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acceleratedsurgical
recovery
Increased Patient Satisfaction
SofPulse Sales Training
September 23, 2011
1/4/2017 1
Welcome to your SofPulse Sales
Training-The Path to Money
Section I: Company Overview 7:00a - 7:30a
Section II: Technology Overview 7:30a - 8:00a
Section III: Clinical Literature 8:00a - 9:30a
Section IV: Clinical Procedures & Applications 9:30a - 10:00a
Break 10:00a - 10:15a
Section V: Sales Tools 10:15a - 11:00a
Section VI: Customer Service 11:00a - 11:45a
Lunch 12:00p - 1:00p
Section VII: Sales Process 1:00p - 2:30p
Section VIII: Competition 2:30p - 3:00p
Break 3:00p - 3:15p
Section IX: Compliance 3:15p - 4:15p
Discussion 4:15p - 5:00p
1/4/2017 2
Early Stage medical technology with an
18 year history of clinical expertise?
New Area of Medicine?
Paradigm Shift in Patient Care?
Culture?
Financial Freedom?
What is SofPulse?
ALL THE ABOVE
Section I:
Company Overview
1/4/2017 3
Culture
• ‘None of us’ is as smart as ‘all of us’
• Getting it right is the important thing
Section I:
Company Overview
1/4/2017 4
Financial Freedom – Commission’s
Product Sales Price Range
Per Box*
Commission Tier
SofPulse $1499+ ($299) 40% (1)
SofPulse $1300- $1498 ($260) 35%(2)
SofPulse $1000-$1299($200) 25%(3)
SofPulse $ 999($199)
(minimum price per Box)
20%(4)
SofPulse Duo $1799+($359) 40%(1)
SofPulse Duo $1500-$1798($300) 35%(2)
SofPulse Duo $1200- $1499($240) 25%(3)
SofPulse Duo $1199($239)
(minimum price per Box)
20%(4)
Plastic Surgeon Sale $1149+($229) 40%(1)
Plastic Surgeon Sale $950-$1148($190) 35%(2)
Plastic Surgeon Sale $750-$ 949($150) 25%(3)
Plastic Surgeon Sale $749($149)
(minimum price per Box)
20%(4)
* A box includes five (5) SofPulse all
of the same type.
** Surgeon sale is limited to the
direct purchase by a plastic surgeon
for the sole purpose of using in
his/her office based surgery center
or other such freestanding surgery
center. This does not include use by
surgeon in an acute care hospital or
other such ambulatory surgery
center affiliated with such acute care
hospital.
Section I:
Company Overview
1/4/2017 5
• EPI founded in 1990, creates first solid state
PEMF device.
– Marketed successfully to treat pressure ulcers in
nursing home.
– CMS drops reimbursement 1997, company sells
off technology to small medical company ADM.
• ADM forms Ivivi Technologies in 2004, to
commercialize new PEMF devices.
– Lightweight, lower-powered, more effective.
Corporate History Section I:
Company Overview
1/4/2017 6
Corporate History
• FDA deems new devices not substantially equivalent to
earlier device (I-Phone, Commodore 64).
– Public company, stock drops to pennies overnight
• Ivivi successfully appeals FDA ruling and FDA issues
new 510k.
– But company is public, out of money in 2009
• Ivivi Health Sciences buys assets in 2010.
– Raises new capital
– Leverage all the clinical and scientific information
produced by EPI and Ivivi
– SofPulse launch 2011
Section I:
Company Overview
1/4/2017 7
Business Structure
Ivivi Orthopedic
Health Inc.
(“IOH”)
Other Current
Businesses
Potential
Future
Businesses
Ivivi Health
Sciences LLC
• SofPulse
Reconstructive
Plastic Surgery
• Ivivi Wound
Healing Sciences
• Assisi Animal
Health
• Cardiology
• Rio Grand
NeuroSciencs
• Incorporated
January 2011
Section I:
Company Overview
1/4/2017 8
SofPulse Corporate Structure
Steven Gluckstern
Chairman & CEO
Kathryn Clubb
President & COO
Kaysie Dannemiller
Fulfillment &
Customer Service
Diana Kyster
Controller
Mark Rich
Sales & Marketing
Sales
Specialist
Independent Sales
Representative
CGI Mexico
Sarah Kermensky
Administration
Andre Di Mino
Regulatory,
Engineering & Mfg.
Contract
Manufacturer(s)
Engineers
Arthur Pilla
Inventor & Senior
Scientist
Sean Hagberg
Basic Research &
New Projects
Section I:
Company Overview
1/4/2017 9
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section II: SofPulse Sales Training
Technology
Overview
September 23, 2011
1/4/2017 10
Short History of Pulsed Diathermy
• Radio frequency to heat deep tissues (1907)
• Ginsberg (1930s)
– Reduces duty cycle, Pulsed Diathermy
– No heat
– Retains therapeutic effects
– Signal not optimized, mechanism unknown
• Creates pulsed electromagnetic field (PEMF) devices
– Treatment of pain and edema in soft tissue
– Delivery electrical current to injured
tissue inductively
Section II:
Technology Overview
1/4/2017 11
Bone Growth Stimulator (BGS) History
• Bone recognized to produce electrical currents
(Fukada, Yasuko 1957)
• Direct electrical stimulation heals recalcitrant
fractures
– Electric currents driven across fracture stimulate
bone growth
• Pulsed electromagnet field devices introduced
(Bassett, Pilla 1974)
– Signal generator and external applicator
– induce electrical current in bone from
outside the body
Section II:
Technology Overview
1/4/2017 12
Bone Growth Stimulator (BGS) History
Bassettetal.1977.ClinOrthop.124:128-143
Early BGS device on patient with tibial non-union.
Outpatient, minimum Rx 4 hours/day, even today
Section II:
Technology Overview
1/4/2017 13
Ivivi Technologies
• PEMF to tPEMF
– Proprietary signals
– A priori targeting of
electrochemical activity
– Decreases power, increases
efficacy
– Delivered through FDA-cleared
devices
Section II:
Technology Overview
1/4/2017 14
The Evolution of tPEMF Section II:
Technology Overview
1/4/2017 15
SofPulse Section II:
Technology Overview
1/4/2017 16
How PEMFWorks
• Pulsed electromagnetic fields
induce signaling microcurrents
in tissue
• Signal characteristics
important
– Duration, Frequency, Power
• Targeted signals
– Speed body’s own mechanisms
– No known side effects
– No adverse effects
Section II:
Technology Overview
1/4/2017 17
How Configuring PEMF Works
Pillaetal.BioeletrochemBioenergetics.1999;48:27-34
Signal to noise ratio (SNR) for Ca/CaM
binding vs. PEMF configuration
Applied Field Frequency (Hz)
10-2 10-1 100 101 102 103 104 105 106 107 108
SNR
5.0e-1
1.0e+0
1.5e+0
2.0e+0
2.5e+0
PRF 2 msec
(SNR)
PRF 65 μsec
(Diathermy)
PEMF Bone Repair
Section II:
Technology Overview
1/4/2017 18
Mechanism of Action (MOA)
PEMF
Ca2+ + CaM Ca2+CaM
PEMF increases Ca2+ binding to CaM (milliseconds)
Ca2+CaM + eNOS NO
Ca2+CaM binds to eNOS, catalyzes NO release (seconds)
Anti-inflammatory: increased Blood & Lymph Flow
Pain/Edema Decrease (seconds)
NO cGMP Growth Factors (hours/days)
VEGF Angiogenesis (hours/days)
FGF Collagen/Granulation (days)
TGF-β Remodeling (days/weeks)
Section II:
Technology Overview
1/4/2017 19
Special Effects of tPEMF
• Targeting Calcium/Calmodulin Binding (Ca/CaM)
• Anti-inflammatory cascade
• Signal configuration couples to Ca2+ binding
Section II:
Technology Overview
1/4/2017 20
Accelerated Surgical Recovery
After MC Robson Surg Cl N Am *83 2003 p. 558
Targets
inflammation
Accelerates
anti-inflammatory
activity
Section II:
Technology Overview
1/4/2017 21
What’s the Difference?
• Static Magnetic Field
• PRF
• EMF
• PEMF
• tPEMF
• Targeted MicroCurrent Therapy
• You make money to sell tMCT
Section II:
Technology Overview
1/4/2017 22
Electromagnetic Spectrum Section II:
Technology Overview
1/4/2017 23
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section III: SofPulse Sales Training
Clinical Literature
September 23, 2011
1/4/2017 24
Key Publications
Key Take Away Rohde PRS
June 2010, 9.16.2011
Rohde PRS + Discussion
Section III:
Clinical Literature
1/4/2017 25
Key Publications
Key Take Away,
Hammond, Dennis, PRS
Discussion
Section III:
Clinical Literature
1/4/2017 26
Key Publications
Key Take Away Johnson
BEMS
Johnson BEMS Study
Section III:
Clinical Literature
1/4/2017 27
Key Publications
Key Take Away Johnson
Animal Pain Study 2008,
9.16.2011
Johnson Pain Study
Section III:
Clinical Literature
1/4/2017 28
Key Publications
Key Take Away Heden Aesth Plast
Surg April 2008, 6.21.2011
Heden & Pilla 2008
Section III:
Clinical Literature
1/4/2017 29
Key Publications
Key Take Away Strauch PEMF
ASJ Mar-Apr 2009, 6.21.2011
Strauch PEMF Aesthetics 2009
Section III:
Clinical Literature
1/4/2017 30
Related Publications
– Roland 2000 PRS
– Weber 2004 PRS
– Strauch PEMF 2007 PRS
Section III:
Clinical Literature
1/4/2017 31
Supporting Publications
– Pila Ankle PRF
– Kloth Wound Closure Article
Section III:
Clinical Literature
1/4/2017 32
Level of Study
• In vitro
• Ex vivo
• In Vivo
• Meta Analysis
• Prospective
• Retrospective
• RCT
• Trial Design
Section III:
Clinical Literature
1/4/2017 33
In vitro
• (Latin: within glass) refers to studies in
experimental biology that are conducted using
components of an organism that have been
isolated from their usual biological context in
order to permit a more detailed or more
convenient analysis than can be done with whole
organisms. In contrast, the term in vivo refers to
work that is conducted with living organisms in
their normal, intact state, while ex vivo refers to
studies on functional organs that have been
removed from the intact organism
Section III:
Clinical Literature
1/4/2017 34
Ex vivo
• (Latin: "out of the living") means that which takes
place outside an organism. In science, ex vivo
refers to experimentation or measurements done
in or on tissue in an artificial environment outside
the organism with the minimum alteration of
natural conditions. Ex vivo conditions allow
experimentation under more controlled
conditions than possible in in vivo experiments
(in the intact organism), at the expense of
altering the "natural" environment.
