вторник, 1 августа 2017 г.

A GUIDE TO ISO 13485


WHAT IS ISO 13485?

The ISO 13485 standard governs quality management for medical devices and related services. It’s published by the International Organization for Standardization. ISO 13485 addresses:
  • Quality control
  •  Risk management
  • Legal compliance
  • Operational efficiency
  • Ability to trace and recall products and devices
  • Process and product improvement
The most recent update to the standard was published in February of 2016, overriding previously published versions from 2003 and 1996. ISO 13485 derived from ISO 9001, a quality management certification that’s available to businesses in a wide variety of industries. However, medical device and pharmaceutical companies have specialized requirements that made some of the requirements of ISO 9001 difficult to apply. ISO 13485 was developed to address these needs.
ISO 13485 provides a great advantage for organizations producing medical devices and related services. It assures a commitment to quality and increases efficiencies within the organization. Becoming ISO 13485 certified can increase client base and reduce barriers to entry of foreign markets, product liabilities, and production down-time.

As the transition period from ISO 13485:2003 to ISO 13485:2016 has begun, it is important for organizations to understand the advantages of becoming ISO certified, identify the key differences between the 2003 publication and the 2016 publication, and begin the work for either transition or first time certification.
The auditing process can appear overwhelming, but it does not have to be. For those seeking their first ISO 13485 certification or those transitioning from the 2003 publication to the 2016 update, the following information can serve as a starting place for implementation. 

KEY DIFFERENCES IN ISO 13485 (FROM ISO 9001)

  • Additional requirements for preventing contamination
  • Monitoring focuses on meeting customer requirements, rather than on subjective customer satisfaction measures
  • Multiple documentation requirements at all stages of product development
  • Focus on maintaining the effectiveness of the quality management system instead of continuous improvement (as required for ISO 9001)
  • Risk management during design and production
  • Additional requirements for regulatory reporting, advisory notices, and recalls

APPLICATIONS OF ISO 13485

ISO 13485 specifies quality management for medical device manufacturers and related organizations. This means a variety of companies in the medical device industry and pharmaceutical supply chain use ISO 13485 standards. Organizations that use this standard include:
  • Manufacturers of medical devices
  • Organizations that supply products or raw materials to medical device manufacturers
  • Quality management organizations that contract to medical device manufacturers
  • Organizations that provide services to medical device manufacturers
  • Makers of sterile medical devices
  • Manufacturers of surgical medical devices
A significant change in the 2016 update addresses outsourcing. This update organization requires the organization to ensure that companies it contracts with meet ISO 13485 standards when outsourcing the development, design, or servicing of a medical device.

ISO standards are voluntary, so being certified as ISO 13485 compliant isn’t always necessary. Europe and Japan offer alternative national standards. On the other hand, Canada requires class I, II and III medical device manufacturers to achieve ISO 13485 certification.

Although certification isn’t required, it can provide an advantage. Many countries base their regulatory standards for medical devices on this standard. Achieving either ISO 13485 or ISO 9001 certification is seen as the first step to approval for a medical device in Europe.

REASONS FOR THE 2016 UPDATE

When the 2003 standard was reviewed, ISO staff discussed potential revisions with a variety of regulatory bodies. The consensus was that the old standard no longer reflected current quality management needs.

According to Eamonn Hoxey, former chair of ISO’s technical committee for quality management:

"When we did the last review, we had discussions with the regulatory authorities and we — both industry and the authorities — felt that it was time to revise the standard … Since 2003, a number of jurisdictions have either revised or introduced regulations for medical devices, so we want to make sure the quality management system requirements align fully with those regulatory requirements."

The requirements  within ISO 13485 have been adopted into a number of different countries’ regulatory programs.  Regulators in Australia, Canada, the European Union, Japan, and the United States use it. It is used with modifications in the United Kingdom and by the Medical Device Single Audit Program.

Many of the revisions made to ISO 13485 reflect its importance to regulatory bodies. Among these revisions are: 
  • Increased alignment with regulatory requirements
  • Adjustment of software standards for measurement and reporting
  • Additional requirements for verification and validation planning
  • Increased emphasis on addressing consumer complaints
  • Additional requirements for reporting to regulatory authorities
    These revisions are expected to ensure that ISO 13485:2016 aligns more fully with regulatory requirements for medical devices while still making certain that ISO 13485 includes quality management requirements from the ISO 9001 standard.

    WHAT IS THE WINDOW TO TRANSITION TO ISO 13485:2016?

    The International Organization for Standardization (ISO) published the ISO 13485:2016 update in February 2016. There is a three-year transition period for this standard. During this transition period, organizations may have either ISO 13485:2003 or ISO 13485:2016 certification.

