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Close-up: Carlos Nunez

CareFusion medical chief focusing on product innovation

When Carlos Nunez, M.D., joined CareFusion almost two years ago as chief medical officer, the company was still in its infancy.

San Diego-based CareFusion (NYSE: CFN) was spun off from Cardinal Health Inc. (NYSE: CAH) in August 2009. CareFusion serves the health care industry with products and services aimed at reducing medical errors and related costs. Products include infusion pumps and mechanical ventilators, automated dispensing cabinets for drugs and supplies, software to automate workflow and technology that automates the surveillance of hospital data, to name just a few.

Nunez signed on in early 2011 along with a slate of new executive management, including new CEO Kieran Gallahue. Nunez's first task was to build a medical operations department that would oversee the clinical aspects of the regulatory process.

Responsibilities for Nunez and his staff of about 50 -- and growing -- include reviewing clinical trials to help move products through the Food and Drug Administration approval process, and providing a clinical voice on hazard and risk analysis of new products.

Carlos Nunez

Now that Nunez has achieved the first objective and the infrastructure is in place, he can focus on what he calls the more interesting and enjoyable part of his job: the innovation that "drives our products forward and drives our company forward -- into new territories, new markets and new technologies," he said.

The self-proclaimed "unapologetic techno-geek" envisions health care information technology being as robust as our smartphones. Connectivity ensures CareFusion technologies get the right information in the right hands at the right time in pharmacy, nursing and surgery areas.

"We need to make sure that our devices not only participate with the health care IT infrastructure in place, but that we continue to add more services, offerings, apps, connections and interoperability that make our devices and make the whole IT structure in the hospital more compelling," Nunez said.

While interoperability has long been a goal of the health care industry, hospitals and health care providers are finding a new incentive to implement new technologies: millions of dollars earmarked to adopt health care IT as part of the $787 billion stimulus package signed by President Barack Obama in 2009. The funds cover a wide range of health care IT projects, such as health records, health information exchange, computerized physician order entry, electronic prescribing and more.

CareFusion is also embarking on aggressive international growth. Its three-pronged approach to expansion includes the Americas, including Canada and Latin America; Europe, the Middle East and Africa; followed by the Asia-Pacific region.

"We have the capabilities to cover the entire world, but I want to have dedicated resources on the ground in each region who report up through the organization to make sure we have the scale to cover these regions appropriately," Nunez said. "We need people on the ground in those regions that understand the regulatory environment, and the nuances of being compliant in the way we go to market so CareFusion always does things the right way in every market where we participate."

Nunez, 47, grew up in South Florida and attended the University of Miami School of Medicine, where he also completed postgraduate training in anesthesiology. He is a trained intensivist and hospitalist.

In 2000, Nunez left the private hospital setting to work in industry. He served as chief physician executive at Picis, now a division of UnitedHealth Group. The company focuses on software and IT solutions in high acuity areas of a hospital, such as operating rooms and intensive care units.

Now at CareFusion, one of Nunez's responsibilities is to keep up with health care trends, to ensure the company stays innovative and relevant. To this end, he reads a lot of medical journals, attends conferences and belongs to various industry groups that meet to share ideas and issues. But staying on top of industry trends is a big charge, and one person can't do it all.

"When I set out to build my department, one thing I made as a requirement was that at least one senior clinical person in my medical operations department would align with one of our key businesses," he said.

For example, since Nunez is an anesthesiologist, intensivist and ventilation expert, he focuses on respiratory care and the company's ventilator business. While he tries to keep tabs on everything, his focus is on the respirator space. Another colleague concentrates on trends in medical safety and infusion, while another focuses on infection prevention, and so on.

"Together we work collaboratively to make sure we keep one ear to what's happening in industry and technology, and the other ear focused on what's happening internally with R&D," he said.

His team has its work cut out, as big changes transform the health care industry. Reform measures aimed at providing universal health care and curbing the growth of federal health care spending present industry with the very modern problem of how to do more with less.

Hospitals are moving away from a pay-for-services model and toward a model of reimbursement based on quality of care and efficiency, Nunez said.

In the past, if a patient on a ventilator got pneumonia, needed antibiotics and had to extend a hospital stay, the hospital would bill for that. In the future, higher rates of infections will lower the rate of reimbursement, so hospitals are incentivized to keep infection rates low and install greater efficiencies.

CareFusion stands poised at the intersection of patient safety and reduced costs.

For example, a CareFusion infusion pump can be wirelessly programmed through scanning a barcode, reducing the likelihood of human error in manual programming. The pump then connects to a hospital's pharmacy system, improving the communication between pharmacy and nursing. The software built into the pump can stop certain infusions when the drug level in the blood is too high. This can lead to faster recovery and shorter hospital stays.

"If you look at our mission -- improving the safety and cost of health care for generations to come -- it's amazing that our mission statement is also the mission statement of the federal government, and anyone in the medical community, in any country: How to provide safe care without going broke in the process," Nunez said.

"All of our solutions do one or the other, and most do both."


Klam is a San Diego-based freelance writer.

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