Medsider: Learn from Medtech and Healthtech Founders and CEOs - Why Medtech Companies Should Care More About Sales Operations

Episode Date: September 18, 2014

It’s safe to say that IDNs are important customers for the overwhelming majority of medical device companies. Therefore, it’s probably rational to assume that medtech companies do a good job of tracking the changing IDN landscape, right? Wrong. Based on the 2014 ZS Associates Commercial Operations Benchmark Study, only 56% of medtech companies track IDN...[read more]Related StoriesSubstantial and Sustainable – 2 Words That Medtech Companies Should Get Used ToSocial Media Best Practices for Marketing Medical DevicesAre Medical Device Models the Key to Building a Lean Medtech Startup? 

Welcome to Medsider, where you can learn from experienced medical device and medtech experts through uncut and unedited interviews. Now, here's your host, Scott Nelson. It's safe to say that IDNs are important customers for the overwhelming majority of medical device companies. Therefore, it's probably rational to assume that med tech companies do a good job of tracking the changing IDN landscape. Right? wrong. Based on the 2014 ZS Associates Commercial Operations Benchmark Study, only 56% of MedTech companies track ID and membership. Surprised? Just wait, there's more. In this same study, only 20% of medical device companies have processes in place to measure marketing program

results or effectiveness. I wonder what Apple and Google would think about that. In this interview with Andrea Traverso, associate principal with ZS Associates, we learn more about the commercial operations benchmark study and what it means for MedTech companies. Here's a few things that we're going to cover. Why should medical device companies track IDNs through a CRM? And for the few companies that are doing well, what do they have in place that is enabling their success? Are there business, intelligence, or CRM platforms that MedTech companies should absolutely be considering? How should medical device companies manage the garbage in, garbage out issue that plague all CRM systems? When trying to implement a CRM strategy, many medical device sales reps view their respective companies as a big brother.

How can this be overcome? And why is the marketing analytics function not a top-of-mind priority? for medical device companies. Of course, there's a lot more that we're going to cover in this interview with Andrea, but before we get started, listen to these brief two messages. First, to get free email updates when another Medsider episode goes live, simply go to Medsider.com forward slash free. We don't send emails often, but when we do, they're full of valuable content.

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That really helps us out. Okay, for you ambitious doers, here's your program. All right, welcome to Medsider, Andrea. I appreciate you coming on. Hi, thank you. It's a great pleasure to be here. Let's first start with a little bit more about yourself as well as Z.S. Associates. Okay, that sounds good. So, as you said, you know, my name is Andrea Traverso. I'm an associate principal based in Z.S. Evanston's office. I've been working in consulting for 16 years. And the last 12 years I've been working with Zias. I'm focused on the METTEX space.

basically helping my clients, you know, in a really broad set of issues going from growth strategies to commercial operations and including, you know, many topics like in the commercial as well as in the sales and marketing space. Okay. And specific, I know you've got a deep knowledge specific to MedTech, but are you focused on certain therapeutic areas within the device arena? Right. So I'm mostly a generalist.

So I have different clients in different therapeutic areas. So I'm more of rather than therapeutic, more, you know, subject expert in that sense. Like, you know, cover specific commercial operations, strategy, specific areas within our offering. But not particular to any single therapeutic area. Okay, okay, very good. And as I mentioned, the topic of our conversation is really around your commercial operations benchmark study. When I say you are, I'm referring to kind of the ZS Associates Commercial Operations Benchmark Studies. So let's start with, if you don't mind, providing a little bit of an overview of the study itself,

how often you release it, number of survey respondents, I guess, for lack of a better, description that are involved and maybe a little bit more about how the data is collected. Yeah, absolutely. And maybe even before I start with that, like I will provide a bit of overview of ZS so that when we look at the survey, you know, we have a bit more context and understand our breadth of expertise in that space. So, CS Associates, it's a global consulting firm. We also do technology and outsourcing solutions for...

focus more on the commercial strategy and implementation, and a significant part of our focus in the healthcare industry. So we right now have over 2,500 consultants in 21 offices around the world, so we're really global in nature. And as I was saying, you know, very focused on the healthcare industry, and just as a point of reference, we work with 49 of the 50 top pharma companies, as well as the top 20 medical med tech companies in the work. So we are very engaged in the industry.