    The 2003 version of this standard will be withdrawn in February 2019. After this date, any existing certifications of ISO 13485:2003 will no longer be valid.

    During the first two years of the transitional period, it is possible for organizations to become certified under either the 2003 or 2016 versions of these standards. In the third year, however, organizations will only be able to become certified under the 2016 version of ISO 13485.

     MAJOR REVISIONS IN THE ISO 13485:2016 UPDATE


    What if your organization is already certified under the 2003 version of ISO 13485? What changes will you need to make in the next few years? To help you get started, we’ve outlined the changes made in the 2016 update below. You’ll find a brief overview of each component of ISO 13485 below, followed by a list of any major changes made to the section in question.

    INTRODUCTION

    The introduction to ISO 13485 provides additional understanding and clarification of terms. Major changes in the introduction include expanded definitions of product life cycles, organizations that this standard applies to, and an understanding of the process approach used by organizations certified under this standard.


    0.1    – General
    • Provides more detail about what types of organizations ISO 13485 applies to and what stages of the product life cycle this standard applies to
    • Expands the list of organizations that this standard can apply to:
      • Suppliers of medical devices
      • Third-party organizations providing raw materials, subassemblies, components, and medical devices for the manufacture of these products
      • Organizations offering sterilisation services, calibration services, distribution services and maintenance services for medical device companies
    • Reminds organizations to identify applicable regulatory requirements
    • Clarifies that quality management systems need to meet regulatory requirements as well as those of ISO 13485
    • Expands upon the factors that can influence the development of quality management programs within organizations

    0.2 – Clarification of Concepts
    • Adds the following to the conditions needed to define “appropriate requirements.” The new definition of appropriate requirements includes those that are necessary for:
      • The product to meet requirements
      • Compliance with applicable regulatory standards (new requirement)
      • The organization to carry out corrective action
      • The organization to manage risks (new requirement)
    • Explains that “risk” for medical products applies to safety, performance standards, or the necessity to meet regulatory requirements
    • Clarifies that documented requirements also need to be established, implemented, and maintained

    0.3 – Process Approach
    • Expands upon the definition of a process approach for medical devices
    • A process approach emphasises:
      • Understanding and meeting requirements
      • Considering the added value of processes
      • Obtaining results of process performance
      • Improving processes based on objective measurements

    0.4 – Relationship with ISO 9001
    • Clarifies that sections of this standard based on ISO 9001 refer to the new ISO 9001:2015, and not the previous versions

    1 - SCOPE



    This section clarifies the organizations and processes that ISO 13485 applies to:
    • Clarifies that ISO 13485 applies to organizations involved in different stages of the life cycle of medical products, including the design, repair, installation, maintenance, and storage of medical devices
    • Expands the standard to include organizations that provide technical support, quality management services, and product support for medical devices
    • Clarifies responsibility for third-party vendors and supplies. States those services and products that are not created by the organization, but are used in its products, are the responsibility of the organization. The certified organization is liable for maintaining, monitoring, and controlling these processes.
    • Explains that the standards in clauses 6, 7, and 8 that are not applicable to the organization can be excluded. This change may be applicable to some suppliers, support organizations, and quality management service suppliers. During certification, the reasons for these exclusions still need to be documented.

    2 – NORMATIVE REFERENCES

    Clause 2 clarifies that any references to ISO 9000 refer to ISO 9000:2015, and not to ISO 9000:2000 (used by the 2003 version).

    3 – DEFINITIONS


    Clause 3 defines terms used throughout this update to ISO 13485.
    • Modifies certain definitions
      • Modified definitions focus on defining medical devices and products. This definition is significantly more detailed than that found in the previous version of this standard. Implantable medical devices and sterile medical devices both get new definitions as well.
    • Adds additional definitions
      • Added definitions focus on defining roles within the life cycle of product development, including defining distributors, importers and manufacturers. Adds definitions of risk, risk management, performance evaluation, and post-market surveillance.

    4 – QUALITY MANAGEMENT SYSTEM

    Clause 4 addresses the requirement to document procedures relating to the quality management process. Documentation requirements have been expanded and clarified in the 2016 update. There is additional language that clarifies that quality management processes required by ISO 13485 do not exempt an organization from meeting any additional quality management requirements mandated by regulatory authorities. A primary change here states that quality management requirements now apply to any outsourced products as well as those produced by the organization itself.