Section III:
Clinical Literature
1/4/2017 35
In vivo
• (Latin for "within the living") is experimentation
using a whole, living organism as opposed to a
partial or dead organism, or an in vitro ("within
the glass", i.e., in a test tube or petri dish)
controlled environment. Animal testing and
clinical trials are two forms of in vivo research. In
vivo testing is often employed over in vitro
because it is better suited for observing the
overall effects of an experiment on a living
subject. This is often described by the maxim in
vivo veritas.[1]
Section III:
Clinical Literature
1/4/2017 36
Meta Analysis
• In statistics, a meta-analysis combines the results of several studies that
address a set of related research hypotheses. In its simplest form, this is
normally by identification of a common measure of effect size, for which a
weighted average might be the output of a meta-analyses. Here the
weighting might be related to sample sizes within the individual studies.
More generally there are other differences between the studies that need
to be allowed for, but the general aim of a meta-analysis is to more
powerfully estimate the true "effect size" as opposed to a smaller "effect
size" derived in a single study under a given single set of assumptions and
conditions.
• Meta-analyses are often, but not always, important components of a
systematic review procedure. Here it is convenient to follow the
terminology used by the Cochrane Collaboration,[1] and use "meta-
analysis" to refer to statistical methods of combining evidence, leaving
other aspects of 'research synthesis' or 'evidence synthesis', such as
combining information from qualitative studies, for the more general
context of systematic reviews.
Section III:
Clinical Literature
1/4/2017 37
Trial Design
• Randomized: Each study subject is randomly assigned to receive either the study
treatment or a placebo.
• Blind: The subjects involved in the study do not know which study treatment they
receive. If the study is double-blind, the researchers also do not know which
treatment is being given to any given subject. This 'blinding' is to prevent biases,
since if a physician knew which patient was getting the study treatment and which
patient was getting the placebo, he/she might be tempted to give the (presumably
helpful) study drug to a patient who could more easily benefit from it. In addition,
a physician might give extra care to only the patients who receive the placebos to
compensate for their ineffectiveness. A form of double-blind study called a
"double-dummy" design allows additional insurance against bias or placebo effect.
In this kind of study, all patients are given both placebo and active doses in
alternating periods of time during the study.
• Placebo-controlled: The use of a placebo (fake treatment) allows the researchers
to isolate the effect of the study treatment.
• Prospective
• Retrospective
Section III:
Clinical Literature
1/4/2017 38
1/4/2017 39
The Joy of a Salesman
Salesman is the ultimate career!
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section IV: SofPulse Sales Training
Clinical
Procedures &
Product
Application
September 23, 2011
1/4/2017 40
Reconstruction/Reduction(DRG)
• Mastectomy
• Reconstruction
• Reduction
Section IV:
Clinical Procedures/Product Application
1/4/2017 41
Breast Reconstruction Comparison
Type of
Reconstruction
Hours in O.R. Days in Hospital Recovery Time
(highly variable)
Tissue
Expander/Implant
1 – 2 Hours 1 – 2 Days 2 - 3 Weeks
Latissimus Dorsi 3 – 4 Hours 3 – 4 Days 4 Weeks
TRAM (pedicle) 4 – 5 Hours 4 – 5 Days 5 – 6 Weeks
Free Flap 6 – 10 Hours 4 – 5 Days 5 – 6 Weeks
Section IV:
Clinical Procedures/Product Application
1/4/2017 42
Cosmetic Surgery
• Tummy Tuck (Abdominoplasty)
• Face Lift (Rhytidectomy)
• Fat Grafting
• Post Bariatric Body Contouring
• Lipo Suction (PAL, Smart Lipo,etc.)
• Breast Augmentation (Augmentation Mammaplasty)
• Breast Reduction (Reduction Mammaplasty)
• Breast Lift (Mastopexy)
• Capsular Contracture
Section IV:
Clinical Procedures/Product Application
1/4/2017 43
Inflammation - Is natural and healthful,
as long as it terminates quickly Section IV:
Clinical Procedures/Product Application
1/4/2017 44
Inflammation
Analgesic
• Anesthesia-
– General is a state of unconsciousness, hypnosis, amnesia and loss of
protective reflexes. Of the autonomic nervous system.
– Regional is affecting only a large part of the body, such as a limb or the
lower half of the body
– Local to induce the absence of sensation in particular part of the body
PCA Pump- to an electronically controlled infusion pump that delivers an
amount of intravenous analgesic (usually an opioid) that is set by the patient
Block A nerve block relieves pain by interrupting how pain signals are sent to
your brain. It is done by injecting a substance, such as alcohol or phenol, into
or around a nerve or into the spine.
Pain Pump disposable, portable, non-electronic device that systematically
infuses an anaesthetic through a special catheter implanted
into the wound site by the surgeon.
Section IV:
Clinical Procedures/Product Application
1/4/2017 45
BREAK
1/4/2017 46
Dreaming of Commissions
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section V: SofPulse Sales Training
Sales Tools
September 23, 2011
1/4/2017 47
Agenda
• Surgeon Brochure
• Patient Brochure
• Economic Message
• In-Service
• Satisfaction Survey
• Company Website – Build a Surgeons Practice
• Trunk Stock
• Value Analysis Packet
1/4/2017 48
Section V:
Sales Tools
Surgeon Brochure
1/4/2017 49
Section V:
Sales Tools
Surgeon Brochure
Elevator Pitch
Advanced User
35 devices a month, article to be published
Clinical Data - Designed to support individual
concerns a surgeon has.
Tissue Viability
1/4/2017 50
Section V:
Sales Tools
Surgeon Brochure
1/4/2017 51
Section V:
Sales Tools
Surgeon Brochure
1/4/2017 52
Section V:
Sales Tools
Tissue Viability
Surgeon Brochure
1/4/2017 53
Section V:
Sales Tools
Surgeon Brochure
Clinical Data - Designed to support individual
concerns a surgeon has.
1/4/2017 54
Section V:
Sales Tools
Surgeon Brochure
1/4/2017 55
Section V:
Sales Tools
Patient Brochure
Why did they go for cosmetic
surgery? Edema, Pain and
recovery should not slow
them up.
1/4/2017 56
Section V:
Sales Tools
Patient Brochure
Surgery is painful.
Patients are very in tuned to complications
associated with prescription drugs.
Gentle, Safe, Natural.
1/4/2017 57
Section V:
Sales Tools
Patient Brochure
Surgery is painful.
1/4/2017 58
Section V:
Sales Tools
Patient Brochure
1/4/2017 59
Section V:
Sales Tools
Patient Brochure
1/4/2017 60
Section V:
Sales Tools
Patient Brochure
Outside dressings not in our body
Ever pay attention to a drug advertisement.
1/4/2017 61
Section V:
Sales Tools
Patient Brochure
1/4/2017 62
Section V:
Sales Tools
Patient Brochure
Ever pay attention to a drug
advertisement?
1/4/2017 63
Section V:
Sales Tools
Economic Message
1/4/2017 64
Section V:
Sales Tools
Economic Message
In - Service
• Nurses take care of patients
• Value there opinion (most industry folks down play their role)
• Opportunity to learn about post-op care and
complications
• Great to practice sales pitch
• Floor Nurses do not like new products without
advanced notice
• Failure to educate can cost you business
• Referrals to other surgeons for additional sales
• Aligns you to get completed surveys
1/4/2017 65
Section V:
Sales Tools
Satisfaction Survey
• Support and Enhance Belief in technology
• Let them know the importance of positive
feedback to surgeon and hospital
administration
• Completed survey becomes part of the close
• Local reference for future calls
1/4/2017 66
Section V:
Sales Tools
Company Website – Build a Surgeons
Practice
• Links to active users.
• Surgeon can link to us helping to educate
patience on what he/she is doing different
• Newsletters/Testimonials- word search is
powerful
1/4/2017 67
Section V:
Sales Tools
www.sofpulse.comCompany Website
Trunk Stock
• Provided at no cost to account manager
» 2 boxes Single ($2600)
» 2 boxes Duo ($2600)
• Designed to drive successful conversions
• Ability to generate immediate revenue on sales call
• Regulated by the FDA
1/4/2017 68
Section V:
Sales Tools
Value Analysis Packet
• Form Letter (under development)
• FDA Approval
• W – 9
• Liability
1/4/2017 69
Section V:
Sales Tools
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section VI: SofPulse Sales Training
Sales Support/
Customer
Service
September 23, 2011
1/4/2017 70
Trunk Stock
• FDA Regulated
• Will not be sent overnight NO EXCEPTIONS
• 2 Boxes Single/Duo-after training
• Sell Boxes
• No more then 3 single sales to any account
• Stock Transfer for each device
• After 4 completed transfers eligible for
another box
Section VI:
Sales Support/Customer Service
1/4/2017 71
In-Field Stock Transfer
• Completed any time you change ownership of
product( sample, demo, sale, another manager)
• FDA Regulated
• Generates Revenue
• Ensures your supply is replenished
• Can list multiple devices on one form if same
end user
Section VI:
Sales Support/Customer Service
1/4/2017 72
In-Field Stock Transfer
In Field Stock Transfer Form
Section VI:
Sales Support/Customer Service
1/4/2017 73
Order Process-Show Me the Money
Jerry McGuire "Show Me the Money"
Section VI:
Sales Support/Customer Service
1/4/2017 74
Order Process-Show Me the Money
• Customer Created in SalesForce.com
• New Customer Sheet-2 week’s prior to expected order. Information entered into Priority.
