Substantial and Sustainable – 2 Words That Medtech Companies Should Get Used To

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As the world of healthcare continues to change and evolve, hospitals and healthcare providers are facing a major dilemma.

There will continue to be an increasing number of patients that need healthcare. But, the reimbursement for healthcare services will continue to decline. In other words, there will be more customers checking out, but less money coming through the cash register.

Therefore, healthcare providers will be looking for solutions that are both substantial and sustainable. Message to medical device professionals: do your products and solutions pass this “S and S” test?

In this interview, Lars Thording and Randel Richner further explain the challenges that healthcare providers are facing and what type of solutions they are looking for. Lars is the VP of Marketing for Intralign while Randel is the VP of Advanced Analytics.

Here’s What You Will Learn

  • What are the biggest challenges that healthcare providers are facing right now?
  • Cost vs. quality: What’s more important? Can you avoid the trade-off?
  • How does Intralign help healthcare providers control costs and improve the delivery of care?
  • How and why are providers missing the mark in regards to the “intra-operative space”?
  • The impact of advanced analytics and “intelligent care design” on the delivery of care and cost containment.
  • Advice from Lars and Randel on how medtech companies can best partner with providers in the new era of healthcare.
  • And much more!

This Is What You Can Do Next

1) You can listen to the interview with Lars and Randel right now:

2) You can also download the mp3 file of the interview by clicking here.

Don’t forget – you can listen to this interview and all of the other Medsider interviews via iTunes.  And if you get a chance, leave us an honest rating and review.

3) Read the following transcripts from my interview with Lars and Randel.  Also, feel free to download the transcripts by clicking here.

Read the Interview

Scott Nelson:    Hello, hello everyone.  Welcome to another edition of Medsider. This is your host, Scott Nelson, and Medsider, for those of you listening for the first time, is the program where you can learn from proven med tech and medical device experts. And on today’s program we’ve got two guests, the first one being Lars Thording, who’s the VP of Marketing and Public Affairs for Intralign, and then our second guest is Randel Richner, who’s a repeat performer, I guess, for lack of a better description, and Randel is the Executive VP of Advanced Analytics for Intralign, and that’s a recent change on Randel’s behalf, and we’ll certainly discuss that point. So, without further ado, welcome to the call, Lars and Randel.

Lars Thording: Thank you.

Randel Richner:       Thank you.

Scott Nelson:    Alright, let’s start off. I’m going to give you both the opportunity to briefly introduce yourselves as well as, Lars, you can give us a brief introduction to Intralign, and then Randel, maybe you can speak to Neocure and then the recent integration of Intralign and Neocure.

Randel Richner:       Sure. Sounds good. Go ahead, Lars.

Lars Thording: Yup. Yeah. So Scott, Intralign was formed very recently on December 31st of last year, so we’re a really young company. Our company has come together as various healthcare entrepreneurs across the healthcare spectrum that are all of us very engaged in trying to make conditions better for [00:01:25] healthcare, you know, and for hospitals particularly. So what you’ll find on the team at Intralign are folks that, including myself, if I can be so indiscreet, have been making a mark in the healthcare industry very recently through the work we’ve done with Stryker Sustainability Solutions, formerly Ascent, the first reprocessing company in the United States that ended up having a major impact in the industry and still does.

Saying goodbye to that challenge and taking on a new one, it was obvious to those of us that left Stryker Sustainability Solutions that we wanted to focus on another area in healthcare where there’s a great need to look at how do we reduce inefficiencies and create better opportunities for hospitals and healthcare providers in doing what they ought to be doing, mainly delivering the best care possible to our patient population. We’re going to get, I’m sure, more into this later on, but we honed in on major joint replacement as a key area, and Intralign was born out of the thought that we could make an impact there. So Randel and others joined us, and we formed Intralign at the end of the year last year.

In terms of my own background, other than having worked at establishing and building the first very successful and the biggest reprocessing company in the industry, I spent time as a pharma consultant and in academia prior to that. Randel, your background is a lot more impressive than that, so [00:03:01] I welcome you to just fill in the space.

Randel Richner:       Thank you, Lars. Well, yes, I started Neocure in 2006 from my previous role as a vice president at Boston Scientific. Our focus at Neocure was really to help new technologies and to help technologies to understand the reimbursement and payment platform, and opportunities and challenges in the United States looking at payment policy and where we could maximize price for technologies, how to present the value argument most effectively. And within that role, we built a very strong data analytics capability based on hospital data, cost data, using a large number of survey databases to actually really help our clients to understand, you know, provider economics and hospital economics, and where and how our technology really made an impact.

