Creativity Under Pandemic Pressure: How O&P Manufacturers Adapt

Businesses everywhere, across the spectrum of global products and services, have been impacted by the COVID-19 pandemic—and O&P manufacturers are no exception. But patients who depend on O&P devices can't put their needs on hold until the pandemic winds down. So how, in the face of the challenging economic climate and the dramatically different work environment that safety demands, are O&P manufacturers able to address these unprecedented conditions and continue to innovate and bring new products to the market? We asked several companies to share their responses to the pandemic's challenges. Most became aware of the spread of the COVID-19 virus and the potential threat it presented in January 2020, but didn't recognize a need to take active precautions until late February or March, when the Centers for Disease Control and Prevention (CDC) guidelines were uniformly followed, including social distancing, more frequent hand washing, sanitation, masks, and using personal protective equipment (PPE). Early Awareness, Proactive Response Christian Robinson, executive vice president of Össur Americas, Foothill Ranch, California, recalls that by March it was clear to all that the pandemic was spreading rapidly—in Europe before North America. "We have a significant business in Europe, and we realized that it was going to be a problem in the United States because Europe was beginning to shut down." Össur took the usual steps to protect their employees and customers, but such steps weren't yet usual, he reminds us. "It meant understanding all the CDC guidelines, best practices on how to limit exposure and spread of the virus, while simultaneously making sure that we had business continuity plans in place to ensure that we were able to continue to operate as a business, to keep our employees employed, and to continue providing products to customers who needed them." It was an alarming wake-up call when he learned in March that an Össur employee had contracted the novel coronavirus. "Learning about the first case required us to take the pandemic seriously, and emphasized the need to observe all the proper protocols—including social distancing, contact tracing, and quarantine protocols—at a time when such terms were very new." Aaron Taszreak, engineering manager for College Park Industries, Warren, Michigan, learned of the virus threat while traveling internationally in January, but says it was business as usual for College Park until mid-March, when Michigan, along with other states, implemented stay-at-home orders. "[In] this day and age you think you would be better prepared," he says. "Obviously, that's not the case." Their standard precautions included social distancing, temperature monitoring, masks, and creation of a COVID-19 committee to establish rules and monitor potential situations. They attributed their slight dip in sales to the stay-at-home orders across the country and around the world. "A lot of our business is tailored toward a wide spectrum of customers—some more vulnerable to COVID—so we assumed some were avoiding nonessential office visits if they were getting by and didn't need to be seen," Taszreak explains. Matt Swiggum, president and CEO, Proteor USA, Tempe, Arizona, reports the company implemented approved safety protocols, including creating one-way traffic patterns through the office to help reduce social interaction, and encouraging remote working. "Our engineering staff learned to operate differently than we had been accustomed to, accelerating our broad implementation of communications and internet technology and leveraging tools like Zoom to continue our meetings and keep product development moving forward," he says. Although Proteor didn't lay off or furlough anyone, he notes that they ran into some early supply chain issues. "We worked pretty closely with our suppliers and vendors to build up needed materials so we could keep producing products. We have had a couple of additional supply chain issues recently, but for the most part, we've been able to keep pace with clinician and patient needs." Christopher J. Nolan, general manager, Ottobock North America, Austin, Texas, anticipated potential pandemic supply chain disruptions as early as January, "which fortunately never became a significant issue for us in the long run," he notes. By mid-March, however, Ottobock began limiting local and international travel, as well as the number of people allowed in a room. By the end of March, they closed down their administrative office, limiting as-needed access to essential personnel who worked remotely for the most part. "We did have to make some difficult decisions to furlough a sizeable amount of our workforce in April," Nolan says. As of October 1, however, most had returned to work. "We were able to continue business activities very effectively remotely," he says, "due to the strength of available technology, but also due to the strength and resilience of our team, and their heightened awareness of what was going on around us at that time." Robinson reports that Össur was proactive in response to supply chain concerns. "We put into place a number of procedures—including split work shifts to make sure that we were taking all the proper precautions—that even if folks had to be removed from the facility for a period of time because they had contracted or been exposed to COVID-19, we would still be able to remain operational. Fortunately, we did not have any shutdown of our manufacturing facility in Tijuana or our distribution facilities, in spite of those employees who contracted COVID or had to be quarantined; nor did we have any major disruptions in sourcing our raw materials and components from our vendors." Customer service