Medec pulse winter 2014

MEDEC PULSE | SPECIAL EDITION 1

MEDEC’s Plan for Success

Smashing the Silos

Reuse and Reprocessing of Single-use Medical Devices

MEDEC.ORG

Ontario Health Innovation Council Announced

PULSESPECIAL EDITION

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PULSE

04 President’s Message

05 Ontario Health Innovation Council Announced

07 MEDEC’s Plan for Success

09 Achieving Success in a Time of Transformation – How to Present Value in a Changing Environment

13 2014 Mercer Life Sciences Survey Communications

14 Smashing the Silos

17 Procurement in Quebec

18 Reuse and Reprocessing of Single-use Medical Devices

22 New Member Welcome

23 Index of Advertisers

MEDEC.ORG

05 14

Contents

SPECIAL EDITION

All rights reserved. The contents of this publication may not be reproduced by any means, in whole or in part, without the prior written consent of the association.

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Toronto, Ontario M9C 5J1Publication Mail Agreement #40787580

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4 MEDEC PULSE | SPECIAL EDITION

PRESIDENT’S MESSAGE

The pages of this issue are overflowing with industry news and events, and even a welcome to all of our new members. Smashing the Silos focuses on a workshop organized by Industry Canada and designed through a partnership with MEDEC, to be a starting point to explore opportunities to remove unnecessary barriers to the procurement of medical devices.

MEDEC’s Plan for Success explains MEDEC’s strategic framework and how we plan on championing a more efficient and sustainable Canadian

health care system; to strengthen the pre-existing bonds between innovators and organizations and create some palpable results.

2013 was a great one for MEDEC. Of course, there were challenges, but we also had many successes, one of the biggest being the conception of the Ontario Health Innovation Council (OHIC). Created to improve the sustainability of Ontario’s health care system, increase the quality of patient care and stimulate innovation and entrepreneurship within the province,

we feel that OHIC is a definite step in the right direction.

We hope that you enjoy this special edition of Pulse. This year holds many more great achievements for MEDEC and we hope to have your support as we continue on our journey to improve healthcare for across Canada.

Brian Lewis

President and CEO

Brian LewisPresident

Welcome to this special edition of Pulse!


Brian Lewis President & CEO

Klaus Stitz Vice President, Regulatory Affairs

Nicole DeKort Vice President, Government Affairs, Ontario and Federal

Benoit Larose Vice President, Quebec

Iris Crawford Vice President, Finance & Operations

Debbie Gates Manager, Events & Education

Natasha Alves Administrative Coordinator

Robert (Bob) Rauscher Vice President, Western Canada

Gerry Frenette Executive Director. Public and Member Relations

405 The West Mall, Suite 900 Toronto, Ontario M9C 5J1

416.620.1915 1.866.58.MEDEC

www.medec.org

MEDEC Staff


This past fall, the Ontario government announced the creation of the Ontario Health Innovation Council (OHIC) – an exciting initiative that has the capacity to transform the way that the medtech sector operates in the province.

OHIC which is led by the Hon. Deb Matthews, Minister of Health and Long-Term Care, and the Hon. Reza Moridi, Minister of Research and Innovation, seeks to study sector innovation in order to grow Ontario’s world-renowned medical technology industry and to help bring new health care products to market in partnership with the province’s health care system.

OHIC’s Terms of Reference state that the “council’s specific focus is to consider how Ontario can:

1) Facilitate technological innovations that promote health and well-being, improve access to health and health services, and deliver effective, efficient, quality care;

2) Strategically find ways to use the purchasing power of the province and broader public sector to accelerate the growth of the health technology sector; and

3) Expand the adoption of innovative new technologies more broadly across the health care sector (e.g., including hospitals, but also in-home and long-term care settings).”

The government has directed the council to deliver a final report by late 2014 and that it should provide evidence-based strategic advice on how the above objectives can be achieved.

MEDEC enthusiastically supports this initiative and it more than satisfies the recommendations that we put forward in our pre-budget submission to the Ontario government in March, 2013. Brian Lewis, President and CEO of MEDEC said “With the announcement of this council, the Wynne Government has recognized that medical technology

companies are key partners in delivering better patient care, while creating new jobs and contributing to a more sustainable healthcare system”.

We are also pleased that our board chair - Peter Robertson (Vice President and General Manager, GE Healthcare) and executive board member, Neil Fraser (President, Medtronic of Canada Ltd.) have been appointed to OHIC’s advisory board. “This is an incredible opportunity for us to work together with clinical partners, academia and government to provide a framework on how the system can better adopt innovative solutions” said Robertson. Mr. Fraser added, “When we embrace innovation as collaborative partners, we increase the likelihood that Ontarians can gain more timely access to the best medical technologies available. The true promise of innovation lies in simultaneously increasing the quality of patient care, while lowering the total cost of each patient’s journey through the healthcare system.”

COVER

With the objective of advancing the province’s already world-renowned health sector

Ontario Health Innovation Council Announced


Since OHIC officially convened, MEDEC staff have already taken the opportunity to present to its advisory board, showcasing the opportunities that exist to better leverage the province’s innovative medtech industry in order to improve patient outcomes, make the health care system more sustainable and improve the economy. One of the key messages delivered to the council was that in order to capitalize on these opportunities, we need to better adopt new medical technologies that have been created in Ontario and we need to make these adoption processes faster and easier to navigate.

MEDEC members will have an exclusive opportunity to provide input to both MEDEC representatives who serve on OHIC (Peter Roberston and Neil Fraser). There will be an open discussion and feedback session with Mr. Fraser as part of MEDEC’s “Supporting Canadian Innovation” initative, taking place at the MEDEC Learning Centre in Toronto on February 28th from 1:00-2:30pm. There are only 30 spots available for the session, so register soon because it will fill up quickly! To register, please contact Debbie Gates at (416) 641.2747 or [email protected]. Both Peter Robertson & Neil Fraser will also be presenting an information and Q&A session at the MEDEC medtech conference in April. For more information about these and many other upcoming MEDEC events, please visit medec.org/content/events.

Further information about OHIC can be found at ohic.ca.

“This is an incredible opportunity for us to work together with clinical partners, academia and

government to provide a framework on how the system can better adopt innovative solutions”

– Peter Robertson, Vice President and General Manager, GE Healthcare


MEDEC is on a mission. Its goal: to champion a more efficient and sustainable Canadian healthcare system by strengthening the bonds between Canada’s medical technology innovators and the healthcare facilities and

organizations in which they serve; as well as the governments who fund Canada’s healthcare systems.