When Intralign executives approached us, it was a very interesting concept that they had seen our data and were very impressed by that, and looking at how we could provide the analytics platform for this new company, which would be involved in analytics as well as intelligent care design and also a physician assistant component to that. It was appealing to me from our background to be able to apply our analytics in a new way in a service delivery model for hospitals to really look at the impact of how you could change the dynamic of care using our analytic solutions. So for us it was a great opportunity to work with some seasoned professionals. And also looking at how the payment models are all changing where the hospitals are really going to have to be equipped to make a lot of hard decisions, and we can provide a lot of that information to them.

Scott Nelson:    Gotcha. I love the idea that you’re so data- and analytics-focused, because I think Lars, if I remember correctly in doing some of this research for this interview, I think you were quoted as saying—I’ve got it in front of me here—“Consultants leave this big fat report and two weeks later everything is back to normal.” I thought that was a great quote because that’s so…I’ve never operated under a consultant capacity within this space, but that quote rang true for me. And I would imagine, it’s probably safe to say that using data and analytics helps you kind of bring life to some of the processes and systems you’re recommending hospitals utilize, correct?

Lars Thording: Hey, Scott, [00:05:53] something that I’d like to add. We spent a lot of time over the last year or so going out there and talking with hospitals, talking with providers, and asking, what are some of the pain points that you have right now? We all know the challenges and I’m sure we’ll get back to that, Scott, but they all come back us with the same kind of answer and they’re saying, “We’re fed up with consultants that come in here and they have some fantastic ideas, some great concepts that we know are relevant to us, but the impact does not stay with us and it’s not substantial enough for us to make a real difference.”

Hospitals are facing very real problems about a bottom line that looks increasingly red and the lack of ability to control all the things that goes into creating that bottom line, so we are focused on from the beginning understanding this business to look at what can be a substantial and sustainable solution to hospitals. Those are keywords for us, and it’s based on these conversations. We went on a tour, Scott, basically, and listened to what are the key pain points here.

And Randel, you can pick this one up because I know you will. One issue for hospitals is the issue of big data, right? There’s too much of it. There’s a lot of it. There’s a lot of data in the healthcare sector. Hospitals have a lot of data, but they don’t have a great way utilizing it to make the types of decisions that they have to make today, which are almost entirely about, how do we create efficiencies within this double pinch of increasing patient numbers and reduced reimbursement?

So that’s what Randel has charged on right now with her team, how to solve the problem with big data, and on a backdrop, again, with hospitals having these challenges. And we want to make it real, and we don’t want to make it a fancy consulting deal with a nice bow on it. We want to make it substantial and sustainable for hospitals. That’s our ambition.

Scott Nelson:    Sure.

Randel Richner:       That was the real beauty of this for me, was that essentially putting the analytics function to work, that you actually are a partner with your hospital over time to really look at the episode of care. We’re ideally suited for that with our analytic capabilities to be able to look at the continuum of care from the community practice to the PCP to the referral to the base procedure to post-discharge care. As you know, all the payment frameworks are changing that are episodic in nature. The ACO kind of thing is looking at that overall payment construct and hospitals are going to be very challenged. They have a lot of data available to them, but being able to connect the dots to be able to look at that continuum and to actually be able to assign credit to a change in an outcome that is related to an intervention such as we are going to be doing in orthopedic delivery is something we can do with these three companies combined. And it’s pretty exciting. So it’s a tactical and practical application. It’s not just doing analysis of data.

Scott Nelson:    Sure. Sure. Makes a ton of sense. And if you’re listening to this, you’re thinking, “Okay, this all sounds good, but how is it impacting me if I’m in the medical device space?”

Lars Thording: Yeah.

Scott Nelson:    And the reason I wanted to have you guys on is because, I mean, you’re servicing hospitals, and we’re certainly going to get into more of the challenges that you’re seeing at the hospital level, but if you’re in medical devices anymore, you realize that it’s an incredibly competitive space. Your margins are most likely shrinking. You really, really need to learn how to partner with these hospitals, your customers, especially as more hospitals acquire physician practices. You better understand your customers, what they’re facing, and how you can best help them and partner with them moving forward other than just simply reducing price.

