Maria Shepherd, Co-Founder, MedExecWomen; President/Founder, Medi-Vantage06.02.21
2020 was a challenging year for most medical device companies and for the industry’s core customer base—hospitals. We all remember the videos from the U.K., Italy, and most recently, India, of patients being cared for in intensive care units and even in hallways of healthcare facilities. Healthcare workers across the globe have put in an agonizing number of hours to provide the best possible patient care and we salute them.
With this difficult year as a backdrop, the organization MedExecWomen felt it was important to take the temperature of the field. With this in mind, for its Spring Forum, the group brought together healthcare, hospital, and clinic customers to see how they're doing, how their strategies have changed, and what they are doing differently for the remainder of 2021 and into 2022. Effective strategy and planning for device companies needs to be based upon the needs of these customers.
Biggest Issues Facing Device Companies
At the start of the March 30 panel, the attendees were surveyed on what they thought were the biggest issues facing the medical device industry today. The clear leader when it came to challenges was volatility in elective procedures (62 percent of respondents).
The expanding decision-maker base was cited by 38 percent of respondents, followed by 36 percent who cited clinical trial backlogs and 36 percent who cited reduced access of sales representatives to clinicians. These were followed by clinician burnout, reduced capital expenditure budgets, health equity, and FDA backlogs, in order of number of respondents who selected each option.
The Spring Forum main panel brought together two regional healthcare leaders to the group of medical device executives for a frank discussion of the challenges and strategic initiatives in their organizations. We asked Alan Levine, MHS, MBA, chairman, president, and CEO at Ballad Health; and Amy Bush, BSN, MBA, RN, CNOR, vice president/chief operating officer at WVU Medicine Children's to share what they view as the most important foci for their organizations for the upcoming year or two.
Changes in Strategy
“There are three things we’re looking at right now that have near-term consequence and long-term advantage,” said Levine, whose system—Ballad Health—serves Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. “We’re paying close attention to the nursing shortage—we think that’s going to be a real limiting factor in the health system if we can’t get nurses or scrub techs. Second, we’re really focused on total cost of care, deeply invested in risk-based models. There are many primary care groups that pay a lot of attention to total cost of care.”
“And the third is healthcare at home—the technology movement towards home-based models. We have a home health agency that serves the whole region. During COVID, we had over 1,000 patients who were able to avoid hospital admissions by keeping them in their homes, monitoring them at home, and having virtual visits with our physicians. And that’s not going to go away,” he added. “What are the technologies that support healthcare at home because payers are increasingly interested?”
Bush said they’re looking at financial alignment between providers and payers. “We’ve all been working toward that. How do we help payers save money? But if we don’t have patients in the hospital, we traditionally lose money,” she said. “We really saw [the COVID] census drop. If I’m a payer that’s really good for me, but how can we better align that model with payers and providers?”
Second, she said, “We’re looking at our interoperability with public health, in particular with local health departments and community wellness—having people move forward from an information technology standpoint at the same pace.”
The third, she explained, is related to workforce shortage and AI/machine learning. “We’re spending a lot of time getting the right people in the right role and decreasing the administrative burden of healthcare so that we can move workers toward the core business functions of patient care,” said Bush. “There are shortages [of certain workers]. We have a much smaller market to pull from—in a much more rural state.”
“In the old days, it used to be, [medical device companies] go to the surgeons, develop relationships, [and we formed] a triad. We had the doctors and the [medical device] companies against the hospital.”
Levine expects this to change. When it comes to cost of care initiatives, Levine said, “Hospitals, if they want to survive, have to find a way to reduce their cost structure—devices that help workflow, improve efficiency, reduce the time in the OR are very attractive to us.” He also talked about changes in the laws and the rules relating to hospitals partnering with doctors. “Everything that will reduce cost structures is very attractive to us. We just entered into two co-management agreements with our orthopedic and general surgeons. More than half the incentive that I’m paying them is tied to reducing supply costs. The dynamic is shifting, and we can now incentivize doctors to help us reduce supply costs and the total cost of care.
“So, we're starting to see a lot of interest from doctors in helping us with that because it will change [the paradigm] so much. When I first started my career, we didn't have a prayer of collaborating with doctors to reduce medical supply costs because they had so many relationships with our vendors. Well, that is changing. And hospitals are being empowered to help doctors share in the gains from reducing the total cost of care,” concluded Levine.
