Keeping in touch

As you struggle through the rain and wind, carrying your marketing or sales message like a battered thermos, you could be forgiven for thinking the world doesn’t care. You’re right – it doesn’t. So what’s the answer? The simple truth is that you can’t afford to go it alone. Being a lone wolf leaves you hungry and in the dark. This issue of On Target is about teamwork and joined-up thinking.

Our lead article explores the growing value of telehealth to an NHS focused on preventative and community-based healthcare. As both of the telehealth industry professionals we interview state, companies looking to become telehealth partners with the NHS need to think in terms of long-term rather than short-term profit. The lead story in this issue’s special extended news section indicates that NHS investment in building telehealth strategies is already under way. The benefits to public health and the UK health economy depend on industry and healthcare professionals working closely together.

Ruth Lessar’s article ‘Leader of the pack’ focuses on Key Opinion Leaders in the healthcare field: who they are, where to find them and how to build effective relationships with them. She notes that the new KOLs may be specialists in other medical disciplines, be working in the community, or even be expert patients. To make the best use of these influential customers, Lessar argues, the marketing and sales departments need to be working in tandem.

Our interview with David Worskett, Director of the NHS Partners Network, looks at the prospects for the independent sector in NHS service provision. His message is clear: “”ISTCs work best when they are integrated and work in partnership with the rest of the local NHS”. Worskett also points out that the independent sector needs to develop “innovative models of care and services”. In other words, to build effective business relationships with the NHS, you need to do a lot more than mimic their body language. You need to make all their language your own.

Finally, Chris Sheehan’s article ‘Flying start’ examines the secrets of a successful medtech product launch. He emphasises that launch planning often needs to start years before the event. Commercial groundwork and planning are essential, and the involvement of sales teams needs to be carefully phased in. Keeping in touch with your colleagues and your customers is the only way to ensure that, once the champagne has gone flat, the product sales figures don’t do the same.

‘You are not alone’ is more than a heartwarming cliché. It’s a statement of the only way to do business in the world of modern healthcare. For the marketing professional, that means channelling your messages to reach the right people in the right way. For the sales professional, it means remembering: if the only thing on your mind is pushing the customer towards a close, it’s likely the only thing closing will be the door in your face. And then you really will be alone.

Don’t be a stranger.

Chris Ross
Editor

 

 

Save Smart, Earn More: The new rules for retirement investing
by Dennis Blitz (David & Charles, £9.99, pb) www.davidandcharles.co.uk

---

This book comes at a timely moment, with the credit crunch hurting many forms of investment, including house purchases and stock markets – but such moments in history can be good buying opportunities too. It is important to have some basic knowledge of investing and a strategy that works for and is tailored to you.

Essentially, this book provides useful insights into investing. The nine rules presented are sound ones that all successful investors will recognise. The discussion of complementary investments is very relevant, and asset allocation is always important to consider in any investment strategy.

The importance of low management fees to maximise returns is obvious, but few people typically pay enough attention to this. Blitz indicates that higher fees can sometimes be appropriate, and goes on to stress the need to check out whether the likely returns make this justified.

There are useful tips in this book, but it does have a major deficiency for British and European investors in that it is very much written for an American audience, using American terminology and mentioning many American investment vehicles – a lot of which are not really relevant to this side of the pond. Equity options are discussed and covered in a balanced way, but typically can only be recommended for the more dedicated investor who is prepared to learn.

Buying a business or franchise, real estate and annuities are all covered in a reasonable manner, but again this is very different in the UK. Tax treatments vary greatly between nations, including across Europe.

Overall this is a good book for some tips, but in desperate need of a rewrite to translate it fully and make it relevant to non-US jurisdictions.

Trevor Lewis is Principal Consultant of the Medical Device Consultancy.

Which? Essential Guides: CV and Interview Handbook by Sue Tumelty (Which? Books, £10.99, pb) www.which.co.uk “Changing jobs or embarking on a new career can be one of life’s most stressful and challenging events. Applications must stand out from the crowd, you have to make a good impression at interview and outperform your competitors in any test or presentation. CV and Interview Handbook will take you through the job-hunting process from application to interview and beyond.” So promises this Which? Essential guide… and it largely delivers. Split into nine sections, this well laid out and accessible guide starts by asking you what you want from your job, outlines the first steps to take in your search, and dedicates an entire section to online technology and web-based job hunting. It discusses recruitment agencies, though the very brief section on specialist agencies is not particularly illuminating for the specific healthcare sector. It makes sensible suggestions regarding choosing an agency – e.g. is it an REC member, and does it really listen to you? There are useful sections on writing a good CV, including tips for more difficult aspects such as explaining career gaps, or presenting a CV when you were sacked from your last position. The guide also tackles the myriad application forms (both paper and online) that you may face, and offers suggestions for answering a variety of tricky questions. A section on tests and presentations gives useful examples of verbal and numerical reasoning, and explains various group exercise scenarios and role-plays. Personality profiles are explored, with web links so you can gain practice before the real event! The interview process is explained in detail, with examples of likely questions together with ‘model answers’. The book ends with a discussion of job offers (yippee!) and a section on starting with your new company. Overall, this is a good read: very visual, with key information highlighted on each page, clearly worked examples and a flow chart to guide you through the stages of job application. Tina Young is a Director of Kirkham Young Ltd, a specialist healthcare and scientific sales recruitment agency.