“What we are really aiming to do is collaborate with our stakeholders in a way that adds continued value, and in a way that builds genuine, lasting partnership,” says Brian Lewis, MEDEC president and CEO. “We want our members’ products and services to be used, however we realize the current healthcare system is under stress. The question is then, ‘How do we partner and work with people in order to make sure we have a sustainable system enabled by the optimal use of medical technologies?’”

The answer is MEDEC’s strategic framework; an operational blueprint designed to position the association as the united voice for Canada’s medical technology (aka Medtech) sector. Formalized by MEDEC’s executive team and its Board of Directors in the fall of 2013, the framework is divided into four “strategic pillars” that have been deemed essential to MEDEC’s mission. They include: Demonstrating the Value of Technology, Supporting Canadian Innovation, Promoting Strategic Procurement, and Serving as a Thought Leader on Both Canadian and Global Issues.

Combined, these pillars serve as operational guideposts for MEDEC as it works to enhance the quality of patient care for Canadian citizens by improving access to vital medical technologies, driving the growth of the Medtech industry, and contributing to the betterment and continued sustainability of Canada’s publicly-funded healthcare system.

Demonstrating the Value of TechnologyWhile all four pillars are essential to MEDEC’s success, demonstrating the value of new and emerging medical technologies to stakeholders remains the most critical, be they provincial or federal government departments, local municipalities, MEDEC member companies, hospital associations, physician and clinician groups, and other decision makers.

This pillar is especially vital in today’s marketplace wherein GPOs (group purchasing organizations) and SSOs (shared-service organizations) are focusing far less on purchasing practices that acknowledge the long-term value of medical technologies, and instead utilize procurement practices that drive operational costs down, thereby contributing to the commoditization of medical devices.

“This has always been a huge issue for MEDEC,” insists Lewis. “The current healthcare system is based so much on purchase price minimization that it doesn’t focus sufficiently enough on the broader health outcome and impact on treatment costs. Therefore, what we need to do is to demonstrate the value that’s brought to patients, and the overall impact on the system, through medical technology.”

With this in mind, MEDEC is committed to promoting the value of medical technologies amongst its stakeholders through numerous objectives – all of which aim to enhance patients’ access to medical technologies by educating stakeholders on how medical technologies contribute to healthcare sustainability. These objectives include, but are not limited to, developing and distributing Medtech publications that aim to quantify the value of various medical technologies; working with government to adopt timely, transparent and comprehensive Health Technology Assessments processes; and outfitting MEDEC members with the tools and techniques to endorse their technologies to key stakeholders.

Supporting Canadian Innovation

Promoting the value of medical technology ranks high on MEDEC’s agenda. Similarly, so too does driving growth within the industry itself, and shining a spotlight on the ideas and leaders within it. As such, MEDEC’s second strategic pillar, Supporting Canadian Innovation, seeks to increase MEDEC’s ability to proactively influence stakeholders by broadening its “footprint” within the industry and forging stronger connections within the SME (small and medium enterprises) sector.

MEDEC is well positioned to serve as a mentor to SMEs and, in turn, influence the commercialization of Canadian medical technologies. Its growing menu of services include mentorship programs between SMEs and MNEs (multinational enterprises), value offerings on essential services, and numerous SME training and educational programs.

In addition to bolstering collaborations with SMEs, MEDEC plans to further support the commercialization of Canadian technologies by building upon its core capabilities, which include:

• Advocacy: working with all stakeholders – including MNEs – to increase exposure to Medtech innovations and highlight the benefits of Canadian medical technologies;

• Education: providing industry training, mentorship, and guidance to both SMEs and healthcare stakeholders;

STRATEGIC PLAN

SuccessMEDEC’s Plan for

By Matt Bradford


• Regulatory stewardship: working with government representatives and bodies at all levels to improve the regulatory landscape and enhance the industry’s global competitiveness; and

• Relationship building: developing “partnership” strategy and guidelines for working with targeted regional Life Sciences associations (i.e. British Columbia, Alberta, Atlantic, etc.) to bring value to a broader audience of SMEs.

Promoting Strategic ProcurementOne of the chief roadblocks to demonstrating the value of medical technology and supporting Canadian innovation is the current procurement system in Canada. Today’s approach to controlling costs is driven by a system wherein new technologies are largely regarded as added expenses as opposed to investments that can pay off in better care and operational savings down the road.

This in mind, MEDEC’s long-term objective is to work positively and proactively with GPOs, SSOs, and relevant government departments to re-define procurement policies to better allow the Medtech industry to communicate the benefits of today’s medical devices to top-level decision makers.

To date, the association has made significant strides in promoting strategic procurement by working with various ministries and provincial groups to:

• Leverage “burning platforms” in Ontario and Alberta to better position MEDEC as a strategic partner and influence future emerging practices;

• rationalize vendor credentialing;

• address concerns about the implementation practices in Canada as we move to global bar coding standards;

• address violations of USA Foreign Corrupt Practices Act; and

• influence the standardization of optimized RFP terms, conditions and process.

Serving as a Thought Leader – on Both Canadian and Global IssuesRounding out MEDEC’s strategic framework is Serving as a Thought Leader; a two-tiered pillar which seeks to make MEDEC both a thought leader amongst its industry partners and enhance Canada’s medical technology stakeholders’ ability to compete on a global scale.

The primary objective of this approach concerns the association’s aim to leverage all of its strategic objectives as means to build better collaboration between our industry, the government and other health partners. This encompasses the association’s participation in regulatory, federal affairs and policy table committees; as well as its ongoing efforts to develop and distribute Medtech industry awareness materials.

MEDEC’s secondary objective is to increase Canada’s global competitiveness, which it will achieve by addressing key issues and items, including:

• Global regulatory harmonization;

• Optimal regulatory processes;

• Interacting with the global device association community (trade, VOT, etc);

• Global data harmonization (UDI, GDSN, etc.);

• Credentialing standards; and

• The adoption of innovation.

Walking the walkWith progress being made across a number of fronts, MEDEC is on track to see its strategic framework produce tangible results, both for its members and their healthcare collaborators.

Moving forward, Lewis says MEDEC is committed to building stronger relationships within the healthcare community, while positioning MEDEC members as knowledgeable and trusted partners in the Canadian healthcare system.

“We want to act in a way that shows more people in government and hospital stakeholders that MEDEC is in alignment with their goals of creating a sustainable, high quality healthcare system for Canadians. We’ve got things to offer that will create better, long-term health outcomes for Canadian patients and save the healthcare system money,” he says, adding, “We just need to be at the table. We’ve made great strides in the last year and look forward to building on our success and progress.”

