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I was privileged to moderate OMTEC® 2023’s Keynote panel featuring orthopedic executives and surgeons. Our panel included the following:
- Rob Ball, CEO of Shoulder Innovations and Director at Genesis Innovation Group
- Wael Barsoum, M.D., President and Chief Transformation Officer at HOPCo
- Nitin Goyal, M.D., Chief Science, Technology and Innovation Officer at Zimmer Biomet
- Kevin McGann, President and CEO of Accelus
Our discussion focused on their challenges and areas of opportunity amid prolonged disruption in the orthopedic market. Below is a recap of the keynote’s major themes, such as adapting to new market realities, the need for transformative innovation in outpatient settings and care delivery and the potential for artificial intelligence to improve patient engagement.
How Prolonged Disruption Shifted Priorities
Our panelists identified supply chain resilience and financial discipline as their top priorities during the market’s disruption. Rob Ball said that Shoulder Innovations’ primary concern, as a small company, was securing supply commitments from manufacturing partners. With the entire industry impacted by the same conditions, Mr. Ball highlighted the importance of working together across companies.
Zimmer Biomet’s Dr. Nitin Goyal concurred that strong supplier relationships are critical. “The disruption created challenges,” he said, “but it’s strengthened our team because now we have people that have gone through, essentially, a war on the supply chain side.” Dr. Goyal also said the disruption pushed Zimmer Biomet to diversify from purely elective orthopedic procedures into “white space” that the company typically hasn’t chased.
The strain on financial markets caused Accelus to shelve plans to go public through a special purpose acquisition company in the spring of 2020. The company ultimately reached a deal to sell off its REMI robotic navigation system to ATEC for $55 million. “We were able to pay down a lot of our debt and get ourselves refocused. We really looked at how we can continue to drive towards high growth, but profitability is really the key right now in today’s marketplace,” said Kevin McGann.
Dr. Wael Barsoum said the strongest organizations during this period are those that can manage their financial challenges the best. Dr. Barsoum also said that hospitals are facing challenges as patients find other places for care. “Hospitals are in a very, very challenging time,” he said. “And if you look in the United States, we’re probably over bedded by 40%. That’s the dirty little secret that nobody wants to talk about.”
Outpatient Orthopedics Brings Obstacles and Opportunities
As more orthopedic procedures move to outpatient settings, logistical challenges compound for device companies. Dr. Goyal said surgeons could operate in a hospital and several different ASCs on the same day. With a knee replacement typically needing three to six instrument trays, the supply situation becomes extremely complex and increases costs for the company.
Those challenges represent an excellent opportunity for innovation, and Dr. Barsoum believes the market needs transformative change to justify the additional cost in the ASC environment. He said slight incremental changes like altering the angle of an implant or adding another widget to a product is a waste of time.
Shoulder Innovations anticipated the ASC shift and tailored its approach to shoulder replacement. Ball said, “The reality is for most implants out in the market, it’s very difficult to change the surgical techniques. Sitting down with about eight trays of instruments and seeing which ones we can chuck out of the box and make this smaller footprint tends to be somewhat impossible; you have to go back and reconceive how the implant and the surgical technique are executed.”
Innovation Needed for Healthcare Delivery
Dr. Barsoum said the U.S. spends $4 trillion a year on healthcare, almost 20% of its gross domestic product and a percentage that is simply too high. Part of the problem, he said, is the DNA of the healthcare industry.
“In the healthcare world, we’re very, very good at innovating technologies and surgical procedures. It’s kind of in our DNA,” he said. “What we’re not very good at, as a country, is innovating healthcare delivery. If you sit in a room with hospital executives, and I’m not saying this in a pejorative way, they don’t really want to see a major shift in how we deliver health care, because they’re good at what they do.”
Zimmer Biomet thinks its digital patient engagement platforms can reduce healthcare cost burdens. Dr. Goyal said telehealth offers significant opportunities to streamline and improve care delivery while solving meaningful problems for customers.
