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Raj Garg: A Healthcare Leader Shares His Views on the Industry’s Challenges

Raj Garg is a former CEO, McKinsey Senior Partner, healthcare attorney and physician. This background gives him a broad and deep perspective on nearly every corner of the health care industry. In particular, we were impressed in our conversation with Raj at his rare ability to integrate across subsectors of health care. His talents for insight and leadership have given him a unique point of view on how to deal with some of the great challenges in healthcare.

He’s a strategic, inspirational, values-based leader with a proven P&L track record. He led the Cancer Treatment Centers of America as CEO and president. He served on its board and its executive, finance & risk, science, strategic growth, and talent committees. In a short time, he orchestrated a massive turnaround that sustained the $4.5 billion enterprise by reducing costs, attracting a strong leadership team, creating a culture of accountability, and establishing a strategy for growth. He has a reputation for courageous and tireless leadership— often in short supply— among his peers, as well as those that worked with him at CTCA.

Prior to CTCA, Raj spent 25 years as a leader in healthcare at McKinsey & Company. There he advised CEOs and C-suite executives of leading companies in the U.S., Europe and Asia. His experiences span the business value spectrum, including strategy, M&A, post-merger integration, sales and marketing, and operations. His clients included top ten companies across biopharma, medical device, ancillary service, and provider/payor subsectors.

In short, there’s hardly a corner of this industry where Raj does not have experience or where he has not applied his considerable wisdom. Given our focus on hospital systems in this issue, we asked Raj a few questions that drew from his experience on both sides of the table.

Q: Given your recent turnaround experience with CTCA, what observations would you have for our readers on hospital providers?

Hospital systems have been and remain under significant financial pressure as health care costs remain a central policy issue. For many institutional providers, 3 percentage points is a good margin. We are seeing some bifurcation among providers—for example, the regional IDNs (Integrated Delivery Networks) seem to be gaining the upper hand on performance and growth given their greater holistic alignment of incentives and scale. For other providers, it’s a paper thin margin. The accelerated turnaround that I orchestrated at CTCA, an out-of-network provider of cancer care, is symbolic of these pressures. Managing outsized bad debt, AR and denials, ensuring a disciplined approach to procurement, aligning provider compensation in a compliant fashion, controlling IS spend, and developing a network that can channel patients to the appropriate site of care to manage costs are among the many issues that providers must manage to maintain their bare margins. This does not even start to address the growth-focused topics that they must juggle in parallel.

To work with hospital providers as customers, pharma, biotech and med device companies need to understand these and other aspects of what the provider customer is managing daily. Providers are routinely taking fresh cuts to their economics as commercial payors reduce reimbursement and promulgate new rules and policies that result in more denials, requests for documentation, and delays in payment. In parallel, government payors are also shifting reimbursement across services and specialties, and often reducing it.

One big area is clearly drug pricing. For hospital systems, drugs used to be one mechanism that helped generate some margin. That is under severe pressure now. The rollback in CMS reimbursement for the 340B drug program last year resulted in a 26.5-28.5% haircut (depending on whether one includes the impact of sequestration). This clearly impacts the 340B eligible entities, which does not include for-profit systems. It will be interesting to watch whether, as a result, drug utilization rises in places like cancer facilities.

A further systemic issue for all Medicare providers is the mismatch and delay in reimbursement adjustment for drugs as prices increase. The lag period means that for roughly nine months, provider reimbursement is based on an outdated cost basis. On the commercial payor side of the equation, hospital provider contracts with payors are under pressure, as commercial payors decrease their reimbursements for drugs and drug administration fees. Further, commercial payors may allow an annual increase in the drug cost but this falls far short of the total increase in drug prices that healthcare companies are pushing through each year.

All of the above are a wake-up call for healthcare companies to think hard about their approach to drug pricing and consider ways that make sense for their provider customers. Can pharma companies moderate drug price increases to match what providers expect to gain in reimbursement? Would companies be willing to do away with the artificial class of trade distinction that renders pricing to hospitals higher than outpatient providers? Can they be more discriminating in pricing their products based on real differentiation and value-add versus “book end” pricing? And how can healthcare companies work with providers to evolve value-based pricing, where providers are credited for drugs (especially the newer and more expensive ones) that fail to produce results in patients? Clearly, with the emergence of gene therapy, this latter mechanism will have to be considered, given the outsized cost of these new therapies.

