"Brava Medical is proud to present an exclusive interview with Mark M. Miller"

Brava Medical is pleased to present a one on one Interview with Mark M. Miller who has served as Zonare Medical Systems, Inc.  VP of Sales and Marketing since March 2003. Prior to joining Zonare, Mr. Miller served as VP of Ultrasound Sales at Siemens Medical Solutions, a medical device company, from March 2001 to March 2003. Mr. Miller was awarded the highly esteemed Medical Marketer of the Year Award presented  in the Medical Devices category by The Medical Marketing Association (MMA)  Mr. Miller holds a B.A. degree in Business Management and History from Albion College.

Brava Medical:  Tell us about your work at Zonare, do you enjoy it?

Miller:  I am passionate about my work and I love what I'm doing here at Zonare Medical Systems.  It is great to come to a start up and have the opportunity to build out an entire sales and marketing team.  This is what I'm doing at Zonare, and it is very gratifying. 

Brava Medical:  What's the most challenging aspect of running a business?

Miller:  Probably the most challenging aspect is finding the right people for sales positions.  It is important to identify sales and applications people who are going to join the company and who are willing to go out and be successful individuals. Because Zonare has a different model to sell – convertible ultrasound – we need people who are able to sell a new concept in ultrasound and execute the orders. Our system is called the z.one ultrasound platform and it is powered by our proprietary Zone Sonography technology, which is a revolutionary advancement in ultrasound today. We truly offer the medical community the world's first convertible ultrasound platform because our system can instantly convert from a full-featured cart-based system into a premium compact 5.5 pound portable unit. Therefore, hiring the right people who are able to go out and actually sell this concept are the people we need in our sales positions.  A sales force is the biggest challenge because it's the people who make the difference. 

Brava Medical:  Do you see a big difference; advantages or disadvantages, from the larger company, when you worked at Siemens, versus a smaller company like Zonare.  Either positive or negative?

Miller:  The positive things are that, as a company, we can make changes rapidly.  We don't get bogged down in a lot of red tape, bureaucracy or indecision making processes. We can get together as a group, make decisions very quickly and implement them.  These decisions can be about the product, the way we go to market, the way we handle things or the way we run our organization.  Because we are a small organization with a lot of focus on our products and our customers, we have the flexibility to pull people together with a 10 minute notice and meet to discuss a customer issue. Our CEO, Don Southard, is real responsive to these types of meetings and he likes to gather people up quickly to resolve issues.  We are not only offering a kind of service, but we also take pride in the service we offer.

Brava Medical:  It sounds like it behooves the end user as well as the company itself to have a smaller kind of tighter ship, than one of the larger ships.

Miller:  Yes, I believe this is very true. As you know, I was involved with running very large company sales organizations and having a lot of resources, which was great. It's nice when you have a lot of options and a lot of different products and product offerings.  However, when it comes to being able to service and support those customers, it can sometimes it take a little bit longer to get through the process of trying to figure out what the problem is.  And then once you identify what the problem is, you need to determine what to do to resolve it.  And, once you decide how to resolve it, you then need to determine who is going to go in and implement it?  As a result, most often the customer suffers because they're waiting for an answer or waiting for something to happen and it doesn't happen as quickly as they'd like it to.  Ultrasound is a hands-on modality; it's an art form.  It's not really a science so Sonographers and the sonology community want to be treated as such and they want to have whatever issues they're dealing with resolved quickly.

Brava Medical:    What do you expect from your own leaders?  Sales managers, apps managers, marketing managers.  What do you expect from your leaders in your own organization?

Miller:  Well I expect them to represent the company at the highest level and to be extremely professional about it, but to also work with their people who they manage and help them to become very successful. I want to try to create a kind of environment, and I think we've done this successfully at Zonare, where it's a lot of fun to work in.  Working for Zonare is very challenging, it's very rewarding and it can be a lot of fun because what we're really doing is making ultrasound history.  We're doing something that people say in this day and age you can't do because there's been such consolidation. For example, the larger companies such as GE, Siemens Philips, Toshiba and others, are very large conglomerate companies with a lot of resources and the challenge is that it is very difficult for a small company to come to market, let alone succeed.  When a small company does succeed amongst the larger conglomerate like Zonare has, you really have to reward yourself, have fun with it and feel proud.

 

Brava Medical:  With the lack of job security in today's work environment, what helps people move forward? What do you do to help them stay motivated? 