(Shipping and billing software)
• Pricing Quote
– Line Item Descriptor
– Ivivi Set up
– Shipping Terms- predetermined as ground or overnight recorded in SalesForce.com
• Hard Copy PO or Credit Card Require to Process-no phoned in orders
– orders@sofpulse.com
– Fax 415-276-1985
• PO cross referenced with Priority/SalesForce
– No Discrepancy-orders ship
– Discrepancy
» Customer service to call /e-mail purchasing to rectify
» Account Manger Contacted
» Director of Sales Contacted
• Confirmation e-mail letter sent to customer
• Account manager to receive shipment notification
• Opportunity is closed in Salesforce.com and set up for commissions
• No direct patient shipment or return
Section VI:
Sales Support/Customer Service
1/4/2017 75
Returns & Shelf Life
• Returns
– ALL SALES ARE FINAL AND NOT SUBJECT TO
RETURN, EXCHANGE OR SET-OFF
• Non Sterile/ Shelf life is related to battery
Section VI:
Sales Support/Customer Service
1/4/2017 76
Technical IFU
Technical IFU
Section VI:
Sales Support/Customer Service
1/4/2017 77
LUNCH
1/4/2017 78
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section VII: SofPulse Sales Training
Sales Process
September 23, 2011
1/4/2017 79
Types of Selling
• Conceptual
• Clinically
• Relationship
• Scrub Sink
• Price
• Features Benefits
—Build the story
—Lowest First
—Against Competitor
—Show me the data
—He/She is your buddy so why not
—Goal is to be in surgery
Section VII:
Sales Process
1/4/2017 80
Selling / Targeting
Alec Baldwin Shows How to
Get it Done
Section VII:
Sales Process
1/4/2017 81
82
Targeting
Building your Territory Target List
Your target list is critical to your success and you should
continually add to the funnel. The following highlights
information that will help you expand your prospecting
pipeline. Additionally, be sure to add new targets to your
reports as a way to build and effectively manage your
pipeline.
You’ll work with SofPulse management to track the Ten
Target Principle (3+2+5 as noted below).
Ten Target Principle
• Three (3) Accounts Ready to Close: You will be expected
to commit to close three new accounts per quarter,
after 60 days on board
• Two (2) Accounts in Cue: You should have an additional
two accounts that are in cue and are in the final phases
of the approval process.
• Five (5) Accounts in Development: You should also have
five additional accounts that are being developed and
cultivated to help ensure you have three solid accounts
that will close next quarter.
Ten Target
Principle
3
Accounts
Ready to
Close
2
Accounts
in Cue
5
Accounts
in
Developme
nt
Section VII:
Sales Process
1/4/2017
Targeting
• Customers you already do
business with
• Research Key Websites
Breastrecon.com
Diepsisters.com (Patient
advocacy - list by state)
Diepflap.com ( Individual
docs)
ASPS.com (American
Society of Plastic Surgeons
Society)
Medical School Websites
US Cancer Centers
Breast Fellowship Programs
Hospital websites
Competitive/ Other
company websites
• Research Additional Key
Information on the Internet
• Google search
“reconstructive breast
surgery, cosmetic breast
surgery ” and city in which
you are prospecting to find
local physicians
• Follow the Fellows
– Assess where fellows are
moving between
territories
– Build concentric circles
to determine additional
friendly customers
where your existing
physicians are trained
NOTE: While you are on these websites, determine who is speaking
at the national and local meetings
Section VII:
Sales Process
1/4/2017 83
Targeting
Managing Your Time
 Identify physicians who go to multiple hospitals.
 Once you sell SoftPulse into one, it’s easier to sell it into the other hospitals where they practice.
 Identify influential physicians who perform the most cases.
 Identify physicians who have fewer barriers to entry: Former customers, existing relationships, physicians
who practice where you live.
 Google the area before you go to your appointment to identify other prospecting opportunities you can
do while you’re there.
 Remember, your time and travel budget is valuable so don’t jump on a plane unless you know they are a
good target.
Be Sure to Follow the Hospital’s Protocol
• If Your Physician Tells you to “Just bring it in”
– You should be credentialed in the top 10 hospitals you are targeting. NOTE: Do not wait to get
physician's approval for a case before you secure your credentialing. This should be done as soon as
possible in case you have the opportunity to attend a case last minute.
– You’ll still need to follow the hospital’s new product policy.
– Protocols may vary depending on whether it’s a small hospital, private, teaching, etc.
– When you arrive at the hospital, you must log in and you MUST log out otherwise,
you may risk losing your access rights to the hospital. (This is important – some
hospitals will score companies and you are responsible for keeping this score high.)
Section VII:
Sales Process
1/4/2017 84
Targeting
Credentialing Process
• Most hospitals require you to have the medical and training credentials to obtain
access to the facility. Requirements differ by hospital and may change at any time
without notice. In addition you may need to register with one or more credentialing
systems used by your hospital customers such as RepTrax, Status Blue, Vendor Clear or
Vendormate.
• Some hospitals and health systems use their own internal credentialing system for
vendors. We will provide you a letter stating you are trained on the technology.
Section VII:
Sales Process
1/4/2017 85
Targeting
Qualifying Questions by Subject Using the SofPulse Surgeon Form
• The SofPulse Surgeon Form provides you with an effective way to log and track information
about your targeted physicians. Keep in mind that a lot of this information should be filled in
prior to meeting with them. Bring this document to your meetings so you have a place to
take notes. The key to a good presentation is to integrate their quotes back into your pitch.
By writing this information down, it will be easier for you to formulate the structure of your
pitch.
• Additionally, there is a comprehensive list of key contacts within the hospital where your
physician practices. (note page 2) You will want to complete this information as soon as
possible. DO NOT WAIT until your physician asks to use the SofPulse before going to the
hospital to get credentialed and/or introduce yourself. If you have not already gotten
credentialed or made contact, you may risk the ability to bring the SoftPulse™ in for the
physician which could delay or potentially lose a sale.
• NOTE: The SofPulse Surgeon Form is located at the back of your training manual. An
electronic copy can be found on the secure section of the website.
Section VII:
Sales Process
1/4/2017 86
Targeting
• Hospitals vs. Office-which one and why
• Selling on label
• Other specialties
Section VII:
Sales Process
1/4/2017 87
Probing Questions
I. What are your thoughts on improved Surgical
recovery? What would you like to change?
Section VII:
Sales Process
1/4/2017 88
Probing Questions
II. How do you currently treat your patients
post surgery to help with recovery? From
a pain stand point? How long have you
been doing this? What was your goal in
starting this process?
We need to bring a surgeon down the path of pain to have the
conversation surrounding narcotic complications.
It accelerates the body’s own natural healing cascade by
reducing inflammation and moving the body on to
the next phases of healing
Section VII:
Sales Process
1/4/2017 89
Probing Questions
III. What is your standard protocol for post
procedure medication? How often does this
change? Have you looked at other alternatives?
Section VII:
Sales Process
1/4/2017 90
Probing Questions
IV. What has been your exposure or experience
with pain pumps? Seroma, infection, pt call
back, catheter problems
Section VII:
Sales Process
1/4/2017 91
Probing Questions
V. Do you use PCA pumps? Ever have problems
weaning patients off?
Section VII:
Sales Process
1/4/2017 92
Probing Questions
VI. Are you familiar with calmodulin and injury
response?
Section VII:
Sales Process
1/4/2017 93
Probing Questions Section VII:
Sales Process
1/4/2017 94
Value Analysis- What is it?
• A framework in which members of the
hospital community may gain access to new
products and equipment, and by which
currently utilized products and equipment
may be reviewed.
Section VII:
Sales Process
1/4/2017 95
Value Analysis- What is it?
• A multidisciplinary committee that reviews
the impact of product or technology adoption.
• A representative from the department
interested in the product goes before the
committee to justify the need.
Section VII:
Sales Process
1/4/2017 96
Value Analysis- Objectives
• Assess emerging technologies
• Determine financial impact
• Contain costs
• Determine clinical relevance
• Standardize products
• Comply with group purchasing contracts
• Enhance quality of patient care
• Make our job harder?
Section VII:
Sales Process
1/4/2017 97
Value Analysis- Alternate Names
• Value Analysis Committee
• Product Standards and Evaluation Committee
• New Product Committee
• Technology Assessment Committee
• Hospital Product Committee
• ROI Committee
• Medical Products Committee
Section VII:
Sales Process
1/4/2017 98
Value Analysis- Members
• Medical Director
• Surgical Service
• Clinical Services
• Purchasing
• Finance
• Nursing
• Infection Control
• Performance improvement
• Education
• Not You
Section VII:
Sales Process
1/4/2017 99
Value Analysis- Process
• Requestor submits request for new product prior to
committee meeting
—Provides information on current practice, possible
affects on patient outcomes/satisfaction
• Vendor provides supporting documentation, as requested,
may include:
—Product specifications
—Pricing
—FDA status
—Research articles
Section VII:
Sales Process
1/4/2017 100
Value Analysis- Manage the Process
• Select a strong SofPulse product champion
Section VII:
Sales Process
1/4/2017 101
– Chief of plastic surgery department
– Vocal busy surgeon
– Mover & shaker
– Not a resident
– Not a pushover
• Don’t assume the doctor knows the
process
Value Analysis- Manage the Process
• Avoid surprises
• Factor the time into your sales forecast
Section VII:
Sales Process
1/4/2017 102
Value Analysis- Manage the Process
• Find out from plastics coordinator/materials:
– What is the process to get a new product into the
hospital?
– Who is in charge of the [Value Analysis] process?