Bush talked about the many technology initiatives they innovated to deal with COVID-19, including a virtual waiting room. She talked about their analytics team with machine learning engineers and data scientists and how they’re looking at home monitoring to prevent readmissions. On other technology and devices, she cautioned, “You get something new and if it doesn’t interface with [equipment] we already have, it just ends up creating more cost to our system and to the cost of care delivery. If we can just shift the mindset to interoperability and strategic thinking, we can make it less transactional.”
Bush continued, “During COVID, we created applications and device trackers where if you are a caregiver going into a patient room, we knew that you went into that room. We could run those reports, so when we were working on how many caregivers are involved, [we knew]. And earlier on, sometimes we didn't realize we had an exposure until after the fact as we continued to finesse things. We also created what I call a virtual waiting room app that we used, and we'll continue to use, so people know where folks are. It's like tracking. We also created apps to do employee assessment, so as they come back into the hospital as an employee and we want that self-screening, other than having folks [lining up] at the door at the employee entrances, we have an app where they can log on and do their assessment.”
Bush also talked about the need to serve rural locations. “Maybe you need preventive care so that you don’t get sick. We have a lot of states that could benefit from that. Socioeconomic disparities just don’t allow many people to come to the hospital. That shift to wellness and prevention would be really helpful.”
One of the audience members asked, “We heard a little about the use of artificial intelligence, but what do you think are the top areas where artificial intelligence or machine learning can help in your hospitals—for example, maybe in operations versus in clinical applications?” Bush responded, “Areas where humans can never be as efficient—lower cost of care, lower administrative burden such as claims, inventory etc. We could redirect dollars to patient care providers.”
Another asked, “What do you think the timing for a ‘return to normal’ will be for surgical procedure volumes? What are key factors for your system that will impact this timing? Could it be patient reluctance, staff shortages, room turns, etc.?” Bush’s response was reassuring. “We have been full steam ahead since February 1. We have done a great deal of education for the public; short-term bonus programs for staff.”
Levine spoke of social determinants and an initiative at Ballad called Strong Starts. He said, “So, we identified in our region, before COVID, we had an unemployment rate of about 3.5 percent. But the workforce participation rate was low, meaning there were a lot of people here who are not in the workforce actively that should have been, and they were suffering from things like addiction, mental health issues. So, what's the role of our health system in trying to solve this problem? We know that third-graders reading at grade level means they are four times more likely to graduate. Kids that are five years old, that are kindergarten ready, are more likely to be third grade reading proficient.”
“Today, we rolled out our Strong Starts initiative where we're doing assessments of every pregnant woman in the region who gets care from us, which is pretty much all of them, and identifying risk factors. So, artificial intelligence and technology, being able to predict where you're going to see problems with physical or mental abuse, addiction, illiteracy—we're trying to intervene. And we formed an accountable care community with about 250 organizations so we can identify those women who are at risk and get them plugged in to help before that baby is born,” explained Levine.
“This is where health systems that want to be health improvement organizations are leaning into this. And we are proud of this initiative because we think this is going to take five years before we know if we've improved kindergarten readiness, eight years before we know if we've improved third grade reading. And if we know if we do those two things, it’s much more likely, in 18 years, [we will have] a better prepared workforce,” stated Levine.
He continued, “So, out in the marketplace, insurance companies are moving to risk-based models to reduce the total cost of care, which means acute admissions are going to decline. And we've seen these admission rates have gone from 120, 130 admissions per 1,000 down to 90 to 100, and hospitals have to find a way to survive, to reduce their cost structure and reduce the total cost of care. So, whether it's medical devices that help us with workflow, improved efficiency inside the walls of the hospital, or even upstream, to implantables that are easily accessible to reduce the time in OR, to post-acute care, anything that can demonstrate to us with real actionable metrics, that [it will] reduce the cost structure within the hospital is very attractive to us.”
Building on Healthcare Leaders’ Strategies
Post panel, the audience split into teams of 10 to discuss the panelists’ comments, and how, as device leaders, they could develop strategies that would address what the panelists discussed. Each team was led by a MedExecWomen board member, and the teams included representatives from some of the most innovative and largest medical device companies in the industry.