We conduct more than 100 engagement in the med tech space every year. So in line with our death of experience, we also have different initiatives to help our customers understand better, allow them to benchmark themselves, et cetera. One of those initiatives is this commercial operations benchmark study that we conduct every two years. So this is the second edition of the survey. And the overall objective of the survey is to help meta companies benchmark themselves

relative to their peers and identify areas where they could improve or as well as, you know, help them prioritize initiatives for future investments in the commercial operations space. Our latest edition of the survey included 25 U.S.-based MetTech companies and included four main areas such as customer relationship management or CRM, business intelligence, information management, and pricing and contract management. And within those four areas, we have a series of questions that help them think about priorities, current situation, as well as expectations for the next two years. Very good.

And in terms of how you identify the respondents for this study, and in terms of how many respondents overall. Can you speak to that as well? Sure. So, you know, in preparation for each survey, we send out invitations to different existing as well as past customers and companies that may have expressed an interest in contacting us.

And then it's really optional. The main incentive for the companies to participate is to get a copy of a detailed report and that detailed benchmark against these other respondents. So it's a free participation and it's really optional. As a result, you know, of that, then we share the results as well as conduct discussions to help them, you know, understand and interpret in more detail the results. And then for those companies that are interested in the results but have not participated, we also have an executive summary that is posted in our website,

and it's free for anybody to access. So if any companies that are listening to this interview are interested in participating, they can reach out to us through our website or directly email me and we'll be happy to include them in the next round of that. research. And I'll definitely link to the executive summary that you mentioned in the show notes for this particular episode on Medsiter.com. But regarding the respondents, I want to go back to that real quickly, in terms of the results of the study, are the response, in terms of the size of the medical device companies, is it all over the place in terms of revenue from, you know,

small cap to mid cap to large cap? That's an extra question. And that's in fact the case. We have different sizes of companies and you'll see that, you know, different, also the focus of the survey is in commercial operations. So one of the questions on the survey is the size of a commercial operation, right? And that definitely reflects a different, a good spectrum of sizes. So I would not, you know, I think it's a good representation.

There's not like a bias or larger or smaller companies. So I think it's a good representation of the market. Okay. Very good. So let's get on to the good stuff, what most people that are listening to this are interested in, and I'm referring to the results of the study. And, you know, we're going to probably cover four different sort of subtopics if we have time, you know, moving from IDNs and what that means.

for med tech companies. We'll then discuss the rise and the upward trend of mobile. We'll move on, hopefully, time permitting, to outsourcing and what that looks like for med tech companies. And then lastly, we'll kind of round it out with the conversation around big data. But as I mentioned, let's first start with IDNs. And I'm going to just list off a couple stats that I found interesting when I read through the report, a couple of these 40% of med tech companies list ID and strategy

as a top customer relationship management priority over the next two years. However, only 56%, so about half of the med tech companies can actually track ID in membership now, while only 36, about a third, are able to track their progress against account management goals. So the relatively low percentage of med tech companies that I just mentioned, you know, that can track membership now and perhaps more importantly, track progress against goals, why do you think that's so important for med tech companies and medical device companies in this current health care environment. And that's a great question.

And I think that, you know, what's important here is to highlight what are those changes and what's the new landscape that MedTech is facing, and that will, you know, bring line to why is that important, right? Where are we highlighting those statistics, those numbers, right? And the reality is in the last few years, the MedTech industry has experienced significant consolidation among the customer base, right? And that really has created a lot of complexity in the marketplace. And from the standpoint that in order to be successful or to sell successfully now, you need to understand and be able to identify many decision makers. So in today's environment, you not only need to be able to identify, you know, those physician

practices or those individual physicians that are relevant and that may use your product. But you also need to understand the influence that the hospital may have on those physicians, right? where, and not only that, right, is not only the physician and the hospital as a whole, now you also need to understand the influence of the integrated delivery networks on that ecosystem, if you want, right? So for companies that have, you know, multidivision or multiple product lines, that makes this system very complex.

So the selling process becomes really hard, is not clear who's making the final decision, and it's not clear what's driving more, and it's not clear how the IDN impacts the final decision. Furthermore, right, the IDN consolidation and the fact that they're becoming more and more powerful brings to light the importance of having a clear strategy source IDN.