Q: We are hearing a lot about personalized medicine these days—especially in cancer. What’s your view on how well that is working from a hospital provider perspective?

The value of precision medicine— therapies based on a genetic understanding of the patient—especially in cancer, is clear, and hospital systems should be embracing it. New therapies like Keytruda and Opdivo have made a significant impact on cancers that were previously difficult to treat. It’s really quite amazing that these two drugs alone have multiple years of clinical trials (alone and in combination with other drugs) lined up that will continue to yield new patient benefits. These products are certainly not free of side effects but, given the alternative, they hold great value for patients. We are seeing an on-going increase in the discovery of disease-associated genes, suggesting that we will see a further proliferation of targeted therapies. Recent analyses suggest that drugs that are targeted at specific population subsets based on biomarkers have a greater likelihood of approval by the FDA. And now, with the first gene therapy coming to market, we are seeing the beginning of the move to permanent cures.

However, despite the virtues of precision medicine, provider systems face real challenges in getting their physicians to adopt precision medicine approaches. The median age of medical oncologists in the US is 54. Their formal medical training pre-dates the age of genomics. To come up to speed on genetic/genomic diagnostics and therapeutic innovations, they have to absorb an enormous amount of information. Which genetic or genomic test to use and why? Which immuno-oncology drugs are best suited for the variants found? What combination of drugs might have the most therapeutic effect? What side effects to look for and how to prevent or manage them? In cases where a clear therapy is not established, what potential therapies are worthy of trial based on the known data? And physicians need to do all of this while they are providing care to their patients—not an easy thing to accomplish.

Healthcare companies have an important role to play. First, they must give serious consideration to why they are not segmenting populations for new drugs based on genomic variants—to the extent that they continue to position a pipeline drug as suited for “all comers.” If companies want to help providers, they should start by providing drugs that are targeted, where possible, to specific patient populations. And, healthcare manufacturers must provide significant assistance in helping HCPs determine how to do that, a need that is not being fully met today. Healthcare companies can play a critical role in helping support objective physician education on the state and evolution of precision medicine. When patients have a genetic variant with no definitive existing therapy, but where the scientific literature suggests a strong signal for potential efficacy of another drug, companies could supply that drug under a patient assistance program. This would be greatly beneficial to a small cohort of patients. Given that payors uniformly refuse to reimburse for such drug uses, such programs have material impact on patients, offset unreimbursed costs to providers, and may even provide directional evidence for potential new indications.

Q: Health tech is growing rapidly. What area of health tech is of interest to you?

Health tech feels like it is starting to come of age. And the valuations of health tech companies are soaring, but whether they will deliver on their promise is yet to be seen. One area that I believe holds great opportunity and should be of interest to providers, payors, employers and manufacturers is virtual care. I see virtual care as being the “last mile” of health care. It fills the gap between the patient-at- home and the multiple formal care settings. Its benefits include chronic disease management, wellness enhancement, avoidance of emergency department visits and re-hospitalizations, assurance of compliance, remote monitoring, proactive self-reporting of symptoms, extension of the reach of care providers to remote areas, and more. As such, it holds promise for filling the gap that exists in health care today, and for reducing the overall cost pressure on the system.

Healthcare companies historically have been challenged on several fronts where virtual care can be a powerful tool. For example, lots of companies talk about understanding the patient journey. With virtual care, much greater real-time data would be available to help complete the patient journey picture. Nearly every biopharma company that I have worked with has struggled to craft an effective digital strategy. A single-enterprise virtual care platform can provide the opportunity to offer customized programs across products and functions. Thus, drug-specific patient support programs can be delivered via virtual care applications. These same applications can be used to collect de-identified data, including data generated by wearable devices, from patients in a disease category. This would provide significant insight into patient/prescriber behavior as well as disease and drug-related issues. With patients in clinical trials, R&D can benefit by directly collecting patient-reported data, thereby improving data quality, reducing trial costs and saving time associated with monitoring visits. The same platform can be a powerful tool for Phase IV/ post-marketing surveillance. I also believe that there may well be FDA drug approvals that are facilitated because the “product” is both a drug and patient support program delivered via a bundled virtual care tool. These are just some of the benefits.