– Contact information for person in charge.
– Information needed from vendors.
– How long does it take to go through the process?
– When does the committee meet?
Section VII:
Sales Process
1/4/2017 103
Value Analysis- Actions
•  Approve
•  Reject
•  Trial with evaluation period
Section VII:
Sales Process
1/4/2017 104
Value Analysis- University Example
• Value Analysis process Q&A
• Description of Value Analysis Program Process
• Value Analysis Request for Product Review
Form
• Summary of Value Analysis Committee
outcome
Section VII:
Sales Process
1/4/2017 105
Value Analysis- University Example Section VII:
Sales Process
1/4/2017 106
Value Analysis- University Example Section VII:
Sales Process
1/4/2017 107
Final
Review
Summary
Value Analysis- University Example Section VII:
Sales Process
1/4/2017 108
Product
Review
Form
Value Analysis- University Example Section VII:
Sales Process
1/4/2017 109
Product
Review
Form
Value Analysis- University Example Section VII:
Sales Process
1/4/2017
110
Final
Review
Summary
Value Analysis- STANFORD
O.R. Value Analysis Committee Worksheet
Section VII:
Sales Process
1/4/2017 111
Value Analysis- Stanford Coaching
Stanford MD Questions for VAC
Section VII:
Sales Process
1/4/2017 112
Value Analysis- STANFORD COACHING
Stanford MD Questions for VAC
Section VII:
Sales Process
1/4/2017 113
Closing
• Is there a difference?
– Try SofPulse
Section VII:
Sales Process
1/4/2017 114
– Sponsored Case
– Free Case
– Evaluate SofPulse
– Use SofPulse
Closing
• Always ask for the order – Keep your eye on the final objective!
First, it’s important to remember your goal is to gain commitment and support from your physician to use
SofPulse. (You do not need to cover everything on the first call.) Additionally, you’ll want to get your
physician's commitment to tell the hospital he/she wants to use SofPulse . This may be a multi-step process
which is fine however, it is critical that you always ask for the order first, versus asking for a scrub PO or
sponsored case. Focus on your end objective at all times.
• What you need to know about Scrub POs, Sponsored Cases and No Charge POs for
SofPulse:
– Scrub PO: A scrub PO will establish you as a VENDOR with in the hospital. This is critical as it will give
you a vendor ID and an internal product code that will allow you to establish par levels. A scrub PO
will also allow you to confirm terms and conditions for shipments. Strategically speaking, you’re
positioning yourself for the final sale. Additionally, scrub POs are important as you are paid. Any
revenue is better than no revenue.
– Sponsored Cases: Only ask for a sponsored case after you’ve tried for a scrub PO. Be cautious about
using the words “evaluation” or “trial” as these words say free to a hospital. Free means there is no
value in product or in your time. Instead, close to “sponsor” a case which means that
you, as the Account Manager, will cover the costs associated with the procedure. This builds
greater value.
– No Charge PO: Getting a no charge PO for the Sponsored case is VERY important as it puts ownership
on the hospital. While there is no revenue you have still established yourself as a VENDOR.
Section VII:
Sales Process
115
Closing
• Who will you need to talk with to get the order, scrub PO or Sponsored cases?
― Plastics Coordinator
― OR Supervisor/Director
― Business Manager
― Others as identified by your hospital and/or physician
• What’s the best way for you and your physician to approach these key contacts?
There are ideally three ways to approach these contacts. In order to help ensure your success, prioritize
them in this manner:
1. Ask your physician to walk with you to see them in person.
2. Ask your physician to send an email and copy you in (This way you have a permanent record.
If you go to see them and they say they have not received the email, be sure to bring a print out so
you can show it to them.)
3. Ask your physician to call them, while you are in the surgeon office. Then go directly t the OR.
Section VII:
Sales Process
1/4/2017 116
Sponsored Cases
• How many cases?
• What are they looking for?
—Should be involved with first five cases and timed
follow up after post-op recovery visit.
Section VII:
Sales Process
1/4/2017 117
Close
118
If you do not get the order
then, close for the following:
Goal 1: Scrub PO
Goal 2: Sponsored case with no charge PO for shipping
Sale is WonSale is Lost
BUILD
Installation
Shipment
In-Service
Preference Card
You Close for an Order
Box of Each
Close for Order
(Do not close for the scrub PO or
sponsored case first! Focus on the end goal.)
After Case(s) – Close for Box of Each
You and your physician need to revisit the Plastics Coordinator,
OR Supervisor/Director, and/or Business Manager
1. Go in person
2. Email 3. Call
Review Committee
Review Reasons With Director
It’s critical to understand why an order is
lost to help avoid it from happening in the
future.
You and your physician visit the Plastics Coordinator, OR
Supervisor/Director, and/or Business Manager
1. Go in person
2. Email
3. Call
Closing Process
Section VII:
Sales Process
1/4/2017
Closing
Gaining Commitment
The following pitch gives you some ideas on how to close your physician to invest in SofPulse following either
sponsored cases or cases where you’ve secured a scrub PO. There are two key steps you’ll want to take your
physician through to successfully close the sale.
Step 1: Reconfirm the benefits of SofPulse with your physician and gain agreement.
Doctor, you have now successfully performed (note # of cases they have performed) SofPulse cases. When we
started, you mentioned your primary goals were to validate the value of the SofPulse to your practice . You
have seen firsthand, that with SofPulse your patients recovered faster and nursing care time was reduced. Are
you satisfied that your patients have benefited from SofPulse like those reported in the clinical data. SofPulse
has delivered the clinical benefits to your patients as expected? Great. How have you found these benefits to
be compelling?
Step 2: Direct your physician to action! Get them to go back to the Plastics Coordinator,
OR Supervisor/Direct and/or Business Director and ask for SofPulse to be brought in
permanently.
That’s great. Now that you have realized the many benefits of SofPulse , the next step to get SofPulse in your
hands on a permanent basis is to go back to your plastics coordinator, OR Supervisor/Director
and/or business manager. If you could walk over with me to see them right now, it would
help expedite the process to ensure we get the SofPulse in as quickly as possible so you can
continue using it on your cases. (Again, going in person is your top priority, email is next and then a phone call.)
Section VII:
Sales Process
1/4/2017 119
Build
• Managing Your Time After the Sale
– In order to have time to sell more SofPulse you’ll want to have time available to do this. Therefore,
once you secure your initial order you’ll want to make sure you set up an account that is self-
sustaining. You’ll always want to provide support, but if you don’t take the following precautions
both you and the account may not be satisfied with the outcomes.
• Service/Support
— The service and support provided by SofPulse comes from you as the account manager and also from
the company. You will want to ensure your cell phone number is posted every place a patient may go
so the staff can easily find it. Nurses on the floor should want and expect SofPulse
• Preference Card
– Since SofPulse is placed after surgery it is important to make sure it is listed. Often times when
setting for a case staff is focused on the surgery and not post-op care. The last thing we need is for
the case to be over and everyone looking for SofPulse. Chances are the surgeon will just say forget
it.
• Develop a Super-User:
— You’ll want to identify and develop a Super-User within the hospital that is the expert. This
Super-User will provide clinical support so they do not need to call you every time
there is a question.
Section VII:
Sales Process
1/4/2017 120
Objections
“Is this covered by insurance?”
Just like all your other products, “ no”,
In the hospital it is no different then the
suture, pain pump or staples you use.
Section VII:
Sales Process
1/4/2017 121
Objections
“My patients do not have pain ”
Most refer to is as mild discomfort. I have
often wondered if there is no pain why are
patients taking Valium or Percocet.
Dr., our focus is not on masking pain rather
accelerated surgical recovery.
Section VII:
Sales Process
1/4/2017 122
Objections
“It costs too much money”
• As compared to what?
• Based on our conversation what would
you be willing to pay?
• How much would you charge the patient?
• So if I got permission to have your office
purchase for $$ would you order today?
Section VII:
Sales Process
1/4/2017 123
Objections
“Not sure about the data”
Can you be more specific?
Section VII:
Sales Process
1/4/2017 124
Objections
“Enrollment in trial was low”
All of our data has reached statistical
significance. The trials where designed to
reach that level. The study from NY
Presbyterian hospital was published in PRS.
Clearly we both agree that is the premiere
journal in plastic surgery.
Section VII:
Sales Process
1/4/2017 125
Objections
“Takes too long to apply”
SofPulse is non invasive and can be placed on
top of dressings, undergarments or even
close.
Section VII:
Sales Process
1/4/2017 126
Objections
“Is this PEMF?”
PEMF is the predicate technology, we are
targeting the specific binding of calcium.
Section VII:
Sales Process
1/4/2017 127
Objections
“I am happy using pain pumps?”
Great glad you are seeing value in masking
pain. We are talking about therapeutically
accelerating surgical recovery that results in
pain reduction.
Section VII:
Sales Process
1/4/2017 128
Objections
“My patients do no have complications”
We are not trying to solve specific
complications rather accelerate the body’s
response to surgical injury.
Section VII:
Sales Process
1/4/2017 129
Objections
“Who else uses this?”
Locally no one. We are just bringing
the product to market. I thought you
might be interested in differentiating
your practice. Most agree that
increased patient satisfaction results
in more referrals. Dr. Gabriel in
Vancouver, Washington treats about
30 patients a month with SofPulse.
Section VII:
Sales Process
1/4/2017 130
Objections
“I have the old machine”
How are you administering the therapy?
Have you considered the benefit a
single patient use device could bring?
Section VII:
Sales Process
1/4/2017 131
Objections
“I’m not sure how patients would dispose
of device, is there a battery?”
The same as any other
battery operated device.
Section VII:
Sales Process
1/4/2017 132
Objections
“My patient will not wear it”
Compliance is the case with some
patience in general. Since this is
elective and they have paid for the
therapy we think they will act different.
Most patients feel the difference when
they stop therapy. Studies show
efficacy after one treatment.
