Healthcare changes are creating opportunities and challenges for medical technology companies, potentially resulting in a new normal for what success in the industry will look like in 2023.
It's once again the time of year when we ask medtech experts to peer into their crystal balls and offer their best predictions for the new year. This year, MD+DI checked in with the following medtech thought leaders to learn what 2023 has in store for the industry: Mike Monovoukas of AcuityMD; Glenn H. Snyder of Deloitte; and Jaime Wong of Intuitive Surgical.
Empower the salesforce (or lose your people)
Change for a successful 2023 starts from within, said Mike Monovoukas, founder and CEO of AcuityMD, a commercial platform for the medtech industry that helps companies target, manage, and execute on commercial opportunities more effectively.
Medtech companies are going to have to focus on empowering rather than monitoring their sales reps in the new year.
“I think there are a lot of factors that have … sprouted up over the last two years with the ‘great resignation,’ which is … hitting all industries. Folks are itching for new opportunities, testing the waters, and leaving their current employers,” Monovoukas said. “In the medtech industry specifically, supply chain issues have reverberated all the way to the sales rep where the reps are unable to sell product, get commission, and hit quota. On top of it all, you have this push into monitoring tools to make sure the sales reps are using their time productively, effectively. Kind of a Big Brother type feeling.”
The scenario is leading many to look for new opportunities.
“That’s a huge risk to a medtech company…. How do you grow commercially?” Monovoukas said. “I think in ’23, the smart companies are going to be the ones that wake up to that earlier and start investing in empowering their salesforce as opposed to monitoring or taking a Big Brother approach.”
Medtech's 'Great Unbinding'
Monovoukas said the “great unbundling of medtech” will continue with at least one more large, diversified enterprise spinning off a medtech business to stay agile, focused, and better able to adapt to the market landscape.
In the last 18 months or so a number of larger, diversified enterprises have spun off medtech or healthcare franchises. GE Healthcare is one example.
“… to effectively adapt to a changing medtech marketplace, you have to take a really focused approach and specialized approach to be competitive in this new environment,” he said.
Beyond episodic care
Startups and strategics are expanding beyond episodic care and procedures, according to Glenn H. Snyder, principal and global medtech leader at Deloitte. Deloitte provides audit, consulting, tax and advisory services to nearly 90% of Fortune 500 and more than 7,000 private companies.
“In the future of health, we expect six key areas — data sharing, interoperability, equitable access, empowered consumers, behavior change, and scientific breakthrough — to collectively transform the existing health system from treatment-based reactionary care to prevention and well-being. The traditional boundaries of the industry will dissolve and new roles will emerge in the future of health as exponential innovation propels the industry towards 2040,” according to a Deloitte Perspectives article.
In essence, Deloitte’s future of health research suggests innovation will shift from its focus on sick care to wellness and prevention, Snyder said.
Snyder and colleagues broke down the focus areas to five chevrons, called the “patient journey,” in the order starting with prevention and wellness, detection and diagnosis, treatment decision, treatment, and post-acute monitoring and chronic care management.
"We found that innovators were fairly evenly focused (with +/1 40%) on each of the non-treatment aspects of the patient journey, nearly double the focus on treatment," Snyder said. "The promise of this shift is that we'll increasingly be able to identify disease early, treat it with personalized interventions, and dramatically improve outcomes and reduce cost of intervention."
A few examples within these chevrons include, in “detection and diagnosis,” liquid biopsies aiming to detect cancers early and determine specific genotypes so treatment recommendations can be personalized; in “treatment decision,” an innovator that focuses on image analysis that can stitch together a three-dimentional “digital twin” for surgical planning; and in “post-acute monitoring and chronic care management,” innovations that alert providers with early indicators of a preventable acute event.
“It’s worth noting that ‘treatment’ is also benefitting from innovator focus. A general trend is ‘simplification,’ where innovators are making surgical procedures more predictable through guidance by [artificial intelligence] that, in theory, can democratize surgery by allowing lesser-skilled practitioners to perform procedures with good quality outcomes,” Snyder said.