LOOKING FORWARD

I am a staunch optimist with respect to the future of healthcare. Just as we are living in the digital age, I am a strong believer that the next half century or more will be the age of genomics and biology. Inherently healthcare will play a material role in shaping that era. I would urge that healthcare companies broaden their perspective and interests to proactively shape our health ecosystem. That means understanding and partnering to address the needs of the other sub-sectors of health care. Broadening our horizons and fostering collaboration will benefit everyone involved.

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Medical Device and Hospitals: Execs from Roche, Abbott, Cathworks, Molnlycke and Velano Offer their Insights

Our Moderator:

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SCOTT NELSON

Co-Founder Joovv Founder Medsider

Our panel of experts:

image of AL CONCEMI

AL CONCEMI

Former VP, Surgical Marketing Mölnlycke Health Care

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JAY GRAVES

Founder and CEO Pathfinder Business Consultants Former VP Sales Roche Diabetes

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BRETT JOHNSTON

Regional Sales Manager Abbott Neuromodulation

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RAMIN MOUSAVI

Vice President – Global Marketing & Strategy (Chief Marketing Officer) CathWorks

image of ERIC STONE

ERIC STONE

Chief Executive Officer & Cofounder Velano Vascular, Inc.

Opinions expressed are those of the participants and not necessarily those of the companies they work for.

Like everyone else in business, the medical device industry is leveling up its game in light of significant changes across several key areas: technology, patient focus, remote medicine. Of key importance, successful players will need to maintain solid relationships with hospitals, which are consolidating and dealing with their own economic, regulatory, and quality challenges. How are leading-edge medical device companies dealing with the emergence of greater demands from Value Assessment Committees? What are the smaller and emerging companies doing to promote their innovations and stay competitive in the face of industry giants? We presented these questions and others to our panel of experts, and we think you’ll find a substantial amount of wisdom in their answers. Read on to learn from the best!

What are the main challenges today in working with hospitals and hospital systems?

AL CONCEMI: The complexity in decision making in hospitals continues to rise despite the ability to share information. Hospitals are under significant pressure to reduce costs, and one way to do that is by reducing spending on products, supplies, and purchased services. There is a strong push for “clinically acceptable” products, however the definition of this term varies widely. Medtech companies are trying to get their evidence, facts, and messages through to the decision makers, yet the ability to get time continues to get harder.

JAY GRAVES: There are so many stakeholders in the decision-making process; it takes a long time to get a consensus. In the past, you could find a coach who could point to the one or two people who would make a decision, but today it seems consensus decisions are the norm which can be complicated and time intensive.

BRETT JOHNSTON: I’ve been in the business for over 25 years and have seen business evolve from companies working directly with the end user 90% of the time to today where you see the majority of decisions being made on a group level. Some systems operate where the end user has virtually no input on a product or service they can access. The problems associated with the centralization of decision making are not always overtly evident either. For example, if you have a good or service that improves patient care with an increase in treatment cost, but a decrease in long term patient cost, no one is capable of properly analyzing those situations. The other main challenge I see with hospitals is the rise of the physician-owned facility. No longer is a hospital likely to be the only location a patient can receive surgical intervention, even complex intervention. Understanding the impact on a local hospital/system is paramount in maintaining a relationship that is mutually productive.

ERIC STONE: Many of the challenges in working with hospitals and systems today are the same that have existed for decades. This continues to be an industry largely averse to change that, while evolving to “keep up,” must also focus on the day-to-day demands of its primary mission – providing crucial-medical support for the communities they serve. So it can be difficult to break through to find a receptive audience for new ideas – ideas that require effort, change and resources. Even when successful, the path to commercialization or process change is long and slow – two endeavors that do not align inherently with innovation and entrepreneurial thinking. And those projects that finally do make it through are subject to friction ranging from staff turnover, exhaustive oversight, to increasingly harsh financial realities.