Section VII:
Sales Process
1/4/2017 133
Objections
“This not a sterile implantable and can be
placed out of the OR, so not my budget ”
If not placed in the OR reducing treatment time,
thus efficacy of our technology.
Is it easier to get approved out of OR?
Section VII:
Sales Process
1/4/2017 134
acceleratedsurgical
recovery
Increased Patient Satisfaction
Section VIII: SofPulse Sales Training
Competition
September 23, 2011
1/4/2017 135
Competition
Since we have the most elite
group there is none!
Section VIII:
Competition
1/4/2017 136
Competition
Time for a Laugh, or, two!
Section VIII:
Competition
1/4/2017 137
BREAK
1/4/2017 138
Dreaming of Commissions
Q&A
1/4/2017 139
Section IX:
Ivivi Customer Relationship Policy

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sofpulse post

  • 1. acceleratedsurgical recovery Increased Patient Satisfaction SofPulse Sales Training September 23, 2011 1/4/2017 1
  • 2. Welcome to your SofPulse Sales Training-The Path to Money Section I: Company Overview 7:00a - 7:30a Section II: Technology Overview 7:30a - 8:00a Section III: Clinical Literature 8:00a - 9:30a Section IV: Clinical Procedures & Applications 9:30a - 10:00a Break 10:00a - 10:15a Section V: Sales Tools 10:15a - 11:00a Section VI: Customer Service 11:00a - 11:45a Lunch 12:00p - 1:00p Section VII: Sales Process 1:00p - 2:30p Section VIII: Competition 2:30p - 3:00p Break 3:00p - 3:15p Section IX: Compliance 3:15p - 4:15p Discussion 4:15p - 5:00p 1/4/2017 2
  • 3. Early Stage medical technology with an 18 year history of clinical expertise? New Area of Medicine? Paradigm Shift in Patient Care? Culture? Financial Freedom? What is SofPulse? ALL THE ABOVE Section I: Company Overview 1/4/2017 3
  • 4. Culture • ‘None of us’ is as smart as ‘all of us’ • Getting it right is the important thing Section I: Company Overview 1/4/2017 4
  • 5. Financial Freedom – Commission’s Product Sales Price Range Per Box* Commission Tier SofPulse $1499+ ($299) 40% (1) SofPulse $1300- $1498 ($260) 35%(2) SofPulse $1000-$1299($200) 25%(3) SofPulse $ 999($199) (minimum price per Box) 20%(4) SofPulse Duo $1799+($359) 40%(1) SofPulse Duo $1500-$1798($300) 35%(2) SofPulse Duo $1200- $1499($240) 25%(3) SofPulse Duo $1199($239) (minimum price per Box) 20%(4) Plastic Surgeon Sale $1149+($229) 40%(1) Plastic Surgeon Sale $950-$1148($190) 35%(2) Plastic Surgeon Sale $750-$ 949($150) 25%(3) Plastic Surgeon Sale $749($149) (minimum price per Box) 20%(4) * A box includes five (5) SofPulse all of the same type. ** Surgeon sale is limited to the direct purchase by a plastic surgeon for the sole purpose of using in his/her office based surgery center or other such freestanding surgery center. This does not include use by surgeon in an acute care hospital or other such ambulatory surgery center affiliated with such acute care hospital. Section I: Company Overview 1/4/2017 5
  • 6. • EPI founded in 1990, creates first solid state PEMF device. – Marketed successfully to treat pressure ulcers in nursing home. – CMS drops reimbursement 1997, company sells off technology to small medical company ADM. • ADM forms Ivivi Technologies in 2004, to commercialize new PEMF devices. – Lightweight, lower-powered, more effective. Corporate History Section I: Company Overview 1/4/2017 6
  • 7. Corporate History • FDA deems new devices not substantially equivalent to earlier device (I-Phone, Commodore 64). – Public company, stock drops to pennies overnight • Ivivi successfully appeals FDA ruling and FDA issues new 510k. – But company is public, out of money in 2009 • Ivivi Health Sciences buys assets in 2010. – Raises new capital – Leverage all the clinical and scientific information produced by EPI and Ivivi – SofPulse launch 2011 Section I: Company Overview 1/4/2017 7
  • 8. Business Structure Ivivi Orthopedic Health Inc. (“IOH”) Other Current Businesses Potential Future Businesses Ivivi Health Sciences LLC • SofPulse Reconstructive Plastic Surgery • Ivivi Wound Healing Sciences • Assisi Animal Health • Cardiology • Rio Grand NeuroSciencs • Incorporated January 2011 Section I: Company Overview 1/4/2017 8
  • 9. SofPulse Corporate Structure Steven Gluckstern Chairman & CEO Kathryn Clubb President & COO Kaysie Dannemiller Fulfillment & Customer Service Diana Kyster Controller Mark Rich Sales & Marketing Sales Specialist Independent Sales Representative CGI Mexico Sarah Kermensky Administration Andre Di Mino Regulatory, Engineering & Mfg. Contract Manufacturer(s) Engineers Arthur Pilla Inventor & Senior Scientist Sean Hagberg Basic Research & New Projects Section I: Company Overview 1/4/2017 9
  • 10. acceleratedsurgical recovery Increased Patient Satisfaction Section II: SofPulse Sales Training Technology Overview September 23, 2011 1/4/2017 10
  • 11. Short History of Pulsed Diathermy • Radio frequency to heat deep tissues (1907) • Ginsberg (1930s) – Reduces duty cycle, Pulsed Diathermy – No heat – Retains therapeutic effects – Signal not optimized, mechanism unknown • Creates pulsed electromagnetic field (PEMF) devices – Treatment of pain and edema in soft tissue – Delivery electrical current to injured tissue inductively Section II: Technology Overview 1/4/2017 11
  • 12. Bone Growth Stimulator (BGS) History • Bone recognized to produce electrical currents (Fukada, Yasuko 1957) • Direct electrical stimulation heals recalcitrant fractures – Electric currents driven across fracture stimulate bone growth • Pulsed electromagnet field devices introduced (Bassett, Pilla 1974) – Signal generator and external applicator – induce electrical current in bone from outside the body Section II: Technology Overview 1/4/2017 12
  • 13. Bone Growth Stimulator (BGS) History Bassettetal.1977.ClinOrthop.124:128-143 Early BGS device on patient with tibial non-union. Outpatient, minimum Rx 4 hours/day, even today Section II: Technology Overview 1/4/2017 13
  • 14. Ivivi Technologies • PEMF to tPEMF – Proprietary signals – A priori targeting of electrochemical activity – Decreases power, increases efficacy – Delivered through FDA-cleared devices Section II: Technology Overview 1/4/2017 14
  • 15. The Evolution of tPEMF Section II: Technology Overview 1/4/2017 15
  • 16. SofPulse Section II: Technology Overview 1/4/2017 16
  • 17. How PEMFWorks • Pulsed electromagnetic fields induce signaling microcurrents in tissue • Signal characteristics important – Duration, Frequency, Power • Targeted signals – Speed body’s own mechanisms – No known side effects – No adverse effects Section II: Technology Overview 1/4/2017 17
  • 18. How Configuring PEMF Works Pillaetal.BioeletrochemBioenergetics.1999;48:27-34 Signal to noise ratio (SNR) for Ca/CaM binding vs. PEMF configuration Applied Field Frequency (Hz) 10-2 10-1 100 101 102 103 104 105 106 107 108 SNR 5.0e-1 1.0e+0 1.5e+0 2.0e+0 2.5e+0 PRF 2 msec (SNR) PRF 65 μsec (Diathermy) PEMF Bone Repair Section II: Technology Overview 1/4/2017 18
  • 19. Mechanism of Action (MOA) PEMF Ca2+ + CaM Ca2+CaM PEMF increases Ca2+ binding to CaM (milliseconds) Ca2+CaM + eNOS NO Ca2+CaM binds to eNOS, catalyzes NO release (seconds) Anti-inflammatory: increased Blood & Lymph Flow Pain/Edema Decrease (seconds) NO cGMP Growth Factors (hours/days) VEGF Angiogenesis (hours/days) FGF Collagen/Granulation (days) TGF-β Remodeling (days/weeks) Section II: Technology Overview 1/4/2017 19
  • 20. Special Effects of tPEMF • Targeting Calcium/Calmodulin Binding (Ca/CaM) • Anti-inflammatory cascade • Signal configuration couples to Ca2+ binding Section II: Technology Overview 1/4/2017 20
  • 21. Accelerated Surgical Recovery After MC Robson Surg Cl N Am *83 2003 p. 558 Targets inflammation Accelerates anti-inflammatory activity Section II: Technology Overview 1/4/2017 21
  • 22. What’s the Difference? • Static Magnetic Field • PRF • EMF • PEMF • tPEMF • Targeted MicroCurrent Therapy • You make money to sell tMCT Section II: Technology Overview 1/4/2017 22
  • 23. Electromagnetic Spectrum Section II: Technology Overview 1/4/2017 23
  • 24. acceleratedsurgical recovery Increased Patient Satisfaction Section III: SofPulse Sales Training Clinical Literature September 23, 2011 1/4/2017 24
  • 25. Key Publications Key Take Away Rohde PRS June 2010, 9.16.2011 Rohde PRS + Discussion Section III: Clinical Literature 1/4/2017 25
  • 26. Key Publications Key Take Away, Hammond, Dennis, PRS Discussion Section III: Clinical Literature 1/4/2017 26
  • 27. Key Publications Key Take Away Johnson BEMS Johnson BEMS Study Section III: Clinical Literature 1/4/2017 27
  • 28. Key Publications Key Take Away Johnson Animal Pain Study 2008, 9.16.2011 Johnson Pain Study Section III: Clinical Literature 1/4/2017 28
  • 29. Key Publications Key Take Away Heden Aesth Plast Surg April 2008, 6.21.2011 Heden & Pilla 2008 Section III: Clinical Literature 1/4/2017 29
  • 30. Key Publications Key Take Away Strauch PEMF ASJ Mar-Apr 2009, 6.21.2011 Strauch PEMF Aesthetics 2009 Section III: Clinical Literature 1/4/2017 30
  • 31. Related Publications – Roland 2000 PRS – Weber 2004 PRS – Strauch PEMF 2007 PRS Section III: Clinical Literature 1/4/2017 31
  • 32. Supporting Publications – Pila Ankle PRF – Kloth Wound Closure Article Section III: Clinical Literature 1/4/2017 32
  • 33. Level of Study • In vitro • Ex vivo • In Vivo • Meta Analysis • Prospective • Retrospective • RCT • Trial Design Section III: Clinical Literature 1/4/2017 33
  • 34. In vitro • (Latin: within glass) refers to studies in experimental biology that are conducted using components of an organism that have been isolated from their usual biological context in order to permit a more detailed or more convenient analysis than can be done with whole organisms. In contrast, the term in vivo refers to work that is conducted with living organisms in their normal, intact state, while ex vivo refers to studies on functional organs that have been removed from the intact organism Section III: Clinical Literature 1/4/2017 34
  • 35. Ex vivo • (Latin: "out of the living") means that which takes place outside an organism. In science, ex vivo refers to experimentation or measurements done in or on tissue in an artificial environment outside the organism with the minimum alteration of natural conditions. Ex vivo conditions allow experimentation under more controlled conditions than possible in in vivo experiments (in the intact organism), at the expense of altering the "natural" environment. Section III: Clinical Literature 1/4/2017 35