So in order to have that clear strategy, right, you need to be able to identify all the stakeholders there, but the environment is so dynamic and there's been so many acquisitions and change is that it's really hard to keep track of the truth source, right, and understand clearly that affiliation process. not only, you may have clarity on the affiliation process, but you may not be totally clear on the level of control of the IDN. So there are many, many different dimensions that end up impacting the success of your selling efforts. Yeah. And if I don't, if you don't mind, I'm going to have you pause right there because I think you, you nailed something that I,

I'd love to highlight that I think is really important in that there's so many different stakeholders involved in the purchasing decision right now. And I think for the longest time, most medical device companies have presumed that it's the physician that drives most of those buying decisions within the hospital setting. And to a certain extent, that's still very much the case. But there's a lot more decision makers that are not only involved, but have power in that process. And what it sounds like to me, and correct me if I'm wrong, what it sounds like because most, based on the survey, it seems like most device companies can't really clearly articulate or define all of those different decision makers very well.

Exactly. Exactly. That's exactly a point. And this is a critical aspect, right? And something critical to be able to have a good handle on so that you can really successfully get your message, right, your value proposition across. So you may be spending a lot of time with some people that you thought would make a decision to find out later that maybe there's an IDN decision maker that will override all the effort

that you've done and progress you've made in potential negotiations that you may have. So that's why it's, you know, it was kind of surprising that given importance of IDNs, there's such a small percentage of companies who have a clear IDN strategy and that are able to track that affiliation between the hospital and the IDN. And to your knowledge, and I certainly wouldn't expect you to call out companies by name, but are you aware of med tech companies that are doing this really well right now? And the follow-up question would be, why is that the case? maybe what are they doing differently internally that's enabling them to get pretty far out ahead

in comparison to other device companies within the space? That's a good question. And I would say that most companies are trying, and if you look at the results of the survey, Also the companies expect that to be a priority in the next two years. So those that may not be doing or trying to do it right now, they are aware of the importance of it and do something about it. I think the main challenge is that, as we were saying, right, there are multiple stakeholders and there are also lack of clarity.

So companies default to the always, what is easier to measure and try. and they sometimes lose visibility of these other elements. And so, you know, the difficulty in tracking, it makes it harder to put an emphasis on. You typically try to track and be able to show progress and because you cannot show the progress, they default to other things that they can track. So that's one of the bigger challenges, right?

And the lack of data, so some companies trying to try to do it, but they don't have data that they can rely on. So sometimes the expectations are that data needs to be 100% correct, and companies don't feel comfortable moving ahead with solutions that may cover most of the needs. And sometimes, you know, with such a dynamic environment, you need to be able to feel comfortable. managing yourself within some degree of uncertainty. And so I think those are some of the barriers that they're facing. But they're becoming aware of the needs and they're putting more effort. And as I said, you know, most of the companies are trying to identify that as a priority for the next two years.

Got it, got it. So it's clearly very important. And I think as the survey said, what was it, 88% anticipate disability within two years. And from my perspective, it seems like the simple ability to track the data, whether the issue is data collection or just whether, you know, where that data exists, whether it's in multiple platforms and it's disparate or if it's in one place. I mean, that seems to be sort of the underlying issue and that if everyone had access to that data are relatively, easy access to that data, it may be a little bit easier to begin to build strategies around that. But, you know, I think one of the quotes, I think, within this study that I have jotted down, I think, is really important, is from one of your colleagues, Raj.

And I'm going to, I'm going to totally mispronunciate his last name. But what don't I ask you? What's the best way to pronounce Raj's last name? I always have the same trouble. We should refer to him as Raj. Raj. We'll leave it at that. Right.

Because even if you corrected me, I probably would continue to not enunciate it correctly. But I'll read Raj's quote. The MedTech industry must effectively treat each IDN as one account. IDN customers don't want a different sales representative associated with each hospital or product line. They want one point of contact and want this individual. to know everything about the account. So I think that's a really good quote, and it makes a ton of sense, and I think everyone that would read that quote or listen to that phrase would agree,

but actually executing against that is obviously the more challenging issue. Exactly. That's a challenge, and even if you have one point of contact right at the IDN level, Well, then if you have multiple hospitals, right, which are dispersed geographically, then you need multiple people and multiple roles interacting with the different stakeholders. So the additional challenge is how you ensure appropriate coordination among those people, right? Those that are covering the different accounts and alignment and clear objectives. And that's where technology starts to play a key role.

