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Introduction: Be’Anka Ashaolu, Director of Marketing, Propel (BA)
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BA: Sometimes the best made plans go awry supply chains have been disrupted shelter in place orders have dispersed teams and new team members are being on boarded remotely.
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BA: The impact of COVID-19 has been unprecedented in terms of speed and magnitude but successful companies are proving that preparation generates resiliency.
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BA: Our VP of professional services September Highem returns to moderate this roundtable industry leaders discussing why they are thriving in this environment and how they're preparing for the next new normal.
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BA: She’s joined by Donielle Baudin director of quality assurance at imperative care, Sherine Khalil, president and chief business officer at Valerie compounding pharmacy.
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BA: Ron Chiarello CEO at LBO and John Milad, CEO of Quanta dialysis technologies. Let's listen in to react respond recovered emerging faster and stronger from the pandemic.
Session Moderated by September Higham, VP of Professional Services, Propel
Ron Chiarello, Alveo
John Milad, Quanta Dialysis Technologies
Sherine Khalil, Valor Compounding Pharmacy
Donielle Baudin, Imperative Care
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SH: Welcome to Danielle runs on and Charmaine thank you all for joining us today and taking some time out for this panel. We really appreciate it.
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SH: So you've all had a really busy 2020 for obvious reasons. Tell us about some of the challenges you've faced this year and why and how you were able to thrive Shereen would you take this question first. So
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SK: Thank you for having me. September. I think this is a really great opportunity.
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SK: I am the president and chief business officer for valor compounding pharmacy. We make customized medication for patients with unique needs.
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SK: And the biggest challenge like some of the challenges that we had in 2020 really were around ensuring that at the start of COVID
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SK: That our supply chains were intact that we were able to get the drug ingredients and source from our wholesalers without any effect of
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SK: Any pause and the imports that were coming into the United States and a few ways that we
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SK: overcame those challenges was we looked at our data and we tried to identify which are the compounds that affect patient care and that have chronic conditions.
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SK: Or our top 10 frequently most prescribed medications and then we will call the wholesalers to
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SK: Increase our order by a 90 day supply to make sure that we have at least 90 days of inventory on the shelf.
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SK: To make sure that our patients did receive the medications that they needed on time without any interruption and
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SK: Without having any unknowns that we're going to be coming forward in the months to come. So that was probably our largest endeavor and making sure that
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SK: Are we okay with the prescription medication that we have on the shelf. I think the other largest one was
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SK: During that time preventative appointments were closed so patients couldn't go to the hospital or the doctor's office because the doctors were
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SK: reassigned to respiratory clinics or Urgent Care. And when that happens, chronic sorry compound medications have a lot of effect for preventative care medications. So we work with our
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SK: hospital systems and physicians to identify, you know, can we help you at least put in your refill prescription orders.
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SK: For the patients. So while you're waiting for the next available appointment that you can see the patient, the patient doesn't miss their medication. In the meantime,
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SH: So those are the big challenges for us. Well, that's, that's a lot to cover. And I mean, you had to do this in the very first few months of the trends mimic
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SH: Things running. What a challenge. All right. I'd love to hear from someone else on the panel about their challenges and how they met them.
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RC: Yet this is I'm Ron chiarello CEO and founder of avail technologies we actually are making at home, do it yourself diagnostics devices.
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RC: So really the big challenge for us has been directly connected to the pandemic, where we added COVID-19 as an asset to our, our portfolio.
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RC: So you know that meant hiring during a time when we could need people on the challenges of bringing in new people onboarding them.
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RC: Making sure they were a cultural fit, making sure they were comfortable. Make sure they were safe.
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RC: And then of course you know having to accelerate from research and development through commercialization.
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RC: Because of the tremendous you know market need and market pool. So some of Sharine challenges, you know, we're looking at those now.
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RC: Around supply chain and around, you know, needing market demand, you know, it was sort of comfortable not to have to me those I really have a lot of
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RC: Respect and empathy for what what you're going through now because I'm looking at all those same challenges as they're coming so it's been, you know, an incredibly
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RC: Exciting time. And also, you know, difficult time challenging time
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RC: But frankly, being able to be part of a solution in the near term and long term is really satisfying ultimately
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SH: Wonderful. Thank you Donielle, which is
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DB: Director of trends at Imperative Care and we actually manufacture medical devices for the treatment of stroke.