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Each year thousands of new medical technologies are approved for use in Canada. In 2012, 4,825 successfully achieved licensing. While the majority are incremental innovations that support healthcare providers in

delivering routine care, some are radically new leaps in science with disruptive potential. Collectively, they enable healthcare providers to treat new illnesses, add valuable quality years to

Achieving Success in a Time of Transformation – How to Present Value in a Changing Environment

INDUSTRY CHALLENGE

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Figure 1. Healthcare Spending in Canada reached $211B in 2013 and is growing 5.4% per annum

life, improve the quality of healthcare being delivered, streamline pathways and processes, and reduce health system spending.

For the past decade, these technologies have entered a market that is struggling to make them accessible to patients and providers.

By Kaveh Katebian, Beaconsfield Group

The Canadian Medical Technology Industry Is Being Challenged

Total spending on healthcare in Canada reached $211B in 2013. The public sector financed 70 per cent of all spending and the healthcare sector accounted for 11.3 per cent of the national GDP. Among the 15 comparable OECD nations that comprise our benchmark index, Canada had the eighth highest rate of both public and total healthcare expenditures per capita, falling from a peak of second in the early 1990s.

Accordingly, much of the recent debate surrounding health system sustainability in Canada has focused on the marked reduction in spending growth after a long period of rapid increases. Average annual growth in total and public health expenditures in Canada slowed to 2.6 per cent and 2.5 per cent in 2012-13 after averaging 7.0 per cent and 6.9 per cent over 1997-2010.


Many analysts have credited high profile transformations including funding reform, primary care restructuring, efficiency initiatives in Canadian hospitals, and group purchasing of drugs and supplies for putting Canada’s provincial health systems on the path to sustainability, but their optimism may be premature.

This is not the first time that annual growth in healthcare expenditures declined dramatically after a long period of sustained growth. The recent decline is consistent with a general fiscal tightening by the Federal government and provincial health system administrators after the challenging economic recession of 2008-10, as was the case with the dramatic reduction in expenditure growth of the early 1990s.

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Spending by provinces could triple without radical change

Figure 3. Public Sector Healthcare Spending in Canada Could Reach $542B in 2033 if Growth Returns to Historical Levels

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Follows public spending cycles closely

Growth Trends

5.4% avg. growth over 1990-2013

Recession

Figure 2. Spending has Grown 5.4% Annually Since 1990 and is at a Cyclical Low

Regardless of whether or not spending will resume, the combination of short-term cost reduction strategies (finding and implementing opportunities to reduce spending immediately) and long-term transformative efforts (restructuring healthcare

delivery to improve value for money) undertaken by health system administrators have permanently altered the balance of power in the healthcare sector.


Both strategies have increased the influence of administrators in medical technology selection and purchasing, and both strategies have pressured the medical technology industry to communicate

the value of their technologies to administrators in terms relevant to healthcare systems or else, face indiscriminate and misguided price pressures.

Alignment with Cost Cutting

Strategy

Best Suited Products and

Services

Critical Competencies

Pricing and Marketing Tactics

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Mature products and services without meaningful differentiation

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Push for long-term contracts with price-centric RFPs

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Value-based pricing

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Price below system value

Key opinion leaders

Executive sponsorship

Push for value-based RFPs with short cycles

Figure 5. Medical Technologies Can Respond to Pressures by Competing on Price or Value but Not Both

Short-term Wins

1

Long-term Transformations

Goals

Go after “ low-hanging fruit” (low-cost, low-reward initiatives that generate immediate savings)

“ Bend the cost curve” (high-cost, high-reward opportunities that reorganize care around the patient, focus on chronic conditions)

Primary Strategies

Cost-cutting (reduce input prices for “ commodities” and routine treatment interactions)

Integration and coordination of providers (capitalize on economies of scope and scale)

2

Real-World Examples

Recent labor negotiations

GPO/SSOs

HBAM

Patient-based Payments

eHealth

Rise of Home Care

Health Links

Some Common Tactics

Seek economies of scale

Leverage bargaining power

Reduce access

Diversification

Clinical benchmarking

Standardized clinical pathways

Value-based procurement and pricing

State of Mind

Deliver care at lower costs within current provider focused, interaction based system (reduce costs of acute episodes)

Find new ways of delivering care that are centered on the patient and focused on keeping them healthy (manage chronic conditions efficiently)

Figure 4. Administrators are Pursuing Two Sets of Strategies for Health System Sustainability

CANADIAN EXPERIENCES WITH HTA AND VALUE-BASED SALESTo-date, the process of selling technologies on the basis of value has been complex and convoluted. Typically, medical technology firms competing on value in Canada have relied on one of two strategies: Health Technology Assessments (HTAs) and direct-to-clinician-collateral. Neither strategy has generated consistent success.

HTA in CanadaWhile there is a bourgeoning HTA industry in Canada with a mix of government (e.g., CADTH, OHTAC, IHE, INESS, HTR), academic (e.g., THETA, PATH) and hospital-based organizations (e.g., CLEAR) trying to better understand the real-world health economic consequences of adopting new medical technologies, the sector is plagued by many issues including:


• Excessive time to completion;

• Lack of consistency in defining and quantifying value;

• Lack of portability across jurisdictions or provider networks; and

• Weak adoption mandates.

As a result, medical technology firms in Canada have struggled with what should be a straightforward process: demonstrating

that new innovations are aligned to the needs and wants of health system administrators. This has resulted in:

• Long delays between approval and first sale;

• Negative reaction towards technologies due to analytical deficiencies with an HTA review; and

• Lack of recognition of value by buyers after supportive evidence has been generated.

Selling Value to CliniciansAnother common strategy, selling value to clinicians, is mired in its own challenges, stemming from the diminishing role that clinicians play in technology selection in Canada. Increasingly, Canada’s physicians are being consulted as stakeholders external to market access and procurement decisions, but the days when they played an integral role are long gone.

Modern value-based sales approaches need to reflect this shift. It is not enough to hand physicians papers and simple calculators that talk about value and expect them to manage internal advocacy.

TOWARDS A VALUE-BASED SALES MODEL FOR CANADAWhile we have witnessed many value-based approaches to market access and sales that failed or struggled, we have had the good fortune of being part of some highly successful efforts with critical lessons for the entire industry.