So, excited to kind of cover that in a little bit more detail, but let’s start out with some of the challenges, the problems that you see hospitals are facing in today’s environment. You touched on one of those in big data, but let’s cover some of the other challenges, and then also then talk a little bit about the unique service offerings that Intralign provides. So, big data, on that note, you already mentioned that challenge, but in regard to big data, is it just simply too much information or is it, how do we apply all this information in order to help reduce cost and improve quality of care?

Lars Thording: You know, I think, Scott, that the issue of data pertains to how does the hospital answer through the challenges that they’re faced with right now. Fundamentally though, the wakeup call for hospitals and providers is that they’re seeing these two developments that are putting them in a pinch. So we all know that reimbursement is going down and the hospitals are experiencing this in individual treatment areas and they’re seeing that they can just not keep going along doing the same things as they have been doing. Their systems are not built for it. At the same time, from the other side comes increased enrolment in federal healthcare programs and increasing patient population in general. That’s certainly the case in major joint replacement. And between these two things, more customers coming to the shop and less money coming in from reimbursement sources to cover it is really why I think the hospitals and providers, that their systems are not optimized for delivering these services in an efficient manner.

And I’m not saying anything other than what the hospitals would say themselves. So the real problem for them, and they’ll provide [00:11:55] great color to that as well, they have been talking with them about it, is that they’re sort of siloed in the way that they look at, how do we bring patients through these processes in an efficient and high-quality manner? And there’s a lack of transparency and there’s a lack of control of that process.

So what the hospitals are looking for, what you’re asking about, is how do we leverage information about what takes place? In other words, what devices are being used? Are we incurring costs? Why is it that quality is being impacted? All that data which exists in overabundance at the hospital, how do we organize and utilize that in an efficient manner? Which is not very academic, by the way, Scott. It’s just a matter of making sure that data is being used for the specific purpose of making decisions and not just sort of sitting there or being available without the purpose of optimizing [00:12:52] system processes. And that’s I think in a short way what the problem is as experienced by hospitals and also the role of data in terms of answering that challenge or resolving that problem.

Scott Nelson:    Got it.

Lars Thording: If that makes sense.

Scott Nelson:    No, it does, and I loved your analogy of more customers coming to the shop but a decreased amount of money coming into the cash register, I guess. I’m kind of paraphrasing there a little bit, but that’s a great analogy. Were you going to add something there, Randel?

Randel Richner:       No, it’s just that manufacturers are going to be really challenged, there’s no question about it, to differentiate their product in this environment. And again, the ones that can, that can really show that it’s going to make an impact somewhere on cost and quality, those are the ones that are going to win as usual. So, even in this model, I think the distinction that we have is the first assists that are actually going to be staffing the procedures, and that’s going to be important to have that kind of opportunity again to show how the technology can work or not in an improved manner, with the right people within the perioperative event too.

Scott Nelson:    Mm-hmm.

Randel Richner:       So the combination of the two is going to be win-win.

Scott Nelson:    Got it. And when you look at those two components, cost and quality, and then using hopefully data and analytics to help create more efficiencies, I guess, and understand what’s going on to help fix some of these problems, is one do you think more important than the other in terms of the view of the hospital, cost versus quality?

Randel Richner:       That’s a very good question. Again, because of the payment model now that it’s a risk-sharing model, that there’s going to be a greater emphasis on quality metrics and how those are captured and which ones are going to driving the payment opportunities. And it’s going to be a shared model between the provider, the payer and the physician, so that dynamic is going to clearly be driven by quality outcomes. There’s no question about that in my mind. But which quality metric is going to be the most important in the orthopedic space and for those procedures, and how again the products that are used during that procedure are going to be important as well as the followup and the other variables that all contribute to a quality patient outcome.

Lars Thording: Let me supplement that a little bit. That’s sort of a different level here. You’re putting it to the test here, cost versus quality. I think the real situation for hospitals as well as for American healthcare in general is that we never want to be in a situation where we sacrifice quality for the ability to treat the numbers of patients, right?

Scott Nelson:    Yeah.

Lars Thording: And that’s the challenge for healthcare, is the challenge for hospitals – they don’t want to stop admitting patients in the front door and they also don’t want to sacrifice quality. So how do you achieve both at the same time? How do you achieve volume and how do you sustain quality? It sounds like a tradeoff but the fact is neither the hospital nor our healthcare system in general should ever have to make that choice.

Scott Nelson:    Sure.