    4.1 – General Requirements
    • States that the organization is responsible for establishing, implementing and maintaining any quality management processes required by this standard
    • Explains that ISO 13485 certification does not exempt the organization from other applicable regulations. The organization is also required to establish, implement and maintain processes required by other regulatory bodies. The requirement to meet other applicable regulatory requirements is emphasised throughout this version.
    • Clarifies that organizations must use a risk-based approach in their quality management processes
    • Explains that an organization is responsible for monitoring any outsourced processes. This is a considerable change from the 2003 version of this standard. Any outsourced processes still need to conform to the quality management standards of the medical device organization, and written quality agreements with the third party must be in place.

    4.2 – Documentation Requirements
    • Documentation requirements have been considerably expanded. With the exception of the medical device file, all documents were required by the previous standard. However, the additional details of what this documentation must include have been clarified.
    • The Quality Manual now requires an explanation of the scope of the project management system, as well as justifications for any exclusions from it
    • Requires the development of a medical device file for each product, which must include specifications, labelling, use instructions, and any requirements for installation and servicing
    • Many of the requirements for document control remain the same. Documents are required to be reviewed and approved before publication. Records and documents applicable to medical devices still need to be kept for at least the lifetime of the medical device.

    5 – MANAGEMENT RESPONSIBILITY


    Clause 5 addresses the management responsibilities for maintaining, documenting, and reviewing procedures. This section has undergone relatively minor changes in the 2016 update. Most of the changes in this section focus on management review.


    5.6 – Management Review
    • Organizations are required to have and use documented procedures for reviews
    • Management review has been expanded to include complaint handling and reports to regulatory authorities
    • Organizations must now record any output from management reviews
    • The list of review outputs has been expanded. It now includes decisions and actions related to resource needs and to improvements needed to maintain the quality and suitability of the QMS system.

    6 – RESOURCE MANAGEMENT

    This section covers requirements for a variety of types of resource management: human resources, infrastructure, work environment, and contamination control. This section, or clauses within it, may not be applicable to all organizations that are seeking ISO 13485 certification. Organizations that believe components of this section are not relevant can also submit an explanation that justifies their exclusion.

    6.2 – Human Resources
    • Changes in this section focus on requirements for additional documentation of the processes for establishing competency
    • The updates include the ability to use processes proportional to the risk level of the action. Low-risk tasks may require very little documentation to prove competency, while high-risk actions require considerably more.

    6.3 – Infrastructure
    • Language has been added to state that it is important to ensure the proper handling of product and that protocols must be in place to prevent product mix-up
    • Required documentation for maintenance activities has been expanded. Maintenance requirements must now be documented for maintenance activities, equipment used in production, work environment controls, and monitoring and measurement systems.

    6.4 – Work Environment
    • An additional clause has been added to state that documentation of protocols for maintaining the work environment is required when the state of the work environment could have an impact on the quality of the product.
    • An additional section (6.4.2) has been added to address contamination controls.
    • If product contamination is a concern, the organization must plan and document the procedure for controlling contaminated products.

    7 – PRODUCT REALISATION


    This section addresses the processes the organization uses during product development. The bulk of changes in the 2016 update occur within Clause 7. Many of the changes in this section specifically address quality management when parts of the product development are contracted to a third party. Other changes in this section expand and clarify the types of documentation required during design, development and production phases.
    7.1 – Planning of Product Realisation

    • Organizations must plan and develop the processes for product realisation, in a way that is consistent with the quality management system
    •  Risk management policies for product realisation must be documented
    • The documentation requirement for policies relating to product acceptance has been expanded. Organizations are now required to document their policies for:
      • Verifying
      • Validating
      • Monitoring
      • Measuring (New)
      • Inspection and testing
      • Handling (New)
      • Storage (New)
      • Distribution (New)
      • Traceability activities (New)

    7.2 – Customer-Related Processes
    • Organizations must determine the customer requirements for the product. These requirements include those stated by the customer and those unstated but required for the product to function as intended.
    • Organizations are also required to ensure that the product conforms to applicable regulatory standards.
    • An additional requirement that the organization must determine any training needed by the user for the product to function has been added.
    • Before committing to supply the product, the organization must review product requirements to ensure they are documented, defined, and meet applicable regulatory standards.
    • During the review of product requirements, the organization must also ensure that any training needed for the product is either currently available or is planned to be made available.
    • The section on communication has been expanded to state that the organization must communicate with regulatory authorities, when this communication is required by applicable regulations.

    7.3 – Design and Development

    This section addresses requirements for the design and development of products. There are sizable changes to the ISO 13485:2016 update in this section.
    7.3.2 – Design and Development Planning
    • Additional requirements for documentation during the planning stage have been added. They include:
      • The requirement to ensure that design and development outputs can be traced to design and development inputs
      • A new requirement to document the resources needed in the design and development planning stage, including the competency of personnel

    7.3.3 – Design and Development Inputs
    • Records of design and development inputs must be maintained, and must be able to be verified and validated.
    • Design and development inputs now include usability requirements, as well as, the functional, safety, and performance requirements that were previously required.

