LAS VEGAS — Nearly four years ago, Johnson & Johnson (J&J;New Brunswick, New Jersey) revealed its intent to acquire Synthes (Solothurn, Switzerland), a firm that develops surgical devices used to treat fractures and traumatic injuries for $21.3 billion. Synthes, has now been carefully folded into J&J's Depuy (Warsaw, Indiana).

Although there have been some criticisms in the past that the merger of operations is incredibly slow-going and has cost the combined company some business and research talent - Depuy Synthes Companies executives, told Medical Device Daily at the American Association of Orthopedic Surgeons (AAOS; Rosemont, Illinois) that the firm has a large enough scale now to foster and incubate innovation at a much greater rate than in the past.

"I think it's a really pretty exciting time [to look at innovation] for a number of reasons," Martin Fitchet, MD, Global head of R&D for DePuy Synthes, told MDD. "Since the merger Depuy Synthes is the largest most comprehensive orthopedics company in the world and I think what's really powerful is that we're also part of the largest most powerful comprehensive healthcare company. I think what this gives us, is real leverage of scale, and to innovate for some really significant orthopedic problems in the future."

Depuy Synthes' commitment to research and development comes at a time when med-tech firms have cut spending and efforts In a recent AdvaMed: Advanced Medical Technology Association (AdvaMed; Washington) poll med-tech firms said that they have reduced R&D spends because of the medical device tax. Fitchet noted that the R&D was as strong as ever, but now it was a unified voice for the company.

"We're seeing, one R&D group, that is being brought together from eight separate R&D groups and within the complex healthcare organization, that has the innovative mission and spirit that J&J has," Fitchet said.

Part of these efforts come in the form of four new products to the firm's adult deformity portfolio. The company revealed the products; the Expedium Osteomy System; the Viper Cortical Fix X-Tab; the Synapse System and the Vivigen Cellular Bone Matrix, during AAOS.

These products are supported by an education platform, which includes a tailored curriculum to address learners' needs and a customized learning experience. An advisory board including both orthopedic and neurosugeons were brought together to assist DePuy Synthes Spine in the creation of the adult deformity education program.

It's concepts like these, that Fitchet said will help the firm continue to move towards innovation.

"If we always think about the patient and we always think about the needs of the surgeons that treat them, I think we will be successful," Fitchet told MDD.

But there are challenges. With the demand for stronger outcomes, Depuy Synthes has to develop products and strategies that are able to withstand any potential factors that could impact the outcome.

"One of the biggest challenges is that it's becoming increasingly important for us working in orthopedics to demonstrate improvements in outcomes. The biggest challenge in orthopedic research and development is that outcomes can be impacted by so many different things. It's not only the product that's developed but by the care the patient receives – post and pre-op, the surgical procedure itself; and the services that the patient receives after he or she goes home."

Fitchet noted that the company is working with healthcare providers to try and positively influence the whole experience for the patient.

Part of that is happening now through an initiative that will allow healthcare professionals a new way to track and analyze patient data in real-time and a new program to improve patients' experience with joint replacement surgery.

The solution is a subscription-based service called CareSense. With CareSense, patient outcomes, patient satisfaction and cost information can be collected and evaluated before, during and after surgery, to help optimize care. The system makes it easy to conduct market research, administer patient satisfaction surveys, benchmark against peers, and analyze financial metrics. CareSense, which is licensed from Medtrak (Conshohocken, Pennsylvania) by DePuy Synthes Joint Reconstruction, is available globally through DePuy Synthes Companies that addresses specialties including joint reconstruction, trauma, spinal surgery and sports medicine.

"With the Affordable Care Act, our customers are now being either incented or penalized on their ability to achieve Triple Aim performance, so with CareSense we give them an opportunity to measure their success and ensure that they have positive success with outcomes," Scott Zellner, director of DePuy Synthes Advantage said.

He added, "It's always been about outcomes but it was about 10, 20 or 30 year survivorship. Now customers say how are you going to impact customer satisfaction 30, 60, 90 days post-op. So we've gone from thinking decades to months in a very short period of time."

Plans call for Depuy Synthes to leverage the resources of J&J and to continue to move toward the development of new products. Fitchet was asked by MDD if the company was looking into 3-D printing, which is gaining momentum in the healthcare field. He replied yes, but did not go into significant detail.

He did say that the company has to be focused on unmet needs in the orthopedics space.

"We have to think about new platforms," Fitchet said. "We have to think about new frontiers where there are still huge unmet needs in patient care. I think we have a great opportunity to define some new exciting platforms to develop, to solve a new frontier of orthopedic problems."