Veteran Health Administration: Shortcomings in implant sourcing, tracking and vendor support


The Veterans Health Administration (VHA), part of the Veteran Affairs (VA), is one of the largest purchasers of medical devices. With 152 hospitals across the country, the VHA spent $562M on implants alone in 2012, a 28% increase from 2008.

However, the VHA recently came under fire from the Government Accountability Office (GAO) for how they purchase, track and use medical devices.

According to the GAO report, the VHA is being investigated on three fronts:

1) Failed to seek most competitive market prices for implants

The VHA is paying a higher than normal price for medical devices. Surgeons at VHA usually determine needs for surgical implants, request the implant of their choice for purchase, and perform the clinical procedures to implant the items. While VA has negotiated compet …

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Medical Device Customer Service Excellence: Beyond Remote Field Support

As we’ve described previously, the role of a medical device rep is complex. Hospitals are increasingly looking for ways to restrict their access to provide a better environment of safety.

So, both medical device companies and hospitals are looking at different solutions to address this problem. Consumer products are not secure as companies can face HIPAA violations; and ‘one-size-fits-all’ remote field solutions are only a small portion of …

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Implications of Orthopedic Consolidation on the Customer Support Model


The estimated $45B musculoskeletal market is going through a period of consolidation that will dramatically impact the orthopedic customer support model. Consolidation is primarily being driven by changes being taken to the healthcare system in response to the Affordable Care Act.

Recently, Zimmer acquired Biomet for $13.35B which brings them to an estimated 40% market share in the Ortho recon market. They mention that they plan to keep everyone, but it is likely that deep cuts will occur as the acquisition realiz …

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Considerations when selecting a remote service solution

The medical device industry is beginning to rethink their service model and are looking at remote service solutions to help them better support their customers in the operating room. A number of players are beginning to emerge. We have identified ten categories of key questions to consider when evaluating remote service solutions.

1. Security

  • What level of encryption do they provide?

  • Do they have documentation supporting HIPAA compliance?

2. Accessibility

  • Can they access restrictive hospital networks?

  • Do they provide network diagnostic tools?

3. Mob …

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Opportunities and Limitations of Wearable Technology in the Operating Room

Guest commentary from renowned surgeons Dr. Pierre Theodore (UCSF) and Dr. Edward Bender (St. Francis Medical Center).

"Using wearables such as Google Glass at the point of care provides a tantalizing view of what future holds. Work still needs to be done in the short-term in order for the technology to be ready for primetime. Enhancements to speech recognition capabilities and more robust image processing will allow for wearable technology like Google Glass to be viable platform that will ultimately improve patient care." - Dr. Pierre Theodore, UCSF Medical Center

Wearable technology presents an opportunity to drive value for surgical procedures by allowing the operating room staff to leverage real time aud …

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Aligning medical device suppliers and hospitals in a value-based healthcare environment

The current medical device support model may not be sustainable in a value-based healthcare environment. As the U.S. healthcare system shifts from a volume-based (fee-for-service) to a value-based payment model (pay-for-performance reimbursement, i.e., bundled payments), medical device suppliers will need to find ways to increase efficiency, drive value, reduce cost while becoming an integral component of coordinated care. In this post, we discuss the health care reform factors that are impacting medical device companies, the challenges and recommendations for medical device companies.

Bundled Payments are defined as the reimbursement to health care providers on the basis of expected costs for clinically-defined episodes of care. Bundle …

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Making service model excellence a part of your medical device commercial strategy

As we’ve written in the past, the medical device industry spends 300-500% more on SG&A as a percentage of COGS than any other industry.

Consequently, these high cost commercial models are becoming ineffective as medical device purchasing decisions shift from individual physicians to value analysis committees armed with transparent information on product prices and outcomes. We’ve seen physician preference decline 10% in past year and it is expected to dip to 20% more in the next two years.

To address these issues, medical device companies should start to look for ways to reduce their SG&A in addition to providing value-added services beyond the medical device. Service model excellence is one area where medical device companies have not been innovative and have chosen models similar to those of their c …

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A Closer Look at Medical Device Support Models


As the healthcare environment continues to evolve at a rapid pace, the medical device industry will also have to adapt by offering a support model that meets the needs of its customers. Over the past year we’ve been tracking different models employed by major medical device companies and the service model innovations that have been taking place.

Although there are many different variations of each model, we’ve outlined four different models.

  • Rep Support - In-person rep support
  • Surgical Assist - Trained hospital staff
  • Remote Support - Remote rep support
  • Repless - No rep support

Choosing a specific model will depend on the …

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6 Challenges with Medical Device Reps in the Operating Room


It is no wonder 75% of hospitals are taking steps to restrict medical device rep access in hospitals. Here are six reasons why hospital operating room managers are looking for ways to restrict medical device rep access from the operating room.

1.    Purchasing Influence

It is no secret that medical device reps provide updates on new product lines during a procedure while in the OR. This can lead to physicians requesting higher cost devices. However, as hospitals move towards a capitated model, they are looking more and more for cost:benefit when purchasing medical devices – not just physician preference. 