  • 36. In vivo • (Latin for "within the living") is experimentation using a whole, living organism as opposed to a partial or dead organism, or an in vitro ("within the glass", i.e., in a test tube or petri dish) controlled environment. Animal testing and clinical trials are two forms of in vivo research. In vivo testing is often employed over in vitro because it is better suited for observing the overall effects of an experiment on a living subject. This is often described by the maxim in vivo veritas.[1] Section III: Clinical Literature 1/4/2017 36
  • 37. Meta Analysis • In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the weighting might be related to sample sizes within the individual studies. More generally there are other differences between the studies that need to be allowed for, but the general aim of a meta-analysis is to more powerfully estimate the true "effect size" as opposed to a smaller "effect size" derived in a single study under a given single set of assumptions and conditions. • Meta-analyses are often, but not always, important components of a systematic review procedure. Here it is convenient to follow the terminology used by the Cochrane Collaboration,[1] and use "meta- analysis" to refer to statistical methods of combining evidence, leaving other aspects of 'research synthesis' or 'evidence synthesis', such as combining information from qualitative studies, for the more general context of systematic reviews. Section III: Clinical Literature 1/4/2017 37
  • 38. Trial Design • Randomized: Each study subject is randomly assigned to receive either the study treatment or a placebo. • Blind: The subjects involved in the study do not know which study treatment they receive. If the study is double-blind, the researchers also do not know which treatment is being given to any given subject. This 'blinding' is to prevent biases, since if a physician knew which patient was getting the study treatment and which patient was getting the placebo, he/she might be tempted to give the (presumably helpful) study drug to a patient who could more easily benefit from it. In addition, a physician might give extra care to only the patients who receive the placebos to compensate for their ineffectiveness. A form of double-blind study called a "double-dummy" design allows additional insurance against bias or placebo effect. In this kind of study, all patients are given both placebo and active doses in alternating periods of time during the study. • Placebo-controlled: The use of a placebo (fake treatment) allows the researchers to isolate the effect of the study treatment. • Prospective • Retrospective Section III: Clinical Literature 1/4/2017 38
  • 39. 1/4/2017 39 The Joy of a Salesman Salesman is the ultimate career!
  • 40. acceleratedsurgical recovery Increased Patient Satisfaction Section IV: SofPulse Sales Training Clinical Procedures & Product Application September 23, 2011 1/4/2017 40
  • 41. Reconstruction/Reduction(DRG) • Mastectomy • Reconstruction • Reduction Section IV: Clinical Procedures/Product Application 1/4/2017 41
  • 42. Breast Reconstruction Comparison Type of Reconstruction Hours in O.R. Days in Hospital Recovery Time (highly variable) Tissue Expander/Implant 1 – 2 Hours 1 – 2 Days 2 - 3 Weeks Latissimus Dorsi 3 – 4 Hours 3 – 4 Days 4 Weeks TRAM (pedicle) 4 – 5 Hours 4 – 5 Days 5 – 6 Weeks Free Flap 6 – 10 Hours 4 – 5 Days 5 – 6 Weeks Section IV: Clinical Procedures/Product Application 1/4/2017 42
  • 43. Cosmetic Surgery • Tummy Tuck (Abdominoplasty) • Face Lift (Rhytidectomy) • Fat Grafting • Post Bariatric Body Contouring • Lipo Suction (PAL, Smart Lipo,etc.) • Breast Augmentation (Augmentation Mammaplasty) • Breast Reduction (Reduction Mammaplasty) • Breast Lift (Mastopexy) • Capsular Contracture Section IV: Clinical Procedures/Product Application 1/4/2017 43
  • 44. Inflammation - Is natural and healthful, as long as it terminates quickly Section IV: Clinical Procedures/Product Application 1/4/2017 44 Inflammation
  • 45. Analgesic • Anesthesia- – General is a state of unconsciousness, hypnosis, amnesia and loss of protective reflexes. Of the autonomic nervous system. – Regional is affecting only a large part of the body, such as a limb or the lower half of the body – Local to induce the absence of sensation in particular part of the body PCA Pump- to an electronically controlled infusion pump that delivers an amount of intravenous analgesic (usually an opioid) that is set by the patient Block A nerve block relieves pain by interrupting how pain signals are sent to your brain. It is done by injecting a substance, such as alcohol or phenol, into or around a nerve or into the spine. Pain Pump disposable, portable, non-electronic device that systematically infuses an anaesthetic through a special catheter implanted into the wound site by the surgeon. Section IV: Clinical Procedures/Product Application 1/4/2017 45
  • 47. acceleratedsurgical recovery Increased Patient Satisfaction Section V: SofPulse Sales Training Sales Tools September 23, 2011 1/4/2017 47
  • 48. Agenda • Surgeon Brochure • Patient Brochure • Economic Message • In-Service • Satisfaction Survey • Company Website – Build a Surgeons Practice • Trunk Stock • Value Analysis Packet 1/4/2017 48 Section V: Sales Tools
  • 50. Surgeon Brochure Elevator Pitch Advanced User 35 devices a month, article to be published Clinical Data - Designed to support individual concerns a surgeon has. Tissue Viability 1/4/2017 50 Section V: Sales Tools
  • 52. Surgeon Brochure 1/4/2017 52 Section V: Sales Tools Tissue Viability
  • 54. Surgeon Brochure Clinical Data - Designed to support individual concerns a surgeon has. 1/4/2017 54 Section V: Sales Tools
  • 56. Patient Brochure Why did they go for cosmetic surgery? Edema, Pain and recovery should not slow them up. 1/4/2017 56 Section V: Sales Tools
  • 57. Patient Brochure Surgery is painful. Patients are very in tuned to complications associated with prescription drugs. Gentle, Safe, Natural. 1/4/2017 57 Section V: Sales Tools
  • 58. Patient Brochure Surgery is painful. 1/4/2017 58 Section V: Sales Tools
  • 61. Patient Brochure Outside dressings not in our body Ever pay attention to a drug advertisement. 1/4/2017 61 Section V: Sales Tools
  • 63. Patient Brochure Ever pay attention to a drug advertisement? 1/4/2017 63 Section V: Sales Tools
  • 64. Economic Message 1/4/2017 64 Section V: Sales Tools Economic Message
  • 65. In - Service • Nurses take care of patients • Value there opinion (most industry folks down play their role) • Opportunity to learn about post-op care and complications • Great to practice sales pitch • Floor Nurses do not like new products without advanced notice • Failure to educate can cost you business • Referrals to other surgeons for additional sales • Aligns you to get completed surveys 1/4/2017 65 Section V: Sales Tools
  • 66. Satisfaction Survey • Support and Enhance Belief in technology • Let them know the importance of positive feedback to surgeon and hospital administration • Completed survey becomes part of the close • Local reference for future calls 1/4/2017 66 Section V: Sales Tools
  • 67. Company Website – Build a Surgeons Practice • Links to active users. • Surgeon can link to us helping to educate patience on what he/she is doing different • Newsletters/Testimonials- word search is powerful 1/4/2017 67 Section V: Sales Tools www.sofpulse.comCompany Website
  • 68. Trunk Stock • Provided at no cost to account manager » 2 boxes Single ($2600) » 2 boxes Duo ($2600) • Designed to drive successful conversions • Ability to generate immediate revenue on sales call • Regulated by the FDA 1/4/2017 68 Section V: Sales Tools
  • 69. Value Analysis Packet • Form Letter (under development) • FDA Approval • W – 9 • Liability 1/4/2017 69 Section V: Sales Tools
  • 70. acceleratedsurgical recovery Increased Patient Satisfaction Section VI: SofPulse Sales Training Sales Support/ Customer Service September 23, 2011 1/4/2017 70
  • 71. Trunk Stock • FDA Regulated • Will not be sent overnight NO EXCEPTIONS • 2 Boxes Single/Duo-after training • Sell Boxes • No more then 3 single sales to any account • Stock Transfer for each device • After 4 completed transfers eligible for another box Section VI: Sales Support/Customer Service 1/4/2017 71
  • 72. In-Field Stock Transfer • Completed any time you change ownership of product( sample, demo, sale, another manager) • FDA Regulated • Generates Revenue • Ensures your supply is replenished • Can list multiple devices on one form if same end user Section VI: Sales Support/Customer Service 1/4/2017 72
  • 73. In-Field Stock Transfer In Field Stock Transfer Form Section VI: Sales Support/Customer Service 1/4/2017 73
  • 74. Order Process-Show Me the Money Jerry McGuire "Show Me the Money" Section VI: Sales Support/Customer Service 1/4/2017 74
  • 75. Order Process-Show Me the Money • Customer Created in SalesForce.com • New Customer Sheet-2 week’s prior to expected order. Information entered into Priority. (Shipping and billing software) • Pricing Quote – Line Item Descriptor – Ivivi Set up – Shipping Terms- predetermined as ground or overnight recorded in SalesForce.com • Hard Copy PO or Credit Card Require to Process-no phoned in orders – orders@sofpulse.com – Fax 415-276-1985 • PO cross referenced with Priority/SalesForce – No Discrepancy-orders ship – Discrepancy » Customer service to call /e-mail purchasing to rectify » Account Manger Contacted » Director of Sales Contacted • Confirmation e-mail letter sent to customer • Account manager to receive shipment notification • Opportunity is closed in Salesforce.com and set up for commissions • No direct patient shipment or return Section VI: Sales Support/Customer Service 1/4/2017 75
  • 76. Returns & Shelf Life • Returns – ALL SALES ARE FINAL AND NOT SUBJECT TO RETURN, EXCHANGE OR SET-OFF • Non Sterile/ Shelf life is related to battery Section VI: Sales Support/Customer Service 1/4/2017 76
  • 77. Technical IFU Technical IFU Section VI: Sales Support/Customer Service 1/4/2017 77
  • 79. acceleratedsurgical recovery Increased Patient Satisfaction Section VII: SofPulse Sales Training Sales Process September 23, 2011 1/4/2017 79
  • 80. Types of Selling • Conceptual • Clinically • Relationship • Scrub Sink • Price • Features Benefits —Build the story —Lowest First —Against Competitor —Show me the data —He/She is your buddy so why not —Goal is to be in surgery Section VII: Sales Process 1/4/2017 80
  • 81. Selling / Targeting Alec Baldwin Shows How to Get it Done Section VII: Sales Process 1/4/2017 81