Ball noted the shift in power away from clinical decision-makers toward administrators. Device companies must recognize the challenge and focus on creating more value. McGann said he thinks collecting clinical data is a crucial piece of demonstrating value and justifying the incremental cost.
AI Could Improve Engagement and Decision Making
The panel agreed that artificial intelligence will play an increasingly important role in orthopedics, especially in patient engagement and provider decisions.
To Dr. Barsoum, connectivity between care teams and patients is one of the biggest challenges in healthcare today. He sees digital enablement as a valuable tool to improve communication. Apps with AI modules, two-way messaging, and computer vision for monitoring and coaching physical therapy sessions were a few examples he offered. “Bringing healthcare to the patient, and making it easier for the patient to understand, communicate and manage their expectations is a huge opportunity,” he said.
The next five years will see progress made in objectifying the episode of care, according to Dr. Goyal. He said healthcare providers are making decisions based on largely subjective information. AI-based algorithms will be instrumental in driving more objective decisions.
“Today, if someone potentially needs a revision surgery, a surgeon will line up x-rays looking for lines and changes,” Dr. Goyal said. “Isn’t that crazy? From a consumer standpoint, I would look at that and laugh. Can’t someone tell me if it’s loose or changed position? Your eyes have to identify that? Boy.”
He also asked who would feel comfortable getting the same surgery in Tuscaloosa, Alabama versus in New York at the Hospital for Special Surgery. Dr. Goyal thinks digital technology can go a great distance in enabling providers with the same tools to achieve optimal outcomes regardless of location.
While our panelists came from a diverse array of companies, Dr. Goyal pointed out that oftentimes big companies and small companies face the same problems. The industry has moved through this period of disruption by becoming more flexible, more cooperative and fully invested in modernizing orthopedics.
I was privileged to moderate OMTEC® 2023’s Keynote panel featuring orthopedic executives and surgeons. Our panel included the following:
Rob Ball, CEO of Shoulder Innovations and Director at Genesis Innovation Group
Wael Barsoum, M.D., President and Chief Transformation Officer at HOPCo
Nitin Goyal, M.D., Chief Science, Technology...
I was privileged to moderate OMTEC® 2023’s Keynote panel featuring orthopedic executives and surgeons. Our panel included the following:
- Rob Ball, CEO of Shoulder Innovations and Director at Genesis Innovation Group
- Wael Barsoum, M.D., President and Chief Transformation Officer at HOPCo
- Nitin Goyal, M.D., Chief Science, Technology and Innovation Officer at Zimmer Biomet
- Kevin McGann, President and CEO of Accelus
Our discussion focused on their challenges and areas of opportunity amid prolonged disruption in the orthopedic market. Below is a recap of the keynote’s major themes, such as adapting to new market realities, the need for transformative innovation in outpatient settings and care delivery and the potential for artificial intelligence to improve patient engagement.
How Prolonged Disruption Shifted Priorities
Our panelists identified supply chain resilience and financial discipline as their top priorities during the market’s disruption. Rob Ball said that Shoulder Innovations’ primary concern, as a small company, was securing supply commitments from manufacturing partners. With the entire industry impacted by the same conditions, Mr. Ball highlighted the importance of working together across companies.
Zimmer Biomet’s Dr. Nitin Goyal concurred that strong supplier relationships are critical. “The disruption created challenges,” he said, “but it’s strengthened our team because now we have people that have gone through, essentially, a war on the supply chain side.” Dr. Goyal also said the disruption pushed Zimmer Biomet to diversify from purely elective orthopedic procedures into “white space” that the company typically hasn’t chased.
The strain on financial markets caused Accelus to shelve plans to go public through a special purpose acquisition company in the spring of 2020. The company ultimately reached a deal to sell off its REMI robotic navigation system to ATEC for $55 million. “We were able to pay down a lot of our debt and get ourselves refocused. We really looked at how we can continue to drive towards high growth, but profitability is really the key right now in today’s marketplace,” said Kevin McGann.
