The Power of Data in Revolutionizing Healthcare Supply Chain with Cody Fisher, President of Concordance Innovations

[00:00:02] Hey everyone, welcome back to the Outcomes Rocket. So excited you joined us for another episode. And so folks, I've got the privilege of hosting the amazing Cody Fisher today. He serves as President of Concordance Innovations and is responsible for the vision, mission, and leadership of the overall financial and strategic plan, as well as management and oversight of the key functions, policies, procedures, and processes that make Concordance Innovations.

[00:00:33] Just amazing with what they do with their Surgeon's Digital Platform, which was brought to market October 2022. And we're going to be covering why it's so important today and why you should care. So Cody, such a privilege to have you here on the podcast. Thanks for joining us.

[00:00:49] Thank you so much, Saul. And hopefully I can live up to that introduction. I will do my best, but very excited to be here. Always look forward to having open, collaborative discussions. And I'm sure you'll throw some crazy current day questions, as well as, you know, where's the vision of surgeons or what's my opinion on the industry? So always happy to share my opinions. I'll share right off the bat. I probably look at both current state industry and future from a very practical approach coming out of finance.

[00:01:19] I guess I always think in data and analytics and value and probably have a very practical view of how to resolve challenges. So looking forward to the discussion. Likewise, Cody. And I love your finance background. I always feel like leaders in finance do have that very pragmatic, measured approach to making innovation actually come to life. So really just curious to kick things off. What got you into health care?

[00:01:46] Yeah, really fair question. So I started my career in banking, had an awesome time there as on the institutional side. Kind of what I'm going to say is got the feel for how mega institutions really operate all the goods and all the challenges. But shifted over to health care, frankly, and I know this will probably resonate with a lot of folks listening. And it's something we can share, whether at conferences, et cetera.

[00:02:09] But I think that easy to see being a part of health care impact on friends, family, the industry at large, customers, you know, patients. Having that like tangible feel in the health care supply chain and being able to see products move, being able to see inventory. And unfortunately, when friends and family are getting care, when we're all getting care, we are recipients of that as customers.

[00:02:35] So I think it really is that full circle approach for me where there's a lot of opportunities to innovate in the health care supply chain, but also that very practical, pragmatic approach of, hey, we're all customers of the same things we're trying to innovate and solve for. So for me, it's kind of that easy, practical, like big impact, big vision, but also so easy and so real to us in an everyday life. Now, that's great. I love that. That's really why what gets me up in the morning, you know, same, same.

[00:03:04] You know, you know, you can make that impact directly. Now, we're talking about supply chain today and Concordance is a huge player in the industry. You guys are doing some pretty fresh stuff. So talk to us about how you approach fostering innovation in an industry that's traditionally just very process oriented. Yeah, really fair question. And I'll probably start just to give some context to listeners.

[00:03:30] Concordance, as you mentioned, saw as a distributor within the health care supply chain, has distribution centers all across the country, moves products to and from manufacturers into providers, etc. As well as that being our core business, we have started the journey in the last couple of years of a technology platform and ecosystem, if you will, called Surgence, which really has the vision to integrate the supply chain at large in a very agnostic approach.

[00:03:57] Meaning Concordance is a customer of Surgence, not necessarily Surgence tucks under just Concordance as a distributor, right? So it kind of sits on the side. Just to give some context to that, because I'm sure we're leaving out of Concordance as a distributor and Surgence. But for your question on how do we think about innovation from Concordance at large, and I'll share some kind of specifics to Surgence as well.

[00:04:23] I think the biggest piece we probably look at is what are those challenges that everyone in the industry talks about, but it is almost too daunting for anyone to solve. So call it the things that need to be done, but for whatever rhyme or reason, we just haven't tackled them yet. I'm going to say the big, audacious, crazy ideas. That's really where Concordance thrives as a distributor and as an organization at large.

[00:04:47] Within Surgence, we then look at it a bit differently of where or how can we solve for some of those challenges that are rooted in data and information, and where is that locked within the industry? And it really took light in the pandemic, I think, and not to bring us back a couple years.

[00:05:06] I know we all want to move on from that, but our opinion of what occurred during the pandemic is almost regardless of how prepared the industry was, we wouldn't have been able to resolve everything proactively. But I think what we could have done through the pandemic and what we can do going forward is have much greater visibility across the supply chain of what's really happening, right? Manufacturers looking downstream, what's happening with their product that's in demand? What does inventory look like?

[00:05:35] What are the real constraints and challenges from a data and information perspective versus the phone call at midnight saying I'm out of product? In my opinion, data exists, and it exists to the point that no organization should be surprised that much and vice versa, right? Providers being able to get a lens upstream of, okay, I'm using this much product. This is my demand. But what's really the supply of that product look like? And what do I have to resolve for?