staff were moved to remote working environments, and still remain there; only critical essential functions continue on site. Working remotely, however, presents some challenges to new product innovation and development, he observes. "Although R&D teams do function remotely, when they need to meet in person, they observe social distancing protocols. We feel that our teams have adapted quite well to these protocols, which have not had a significant impact on our ability to develop new products," says Robinson. Ben Auzenne, vice president of sales and marketing for Blatchford US, Miamisburg, Ohio, joined Blatchford's leadership team on June 8, in mid-pandemic crisis, following a virtual job interview. Auzenne notes, as of October, "I have still not met CEO Paul Roberts, or anyone on our UK team in person. So, personally, the pandemic had a big impact on my transition into Blatchford; organizationally, it was an unbelievably difficult situation—not just for us but for everybody around the world." He praises the technology that has made it possible to communicate virtually in an "almost in-person" manner. And he credits Blatchford's head of operations, Simon Loyns, for balancing the risks by not only erecting barrier screens and one-way walkways, but creating a working bubble concept that segregated different groups by geography or working patterns to limit contact and potential spread of the virus by discouraging crossover between groups. Auzenne estimates that at least 90 percent of their employees are able to work remotely, with just 10 percent essential to production. Demand for products, he says, varied significantly during the height of the pandemic, impacted by the downturn in flights and the closure of clinics worldwide. In an effort to pace production to match the current demand as it rose and fell—and to protect employees by reducing the time they spent manufacturing products onsite—Blatchford carefully monitored patient throughput by working with industry contacts. With help from the US and UK governments, the company was able to reduce production volumes to match the lower demand, then furlough, and then ramp production up again as clinics reopened, transportation picked up, and throughput increased. Blatchford's research and development team even turned the throughput slowdown to advantage, Auzenne points out, using their time to brainstorm and conceptualize new products for 2021. Like others, Taszreak says, College Park encouraged those who could work remotely to do so, including his six-person team of engineers. "At the time, they were working on projects for new product development; we encouraged the team to work from home if they could in order to keep making progress." As product development progresses, with testing and prototype building required, he admits things may change. "Engineering is a hands-on job, and it's hard to do your job remotely without the in-person interaction. So it's inevitable that we'll have to come in to work at least on a part-time basis, which is how we're operating at present." Although their customer service and other departments are now mostly remote, representatives are still in constant contact with other employees regarding issues, concerns, product availability, and orders, he notes. "We never would have imagined it, but most departments are just as effective as they were before. I think it will stay this way even after the pandemic ends." College Park recognized long ago that their path to success was new product development, says Taszreak. "So we put a big emphasis on launching new products, one to two or three new products a year, to keep our product offerings fresh, always innovating with new items. During the pandemic, as things were shutting down, that became difficult. When you're developing a new product, you're waiting on prototypes and other materials to come in to progress your project along—and a lot of those things were delayed since our supply chain was impacted as well. "We had a product revamp that launched in early June, and then we had the recent launch with our new hydraulic knee, the Capital Knee, in late September. Both of those were delayed by about five or six weeks. But we stuck to our guns and kept pushing along; it's just a matter of weathering the storm," he says. Bringing New Products to Market Is it smart to launch new products in a pandemic? "I think there's still a great interest in a lot of these things that I've been working on—the success of the launches was very well received," Taszreak points out. "Early on we set sales targets, and our estimates were very, very close to what we realized." Robinson acknowledges that "it was a difficult time for us to launch products, especially right at the height of the pandemic, because initially a number of facilities were very concerned about visitors coming in. Because of that we had to adapt, and we had to do a lot more virtual meetings with our customers. As time went on, people better understood how you could engage in in-person visits appropriately with proper protocols." Swiggum's strategy was motivated by a different set of circumstances, as Proteor was then finalizing negotiations to acquire Freedom Innovations' lower-limb prosthetics line, including their new microprocessor offerings. "Despite economic uncertainty, Proteor and Ottobock successfully completed the transfer of key Freedom technology. This supports the Federal Trade Commission direction intended to maintain a competitive market space for microprocessor technology," he explains. "There's always risk any time you complete an acquisition or launch new products—and there's certainly more risk in today's shifting environment—but we continue to maintain our focus on patient outcomes." Swiggum also points to continued