 

 

Bridgehead Consulting gets under the skin BIOPHARMACEUTICAL CONSULTANCY Bridgehead Consulting has completed an independent due diligence study on skincare company Tyrell Inc. as part of a fundraising programme. Tyrell develops and markets medical devices for the treatment of skin lesions, based on its proprietary ClearPoint™ Technology – including Zeno™, an over-the-counter treatment for acne. Paul Tufano, Chief Financial Officer of Tyrell, said: “As an international medical device company which has launched multiple devices spanning numerous indications, we often have difficulty finding a consultancy firm that has the depth of technical expertise and market resources to assess the landscape with which we work. “Our engagement of Bridgehead has proven to be very valuable to the growth and operation of our business. Their assessment of the competitive landscape, our product strategy and the intellectual property environment has driven many important changes to the way we have managed the success of our business.” Bridgehead Consulting offers consultancy services aimed at helping healthcare companies to achieve growth by developing market access solutions, technical and commercial evaluation and healthcare education services.

Restructure at hsdcommunications FOLLOWING ITS RECENT ACQUISITION by Gyro International, specialist medical education agency hsdcommunications has appointed new divisional heads and account executives. Justine Haddon joins the agency as Head of Events and Conferences, Helena Symeou has been promoted to Head of Medical Communications, and former HR Manager Anne Allum has become Head of HR. Justine began her career as a theatre nurse and has over 10 years’ experience of in-house marketing in healthcare, most recently as Marketing Manager for medical device company Mölnlycke Health Care. Helena has been part of the senior management team at hsdcommunications for over four years, and previously worked at GCI Healthcare. Anne has been with the agency for two years, having previously worked for Marks and Spencer. Following recent business wins and expansion plans, hsdcommunications has also appointed Meera Nathan as Account Executive and both Samantha Brown and Gemma Cooper as Junior Account Executives. Meera previously worked at Resolute Communications, where she promoted both prescription-only and OTC brands. Samantha is a recent graduate in Biological Science from the University of Plymouth. Gemma Cooper is a recent Media and Cultural Studies graduate and has completed a three-month PR internship at Beatrix Ong.

New Activa website up and running UK LEG HEALTHCARE SPECIALIST ACTIVA HEALTHCARE has revamped its website, which provides health, product and service information to its customers. Activa Healthcare, winner of a Queen’s Award for Innovation 2008 (see the May On Target), is a UK market leader in compression therapy. The modernised website at www.activahealthcare.co.uk provides case studies and research papers – as well as promotional materials such as the award-winning Tissue Viability Society (TVS) Conference poster, which features a patient who was successfully treated with ActiFormCool, Activa’s multipurpose ionic hydrogel dressing. The website still displays established features such as Activa’s Hosiery Selector, where customers’ leg measurements can be input to help them determine which compression hosiery product is the best for them, as well as video presentations and information on various leg health conditions and products that can treat them. The website’s redesign aims to emphasise Activa’s commitment to education initiatives, product development and customer service.

HSP appoints Subscriptions Marketing Manager HEALTH SECTOR PUBLISHING has appointed Chan Joshee as Subscriptions Marketing Manager. Chan will develop and maintain the circulation database of HSP’s portfolio of business titles, including On Target and Pf. The role will also support the development of HSP’s publications into new markets as the company continues to expand. To achieve the company’s circulation objectives, Chan will drive marketing initiatives through telephone campaigns, paper research, direct mail, exhibitions and e-mail, and develop a complementary online strategy. Chan has a B.A. (Honours) degree in Marketing, Advertising and Public Relations from the University of Central England. She also brings with her experience in marketing and PR, including time with BAA as well as voluntary work for the BAPS organisation. “I feel that my role is a key element in driving HSP forward,” Chan said. “I have many ideas that will help the business to grow and develop, reaching new heights.”

Kirkham Young appoints Candidate Manager HEALTHCARE RECRUITMENT SPECIALIST KIRKHAM YOUNG has appointed Paul Cornell to join its growing team in the newly-created role of Candidate Manager. “As always, all new candidates will receive a personal response from us with regard to their application,” said Paul. “My role will enable us to take this to the next level and offer all candidates a truly bespoke service, enabling us to recognise their talent and offer the very best opportunities in order to take their career forward.” Director Sam Kirkham commented: “The addition of Paul to the team enables us to further develop our commitment to really understand the needs of our customers. It will make sure that our candidates can be offered opportunities which accurately match their requirements in terms of both role and culture, with our wide range of clients – from blue chip organisations to small, niche market, start-up operations.”

Abbott nurse advisor wins CHASE award LOUISE BECKER, an Abbott nurse advisor on CHASE contracts, has won the CHASE Award for Nursing Excellence at the annual Abbott Nutrition conference. The Abbott team of 30 nurse advisors, headed up by National Nurse Manager Sue Morris, is a specialist national team run by the contract sales organisation CHASE. “We’re delighted to support the Abbott Nurse team – they do a great job, working in the community to ensure patients receive the very best nutritional care and support,” said Chris Phillips, Managing Director of CHASE.

VMC partners for training THE VACANCY MANAGEMENT COMPANY (VMC) and Training Central have formed a partnership to enhance the service provision both companies offer to their customers in the healthcare industry. VMC is a healthcare and medical recruitment specialist. Training Central is a learning management service designed specifically to meet the distance learning requirements of the healthcare and pharmaceutical industries. The new training service aims to benefit everyone involved in the training process. It enables the sales representative to access training and incorporate it into their working day – thus saving time, reducing costs and ensuring that everyone in the team is trained to the same level. Customers of the partnership will benefit from a fullymanaged training service with a comprehensive feedback reporting system. For more details, call Sue Birch on 01420 82202 or e-mail suebirch@vacancymgt.com.