Lars Thording: And that’s where the key—so how do you avoid that tradeoff? You avoid that tradeoff by looking at where do you have inefficiencies in the delivery system, and is there a way on a global scale, given what Randel is talking about in terms of different new reimbursement practices as well as new hospital models, including ACOs and increasing physician [00:16:42] hold situations with hospitals? How do you accomplish that, right?

Scott Nelson:    Yeah.

Lars Thording: And the political discussion is a very real thing for the hospital, is a very real thing for the surgeon, but I also think it’s a very real thing for all of us that are part of American healthcare. We don’t want to make that tradeoff, so the injection point for us all to discuss is, are there inefficiencies in the system, and if so, how can we identify them and remedy them? We try to be very practical about it in terms of designing the offering that Intralign is coming out with, and Randel has already spoken to what some of the components of our solution to that catch-22, how that looks.

Scott Nelson:    Yeah…

Randel Richner:       You know, so I think…

Scott Nelson:    Oh, go ahead. I’m sorry.

Randel Richner:       I’m sorry. To summarize very briefly the Intralign model that we haven’t really articulated yet, first is the analytics platform. The second is what’s called intelligent care design, which is the human factor of engineering, really looking at how the patient moves through the system and capturing sort of also some inefficiencies associated with that. The third element of this is the intraoperative first assist stafft that would be working with the hospital as well. And then, the analytics platform sort of wraps around all of this to capture those things along the way.

But the intelligent care design, this is looking at, you know, [00:18:12] can sometimes be overused but…

Scott Nelson:    Uh-huh.

Randel Richner:       …it’s that same kind of process of really looking at efficiencies of movement of patients, again, through the system, and where those are most easily impacted for change.

Scott Nelson:    Right. And I’d like you to go into those three kind of categories that you just mentioned…

Randel Richner:       Mm-hmm.

Scott Nelson:    …the advanced analytics, intelligent care design and kind of the surgical first assistant I think is what you call it. I want to get into that, but I love the idea, Lars, that you brought up, the tradeoff cost versus quality, because the bottom line is, in a sense, the entire American…everyone who considers or calls themselves an American citizen or lives in the United States most likely understands the fact that we’ve got a healthcare system that’s broken. It’s too, I mean, [laughs] everything costs way, way too much money, but at the same time, if you have a family member that gets sick or needs some sort of surgery or some sort of procedure, you don’t want quality to kind of take a second role or second place next to cost at that particular hospital, that particular clinic. So it’s a great point, and I love the fact that you brought that up.

And this provides a perfect transition to what you just mentioned, Randel, that if I’m a hospital, if you’re presenting to me at the hospital level, I understand, okay, we’ve got these issues, cost and quality, and we don’t want to make the tradeoff here at ABC Hospital, what do you suggest? And so help me, help the audience, understand those three different service lines that Intralign offers. And if you could provide an example of each of those, that’d be great.

Lars Thording: So, Scott, the most immediate impact that a hospital will see right now from Intralign’s services is what Randel mentioned before, namely, our surgical first assist program, our intraoperative support program. Through this program, we offer the hospital the ability to take the surgical first assist off their payroll, take them off the cost sheet.

Scott Nelson:    Okay.

Lars Thording: We’ll hire them on. We’ll train them. We’ll make them equipped to form better value within the intraoperative episode as Randel was illustrating before. And, I mean, the backdrop from this, and this is unfortunately not a very clean situation, is there are tons of different types of practices among hospitals depending on state, depending on what type of hospital in terms of how they’re using surgical first assist, but the bottom line is the surgical first assist is the surgeon’s right-hand helper during the intraoperative episode where clinical quality is ensured as well as where procurement decisions are made, utilization decisions are made.

So by inserting Intralign surgical first assist, there are four different types of effects that the hospital can experience immediately out of the gate today, and that is, number one, more consistent quality of the clinical support provided, because of highly-trained surgical first assists that come in and can deliver this quality at the same level every time. Number two is lower administrative hassle and cost for the hospitals because they no longer have those SFAs, those surgical first assists on staff. That is entirely our [00:21:46].

Number three is increased throughput. So we can actually document that using our surgical first assist reduces the time it takes to go through a surgery procedure in major joint, and that increased throughput [00:22:03] which is exactly what we were just talking about, namely, increased number of patients, how can you handle that with only so many resources. And then, finally, the fourth thing is more appropriate utilization decisions about implant type, size, disposables involved in the surgery and so forth. So those four things are the effects of utilizing Intralign surgical first assist, and it’s a very direct impact that our program offers.