Of course, the truth is that any changes in medical delivery or care must be approached with caution. It’s simply challenging, and at times frustrating, for change agents to bake these realities into their formula or path to success – particularly in the early stages of disruption and transformation.

RAMIN MOUSAVI: The main challenge when working with hospitals and hospital systems is that many if not most of the hospitals face appropriate resourcing issues and therefore are unable to adopt and appreciate disruptive technologies and changes at the appropriate pace. This is not good for anyone, especially not good for patients. When hospitals are slow to adopt meaningful innovation, they unintentionally stop patients from benefiting from disruptive technologies. This, at its core, is at odds with physicians’ desire to help patients.

How has the role of Value Assessment/Value Analysis Committees changed over the past few years and how are you responding to their new requests?

BRETT JOHNSTON: Many companies have adapted by adding personnel resources directly to service this growing need. It is almost a requirement to have designated people to gather, sift, prepare and respond to the growing number of Value Committee requests and even RFPs (Request For Pricing/ Proposal) that companies now field. The VAC groups vary wildly between hospital systems and try and balance the finance side of the table with the clinical side. Through the years, the balance point has definitely moved from the clinical side to the finance side, but varies from location to location, sometimes vastly.

ERIC STONE: VACs and truly breakthrough innovations oftentimes experience friction, as neither is typically organized to coexist peacefully with the other – despite what both parties say. The more progressive VACs staffed by true change agents who can dutifully fulfill the hospital or system’s mission while maintaining financial stability are where innovators need to start. With a few of these groups and reference customers as champions, the subsequent VAC processes can become much less daunting. The data has to come from somewhere, start somewhere, and so getting that “first chance” with VACs and progressive hospitals can go a long way towards revolutionizing medicine. We’ve been fortunate to have finance (in the form of VACs and/or finance leaders) engaged since the earliest stages of collaboration. This is a must to transition our efforts from innovation to clinical and operational reality.

AL CONCEMI: Some hospital systems are outsourcing the value analysis process to consultants. As the number of stakeholders increases, and their backgrounds and interests become more varied, it creates a challenge to medtech companies on how to get their value proposition understood and accepted. Medtech companies continue to adapt in many ways. One way is to structure your message with a core theme that addresses all stakeholders while still having the ability to tailor the message to the individual decision makers.

VALUE ASSESSMENT

RAMIN MOUSAVI: As we have experienced a large number of consolidations over the past decade, VACs have become the necessary step to introduce any new technology to the hospital. It used to be your physician champion who decided what new technology can get into the hospital. Now, in addition to strong physician champion(s), you need strong support from administration, supply chain and IT. This is not necessarily a negative change, especially for innovative technologies that successfully check the box for the triple AIM of quality care, population health and cost effectiveness. However, the internal bureaucracy and resourcing issues within hospitals can turn VAC to a slow and painful process. In order to get ahead of this, we try to proactively identify key stakeholders and meet with them and answer all of their questions and concerns. Current VAC setting puts a lot more pressure on us as marketers on how we introduce our product and convey the value proposition. Luckily, with the CathWorks FFRangio SystemTM, we have a strong value proposition that is interesting to both clinical and administrative stakeholders. We have found it is essential that we successfully answer all the non-clinical key questions in advance of a VAC meeting, and then our physician champions always do a great job to speak about the clinical benefits for patients.

JAY GRAVES: The whole idea behind value-based care has had a significant impact on our healthcare landscape. When I speak with hospital administrators, there is a real struggle to attain the level of care desired and mandated while maintaining revenue goals. This is requiring medical companies to think about how they can contribute to the value-based goals of their customers. This might mean adding ancillary programs or research on how their products and services can help their customers while addressing the financial restrictions of a capitated payment system.

As large multi-national medtech companies continue to make acquisitions and expand their product portfolios, do you believe hospital systems respond favorably to this type of value proposition?