 

 

What does the future hold for Independent Sector Treatment Centres in the NHS?

David Worskett is Director of the NHS Partners Network, an alliance of independent healthcare providers involved in partnership with the NHS. He talks to On Target about ISTCs and the challenges they face.

How is the NHS Partners Network involved in building and supporting partnerships between healthcare companies and the NHS?

The main role of the NHS Partners Network is to help the NHS and the independent sector understand each other’s requirements and develop the role of the sector within the NHS by improving formal and informal interfaces between the two.

It is important to perform this ‘bridging’ role because the use of the independent sector within the NHS is still relatively new and comes in a growing number of forms. These include Independent Sector Treatment Centres (ISTCs): hospital groups that are part of the extended free choice network and the new generation of primary care providers. Full ‘free choice’, which our members have been working hard to support and develop, only went live in April this year.

Part of our role is to help ensure that the mechanics of reporting statistics and information to give patients and GPs a sound basis for exercising choice are robust and efficient. We have set about this through a programme of harmonising the data and explaining it to the press and the public, and so helping people to get an accurate picture of the merits of co-operation and partnership between the traditional NHS and independent providers – with a clear emphasis on the benefits to patients.

What was the message to the private sector of the Government Health Select Committee Report on ISTCs published in 2006?

The most important issue is not what the message of the Select Committee was, but what the conclusions have turned out to be. The report was commissioned and compiled in the 2005–2006 parliamentary session, then released in mid-2007. A fair bit of water has passed under the bridge since then.

We now know ISTCs have contributed substantially to reducing waiting times. There is also now validated independent research from BMC health services showing that ISTCs deliver better outcomes for patients. The Healthcare Commission, through its regular reports and a sector-specific study, has confirmed that ISTCs offer better overall patient satisfaction rates, are rated as cleaner by patients, and have significantly lower rates of infection from hospital-acquired MRSA. There are a number of reasons for the latter, but the bottom line is that the ISTC delivery model offers patients a lower risk of infections.

In short, there is a growing body of evidence to support what ISTCs have to offer the NHS. NHS Partners Network members are determined to take this work forward not only through the ongoing ISTCs, but also through the steady expansion of the free choice network that has developed since the committee’s report. With these elements of choice in place, patients have the opportunity to choose the best treatment available and will increasingly ask for more choice, not less, as they realise its benefits.

What lessons have been learned by the healthcare industry from the first wave of ISTC provision?

There are many useful lessons that we can take from the first wave of the ISTC programme. The key lesson to take away – and one that is applicable throughout independent sector involvement in public service reform, I would argue – is that ISTCs work best when they are integrated and work in partnership with the rest of the local NHS. The other lesson is more straightforward but nonetheless important to repeat: doctors are using ISTCs more, and are referring to them with increasing enthusiasm as patient feedback comes through saying that they liked using them and received good care. It always comes back to the importance of focusing on the patient at all times.

How can the private sector most effectively overcome the organisational mistrust of ISTCs that exists within the NHS?

Dogma or preconceived ideas about what the independent sector is there for tend not to matter much to patients. They are more interested in how well the system works and in the quality of care they receive. Our members therefore do their best work when the relationships are strong between all relevant NHS organisations, with a shared commitment to the patient providing the unifying force in the system.

Such an atmosphere of trust and confidence cannot be created through the signing of a contract. People identify personally with each other when they are clear that they are working towards common goals.

What advice would you give to independent healthcare providers that are looking to set up ISTCs to treat NHS patients?

ISTCs are now recognised as a vital part of the modern NHS, and neither of the main political parties questions that. As procurement moves to a local level, firms entering the market need to be able to highlight added value in terms of efficiencies and quality of care.

Developing innovative models of care and services will also be essential. The divide between primary and secondary care is no longer a particularly useful way of splitting up and organising healthcare – quite the reverse in fact. New ways of working coupled with better use of technology mean that a key part of any new offering may well be to show how you can link primary care services to diagnostic or elective care capability.

This more integrated way of working is likely to be reflected in the upcoming Darzi review, and the independent sector could have a central role to play in providing ‘joined-up’ patient-centred care, using new configurations that many patients will find both convenient and attractive.

 

 

APC delivers contrast for hospital HEMEL HEMPSTEAD HOSPITAL is using a new contrast delivery system to enhance the safety of its diagnostic and interventional procedures. The ACIST Contrast Management System, from UK company APC Cadiovascular, has features that increase the safety of the patient and the clinician, speed up operating times and minimise wastage of expensive contrast media. The ACIST provides a variable-rate adjustment of contrast media flow and volume in the form of hand controller buttons. This allows clinicians to use less contrast, which potentially reduces the incidence of contrast-induced nephropathy (CIN) and means that higher-quality images are produced. It also allows the use of smaller catheters, which helps to speed up patient recovery. An important safety feature is the built-in sensors, which monitor the key system functions and contrast lines. This means that the risk of injecting air into the patient is reduced. In addition, the medical professional is better protected from radiation exposure: the ACIST allows the clinician to administer contrast whilst stepping away from the imaging device. Mary Kelly, Superintendent Radiographer at Hemel Hempstead Hospital, said: “After I familiarised myself with the system, I found the ACIST reliable, efficient and easy to use.” For more details, visit www.apc-cardiovascular.co.uk