[00:05:59] Whether it's thinking about new products to source, whether it's thinking about how I'm facilitating care to customers. So when we take that broad stroke, we look at not only the data and the power of data, but how do we unlock it to be collaborative within organizations and across organizations? So that multi-enterprise landscape that we all, that's how we do business, right? We do business with many partners throughout the industry.

[00:06:24] And the reality is we're all successful when we can collaborate together. And we believe that all organizations can get to more success faster when they're on the same journey versus on disparate, either parts of the journey or really with disparate priorities. No, thanks for that, Cody. And yeah, you know, you brought up COVID, the one in a hundred years types of events, you know, the black swans, so to speak, that we can learn so much of. Then there's problems like the data is siloed and locked.

[00:06:53] And so how do you access it? What are the biggest challenge healthcare providers face in supply chain? And how is surgeons addressing these through innovative solutions? Yeah, it's a great, great question. So and I'll kind of speak conceptually a little bit first. I think as we collaborate with providers and distributors and manufacturers, you know, across the spectrum, I think all organizations are innately challenged with,

[00:07:17] I have day to day responsibilities, I have day to day priorities, I have day to day challenges that I'm trying to solve for. But simultaneously, I have big visions for strategy, big visions for innovation. But I have a restricted pool of resources. I have a restricted pool of resources to do today's work. And oftentimes we're trying to lean on that same pool of resources to do tomorrow's strategy, right? And like we just see that conflict, if you will. I think it happens in every organization.

[00:07:45] We all want to get to work or get to priorities that are hard to get to because we have buyers that we're trying to put out, all the stuff that we hear. How we kind of look at addressing that is we don't necessarily have to take a linear approach to solve today to get to tomorrow. But we do believe the more we can help organizations optimize their work today and resolve the challenges of today and collaborate today across their multi-enterprise landscape,

[00:08:11] the more we can optimize their resource constraint today, the more those resources have the ability to focus on tomorrow's strategy. And from a surgeon's perspective, we like walking that fine line of applications exist to solve today's problem, but many applications also exist to be proactive and look out into the future in advance when you think of like demand planning and forecasting as an example.

[00:08:35] How do we start to look to the future to shape and to get ahead of the challenges so we're not just continuing this kind of hamster wheel, if you will, of, yep, we're solving today's priorities, today's problems, but we can't get ahead. We can't innovate to stop those challenges from happening tomorrow. So we try to balance that in the terms of applications when you think of the surgeon's landscape. Yeah, that's great. I mean, look, if you don't have a roof over your head, you're not going to be thinking about getting on an airplane, right? Or yeah, so I love that.

[00:09:04] And there are so many problems from, you know, large IDNs struggling to get what they need to small ASCs with, you know, those budget constraints. I find that we learn best, Cody, when we get examples. Can you share a use case or maybe like a recent example of how surgeons, this platform you're sharing with us, has had a measurable impact on healthcare outcomes? Yeah. Yeah. I'll provide a couple examples.

[00:09:30] You know, I think conceptually, if I just look at and not to single out providers by any means, right? All segments have their own individual challenges. And collectively, we're all trying to address very similar priorities. When I look at providers, and again, this will resonate with the other segments, ultimately what I see them trying to solve for is they have revenue compression, whether it's be new negotiated rates, new insurance coverage, et cetera.

[00:09:55] While largely expenses are increasing, right? Employee costs go up, product costs go up, transportation goes up, et cetera, right? Like everything seems to be like the imbalance. And I know manufacturers and distributors can relate to that, those same kind of levers or pressures as well. So when we take that to a practical level, for example, with providers, all providers have product on hand.

[00:10:21] All providers buy product, that product on hand, and they use that product to take care of patients and or to protect clinical staff that's taking care or delivering care to patients. One example of how we're delivering value pretty quickly, regardless of where a health system is and call it the innovation, their own innovation curve, their innovation strategy.

[00:10:42] In the balance of optimizing inventory while also managing resiliency, those two what seem like levers that are never in balance and they actually conflict. We've seen organizations, again, regardless of where they're at on that curve of innovation, really optimize the product they have on hand between 15 and 30 percent. And we've actually seen some examples upwards of 35 and 40 percent.

[00:11:05] To talk in easy numbers, if a health system has $10 million throughout all their par locations, their storerooms, et cetera, we've seen pretty easy one and a half to $3 million have the ability to be optimized, right? I mean, just speaking very practical hindsight for me, financial numbers. And that's just an easy use case. It doesn't necessarily mean all product can be, but it's the ability to move and manage product better throughout the network in which the product already sits.

