Becker's Spine Review

5 SPINE SURGEONS The most essential technology in spine and orthopedics post- pandemic — key concepts and big ideas By Laura Dyrda T hree orthopedic and spine surgeons participated in a panel titled "ASCs, Orthopedics and Spine – e Next 5 Years" on June 18 as part of the Becker's Spine, Orthopedic and Pain Manage- ment-Driven ASC + the Future of Spine virtual event. e surgeons addressed how their practices are recovering from the pan- demic and their projections for the future. Here is an excerpt from the discussion about the technology that will be most essential for orthope- dics and spine in the future. Bert Mandelbaum, MD. Co-Chair of Medical Affairs at Cedars-Sinai Kerlan-Jobe Institute and Co-Director of Sports Medicine in Depart- ment of Orthopedic Surgery (Los Angeles): e use of virtual medi- cine is going to be a tool as we confront the consumer. We had meetings talking about using virtual medicine on initial contact with patients. … When you couple virtual medicine with the use of robotics, including arthroplasty, and look at some of the other issues such as orthobiologics and new technology going forward, I think the real opportunity for us to evolve our field and improve outcomes as we go forward. e use of the ASC, the use of robots in ASCs, doing spinal surgery with microscopes and orthobiologics are really the next step in innovation going forward. I think it's an exciting future. Kam Momi, MD. Founder and partner of CoastalSpine New Jersey (Mt. Laurel): e only thing I would add to the ASC, robotics and tele- health is data. We keep hearing about data and it's like oil: it's valuable, but not the way it comes out of the ground. You have to refine it, there are different products to come out of it; it is important for different people in different industries; and data is the same way. Raw data is not very useful, but we are learning how to si through it and identify very important as- pects of it for total joints and spine, and once we get that data in place, we will be able to make a difference on population health and predicting who needs surgery and also really be able to demonstrate outcomes as we've all talked about to challenge the insurance companies on their arbitrary, whimsical denials they oen have. Richard N.W. Wohns, MD, JD, MBA. Founder and President of NeoSpine (Puyallup, Wash.): My spin on the technology piece is that sometimes we have all the technology in the hospital and it's hard to get the same technology in the surgery center because of capital expendi- tures. at needs to change. We need partnership with industry to help promote use of $1 million robots, O-arms and other high cost technolo- gies that are generally hospital based to be able to use in the surgery cen- ter. I use a robot in the hospital and I'm trying to get one for the surgery center, but to make it feasible, it's somewhat difficult. If we want to go the way we should be going, we need help from industry to make all the tech- nology readily available in the outpatient surgery center. e payback will be there because the case will be able to migrate fully over if we have all the neuronavigation, robotics, orthobiologics that we need outpatient. n The future of private practice and payers in spine: 3 key thoughts By Laura Dyrda T hree orthopedic and spine surgeons partici- pated in a panel titled "The Future of Practice, Bundled Payments, Out-of-Network, Venture Capital, Hospital Partnerships and More" on June 18 as part of the Becker's Spine, Orthopedic and Pain Management-Driven ASC + the Future of Spine virtual event. The panelists shared thoughts about the future: Sigurd Berven, MD. Orthopedic Surgeon at the University of California San Francisco: I don't think this pandemic is over at all. I think we are going to see major bumps of COVID with the protests. I think this pandemic will last until we have an effective vaccine. I think it will be at least through November. We are see- ing numbers in the range of 40 million-plus that are unemployed and can't access healthcare. I'm really concerned about those patients who have lost insur- ance and can't access healthcare. It will introduce the need of universal health insurance and that is the long term effects of that. If there is one take home message of what I would predict in healthcare, this will open up the need for universal healthcare. Scott Blumenthal, MD. Founder and Medical Direc- tor for the Center for Disc Replacement at Texas Back Institute (Plano): I'm very optimistic. I do feel that we will get back to normal quicker. I think we will incorporate telemedicine into our practices. When flu season starts again, some of the social habits, stay home, wash your hands a lot, and that will help miti- gate a second wave of COVID-19. I don't see the (sec- ond wave) being overwhelming. Thomas Schuler, MD. CEO and Founder of Virginia Spine Institute (Reston): Most people are ready to get back to work but trying to figure out how to do it legally safe. We have had a decade of innovation in the past two months; I agree there will be a continued push for a single payer, that has been overwhelming. If we get the Medicare for All system, we will always have Americans that aren't willing to accept that. They want the MRI today, surgery this week; there will be an opportunity for those that provide unparalleled pa- tient service, and surgeons will be able to take advan- tage of that. n

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