Miller:  I think the key to anything at any time, whether it's at a time when things are going tough, or at a time when things are going really well, is that you have to have really strong communications between employees on all levels.  I think it is critical to stay close to the people within your organization, and it is important to communicate expectations with them on a regular basis. In addition, it is important to challenge people and help them learn new skills, and also communicate areas for improvement as well as highlight areas of strength, again on a regular basis.

Brava Medical:  What is going on in the medical industry that is causing more and more organizations to face up to changes?  Again, reorganizing what is happening.

Miller:  I don't know if there is any easy answer, rather it is quite complex.  I think that there are a lot of changes going on in the medical industry due to downward pressures and increased competition. For example, there is downward pressure for reimbursements for medical imaging in our industry.  There are also the DRAs that were employed over a year ago for private offices when they reduced the overall reimbursement of imaging modalities.  Although I believe this is a real plus for ultrasound, I don't think ultrasound has really been affected, because it is a low-cost modality to begin with. It's very efficient as far as cost goes and it is also hands on.  It's very easy to set up an ultrasound lab.  It's not invasive, there's not a lot of regulation and there are not a lot of processes that have to be followed closely.  So I think ultrasound has actually found a way where it can actually help physicians and sonographer increase the amount of exams they perform. 

Ultrasound in all these nontraditional market places is exploding.  So while the traditional markets in radiology, cardiology, maybe some of the pressures that are there for there to be a reduction in exams there are these other growth areas or emerging markets where ultrasound is being used, and these are virtually everywhere in the hospital.  When you look at it from a standpoint of radiology, vascular cardiology, emergency medicine, OB, labor and delivery, critical care, anesthesiology, these departments are using ultrasound. For example, ultrasound is now used for nerve blocks and PIC lines.  They're doing muscular/ skeletal ultrasound now, and they're using it to complement mammography.  There are a lot of uses for ultrasound, but as far as your question of why is it that it's so difficult today; I think it is directly related to the downward pressure for a lot of modalities in the medical imaging field. If you take a look at ultrasound, it's really split up into two sections.  There is the diagnostic end of the market, which encompasses all of the traditional areas such as radiology, cardiology, vascular, ob/gyn, where there is a diagnosis being made for the patient.  Then there is the procedural marketplace, where ultrasound devices are used to perform a specific procedure like a nerve block or a PIC line, or to guide a biopsy.  .At ZONARE, we have been able to balance out our business by being able to go to both sides of the market because of the quality and the flexibility of our equipment.  Zonare has built a device based on Zone Sonography technology. New clinical applications and advanced system capabilities can be made available to clinicians quickly and inexpensively through software upgrades via the internet. Going into the ICU or NICU with our premium compact unit, which can be battery operated, is a huge advantage to our customers and the patients they are caring for.  We're being asked to come into all these different departments.

 

Brava Medical:  Are you seeing a diminishing customer loyalty?

Miller:  No, we have not seen that at Zonare. Most of the people who work here have come from other ultrasound companies that were very large in nature, and there diminishing loyalty at those companies.  Zonare is still considered a small company and it is extremely gratifying to work for a company with dedication and focus. As a result, we find that our customer loyalty is very strong due to the philosophy behind the technology, the people and our commitment to customer satisfaction. Additionally, we have found that once a customer has purchased from us, they will purchase from us again in the future because of their positive experience with our technology and the people that make up Zonare Medical Systems. In fact, forty percent of our customers are repeat customers.

Brava Medical:  As a company, how do you strategize against so many distributors selling ultrasound as well as physicians just simply purchasing equipment over the internet?

Miller:  At Zonare, we are concentrating on the hospital market.  I would estimate that 70 to 75 percent of our business is hospitals.  And the private practices that we do sell to are usually the physicians, like vascular surgeons, who are affiliated with the hospital sale that we make.  So we have not had to get too heavily involved in competing against distributors, dealer and third party vendors who are selling equipment at a lower cost, nor have we had to deal with physicians who prefer to go online and buy an ultrasound system on the internet.

 
In addition, the markets we do pursue are more traditional in nature.  Emergency medicine is an evolving market, but the radiology, vascular and interventional markets have been buying ultrasound for some time.  They buy the most sophisticated, highest performing systems and the ones that sell for the highest prices.  As a result, it is important to have these established markets as your core business.

Brava Medical:  In your opinion, do the end users expect manufacturers to help out with reimbursement?  In other words, go to Capitol Hill and advise reimbursement proposals instead of doing that midnight oil of passing a bill, but do find that the end users are expecting the manufacturers to continue to support bills that will help them with their reimbursement?

