Orthopedic Companies Have Two Massive Logistics Problems

OTW spoke with former U.S. Army Logistics Officer, Ethan Lauer, about the logistics of Orthopedic and Spine products and he highlighted two massive problems.

According to Lauer, “The problem that orthopedics has is tons and tons of orders. The same rep has 20 surgeries a month, the distributor has 400, the manufacturer has 3,000…and all at different stages in this process.”

“In the orthopedic industry, when you ship finished goods out of SAP or Oracle, it goes out to the field and for the manufacturer it kind of disappears into a big gray smoke cloud. They don’t know where it is.”

“Manufacturers don’t have any idea of the stuff they have on the field that’s not being used in this place but could be used over in this other place. There’s a tremendous amount of inefficiency. The simplest way to describe it is this industry has billions of dollars of inventory invested and shipped into the field that’s rattling around in the trunks of sales reps and in their garages and in distributor offices and they don’t have any visibility of it anymore.”

Lauer explained, “The vast majority of inventory on these companies’ balance sheets is sitting out in the field and they have no system to track it, no visibility to track it.”

So, Lauer decided to light that up.

A U.S. Army Logistics Officer Tackles Orthopedics and Spine

Automation infrastructure from the 1970s and technology from the 1990s probably don’t make you think of operational efficiencies. However, for Lauer, they capture the essential logistical issues creating inefficiencies and cost in Orthopedics and Spine today.

“What we’re doing today started almost all the way back in 1994 or ‘95”, explained Lauer. “At that time I was an Army officer, I was a logistics officer in the cavalry. That job is all about making sure that bullets and ice and repair parts and medical supplies and other things are in the right place at the right time.”

Lauer continued, “So from a very young age I was kind of programmed in my thinking. In my operations-type thinking, I was programmed around systems. And we had systems in the Army, although they were 1970s automation infrastructure.”

Lauer explained, “So you had a computer that was in one location that you processed some stuff in and then you wrote a floppy disk out of that and you ran it up to the next location, whether that was down the street or 20 miles across the desert. Then you put that into another computer, as did like 20 other people, then all of that information got compiled together and then that got turned into a disk and it got sent somewhere else.”

Lauer added, “On those disks was all the same types of information that is being transferred now in Orthopedics. So, there’s a surgery scheduled somewhere and there’s some equipment that is needed at that surgery. Well, that’s no different than when there’s 20 soldiers in a location and they need to eat dinner tomorrow night, so we need to make sure the right number of MREs [meals ready-to-eat] get there when those guys are ready to eat.”

Learn Orthopedics From the Ground Up

“Roll forward to early 2000 when I got to the Orthopedic industry as a sales rep and you know at the time, and even today, corporate America hired a lot of junior military officers. Corporate America loves these guys and girls because they have all this experience doing things way above their age range.”

Lauer continued, “I got to this job as a sales rep and my boss says take this clipboard and this piece of paper and this pen over to Brackenridge Hospital and write down what Dr. Spann used today.”

Lauer chuckled as he added, “I thought I was getting hazed.”

It didn’t take long before Lauer began to use database tools to try to organize and automate the processes for his sales rep job. While he was there, the distributorship went through significant growth and according to Lauer, “I became a sales manager and an ops manager, so I was managing all of these processes. So, the system that we were developing—even more and more so—matured.”

Building Software for Ortho Sales Reps

A few years later, Lauer stopped selling implants and started a surgical neuromonitoring company where he also utilized his operations experience to solve logistics problems. Lauer told OTW, “I got over to neuromonitoring and I had all the same problems. All those logistics problems—what surgeries are tomorrow, what equipment needs to be there, what supplies got used, who needs to be billed, what person needs to go do this, who’s assigned to this—all the same exact problems except for now I owned the company, and I had the purse strings.”

Lauer continued, “I said I’m going to get some real software guys, not me being just a sorta hacker putting these things together. So, we developed a solution there and it was called NeuroStream, and we started selling that to other neuromonitoring companies. That’s really how I got bitten by the software bug basically.”

In 2010, Lauer began the process of selling his neuromonitoring company and he became reunited with his orthopedic buddies.  “When I circled back to my orthopedic buddies, they were all still doing the same thing—handwriting stuff, making lots of phone calls, sending lots of text messages, doing that kind of thing. So, in 2009, we created ImplantBase.”

Building Logistics Systems From the Rep Up, What a Concept!

Lauer’s ImplantBase approach was different than the approach taken by other Orthopedic and Spine companies. Instead of creating a system for manufacturers that sales reps had to use, Lauer decided to create something just for the sales reps.

Lauer explained OTW, “We said let’s build something that’s just a really fast way for a sales rep to create a sales order from their phone and turn that sales order in—because that’s ultimately the main thing that a rep cares about.”