[00:11:34] So that's a practical example. And again, to speak to the call it the counter of the financial, the optimization piece, it's really how do we enable organizations to think about resiliency and not just think about it and strategize, but how do you put the tools and applications in place to manage it from substitutions to how do you manage constraints and resolve for constraints quickly? So those are some other practical examples in there that really speak to the resiliency side.

[00:12:01] But I think the art is how do you balance the financial or the value output while also not bringing an incredible amount of risk into one supply chain. Yeah, that's great, Cody. And, you know, quick clarifying question there. I think on the one hand, a lot of people are thinking, OK, you know what? Distribution, we're talking supplies from physician preference to not possession preference. What about equipment?

[00:12:25] You know, is the platform like measuring, say, optimization of, say, a scope or something like that? Or is it strictly supplies? Great question. Most organizations are starting with supplies and kind of advance from supplies, then into implants and devices. And then when you start thinking about other channels like equipment and or pharma, right? Yeah. How we kind of look at it, it's a very agnostic, very general view.

[00:12:51] If it's in data and information, it is a widget of information for us in the world of surgeons. We can put rules. We can put logic. We can put configurations around data, right? Knowing some of those channels are different than call it supplies and how they flow, how they're stocked, how they're used, how they're repurposed. When you think of implants or the equipment and the scopes you had mentioned.

[00:13:13] So today we don't necessarily have a provider tackling or prioritizing reprocessing, et cetera, within surgeons, but unlocking the visibility, too. And how is that product or how is that widget moving downstream through the supply chain? Or in some of those scenarios, how is it actually being reprocessed and moving back upstream? And you kind of have that circular approach.

[00:13:34] So well within scope, but today most of the focus is around supplies and plants, devices, and then a couple of those other channels that I mentioned will be coming next. No, I really appreciate it. So it's very flexible. That's great to know. And so a big part of it is data, right? So talk to us about that part of the business. How is Concordance leveraging data and analytics to improve the efficiency and effectiveness of this healthcare distribution area? Yeah, absolutely.

[00:14:00] So I'll kind of speak from the Surgeon's lens just to kind of frame this up and looking at Concordance as a distributor, as a customer of Surgeon. So Concordance as a distributor internally is leveraging applications within Surgeon's to help optimize inventory beyond the WMS, beyond the ERP. And really what that's doing is it's unlocking a couple of things.

[00:14:23] One, it's allowing custom configurations around how do we want to manage or how does Concordance want to manage specific rules around specific items. So think as like, hey, there's a crisis like a hurricane that might come up really quickly. What are the items of impact? Okay, narrow that scope. We want to put these rules and configurations around that. Those drive alerts. Those drive insights. And furthermore, workflows and actions.

[00:14:48] So what Concordance is doing beyond inventory optimization is really also embedding. Think of manufacturing contracts, vendor return policies, all of those type of, I'm going to say, qualitative information components versus data itself. And really powering the combination of raw data, inventory levels, open orders, lead times, et cetera, with the qualitative impact of information of what's in a contract. What are my lead times?

[00:15:17] What are my return policies? Concordance is really important. How do we optimize or how does Concordance optimize inventory across its locations, but also how does it manage risk of asset product? If product's not moving, Concordance has a 90-day return window on XYZ product with XYZ manufacturer.

[00:15:35] Really instituting those automated workflows to take, again, what we talked about earlier, some of that day-to-day friction and that day-to-day responsibility off of employees, especially when it comes to I have to run the data, I have to analyze the data, then I have to make decisions on the data. But I might need to reach out to five different organizations or departments to make that call. We really look at how do we automate that. That's a lot of internal as a use case and then externally as a distributor.

[00:16:02] Concordance, again, is the first distributor on Surgence, really took, I'm going to say, the leap and basically took the leap in the stance to say when we're talking to providers downstream as a distributor, Concordance has provided full visibility of product in its warehouse to its customers. So there's a lot of governance and security to that so customers can see what they buy from the warehouses they're buying from.

[00:16:25] And in practical terms, they see the inventory, they see the open orders, they see the lead times of those orders, they see items at risk, all at a, call it user-friendly, on-demand basis versus what I'm going to say is probably more widespread in the industry is, hey, on Wednesday, you get a file, on Friday, you get an update of the file, on Monday, you get another update, right? So we're trying to really digitize or Concordance took the stance to digitize that work and just say, hey, there's visibility on demand when you have a question.