Intuitive Surgical saw da Vinci procedures grow about 20% worldwide in the third quarter of 2022 compared to the same quarter the previous year. The third quarter of 2021 reflected disruption caused by the COVID-19 pandemic, which impacted our procedures. The compound annual growth rate between the third quarter of 2019 and the third quarter of 2022 was roughly 16%, the company reported.
Jaime Wong, SVP and senior medical officer at Intuitive, told MD+DI he is encouraged that the greater healthcare community has found innovative ways to help it continue to recover from the pandemic’s challenges.
“While hurdles remain, the hospitals and care providers with whom we work continue to persevere,” Wong said. “For Intuitive, it means a greater opportunity to understand our surgeon, care team, and hospital customers so that we can continue to develop innovative technology to help their patients and drive toward better outcomes.”
From inpatient to outpatient
The pandemic had negative and positive impacts on the medtech industry, Monovoukas said.
For example, while companies that sold orthopedic implants were impacted when hospitals closed for elective surgeries, some pivoted to focusing on an ambulatory surgery center strategy and rode out COVID with less negative impact. That strategy will likely put them on stronger footing for ’23 as the migration of surgeries to the outpatient and ambulatory surgery center settings will continue, Monovoukas said.
Snyder said the pandemic created a new awareness of and demand for distributed services (including virtual) that are more convenient for the patient, have a lower climate impact, and, in selective types of patient/clinician interaction, have a “good enough” quality level.
"While there has been a fair bit of an elastic trend, many executives believe the new way for patient triage will be digital first, virtual second, and physical third (and only as-needed),” Snyder said. “Clinicians have pointed out that this new mindset must be built into clinical practice protocols before it will stick.”
Meanwhile, the healthcare system is evolving models for physical care delivery. Snyder points to three trends in this area, including hospital care moving to the home, with the hospital at home model; increasingly complex hospital-based surgery moving to the ambulatory surgery center or office-based lab settings; and clinical-based care moving to retail stores.
Medtech innovations, like handheld ultrasound technology with built-in AI capabilities, are helping to pave the way.
Personalized medicine is here to stay
Personalized medicine will continue to drive innovation into new medical technologies, Monovoukas said.
“[Personalize medicine] creates stress, in a good way, on the overall industry,” Monovoukas said. “The patient is unique and deserves to be operated on with unique products that map to their body type and clinical starting point, their anatomy, the preferences of the surgeon factor in; so, personalized medicine has a huge impact on the medtech industry.”
This challenges the industry in ways that will impact how medtech companies go to market.
“Think about it from a doctor’s or hospital’s perspective. The broader the suite to treat a patient, the more difficult it becomes to keep up with the latest and greatest technology ... Then take another step and think about what the impacts of that are to the medical device industry. You have to think about exactly which hospitals or doctors need to be educated on certain products that they might not have exposure to,” Monovoukas said.
And manufacturing will need to keep up with a supply chain that is a lot more dynamic given the macroeconomic factors in the proliferation of all these different products, he said.
Medtech companies, Monovoukas said, will need to be targeted and focused about how they’re messaging their new products and where they’re messaging their new products.
Supply chain and other challenges remain
Keeping up with demand and coordinating the supply chain was a huge risk to many medtech businesses in 2022, when backups and order and product backlogs made getting innovative new technologies out to market challenging.
The supply chain remains a headwind that medtech companies are facing into 2023, Monovoukas said.
Wong said the healthcare teams Intuitive works with continue to face challenges including staffing issues and the unpredictability of COVID-19 and other viruses, which will create obstacles for resource allocation.
There, too, is an opportunity to find solutions, Wong said.
“Intuitive wants to offer solutions in these areas to help customers improve workflow to staff robotic-assisted procedures, and analytics that generate actionable insights to help customers care for more patients effectively,” Wong said. “As part of that, we understand that it takes much more than a robot. We provide an ecosystem of support, from technology training to system support to clinical research into new procedure opportunities.”