JAY GRAVES: Decision makers in hospital systems have limited time and have often commented to me in the past that they would like companies to have a single point of contact for multiple offerings from their companies vs. several sales representatives. In theory, with consolidation, many companies would be able to bring a more holistic portfolio to customers from one representative. Some device and diagnostic companies have reorganized themselves to have this single point of contact for hospitals and large customers. Interestingly, I was speaking with a key opinion leader from a large hospital system recently, and he stated that many hospitals use medtech as a way to attract more patients but that the solutions aren’t better than cheaper alternatives. The example he used was how robotics are marketed by hospitals as superior vs. manual surgery, but studies have shown this is not always the case. This leads me to believe that system administrators appreciate the efficiency of consolidation but are also wary of the high cost of some solutions if they are not truly better than current treatment, especially with tight budgets.

RAMIN MOUSAVI: Hospitals expect good technologies that produce consistent results, with the right level of service. Medtech acquisitions further the reach of smaller companies and make meaningful innovations available to a much broader patient population. There are also economic benefits to hospitals when dealing with these companies, because given the breadth of their portfolio, they can offer things that smaller or single segment focused companies simply cannot offer. From experience, I know that hospitals like and appreciate the service they receive from smaller companies and those companies that only focus on specific areas

AL CONCEMI: I believe that many hospital systems like the ability to reduce the number of suppliers that they work with, and see value in getting more of their product portfolio from fewer vendors. There is certainly an economy of scale that can be achieved to create value for both the hospital and the company. Hospitals are now looking beyond just the cost savings that such a relationship provides and seeking additional value-added services.

ERIC STONE: I think systems are of two minds about this consolidation and the resulting expanded product portfolios. At a time when hospitals are increasingly caught up in patient backlash over pricing and transparency, having to deal with large conglomerates with monopolies on devices, procedures or medicines puts them in an awkward position. But at the same time, working with these large, familiar organizations makes it easier to conduct day-to-day business because they are comfortable with one another’s teams and procedures, and the larger companies by their very scale can make doing business easier than dealing with a litany of small firms.

BRETT JOHNSTON: My personal opinion is the hospital system only cares in so much as it gives them fewer people to work with. If scale for the sake of scale worked, Johnson & Johnson would have buttoned up the medical device business 50 years ago. That is not to say that a company providing tools for hip replacement for example would not benefit from offering all the tools necessary to perform a hip replacement. Those things make sense. In my experience, the larger the medtech company, the more difficult it is for them to even communicate cross functionally.

Do you feel that new technology and/or partnering with hospital systems on clinical studies influences your relationships in those settings?

JAY GRAVES: Yes, there is a bias. It is in our nature that we get familiar and comfortable with a particular brand or technology and tend to stick with it. If you are using a product and gaining familiarity in it during clinical studies, then you are more likely to use the same product in your practice. Medical companies are counting on this muscle memory when partnering with clinical studies.

RAMIN MOUSAVI: There are many ways to build credibility with hospital partners, but ultimately they judge you based on three simple factors: Is your technology offering real and impactful innovation that can help providers and patients? Do you have reputable and reliable clinical data supporting your technology? Does partnering with you make things better and easier? For example, as we have commercialized CathWorks FFRangio in the US, we stood on strong clinical data from FAST FFR study that showed FFRangio has a high concordance with invasive FFR technologies and is very accurate. Well, FAST FFR, combined with FAME and FAME II studies that had already demonstrated significant reduction in the composite rate of death, nonfatal MI and urgent revascularization when FFR was used (vs. coronary angiography alone), gives us a lot of clinical credibility. We also benefit from the fact that our system is very easy to use and gives comprehensive analysis within few minutes.

ERIC STONE: We’ve found collaboration or partnership to be an important part of the innovation cycle with new hospital partners. By working closely with hospitals on studies and pilots, both teams learn valuable lessons and insights, and the technology benefits – in terms of refinement, enhanced training and education, insights into how to optimize procedures, realization of outcomes in unique settings, and more. Successful pilots help create advocates within a system that can facilitate full adoption and commercialization. And familiarity by staff during a study or pilot helps shorten the runway to technology/innovation adoption.

In fact, our early success doing this with partners like Intermountain Health for our needle-free PIVO blood draw device convinced us to make this a standard approach with more recent partners like Centura Health and others. Everyone wins through joint exploration – as long as both parties keep an open mind and are willing to explore together. Change is rarely easy, nor is it pretty.