And I think that's a key segue to the mobility discussion and how these new technologies as well as big data, cloud, all those things are starting to enable more and more that coordination and that visibility of the different dimensions at the IDN, account, and individual physician level. Yep. Let's, for the sake of time, let's move on to mobile if you don't mind. Are you okay with that? Absolutely.

Yeah. Okay. So I'll start out with, you know, let's move on to that topic, which is really the upward trend or the rise of mobile and the use of mobile platforms and mobile hardware devices specific to med tech companies. But one of the stats that I jotted down in preparation for this interview was that it was this one is that over the past two years, the use of mobile technology by device companies has more than doubled from 35 percent to 75 percent.

So roughly three-fourths of the device companies, at least according to your survey, are using some sort of mobile platform. And this percentage is expected to reach basically 100% within the next two years. And again, I'm going to quote Raj. I'm not going to pronounce his last name. We'll leave it at that. I'm going to quote Raj. He's popular today this afternoon.

Again, a good quote that I think he laid out was, you know, companies first viewed mobile devices as replacements for laptops to run email and video demos. But today they are vital BI or business intelligence and CRM tools serving as platforms for real-time automated customer alerts delivered immediately. before sales call, which I think is another good quote, because from my perspective, most device companies, when they think of mobile, they think of, you know, let's put a print-based brochure. Let's take it online or make that digital so the sales rep can, you know, can shoot or can show a, you know, a physician or, you know, a brochure on their iPad instead of, you know, in this print form.

but we've seen a strong evolution of sort of the mobile platform over the last two years, not just from the extent that device companies are using mobile platform, but just how they're using it. And so my question for you is really more specific to business intelligence and CRM. Are there tools and our systems that have caught your eye or that have impressed you in regards of their effectiveness in order to, you know, drive revenue for device companies? Sure. You know, I think that as we were digging deeper on this CRM and mobility,

it's clear that, you know, some tools and some solutions are used more than others. And most of the companies we interviewed, I think that nobody would be surprised by this. Most of them, the solution that the current platform that they used, like 40% of them were using Salesforce.com, and there were like, you know, the other solutions in terms of CRM platforms were, you know, way far in terms of percentages. So, you know, the platform, it can be great, right, but is that as good as the use that people give to them. And that's one of the main challenges.

When we were digging deeper in terms of the satisfaction level with the solutions, and we were asking the respondents to rate the overall satisfaction with their CRN system on a scale from one to seven, and the average rating was around three and a half. So it's not only about the tool, right? So you can have the best tools, but you need to make sure that it's aligned with the needs, specific needs of your company, as well as, you know, a clear vision on how you're going to use it and leverage. So as Raj was saying, you know, today technology offers so many more, so much more than

just being able to project a brochure super quickly, right? There are many things, and you can really leverage it to provide insights and to enable your sales force to be much more effective beyond the brochure. So help them be able to keep track of the different interactions they have with the different stakeholders, be able to have visibility to what other people, other salespeople or other roles that interact with the cell force, what type of activities they engage with different stakeholders on your account, as well as how that relates. to the overall, for example, IDN level.

And things that, you know, it could be leveraged for is like get alerts in terms of, you know, different metrics or key performance indicators that you could set up. So that really there's like so many possibilities, right? And even though the use of mobility has increased substantially compared to two years, there's still significant room

to leverage all these other aspects that could be enabled by the technology. Right. I think we're just, that's a great point because it feels still very much like we're just that we're so early in this and that, you know, it's a big feat for a company or a medical device company to simply adopt a platform and they're not even getting, they're not even realizing the full potential of what these, what these platforms have to offer. Before we move on to the concept of outsourcing, a follow-up question I have for you is that I would imagine that most folks in the med tech industry that are listening to this, listening to our conversation right now would say, yes, I agree with this. CRM or business intelligence tools are great, but I'm having a hard time overcoming this idea of garbage in, so garbage in, garbage out.

So the data that sales reps enter or account managers enters garbage. And so, you know, we can't really do anything with the data. Or the alternative would be, you know, our sales force, our account, you know, our account managers, our sales reps, et cetera, kind of view the company as big brother now. And so do you have any thoughts about those two issues or recommendations on how companies should try to overcome that in an effort to deliver on the necessity of, or I should say, deliver on the, or fulfill the importance of, you know, what a CRM system or BI system can offer.