Dr. Wael Barsoum said the strongest organizations during this period are those that can manage their financial challenges the best. Dr. Barsoum also said that hospitals are facing challenges as patients find other places for care. “Hospitals are in a very, very challenging time,” he said. “And if you look in the United States, we’re probably over bedded by 40%. That’s the dirty little secret that nobody wants to talk about.”
Outpatient Orthopedics Brings Obstacles and Opportunities
As more orthopedic procedures move to outpatient settings, logistical challenges compound for device companies. Dr. Goyal said surgeons could operate in a hospital and several different ASCs on the same day. With a knee replacement typically needing three to six instrument trays, the supply situation becomes extremely complex and increases costs for the company.
Those challenges represent an excellent opportunity for innovation, and Dr. Barsoum believes the market needs transformative change to justify the additional cost in the ASC environment. He said slight incremental changes like altering the angle of an implant or adding another widget to a product is a waste of time.
Shoulder Innovations anticipated the ASC shift and tailored its approach to shoulder replacement. Ball said, “The reality is for most implants out in the market, it’s very difficult to change the surgical techniques. Sitting down with about eight trays of instruments and seeing which ones we can chuck out of the box and make this smaller footprint tends to be somewhat impossible; you have to go back and reconceive how the implant and the surgical technique are executed.”
Innovation Needed for Healthcare Delivery
Dr. Barsoum said the U.S. spends $4 trillion a year on healthcare, almost 20% of its gross domestic product and a percentage that is simply too high. Part of the problem, he said, is the DNA of the healthcare industry.
“In the healthcare world, we’re very, very good at innovating technologies and surgical procedures. It’s kind of in our DNA,” he said. “What we’re not very good at, as a country, is innovating healthcare delivery. If you sit in a room with hospital executives, and I’m not saying this in a pejorative way, they don’t really want to see a major shift in how we deliver health care, because they’re good at what they do.”
Zimmer Biomet thinks its digital patient engagement platforms can reduce healthcare cost burdens. Dr. Goyal said telehealth offers significant opportunities to streamline and improve care delivery while solving meaningful problems for customers.
Ball noted the shift in power away from clinical decision-makers toward administrators. Device companies must recognize the challenge and focus on creating more value. McGann said he thinks collecting clinical data is a crucial piece of demonstrating value and justifying the incremental cost.
AI Could Improve Engagement and Decision Making
The panel agreed that artificial intelligence will play an increasingly important role in orthopedics, especially in patient engagement and provider decisions.
To Dr. Barsoum, connectivity between care teams and patients is one of the biggest challenges in healthcare today. He sees digital enablement as a valuable tool to improve communication. Apps with AI modules, two-way messaging, and computer vision for monitoring and coaching physical therapy sessions were a few examples he offered. “Bringing healthcare to the patient, and making it easier for the patient to understand, communicate and manage their expectations is a huge opportunity,” he said.
The next five years will see progress made in objectifying the episode of care, according to Dr. Goyal. He said healthcare providers are making decisions based on largely subjective information. AI-based algorithms will be instrumental in driving more objective decisions.
“Today, if someone potentially needs a revision surgery, a surgeon will line up x-rays looking for lines and changes,” Dr. Goyal said. “Isn’t that crazy? From a consumer standpoint, I would look at that and laugh. Can’t someone tell me if it’s loose or changed position? Your eyes have to identify that? Boy.”
He also asked who would feel comfortable getting the same surgery in Tuscaloosa, Alabama versus in New York at the Hospital for Special Surgery. Dr. Goyal thinks digital technology can go a great distance in enabling providers with the same tools to achieve optimal outcomes regardless of location.
While our panelists came from a diverse array of companies, Dr. Goyal pointed out that oftentimes big companies and small companies face the same problems. The industry has moved through this period of disruption by becoming more flexible, more cooperative and fully invested in modernizing orthopedics.
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Mike Evers is a Senior Market Analyst and writer with over 15 years of experience in the medical industry, spanning cardiac rhythm management, ER coding and billing, and orthopedics. He joined ORTHOWORLD in 2018, where he provides market analysis and editorial coverage.