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DB: Which is one of the procedures that is critical to care. So our first priority when we first found out about COVID not to stay at home worse was to make sure that we knew what we can do specifically to protect
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DB: The manufacturing team on site here and protect the supply chain, both to us, and then to the end user. So that stroke treatment can continue to be supported.
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DB: Throughout this time frame. So we kind of sent the peripheral team home brought in manufacturing and kept them here.
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DB: And then we started trying to figure out how to do regular research and development business or new device platforms remotely. So it was exciting to see what R & D engineers took some of the small equipment out of their home.
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DB: Home labs in their garage and they can keep holding over because pieces we will see this video conferencing on this is our doing things. And we've actually
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DB: Hired probably 20 people throughout the pandemic and some of them have been on the research development side, but the majority that on the operation side and it has an
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DB: Interesting and a struggle at times to be able to make sure and so on, and said, you get that cultural fits when oftentimes the first communication happens only through video
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SH: I can john went to your experiences, then
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JM: Yeah hello John Mallad. I'm the CEO and founder of on the Dallas was technologies, based in the UK. Thank you for having me today. And so, Fanta.
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JM: as developed as a portable, easy to use medallia system that we've designed to provide greater flexibility and the delivery of life sustaining dialysis care. And our mission is to improve dialysis experiences and to help patients that more freely.
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JM: We were in the process of planning our commercial launched the spring as coated hits and the entire UK went into lockdown. So that was a really interesting experience to do a product launch
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JM: Of a medical device into an environment that was heavily constrain
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JM: That, that, that's our entire workforce needs to be configured to work from home to the extent possible, with the exception of key workers who needed to be in the labs or field.
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JM: Staff will need to be in clinics and also forced us to rapidly pivot away from our initial
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JM: Customer sites that were selected for a home that dialysis patients because those programs and just shut down the middle of the pandemic and they didn't want people coming into clinics to do stuff like that.
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JM: The training.
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JM: And we
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JM: Spoke to our contacts of the NHS to understand whether we can be helpful with the coven
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JM: And Damn it, because we understood that there was a shortage of ICU beds and a shortage of Alice's capacity and the icy years and we were
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JM: We were really gratified to discover that, in fact, there was a desperate. We couldn't satisfy a desperate need that exists that was being met. So we immediately sold all of our launch, stock to the NHS England.
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JM: To deploy and the ice used to help deal with patients who had kidney injury as a result of it. And we also rapidly validated another market segment for ourselves that we had originally intended to pursue a little bit later. And instead, found that it was
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JM: Really demonstrated that having small simple to use portable device can make a difference in allowing terribly rapidly and flexibly deployed under very difficult circumstances. So really exciting for us but also
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JM: Along the way, we had to learn how to work different ways.
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SH: Wow, he has been really busy so one thing I'm interested to learn from all of you and
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SH: Business as business leaders, how does technology play a part in your ability to adapt to the new reality, for example, sharing and you took the very bold step of
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SH: Purchasing and implementing propel in the very first weeks of the pandemic.
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SH: And that's a big undertaking, when suddenly you've had to send all of your employees home. Can you tell us a little bit about technology and its role in your ability to account. Yes, so
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SK: In technology is something that we took a very conscious effort to invest in a compounding pharmacy and it doesn't happen in most independent pharmacies, you typically rely specifically on your pharmacy software for your orders in in your orders out
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SK: In compounding your highly regulated and standard operating procedures have to be documented. You also have to be able to
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SK: Track any of the changes to those documents when those changes happened, who made those changes. Why was it made
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SK: And then you have a new version. After you have the new version. Everyone has to be trained on that certified that they understand how to do it. And that if it's a practical application that someone's tested that they know how to practically follow that sop
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SK: What we decided as a organization was that technology and compounding needed to extend beyond equipment and machinery in the pharmacy for efficiency and workflow, but more about
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SK: Business Continuity efficiency of time and effort labor disaster planning and we took a measure to identify if we were to launch
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SK: Propel it within the organization, along with some of our other tools and systems that this would create a huge savings of time for our pharmacists and for our pharmacy technicians to be able to focus on
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SK: The work and new formulas and taking care of patients and talking to physicians and not having to spend time figuring out who made that last track change in Word and where did that go and
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SK: You know, and so these are when we talk about technology, we look at it specifically from a return on investment.