Yeah, absolutely. And what you're saying is totally true, right, because a significant percentage of those initiatives fail, and we hear, you know, our customers oftentimes call us saying, you know, we invested so much money on this system and it's not being used by the reps. It's been like, you know, it feels like we're wasting all these resources. So the key there is to avoid that big brother perception, right? If you're going to implement something just to keep a check on your reps, right, just to see what they're doing, that's, it's not going to be embraced by yourself.

So you need to make sure that you are providing value to them too, right? And that's where being able to provide analytics to them and give them value, help them in their day-to-day job, right? So giving them useful information, enabling them to have better conversation with their customers, sharing with them updated, right, and tracking metrics that will help them. them have more powerful discussions, being able to demonstrate the value of the product. So there's tools where you can set so that the rep can use to demonstrate the value added of your product. That's something that is a tremendous opportunity there.

So whenever we position a new tool as keeping track of what they're doing or making people feel that they're being watched over, that's typically not. not a very successful approach. But when you design it and you have a clear vision of the tool and designing it is such a way that will make the rep, the Salesforce more effective, more successful in a day-to-day job and they understand it, right? That's where we're seeing successful implementations.

So that's the key. Yeah, that makes sense. And I'm almost taking on the view that when rolling out are implementing a, you know, a CRM system or a BI system to your sales force, almost treating them as the customer and that you've got to deliver value to them in order to expect them to utilize that platform in return. So I think that's a good point. So, you know, for, you know, we're on kind of a time crunch, and I want to make sure we try to squeeze as much into this conversation as possible while I've got you on the line. But let's move on to the concept of

outsourcing. And, you know, an interesting stat here that I pulled out. And I would encourage everyone again to check out the summary that will be linked in the show notes. So, of course, you could always Google, you know, ZS Associates, you know, MedTech survey. I'm sure it'll come up on the first page. But, you know, one of the stats is nearly half of MedTech companies already outsource at least one commercial operations function, which I think is interesting. But more importantly, my question for you is more around this concept, when of the idea that, of the variation in the size of commercial operation team. So I think in the study, this was called out, companies with, you know, 2 to 300 member

Salesforce, which is fairly common within most MedTech companies, will manage with as few as four commercial operations or as many as 30 or more. And I think that's such a huge variation. So I want to get your thoughts around that and whether or not there is an ideal size of a commercial ops teams for MedTech. That's a great question. They're one million dollar question. So, yeah, as you were saying, right, there's a really broad range of number of FTEs that we've seen, right? And sometimes, just to clarify, sometimes it's not one single group that, you know,

consolidates all those FTEs, but sometimes it's, you know, pieces of different groups that may include, like finance, IT, specific commercial ops groups. So there may be many FTEs spread around the organization that may be covering different areas. So I wouldn't say that's like one magic number or a magic ratio that will tell you what's the optimal number of commercial ops resources. But what we think is that if you have a group that is too broad, too large, there may be a potential inefficiency there. And you may be overseeing, you may not be taking fully advantage of some operational efficiencies

that could be achieved, right? And today there's cost pressures everywhere, right? We hear all the time. Everybody's facing cost pressures. So one of the ways to achieve some efficiencies is to outsource. some of the areas. So right now, you know, as you were mentioning, like only 25% of the companies that we surveyed were outsourcing a couple of functions, but we do see that as a trend. And like a double trend, why I'm to try to achieve efficiencies, but also there are some things

that can easily be done in a more efficient way, an outsource way, but that would potentially free up resources for your resources, the Metta company resources, to be able to dedicate that effort to more value added, for example, analytics. And instead of just processing data or creating repetitive reports, you could potentially, we assign that effort and that energy on more valuable, predictive analytics, more insights

that could help you refine your strategy or, you know, have more success with your customers. Got it. Very good. And so the key takeaway there is there's not necessarily a magic number in terms of how large a commercial ops team should be in order to really drive top line revenue growth. The takeaway is that is a relatively simple one in that there could be areas of the sales ops team, for example, analytics, not that that has to be one, but that could be outsourced. And so MedTech companies should begin to look in that direction. I like your, you know, the concept or the, you know, where you were going with that.

the phrase earlier in that, you know, if there's too many people involved or if there's too many chefs in the kitchen, you know, nothing's going to get done and any efficiencies will, you know, will certainly be a result of that. So let's move on, if you don't mind, to the last subject, which is big data. And again, this is, this was really interesting to me. You know, a couple of the stats here on, you know, related to this topic is roughly a, Third, device companies or MedTech companies have processes in place to monitor marketing campaigns or marketing programs, and only 20% actually have processes in place to measure those marketing programs.

