bilities to ensure reps and their cus-tomers are taken care of and issues are resolved,” she says.

Klein was somewhat new to the job when she received the call from Deitz. “I have worked in medical sales support for approximately 18 months,” she says. “I was immediately drawn to the challenge of learning

medical products, working with Henry Schein reps and understand-ing the unique company culture and how Team Schein Members inter-act with customers. I enjoy assisting customers and working with fellow Team Schein Members.

“I am Melissa Deitz’ backup,” she continues. “This particular evening, Melissa was scheduled to be off. She notified me of this order and asked that I please keep an eye on it to make sure it cleared the necessary channels in order to ship.” As it turned out, Deitz stayed on top of the situation in spite of her day off. “Even though it was her day off, Melissa and I kept in contact on this order. I provided her with updates throughout the day

to ensure the order was progressing to the warehouse for shipment.” Be-cause the order was being shipped to a new location, it needed to go through the credit department. “It did so without any problems. Then we needed to contact verifications and provide them with a brief synop-sis of the situation to ensure all pro-cedures were followed.” As a result of this teamwork, both the monitor-ing device and the medication were delivered that Saturday by noon.

A sense of purposeGift of Life is the real hero in this story, according to Deitz and Klein. “What they do for children in El Salvador is truly amazing and in-spiring,” says Deitz. Having played a role in saving Baby Dana’s life has been a source of motivation for them. “No matter how frustrat-ing the situation might become, at the end of the day, all the work we do together as a team can result in a baby, a child or any person being saved by our company’s efforts to make every order ship and resolve any situation,” says Klein.

“I like to think that every day we have a positive impact on the medi-cal industry across the world, as well

“ I like to think that every day we have a positive impact on the medical industry across the world, as well as our neighbors next door. Our goal as a company is to help health happen, and we pride ourselves on making sure that gets done.”

– Melissa Deitz

as our neighbors next door,” says Deitz. “Our goal as a company is to help health happen, and we pride our-selves on making sure that gets done.

“Learning about Dana gives us a sense of purpose in our daily lives,” she continues. “I’ve been in this field for nearly 15 years, and this was the first time I’ve heard that my efforts helped save a life. It may be another 15 years before I hear another story of a life saved, but that’s okay. I will continue to go that extra mile, be-cause whether I hear about it or not, I’m in this industry to do my part sav-ing lives. Together with Team Schein, we hopefully can continue to make that happen.”

Wendy Klein

Melissa Deitz


CLASSIFIEDS

NEWS

Repertoire/HIDA currently accepting nominations for 2014/2015 Excellence in Sales AwardRepertoire Magazine and Health Industry Distributors Asso-ciation’s (HIDA) (Alexandria, VA) 2014/2015 Excellence in Sales Awards will be given to a top-performing distributor sales representative and manufacturer sales representative.

Alfa Wassermann President’s Club WinnersPresident’s Club Awards dinner. Pictured from left to right is Corinne Robbins (Business Development Manager for the Northeast region), Mark Gnagy (VP of Sales), Jennifer Kennedy (Business Development Manager for the West region), Peter Napoli (COO & President, AWDT), and David Christy (Business Development Manager for the Southeast region).

Our industry’s most prestigious sales awards will be present-ed during the Medical Distribution Hall of Fame Dinner in Atlanta, Georgia on June 4, 2015. The deadline for nomina-tions is April 1, 2015, so submit your nomination today at www.repertoiremag.com/sales-award-nomination.

Pfizer to acquire HospiraPfizer Inc (New York, NY) and Hospira Inc (Lake Forest, IL) entered into a definitive merger agreement under which Pfizer will acquire Hospira for $90 a share in cash for a total enterprise value of approximately $17 billion. The boards of directors of both companies have unanimously approved the merger. The combination will add a growing revenue stream and a platform for growth for Pfizer’s GEP business. The transaction is subject to customary clos-ing conditions, including regulatory approvals in several jurisdictions and approval of Hospira’s shareholders, and is expected to close in the second half of 2015.

VHA, UHC sign merger agreementVHA Inc (Irving, TX) and UHC (Chicago, IL) signed an agreement to combine into a single organization that will be the largest member-owned healthcare company in the country. Financial terms of the deal, which is expected close by the end of March 2015, were not disclosed. Curt Nono-maque, president and CEO of VHA, will serve as president and CEO of the new company. Irene Thompson, president and CEO of UHC, will accept a leadership position focused on academic medical center networks during the transition. Marna Borgstrom, president and CEO of Yale New Haven Health System (New Haven, CT), will be the board chair, and Ann Madden Rice, CEO of UC Davis Medical Center (Sacramento, CA), will be vice-chair of the board. The new combined company, which will be headquartered in Irving, Texas with an office in Chicago, will serve more than 5,200 health system members and affiliates, provide services to nearly 30 percent of the nation’s hospitals, and boast more than $50 billion in purchasing volume. A new company name will be announced at a later date

TERRITORY MANAGERNDC, Inc., a healthcare supply chain company, is seeking a Territory Manager to serve as an account manager to distributors – to encourage full engagement of services offered through membership. This candidate will also work closely with manufacturing partners to increase mindshare and find opportunities for members to grow sales volumes within target accounts. • Inspire trust and build credibility within membership and

manufacturer partners• Possess a commitment to service with exceptional time

management skills• Self-motivated, reliable and able to solve problems independently• Minimum of four years healthcare sales/distribution experience,

including knowledge of contracts, pricing and GPOs• 50% travel expected; Nashville-based preferred

If you are ready to make a difference at NDC, please submit a cover letter with salary requirements to [email protected].

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and our commitment to it. The development of the ophthalmoscope paved the way for future innovation, in and outside of Welch Allyn. In June 2014, Welch Allyn acquired PediaVision and its revolutionary Spot™ Vision Screener.

Spot Vision Screener

A handheld, portable device designed to help caregivers automate vision screening on both eyes in seconds, with objective, accurate results for referral.

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1915Dr. Francis Welch and William Noah Allyn (pictured) develop the world’s first hand-held, direct-illuminating ophthalmoscope. They understood that physicians could diagnose a number of conditions with ophthalmoscopy, but needed a simple, portable and reliable device to do so.

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