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SK: We invest this much in the technology, how much time and savings when we get back. And what does it do for us to free up individuals within our pharmacy, so we can focus on their professional development and improve their careers.
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RC: Yeah, this is, this is Ron i i'd like to build on what stream said so, you know, for us it's really three areas. And again, you know, we, we've been using propel on those
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RC: Since we started our quality management system. So it's, it's been a while as using that tool and those services example.
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RC: Um, but really communication documentation and integration are the three major areas for us, you know,
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RC: We're still startup. We're a growing company we're building infrastructure. So we rely heavily on technology for all three of these areas, especially
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RC: On you know in during this time of the pandemic where we've had about 30% of our workforce shift to working remotely, you know, working from home and so forth so that you know the comms partner everything from written communications, you know, instant messaging.
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RC: To to video conferencing and of course you want to be careful about to teach around these these methods.
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RC: Are particularly you know video conferencing, you know, we see it's sort of a real thing that I'm during the pandemic as a reflection.
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RC: Of, you know, anxiety and depression from stress in society is reflected in our corporations so using these tech tools to help relieve that while we're staying connected but not overdoing it has been very important
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RC: And the documentation piece again, you know, as a company that's developing
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RC: essays and products, you know, the r&d Polly management regulatory all have to be integrated and documented and moving together and not only the checks and balances, but that
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RC: Communication of the of the right hand, knowing what the left hand is doing, of course, and then again the integration of all of these seemingly disparate elements. Combined, you know, it cannot happen. And so using
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RC: The technology tools that we've implemented have really done a great job in you and ensuring the integration. So really, for us it spans the practical component of keeping the company together. We've talked about culture, a couple of times your Sherine mentioned that, of course,
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RC: And and also just the element of keeping the workforce. Well, right. You know, we're all in healthcare. We're all trying to
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RC: You know benefit, public health, but starts in our companies and looking out for our employees and our management team and then you know that that is an extension of what we do in the public
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RC: And Ron. It's interesting you you've had propelled for quite a while yet even during the pandemic and particularly stressful times you are extending the use of the technology, for example.
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SH: In propel you've been working on implementing lot history tracking and that's not a function that's normally done an appeal on system yet you've extended the use of propelled to do that.
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SH: So kudos to him for being brave and and even, even during difficult times, extending the use of technology and
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SH: Donielle. You've also had an experience like that your propel implementation has one of everything you've used you virtually every model for every module and propel and you keep extending them on to some thoughts about how technology has helped you.
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DB: Yeah, absolutely. Originally, we had invested in a technology solution.
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DB: Or some efficiency get have a single source of truth so that everybody knew exactly where they could get this information to track the training easier so that there was just more accountability within the personnel.
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DB: And also for some environmental reasons medical device just generates a ton of paperwork. As you're going through the process. You're not electronic
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DB: So we had originally gone into that path and to provide some building or off site employees to have flexibility and when you travel, you can still see the documents for participating reviews.
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DB: And it was fortuitous on this aspect because when we did have to suddenly shift to out of the business area. We could still be found in could still fully function.
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DB: On that aspect. So we were still able to make process changes. We were still able to track and make sure that the operations team was getting the training that they needed that.
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DB: procedures were there and available to them and we use just a tablet for them. So we don't have to print them out, they can access it straight from the PLM system so
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DB: It keeps making sure that we're current we're not missing those steps with them pretty important for us. And then we've used it.
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DB: As well, we're starting to put together a plan to integrate propel turnkey system, though I would be something we put in place fully
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DB: Cheaper and it leverages on we got into technology and who could interlink I could continue to advance us and make things more efficient as time goes on. We have to be vital to the company. I don't think we could have works.
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DB: Nearly as well or continue to meet the customer needs that we have every we're still doing this and the old way on paper.
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SH: And then, John. You've got some interesting experiences in the middle of a pandemic, you're doing some interesting work in propelled
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SH: Totally revising the way you're approaching GH F and TMR as well as some other processes. Can you tell us about how technology has helped you get through this time and thrive.
