The End of Codependency: Could Covid19 Be the Beginning of the End for the Current Ortho Implant Del

Healthcare providers have an unhealthy dependency on orthopedic device reps. Will the adjustments forced on healthcare by the novel corona virus pandemic spur them to fix it?

As we are all aware, social distancing has affected all of our lives in a dramatic fashion. It has particularly impacted healthcare providers, who have implemented strict access policies to their facilities in order to limit the spread of this dangerous virus. Restrictions in many cases include orthopedic device reps, who generally have unfettered access to the operating room and sterile processing environment. For a variety of complex reasons, providers have come to rely on these reps to manage their implant supply chains- from recording usage in the OR during surgery to reassembling and restocking the sets and trays in sterile processing (SPD) after they have been washed and cleaned. In many hospitals, there can be more device reps down in reprocessing than SPD technicians. It’s a “white glove” level of service, and most healthcare providers have become addicted to it.

It’s a great deal for the orthopedic device companies and their reps, as this level of control results in cushy profit margins and sales reps who can make more than the surgeons. Conversely, it’s not such a great deal for the healthcare providers, as this ecosystem is often a capitated cost/zero sum game: fat margins for one side leads to thin margins for the the other. And with the OR being the profit center for the provider, the situation is problematic.

This system is a relic of the past, where complex mission critical ortho sets and trays required the expertise of trained specialists (device sales reps) to ensure that everything was in order and complete upon arrival in the OR for surgery. Even today, the management process of these trays is generally entirely manual, with all the knowledge tied up with the device rep. Complex, poorly labeled trays and lack of digital tools to manage the process are prevalent. As mentioned the sales rep manages both the front end (OR) and the back end (SPD) of the process cycle. And as mentioned there is a lot of “margin in the mess” for the device OEMs.

It doesn’t have to be this way.

The answer for providers is in requiring digitally managed orthopedic sets and trays from their OEM device partners. This will enable:

  • Scanning from the field during surgery, at point of use, to accurately record usage for patient records

  • Utilization of scanning and software to reassemble and restock the orthopedic sets and trays in SPD

  • Sending this data directly to OEMs for automated resupply

Codependency is defined as a behavioral condition where one person or party enables another’s dysfunction. Generally speaking, the more competent a device sales rep is, the more the provider completely leans on him/her to manage tasks that should be completed internally. Good sales reps are not going away, and are vital for educational and logistical service to providers. Any rep knows that at least half their cases are routine, however. Putting a rep to stand in every case, to play ‘defense’, to simply count implants or to place orders should simply not be necessary.

If in the effort to limit the spread of COVID19 access to providers is going to be limited and restricted, it is time for the these providers to seize the moment, leverage technology, and start to gain control of their orthopedic implant supply chains. They are the customers: they have the power. Scan Ready sets and trays should be the standard they require.

Every other department in the hospital, in fact every other industry in the world, has adopted scanning at point of use to initiate supply chains. The fact that providers don't scan at point of use for some of the biggest line item costs in their biggest profit center simply doesn't make any sense.

For more information on digital management of orthopedic sets and trays, please go to:


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