The big opportunities and takeaways the executives in the audience developed were:
Conclusion
“Great meeting!” said Angie Conley, CEO of Abilitech. “There was plenty to discuss that allowed for natural and meaty discussions.”
“The feedback from the group was fantastic,” said Karen Zaderej, president, CEO, and chairman of the board of Axogen. “They were so energized by the information that [Alan and Amy] shared.”
MedExecWomen is holding a second face-to-face all-day strategy meeting in Boston on Oct. 26, 2021, if COVID-19’s claws are sheathed and state and national guidelines permit the group to meet. In any event, MedExecWomen plans to pivot to a hybrid event if necessary and/or for those attendees who cannot travel to the Boston area, but want to participate. The board is working on an agenda that will be released shortly. There are many unmet needs, but three that immediately come to mind: 1) to create risk sharing with hospitals; 2) to increase the incentive to use our products, and 3) to address the expectations of younger people, such as Millennials, who are new to the healthcare workforce and have different workflow needs.
Maria Shepherd co-founded MedExecWomen in 2019. The organization empowers female executives to accelerate the positive impact of medical devices, diagnostics, drug delivery, and digital healthcare, and looks to increase gender parity in leadership positions. She has more than 20 years of experience in medical device marketing in small startups and top-tier companies. After holding senior roles at Oridion Medical, Philips Medical, and Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing, business strategy, and innovation research for the medical device, diagnostic, and digital health industries. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd can be reached at 617-548-9892.
With this difficult year as a backdrop, the organization MedExecWomen felt it was important to take the temperature of the field. With this in mind, for its Spring Forum, the group brought together healthcare, hospital, and clinic customers to see how they're doing, how their strategies have changed, and what they are doing differently for the remainder of 2021 and into 2022. Effective strategy and planning for device companies needs to be based upon the needs of these customers.
Biggest Issues Facing Device Companies
A poll of the medical device leaders during the Forum* posed the following question: “What are the biggest issues facing medical device/medtech organizations today?” Results were:
|
The expanding decision-maker base was cited by 38 percent of respondents, followed by 36 percent who cited clinical trial backlogs and 36 percent who cited reduced access of sales representatives to clinicians. These were followed by clinician burnout, reduced capital expenditure budgets, health equity, and FDA backlogs, in order of number of respondents who selected each option.
The Spring Forum main panel brought together two regional healthcare leaders to the group of medical device executives for a frank discussion of the challenges and strategic initiatives in their organizations. We asked Alan Levine, MHS, MBA, chairman, president, and CEO at Ballad Health; and Amy Bush, BSN, MBA, RN, CNOR, vice president/chief operating officer at WVU Medicine Children's to share what they view as the most important foci for their organizations for the upcoming year or two.
Changes in Strategy
“There are three things we’re looking at right now that have near-term consequence and long-term advantage,” said Levine, whose system—Ballad Health—serves Northeast Tennessee, Southwest Virginia, Northwest North Carolina, and Southeast Kentucky. “We’re paying close attention to the nursing shortage—we think that’s going to be a real limiting factor in the health system if we can’t get nurses or scrub techs. Second, we’re really focused on total cost of care, deeply invested in risk-based models. There are many primary care groups that pay a lot of attention to total cost of care.”
“And the third is healthcare at home—the technology movement towards home-based models. We have a home health agency that serves the whole region. During COVID, we had over 1,000 patients who were able to avoid hospital admissions by keeping them in their homes, monitoring them at home, and having virtual visits with our physicians. And that’s not going to go away,” he added. “What are the technologies that support healthcare at home because payers are increasingly interested?”
Bush said they’re looking at financial alignment between providers and payers. “We’ve all been working toward that. How do we help payers save money? But if we don’t have patients in the hospital, we traditionally lose money,” she said. “We really saw [the COVID] census drop. If I’m a payer that’s really good for me, but how can we better align that model with payers and providers?”
Second, she said, “We’re looking at our interoperability with public health, in particular with local health departments and community wellness—having people move forward from an information technology standpoint at the same pace.”