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JM: So as you don't were still early in the implementation profile.
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JM: But I would say that the experience of the last
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JM: The last six months, and indeed the experience, the last several years has driven us to understand that, we need a tool like this. So strictly a lot of our lot of our documentation and proceed PCs were manual
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JM: And then we build something internally to help manage that using off the shelf tools and only got so far. And as we've as the complexity of our offering has increased.
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JM: As the complexity of our operational activities increased you've seen the limitations of those tools. And so it became clear that we needed something that would be more scalable. That would also have baked into it and best practices.
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JM: In something cloud based. So as we, as we all had to work on most of us have had to work on or more more remote basis that has become abundantly clear.
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JM: We're also looking to set up currently setting up operations in the US who set up another production line in the UK.
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JM: So really to make all that work and to also facilitate the mobility of people that goes along with it. You need flexible, scalable cloud based solutions.
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JM: So this is all part of where we need to go. I wish, I wish I could say that we already had it in place from your PLM
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JM: QMS systems we're up and running. I suspect it would make our lives a bit easier right now.
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JM: They're not yet so it is challenging to implement that while you're in a product launch while you're in a pandemic, but we're doing our best to map, what we have on to your school and I look forward to the day when that's fully implemented.
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SH: Thank you for bringing up cloud. I'm interested to hear from the rest of the panel.
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SH: We've all been around for a while. And so we've lived in the world of on premise applications, probably for most of our careers that are in the process of moving to the cloud. How has using cloud technologies helped you to thrive in this environment.
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RC: This is Ron, I'll start on. In fact, our product is fully cloud enabled on data from our diagnostic tests and user inputs.
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RC: Traveled to the cloud visa via HIPAA compliant application program. So really, again you we were using it for everything around our technology, our product. You know how we're again implementing the things I talked about the previous
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RC: Question, you know, around communication documentation so. So for us it's it's it's it's essential it's essential not only
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RC: To have it as, you know, again, part of the product part of the infrastructure, but it has to be secure. So in our FDA conversations for our product.
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RC: On user security, cyber security on information is is their key concern alone without anti counterfeiting for, you know, our product.
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RC: So really the the cloud has become cloud enabled technology cloud enabled services have become so routine for us that it's more about
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RC: You know how we protect information from individuals and so forth, versus whether we're going to use it or not.
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SH: Right. And you promote the FDA, the FDA has been a little bit slow to adopt to the reality of cloud technology. And if any of you had challenges or opportunities with the FDA.
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SH: To educate them that software is now cloud and then maybe the validation will be a little bit different. What things have come up
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SH: You’re all kind of laughing
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SK: I would say I guess when I think about top solutions in in healthcare, it's still, it's still very foreign. You know, I think, you know, healthcare is one of those
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SK: Really antiquated industry still where it's super heavily protected by HIPAA and medical privacy laws and we still receive prescriptions by fax. For example, you know, there
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SK: I think the fax machine exists because healthcare exists right so you know i think i'm talking about solutions in the in the pharmacy world.
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SK: It's it's a lot of questions and making sure that whatever software you're using if it has any part of patient information.
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SK: That you are really understanding what HIPAA rules are and that there's backups and that you have encryption and
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SK: That if you have remote access that your permissions and definitions are there that's been one of the biggest challenges, I would say for us as a compounding pharmacy and
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SK: Even in talking with Propel and understanding what the you know what the business associate agreement says, and that it's on a Salesforce platform. These are things where
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SK: It does play into our decision making and how we're going to make sure that our patient information is protected.
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SK: So, you know, we would love for things to be 100% on the cloud, because it does. We learned a lot during this period of time where
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SK: I did have to get non essential workers out of the pharmacy and set them up remotely and when you have on premise servers, you have to deal with a lot of hoops on VPN and networks and settings. And that's been a big challenge for us as well.
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SH: In this environment and then 2020 is thrown so many curveballs at us and I'm sure you're thinking as leaders, what is the next big event. When is the next interesting event and tell me your thoughts about that and how you're planning for that next big unforeseen event.
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RC: This is this is Ron. I just like to comment, first of all, that there's been seven lunatic episodes of a virus like SARS to v2.