AL CONCEMI: Partnering for clinical studies does seem to help in that the hospital clinical staff can provide some insight into the benefits and value of the new technology or procedure. If there are doubts about the clinical and or economic benefits, then the hospital has first-hand experiences upon which to base decisions.

As you think about access to hospitals and hospital systems, are direct relationships with HCPs, particularly surgeons or interventionalists, still important? What/who else is important or influential when it comes to access in today’s healthcare climate?

ERIC STONE: Absolutely – it’s important to build those relationships for advocacy, a robust feedback loop hearing and gaining honest insights, and more. A two way relationship is also critical when working with patient care, innovation, investment, marketing, and other hospital teams. In our experience, identifying an executive champion(s) representing the constituency most impacted, and benefitted (not always the same executives/functions) by an innovation is critical. For Velano, that philosophy has helped us to seek out relationships with nursing, laboratory, quality, finance and other leaders. Also, we’ve increasingly found that hospital systems are building innovation ecosystems led by a Chief Innovation Officer – an important advocate for any change agent seeking to collaborate with health systems.

AL CONCEMI: Relationships will always matter because “people buy from people,” but the number of physician preference items is dwindling. Having clinical and economic evidence to support your products is important because you can then leverage your relationships to share this data with their colleagues to help communicate your value proposition. Relationships with supply chain continue to be important, which is why the need for strong health economics data is critical. There is also a growing influence of infection prevention in value analysis decisions, as reimbursement continues to be tied to the prevention of negative outcomes like hospital acquired conditions.

BRETT JOHNSTON: Speaking of access alone, I find direct relationships with HCPs imperative! In fact, a relationship is just the beginning. You really need a true partnership with your customers. It is no different from any other kind of service business. The better you know your customer, the better solutions you can offer and the more likely they will be to listen.

RAMIN MOUSAVI: There is no replacement for meaningful partnership with physicians. They are ultimately responsible for the patient care and it is essential that they see benefit in your technology. But, in addition to the physician champions, the administrative team needs to see the economic value of your product. In our case, the IT stakeholders want to know about the security of our system and its ease of integration. This is much more important for disruptive technologies like CathWorks FFRangio, because we are not just another invasive wire. We are changing an entire category, so it’s important that everybody understands the value proposition clearly.

JAY GRAVES: In the past, there was more of an emphasis on HCPs than there is today. Not to say it is not essential to build relationships with key contacts, but a lot of the decisions are made at the C-suite, which is where commercial teams are trying to gain access today.

In terms of your relationships with hospitals and hospital systems, how relevant is valuebased healthcare (VBHC)? What is your company doing to align with VBHC initiatives?

AL CONCEMI: Value-based healthcare is extremely relevant, as reimbursement and potential penalties are tied to outcomes. Value is not just created by the initial purchase price being lower, but rather by a lower total cost of care. Saving a few dollars up front on a product that may result in hundreds or thousands of dollars of additional costs is just not good economics. Companies need to have the data to show how their products influence outcomes, and how better outcomes drive down total cost of care.

ERIC STONE: Our core mission is to deliver a more humane, patient-centered standard of care that delivers significant quality improvement for one of medicine’s most frequent invasive procedures — inpatient blood draws. In today’s industry environment, that focus on the patient not only improves their experience but also can advance a system’s bottom line through satisfaction ratings and reimbursements, competitive differentiation, practitioner satisfaction and more.

We are finding in collaboration with system partners that removing the needle from inpatient blood draws positively “moves the needle” on HCAHPS scores.

As you know, better HCAHPS performance means more dollars for hospitals. It also has secondary benefits, including competitive differentiation within markets. This domain is heavily nuanced, but early insights are proving positive.

JAY GRAVES: I am in a unique position where I work with both hospital systems as well as medical and pharmaceutical commercial teams, so I get to see both sides of the coin. With the hospitals, value based healthcare is vital because it is the standard they are measured against. For commercial teams, it is a variable they must consider when developing their sales strategies.