Extravasation detector wins design award MEDRAD’S XDS™ EXTRAVASATION DETECTOR has received a 2008 Medical Design Excellence Award® from MDEA. The award was received by Medrad and its development partner, Battelle Medical Device Solutions, at the Medical Design & Manufacturing (MD&M) East 2008 Conference and Exposition in New York. The XDS aids in the detection of leaking intravenous contrast media from the injection site into surrounding tissue during computed tomography (CT) diagnostic investigations. “This prestigious award recognizes our XDS Extravasation Detector technology, the investment of many resources for research and development, and the inherent risk of developing medical devices; the MDEA validates that the investment and risk were worth it,” said Cliff Kress, Senior Vice President, Medrad CT Business Unit. “We are proud that we have succeeded in developing an extravasation technology that continues Medrad’s long-standing commitment to patient safety.” The MDEA competition, presented by Canon Communications and sponsored by Medical Device & Diagnostic Industry magazine, recognises medical product excellence in design and engineering features, innovative use of materials, user-related functions that improve healthcare delivery, features that benefit patients, and the ability of the development team to overcome challenges. Medrad Inc. is a global provider of diagnostic imaging systems. For more details, visit www.Medrad.com.

Panadent to market ViziLite Plus PANADENT LTD has been selected as the exclusive distributor of ViziLite® Plus with TBlue™, Zila’s proprietary oral cancer screening product, in the UK and Ireland. “Panadent’s speciality in selling dental products to dentists and hygienists through education, technical expertise and service will make them an effective marketer of ViziLite Plus,” said David Bethune, Chairman and CEO of Zila. “The UK market represents a significant opportunity for Zila and establishes a solid foothold for expanding throughout the rest of Europe.” “ViziLite Plus is a much needed oral cancer screening product for patients in the UK,” said Peter Gowers, Managing Director of Panadent. “Given that 25% of oral cancers occur in people who do not smoke and have no other behavioural risk factors, it is imperative that every adult, particularly those at high risk for oral cancer, be screened at least once a year.” Oral cancer is the sixth leading cause of cancer worldwide, and early detection is crucial to reducing the impact of this disease. ViziLite Plus uses a chemiluminescent light source (ViziLite) and a pharmaceutical- grade vital tissue dye (TBlue) to help dentists and dental technicians identify and evaluate abnormalities. For more details, visit www.zila.com.

New pacemaker makes hearts beat faster THE ALTRUA™ PACEMAKER from Boston Scientific has gained CE Mark approval and been launched in the European market. Altrua is Boston Scientific’s most advanced pacemaker and its first to treat bradycardia, a condition in which the heart beats too slowly. Fred Colen, Executive Vice President, Operations and Technology, CRM at Boston Scientific, said: “Altrua’s innovative technology – enabling physicians to adjust the therapy to meet the needs of their patients – demonstrates our renewed focus on treating bradycardia.” The Altrua pacemaker provides physicians with a number of diagnostic and therapeutic capabilities that enable them to tailor the therapy to specific patient requirements. Multiple Atrial Ventricular Delay programming options reduce unnecessary right ventricular pacing. A Minute Ventilation Blended Sensor treats chronotropic incompetence, the inability of the heart to regulate its rate appropriately. Ventricular Rate Regulation helps physicians to manage patients with frequent atrial arrythmias. In addition, the Automatic Capture capability checks every heartbeat to see whether the ventricles contract in response to the delivered pulse. If no contraction is detected, a backup pace with more energy is delivered. For more details, visit www.bostonscientific.com.

Cordis launches new bare metal stent CORDIS CORPORATION has launched a bare metal stent, the Presillion™ Cobalt Chromium (CoCr) Coronary Stent, in Europe. The Presillion stent, which received CE Mark approval in March, displays both flexibility (for ease of delivery) and conformability (for adaptation to the blood vessel). “The Presillion stent had a very smooth delivery and passed the calcified area proximal to the lesion quickly,” said Professor Eberhard Grube M.D., Chief of Cardiology at Heart Center Siegburg in Germany, who recently implanted the device in a patient. “The final angiogram showed the excellent conformability and scaffolding of the Presillion stent to the vessel walls.” The Presillion stent consists of alternating rings of narrow and wide struts that provide both flexibility and optimal radial strength. The unique design enables the stent to be flexible in the unexpanded configuration, and to support the vessel while conforming to its shape in the expanded configuration. Staffan Ternstrom, President of Cordis Europe, said: “The Presillion stent is a great complement to our Cypher® Select Plus™ sirolimus-eluting coronary stent. It is highly deliverable and very flexible, which are two characteristics important to physicians today.” Cordis Corporation, a Johnson & Johnson company, specialises in vascular intervention products. For more details, visit www.cordis.com.

Software to help with memory loss A RADIO-PAGING REMINDER SERVICE that helps brain injury patients regain their independence has been upgraded using software from Norwich-based communications specialist Autopage. The NeuroPage™ reminder service is operated nationwide from the Oliver Zangwill Centre for Neuropsychological Rehabilitation, based at the Princess of Wales Hospital in Ely. NeuroPage is designed for people with memory, planning or organisation problems resulting from brain injury, but can also be used by patients with dementia or learning disabilities. Patients send in a list of things they need to remember, and at the appropriate time the computer-run system sends a message to their pager or mobile phone. Patients who took part in trials of the new Autopage-operated system included 40-year-old Bruce, who suffers from seizures and subsequent memory loss. NeuroPage prompted him to complete tasks such as taking his medication and charging his mobility scooter. It has reduced the frequency of his seizures and his need for care support. NeuroPage™ has helped hundreds of people since it was launched 10 years ago. In February it made the transition to a Windows-operated Autopage system. This has made it easier for NeuroPage to use text messages rather than paging, increasing its appeal for many patients.