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RC: Making the jump from, you know, animals to humans. Those seven have occurred in the last 14 years
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RC: Not all have made it into the public's attention. So that's every other year, we had something like this happening that could be an epidemic or pandemic.
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RC: So the idea that it's not going to happen again is probably on the naive side. So we do have to continue to prepare
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RC: For for future events. And I think this one, you know, again I on a couple of things you just brought up the cloud. And, you know, digital health overall the use of Telehealth telemedicine. I really do feel Navy optimistically that
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RC: This pandemic has broken the seal on the needs for digital health to really become part of the details of how we do things you'll where JOHN Is he has potentially something more stringent.
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RC: Than HIPAA and GDPR requirements that that again. It's just part of the fabric of what we're all going to have to go through, you know, as, as we
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RC: Extend the healthcare ecosystem to include you know Telehealth telemedicine perhaps have on treatment services pharmaceuticals delivered to individuals.
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RC: True machine learning AI in collaboration with clinicians not excluding them but them working in a different way than they've worked in the past.
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RC: As you know, more stringent gatekeepers. Again, the the big data will enable this that that we're, we're, I think now is inevitable and the pandemic in the best light has has unleashed this and I, I would like to offer this to be predicted, it's going to grow and it's going to happen.
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SH: Great Donielle. Do you have any thoughts on cloud technology and helping you to prepare for unforeseen events, you're keeping a very complex quality system earning right now.
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DB: And thank you and Salesforce for making that happen.
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DB: I mean this, its business continuity for us. Right. So the challenge on manufacturing is we can't just pick up and move that as quickly as we could other areas of our business re establish
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DB: Research and development. So we're looking at ways to use cloud to get to an interconnect with 3PLs and our suppliers, so that we can kind of extend and secure our supply chain.
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DB: A little bit differently. Maybe store component cell service suppliers have finished goods in a couple of different locations. Because right now, if we had
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DB: Not come, would he had events that actually closed her business for several weeks ball we dealt with potentially employee.
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DB: Health issues here, we would actually not be able to ship any products, it would it would stop everything in its line. So we're looking at that and having to make sure that you know we're inventory was at all times that we maintain those connections between customer service and
00:26:47.130 --> 00:26:57.060
DB: Leadership that you still received in components to do we set up an extra laughs and browse for even inspection, so that if we had to quarantine something's how much could we
00:26:57.450 --> 00:27:07.710
DB: Secure on that aspect and still be able to function. And all of those have ever again. That same source of truth on what is it that we're building how I apply
00:27:08.910 --> 00:27:14.730
DB: The IT group as well. They just really appreciate it. Not happy to have to set up a
00:27:15.840 --> 00:27:24.420
DB: 50 VPN weather like to be able to suddenly access elements because if this had happened last year, they would have
00:27:25.380 --> 00:27:30.030
DB: Trying to manage that for them without them very difficult as well. A right. Thank you.
00:27:30.840 --> 00:27:47.220
SH: John you described some pretty ambitious goals for the year term. Do you have any we have about a minute left. Do you have any advice for other companies who are navigating through this environment and how to use technology or what they should be doing now to plan for the future.
00:27:50.160 --> 00:28:00.090
JM: Good question. What I think a good starting places to have a pretty good idea of where you want to get to, so that you can make sure that whatever tools and processes.
00:28:00.630 --> 00:28:14.580
JM: That you're putting in place we're using now and about what that future destination. So that sort of working backwards from the future state is certainly something that drives us why we're pushing to make our systems more robust and scalable.
00:28:16.890 --> 00:28:19.770
JM: Especially in a start up, you know, you're often in a position where you
00:28:20.790 --> 00:28:25.470
JM: Have everything you do. There are the five things you'd like to do, but just don't get done so.
00:28:26.880 --> 00:28:42.030
JM: But you know, I always I always try to remember all that, you know, you're only as good as the schools that you have put in the hands of the other craftsmen. So, you know, don't, don't want to make sure, make sure that we don't short shortchange ourselves on
00:28:43.290 --> 00:28:57.810
SH: Wise words. Thank you very much. JOHN and thank you to all of you today for joining us. I really enjoyed hearing your perspectives and I'm hearing about your, your, your long term plans and we really appreciate you participating on this panel.
00:28:59.190 --> 00:28:59.550
SK: Thank you.
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