Miller:  I don't think directly we have customers that are expecting us to do that.  But indirectly through our association with the various societies I think we support that.  We're very active in the Society of Radiologists in Ultrasound, (SRU), in the Radiological Society of North America (RSNA) and the American Institute of Ultrasound in Medicine (AIUM) among others.  These groups do lobby the government regarding reimbursement issues, and more, but we have never been asked specifically to do this.

 Brava Medical:  I think Zonare images are beautiful   In fact; they're one of the best on the market.  And your handheld division, I think, is very nice.  But is image quality enough in today's market?

Miller:  By offering an innovative way to capture and process ultrasound images, our Zone Sonography technology is a revolutionary advancement in the imaging industry. As I mentioned earlier, our system is unique and flexible. The z.one ultrasound platform is powered by Zone Sonography and it is the world's first convertible ultrasound system. It is able to instantly convert from a full-featured cart based system into a premium compact ultrasound system with all of the performance of larger and more expensive ultrasound systems. This flexibility, coupled with our superb image quality makes Zonare truly the best system out there. The flexibility without performance compromise allows the clinician to concentrate on the demands of their workflow instead of compromising the patient study by using conventional compact ultrasound systems. Additionally, the removable Scan Engine is a premium compact unit that can be undocked from all z.one ultrasound systems and transported to the patient's bedside quickly and easily. The compact unit weights 5.5 pounds and can be used for hand-supported, one-thumb operation. In total, the z.one ultrasound system uses proprietary technology to deliver full-featured premium compact ultrasound performance and unique workflow advantages – whether using the z.one systems in their cart based configuration or the ultra-portable unit – and there is no compromise to image quality or diagnostic performance.

Brava Medical:  Zonare ranked Best in KLAS as handheld carry ultrasound vendor in 2007 top 20 in the annual report, what do you attribute this to?  And I think you pretty much answered it but if there's anything else you'd like to elaborate on, that be great.

Miller:  Yes, we're very proud to have won that.  Obviously, for a newer company like ourselves, we were very happy and proud to rank as best in KLAS.  Out of four major categories we were ranked number one, out of a long list of companies, which is really compelling.

Brava Medical:  What is it that satisfies your customers the most?  What satisfies them so much that makes them a Zonare customer? 

Miller:  I think what satisfies our customers the most is the fact that they are to evaluate a technology that is new and different from anything else out there today.  And, they are able to make a decision to bring this system into their lab or into their department and have it actually work at the level they expected it to or greater.  As a result, they often feel less taxed and tired and they are able to do their jobs more efficiently and effectively.

 

Brava Medical:  Are we at our ultrasound peak or do you see technology continuing to grow?

Miller:  The ultrasound technology is definitely going to continue to grow. What we've been able to do is bring to the market a technology that is truly software based and we've been able to prove this benefit to our customers through the several upgrades we have introduced.   By merely downloading software our customers are able to see the value of state-of-the-art technology through our advancements.

Brava Medical:  When a facility purchases an ultrasound system, what do you think their expectations are from a company like yours?  What are their expectations when they buy equipment? 

Miller:  I think the biggest expectation is that we deliver what we promise.  That we're going to deliver a technology, deliver a platform or system and it's going to do what we say it will do, and what they expect it to do.  But beyond that it's that they will have the kind of follow up after the point of sale, have the proper service and have the proper support.  That the company will actually come through for them and provide updates that will improve the quality of the system.  So it will be upgradeable.  And what we've been able to do is upgrade it through software.  But there will also be some hardware upgrades.  Maybe some transducers that are added or other necessary things that will grow the system so that what they buy day one is not what they're going to have one year, two years, three years from now.

Brava Medical: In your opinion, what is the most significant medical advancement in the last decade?

Miller:  That's a tough one.  Certainly, you have to think of the imaging of the brain.  Some of the PET imaging they are doing and some of what they are able to show of brain function is very impressive.  Of course there are also the major advancements in ultrasound itself. For example, look at portable ultrasound. The compactness of ultrasound making it affordable, attainable is also a significant contribution to medical imaging.

 Brava Medical: Is there anything you would like to say or any advice to the health care community?

Miller:  I guess the only thing I'd like to say to the health care community is that I think we need to find a way to continue to improve patient care.  Whether that's through technology or through one on one treatment of people, but also to reduce cost.  I think the entire health care community needs to figure out a way to do that because here in the United States, the rising cost of health care is out of control.  .  And I think Zonare is doing this in its own way by providing a high performing modality that can reduce cost and improve patient care. 

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