improvement in sales volume each year. "We are growing rapidly, we continue to see higher utilization rates of our products over prior years, and our new product development phases are moving safely forward despite COVID-19. "Due to a multitude of factors, some generated by the pandemic, we have deliberately delayed product launches. We want to be part of the solution, not adding stress to our healthcare systems with unnecessary activity." Meanwhile, Proteor has been learning new ways to use communications technology developments to connect with customers, creating and sharing educational offerings to prepare O&P patients and professionals for the launches that lie ahead. Swiggum hints that we can look forward to those launches early this year. Nolan reminds us that orthotists and prosthetists are always looking for innovation, and Ottobock recognizes their responsibility to provide that innovation, the pandemic notwithstanding. "The technology that we've launched, the Taleo Vertical Shock and Taleo Harmony, hasn't necessarily been to replace existing products, but to enhance our product range with unique solutions within the products we've launched. "I'm very pleased with the level of sales from all the new product launches—including the Taleo Low Profile foot launched in May," Nolan says. "One of the worst times ever to launch a product would be the height of a pandemic, but we felt it was important to honor our R&D colleagues and everybody who had done the testing—and important to get the product commercialized and to market so patients could take advantage of it. "Were sales what we had hoped when we drew up plans to launch these products initially? Certainly not, but sales are strong and will continue to get better as the message gets out and the news reaches more people." Auzenne characterizes the July introduction of the Elan IC waterproof microprocessor ankle, and the September introduction of the Echelon ER extended range of movement hydraulic ankle as two of the most successful launches in Blatchford's history. "US sales are growing at a very rapid rate," he says, "even faster than we thought. They're great advancements on the previous technology and truly unique products for the market." O&P professionals, he finds, are technically skilled and passionate individuals. "These are people who not only accept technological advancement, they expect it. Speaking to that character, that focus, and the desire for new product, it's not surprising that when we launch two very unique products during a pandemic, that they would be well received." Patients who had tested and used these products were waiting for and encouraging their release, Auzenne notes. "What if we launch it during this pandemic and we can't get it out to everybody? How can we be sure there won't be another shutdown? Those are things you can't predict. But our commitment is to improve the future of mobility rehabilitation and the lives of our patients, and we couldn't live up to that vision if we had held back the launch." Robinson points to another pandemic-rooted need that Össur discovered—and acted to solve: "In addition to new technology and new products, our customers are more interested than ever in any solutions that help them solve business problems. COVID has introduced yet another level of complexity into a dynamic business environment—with resulting new problems to solve. "This has been game-changing for many customers who have been trying to operate short-staffed and trying to figure out how they can do as much as before, with less resources and in fewer patient visits." Many are rethinking their operations, he says, including how their facilities are utilized, their operating protocols, and solutions like practice management software. "In any place where our innovative product solutions have touched on these trends, we have seen an increase in demand." He lists examples like the Össur Legs and Arms complete solutions program—which includes multiple socket options and device componentry that allow the practitioner to deliver a prosthetic solution with less effort and cost while retaining full control of the socket. The program includes Össur Design Studio, in which clinicians can scan and modify the socket design more easily than traditional CAD software. He reports significant growth in Össur Leg and Arm orders since the pandemic arrived. Ottobock, too, offered ways to support customers' pursuit of efficiency. "We made all of our educational training opportunities available online at no cost early in the pandemic, recognizing that many clinicians were going to be looking for ways to be productive if their patient load was down," Nolan says. "We also made our online ordering a lot easier through our ecommerce portal, to enable after-hours ordering and order tracking. "[Our customers'] number one concern is their patients—not talking to an Ottobock rep. So we developed a lot of ways to make their day more efficient, including making sure they could see patients during business hours—and after hours, we'd be available virtually." As the pandemic continues to evolve in unknown directions, challenges remain, but O&P manufacturers' ability to develop innovative devices and solutions to support O&P professionals remains robust. "Challenges are always a litmus test," reflects Robinson. "And I think it's a compliment to the industry that COVID pulled us together. That's the sort of thing that makes me proud to be in O&P." Judith Philipps Otto is a freelance writer who has assisted with marketing and public relations for various clients in the O&P profession. She has been a newspaper writer and editor and has won national and international awards as a broadcast writer-producer.

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