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42 HEALTHCARE NEWS Elective, outpatient surgery begin to return — insights for spine surgeons By Laura Dyrda E lective and outpatient surgeries are beginning to return in some communities, which will allow spine and orthopedic surgeons to resume care for their patients most in need. On April 16, President Donald Trump released his Opening America plan, which included calling for outpatient elective surgeries to re- sume under CMS guidelines. Phase two of the plan includes restarting elective surgeries safely. Detroit-based Henry Ford Health System resumed outpatient surger- ies at five hospitals, according to a report from the Detroit Free Press. e hospitals have dedicated operating rooms for the outpatient pro- cedures, which began on April 16. e surgeries will be for patients without the coronavirus that need time-sensitive procedures, includ- ing for cancer and heart disease patients. e operating rooms will include dedicated teams that are tested for COVID-19 to avoid the spread. Patients are also tested and the health system has a sterilization process to keep the space safe. e patients undergoing surgery are also unlikely to need overnight stays or the ICU. Oklahoma also cleared the path for elective surgeries to begin in April. Medical providers will have the authority to determine which elective surgeries to move forward with and Gov. Kevin Stitt signed a mem- orandum featuring an "Elective Surgery Acuity Scale" to help. Minor medical procedures and nonemergent dental procedures will also re- sume May 1 in the state. A Fargo, N.D.-based pain clinic and surgery center also plans to re- open April 22 on a limited basis. Patients will undergo COVID-19 screenings before entering the facility and take additional precautions while there. e Center for Pain Medicine Clinic and Surgery Center also plans to enhance cleaning procedures and disinfect surfaces sev- eral times per day. Spine and orthopedic surgeons across the country are reviewing their patients to understand how postponing procedures will affect the patients' long term functionality when deciding how to ramp their practices back up. Additional key considerations include the patient's insurance status — many people may have lost coverage due to sudden unemployment in the past month — and others may need a new pre- authorization. Surgeons also need to make sure patients will be safe to return home aer surgery and have access to virtual physical therapy aer surgery. Ratnesh N. Mehra, DO, outlined how he was able to perform the first neurosurgical procedure on a known COVID-19 positive patient in Detroit in late March, detailing his precautions and sterilization protocols. e patient required necessary spine surgery, despite the COVID-19 diagnosis. n $838M neuroscience facility at Connecticut hospital gains unanimous approval By Alan Condon Yale New Haven (Conn.) Hospital's plans to build a neuro- science medical research and treatment facility received unanimous approval from the City Plan Commission on April 15, the New Haven Independent reports. Three things to know: 1. Spanning 505,000-square-feet, the facility will feature a seven-story building above the McGivney Surgery Center, which specializes in joint replacement procedures, and an- other eight-story building nearby. 2. The neuroscience center will research diseases such as Parkinson's, Alzheimer's, epilepsy, multiple sclerosis and strokes. 3. Construction was initially slated for spring 2021, but the COVID-19 pandemic has forced the hospital to halt con- struction plans for now. n $4.7M SBA loan given to Conformis to mitigate economic impact of COVID-19 By Alan Condon O rthopedic implant manufacturer Conformis recent- ly received a $4.7 million loan through the Small Business Association to help maintain liquidity during the COVID-19 pandemic. Four things to know: 1. The loan was provided through the Paycheck Protection Program, offered by the SBA. 2. The Coronavirus Aid, Relief, and Economic Security Act authorizes the SBA to provide low-interest rate loans to small businesses under the PPP. 3. All or a portion of the loan may be forgiven if the funds are used for payroll costs, interest on outstanding debt, rent and utilities, according to the terms of the PPP. 4. Conformis furloughed about 80 employees and all of its temporary workforce, effective March 23. n