The third, she explained, is related to workforce shortage and AI/machine learning. “We’re spending a lot of time getting the right people in the right role and decreasing the administrative burden of healthcare so that we can move workers toward the core business functions of patient care,” said Bush. “There are shortages [of certain workers]. We have a much smaller market to pull from—in a much more rural state.”
“In the old days, it used to be, [medical device companies] go to the surgeons, develop relationships, [and we formed] a triad. We had the doctors and the [medical device] companies against the hospital.”
Levine expects this to change. When it comes to cost of care initiatives, Levine said, “Hospitals, if they want to survive, have to find a way to reduce their cost structure—devices that help workflow, improve efficiency, reduce the time in the OR are very attractive to us.” He also talked about changes in the laws and the rules relating to hospitals partnering with doctors. “Everything that will reduce cost structures is very attractive to us. We just entered into two co-management agreements with our orthopedic and general surgeons. More than half the incentive that I’m paying them is tied to reducing supply costs. The dynamic is shifting, and we can now incentivize doctors to help us reduce supply costs and the total cost of care.
“So, we're starting to see a lot of interest from doctors in helping us with that because it will change [the paradigm] so much. When I first started my career, we didn't have a prayer of collaborating with doctors to reduce medical supply costs because they had so many relationships with our vendors. Well, that is changing. And hospitals are being empowered to help doctors share in the gains from reducing the total cost of care,” concluded Levine.
Bush talked about the many technology initiatives they innovated to deal with COVID-19, including a virtual waiting room. She talked about their analytics team with machine learning engineers and data scientists and how they’re looking at home monitoring to prevent readmissions. On other technology and devices, she cautioned, “You get something new and if it doesn’t interface with [equipment] we already have, it just ends up creating more cost to our system and to the cost of care delivery. If we can just shift the mindset to interoperability and strategic thinking, we can make it less transactional.”
Bush continued, “During COVID, we created applications and device trackers where if you are a caregiver going into a patient room, we knew that you went into that room. We could run those reports, so when we were working on how many caregivers are involved, [we knew]. And earlier on, sometimes we didn't realize we had an exposure until after the fact as we continued to finesse things. We also created what I call a virtual waiting room app that we used, and we'll continue to use, so people know where folks are. It's like tracking. We also created apps to do employee assessment, so as they come back into the hospital as an employee and we want that self-screening, other than having folks [lining up] at the door at the employee entrances, we have an app where they can log on and do their assessment.”
Bush also talked about the need to serve rural locations. “Maybe you need preventive care so that you don’t get sick. We have a lot of states that could benefit from that. Socioeconomic disparities just don’t allow many people to come to the hospital. That shift to wellness and prevention would be really helpful.”
One of the audience members asked, “We heard a little about the use of artificial intelligence, but what do you think are the top areas where artificial intelligence or machine learning can help in your hospitals—for example, maybe in operations versus in clinical applications?” Bush responded, “Areas where humans can never be as efficient—lower cost of care, lower administrative burden such as claims, inventory etc. We could redirect dollars to patient care providers.”
Another asked, “What do you think the timing for a ‘return to normal’ will be for surgical procedure volumes? What are key factors for your system that will impact this timing? Could it be patient reluctance, staff shortages, room turns, etc.?” Bush’s response was reassuring. “We have been full steam ahead since February 1. We have done a great deal of education for the public; short-term bonus programs for staff.”
Levine spoke of social determinants and an initiative at Ballad called Strong Starts. He said, “So, we identified in our region, before COVID, we had an unemployment rate of about 3.5 percent. But the workforce participation rate was low, meaning there were a lot of people here who are not in the workforce actively that should have been, and they were suffering from things like addiction, mental health issues. So, what's the role of our health system in trying to solve this problem? We know that third-graders reading at grade level means they are four times more likely to graduate. Kids that are five years old, that are kindergarten ready, are more likely to be third grade reading proficient.”
“Today, we rolled out our Strong Starts initiative where we're doing assessments of every pregnant woman in the region who gets care from us, which is pretty much all of them, and identifying risk factors. So, artificial intelligence and technology, being able to predict where you're going to see problems with physical or mental abuse, addiction, illiteracy—we're trying to intervene. And we formed an accountable care community with about 250 organizations so we can identify those women who are at risk and get them plugged in to help before that baby is born,” explained Levine.