[00:16:55] Ideally, the data is answering the question for you without even picking up the phone, without an email, et cetera. So just a couple of examples, internal and external, if that helps. Yeah, no, I love it. You know, we sort of have been trained to have that visibility with things like Amazon. You know, I know when my package is going to get here, my son goes crazy and he's like, oh my gosh, he's a couple stops away. Like, why can't we have that with our supply chain, right? A hundred percent.

[00:17:21] Yeah, we have heard, you know, and being in industry organizations that aren't just specific to healthcare, it's pretty common to what I hear earlier this morning, actually. It was a comment, like, we know how many Snickers bars there are on every shelf and every retailer in the country. But during the pandemic, we didn't know about N95s, right? Or we didn't know about gowns or masks. And I think those are just real. Like, they're very real things.

[00:17:48] We know where the $1 or $2 Snickers bar is, but we don't know where the product is that's going to impact the care that we as organizations throughout the healthcare supply chain are delivering. Or as people that we're receiving, right? So when we start to put that in perspective, it's, I'm going to say alarming, but I look at it as also, like, very energizing to say, look at the impact we can make when we take on that type of challenge. Totally. Yeah, I love that.

[00:18:13] I always love the retail, you know, like the hotel, the, you know, all these industries that are doing things differently, the tech. And we could take so much from it. So, you know, resilience has come up a couple times during our conversation. COVID was insane for all of us. Talk to us about surgeons and what innovations you guys have implemented to really build more resilience and responsiveness in supply chain. I know, like recently, right?

[00:18:41] The IV bags, that was a surprise. What are we doing to be resilient and responsive and how surgeons going to help? Great question. I'll answer it in two ways. I'll keep them short. But I think there's really two ways, in my opinion, to think about resiliency. One is resiliency from a preparedness perspective. How can you be prepared for what could come? And or what work are you doing when you think about substitutes, cross-referencing, visibility, when that event does happen or when that thing happens?

[00:19:10] What is kind of the plan of attack? And did the work happen in advance to make the work after the event easy? That's one way. I'm going to call that proactive. The other way is, once the event happens, do you have the tools and resources to make decisions quickly? To get visibility, to understand the impact, and to make decisions as fast as you can. Ultimately, those things tie together. But in the surgeons' world, we do think of them as a bit separate, even though they're all on the same platform. So on the front end, we think of things like, how do you understand the risk in your item or product portfolio as a provider?

[00:19:40] Or as a manufacturer and distributor, how do you collaborate with your customers to help assess the risk in an item or product portfolio proactively? You know, it could be, okay, do you have critical items identified? Regardless of the definition, we can have a whole other session on what defines critical items. What does cross-referencing look like? What do substitution policies look like? How much of your current item master or product portfolio that you buy do you have cross-references to?

[00:20:07] Largely, I would say, I think the industry would be very surprised, right, at how little resiliency we may have collectively as an industry when we think about substitutes in advance of a problem happening. I think it's unfortunately very common for the issue to happen and then say, ooh, what are my subs to that? Help me figure that out. All that figuring it out is taking away from, I need to make a decision now. So that's one piece, kind of in advance proactively assessing risk around item management, product management, et cetera.

[00:20:37] And then when you think about responsiveness, really allowing and leveraging the combination of data and applications or workflows to, one, get visibility too, but then to quickly understand the impact of constraints, understand how it's impacting a health system, how it's impacting a distributor, how it impacts manufacturer expectations on a manufacturer. And then lastly, what decisions can I make or can we collectively make to resolve that inherent challenge, right?

[00:21:05] Whether it be the recent hurricanes, whether it be the pandemic, or whether it be a random disruption that nobody was seeing happening. So we kind of look at it between proactive and then how quickly can we help organizations respond to what about it. That's great, Cody. No, I love the framework. And it's good for all of us to think about that. And even like, you don't have to do it with everything, right? Like what are your high volume items? Do it with those first and kind of ease your way into what would be most problematic and do it there, right? Yes, 100%.

[00:21:34] And as much as we, you know, going a couple of questions ago, so as much as we probably look at other industries, the Snickers bar example, like, oh, what if? Just what if we could do that? As much as that resonates with all of us, I do want to give a lot of props to organizations throughout the healthcare supply chain. I mean, we did learn from the pandemic collectively. And to be really honest, I think it's amazing to see organizations and what they're doing from an innovation perspective.

[00:22:01] And what made me think of that was your comment on how do you think about critical items? How do you think about your high movers? At least start chipping away. And I think that's a great comment. Like, don't feel like we have to eat the entire elephant at once. Like, make progress and take action over perfection are a couple of things that we live by within Surgence.