Telehealth is the use of electronic and web-based systems for the remote monitoring of patient vital signs, such as blood pressure and pulse rate, in order to treat long-term conditions more effectively and reduce hospital admissions.
On Target talks to an industry e-health alliance and two leading UK telehealth companies about the opportunities and challenges facing this new model of healthcare technology.

A powerful message

Dr Malcolm Clarke, a Board Director of the UK eHealth Association, discusses how telehealth services can change public healthcare.

What key clinical benefits does telehealth offer, and in which disease areas is it making an impact?

By measuring clinical parameters in the patient’s own home and on a daily basis, telehealth offers the possibility to provide a service that is both convenient for the patient and able to provide powerful data that allows the health professional to have detailed knowledge of the health status of the individual. This supports intervention in acute exacerbation of conditions such as chronic heart failure where prompt intervention can avoid the need for expensive hospitalisation, or indicate rapid admission, so that early treatment can reduce hospital stay.

The information, used in the management of patients with long-term conditions, can result in better control of the condition. This includes reducing and maintaining blood pressure in patients with hypertension to recommended values, so that long-term risk of stroke and cardiovascular disease is reduced. In patients with diabetes, reducing and maintaining blood glucose levels means that the long-term risk of vascular disease and resulting ulceration or loss of limb, or retinopathy and resulting sight loss, is significantly reduced.

How does telehealth improve NHS service provision and performance?

The technology can support the health professional to target intervention. Those who are well controlled need fewer routine checks, whereas those requiring assistance can have intervention targeted until suitable control is achieved. Furthermore, having the patient’s own data allows personalised educational messages. The patient’s own data may be visualised on graphs and compared against target values. This provides a powerful message to assist in supporting the patient to achieve target values.

What is the biggest challenge facing the UK telehealth sector? How can it be overcome?

The health sector currently lacks resources, incentive and knowledge. Long-term management of long-term conditions using telehealth could be well managed by primary care, given suitable incentives to achieve targets. Financial incentives could provide impetus for clinical willingness and provide the resources to achieve those targets. Novel approaches and uses need to be investigated.

The long game

Peter Range, CEO of Home Telehealth Limited, discusses how telehealth companies can work in partnership with the NHS.

How can telehealth companies most effectively do business with the NHS?

In our view companies looking to become telehealth partners with the NHS have to be prepared to view NHS business as a long-term strategy rather than a short-term financial gain. In our experience, the ability to prove that the company has many years of ‘handson’ telehealth project experience and can produce referrals and successful clinical and financial outcomes from previous projects is an absolute ‘must have’ rather than a ‘nice to have’.

The NHS is looking for true partnership working relationships and close co-operation, including telehealth programme design, implementation, management, training and web server hosting, plus the development of clinical pathways, policies and procedures ‘bespoke tailored’ for the way they wish to develop community care in partnership with other stakeholders.

Over 80% of Home Telehealth Limited business comes from NHS Trusts, who require us to design, manage and implement their telehealth programme rather than simply be a supplier of boxes with no added value.

To what products and business strategies would you attribute Home Telehealth’s success in the UK healthcare market?

Telehealth service delivery is relatively new to the UK, and the level of knowledge and expertise varies considerably from Trust to Trust. A key business strategy for Home Telehealth Limited has been networking, membership of professional trade associations and a thorough understanding of DH policy and funding streams for telecare, as well as having our telehealth products and managed service offerings listed on the NHS PASA National Framework Agreement.

A critical success factor for our business is finding the ‘right people’ to employ in order to deliver telehealth sales and support functions, as such skills are in very short supply in the UK. Our growth success can be directly attributed to identifying ‘best of breed’ telehealth solutions for remote patient monitoring and securing exclusive distribution rights for the UK.

A key element of our business strategy is our telehealth managed service offering: we provide the NHS with the technology, installation into the home and 365 days a year patient monitoring via our nurse-led telehealth care centre triage operation for those Trusts who do not have the trained staff and/or deliver a 9am–5pm Monday–Friday primary care service.

Who are your key customers and partners?

Home Telehealth Limited is partnered with a large number of NHS Health Trusts in England, Scotland, Wales and Northern Ireland who are implementing telehealth programmes for the first time. One key company partnership is with Cornwall and Isles of Scilly NHS Primary Care Trust, undertaking a major UK telehealth programme and randomised clinical trial for over 1,300 long-term condition patients.

What are the prospects for the UK telehealth sector?

Numerous research reports indicate swift growth for the telehealth market. Datamonitor predicts a five-year compound annual growth rate of 56% compared with 9.9% in the clinical market. Key factors driving this growth are: the ageing population; more people with long-term conditions; shortages of healthcare professionals; and DH policy to deliver more care in community settings as opposed to secondary care, helping people to maintain their independence.

Successful outcomes from the three DH whole-system demonstrators are also crucial to the future success of telehealth in the UK. Negative outcomes from these clinical trials would have a direct impact on the future level of Government funding and the DH’s strategy for telehealth implementation.

“Companies looking to become telehealth partners with the NHS have to be prepared to view NHS business as a long-term strategy rather than a short-term financial gain.”

Everybody wins

Joshua Rowe, Chairman of Broomwell Healthwatch, discusses the huge benefits to the NHS that remote monitoring technology can bring.

How can telehealth companies most effectively do business with the NHS?

By adding value to NHS services. They need to work alongside existing healthcare provision, offering an enhanced service.

To what products and business strategies would you attribute Broomwell Healthwatch’s success in the UK healthcare market?

