An expanding customer base, rapidly advancing technology and intense cost pressures are driving medtech companies to use surgical telepresence to cost effectively meet customer needs, enhance customer relationships, develop new products faster and empower healthcare providers to raise the standard of care.
By Daniel Hawkins, Avail Medsystems
The Avail Medsystems console brings remote experts into the operating room virtually. [Photo courtesy of Avail Medsystems]
The medical technology medtech industry is relentlessly challenged to efficiently maintain growth, fund innovation, and provide an appropriate return to shareholders. Over the last decade, this has become increasingly difficult due to myriad challenges resulting from rapid expansion in the number of sites of service, declining reimbursement, relentless pricing pressures and increasing technical complexity across the industry.
Throughout my 30-year medtech career, I have touched every aspect of the product life cycle, from ideation to product release, market creation and widespread adoption. Whether for groundbreaking new technologies or incremental enhancements, core challenges in product development and commercialization are consistent: progressing along the product life cycle requires physical presence in operating rooms at every stage of the process.
Requirement for physical presence in ORs structurally gates product development, clinical trials, and commercial launch. Later in the cycle, it imposes a high cost burden on medical education and go-to-market activities while simultaneously limiting sales growth. [Image courtesy of Avail Medsystems]
As products are designed, tested, and moved to clinical trials, OR access is essential to optimize device performance and enroll patients in studies prior to regulatory approval. Absent the need for physical presence in ORs during this process, new products would reach the market more quickly.
Launch and early commercialization tests a company’s ability to train field teams and surgeons at scale, again due to the requirement for physical OR presence. Absent this requirement, launch and market penetration could accelerate, yielding higher first 12-month revenues, higher return on investment and incremental resources to fund further product innovation.
Catch Avail Medsystems CEO Daniel Hawkins at DeviceTalks Boston May 10-11, 2023
The requirement for physical OR presence to serve customers becomes a burden on established products where medtech companies need to tightly manage medical education and go-to-market costs across an expanding customer base while navigating intense competition, pricing pressures and growth requirements. Travel time between accounts wastes 50%-plus of selling time, further limiting growth for premium-priced products, and exacerbating the cost burden for price-sensitive ones.
Q: Should go-to-market strategies be essentially the same regardless of product type, market dynamics and product/market maturity?
A: Likely not, but often that’s exactly what’s happening.
Properly selected technology can enable customization of commercial activities such that existing staff can efficiently meet the needs of nearly any medtech business, regardless of stage or market dynamics.
Across much of the medtech industry, there is a pressing need to:
- Deepen customer relationships
- Accelerate the pace of innovation
- Deliver operating profits to fund continued product innovation
- Re-invent go-to-market strategies to align with market dynamics
- Cost effectively grow revenues
- Unlock operating leverage with existing sales teams
The common denominator impacting all the above is the need to be physically present in the OR. A powerful set of new technologies known as surgical telepresence connects the medtech companies, surgeons, and digital tools to and from the operating room has emerged as a potent force, fueling a transformation in every stage of procedural healthcare.
Surgical telepresence: Accelerating the medtech industry through connectivity
Having gained favor during the COVID-19 pandemic, surgical telepresence is enabling medtech companies to develop and launch product faster, deepen commercial relationships, cost-effectively service customers, and better access a market forecasted to reach $800 billion by 2030. To take full advantage of this expansion, medtech companies must reinvent themselves to efficiently launch products and grow revenues without commensurate growth in expenses. In essence, they need to unlock operating leverage; something not widely present in the industry. Adopting a digital connectivity plan centered around Surgical telepresence is a key way to efficiently and effectively achieve these goals.
Since introducing the technology within his organization, a medtech commercial leader told me he’d saved a substantial amount of time by joining procedures remotely. “For me alone, I’ve gained 300 incremental OR hours,” he said. “Imagine the travel and logistical time that would have been needed to achieve that, and the positive impact that can have when implemented across our entire field team…” Another leader said he’d used remote OR access to train a large group of field representatives across multiple countries, something his company had never dreamed of doing so quickly before.
While many medtech organizations are using surgical telepresence for specific use cases along the product development lifecycle, Medtronic Neurovascular is deploying it in a comprehensive way across every aspect of their business to bring the entire organization closer to their customers. Engineers are connecting directly with clinicians to collaborate on new technology development, other parts of the organization use it to conduct internal training and education, provide medical education, and support clinical trials and product launches. Field teams leverage the technology to deepen customer relationships and cost-effectively serve more customers with existing staff. In a visionary application of the platform, the company is using surgical telepresence to establish a network of healthcare providers to collaborate on the treatment of individual patients as well as advance techniques for the benefit of the broader clinical community. This forward-thinking strategy looks to further solidify Medtronic Neurovascular’s position as the world’s leading neurovascular device business.
Connectivity enhances the commercial success of medtech customers
Like me, many of you follow the popular “Milkmen” series by Boston Consulting Group (BCG). In a recent industry survey, BCG found that medtech companies, on average, spend two to three times more on sales and general and administrative expenses (as a percent of the costs of goods sold) than a typical technology or industrial company. Yet, the survey also found that remote device-sales representatives can close that gap when working within a “well-oiled, omnichannel model” that encompasses measures such as digital marketing, self-service portals, and virtual-engagement platforms.
