Becker's ASC Review

36 Thought Leadership How 2 physicians believe ASCs will adapt post-pandemic By Carly Behm T he pandemic put a strain on the supply chain for ASCs, and COVID-19 has le some patients with lingering, long-term effects. For physicians, that means thinking about patient volume and future supply chain strategy. Two ASC physicians told Becker's ASC Review their predictions: Note: Responses were edited for style and clarity. Question: Could long-haul COVID-19 patients affect which cases ASCs take on? Ariz Mehta, MD. Ambulatory Pain and Disability Manage- ment Center (Jersey City, N.J.): We have a newly licensed ASC in New Jersey, and we have seen how beneficial our practice options have expanded for patients looking for state-of-the-art precision interventional pain medicine in a private and person- alized facility. In fact, many patients have specifically asked for options that do not include hospital-based facilities since the pandemic began. We anticipate this will continue for the long term not only for long-haul COVID-19 patients but in general for patients treated for orthopedic, spine, sports or chronic pain-related conditions. Rajiv Sharma, MD. President and Founder of Digestive Health Associates (Terre Haute, Ind.): COVID-19 should ac- tually drive more patients to ASCs for less infection burden due to less square footage that can harbor more viruses. Most ASCs are newly built compared to hospital structures and have newer flooring and carpeting which has less infection, bacterial spores or infectious agents. It's more cost-effective to replace an ASC's flooring compared to a hospital's due to lower square footage. I also predict faster turnaround, less waiting and less exposure to infectious agents on top of COVID-19 compared to hospitals. Q: How will supply chain strategy change for ASCs? Will there be more investment to prepare for future global emergencies? AM: Supply chain strategy change for ASCs will include al- lowing continued access for patients in need of interventional pain medicine treatments, as the lack of access could be related to the concomitant increase in opioid and other drug related mortalities. We cannot forget the preceding opioid epidemic and the need to recognize this field of medicine as essential to the function and quality of life of the patients we serve. Investment to prepare for future global and regional emergen- cies may materialize as an accelerated coordination related to neuromuscular and musculoskeletal outpatient service lines. RS: ASCs will likely partner with vendors to have a six-month to one-year supply of personal protective equipment available as a ration. I predict positive pressure to get ventilation rooms for better viral clearance. ASCs might consider selling back to vendor options if equipment is not used and return to get credit for future purchases. n Revamping anesthesia screening, supply chain strategy key to post- pandemic strategy for one Missouri ASC By Carly Behm S evere cases of COVID-19, including long-term symptoms, had Lisa Weindel, administrator at St. Louis-based Center for Urologic Surgery, reassessing patient risk. The pandemic also caused her center to take a less budget-friendly approach to supply chain management. Here's what she told Becker's ASC Review about those changes: Note: Responses were edited for style and clarity. Question: Could long-haul COVID-19 patients affect which cases ASCs take on? Lisa Weindel: We have revamped our pretesting and anesthesia screening for patients that have had severe cases of COVID-19. Recommendations include waiting at least: • 12 weeks for patients who were admitted to an ICU for COVID-19 • Eight to 10 weeks for symptomatic COVID-19 patients with dia- betes, severely low immune defenses or required hospitalization • Six weeks for symptomatic COVID-19 patients with a cough or difficulty breathing, but didn't require hospitalization • Four weeks for mild or asymptomatic COVID-19 We continue to monitor guidance from the ASA, CDC, and state and local agencies. We almost need a full-time person just ensur- ing we are keeping up with all the available research. We have not changed what cases we are doing, but continue to educate ourselves on risks to patients after COVID-19 infections. Q: How will supply chain strategy change for ASCs? Will there be more investment to prepare for future global emergencies? LW: Our supply chain efforts have also changed. We had to commit to a higher level than anticipated at set prices. It's not budget-friendly, but we are unable to predict what future strains of the virus may do to the resources, and we are competing with very large health systems in our areas. If not for the foresight of our very capable veteran supply man- ager, Sue Pratt, we would not have made it successfully through this last year. She has had wonderful relationships for years with multiple vendors, so we were able to utilize those relationships to keep an adequate supply. But times are very uncertain, especially with raw materials, so insight, education, relationships and atten- tiveness to market turns are crucial. I am grateful for our dedication as a team to ensuring we have the necessary materials and for our ability to turn on a dime and source the needed materials. That is potentially an advantage for smaller centers that don't require 15 signatures to make a vendor change. n

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