Our primary product is the ECG Interpretation Service. This enables doctors, in effect, to import ECG expertise into every surgery. The service is appreciated by GPs because it helps them make better-informed diagnoses. It’s very much appreciated by patients because of its convenience: you go to the surgery and you’re dealt with. You don’t have to take three buses in the freezing winter to go to some outpatient unit in the secondary sector. It’s also appreciated by patients because of its immediacy: you go to the surgery and within a minute you have your diagnosis. You don’t have to spend a week or two worrying “Am I ill or not?” The NHS should like it because it saves them an absolute fortune – I say should because I don’t know whether it’s clicked yet – in saved referrals.

Certain things (like closing hospital beds) are excellent for the NHS but bad for patients. Certain things (like expensive cancer drugs) are good for patients but bad for the NHS. This is a win-win-win project: doctors like it, patients love it, and it fits well with the DH guidelines on care closer to home, patient choice and the 18-week target. Everybody wins.

We also provide an ECG Interpretation Service at home for people who’ve had a heart operation or a heart attack or have chronic heart disease. These people can now call a 24-hour centre and talk to cardiac experts, and can transmit a full ECG down the phone line to get an immediate evaluation. The experts can either give you the reassurance you need or send you to hospital.

Another service that we provide in Southampton and Bolton monitors congestive heart failure. Doing that takes up a million hospital bed days each year in the UK. Our monitoring system is based on body weight: when fluid enters the lungs, weight increases dramatically. We install a weighing scale in the patient’s home that transmits automatically to our centre. We monitor the patient’s weight every day, and the minute we notice an increase we call the area nurse. All the monitoring can be done from home.

“Not everybody embraces new technology that quickly. But once you’ve proved yourself, once it’s accepted, once people use it, they absolutely wonder how they could ever live without it.”

Who are your key customers?

The majority of our customers are PCTs – there are 14 PCTs already in the system and another 12 in line to join. The main users are surgeries. Virtually all the PCTs in Greater Manchester are using the service, and more surgeries are joining every day. The contract comes through the PCT. We’ve been through two NHS pilots, one with the South Cumbria and Lancashire Cardiac Network and one with the Greater Manchester and Cheshire Cardiac Network. Manchester is showing a 58% saving in referrals to hospitals. Extrapolating from those figures nationally, we’re talking about savings to the NHS of nearly half a million referrals per year.

We initiated these projects with keen support from the DH. Professor Robert Boyle, National Director for Heart Disease and Stroke, gave us guidance at an early stage. And Bob Ricketts, who’s in charge of commissioning in the DH. In the North-West there’s Mike Farrah, Chief Executive, and Joe Rafferty, Head of Commissioning. In Cumbria, Dr Steve Ward and Sally Chisholm, Director of the Cardiac Network, were heavily involved in the pilot. In Greater Manchester, Janet Radcliffe and Karen Gibbons, who run the Cardiac Network. All these people believed in the concept when they heard about it, wanted us to do the pilots, and are pushing for adoption.

We’re serving a community hospital in Somerset, where we have reduced the need to have cardiologists on call: when a patient experiences chest pains, the information is transmitted to us and we advise whether a cardiologist is required. We estimate this saves the hospital around £200,000 per year. They’re talking about applying it to all their community hospitals. We’re also serving 18 prisons, a drug rehab centre, oil rigs all over the world, and cruise liners.

But this is an expensive operation to run: it’s very labour-intensive. It’s a long-term investment, because the profit will only come when the volume is much higher. The number of staff you need increases in line with the number of customers. We’re not a charity, but if profit is your main driver you’ll go into another business. Public companies would find it difficult because they have to report to their shareholders every quarter.

What are the prospects for the UK telehealth sector?

There are a lot of hurdles to get through. There’s the initial hesitation, reluctance and scepticism. Not everybody embraces new technology that quickly. But once you’ve proved yourself, been through all the pilots and all the various hoops that you have to go through, once it’s accepted, once people use it, they absolutely wonder how they could ever live without it.

 

 

DH invests £31m in testing e-health A MASSIVE DH INITIATIVE to test the effectiveness of telehealth and telecare with 6000 patients is under way, backed by funding of £31m. The Whole System Demonstrator Programme is being rolled out across Kent, Cornwall and Newham to test the potential of e-health technologies for supporting those with complex health and social care needs. Health Secretary Alan Johnson commented: “Improving care with new scientific advances and innovation is vital if the NHS is to continue to offer the very best services, but this innovation must be at the frontline of the NHS to help people manage their conditions better themselves.” The pilot scheme will make e-health facilities such as remote monitoring and automated safety devices available to patient groups including the elderly and frail and sufferers from diabetes, heart failure and COPD. The demonstrators will run for a minimum of two years, addressing the needs of 6000 patients (2000 in each site) – the biggest such project undertaken to date in England. The scheme is expected to deliver a reduction in emergency admissions, use of the acute hospital sector and dependence on care home settings. A Green Paper on the future of care and support services is planned in 2009.

