Rep-Less: Loma Linda Leaders Reflect on the Process

Rebecca Rudolph-Witt

The room was full of OR managers, eager to hear about how their peers had adopted a newer concept. “I want to make one thing very clear – we are not anti-vendor in any way,” stated Ilsa Nation, RN, MA. She’s the director of Loma Linda University Medical Center’s East Campus Perioperative Services and Loma Linda Health Perioperative Services Scheduling and Billing. With her was Dr. Gary Botimer, chair of Orthopedics at Loma Linda University School of Medicine and Chief Operating Officer of Loma Linda Health Faculty Medical Practices. They were getting ready to share their experience implementing a rep-less model.

The premise of a rep-less model is facilities can reduce the cost of a procedure by reducing the cost of the materials by bypassing the OEMs, GPOs, sales representatives and distributors and purchasing from the materials manufacturer. In this case, it was purchasing orthopedic implants. Botimer stressed the total hip and total knee primary and replacement sets they used are American-made, FDA cleared products, and worked just as well because “not much has changed” in implant design in the last 10 years.

Instead of a supplier’s representative selling product and being present in the OR, a facility connects with an individual manufacturer to obtain inventory and trains one of its surgical technicians as a rep. For Loma Linda, this hybrid position was a new, but Nation and Botimer both agreed it was paramount to the program.

The motivation for this change started when Loma Linda was founded in 1905. The organization wanted to provide high level care to its economy challenge community and pushed toward innovation by trying new methods in its university with the vision: innovating excellence in Christ-centered healthcare. Just like the in rest of the world, the university health system felt the new pressures in healthcare. The surrounding area experienced economic challenges, there was an increase stress on value based purchasing and costs to the facility, which is one of the few Christian medical schools, kept increasing. “With the changes in government funding, it’s making it a challenge to keep the institute open. The other side of that coin is we have a moral obligation to try to provide care, and care that isn’t affordable, isn’t care,” Botimer explained.


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Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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