Alone or in tandem with traditional sales forces, BCG found that field representatives operating remotely can reach more accounts and do so with a higher level of effectiveness, particularly when explaining complex technologies. Surgical telepresence technology is designed for exactly that, allowing medtech companies to increase commercial reach without deploying more representatives on the ground — gaining much-needed commercial operating leverage.
BCG suggests that establishing “a next-generation commercial model — one that capitalizes on digital and omnichannel interactions” can help medtech companies “go beyond commercial effectiveness” to realize another pivotal goal: helping their customers achieve success, representing a win-win. As Medtronic Neurovascular has done, medtech companies across clinical specialties can enable this using surgical telepresence.
Dr. Alex Spiotta, a neurosurgeon at the Medical University of South Carolina, has leveraged the technology to enable his team and other clinicians to share insights about techniques and device use. In a recent podcast, he recalled an occasion when “a fellow from another institution joined us to watch a procedure that is nuanced, but which we consider routine. She said, ‘We struggle with that, but now we know a technique we can use to overcome it.’ She planned to bring the information back to her team and apply it the same day.” Without telepresence technology, that type of interaction occurs far less frequently than it should or could be beneficial.
Finally, surgical telepresence allows physicians to collaborate with colleagues at other institutions to optimize care for the patient being treated at that moment. It also enables device representatives to be available where and when they are needed — regardless of location, even in rural areas or during emergency procedures — to provide the support otherwise inaccessible when on-site attendance was the only option.
Choosing a surgical telepresence technology
When evaluating a platform, medtech companies and healthcare providers should consider the following factors:
- User experience: Do the system’s hardware and software components easily dovetail with medtech and healthcare workflows — at scale? An important test is whether the process of reaching out for support during an urgent situation is quick and simple. Also helpful is hardware that includes a large, OR-based screen and purpose-built audio capability, ensuring that all collaborators can see and hear what is being streamed. An added benefit would be the platform’s ability to host and broadcast real-time applications of novel software, such as AI, machine learning, virtual reality, and software designed to assist with surgical robotics. Software innovation is underway in a world absent consistent networking hardware in the procedure room, once telepresence technology is in place, development will accelerate.
- Consistent quality: Experts recommend uniformity of hardware and software across institutions to establish familiarity and “sameness” among networks of users, such as a medtech field commercial team. Cameras with optical zoom are preferred over those with digital zoom, as are those with color and white balancing, as viewers require high-resolution images to distinguish delicate anatomy and assess tissue planes in fine detail. Also important is consistent use ethernet connections versus WiFi as unwired connections are subject to higher levels of disruptive variability. Finally, it is important that ambient noise can be dampened as the humming and beeping of OR machinery, not to mention the echo of voices and other typical OR noises, can interfere with audio communication between participants in a telepresence session.
- Service and support: Given the reasons to use surgical telepresence noted above, it is vital that the company providing the service installs and tests the system, then supports users and stakeholders through a comprehensive program to integrate it into their practice. In short, an involved company makes it easier for users to seamlessly implement a surgical telepresence platform – and provides 24/7/365 manned support to ensure consistent system functionality.
- Privacy and security: Security and privacy standards are of the upmost importance in healthcare to minimize the risk of unsanctioned access to protected health information (PHI). As such, it is vital that surgeons, hospitals and medtech companies adhere to these standards prior to adoption of a surgical telepresence technology. There is no justification for lower standards using surgical telepresence than are required when sharing a recorded or live procedure in medical education setting where security and privacy practices including explicit patient consent are standard practice.
Key questions include:
- Is all hardware used by the service provider designed to minimize security risks? Has it been tested by a third party for penetration risk?
- Are all communications end-to-end encrypted?
- What are the policies around notification of potential security breaches?
- Does the service provider fully comply with your facility’s/company’s HIPAA policies?
- What are the surgical telepresence provider’s policies and practices regarding patient, hospital staff privacy with respect to: recording procedures; ownership of those recordings; chain of custody of recordings; archiving of recorded procedures; and access to recordings/PHI?
- Does the service provider secure explicit patient and hospital permission prior to recording procedures?
Closing thoughts
With an understanding of what a well-selected surgical telepresence system can provide, stakeholders in medtech, hospitals and surgeons can look forward to enhanced opportunities to work together with the shared goal of improving the standard of care for patients.
Several medtech firms have already stepped forward to pioneer the future of digitization in our field and done so with impressive results. Yet according to BCG, the industry has a long way to go when it comes to incorporating digital tools and remote sales forces. Early adopters have already begun reaping the rewards of surgical telepresence and I believe their success signals the beginnings of meaningful trends that will change the medtech industry and healthcare overall — with the greatest benefits accruing to those that lead that change.
Avail Medsystems founder and CEO Daniel Hawkins [Photo courtesy of Avail Medsystems]
Daniel Hawkins is the founder and CEO of Avail Medsystems, whose complete hardware-and-software telepresence system audibly and visually connects the medtech industry and healthcare providers during live operating-room procedures so that they can work together more often and more efficiently to accelerate innovation and improve patient care. An entrepreneur who previously co-founded two successful medtech startups including Shockwave Medical, Hawkins launched Avail in 2017 with the goal of “reinventing the medtech industry” by streamlining and efficiently expediting medical device development and commercialization. He is a named inventor on over 160 patents and applications and has been honored three times by Goldman Sachs, most recently in 2022, as one of its 100 Most Intriguing Entrepreneurs.