The advanced analytics and intelligent care design solutions that we’re offering as well, as you will appreciate, Scott, this is a very new company so we’re still developing those resources, but what we know we can [00:22:46] act through the surgical first assist model is the ability for analytics to have the hospitals better understand how and why they’re using their resources so that they can go in and pinpoint this is where we can create improvements. And the intelligent care design model, as Randel was describing before, is essentially a matter of mapping out the intraoperative process at first, but eventually the entire episode of care for major joint and later on other things, to look at how do we optimize the process in terms of human interactions, interactions between humans and [00:23:2] develop that through the use of physical space and so forth.

Scott Nelson:    Got it. And so the surgical first assist, these are people in the operating room, are they nurses, medical assistants, physician’s assistants? Do they fall under a certain umbrella in terms of their licensure?

Lars Thording: They’re typically certified physician assistants, but they can have other educational and degree backgrounds as well, and some of them are physicians themselves.

Scott Nelson:    Okay.

Lars Thording: It’s a [00:23:55] function. So in the intraoperative space, you have the surgeon and you have the scrub techs, but you usually have the surgical first assist that plays a major role in assisting the surgeon clinically during the joint implant, but also in terms of everything else that goes into that process such as utilization decisions and so forth.

Scott Nelson:    Got it. Okay. And so from the hospital perspective they’re saying, “Okay, we’ve got existing staff on board already that’s in the OR with our surgeons doing these joint cases or helping with these joint cases,” why would they consider the Intralign surgical first assist? Is it because the Intralign surgical first assists—it’s kind of hard work to kind of say that three times in a row. I’m not sure I’d be able to do that. [Laughs]

Randel Richner:       Mm-hmm.

Scott Nelson:    Is it because the Intralign surgical first assists are so specialized and they understand intelligent care design, analytics, etc.?

Lars Thording: So, again, Scott, unfortunately, it gets a little bit complicated to discuss what the situation is at hospitals right now…

Scott Nelson:    Sure.

Lars Thording: …because some hospitals use these and a lot others use them less frequently. For some hospitals, it’s a matter of utilizing the surgeon’s physician assistant that that surgeon is also using in clinic and taking them with them into the surgery space, so they’re just not…

Scott Nelson:    Got it.

Lars Thording: They’re just not trained at the same level and utilized exclusively for the intraoperative space. So it’s a less specialized type of function. So what we’re trying to say is if you specialize this function, if you create the right level of education about things, then you get that higher and more consistent level of quality and you get the ability for the hospital to make sure that there are no inefficiencies created in that space.

Scott Nelson:    Okay. Okay.

Lars Thording: Make sense?

Scott Nelson:    Yeah. No, that does. So for example, if a hospital didn’t have or maybe it was someone inconsistent in regard to whether or not they included surgical first assist in their joint cases currently, they could consider bringing on the Intralign team in order to help establish whether…you know, maybe there are things that their surgeons are doing within the case that could be improved upon in terms of quality or maybe there are just different inefficiencies in the case that are leading to increased costs, that kind of thing? Am I going down the right path there?

Lars Thording: You are, and some of these things we’re still learning how to precisely deliver solutions on.

Scott Nelson:    Got it.

Lars Thording: What remains though, Scott, is that the surgeon is the one that needs to make the decision in these situations. So this is not about reducing the ability of the surgeon to make the right clinical choice in any given situation. That needs to reside with the surgeon. The surgical first assist though, while right now is a somewhat inconsistent player in that space, making consistent what that person can provide and also helping the surgeon, empowering the surgeon, if you will, in his or her decision-making, we think will create some major improvements.

Scott Nelson:    Gotcha. Okay. No, that makes sense. And then, Randel, you mentioned this earlier, and you did as well, the idea of intelligent care design in kind of tracking a patient through the system, is there something common that you see where there are a lot of inefficiencies at the hospital level or within the healthcare system in terms of kind of that idea of care design? I mean, do you see certain trends where a lot of hospitals are missing the mark or a lot of health systems are missing the mark?

Randel Richner:       Oh, I think everyone recognizes the way to look at process improvement in some sense within the hospital environment, and the fact that we’re narrowing our focus on one therapeutic area and one sort of category of patients moving through the system is going to clearly provide some obvious fixes in the systems…

Scott Nelson:    Mm-hmm.

