Dear Kinamed Sales Agents & Representatives,
As you have no doubt heard, there is much talk of elective surgeries migrating from hospital settings to separate facilities such as Ambulatory Surgery Centers (ASCs), specialty surgical hospitals or Hospital Out Patient Departments (HOPDs), upon resumption of these procedures. The reasons cited for this trend are the health system’s desire to segregate elective surgery patients to limit their exposure to the COVID-19 virus and elective surgery patient’s reluctance to have surgery in a regular hospital for fear of catching the virus. It remains to be seen to what degree and at what pace this migration may occur but, however this plays out, this is something that we must watch closely and prepare for now.
Elective knee arthroplasty cases in particular are predicted to move to outpatient settings whenever possible as TKA has already been added to the ASC-payable list by CMS, and were already in the process of migrating to same day surgery settings prior to the COVID-19 crisis. This migration could impact our CarboJet business profoundly if we are not prepared. CarboJet instrument sets would need to be installed at the new site, CO2 tanks would need to be procured, staff would need in-servicing, etc. And beyond just these practical considerations, we need to make sure that a decision is not made to omit CarboJet from the knee arthroplasty case to simplify the transition or to save costs.
Therefore, we are providing this CarboJet account list (linked here) for your territory and are asking you to fill it in in to identify where pre-existing CarboJet accounts will be doing their CarboJet related surgeries upon restart of elective cases. Your regional manager will work with you to complete this form. And here are a few key points we’d like to make to help you ensure that none of your hard-won CarboJet business is lost going forward during a relocation to a new facility:
- Be proactive about preparation!
- If cases are moving to a new facility, contact key personnel there to inform them that the surgeon needs the CarboJet sets as an essential item for performance of cemented arthroplasty cases.
- Communicate with your surgeon customers to reinforce the benefits of CarboJet and to coordinate a move to a new facility.
- Make plans for and execute relocation and installation of CarboJet sets at the new facility.
- Be prepared to suggest use of bulb syringe lavage, with elimination of pulsatile lavage, if there are procedure cost pressures, as well as reinforcing all the benefits.
There may also be concerns by surgeons and staff about blood aerosol risks with CarboJet that will need to be addressed. We have not found any evidence that transmission occurs with these aerosols and we have heard surgeons state that epidemiologists at their facility say the virus does not exist in bone and marrow; and, of course, oscillating saws and other cutting tools cause blood aerosols in these procedures that are unavoidable. In any case, be mindful of the need to reinforce and train for effective use of the lap sponge to control debris during the initial part of CarboJet cleaning. We have some of the splash shields for the wide-angle knee nozzle available as well.
We look forward to your feedback on what you are anticipating and what you are seeing in your area. These have been trying times for all of us on many fronts and we look forward to getting busy again! There should be a significant backlog of cases so let’s not miss out on any of this upcoming opportunity!
Best Regards,
Bob Bruce
VP, Global Marketing & Product Strategy