    7.3.4 – Design and Development Outputs
    • There are no changes to the design and development outputs requirements.

    7.3.5 – Design and Development Review
    • Reviews are still required to ensure that the product design and development meets requirements.
    • In addition to documenting reviews and necessary actions, the organization is now required to identify the product being reviewed, the date of the review and the reviewers participating.

    7.3.6 – Design and Development Verification
    • This section has been expanded to clarify what must be contained within a design and development verification. These requirements include:
      • Methods
      • Acceptance criteria
      • Statistical methods with justification for sample size (if applicable)
    • If the medical device will be connected to another medical device, the organization must verify that the inputs and outputs work as intended when connected to the device in question.

    7.3.7 – Design and Development Validation

    • The organization is required to perform design and development validation in accordance with its documented procedures.
    • A new requirement to perform validation on representative products, such as initial production units, must be added. Whatever the product used for validation, an explanation that justifies this choice is required.
    • An additional statement has been added that when clinical trials or evaluations are used to validate a product, the product is not considered to be released for consumer use.

    7.3.8 – Design and Development Transfer
    • This is a new section to ISO 13485.
    • This section requires the organization to follow documented procedures for transferring design outputs to manufacturing. The organization is now required to confirm that the manufacturing outputs match those of the design phase.

    7.3.9 – Control of Design and Development Changes
    •  
    • Additional requirements have been added to control design and development changes, in accordance with an organization’s documented procedures.
    • Potential changes to the design must be reviewed to determine how they will affect the performance, safety, and usability of any device.

    7.3.10 – Design and Development Files
    • An additional requirement to maintain design and development files has been added. These files must include records of any changes to the design.

    7.4 – Purchasing
    In line with earlier updates to address outsourcing product parts, the purchasing requirements have been updated. Most of these updates clarify expectations of what type of processes and documentation of purchasing decisions is required.

    7.4.1 – Purchasing Processes
    • The criteria for selecting and evaluating potential suppliers has been clarified
    • An additional requirement to evaluate suppliers based on their performance has been added
    • This section includes a statement that suppliers must be evaluated with respect to risk. Products that would have a bigger impact on the quality of the device must be evaluated more strictly.

    7.4.2 – Purchasing Information
    • Purchasing information is still required to include product specifications, criteria for product acceptance, requirements for the competency of personnel with the supplying organization, and quality management system requirements.
    • An additional requirement that suppliers notify the organization of any changes in the purchased product prior to implementing the change has been added

    7.4.3 – Verification of Purchased Product
    • An additional requirement has been added for when organizations become aware of changes in the purchased product. The organization is now required to review whether the changes in the supplied product will have an impact on their product or its performance.

    7.5 – Production and Service Provision
    7.5.1 – Control of Production and Service Provision
    • Adds new language stating that production and service provision must be monitored
    • The list of criteria for production and service provision has been expanded to include documented procedures for production controls

    7.5.2 – Cleanliness of Product
    • An additional requirement regarding product cleanliness has been added
    • Organizations are now required to document procedures when a supplied product cannot be cleaned, and its cleanliness affects the quality of the final product.

    7.5.4 – Servicing Activities

    • When a medical device is required to be serviced, the organization is required to review any activities relating to servicing
    • Servicing activities must be evaluated to determine whether it’s a customer complaint or whether the issue must be considered for future improvements

    7.5.6 – Validation of Processes for Production and Service Provision
    • When the output can’t be monitored or measured, the organization is required to validate the process that leads to this output
    • The list of documentation for validating procedures has been expanded to include:
    • The approval of changes to the process
    • The use of statistical techniques with rationales for the sample size (as appropriate)
    •  The section discussing the need to validate computer software has been expanded and clarified
    • Reminds organizations to use validation processes that are proportional to the risk associated with the software

    7.5.7 – Particular Requirements for Validation of Processes for Sterilisation and Sterile Barrier Systems
    • Adds a requirement for sterile barrier systems

    7.5.8 - Identification
    • Maintains the previous requirement to identify the product throughout the product realisation, and to document the procedures by which products are identified
    • A new requirement to document the system the organization uses to assign unique identification numbers to devices has been added. This requirement is only applicable when unique device identification numbers are assigned.
    • An additional requirement to identify product status has been added. Organizations are now required to identify product status throughout production.