And so I think that's such a low, those percentages are so low, especially when you compare it to, you know, Silicon Valley startups, you know, within consumer tech that are all, that are so focused on, you know, A, B. and really, really measuring what programs and campaigns are working versus those that aren't. And so do you have any thoughts or comments around the low percentage of med tech companies that are utilizing big data? No, that's a good point. It's just to add to the numbers you were sharing.

I think that's more shocking. As we were talking about the different, like the 30 to 40 people or like sometimes and that, you know, different sizes of overall commercial groups, right? When you will look at the marketing analytics, we see that it's like an average, like a single FTE dedicated to marketing analytics. So not only the percentage of companies, but also those that have some analytics, it's such as small effort. So definitely, you know, in MetTech seems that marketing analytics is not like top

of mind, but that's definitely something that is changing and that is important. So we anticipate that they're going to continue to increase. And within marketing analytics, right, big data analytics is going to be something that really needs to pick up. It's one of the least developed functions right now in MetTech companies. As you were saying, you know, 60% don't have a function like that in place, but we anticipate that growing. And it's going to be a key priority going forward, you know, as you were saying, to remain competitive, right? So we definitely expect a shift on that space.

Yep. And again, as I mentioned earlier, it's just shocking considering how much budget is typically allocated towards, you know, towards the marketing with, you know, for certain product franchises, yet very little of it is actually ever measured and tracked. And so I would wholeheartedly agree and hope that that would, you know, that we'd see that increase, you know, the aspect or the concept of marketing analytics. So let's kind of, as we reach towards a conclusion here, you know, we discussed those four main,

these four main kind of topic areas based on the commercial operations benchmark study. And is there any major takeaways that you'd like to leave the audience with, whether it's just thoughts or comments from the study or just things that you would encourage med tech leaders to really begin to either take a deeper dive in terms of their look or maybe even begin to look at implementing? Absolutely, yeah. And we've spoken about many of them, but just to recap and highlight the importance of the IDNs and how to have clear strategies as well as leverage the technology to enable your

field, your salespeople to have more visibility at that IDN level. So that may require collecting, tracking more data, but that's something that, you know, you really need to develop and implement. Mobility also, you know, significant growth. We've seen significant growth, but still there is a lot of potential there that needs to be taken advantage of, right? so many things that could be done to enable the field and enable commercial success on that area. We mentioned some of them.

It could be data alerts, making sure that you enable your field to leverage all the information that you have available, to have more visibility, not only at the account level, but within the stakeholders as well as at the ITN level. so those different levels of stakeholders and contacts. And finally, how to be more efficient and make sure that you have the appropriate commercial operations support. That may require taking a closer look

at your current organization, the functions, and potentially identify some areas, which could be a bit more efficient throughout sourcing. as well as some additional areas that you can take on to provide more insights and better analytics to support your operations. Very good. Very good.

Well, Andrea, I mentioned earlier and just to serve as another reminder, I'll definitely link to the executive summary of the Zs Associates Commercial Benchmark Study in the show notes for this episode. But are there any other websites or what's the best place for or the best way for someone that's listening to this to reach out to you or to learn more about yourself or ZS Associates? Absolutely. They can visit our website, which is zSsociets.com or, you know, you can feel free to email me directly if they want more details about the study or if they're interested in participating

in the next study. my email is Andrea. Dotraverso at ZS Associates.com. Gotcha. And Traverso is T-R-A-V, as in Victor E-R-S-O. Exactly. Correct. Andrea.

dot Traverso at ZSsociets.com. We're very good. I'll ask you to hold on to the line, but again, thanks so much for your time, and I really appreciate it. Thank you so much. It was a pleasure being here with you. All right.

All right. So hold on to the line. real quick, Andrea. But for those listening, thanks for your attention. And until the next episode of Medsider, take care.