“This is where health systems that want to be health improvement organizations are leaning into this. And we are proud of this initiative because we think this is going to take five years before we know if we've improved kindergarten readiness, eight years before we know if we've improved third grade reading. And if we know if we do those two things, it’s much more likely, in 18 years, [we will have] a better prepared workforce,” stated Levine.
He continued, “So, out in the marketplace, insurance companies are moving to risk-based models to reduce the total cost of care, which means acute admissions are going to decline. And we've seen these admission rates have gone from 120, 130 admissions per 1,000 down to 90 to 100, and hospitals have to find a way to survive, to reduce their cost structure and reduce the total cost of care. So, whether it's medical devices that help us with workflow, improved efficiency inside the walls of the hospital, or even upstream, to implantables that are easily accessible to reduce the time in OR, to post-acute care, anything that can demonstrate to us with real actionable metrics, that [it will] reduce the cost structure within the hospital is very attractive to us.”
Building on Healthcare Leaders’ Strategies
Post panel, the audience split into teams of 10 to discuss the panelists’ comments, and how, as device leaders, they could develop strategies that would address what the panelists discussed. Each team was led by a MedExecWomen board member, and the teams included representatives from some of the most innovative and largest medical device companies in the industry.
The big opportunities and takeaways the executives in the audience developed were:
- The need to shift healthcare organizations’ transactional relationships to strategic partnerships.
- For example, risk sharing such as the Stryker Surgicount Promise
- The site of care shifting to home healthcare accelerates as a trend
- Continued investment in AI/ML for preventive care or to improve productivity
- Amy Bush’s AI/ML app decreases administrative burden for healthcare workers, improves productivity and addresses workforce shortages
- Growing need for better mental health care for frontline workers
- Need for evidence—data from clinical and other studies to support adoption of their products into healthcare
- Identifying the total cost of care elevates economic buyer decision-making to that of the clinical buyer
- Need to map the patient journey through the continuum of care
- Workflow expectations have changed for healthcare worker Millennials; must be addressed in devices
- Human factors/ease-of-use studies can reduce costs (e.g., training, etc.) to address staffing shortages
- The need for medtech to reduce cost burdens for healthcare organizations—the example shared was using a mobile bus as a training facility
- Can medtech’s many process innovations and innovation strategies be shared with healthcare organizations?
Conclusion
“Great meeting!” said Angie Conley, CEO of Abilitech. “There was plenty to discuss that allowed for natural and meaty discussions.”
“The feedback from the group was fantastic,” said Karen Zaderej, president, CEO, and chairman of the board of Axogen. “They were so energized by the information that [Alan and Amy] shared.”
MedExecWomen is holding a second face-to-face all-day strategy meeting in Boston on Oct. 26, 2021, if COVID-19’s claws are sheathed and state and national guidelines permit the group to meet. In any event, MedExecWomen plans to pivot to a hybrid event if necessary and/or for those attendees who cannot travel to the Boston area, but want to participate. The board is working on an agenda that will be released shortly. There are many unmet needs, but three that immediately come to mind: 1) to create risk sharing with hospitals; 2) to increase the incentive to use our products, and 3) to address the expectations of younger people, such as Millennials, who are new to the healthcare workforce and have different workflow needs.
MedExecWomen (medexecwomen.org) empowers women executives to accelerate the positive impact of medical devices, diagnostics, drug delivery, and digital healthcare. The organization seeks to strengthen the field’s gender diversity through a connected, effective, and visible women’s leadership pool and supports female execs. MedExecWomen meetings connect industry leaders and cover topics that help them navigate ambiguity and complexity to support their leadership roles in rapidly changing markets. Interested executive level women can reach out to the organization via membership@MedExecWomen.org to request to join. |
Maria Shepherd co-founded MedExecWomen in 2019. The organization empowers female executives to accelerate the positive impact of medical devices, diagnostics, drug delivery, and digital healthcare, and looks to increase gender parity in leadership positions. She has more than 20 years of experience in medical device marketing in small startups and top-tier companies. After holding senior roles at Oridion Medical, Philips Medical, and Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing, business strategy, and innovation research for the medical device, diagnostic, and digital health industries. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd can be reached at 617-548-9892.