    7.5.11 – Preservation of Product
    • Updates to this section expand upon the requirement to protect products from alteration and damage.
    • Clarifies that protection must include:
    • Designing appropriate packaging
    • Documenting any special conditions for storage, if applicable

     8 – MEASUREMENT, ANALYSIS AND IMPROVEMENT


    This section addresses the need to monitor products to ensure that they meet the required quality standards. These processes are used to ensure that the quality management system is working as intended, and to make any changes needed.

    8.2.1 – Feedback
    •  The requirement to collect feedback has been expanded to include collecting feedback from post-production activities, as well as, from the production process
    • A new requirement to use this feedback as input into risk management processes has been added
    • Organizations are still required to use this feedback as input into the production and improvement processes
    • Regulatory requirements regarding feedback from post-production processes must be incorporated into this process

    8.2.2 – Complaint Handling
    • This sub-clause is new to the 2016 update
    • Requires the organization to document their procedures for timely complaint handling, which must be in line with any regulatory requirements
    • Provides a list of items that must be documented within the complaint handling procedures
    • Organizations must maintain a record of complaint handling activities

    8.2.3 – Reporting to Regulatory Authorities
    • This sub-clause is new to the 2016 update
    • If regulatory requirements require any complaints to be reported to a regulatory authority, the organization must document their procedures for providing notification

    8.2.6 – Monitoring and Measurement of Product
    • An addition to this section states that the organization needs to identify the test equipment used to measure products, when applicable

    8.3 – Control of Nonconforming Product
    • This section addresses the need to identify products that don’t meet quality standards and to ensure that they’re not delivered along with conforming products
    • The list of controls for segregating nonconforming products has been expanded. It now includes:
      • Identification
      • Documentation
      • Segregation
      • Evaluation
      • Disposal
    • New sub-clauses address actions taken when nonconforming product is detected before delivery, and actions taken when it’s detected after delivery
    • Additional information has been added to address the acceptance of a nonconforming product. When nonconforming products are accepted, the organization must document the event and include a justification for the acceptance.
    • A new requirement has been added to state that organizations must document the procedures for issuing advisory notices
    • A new requirement to maintain records of any advisory notices released has been added

    8.4 – Analysis of Data
    • Adds a new requirement to document how statistical techniques and measurement methods were determined to be appropriate.

    8.5 – Improvement
    • This section requires organizations to implement any changes that help to maintain the suitability of the quality management system.

    8.5.2 – Corrective Action
    • A new requirement that any corrective action must be taken without unnecessary delay has been added
    • A new requirement regarding preventative action has been added. The preventative action must not adversely affect the product’s:
      • Safety
      • Performance
      • Ability to meet regulatory requirements

    8.5.3 – Preventative Action
    • A new requirement has been added
    • Organizations are required to verify that any preventative changes will not affect the safety, performance or ability to meet regulatory requirements of the device

    THE BENEFITS OF IMPLEMENTING ISO 13485:2016


    Businesses that have implemented ISO 13485 cite numerous benefits. Many companies seek the certification because of the financial benefits to their business. The certification demonstrates their commitment to building high-quality medical devices. That allows businesses to attract more clients than before.

    Additional of the other benefits include:

    1.    Ability to Contract with Larger Companies

    Many large medical device businesses prefer to work with vendors who are ISO 13485 certified. The 2016 update to this standard may make this even more desirable. The revisions mean that large companies are responsible for ensuring that any subcontractors conform to ISO 13485 standards. That means subcontractors who already have the certification are likely to be prioritized.

    2.    Demonstrate Commitment to High Quality

    Both ISO 13485 and ISO 9001 are seen as indicators of an organization’s commitment to quality. Achieving a quality management certification demonstrates to customers and regulators that your company values quality.

    3.    Expand Potential Market

    Standards like ISO 13485 are created to ensure that medical devices in different places demonstrate the same reliability and quality. If you’re considering exporting products, ISO 13485 certification can lend an advantage. Not only is it the first step to regulatory approval in major markets like the European Union and Canada, but it also demonstrates the quality of the product to potential buyers.

    4.    Help Personnel Access Relevant Information

    The documentation requirements in this standard are designed to ensure that all members of a development team have access to the information they need, when they need it. Having access to the right information can reduce the time and expense associated with product development.

    5.    Expand and Consolidate Business Knowledge

    We also hear from clients that documenting the processes associated with their medical device helps the business develop a consolidated knowledge base. This knowledge can help to identify problems, improve the product, and streamline the manufacturing process. It also makes the process of on-boarding new employees easier.