Randel Richner:       …I think fairly rapidly. And the fact that we’re partnering with the hospitals that really this is not…again, going back to that old…in the beginning of the conversation about a consulting model, this is not that…we’re really going to be a service partner with them with ensuring the risk and being there with them over time. And I think, you know, Friday I was at a meeting with hospital finance people, and they were talking about how this one coding type of requirement was required in over…they tracked it to 37 different times for a two-day hospital stay where this had to be replicated over and over again was completely and utterly redundant.

Scott Nelson:    Hmm.

Randel Richner:       It’s a simple example, but looking even about how the history and physical is conducted, how that patient is then efficiently moved to the OR suite based on their clinical parameters and this kind of thing, is there some way to make that more efficiently happen.

Scott Nelson:    Mm-hmm.

Randel Richner:       And this is what these people are experts at that are part of our team. They’ve been doing this for many years in emergency rooms and looking at efficiencies there, and they are now applying all those skills to the orthopedic event in the hospital. And combined with the physician assistants and our analytics function, we’ll be able to talk to the patients on the patient level to get information on their satisfaction and outcomes as well as efficiently moving them through, and then having the physician assistant in the operative suite with the surgeon. So all that combined is a very attractive model to a hospital to look at how they can improve their services.

Scott Nelson:    Right, right. And it’s easy to use the word, you know, “partner with the hospital,” but in a sense, and without knowing a ton about Intralign, it really does seem like it’s very much a partnership sort of role, because it’s  not like you’re presenting this 30-some-odd page report on how to best, you know…

Randel Richner:       No.

Scott Nelson:    …reduce cost and improve quality, and then it’s like, “Here you go,” and you’re off to another hospital to help them try to do the same thing. There are definitely a lot of service lines where you’re actually playing an active role and seeing that throughput.

Randel Richner:       Right.

Lars Thording: And that’s the idea, Scott. No reports, no products, just solutions.

Randel Richner:       Mm-hmm.

Scott Nelson:    Sure. Yup. And so with your experience with Stryker Sustainability Solutions, you’ve in a sense been doing this for quite some time because, I mean, when did Stryker acquire Ascent?

Lars Thording: End of year 2009.

Scott Nelson:    Okay. And you helped build Ascent, correct?

Lars Thording: I did not help personally build Ascent. I was a part of the executive team for the last few years up to the acquisition by Stryker.

Scott Nelson:    Gotcha, but, I guess, my point being that you have a history of kind of doing this with Ascent and then Stryker and helping hospitals reduce costs.

Lars Thording: Our heritage, Scott, is exactly that…

Scott Nelson:    Mm-hmm.

Lars Thording: …which is what I was trying to get at at the beginning. We’re healthcare entrepreneurs that are looking at, how can we make healthcare function better by challenging some of the assumptions that are out there? And I think that just bringing that back to the med tech industry and others as well, this is a situation where nobody that plays a role in healthcare can get away with business as usual.

Scott Nelson:    Right.

Lars Thording: And I think the way that we’re seeing ourselves is as enablers of that particular development. But Randel and her team as well as the folks that are involved in intelligent care design and the surgical first assist folks are a part of this I think broader team now that they’ve joined together and saying, “Okay, how can we continue the track of really disrupting practices in healthcare and enabling hospitals and other key providers in terms of getting through the next step.” It goes for med tech companies as well.

Scott Nelson:    Mm-hmm.

Lars Thording: And you know this, Scott, better than anybody, that they also cannot survive with business as usual. They also have to, just like the surgeons are today, the orthopedic surgeons are going to have…they’re looking at themselves, they’re asking, “So, how am I going to do this in the future?” Hospitals are looking at, “Okay, we can’t keep doing things like we have. How are we changing things?” And med tech companies are facing the same kind of challenge.

Scott Nelson:    Yup. Yup, there’s no doubt. And I keep sort of repeating this, but I love the idea that what you guys are doing, it’s not just kind of fluffy…I think you guys have your…well, you’ve [laughs] got graduate work in your past…

Randel Richner:       [Laughs]

Scott Nelson:    …my point being that it’s not fluffy MBA type of stuff. It’s actually very practical, very tactical sort of things that you’re bringing to the table.

Randel Richner:       Yes.

Scott Nelson:    So, no, that’s great stuff. We talked about a lot, and in kind of reaching towards a conclusion here, one, is there something that we haven’t discussed that you’d like to cover? And then two, looking two, three, four, five years into the future, where do you see this going as quality becomes much more important in terms of hospitals getting paid and physicians getting paid? What do you see over the course of the next several years in healthcare?

Randel Richner:       Go ahead, Lars. Go ahead.