1. Organizational Commitment Required. Selling medical technologies on the basis of the value that they provide to healthcare systems is a fundamentally new way of doing business and not a fad. To be successful, firms must commit to new approaches to the market, rather than just adopting new gimmicks or tactics within existing sales models. Successful firms use value-based approaches to drive strategy.

2. There is No One Size Fits All Solution. Some technologies do not generate meaningful value and should be sold on the basis of price. Some technologies do not benefit patients, but do reduce costs. Other technologies do not reduce costs but dramatically

improve quality of life. There is no single way of capturing, quantifying or communicating value. Successful organizations develop sophisticated strategies that map the value of their technology against the stakeholders it impacts to identify who benefits, who loses and how. They formulate asks. They identify those with power to affect change and those that can influence it. They identify the evidence that these stakeholders need to deliver on their asks.

3. Do Not Over-Rely on Existing HTA Channels. As HTA organizations evolve, they are increasingly becoming validators rather than producers of evidence. Successful organizations create their own evidence as part of sophisticated value-based strategies. HTAs are used for trusted third-party validation.

4. Keep Brand Out of It. When engaging potential customers, focus the conversation on the issues. Specifically, talk about the problem being solved and the features of the technology that benefit the system. Selling value is bigger than brand. Focusing the conversation on the practical implications of technological features is a critical differentiator of successful firms.

5. Be Patient. Value-based purchasing is just as new of a concept to buyers as value-based sales is to the medical technology industry. Many value-based approaches will likely fail in the near term due to execution failures, and others still due to a failure on the buy-side to properly account for value in the purchasing decision. The long-term trend is clear though: value-based sales is here to stay. In the near term, organizations should take lessons from the failures and use that to improve the way they approach value-based competition over the medium- and long-terms.

Government/Payor

Agencies

Healthcare Providers

Physicians

Patients

Administrative Players are Moving from Passive to Active

Vocal steward

Thought leaders

Expert staff

Active consumers

Idle payor

Clinical experts

System gatekeepers

Passive recipients

Access points Quality managers

Influence in Technology Selection is Evolving

Traditional Vendor Focus

Illustrative Examples

HSSBC ICD/CRT Procurement

New HPV Guidelines

OMA Negotiations

Ontario Lab Review

Premium Wound Care Products

Low Medium Purchaser

Figure 6. Value-based Market Access Can Only Succeed in an Organization that Shifts Focus to Payors and Providers


How can I retain key talent with a limited

merit budget?

Do some sales roles command a premium based on what type of product they sell?

Get answers to these questions and more with compensation data from the 2014 Mercer Life Sciences Compensation Survey – Medical Devices Report (MEDEC)!

MEDEC and Mercer (Canada) partner to deliver the Mercer Life Sciences (MLS) Compensation Survey as a valuable resource providing companies with need-to-know information about compensation practices in the medical device industry.

The survey covers a broad selection of benchmark positions relevant to the medical devices industry ranging across pre-clinical and clinical research, engineering, medical affairs, sales, marketing, production and administration, as well as the full range of general infrastructure/support functions.

This survey is accepting data submissions from February 12 through April 18. You are invited to download the 2014 participation materials at imercer.ca/camls. Former MEDEC survey participants will receive an email from Mercer with a pre-populated questionnaire, making the year-over-year submission process even easier.

Join us on March 19 for an overview of the participation process including highlights of MLS, job matching, data submission, and input verification. Register now for this training webcast at imercer.ca/events.

MEDEC Survey Highlights:• Enhanced data levels and an expanded participant base.

The 2013 Mercer Life Sciences - Medical Devices Report (MEDEC) reported 185 benchmark jobs based on data from over 6,000 incumbents representing 38 participating organizations, a 38% increase over 2012.

• Additional benchmark positions that align with your organization structure. Over 50 new life sciences jobs added to the 2014 survey catalogue bringing total industry specific jobs to more than 400 in addition to over 500 general industry jobs.

• The ability to look at sales data in a more refined manner. Sales jobs defined by both sales channel and product line (capital equipment, durable goods, consumables/disposables, and implantable devices) for additional insight and analytics.

• Multiple purchase options. Buy only medical devices data or data from across life sciences (medical devices, pharmaceutical, biotechnology, and related areas) with the ability to refine the market by multiple characteristics.

Exclusive offers for MEDEC members:

• A $500 discount when MLS purchase is bundled with Mercer MBD or EMP general industry surveys.

• FREE access to Mercer Compensation Policies and Practices Survey - Standard Report, upon participating in the biennial survey.

Visit imercer.ca/camls for full survey details including, data fields collected, benchmark position coverage, data analysis options, current participant list, survey pricing and schedule.

The survey results will be released in late September, and are only available to participants, so don’t miss your opportunity to be part of the 2014 Mercer Life Sciences Survey. If you have questions regarding the survey or the participation materials, please call a Mercer Representative at 800 333 3070.

2014 Mercer Life Sciences Survey Communications

MERCER SURVEY


INDUSTRY CANADA

Smashing the SilosWorkshop a step forward in getting government, industry and medical profession to talk about procurement

While the average person uses Canada’s fine medical system, they rarely give a second thought to how all the

equipment and supplies come together to provide the healthcare that they need.

Medical device procurement is a complicated issue, with many actors involved in the process.

On October 24, 2013, a workshop organized by Industry Canada, in partnership with MEDEC, set out to start a dialogue with a goal to explore opportunities to remove unnecessary barriers to the procurement of medical devices. To this end, the involved stakeholders were invited, and they included industry representatives, representatives of industry associations, the healthcare system, group purchasing and shared services organizations, as well as federal and Ontario ministries. The detailed objectives of this workshop were to review and discuss issues identified in an Industry Canada-commissioned research paper; develop a preliminary action plan for addressing identified key procurement challenges at the provincial level; and to come to agreement on priority actions over the next six months

By Nestor Gula

to ensure that Canadian patients and the healthcare system derive maximum benefits from advances in medical device technologies.

After a welcome address by Tim Karlsson, director, Emerging Technologies Directorate, Industry Canada, the facilitator of the workshop, Dorothy Strachan, said that there has been a lot of talk and a significant amount of examination of the situation concerning the procurement of medical devices. “Our purpose today is to set the table for action planning in the morning and then follow through on it in the afternoon,” she said. “We did not want to get together today just to update people. We want to make steps forward in a concrete way. We are really looking with respect to the outlook in six months and practical things that can be done in a collaborative way with all the stakeholders at the table.”