During the first few years, sales reps would pay to use this very straightforward and yet very valuable service. As the rep’s reliance on the system grew, so did their needs. Lauer told OTW, “What happened after that was that other features started to get requested. So now they wanted to manage their inventory in ImplantBase, now they wanted to be able to submit loaner requests, then they wanted to be able to do sales reporting, then they wanted to be able to calculate commissions.”

After a while, manufacturers started paying attention to what ImplantBase was doing. Up until that point, manufacturers had struggled with getting sales reps to adopt their systems.

Lauer explained to OTW, “So manufacturers started coming to us, rolling this out to their sales force and then putting layers of manufacturer functionality on top of that sales rep functionality because that sales order function, it’s just two sides to the same coin.”

“So that’s the backstory. You know that thinking I learned in the Army about how to organize things and how to get things where they need to be on time and on target is what led me to experiencing this problem firsthand and then deciding to do something about it.”

97% Sales Rep Adoption

As of today, according to the company, the ImplantBase platform has a 100% implementation success rate with 50 medical device companies, processing over $5 billion of revenue and a 97% sales rep adoption rate.

Lauer explained how the company views its implementation success, telling OTW, “Our 100% success is every project that we have started, we have finished, and we have got them to go live.”

While implementation success is at 100%, field adoption is a few percentage points lower. That lower rate is because, as Lauer told OTW, “The Orthopedic sales force is largely a distributor-based sales force so they’re 1099s. They’re not direct employees.”

This means that essentially they can choose whether to take on new technology or keep doing what they are doing. For seasoned reps, this may mean that they choose to stick with their Day-Timer as Lauer explained. A Day-Timer, for younger readers, is a personal organizer and planner.

System Flexibility

A distinctive feature of ImplantBase is that its implementation is very flexible. That is perhaps one of the key reasons that ImplantBase can boast 100% implementation success. Lauer explained to OTW, “Our system is designed so that customers can phase their implementation. You can do it by when you’re going to your field rollout phase, you can do it by rep, you can do it by region, you can do it by distributor, you can do it by enthusiastic sales manager that wants to get this in place for all their reps and distributors. You can do it in a lot of different ways but still have inventory transaction and visibility continuity as well as revenue continuity.”

Scalability Without Throwing More Bodies at Problems

“There are a number of areas that people find ROI [return on investment] by using the ImplantBase approach, but number one is headcount stabilization within their internal operations.”

Lauer continued, “With ImplantBase, the inventory request gets entered one time from the phone and those people inside customer service go from being data entry people to data analysis people and really customer service people.”

“They don’t have to type in anything, they don’t have to verify lot numbers or do any of that stuff and so the efficiency as they grow is that the company doesn’t have to keep throwing bodies at problems inside customer service, inside field inventory, inside asset management. They don’t have to do any of that because we streamline. It’s the promise of digital transformation. And it’s nothing special about ImplantBase. It is just what digital transformation does for companies.”

Lauer elaborated, “It's not headcount reduction…it’s headcount stabilization. You can grow. We have companies that have grown four to seven times and haven’t added a single person in their field support operations. So that’s really where the ROI is, it’s in people. And in any one of these companies, it’s inventory and people that are their two top expense lines.”

Not One-Size-Fits-All

A key component of ImplantBase is its versatility. Lauer described to OTW, “ImplantBase serves all different sizes of orthopedic manufacturers. From very small companies that are just running on QuickBooks or QuickBooks online all the way up to 1,000 plus person implementations in companies that have big, comprehensive Oracle and SAP. We sell the product in a way that is modular, and it’s priced for each different size of customer. So we have SMB pricing, enterprise pricing.”

Lauer added, “ImplantBase is not a static thing. We put out a new version of ImplantBase every two weeks and in those versions are customer requested enhancements. We’re constantly wrapping ImplantBase around the needs of our customers. Both from their individual needs, whether that’s reporting or workflow processes or anything like that, as well as based on industry trends or regulatory changes, things like that.”

Lauer finished, “ImplantBase it’s not a one size fits all. It is a 450 sizes fits 450 people. Our feature set is 99.99% customer driven.”

Amateurs Talk Tactics, Professionals Study Logistics

As former U.S. Army logistics officer Ethan Lauer understands so well, “Amateurs talk about tactics, but professionals study logistics” (General Robert H. Barrow USMC).

And for mission critical jobs like surgery, well, again, we reach back to the great military leaders for guidance: “…in its relationship to strategy, logistics assumes the character of a dynamic force, without which the strategic conception is simply a paper plan.” (Theo Vogelsang, USN)

So, in conclusion, gentlemen and women of the Orthopedics and Spine Industry: may the (logistics) force be with you.

To reach former U.S. Army Logistics officer Ethan Lauer, please contact his company ImplantBase at: https://us.implantbase.com/company/contact-us.