    6.    Make Achieving ISO 9001 Certification Easier

    Many businesses hold both ISO 13485 and ISO 9001 certifications. If your business is ISO 13485 certified, achieving ISO 9001 certification is significantly easier. The requirements of these two standards are generally harmonised. ISO 9001 does contain a few requirements related to business clauses that ISO 13485 doesn’t cover.

    GETTING CERTIFIED FOR ISO 13485


    Getting certified for an ISO standard can be a difficult process. Preparation and good organization can make it less stressful.

    Understanding the requirements of ISO 13485 is a good place to start. Your auditor will be referring to these standards as they evaluate your organization. Documenting and organising your quality management procedures is another important step.

    Next, make sure employees as well as management know the organization’s quality management processes. Keeping everybody on the same page will help the audit process go smoothly.

    It is often required to conduct an internal audit before conducting the external audit for certification. An internal audit can help you determine whether any changes need to be made to your quality management system before certification.

    It’s also important to choose the right auditor to conduct the audit. Since an audit is fundamentally an on-site verification of your quality management processes, look for an auditor with a local presence. This can speed up the auditing process and reduce problems that arise from language or cultural barriers.

    Your auditor should also be experienced. For instance, NQA has conducted more than 35,000 certifications in 70 different countries. This means that, when questions about logistics or the audit process arise, our experienced auditors can help you find the answer.

    When NQA audits a business, we work with your processes and procedures. That means you won’t be required to add processes that don’t work for your business. Dedicated Customer Service representatives will ensure that you have feedback throughout the registration process so that you can address questions that arise during the auditing process quickly, and get back to work sooner.

    ISO 13485:2016 TRANSITION GUIDANCE FOR EXISTING NQA CUSTOMERS

    The new standard ISO13485:2016 - Medical device quality management system was published on March 1, 2016. Compared with ISO 13485:2003, the requirements have changed significantly and organizations with ISO 13485:2003 certification are now in a transition period.
    In accordance with the IAF, all accredited certificates to ISO 13485:2003 and ISO 13485:2012 have until March 31, 2019 to successfully transition to ISO 13485:2016. This is 3 years after the publication of the 2016 standard.
    Transition period 3 years from the publication date of ISO 13485:2016.
    The expiry of the certificates to ISO 13485:2003 and BS EN ISO 13485:2012 is March 31, 2019.
    From March 31, 2019 all accredited certifications to ISO13485:2003 and BS EN ISO13485:2012 will cease to be valid. Clients who fail to complete the transition by this point will have their certificate withdrawn. If clients feel the need to continue certification they will require a full initial audit.

    The IAF has also stated that from March 1, 2018 (2 years after the publication of ISO 13485:2016) all new certification and re-certification certificates issued must be to ISO13485:2016. We will, therefore, not issue any ISO 13485:2003 or BS EN ISO 13485:2012 certifications from 1 March 2018.

    STEP 1: TRANSITION GUIDELINES - ISO 13485:2016

    1. Clients should prepare for the transition as early as possible in order to ensure that they have sufficient time. Preparation should include as a minimum:
    • Standard training
    • Understanding the changes and the requirements of the new standard including the technical requirements
    • Recognizing the difference between the requirements of the current standard and new standard
    • Conducting a gap analysis of the management system between the old standard and the new standard.
    2. Create a transition plan to ensure compliance by March 31, 2019. Clients should conduct comprehensive and effective training on the new standard for all relevant persons within the organization. Internal Auditor training is also recommended for the organizations internal auditors.

    3. Update the existing management system according to the new standards. This should include revising and improving the management system processes and policies, and then implementing them. Please ensure that all of the specific requirements of the new standard have been fully and demonstrably implemented.

    4. Conduct an internal audit and management review to  assess whether the management system meets the requirements of the new standard ISO 13485:2016 and is ready for an ISO 1348:2016 transition audit. Clients should take corrective and preventive measures if they do not meet the requirements.

    5. Until the transition is complete, the organization’s Management System must maintain compliance with the old standards. Where a lack of conformity is identified, a non-conformance will be raised and must be addressed per the current corrective action process.

    6. If your organization’s current certificate expires before you are able to fully transition to the 2016 standard, you may be re-registered to the previous version (subject to a cut-off period to allow for subsequent transition). The expiration date of this new certificate will be the three year anniversary of the release of the 2016 version, as mentioned above.

    7. A new certificate to the 2016 version will be issued when it can be satisfactorily shown that your organization has fully met the requirements of the new standard.  As is the current practice, all major non-conformities must be formally closed out and corrective actions for any minor non-conformances must be received and accepted by NQA, prior to issuance of a certificate.

    Contact NQA as early as possible to discuss your transition plans.