The assembled participants then heard a presentation from Dr. Rick Audas, associate professor of health statistics and economics in the faculty of medicine at Newfoundland’s Memorial University. He gave a brief outline of a paper he co-authored with Miranda V. Polgar, from the faculty of medicine, Memorial University

titled, “Has the Pendulum Swung too far? The Impact of Group Purchasing Organizations (GPOs) and Shared Services Organizations (SSOs) on Small and Medium Enterprises (SMEs) in the Medical Device Industry.”

In his summary, he stated that current procurement pro cesses can be unnecessarily bureau cratic and cumbersome, while the length of contracts tend to be too long in duration (which can deter the entry of new innovations). He also said that another issue facing SMEs is that contracts often call for products to be bundled together, which tend to often favour firms with broader product lines. This restricts access to end users and can potentially stifle innovation.

Dr. Audas went on to say that under the current system, there is no advantage to being a Canadian firm and that this should be examined in order to give Canadian companies an enhanced opportunity to enter into the Canadian market.

Following this Allen Paul, manager, Life Science Programs in the Ontario, Ministry of Economic Development, Trade and Employment, and Ministry of Research


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and Innovation, gave the assembled an account of the landscape in Ontario, and provincial government initiatives.

Next was a panel presentation titled, “Perspectives on Procurement,” where Jenefer Barnes, vice-president, Canadian Sales and Marketing, Southmedic Inc.; Liana Scott, vice-president, Members Support, HealthPRO; and David Yundt, president and CEO, PLEXXUS, gave their opinions on medical device procurement from the perspectives of three of the stakeholder groups – SMEs, GPOs and SSOs, respectively.

The workshop then broke into several groups and each were assigned a specific issue to discuss. They were also asked to come up with realistic and achievable suggestions to address their issue that would improve the medical device procurement system in Canada. The intensity of the working groups was evident and the discussions carried on throughout lunch and during the session breaks.

To conclude the workshop, the groups presented their action plans and in his closing remarks, Brian Lewis, President and CEO of MEDEC, thanked everyone for their hard work and dedication, noting that the real work is just starting now.

Attendees were impressed by the workshop and thought that it was productive. Sara Friesen, CEO and general manager of the Central Ontario Healthcare Procurement Alliance (COHPA) said, “It was very important (in) that it brought together the three stakeholder groups to have

Brian Lewis, President and CEO of MEDEC, addressing workshop participants.


some productive dialogue as opposed to all of us operating in our silos... it was very interesting for me to hear their perspectives.” she said. “What I think is very important is that we continue the dialogue and that we actually do effect the change that we talked about in terms of how we approach the procurement of innovative technologies.”

Friesen was enthusiastic about having further workshops, “As long as they are productive and there are some very tangible take-aways,” she said. “I

enjoyed the workshop and thought that it was productive in terms of establishing outcomes – potential outcomes, as long as everybody keeps their eye on the focus and we actually do deliver against those potential outcomes.”

Jenefer Barnes, vice-president, Canadian Sales and Marketing for Southmedic Inc., stated that she is looking forward to participating in the 6 month actions once the report comes out.

MEDEC would like to thank all of the participants at the workshop, its

presenters and panelists, and give special thanks to Industry Canada – and in particular to Brad Feasey (who at the time of the workshop served in the role of Senior Sector Analyst for Medical Technologies at Industry Canada) – for all of their hard work and partnership organizing the event. MEDEC looks forward to continuing to work with our partners in government and industry in moving forward with positive change and initiatives related to the medical technology community.

There is currently no advantage to being a Canadian firm, and that should be examined in

order to give Canadian companies an enhanced opportunity to enter into the Canadian market.


Through the activities of the very busy Quebec Procurement Committee, MEDEC strives to deal with these priorities by working closely with its partners at all levels of Quebec’s healthcare system and the Treasury Board. This is not an easy task because despite a strong push towards decision centralization, the multiplicity of organizations involved, each with varying degree of influence, adds to the complexity.

MEDEC has recently been able to open a direct channel with the Treasury Board, the government body responsible for

the province’s procurement legislation and related regulations. Concerns about new rules like the automatic rejection of tenders containing alternate proposals for line items were discussed and we will insist on following up.

An interesting provision in the new National Policy on Research and Innovation (PNRI) calls out the role of public markets (i.e. healthcare network RFPs) to encourage innovation. MEDEC will take every opportunity to leverage that element of the policy to push its strategic procurement agenda forward.

I cannot emphasize enough that in order to make MEDEC truly effective in its actions, members need to voice their concerns and take part in the action plan to address them. The work of the Quebec Procurement Committee has a very tangible impact on both the short-term and long-term business of our members, and is also a great forum to learn about the latest industry trends. If your company does business in Quebec - in any significant manner, you should delegate a participant to its Procurement Committee.

The procurement landscape in Canada is evolving constantly and Quebec is no exception. MEDEC is investing a lot of energy to remain involved in all aspects of procurement issues in the province. Here are the highlights of MEDEC’s priorities in this critical industry challenge.

Procurement in QuebecNavigating on choppy waters

CHOPPY WATERS

By Benoît Larose

Changes in procurement policies and practices

GPO mergersVolume consolidationRFPs and contract templates revisionVendor credentialing and access managementPayment delaysManagement of rebates and value adds in GPO-lead RFPsInadequate changes in procurement regulations

Logistics improvement initiatives Regional centralized distribution projectsMandatory EDI adoption

Diagnostic imaging equipment terms and conditions

Dealing with unusual RFP requirements

Increase of the legislative burden Confusion around the application of the Lobbying ActEventual application of the Integrity Act

Lack of interest for Strategic Procurement

Change the focus from cost minimization to value maximizationUrge the Ministry of Health to assume its role in innovation and economic development


In an effort to save money and reduce medical waste, Canadian hospitals are reusing medical devices that are licensed by Health Canada to be used only once or on a single patient during a single procedure.

There are no regulations in Canada regarding this practice, raising concerns about patient safety and legitimate questions regarding legal liability.

This practice is widespread. The Canadian Agency for Drugs and Technologies in Health (CADTH) reported that 28 per cent of hospitals in Canada and 42 per cent of hospitals with over 250 beds were reprocessing single-use devices (SUDs) either in-house or by a third-party reprocessor.

The case for Canadian regulationsIt has been almost 10 years since the Auditor General of Canada recommended that Health Canada take action, such as regulating the reprocessing of single-use devices, to manage the health and safety risks related to the reuse of single-use medical devices.

Health Canada has concluded that the Food and Drugs Act, from which the Medical Device Regulations derive their authority, is not intended to apply to the use of a device after its sale, therefore Health Canada doesn’t have the authority to regulate reuse.