  • 82. 82 Targeting Building your Territory Target List Your target list is critical to your success and you should continually add to the funnel. The following highlights information that will help you expand your prospecting pipeline. Additionally, be sure to add new targets to your reports as a way to build and effectively manage your pipeline. You’ll work with SofPulse management to track the Ten Target Principle (3+2+5 as noted below). Ten Target Principle • Three (3) Accounts Ready to Close: You will be expected to commit to close three new accounts per quarter, after 60 days on board • Two (2) Accounts in Cue: You should have an additional two accounts that are in cue and are in the final phases of the approval process. • Five (5) Accounts in Development: You should also have five additional accounts that are being developed and cultivated to help ensure you have three solid accounts that will close next quarter. Ten Target Principle 3 Accounts Ready to Close 2 Accounts in Cue 5 Accounts in Developme nt Section VII: Sales Process 1/4/2017
  • 83. Targeting • Customers you already do business with • Research Key Websites Breastrecon.com Diepsisters.com (Patient advocacy - list by state) Diepflap.com ( Individual docs) ASPS.com (American Society of Plastic Surgeons Society) Medical School Websites US Cancer Centers Breast Fellowship Programs Hospital websites Competitive/ Other company websites • Research Additional Key Information on the Internet • Google search “reconstructive breast surgery, cosmetic breast surgery ” and city in which you are prospecting to find local physicians • Follow the Fellows – Assess where fellows are moving between territories – Build concentric circles to determine additional friendly customers where your existing physicians are trained NOTE: While you are on these websites, determine who is speaking at the national and local meetings Section VII: Sales Process 1/4/2017 83
  • 84. Targeting Managing Your Time  Identify physicians who go to multiple hospitals.  Once you sell SoftPulse into one, it’s easier to sell it into the other hospitals where they practice.  Identify influential physicians who perform the most cases.  Identify physicians who have fewer barriers to entry: Former customers, existing relationships, physicians who practice where you live.  Google the area before you go to your appointment to identify other prospecting opportunities you can do while you’re there.  Remember, your time and travel budget is valuable so don’t jump on a plane unless you know they are a good target. Be Sure to Follow the Hospital’s Protocol • If Your Physician Tells you to “Just bring it in” – You should be credentialed in the top 10 hospitals you are targeting. NOTE: Do not wait to get physician's approval for a case before you secure your credentialing. This should be done as soon as possible in case you have the opportunity to attend a case last minute. – You’ll still need to follow the hospital’s new product policy. – Protocols may vary depending on whether it’s a small hospital, private, teaching, etc. – When you arrive at the hospital, you must log in and you MUST log out otherwise, you may risk losing your access rights to the hospital. (This is important – some hospitals will score companies and you are responsible for keeping this score high.) Section VII: Sales Process 1/4/2017 84
  • 85. Targeting Credentialing Process • Most hospitals require you to have the medical and training credentials to obtain access to the facility. Requirements differ by hospital and may change at any time without notice. In addition you may need to register with one or more credentialing systems used by your hospital customers such as RepTrax, Status Blue, Vendor Clear or Vendormate. • Some hospitals and health systems use their own internal credentialing system for vendors. We will provide you a letter stating you are trained on the technology. Section VII: Sales Process 1/4/2017 85
  • 86. Targeting Qualifying Questions by Subject Using the SofPulse Surgeon Form • The SofPulse Surgeon Form provides you with an effective way to log and track information about your targeted physicians. Keep in mind that a lot of this information should be filled in prior to meeting with them. Bring this document to your meetings so you have a place to take notes. The key to a good presentation is to integrate their quotes back into your pitch. By writing this information down, it will be easier for you to formulate the structure of your pitch. • Additionally, there is a comprehensive list of key contacts within the hospital where your physician practices. (note page 2) You will want to complete this information as soon as possible. DO NOT WAIT until your physician asks to use the SofPulse before going to the hospital to get credentialed and/or introduce yourself. If you have not already gotten credentialed or made contact, you may risk the ability to bring the SoftPulse™ in for the physician which could delay or potentially lose a sale. • NOTE: The SofPulse Surgeon Form is located at the back of your training manual. An electronic copy can be found on the secure section of the website. Section VII: Sales Process 1/4/2017 86
  • 87. Targeting • Hospitals vs. Office-which one and why • Selling on label • Other specialties Section VII: Sales Process 1/4/2017 87
  • 88. Probing Questions I. What are your thoughts on improved Surgical recovery? What would you like to change? Section VII: Sales Process 1/4/2017 88
  • 89. Probing Questions II. How do you currently treat your patients post surgery to help with recovery? From a pain stand point? How long have you been doing this? What was your goal in starting this process? We need to bring a surgeon down the path of pain to have the conversation surrounding narcotic complications. It accelerates the body’s own natural healing cascade by reducing inflammation and moving the body on to the next phases of healing Section VII: Sales Process 1/4/2017 89
  • 90. Probing Questions III. What is your standard protocol for post procedure medication? How often does this change? Have you looked at other alternatives? Section VII: Sales Process 1/4/2017 90
  • 91. Probing Questions IV. What has been your exposure or experience with pain pumps? Seroma, infection, pt call back, catheter problems Section VII: Sales Process 1/4/2017 91
  • 92. Probing Questions V. Do you use PCA pumps? Ever have problems weaning patients off? Section VII: Sales Process 1/4/2017 92
  • 93. Probing Questions VI. Are you familiar with calmodulin and injury response? Section VII: Sales Process 1/4/2017 93
  • 94. Probing Questions Section VII: Sales Process 1/4/2017 94
  • 95. Value Analysis- What is it? • A framework in which members of the hospital community may gain access to new products and equipment, and by which currently utilized products and equipment may be reviewed. Section VII: Sales Process 1/4/2017 95
  • 96. Value Analysis- What is it? • A multidisciplinary committee that reviews the impact of product or technology adoption. • A representative from the department interested in the product goes before the committee to justify the need. Section VII: Sales Process 1/4/2017 96
  • 97. Value Analysis- Objectives • Assess emerging technologies • Determine financial impact • Contain costs • Determine clinical relevance • Standardize products • Comply with group purchasing contracts • Enhance quality of patient care • Make our job harder? Section VII: Sales Process 1/4/2017 97
  • 98. Value Analysis- Alternate Names • Value Analysis Committee • Product Standards and Evaluation Committee • New Product Committee • Technology Assessment Committee • Hospital Product Committee • ROI Committee • Medical Products Committee Section VII: Sales Process 1/4/2017 98
  • 99. Value Analysis- Members • Medical Director • Surgical Service • Clinical Services • Purchasing • Finance • Nursing • Infection Control • Performance improvement • Education • Not You Section VII: Sales Process 1/4/2017 99
  • 100. Value Analysis- Process • Requestor submits request for new product prior to committee meeting —Provides information on current practice, possible affects on patient outcomes/satisfaction • Vendor provides supporting documentation, as requested, may include: —Product specifications —Pricing —FDA status —Research articles Section VII: Sales Process 1/4/2017 100
  • 101. Value Analysis- Manage the Process • Select a strong SofPulse product champion Section VII: Sales Process 1/4/2017 101 – Chief of plastic surgery department – Vocal busy surgeon – Mover & shaker – Not a resident – Not a pushover • Don’t assume the doctor knows the process
  • 102. Value Analysis- Manage the Process • Avoid surprises • Factor the time into your sales forecast Section VII: Sales Process 1/4/2017 102
  • 103. Value Analysis- Manage the Process • Find out from plastics coordinator/materials: – What is the process to get a new product into the hospital? – Who is in charge of the [Value Analysis] process? – Contact information for person in charge. – Information needed from vendors. – How long does it take to go through the process? – When does the committee meet? Section VII: Sales Process 1/4/2017 103
  • 104. Value Analysis- Actions •  Approve •  Reject •  Trial with evaluation period Section VII: Sales Process 1/4/2017 104
  • 105. Value Analysis- University Example • Value Analysis process Q&A • Description of Value Analysis Program Process • Value Analysis Request for Product Review Form • Summary of Value Analysis Committee outcome Section VII: Sales Process 1/4/2017 105
  • 106. Value Analysis- University Example Section VII: Sales Process 1/4/2017 106
  • 107. Value Analysis- University Example Section VII: Sales Process 1/4/2017 107 Final Review Summary
  • 108. Value Analysis- University Example Section VII: Sales Process 1/4/2017 108 Product Review Form
  • 109. Value Analysis- University Example Section VII: Sales Process 1/4/2017 109 Product Review Form
  • 110. Value Analysis- University Example Section VII: Sales Process 1/4/2017 110 Final Review Summary
  • 111. Value Analysis- STANFORD O.R. Value Analysis Committee Worksheet Section VII: Sales Process 1/4/2017 111
  • 112. Value Analysis- Stanford Coaching Stanford MD Questions for VAC Section VII: Sales Process 1/4/2017 112
  • 113. Value Analysis- STANFORD COACHING Stanford MD Questions for VAC Section VII: Sales Process 1/4/2017 113