    STEP 2: YOUR TRANSITION OPTIONS

    Based on the three-year transition timeline, we have developed the three options below to support your implementation approach. Each option has different implications for timing and cost of transition.

    OPTION 1 - Re-Certification Transition Recommended and Default Option
    • Full transition conducted at the time of re-certification audit. NQA recommends that you use this opportunity to undertake your transition audit as it will minimize the amount of additional audit time needed over a three year audit cycle.
    • If you wish to bring forward your next re-certification visit you must contact NQA in advance, if successful, allowing NQA to issue a new certificate. This will reset the three year certification cycle and the certificate valid until date. 
    • If your re-certification visit is between September 2015 and September 2016 and you are not ready to transition NQA recommend you consider option 2 or 3. 
    OPTION 2 - Surveillance Transition
    • Full transition will be conducted at the time of your existing surveillance audit.
    • Additional time will be added to the audit activity to allow time to complete a full assessment against the new standard. This additional time will equate, as a minimum, to the duration of a re-certification audit.
    • If successful NQA will issue a new certificate and will reset the three year certification cycle and the certificate valid until date. 
    OPTION 3 - Special/Any-time Visit Transition
    • Special Visit conducted as a stand-alone visit (out of the annual sequence at your request) or where the current certificate has expired prior to a transition audit being conducted. 
    • This will be additional to your existing certification activities and will therefore incur additional costs.
    • If successful NQA will issue a new certificate and will reset the three year certification cycle and the certificate valid until date.
    Please note: At the point of scheduling your transition audit you will be informed of the additional days required and therefore the audit duration and cost. This will be determined by NQA and applies to all of the options above.

    STEP 3: INFORM NQA

    We need to know if you do not wish to transition at your next RE-CERTIFICATION audit. If you are planning on transitioning at re-certification you do not need to do anything.

    понедельник, 31 июля 2017 г.

    The Non-Pharma Pharma Company?


    Pharma’s commercial model is rapidly evolving. But where will it be in twenty years’ time?



    Across all industries, consumers are demanding more and companies are responding, adapting their commercial models in efforts to meet their customers’ evolving needs.
    Pharma is not immune to these wider changes and most companies are actively rethinking the traditional model to ensure they can compete in an increasingly multi-channel, multi-stakeholder environment.
    Healthcare is going through an “amazing transformation process” driven by new media, says Tim Kneen, Executive President at Merck. “The standard pharma business model of high volume, get access, make as much noise as possible will not be relevant going forward,” he says. “Across all industries, the most successful companies offer solutions that reflect the individual needs of their customers, but especially those that recognize these needs before the customer does.”
    Seismic shifts

    There are three “mega trends” in healthcare at present, says Kneen – the delivery of outcomes, personalized treatment and customer engagement. Addressing each will be critical to pharma’s successful evolution.
    “Healthcare is shifting from acute medicine to health management, which includes determining susceptibility to certain diseases and early interventions that improve health outcomes. The focus is shifting beyond innovative drug – right now, the best possible outcome is that the patient takes the drug as directed but, with chronic disease, lifestyle intervention can often have bigger impact than drugs themselves.”
    Pharma must think seriously about extending its offering through innovative devices and patient support programmes, he says, pointing to Merck’s Rebismart, a connected device that complemented MS therapy Rebif.
    “Not only can we collect information on adherence but we can see the impact of the drug in terms of quality of life,” says Kneen. “This means physician and patient can have a discussion based on data, which essentially transforms the interaction to improve outcomes.”
    With personalized treatment, the use of molecular markers and advanced algorithms can help companies to identify those patients who would benefit the most from treatments. He points to Merck’s use of Crispr genomic technology for gene editing as an example, but looking more widely asks who will pay for such approaches in the short-to-medium-term.
    His third megatrend is customer engagement. “Patients have unparalleled access to health information, and pharma has to respond to this changing reality. Requirements for engaging with healthcare organisations are radically shifting and pharma is constantly seeking compliant ways to engage with patients.”
    Commercial teams have changed hugely over the past 20 years, he says, when pharma was based on a large monolithic sales model with commercial teams tasked to see as many doctors as possible and disseminate promotional materials. Such a single channel model of face-to-face interaction is as good as obsolete, he says, while multichannel selling is essential.
    “Historically, the commercial model was repetitive and lacking differentiation, with little guideline influence, for example. The past decade has seen dramatic change; now, multiple stakeholders are involved in treatment decisions and patients are key decision-makers, in addition to physicians, guidelines, HTA, payers, and government, among others,” says Kneen.
    “With an increasing number of stakeholders involved in treatment choice, commercial roles have multiplied and diversified, while traditional back-office functions have become customer-facing. Key account management to tailor the right information to the right customer is a critical component.”
    Enabled by digital, information now flows through multiple channels, moving beyond face-to-face to social media and remote calls, for example. “It is bi-directional and continuous,” he says. “Now, we can listen and learn, we can provide information as it is required, and this makes a massive impact on how we function as commercial entity now and in the future.”
    Integrate or die?