RAMIN MOUSAVI: There is a change of trend towards VBHC. Hospitals want to know that they are adopting a technology that creates real value for everyone involved. With the Cathworks FFRangio System this is a big focus for us. In addition to strong clinical evidence, our product is a non-invasive technology that is a much better substitute for existing invasive solutions. We can help reduce risk, reduce cost AND provide a much more comprehensive physiology information.

What strategies has your company employed to adapt to the new environment?

RAMIN MOUSAVI: We have developed a unique commercial strategy that is focused on maximizing adoption. We are constantly working on ways to remove traditional barriers to adoption by being flexible to our customer needs. For example, IT security and integration is a big challenge and concern for hospitals when considering artificial intelligence based technologies. Our product development team in Israel has done a fantastic job taking all of these concerns into account, and has made our system super easy to integrate into hospitals IT, with almost no risk. Another example is our commercial rollout of FFRangio. Our sales team proactively evaluates the requirements at every customer, and develops a comprehensive package of information that focuses on answering all stakeholder questions. We are focused on shortening the feedback loop to respond to our customers ever changing needs.

JAY GRAVES: I have experts on my team who have successfully managed value-based healthcare and population management programs for large hospital systems, which is critical for us to be able to consult with our clients successfully. Without this expertise, we would just be spouting off theory.

AL CONCEMI: The development of clear health economic data and presenting that data in an easy to understand way is important in today’s environment. You need to be able to “connect the dots” of how a product, service, or procedure impacts the outcome being measured, and be able to tie an economic value to the improved outcome.

Do you think the next five years will hold more significant changes? How?

ERIC STONE: Healthcare is undergoing incredible change driven by changing patient expectations, emerging technology capabilities, new financial realities, and a shifting regulatory and political environment. So there is no doubt we’ll continue to see significant change in how hospitals identify, test, rollout and measure new and innovative technologies. As those influences gain steam and feed into one another, it is going to shape a dramatically different healthcare sector within the next decade, one that is even more patient-centered and experience-focused than today, where financials are transparent to patients and tied to outcomes on the payer side, and that relies on technology and remote treatment for a majority of routine issues. I expect more consolidation to occur and large technology or consumer brands to blur the lines by taking on more of a role within the traditional healthcare system.

Moving Forward

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BRETT JOHNSTON: I’m actually one that does not think there will be significant changes in the next five years. All sides are responding to pricing pressures in multiple ways. Clinical studies will continue to drive decision making (hopefully). Politicians will continue to both condemn and praise the industry with little coherence on either side. Maybe Trump’s new executive order on pricing visibility will be a positive for the industry and provide some significant change. We will see.

JAY GRAVES: The only way it changes is with payment reform. If value-based goals continue to be the norm, then that will dictate behavior and investment, but if an administration decides to make changes to healthcare, then those become the new expectation. We know what we have today and can only speculate what is coming down the road based on what we hear and interpret out of D.C.

AL CONCEMI: I do see significant changes in the future. The role of personalized medicine has evolved significantly in the past decade, and I see that accelerating in the future. Technology that can respond real-time to changes in the patient will continue to evolve and provide therapeutic options once thought impossible. There is still a chasm to cross in terms of data that is based on large patient populations and those based on an individual, and medtech companies will continue to work with clinicians to better understand how to utilize this data to maximize patient outcomes.

RAMIN MOUSAVI: Innovation forces change and that’s a good thing. Non-invasive and less invasive technologies will replace more invasive solutions, and hospitals will continue to demand strong clinical evidence, economic benefit and seamless integration. The increased focus on healthcare cost and efficiency will create an opportunity for technologies to disrupt each category and become the standard of care. Another change we all need to be prepared for is the increasing awareness among patients and caregivers. With the expansion of social media and digital platforms, patients are becoming and will be empowered to demand better care. Patients are the best ambassadors for good patient care. Increased awareness about different therapies means that the patient education will play even a bigger role 5 years from now. Social media already has enabled patients to make their voice heard, but I think there will be a significant increase in that in the coming years. Meaningful innovation can positively impact patient care and we are all very lucky to play small role in our space.

What do you think?

Written by hsandm

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