  • 114. Closing • Is there a difference? – Try SofPulse Section VII: Sales Process 1/4/2017 114 – Sponsored Case – Free Case – Evaluate SofPulse – Use SofPulse
  • 115. Closing • Always ask for the order – Keep your eye on the final objective! First, it’s important to remember your goal is to gain commitment and support from your physician to use SofPulse. (You do not need to cover everything on the first call.) Additionally, you’ll want to get your physician's commitment to tell the hospital he/she wants to use SofPulse . This may be a multi-step process which is fine however, it is critical that you always ask for the order first, versus asking for a scrub PO or sponsored case. Focus on your end objective at all times. • What you need to know about Scrub POs, Sponsored Cases and No Charge POs for SofPulse: – Scrub PO: A scrub PO will establish you as a VENDOR with in the hospital. This is critical as it will give you a vendor ID and an internal product code that will allow you to establish par levels. A scrub PO will also allow you to confirm terms and conditions for shipments. Strategically speaking, you’re positioning yourself for the final sale. Additionally, scrub POs are important as you are paid. Any revenue is better than no revenue. – Sponsored Cases: Only ask for a sponsored case after you’ve tried for a scrub PO. Be cautious about using the words “evaluation” or “trial” as these words say free to a hospital. Free means there is no value in product or in your time. Instead, close to “sponsor” a case which means that you, as the Account Manager, will cover the costs associated with the procedure. This builds greater value. – No Charge PO: Getting a no charge PO for the Sponsored case is VERY important as it puts ownership on the hospital. While there is no revenue you have still established yourself as a VENDOR. Section VII: Sales Process 115
  • 116. Closing • Who will you need to talk with to get the order, scrub PO or Sponsored cases? ― Plastics Coordinator ― OR Supervisor/Director ― Business Manager ― Others as identified by your hospital and/or physician • What’s the best way for you and your physician to approach these key contacts? There are ideally three ways to approach these contacts. In order to help ensure your success, prioritize them in this manner: 1. Ask your physician to walk with you to see them in person. 2. Ask your physician to send an email and copy you in (This way you have a permanent record. If you go to see them and they say they have not received the email, be sure to bring a print out so you can show it to them.) 3. Ask your physician to call them, while you are in the surgeon office. Then go directly t the OR. Section VII: Sales Process 1/4/2017 116
  • 117. Sponsored Cases • How many cases? • What are they looking for? —Should be involved with first five cases and timed follow up after post-op recovery visit. Section VII: Sales Process 1/4/2017 117
  • 118. Close 118 If you do not get the order then, close for the following: Goal 1: Scrub PO Goal 2: Sponsored case with no charge PO for shipping Sale is WonSale is Lost BUILD Installation Shipment In-Service Preference Card You Close for an Order Box of Each Close for Order (Do not close for the scrub PO or sponsored case first! Focus on the end goal.) After Case(s) – Close for Box of Each You and your physician need to revisit the Plastics Coordinator, OR Supervisor/Director, and/or Business Manager 1. Go in person 2. Email 3. Call Review Committee Review Reasons With Director It’s critical to understand why an order is lost to help avoid it from happening in the future. You and your physician visit the Plastics Coordinator, OR Supervisor/Director, and/or Business Manager 1. Go in person 2. Email 3. Call Closing Process Section VII: Sales Process 1/4/2017
  • 119. Closing Gaining Commitment The following pitch gives you some ideas on how to close your physician to invest in SofPulse following either sponsored cases or cases where you’ve secured a scrub PO. There are two key steps you’ll want to take your physician through to successfully close the sale. Step 1: Reconfirm the benefits of SofPulse with your physician and gain agreement. Doctor, you have now successfully performed (note # of cases they have performed) SofPulse cases. When we started, you mentioned your primary goals were to validate the value of the SofPulse to your practice . You have seen firsthand, that with SofPulse your patients recovered faster and nursing care time was reduced. Are you satisfied that your patients have benefited from SofPulse like those reported in the clinical data. SofPulse has delivered the clinical benefits to your patients as expected? Great. How have you found these benefits to be compelling? Step 2: Direct your physician to action! Get them to go back to the Plastics Coordinator, OR Supervisor/Direct and/or Business Director and ask for SofPulse to be brought in permanently. That’s great. Now that you have realized the many benefits of SofPulse , the next step to get SofPulse in your hands on a permanent basis is to go back to your plastics coordinator, OR Supervisor/Director and/or business manager. If you could walk over with me to see them right now, it would help expedite the process to ensure we get the SofPulse in as quickly as possible so you can continue using it on your cases. (Again, going in person is your top priority, email is next and then a phone call.) Section VII: Sales Process 1/4/2017 119
  • 120. Build • Managing Your Time After the Sale – In order to have time to sell more SofPulse you’ll want to have time available to do this. Therefore, once you secure your initial order you’ll want to make sure you set up an account that is self- sustaining. You’ll always want to provide support, but if you don’t take the following precautions both you and the account may not be satisfied with the outcomes. • Service/Support — The service and support provided by SofPulse comes from you as the account manager and also from the company. You will want to ensure your cell phone number is posted every place a patient may go so the staff can easily find it. Nurses on the floor should want and expect SofPulse • Preference Card – Since SofPulse is placed after surgery it is important to make sure it is listed. Often times when setting for a case staff is focused on the surgery and not post-op care. The last thing we need is for the case to be over and everyone looking for SofPulse. Chances are the surgeon will just say forget it. • Develop a Super-User: — You’ll want to identify and develop a Super-User within the hospital that is the expert. This Super-User will provide clinical support so they do not need to call you every time there is a question. Section VII: Sales Process 1/4/2017 120
  • 121. Objections “Is this covered by insurance?” Just like all your other products, “ no”, In the hospital it is no different then the suture, pain pump or staples you use. Section VII: Sales Process 1/4/2017 121
  • 122. Objections “My patients do not have pain ” Most refer to is as mild discomfort. I have often wondered if there is no pain why are patients taking Valium or Percocet. Dr., our focus is not on masking pain rather accelerated surgical recovery. Section VII: Sales Process 1/4/2017 122
  • 123. Objections “It costs too much money” • As compared to what? • Based on our conversation what would you be willing to pay? • How much would you charge the patient? • So if I got permission to have your office purchase for $$ would you order today? Section VII: Sales Process 1/4/2017 123
  • 124. Objections “Not sure about the data” Can you be more specific? Section VII: Sales Process 1/4/2017 124
  • 125. Objections “Enrollment in trial was low” All of our data has reached statistical significance. The trials where designed to reach that level. The study from NY Presbyterian hospital was published in PRS. Clearly we both agree that is the premiere journal in plastic surgery. Section VII: Sales Process 1/4/2017 125
  • 126. Objections “Takes too long to apply” SofPulse is non invasive and can be placed on top of dressings, undergarments or even close. Section VII: Sales Process 1/4/2017 126
  • 127. Objections “Is this PEMF?” PEMF is the predicate technology, we are targeting the specific binding of calcium. Section VII: Sales Process 1/4/2017 127
  • 128. Objections “I am happy using pain pumps?” Great glad you are seeing value in masking pain. We are talking about therapeutically accelerating surgical recovery that results in pain reduction. Section VII: Sales Process 1/4/2017 128
  • 129. Objections “My patients do no have complications” We are not trying to solve specific complications rather accelerate the body’s response to surgical injury. Section VII: Sales Process 1/4/2017 129
  • 130. Objections “Who else uses this?” Locally no one. We are just bringing the product to market. I thought you might be interested in differentiating your practice. Most agree that increased patient satisfaction results in more referrals. Dr. Gabriel in Vancouver, Washington treats about 30 patients a month with SofPulse. Section VII: Sales Process 1/4/2017 130
  • 131. Objections “I have the old machine” How are you administering the therapy? Have you considered the benefit a single patient use device could bring? Section VII: Sales Process 1/4/2017 131
  • 132. Objections “I’m not sure how patients would dispose of device, is there a battery?” The same as any other battery operated device. Section VII: Sales Process 1/4/2017 132
  • 133. Objections “My patient will not wear it” Compliance is the case with some patience in general. Since this is elective and they have paid for the therapy we think they will act different. Most patients feel the difference when they stop therapy. Studies show efficacy after one treatment. Section VII: Sales Process 1/4/2017 133
  • 134. Objections “This not a sterile implantable and can be placed out of the OR, so not my budget ” If not placed in the OR reducing treatment time, thus efficacy of our technology. Is it easier to get approved out of OR? Section VII: Sales Process 1/4/2017 134
  • 135. acceleratedsurgical recovery Increased Patient Satisfaction Section VIII: SofPulse Sales Training Competition September 23, 2011 1/4/2017 135
  • 136. Competition Since we have the most elite group there is none! Section VIII: Competition 1/4/2017 136
  • 137. Competition Time for a Laugh, or, two! Section VIII: Competition 1/4/2017 137
  • 139. Q&A 1/4/2017 139 Section IX: Ivivi Customer Relationship Policy