    Amid such change, much discussion and debate has revolved around whether the sales and marketing functions should be more integrated, given the undoubted benefits.
    GSK is one company that is re-evaluating traditional ways of working, moving into a more cross-functional approach to delivering customer value. “Our aim is to deliver an exceptional customer experience through an integrated approach across sales, marketing, medical and market access.  This includes everything from capability building and benchmarking to business planning and execution on the ground,” says Colleen Schuller, Vice President, Global Head of Selling Excellence.
    The company now has joined-up teams that look after multichannel marketing and launch excellence, selling excellence, medical excellence and market access capabilities, she adds. “What is most critical here is to be crystal clear on the strategy and how cross-functional teams will work together to deliver value for both health care professionals and patients,” says Schuller.
    For Laurie Gery, Head of Commercial Operations at Sanofi Pasteur, integration means education. “We need to make people understand the value of what they bring to the commercial plan – then integration will happen more seamlessly because you are automatically aligning objectives. Integration means fewer head count but it also means that sales gets more complex. It is a matter of mindset and not who is reporting to whom.”
    Sales and marketing must be “reinvented” into a seamlessly integrated, commercial outfit, says the Head of Commercial Excellence for a top 10 pharmaceutical company who wishes to remain anonymous.
    Ultimately, a successful integration will be based on trust, he says. “The equation for trust is credibility plus reliability plus empathy. Often when it comes to a bad leader, one of these is missing in their role or they have all these components but everything is eroded by self-interest. You have to continually be doing things to build that trust, to ensure it is not eroded.”
    A key element is to identify ‘them’ as something external, not sales versus marketing, he says. “It sounds like a minor thing, but it has a big impact on performance.”
    Running a digital marathon
    Digital underpins the metamorphosis of the current commercial model, with next-generation pharma adopting a multichannel selling model to reach plugged-in patients and healthcare professionals.

    Pharma needs to become better at selling in a multichannel world, says GSK’s Schuller. “Reps need to become better at facilitating peer-to-peer dialogue, better at selling using the iPad, and better at virtual detailing. This will help take the sales force into the future.”

    For Bogdan Rakitskiy, ‎Associate Director of Commercial and Business Excellence at Teva, pharma must become “efficient in digital strategies through the transformation of the commercial team into powerful skilled contributors. This is the hottest topic across all industries, not just the pharmaceutical industry. Proper management and implementation could bring a quick win in our fast-changing market.”
    Building a cross-functional team, with buy-in from employees, is critical. Rakitskiy cites a personalized digital multichannel campaign run internally that aimed to engage 10 percent of employees that in fact reached closer to 50 percent, demonstrating that the staff are willing.
    “Modern commercial teams are running an endless marathon of digital transformation,” he says. “We need to give our employees this new knowledge and skills.” A digital manager is necessary for overseeing this process, acting as the ‘coach’ of the cross-functional team, offering skills, support, coordination and communication.
    One critical issue for pharma is the need for a continuous stream of new content, he says, pointing to Snapchat stories that are only live for 24 hours. And generic messages no longer cut the mustard. “Pharma content needs constant revision in order to meet customer demand for personalised messages. Before, we could use a sales presentation for over a year, now everything must be changed and updated all the time,” says Rakitskiy. As the longevity of content decreases, so too the cost of content production must decrease.
    Beyond pharma
    Is the future of pharma an integration of sales, marketing and medical into a seamless, virtual selling organisation?

    “Perhaps,” says Kneen, who says that pharma companies must continually revisit and redefine. “The model of commercial teams will continue to evolve at a pace aligned with the rapid transformation of healthcare systems. The challenge for the industry is to identify the solutions required before anyone else, to respond and evolve quickly. Pharma will need to develop and bring in the variety of skills and knowledge that can respond to this pace of change in our transforming healthcare market,” he says. “As we move away from a focus on volume, it is the valued solution, not the product, that will dictate future winners.”
    There are three possible approaches, he says. Pharma can remain as commodity producers, become value innovators or it can become digital health integrators, providing integrated healthcare solutions that reach far beyond the traditional tablet. The latter is where the most interesting changes will occur, he says, as it would clear space for disrupters to enter the market. “Which will be the first pharmaceutical company that does not produce a single drug?” he asks. It certainly seems to be a case of when, rather than if.