What challenges is your company facing at the moment?

ES: Economic uncertainty, fewer physicians, more administrative demands, less money spent on patient care, cost-effectiveness and a diminishing access to the physician…for starters. The doctors’ time is spent less on patient-focused communication, more on insurance and medical payers. So there’s less time available for traditional detailing.

SB: Because of the economic downturn, elective breast augmentation has declined in recent years. But the breast cancer reconstruction part of our business continues to grow.

EH: Traditionally, the decision-maker for selecting our products has been the surgeon. But now it’s more complicated. Hospital administrators like the CFOs are involved, as are the IDNs and others. Price has become more important. Also we need to be seen as a single-source solution in order to get the door open.

RM: The biggest change is that providers are focused on reducing operating costs about 20% due to Medicare Plus. You can’t do that just by focusing on the supply chain. We could give them everything free, and it wouldn’t help. This is an enormous challenge to hospitals. The biggest savings are going to be a result of focus on patient outcomes. But it’s hard to get past the supply chain to the decision makers in the C-suite. Those are the people focused on strategic goals.

ES: Reimbursement is a major issue. We do that through communication with nurses and billing staff, providing accurate language for reimbursement, establishing a reimbursement hotline. Most companies don’t have that service, and it’s vital. We also conduct webinars. It takes a lot of attention to detail to help customers understand how to maximize their profitability and avoid errors.

RM: It’s about our customers’ challenges as much as it is about our own. They’re spending $11 billion on treatment of pressure ulcers, a cost that’s not reimbursable, and could be eliminated. What many people don’t know is that 50% of nurses get injured every year! This is one of the reasons 20% of nurses are leaving the industry annually. If ArjoHuntleigh saves a hospital $4 million by reducing those injuries, colocwe prove our value to customers.

How will these affect your mission? What’s your responsibility in addressing the challenges?

ES: Our messaging has to be more efficient, to help the customer understand something about system support – better utilization of our next-generation technology, how to get more out of the product. We have to educate the customer as well as selling product.

SB: There’s no question that our focus has to be on product differentiation, the value proposition of good outcomes, safety and patient satisfaction. All these factors will help us to be the preferred vendor for products that are sometimes, unfortunately, seen as interchangeable. We have to make sure it’s not an issue of price. One of our key differentiators is that we have the only implants made in the U.S.

RM: A big part of our business is consulting. We need to sell solutions, not just equipment. When the equipment is not used properly it doesn’t help. We changed the culture as well as improved the equipment. We examined what the quality indicators are for caregivers and patients, so we can bring our customers up the learning curve.

EH: Clinical data is vital – evidence-based medicine is playing a more formal role in our industry. Coloplast is not the low-priced provider, so we need to provide evidence that our performance is greater. It’s a value proposition. We primarily work with surgeons, but our definition of a relationship is having a sales person add real value, provide educational opportunities, do some training with staff.

ES: We have evolved from being relationship-based to helping customers see problems and solutions. We’re gaining an understanding of how to help them move their thinking along, challenging long-held beliefs and habits. Rethinking the algorithm.

There seems to be a lot of focus on education and training.

ES: Definitely. We do peer-to-peer training, society-based training, and develop new training approaches. We try to do much more education in national courses, to reduce their time commitment. They’re less inclined to come to us, so we go to trade shows and society meetings, and provide raw material for seminars. To establish brand loyalty early, we spend time training fellows. We also publish on clinical sites, support research, do public relations, and encourage more stories about relevant topics. It’s not all just about us, but supporting this kind of education does benefit our brand name.

SB: Unlike medications, physicians influence the choice of this product much more than patients, who tend not to know brand names. So we mentor surgeons, provide physician search tools. Also, we don’t have the kind of barriers to physician access that other companies have. There’s a very strong relationship between the surgeons and our reps. That said, we also have to educate other stakeholders: materials management personnel, procurement, value analysis committees. And they’re looking at different parameters: price rather than value. We make the case with them by indicating that our product is safer, and has fewer complications. So this means we also have to train the reps to identify at each account who are key decision makers. Every culture has its own dynamics.

RM: We branched into consulting about ten years ago, and have about 700 hospital customers now. This was originally around patient injuries and a safe work environment, and it’s expanded ever since. We’ve averaged around 93% reduction of patient handling injuries. We can track the cost to hospitals or longterm care homes, but it goes even further. This also reduces restricted duty costs when a patient goes back to work.

EH: In the past, you just had to be present, now you have to add real value. We offer surgeon-to-surgeon training and cadaver training, because increased understanding of anatomy is critical to success. We’re also intent on helping patients becoming more educated, even to brand and type of technology. The younger patients are driven by technology and availability of information, so we have to be where they are.

ES: Very true. We’ve launched a patient advocacy site and notice that some are extremely engaged, so our outreach to them and their feedback to us is important.

What will you have to do moving forward?

EH: We continue to develop and provide a very high quality product. We have been voted as the best medical device company, but that only means we have to keep up the pressure on ourselves to maintain that position. We are shifting focus to be more educational, providing clinical value rather than the old-fashioned feature/benefit approach. Surgeons appreciate this.

ES: Stay leading-edge. It’s not clear how navigation is changing with new platforms and programs coming online all the time, but if we don’t get up the curve someone else will.

RM: Right. We have to become smarter about using technology, and create solutions around cost savings. For instance, deep vein thrombosis, or DVT, is a huge cost. About 60,000 people die every year from DVT. If the nurse is not following protocol and putting a particular patient on our DVT product, we have software that tracks patient records and alerts us, so we can address that. The software also automatically sends a text to the physician about the risk to the patient. We have reduced the DVT rate by as much as 50% with this breakthrough.

SB: More of what we’re doing. Conducting KOL meetings, educating not just on product features but on overall benefits. Giving physicians the tools they need to discuss the product with patients: material for their websites, FAQs. We have two branded sites they can link to:  for augmentation patients, and  for reconstruction patients.

Any other trends that you find valuable?

RM: Partnering. We’re working with other companies to develop joint solutions: Ovation, Smith & Nephew, wound care companies, even a flooring company. We also partner with educational institutions. The University of Denver has the best outcomes in country, and we’re building on their metrics.

EH: Patient focus. Patients are increasingly more responsible for their care, not just physically but fiscally as well. They want good value. We work with them on development of products. Once the patient goes home, how do they use our product? This gives us insight and influences both our technology and our messaging.

ES: True. The patient has become central to the treatment paradigm. Docs have moved from “It’s not appropriate to consider the patient’s opinion” to “I’m happy to discuss it” – because they realize the patient is up-to-speed on the new technology.

Final thoughts?

RM: Quality of care equals quality of life. •


Mixing it Up