Lars Thording: No, you go, Randel.

Randel Richner:       No, I think to us…it’s the central time for us to be playing at the table together with our hospital and payer and physician partners, and the patients as well. I mean, so everybody play a part in what’s going to happen next. Things are being, you know, like 2014, there’s going to be a whole change in how, you know, required changes in data capture, we’re going to go through [00:34:31]. All kinds of things are going to be happening soon, and this is the time to finally make the right reforms that we need for delivery of care based on the right principles, which is about quality care and sharing risk to obtain a positive patient outcome. And for me this is very exciting, and I think we’re starting with orthopedics, but I think it’s very clear that we can replicate this model in other therapeutic areas starting with cardiology next too.

Scott Nelson:    Mm-hmm.

Randel Richner:       So everyone is going to have to play a part in thinking about how to deliver care more efficiently, and this is the time.

Scott Nelson:    Mm-hmm.

Randel Richner:       So, yeah, and go ahead, Lars.

Lars Thording: Well, it’s hard to after that but, Scott, is that within a two- to three-year timeframe, Intralign is going to become a major player as an enabler in this transitioning process that both hospitals and surgeons are going to have to go through. And I suspect that as med tech companies and group purchasing organizations and others also start taking steps towards real reform, we’re all going to be talking about how to enhance efficiencies and how to focus more appropriately on the quality of care as it happens while it’s being delivered that will become a vehicle for that discourse going forward and a big part of the solution.

Scott Nelson:    Right. Yeah, there’s no doubt that Intralign is at…it appears that that’s kind of the beginning of this wave here. And, I mean, it really comes to a point when you hear, you know, like Omar, the CEO of Medtronic, Omar Ishrak, I mean, he seems very, very vocal about Medtronic’s take on partnering with payers, for example, on medical device development, for example. I mean, that could be an idea worth exploring as well. But I love the fact that you’re so focused on not only just increasing efficiencies and reducing cost, but also helping to improve the quality of care as well.

So let’s go ahead and leave, I mean, if you have nothing else to add, we’re going to leave it at that. But for those listening that want to learn more about Intralign and what you folks bring to the table, where would you direct them?

Lars Thording: They should go to our website

Scott Nelson:    Gotcha. That’s I-N-T-R-A-L-I-G-N dot com, correct?

Lars Thording: Yes, correct.

Scott Nelson:    Got it. And this is kind of a side note, but for those listening that want…you two have incredibly impressive backgrounds. You’ve been involved with healthcare for such a long time. But for those listening that want to like maybe just get a better idea of…because most of my audience listening are people actively involved in the med tech/medical device world, but for those listening that want to get a better idea, maybe a little sampling of…want to learn more about healthcare, about, like you mentioned, intelligent care design, the idea of where a patient goes from beginning to end, that kind of thing, are there any resources that either of you would recommend?

Randel Richner:       Oh, geez. [Laughs]

Scott Nelson:    [Laughs]

Lars Thording: Specifically for intelligent care design, Scott, or…?

Scott Nelson:    No, just anything in general, you know, for those listening that… And the reason I ask that question is, you know, 10-plus years ago when I first got into the device space, resources or even just learning more about service offerings that a company like Intralign offers, that would have been extremely helpful to be, you know, as in a sales and marketing role within a medical device company, just learn more about what a hospital goes through and what the patient life cycle looks like within the healthcare system, that kind of thing. So I’m not sure if anything comes to mind, but just thought I’d throw that question out.

Lars Thording: Scott, I think the reason why we’re at a disadvantage here is that the pieces that we have put together to form this particular solution are at the forefront of what is being done in healthcare.

Scott Nelson:    Mm-hmm.

Lars Thording: So there are very few documented resource banks out there that can inform anybody specifically about combined human factor and Six Sigma development processes.

Scott Nelson:    Yup.

Lars Thording: We’re trying to look at a sector that is dissatisfied with solutions that they have been served up, and in terms of a resource bank, that’s what a resource bank will show you, right?

Scott Nelson:    Mm-hmm.

Lars Thording: Those things that have been provided for healthcare in the past. And so that’s why we’re a little bit at a disadvantage. I’d encourage anybody listening though to look at when you’re finding resources that speak about process improvement as well as utilization of analytics and support in the operating room, keep asking the same question, namely, are you getting substantial and sustainable results from this?

Scott Nelson:    Mm-hmm.

Lars Thording: In other words, stealing your words, Scott, is there any fluff in this, right?