According to Canada’s Medical Device Regulations, a manufacturer is defined as a person who sells a medical device under their own name, or under a trade market design, trade name or other name or mark owned or controlled by the person, and who is responsible for designing, manufacturing, assembly, processing, labelling, packaging, refurbishing or modifying the device, or for assigning to it a purpose, whether those tasks are performed by that person or on their behalf.

For a number of years, MEDEC has been providing compelling evidence to Health Canada that based on the definition of a manufacturer, Health Canada does have the authority to regulate third-party reprocessing companies because they are refurbishing and/or selling reprocessed single-use devices to Canadian hospitals.

Reuse and Reprocessing of Single-use Medical Devices

SINGLE-USE DEVICES

Patient safety – Why Canadian regulations are importantIn Canada, original equipment manufacturers must present substantive scientific evidence of a product’s safety, efficacy and quality as required by the Food and Drugs Act and Medical Device Regulations, prior to being given authorization to sell and market a device in Canada.

The majority of Canadian hospitals reprocessing single-use devices are doing so using a third-party reprocessor based in the United States. The fact that these reprocessing companies aren’t required to comply with Canada’s Medical Device Regulations raises two important concerns regarding Health Canada’s role in ensuring patient safety.

The first concern is that Health Canada does not require third-party reprocessors to submit safety, efficacy or quality data for the devices they are shipping back for use in Canadian hospitals.

The second concern is related to adverse events. The Medical Device Regulations, specific to adverse event reporting and recall requirements, currently do not apply to third-party reprocessors. For instance, third-party reprocessing companies aren’t required to maintain records of reported problems related to a device and action taken to respond to those problems, nor are they required to report adverse events to Health Canada. In the event of a product recall, unlike original equipment manufacturers regulated by Health Canada, third-party reprocessing companies aren’t required to provide a proposed strategy to the Health Minister as to how the recall will be conducted and proposed action plan to prevent a recurrence of the problem.

Health Canada has recently communicated to MEDEC that any new position taken by Health Canada will be based on oversight being proportional to risk. Given the current situation and gap in adverse event reporting it will be very difficult for Health Canada to assess that risk.

Legal implications Healthcare Quarterly recently published an article that outlines the legal implications of single-use medical device reprocessing and potential liability for the hospital, physician,

Legal implications and the need for Canadian regulationsBy Nancy Abbey


device manufacturer and third-party reprocessor. A number of important points are raised in the article that require consideration:

• Hospital liability – should an injury arise, hospitals would need to demonstrate that it was reasonable to reprocess that particular device and that it had taken reasonable steps to ensure that doing so was safe for patients.

• Physician liability – relevant factors in the event of an injury would be the nature of the device, the extent to which the physician reasonably relied upon the safety and efficacy of the reprocessing and whether there were any signs that the particular device had suffered damage or deterioration from prior uses or the reprocessing to which it had been subjected.

• Device manufacturer liability – reprocessing rarely if ever removes the brand name of the manufacturer from the device even after it has been reprocessed despite the manufacturer’s instructions indicating for single-use only. A key consideration for manufacturers in accessing negligence is whether the kind of harm that arose was foreseeable and what effort was made to warn of potential harm.

• Third-party reprocessor liability – if a reprocessing procedure were ineffective at cleaning and sterilizing single-use devices in a manner that maintained the safety and efficacy of the device, the reprocessor would be exposed to substantial liability. A Canadian court could also find that a United States third-party processor had violated either the Food and Drugs Act or the Medical Devices Regulations. For example, if by shipping devices that were not the hospital’s own devices into Canada without a licence, a court could determine that the Medical Device Regulations had been breached.

MEDEC recommendationsThe reuse and reprocessing of single-use medical devices is a long-standing issue. MEDEC understands the financial challenges being faced by provincial governments and hospitals and the pressure to find cost savings. We are however very concerned with the lack of regulatory oversight regarding this practice and have recommendations for both federal and provincial governments to consider the following:

• Federal – Health Canada should define and regulate third-

party reprocessing companies as manufacturers in the

context of Canada’s Medical Device Regulations as has been

the case in other countries, including the United States. In

the short term, we are asking Health Canada to issue a notice

to stakeholders clarifying its position regarding the reuse and

reprocessing of single-use devices; revise the adverse event

reporting forms to capture data relevant to reprocessed single-

use devices and clarify terms within the Food and Drugs Act

and Medical Device Regulations specific to this issue including

the definition of a sale, original device, and refurbishing or

modifying a device.

• Provincial – provincial policies should be reviewed and updated

to reflect the current gap in federal regulatory oversight

including:

1. Clinical evidence – establishing clear, appropriate

requirements for clinical evidence to demonstrate that

devices will perform effectively and are safe for patients

when used by a well-trained healthcare professional and

as intended by the manufacturer according to Canadian

regulatory requirements, not what is required in the United

States based on the 510(k) process.

2. Enhanced vigilance and market surveillance – to allow

for rapid identification of adverse events and to ensure

coherent and timely action to prevent a possible recurrence.

Nancy Abbey is a consultant working with the MEDEC – Reuse of

Single-Use Devices Task Force. She has more than 25 years of

experience working in the medical device industry, including eight

years working for Baxter Corporation as the Director, Government

Affairs and Health Strategy, representing the interests of three

business units at both the federal and provincial level.

The majority of Canadian hospitals reprocessing single-use devices are doing so using a third-party reprocessor based in the United States.


Health technology assessment appears to be the new, old buzzword within the Canadian health care system. Technology assessment was popularized in the mid-1960s when a greater appreciation for

understanding both the intended and unintended consequences of introducing a new technology into society was realised. Not surprisingly, policymakers lamented that information about new technologies was too technical in nature and not in the right format to support policy decisions. Policymakers started asking for evidence-based information to support decisions around technology adoption that served the interests of the public and private sectors, and which maximized the benefit(s) to society. Technology assessments used and continue to use a variety of analytical, evaluation and planning techniques.

Health technology assessment was often the topic of early technology assessments, being studied for safety, cost, effectiveness and appropriateness. Generally speaking, all health technology assessments attempt to answer four fundamental questions: Does the technology work, for whom, at what cost, and how does it compare with alternatives? However, the information generated through a health technology assessment is only intended to support policy decision making, and is not a decision unto itself. This brings us back to the title of this article, which suggests that health technology assessment is just a part of a required system. That leaves the question as to what is a “required system” in decision making for emerging (health) technologies. Importantly, does one actually exist?