[00:22:24] Because if we wait for perfect, it's going to be a long time coming for all of us versus take action to start the journey or start advancing down that journey. That's awesome, Cody. And yeah, folks, like to Cody's point, like make sure you're leveraging software like Surgence to help you understand prioritization. How can you take small bites at a time? Because oftentimes it's knowing where to start. That's the biggest challenge. And that's why Surgence exists.

[00:22:52] Cody, looking ahead, what does supply chain and healthcare distribution look like in the next 5, 10 years? I knew you'd throw something at me like this. It's a hard one. Here's what I'll kind of say and where I think we're at collectively in our journey throughout the supply chain. And I think today, the industry at large probably feels like data and visibility is the goal. If I just had data, if I just had visibility to my own systems collectively, to my partners, whatever it may be, it feels very much like the end point.

[00:23:21] And what I will say in the next couple of years, which then leads into the 5 to 10 years, I think we are quickly going to realize data and visibility are the end. They're just the beginning. Meaning it is incredibly common with organizations we work with. Once you have visibility to data and information, especially when it's bridging like I've never seen this before from my partners, the immediate next question is what do I do with it? It's like we've been chasing data and visibility for so long as an industry.

[00:23:50] We almost don't know what we would do with it if we caught it. What's awesome is to see that quick turn, right? So when to answer your question over the next 5 to 10 years, I think we are going to harness the power of data and visibility. We're going to address that challenge, right? And then we're going to harness the power and data, power of the data and the visibility. And it's going to unlock opportunities that we probably never really dreamed of or thought about because it's really difficult to see past something that I don't have data to understand the problem itself.

[00:24:20] I might get emails. I might get phone calls about a challenge, but I actually don't understand it. And once that data and that visibility exists, the potential of what we can do together as a supply chain, I think is really going to transform how the healthcare supply chain operates not just in collaboration, but I think even in the physical nature of the supply chain.

[00:24:39] So as providers are changing how they deliver care, both probably from the demand of patients and as the landscape for providers is changing anyways, not only will that visibility allow organizations to collaborate different, but I think it's ultimately going to end up in organizations collectively really challenging. Like how does product move throughout the supply chain? Where does product get stored? Who owns the product?

[00:25:04] How do we, yeah, you buy the product and it's an inventory somewhere else in the building you may not even own, or is it more of like a consignment service fee structure? So I think all those things are in the scope of what's beyond data and visibility. And personally, I'm excited to see some of those come to life because I think when we collectively move down that path, we'll find, and I think organizations are already finding a lot of win-win scenarios across partnerships and collaborations.

[00:25:32] And I think that's where it's really exciting, where it's not a win and a lose. It's actually collectively, this makes sense for the better good. And that's all happening really through, call it intent, but also just the power of data. Yeah, that's great. Those partnerships are everything and can't do it all on our own. So certainly, man, we love our partners. And when you have a great partner, you're able to achieve, you know, one plus one isn't two, it's five. Couldn't decide it better, 100%. Yeah, no, you're awesome, Cody.

[00:26:01] I love your approach and the way that you think. I wish we had more time. Maybe we'll have a part two to this thing. If you're game, I'm game. Yeah, we'd love that. So look, for everybody that's with us, I just want to say thanks for being with us. Where can everybody that's listening and watching reach out to you to learn more about Surgence and how Concordance is leading the way with innovation? Oh, thank you so much. Well, first and foremost, love being here, excited about the conversation.

[00:26:30] From anyone that's listening, would love to hear where you're at on your journey, some of the challenges you're trying to address or the bigger picture strategies you have in play. Simultaneously, would love to share in more detail what we're up to within the world of Surgence, how organizations are leveraging the platform and kind of our vision as we look over the next 12 to 24 months. To reach out, you can reach out to me directly on LinkedIn or you can find us at wearesurgeons.com.

[00:26:59] There's a lot of contact pages there, request demos, all the fun stuff, but would love to hear from you, answer questions and more than anything, really collaborate and kind of understand how we can help and how organizations are really thinking about kind of the future of their own supply chain. Amazing. Cody, thanks for that invitation. Folks, make sure you check out the show notes where you'll find the short notes to our entire conversation, all the links that Cody shared with how to get in touch with him and his team.

[00:27:28] The opportunities now, let's take advantage. Let's not wait until the next pandemic. Let's not wait until the next hurricane. Let's get ahead of it. Now's the time. And the good news is, Cody, you're helping people with today's things so they can take care of tomorrow's issues. That's right. So love what you guys do, Cody. Thanks for joining us and looking forward to being in touch. Thank you, Saul. I appreciate it. Likewise.