Scott Nelson:    [Laughs] Yeah. Yeah.

Lars Thording: And assess your resources based on that.

Scott Nelson:    Got it.

Randel Richner:       But I have to say—I’m going to give a really, really wonkish answer. First, I think Health Affairs is sort of that bellwether of what everyone relies on in terms of a monthly publication or whatever that keeps you one step above of what the people that are managing the purse strings read every day and rely on. The other is HFMA is also very good, which is Healthcare Financing Management Association, that gives you the trends and issues associated with hospital management. But then, the last is the New York Times and the Wall Street Journal.

Scott Nelson:    [Laughs]

Randel Richner:       [Laughs] You know, just reading and pulling it all together and constantly thinking about where things are moving. I mean, that’s what it is…

Scott Nelson:    Yeah.

Randel Richner:       …and those are the places I rely on all the time.

Scott Nelson:    And what was the first one you mentioned, Randel?

Randel Richner:       Health Affairs.

Scott Nelson:    Oh, Health Affairs. Got it. I thought you said Health Fairs. Health Affairs, got it.

Randel Richner:       Oops. [Laughs] No.

Scott Nelson:    Got it. Cool. No, that’s good stuff.

Randel Richner:       Yeah.

Scott Nelson:    And Lars, to your point, I mean it speaks to the idea that Intralign and you guys are, like I said before, kind of on the front side of this wave, because of the fact that there isn’t really a whole lot of data. Maybe that’s an idea for you guys to have like a resource bank of case studies as Intralign grows…

Randel Richner:       Yeah.

Scott Nelson:    …you know, down the road.

Randel Richner:       Yeah.

Scott Nelson:    I imagine that you’d have some pretty remarkable case studies put together. But let’s go ahead and end it there. I can’t thank you enough for coming on, and for those listening that didn’t catch it the first time,, I-N-T-R-A-LI-G-N dot com. You can go learn more about this young company that’s doing some interesting things in the world of healthcare. Lars and Randel, thanks again for coming on. Really appreciate it.

Lars Thording: Thank you, Scott.

Randel Richner:       Thank you.

Scott Nelson:    And I’ll have you hold on the line there, but that’s it for now, folks. And again, if you’ve stuck with this the whole way, remember that you can catch all of these Medsider interviews on iTunes as well or Stitcher Radio. Just do a search for Medsider and those two options will come up. So, anyway, thanks so much for your listening attention. Until the next episode of Medsider, everyone. Take care.

[End of Recording]

More About Lars and Randel

Substantial and Sustainable - Medical Device - Lars Thording

Lars Thording is the VP of Marketing & Public Affairs for Intralign. Prior to Intralign, Lars led Marketing and PR for Stryker Sustainability Solutions (formerly Ascent) and served on the executive leadership team as well as on Stryker’s worldwide Marketing Council. While with Ascent and Stryker, Lars introduced an aggressive re-positioning plan and executed novel marketing and PR strategies that allowed Ascent/Stryker to achieve and maintain an uncontested industry leadership position. Lars also served as a member of the board at AMDR (Association of Medical Device Manufacturers).

Born in Denmark, Lars initially pursued an academic career, teaching at universities in Denmark, Ireland and the United States. After more than ten years in academia, Lars became a branding consultant helping large pharmaceutical companies position and launch blockbuster brands. Since 2008, Lars has served as a marketing and PR executive. Lars has undergraduate degrees in Theology, Education and Marketing; a Masters degree in International Commerce; and a Ph.D. in Marketing.

Substantial and Sustainable - Medical Device - Randel Richner

Randel Richner is the Executive VP of Advanced Analytics for Intralign. Richner has over 20 years experience working in health policy, reimbursement, economics, and data analytics for technology companies and providers. In 2006 Richner founded Neocure Group, a consulting firm specializing in reimbursement and healthcare data analytics. Prior to founding the Neocure Group, Richner was VP of Global Government Affairs, Reimbursement and Outcomes Planning for Boston Scientific Corporation.

Richner served a four-year term as the first industry representative to the Executive Committee of the Medicare Coverage Advisory Committee (MCAC), contributing to the development of national coverage and MCAC process guidelines. Richner continues to serve on the Executive Advisory Board to the Dean of the University of Michigan’s School of Public Health. Richner has a master’s degree in public health policy and administration from the University of Michigan. Prior to her current career, Richner was a practicing dialysis and transplant nurse for 12 years at the University of Michigan Hospital and Northern Michigan Hospital.

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