Endoscopy firm widens its scope THE UK OPERATION OF ENDOSCOPY DEVICE SPECIALIST KARL STORZ has expanded its occupancy at Slough Trading Estate. Karl Storz has taken further space on the trading estate for additional storage and archiving following recent corporate expansion, due in part to a new £120,000 contract to supply its Endoscopic Airway Kit to Worcester Acute Hospitals NHS Trust. Neil Impiazzi, Inward Investment Manager at Slough Trading Estate, commented: “Probably the most important aspect of what we do at Slough Trading Estate is working with our occupiers to fulfil their changing property requirements as their businesses grow and develop. We have always believed that creating a supportive business environment can play a pivotal role in a company’s future growth and success, and so we are all the more delighted to be working with Karl Storz as it goes from strength to strength.” Slough Trading Estate is the largest business centre of its kind in Europe under single private ownership. Some of the world’s most successful companies operate there, including Ferrari, Fiat Auto (UK) Limited and Black & Decker. Headquartered in Germany, Karl Storz develops, sells and distributes specialist medical equipment. It has offices throughout Europe, Asia, North and South America and Africa.

Scottish eye laser inventor wins European award THE SCOTTISH INVENTOR OF A LASER SCANNER for the eye is among four innovators honoured with the European Inventor of the Year 2008 Award. The awards, selected by an international jury, went to leading inventors from the UK, Belgium, Germany and the USA. They were presented at a ceremony in Ljubljana by Slovenian President Danilo Türk, European Commission Vice-President Günter Verheugen and President of the European Patent Office (EPO) Alison Brimelow. The European Inventor of the Year Award, jointly instituted by the European Commission and the EPO, recognises inventors who have made a significant and lasting contribution to technical progress and helped to strengthen Europe’s competitiveness. The prizes were awarded in four categories: industry, SMEs/research institutes, non-European countries and lifetime achievement. Douglas Anderson, a Scottish inventor and the winner in the SME category, has pioneered a powerful but pain-free eye laser treatment. In 1992, Anderson’s son, then five years old, went blind in one eye when a retinal detachment was detected too late. Anderson set out to develop a system that could give a complete and detailed wide-scan image of the retina. More than 13 million patients have since benefited from the non-invasive optical laser scans developed by Anderson’s team.

Digital Healthcare wins NHS Framework contract DIGITAL IMAGING SPECIALIST DIGITAL HEALTHCARE has been appointed by NHS Connecting for Health to the NHS Additional Supply Capability & Capacity (ASCC) Framework, following open competition bids. Digital Healthcare will supply the NHS with clinical IT services within the ASCC Framework, which is designed to supplement the existing supply capacity, enable new requirements to be met and mitigate risks of existing suppliers being unable to meet contractual commitments. The new contract does not replace or conflict with any existing contracts. Cambridge-based company Digital Healthcare is a producer of specialised digital imaging software and electronic patient care management systems for the healthcare market. It is the leading supplier of ophthalmic and diabetic retinopathy screening solutions to the NHS. Digital Healthcare’s software is designed to comply with NHS standards for the secure electronic transmission of data. It provides automatic surveillance for patients at risk, with electronic referral to clinical experts when symptoms appear. Managing Director Martin Procter said: “Digital Healthcare’s software is already used to screen for eye disease for over a million UK patients with diabetes. This is an opportunity for all parts of the NHS to utilise our groundbreaking technology to improve patient care.”

Marathon man runs 117 miles on Össur limbs A BILATERAL AMPUTEE has run four marathons over a six-week period, using state-of-the-art prosthetic limbs from Össur. Nottinghamshire athlete Richard Whitehead achieved successive personal bests of 3hrs 54m (Kilimanjaro), 3hrs 39m (Rome), 3hrs 36m (Georgia) and finally 3hrs 22m at the London Marathon. He raised a total of £1,369.93 for Macmillan Cancer Support. A full-time Disability Sports Performance Pathways Coach for Nottinghamshire County Council, Richard receives sponsorship from prosthetics manufacturer Össur. “Össur’s technology enables me to reach new heights in fitness and performance,” he said. “The special-designed Flex-Run® prosthetic limbs help me to run more naturally and use my fitness to best effect. I could not even dream about a global four-race programme like this without them. “Running with 80,000 other runners and watched by thousands more cheering supporters is an immense privilege. All these races have changed how I feel about running and my responsibilities as a role model to amputees and runners across the globe!” Another amputee who successfully completed this year’s London Marathon is Andrew Palmer, a Prosthetic Engineer from Cardiff DSC and a left below knee amputee. He finished in 3hrs 23 minutes, raising £2,132.50 for the Limbless Association.

Lord Darzi gives high five to NHS HEALTH MINISTER AND SURGEON LORD DARZI has issued five pledges on how the NHS will handle changes to services. Lord Darzi’s report ‘Leading Local Change’ sets out a process requiring changes to be transparent, clinically evidenced, locally led and for the benefit of patients. The new report, aimed at the public, patients and NHS staff, outlines the checks that any change has to undergo before it proceeds. PCTs will need to observe five pledges: 1. Change will be to the benefit of patients, i.e. it will improve the quality of care. 2. Change will be clinically driven, i.e. led by clinicians and based on clinical evidence. 3. Change will be locally led – “different places have different and changing needs”. 4. Patients (and other stakeholders) will be involved. “NHS organisations will work openly and collaboratively.” 5. Patients will see the difference first. Existing services will not be withdrawn until new and better services are available. Lord Darzi said that the focus of his final report on the next stage of NHS reform (expected this month) will be “how we can enable local clinicians and patients to be the driving force of improvement and change in the NHS”.

Leader of the pack

 

Leader of the pack

Who are the Key Opinion Leaders in the new NHS, and how can medtech build successful relationships with them? Ruth Lessar looks at how to identify and access the supercustomers.

We all use the phrase ‘Key Opinion Leader’, and we all like to think we know one or two well-regarded professionals who are experts in their field – and who like and use our products and are prepared to tell their peers about them. But is this enough? Should we be making better use of our professional opinion leaders?