“They are really good at having surgeons request products that are more expensive than we’d like to bu …

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A Day in the Life of an Orthopedic Rep—A Real-Life Account


This is the first in our series of “A day in the Life of…” In this months post, we asked an experienced DePuy Orthopedics medtech representative to diarize a their day, describing the activities performed in his own words and giving his own perspective on how the day unfolded. At the end of the post you can see an analysis of how his time was spent. The results may surprise you.

[Note: The identity of the representative has been kept anonymous.]

A Day in The Life…

6:15 am: Drive to Hospital to support total hip case (45 mins)

This hospital is one of my most loyal customers and does one of the largest [product] volumes in my territory. Typically, I use this travel time to catch up on news and make phone calls …

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Medtech facing strong headwinds—a need for a new support model


The last 5 years haven’t been the easiest for the medical technology (medtech) industry. A time period characterized by flat revenue growth and an unsustainably high cost structure is paving the way for a change in how they sell to and support their customers.

The current medtech support model

The medical device industry’s sales approach has remained virtually unchanged since almost the beginning of time. It is based around the notion that relationships are the cornerstone of effective selling, and that good relationships are built through regular in-person customer visits. This is sound logic, but what if the healthcare environment had changed when nobody was looking and relationships no longer got you as far as they once did? This is the situation that we are seeing today and it is forcing medtech companies to address the …

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Hospitals taking steps to reduce medical device rep access


Hospitals first restricted the access of pharmaceutical and biotech sales representatives. Now, hospitals are beginning to restrict access of medical device representatives into the operating room. Here are six steps that have been taken to limit medical device rep access in hospitals.

1) Appointment required to gain access

75% of US hospitals require an appointment for a medical device rep to enter the hospital. Physicians now have to plan ahead to ensure their local medical device rep is available, and then ensure the rep has the appropriate hospital approval for access to the operating room.

2) Limited to interactions with purchasing department

53% of US hospitals only allow medical device reps to interact with the purchasing de …

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Five opportunities to improve the medical device sales and support model


1) Physicians have challenges identifying new devices and device protocols in real-time.

"I don’t even know what new devices are available."

  • Potential Result: Suboptimal device may be used and/or improper use of appropriate device.
  • Potential Impact: Compromised patient care.
  • Suggestion: Consider providing device-specific information all in a single, easy to access location for physicians.

2) Scheduling cases can be challenging as cases may occur earlier/later than planned. Trauma cases are rarely ever planned.

"The entire OR staff …

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Four reasons why not to use Skype (or FaceTime)


A lot of people ask us “Why not just Skype”? There are countless reasons why, but we felt it would be valuable to sum up four of the main reasons.

  1. Poor Security:
    • Not HIPAA-compliant: Skype doesn’t meet federal requirements for protecting sensitive healthcare data.
    • Risk of losing or abusing patient data: Skype is a hacker’s delight.
    • Unsafe: More spyware infect computers through Skype than any other way with the exception of music file-sharing.
    • Risk of impersonation: No guarantee on Skype that the person you’re speaking to is who they say they are.
  2. Not a Closed Community: Skype is a consumer-based pr …

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Nurep Joins Blueprint Health winter 2013 class


Today, we are excited to announce that we have joined the Blueprint Health winter 2013 class. It is an honor to become part of the Blueprint Health family, which has the largest network of mentors with healthcare experience of any accelerator. Blueprint Health is also a charter member of the Global Accelerator Network, which was started by TechStars. You can see the official press release in TechCrunch.

Here are a few (of many) reasons why we are excited about Blueprint Health:

  • Mentors: With over 160 mentors with targeted expertise in different fields including: insurance, hospitals, med …

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Mobile medical apps & FDA regulation


Over the last six years, there has been significant growth in the health technology sector (e.g. mobile medical apps), driven by advances in technology and an increase in venture capital (VC) funding. VCs have been lured into the space due to the perception of high returns on investment within shorter timeframes versus their traditional life science funds. The significant growth in this market has driven the need for increased scrutiny from the FDA in how these products should be regulated.

The FDA has the authority to regulate software if it falls within the broad definition of a “device”. It has further segmented medical devices into three classes; …

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Medical device sales reps - What does the future hold?


Role of a Medical Devices Sales Representative

With the complexity and rapidly changing protocols of medical devices, the individuals who sell devices such as pacemakers, hip replacements, spine screws have become critical to supporting surgeons in the operating room (OR). Medical device sales reps work with surgeons
and their care teams, providing recommendations on how to use their devices and guidance in the OR.

For example, an orthopedic device sales rep will join the surgeon in the OR, study x-rays alongside the surgeon and assist the s …

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Mobile technology and advances in medicine


Dr. Edward Bender (advisor and investor in Nurep) was recently interviewed on how technology plays a critical role in advancing medicine. As a dual threat, Dr. Bender is both a thought leader in cardiac surgery and medical app development, creating more than 20 iOS apps for cardiac surgery.

What is interesting about his interview is the topic of digital health technology in terms of cost and efficiency. Technology in healthcare can have tremendous benefits, so long as the benefits outweigh the costs. Expensive technology that has significant infrastructure and costs associated with it can be more burdensome than it is beneficial.

More specifically, hospitals are facing cost pressures from the American Medical Association as a result of healthcare refor …

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