Answering the last question first, the answer would have to be no; at least not in its entirety. This makes the first question even more compelling to explore and respond to - what is a “required system” in decision making for health technologies?

The required system would be far reaching, moving seamlessly across clinical, practice, policy and political environments, being managed through a single gate. Fundamentally, it would be a need(s) based system, where medical technology innovation is driven up and out from identified gaps in patient care or clinical needs, and where industry partners with health care leaders in pursuit of viable solutions. Opportunities to gather decision making, evidence-based information would come through field based, clinical research, where impact and outcome data would be collected through well organized and systematic processes. Promising medical technologies would be flagged early in the clinical assessment phase, which automatically starts the

Health Technology Assessment – Part of a Required System for Emerging Technologies

HTA

first steps of the procurement process. Evidence is gathered, analyzed, synthesized and reported through a single health technology assessment that incorporates existing research with local clinical outcomes achieved and that includes safety, cost, effectiveness and whole system value measurements, supporting informed decision making. Positive results would influence a policy decision that leads to reimbursement that, in turn, completes the procurement process. Truly novel medical technologies are commercialized worldwide, adding value beyond the boundaries of health care, contributing to the economy of the province. Industry continues the collaboration process with health care leaders to fully optimize the implementation, uptake and use of the technology.

Sound utopic? Perhaps, but Alberta is starting to show some very positive signs in creating this type of system. At the last meeting of MEDEC’s Western Regional Committee, two Alberta health care leaders made presentations that support this observation. Dr. Gary Falkner, Director of Research and Technology at the Glenrose Rehabilitation Hospital, presented on their first effort to match patient care needs to existing, developing or novel medical technologies. Labeled as a Reverse Trade Show, Dr. Falkner described a process of performing an extensive needs assessment with health care providers to identify care gaps within their practice settings. Gathering more than 60 stated needs, they distilled these down to the top 10, which were shared with clinicians, other members of the Alberta Health Services including legal and procurement, as well as members of the local medical technology sector. The results were impressive, in that at least four needs are being addressed or actively pursued in various partnership arrangements. Dr. Falkner’s reverse trade show demonstrated the current issues within the Alberta system around gaining local market access, provincial procurement and moving to commercialization. Interest in Dr. Falkner’s needs based approach to innovation is gaining much interest in Alberta across different areas of the health care system.

The other presenter was Dr. Cy Frank, the Chief Executive Officer of Alberta Innovates – Health Solutions (AIHS). Dr. Frank opened the presentation stating that Alberta has five primary objectives they are in pursuit of. Alberta wants to be the best in: 1) Health; 2) Health Care; 3) Health Research; 4) Innovations in Health; 5) Health as Economic Driver. Specific to AIHS, Dr. Frank sees the role of AIHS as a broker and facilitator, aligning

By Bob Rauscher


partnerships that will attract investments to Alberta. AIHS will build networks, develop key platforms and build sustainable solutions with partners through strategic investment in health research and development. AIHS will actively invest in provincial “value creation” opportunities, providing seed funding to attract and support partners. The medical technology sector is considered a strategic partner. Reporting directly to the Minister of Health, Mr. Fred Horne, Dr. Frank is certainly well positioned to realize his vision of AIHS. That being said, he provided first hand evidence as part of his presentation on how this has already happened in Alberta.

As an orthopaedic surgeon in Calgary, Dr. Frank saw and pursued an opportunity to improve the Bone & Joint Program by introducing a care model in three locations built on seven key elements: 1) evidenced based provincial care path; 2) centralized, multidisciplinary teamed intake clinics; 3) individualized case management approach for each patient; 4) introduction of patient contracts to share accountability; 5) data informed process with quality measures by institute; 6) resource alignments around beds, ORs and staff; 7) case rate funding for clinic and surgical care. The outcomes and evidences produced demonstrated that change can be made within a health care system:

• 98% patient satisfaction with team approach

• Average wait for consult 59% faster than 2005

• Average wait for surgery 67% faster than 2005

• Faster access avoids $22.7M/yr out-of- pocket for patients (wages), with ~$2.5M system costs

• Surgical volume up 73% since 2004/05

• Inpatient bed use up only 5% since 2004/05

• 32,000 bed days gained since 2010 (a resource productivity gain of ~$32.8M)

The key take-away message was that faster access is possible through the more efficient use of resources that achieved better outcomes at a lower cost.

AIHS sees the province advancing many other similar projects to include the introduction and/or management of health technologies while striving to do more, quicker, more efficiently, achieving improved outcomes at a lower cost. This

will be achieved through two primary enabling structures that were recently introduced within Alberta Health Services – the Scientific Clinical Networks (SCNs) and the Operating Clinic Networks (OCNs).

The SCNs strive to align key decision makers across different populations that include administrators, providers, policy makers/payers and patients. SCNs focus on the continuums of care that make up the different parts of the health system. OCNs focus on pathways that make-up part of the SCNs. Combined, these networks will link basic and transitional research with clinical research and further to health systems research as well as prevention, population and public health research. SCNs and OCNs will work to identify, develop and evaluate health innovations for clinical and public value, and procure external health innovations of value. Finally, SCNs and OCNs will support commercialization from discovery to evaluation, to an evidence-informed procurement decision support.

MEDEC currently participates on the Alberta Ministry of Health’s health technology assessment committee, where we already see the linkages between the SCNs taking a blue sky approach to needs based innovation and some of the emerging medical technologies that are entering the assessment process. At least one of the medical technologies raised within the health technology assessment process is going under further clinical evaluation within the relevant SCN, while another medical technology has been directed to a new research method in Alberta called Access with Evidence Development (AED). Under the AED, the medical technology under consideration will receive at least partial reimbursement for the duration of the study. MEDEC has been invited to participate on this AED.

MEDEC, through Board and Executive member representation, will be meeting with the Ministers of Health and Enterprise to discuss a partnership framework between the medical technology sector operating in Canada and the Government of Alberta in early 2014. The meeting will be hosted by AIHS and Dr. Frank.

As stated by Dr. Frank at the start of his presentation to the Western Committee, the “stars are aligning in Alberta” around innovation in health care and creating the required systems to facilitate evidence-based, system wide, value-added decision making. MEDEC couldn’t agree more.

The required system would be far reaching, moving seamlessly across clinical, practice,

policy and political environments, being managed through a single gate.