What is a KOL?

‘Key Opinion Leaders’ is a traditional term for specialist medical practitioners who influence their peers’ medical practice, including their choice of adoption of new medical technologies and prescribing. Companies traditionally engage with KOLs early in a product’s development to provide advocacy on the product and feedback on marketing. Nowadays, however, there’s no reason why a KOL cannot be a specialist nurse or from another discipline, provided they have the kudos and gravitas necessary to influence their peers.

In general, a KOL will have a specific area of expertise such as oncology, orthopaedics or gynaecology, and may be involved in very specific sub-specialities of a discipline. Some KOLs are actively engaged in publications, clinical trials or market research.

A cursory glance at a hospital telephone extension directory will enlighten you as to the sheer number of specialities that exist in a general hospital, let alone a major university teaching hospital. All of these areas either already have their KOL experts or have the ability and potential to develop them.

Why do KOLs matter?

Finding ‘someone special’ who will see the benefits of your technology and want to disseminate this insight to their colleagues is invaluable. It is through such ‘trickle-down’ that technologies become accepted and adopted. A KOL will influence other specialists on a local, regional and even national level. Some KOLs, though few and far between, achieve global status – though the UK is perhaps more parochial than elsewhere in the world.

KOLs often rely on information provided to them by the medtech industry to ensure that what they say is accurate and up to date. This is a two-way relationship for the KOL and the company involved. The relationship will need to be managed. If you’re in a big company, it’s important to make sure that other divisions in your company are not already engaged in work with the KOL. It’s not uncommon to find one KOL engaged on several different projects within different departments of a company – which could lead to a PR nightmare or worse! Those in smaller companies need to manage their relationships with KOLs carefully, keeping track of any business transactions and communicating them to colleagues.

First catch your KOL

Here’s the tricky part. You have a mega-blockbusting technology in a niche area of, for example, urology. You seek the internationally eminent Prof. Plumber as a KOL. The chances are that every other medtech company with an interest in urology has already got there first, and the Prof. has a close KOL relationship with several companies. The smaller the niche, the more pressure there is on the few KOLs in that discipline. It is therefore very important to understand the KOL’s needs and develop a meaningful two-way relationship. You will need to determine whether and how the relationship will develop, and to monitor it continually.

Should you not be able to do this, don’t despair: there are other options. Even the likes of our supernova Prof. had to start somewhere. Where better to look in the firmament than on the horizon for a rising star? Utilise your field representatives. Sales and clinical teams will often be able to identify professionals who are interested in your technology and would like to impart the information to their peers. You could also be helping them along their career route, especially if they want to publish articles in medical journals.

Make sure the marketing department works in tandem with the sales department. From a representative’s view, finding a rising star and then losing them to marketing can cause serious disharmony within the company. Both internal and external relationships need to be handled with care.

KOLs and the new NHS

We are now three quarters of the way through the new NHS plan, and we’ve seen quite a few changes. Probably one of the biggest is the move towards treating patients in the community. This means that fewer patients are referred to hospital and therefore fewer see your traditional potential KOL, the medical specialist. The flip side of the coin is that more opportunities have been created for use of medical technologies in the community, especially to treat long-term conditions.

Rest assured: those who need hospital treatment will still receive it. We will, however, see many patients referred initially to (in the case of orthopaedics) a triage centre run by specialist GPs, nurses or allied specialist health professionals such as extended scope physiotherapists. Many cases will be treated then and there, and only those requiring surgery will be sent to the hospital to see a consultant.

If you are trying to sell an orthopaedic technology, you need to think about who is the most appropriate professional to develop as a KOL. That may be any, all or none of the above professionals. It really depends on what your technology does and for whom, and where it is used. If its ultimate purpose is to help keep patients out of hospital and in the community, not only those concerned with the medical aspects of the technology will be important.

Make sure you’re being objective – don’t choose a person as your KOL because you had a 3am drink with them in the bar at the last conference and they’re now your ‘best mate’.

Don’t forget those responsible for commissioning services. If a Director of Commissioning can see a cost benefit to your product and the healthcare professionals and patients like it, then the possibility of having a commissioner as a KOL is worth considering. Most people in senior positions within Primary Care Trusts network with colleagues in other PCTs, and good news travels. Practice-based commissioning will also offer some medtech companies the opportunity to develop KOLs within the community.

And don’t forget the patients. Do you remember the ‘expert patient programme’? Depending on your medical technology, you may be able to develop certain patients into KOLs – particularly those involved in national medical charities or pressure groups.

Relationship building

When you’ve identified a potential KOL with the aid of your team, there are certain points you must consider in your approach:
• Make sure you’re being objective – don’t choose a person as your KOL because you had a 3am drink with them in the bar at the last conference and they’re now your ‘best mate’.
• Make sure you understand the needs of your KOL and their perception of your company and products.
• Devise an approach that allows you to monitor, manage and measure the KOL programme.
• If you have several KOLs, be strategic in your management of them. Profile and follow up, then develop and implement a plan to manage the relationships.
• Review and analyse KOL input regularly to measure change and programme effectiveness.

Above all, enjoy the relationship with your KOLs – and remember the benefits are mutual.

Ruth Lessar is an independent consultant specialising in the healthcare market. She has worked in the NHS as a nurse and practice manager and has many years’ experience of NHS liaison in the medtech and pharmaceutical industries. Ruth has lectured on legal aspects of healthcare and advised businesses on strategy in the new NHS. For more information, e-mail
ruth@lessar.fsworld.co.uk.