New Member Welcome

NEW MEMBERS

Richter is a professional strategic accounting, business consulting and financial advisory firm with full-service offices in Montreal and Toronto. The firm has consistently been named as one of Montreal’s Top Employers and Canada’s Top Employers for Young People for the past several years. Founded in 1926, the firm provides a full range of services in the areas of auditing, taxation, risk management, litigation and forensic accounting, transaction advisory services, business evaluation, financial restructuring and insolvency, small business support, financial reporting advisory services, and wealth management. With more than 50 partners and 350 team members, Richter offers a comprehensive and integrated approach, often becoming a natural extension of each organization it serves.

m-Health Solutions (mHS) is part of an emerging and rapidly growing field that offers mobile Health solutions. mHS provides family doctors with the ability to order cardiac tests and receive a diagnosis without having to refer patients to a specialist. mHS developed a mobile cardiac event loop recorder (ELR) and service that transmits ECG data in “real time” through the BlackBerry smartphone. ELRs (for diagnosis of arrhythmias) have been covered in Ontario by OHIP for over a decade. What mHS did was take ELR technology and made it mobile – naming the service m-CARDS™. mHS markets their technology and service to family doctors. When a patient comes in with suspicious symptoms that warrant running an ELR, the doctor will attach two electrodes to the patient’s skin and send a requisition to mHS. mHS will then courier a kit containing a monitor, a BlackBerry smartphone and thorough instructions to the patient’s home or office for self “hook-up.”

mHS’s Ontario licensed cardiologists can log in remotely to securely view all the results on the server and make a diagnosis from anywhere in the world using our web-based and standardized Cardiac Interpreting Template (CIT). In addition, cardiologists are able to electronically sign current reports and search for previous reports.

Laporte is a firm of more than 185 employees specializing in biopharmaceutical, food and beverage, and industrial engineering that offers a wide array of services in the process: building and infrastructure, automation, packaging and regulatory compliance fields.

The recognition Laporte has gained since 1999, and the significant business volume stemming from repeat contracts from clients, demonstrates our understanding of our clients’ business goals.

Indeed, whether it is for a capacity expansion, to launch a new product or for the design of a new factory, no project is too big or too small for Laporte.


Making Sense of the Healthcare Puzzle

February 25, 2014 Allstream Centre, Exhibition Place, Toronto

Combining the Right Pieces to Achieve Optimal Health Outcomes

Conference Agenda7:30 – 8:30 am Continental Breakfast and Registration

8:30 – 8:35 am Welcome from MEDEC

8:35 – 9:30 am Disrupting the Healthcare System: The Virtualization of Care

• Speaker: Will Falk, PwC• Focus: how do you facilitate, lead and incentivize the action plan to achieve change; share innovative

practices from other healthcare systems• Q&A

9:30 – 10:30 am Ongoing Change in Health Services in Alberta

• Speaker: Janet Davidson, Deputy Minister of Health• Focus: ongoing change in Alberta; what changes are planned; how the change is

being managed• Q&A

10:30 – 11:00 am Coffee break

11:00 – 12:00 pm Creating an Innovative Culture

Speaker: Brady Wilson, Juice Inc.This session will show leaders how to find the treasure in the tension. There are innovations that lie hidden within the tensions that exist between government mandates, hospitals challenges and industry solutions. Participants will hear how leaders have skillfully stepped into those types of tensions and uncovered the hidden currencies that drive decisions and enable people to embrace change.

12:00 – 12:45 pm Lunch

12:45 – 1:00 pm Best Practices in Applying Key Learnings from the ConferenceSpeaker: Andrew MillerThis session will set the stage for the afternoon and help you to get the most outof the workshops.

1:00 – 2:00 pm Breakout #1 – participants select a session to attend

• Increasing Collaboration between Providers & Suppliers (Denise Odenkirk, GHX)• Implementing a Culture of Change (Ivan de Souza, 3M Canada Company)• Best Practices in Communication (Brady Wilson, Juice Inc.)• Local Hospital Innovative Practices (Altaf Stationwala, Mackenzie Health)

2:00 – 2:30 pm Coffee break

2:30 – 3:30 pm Breakout #2 – sessions repeated; participants select another session to attend

• Increasing Collaboration between Providers & Suppliers• Implementing a Culture of Change• Best Practices in Communication• Local Hospital Innovative Practices (Altaf Stationwala, Mackenzie Health)

3:30 – 3:45 pm Key Insights and Call to Action – Andrew Miller

Centre for Imaging Technology Commercialization (CIMTEC) .................... 8 www.cimtec-canada.ca

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Moore Med-Tech .............................. Inside Front Cover www.mooremedtech.com

Index of Advertisers

SPECIAL THANKS TO OUR MEDEC SPONSORS:

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DATETuesday, February 25, 2014

WHO SHOULD ATTENDHealthcare Leaders and Clinicians in Hospitals, Community Care,Home Care, etc.GPOs and SSOs; Regional & Local Health Authorities; GovernmentMedTech Industry

LOCATIONAllstream Centre, Exhibition Place, 100 Princes’ Blvd., Toronto

REGISTRATIONEarly Bird until January 31, 2014MEDEC Members - $399 plus taxNon-Members Industry - $499 plus taxHealthcare Providers/Government - $99 plus taxAfter January 31, 2014MEDEC Members - $499 plus taxNon-Members Industry - $599 plus taxHealthcare Providers/Government - $99 plus taxRegistration includes conference, continental breakfast, lunch and breaks

MEDEC405 The West Mall, Suite 900, Toronto, Ontario M9C 5J1T: 416-620-1915 F: 416-620-1595Toll-free: 1-866-58-MEDEC(632332)E: [email protected] www.medec.org

Conference Outline:The healthcare environment is changing rapdily.How do we determine the right strategy to man-age change and work together collaboratively?This conference will include sessions to providepractical solutions for communication, changemanagement, leadership and process changes /enhancements for healthcare providers, govern-ment and industry to better enable collaborationtoward a sustainable healthcare system.

Disrupting the Healthcare System -Will Falk, PwC

Ongoing Change in Health Services inAlberta - Janet Davidson, Deputy Minister ofHealth, Alberta

Creating an Innovative Culture -Brady Wilson, Juice Inc.

Increasing Collaboration betweenProviders and Suppliers - Denise Odenkirk,Global Healthcare Exchange (GHX)

Implementing a Culture of Change -Ivan de Souza, 3M Canada Company

Best Practices in Communication -Brady Wilson, Juice Inc.

For information on sponsorship opportunitiescontact Debbie Gates, [email protected] or416.641.2747.

REGISTER NOW !February 25, 2014

Combining the Right Pieces to Achieve Optimal Health OutcomesMaking Sense of the Healthcare Puzzle

Documents

Medec pulse winter 2014