Issue link: https://beckershealthcare.uberflip.com/i/1368676
37 Thought Leadership Hospitals vs. ASCs: What 3 spine surgeons expect as outpatient migration continues By Alan Condon W hile many surgical procedures have been steadily migrating from the inpatient to outpatient setting in recent years, the COVID-19 pandemic has ac- celerated this trend. There are certain high-risk procedures that surgeons will likely never perform at outpatient settings, but hospitals are expected to alter their strategies and become more involved in ASCs as outpatient migration continues in the coming years. Three spine surgeons share their thoughts on competition between sites of care, joint-venture partnerships and how outpatient migration has stifled innovation in orthopedics: Note: Responses are lightly edited for style and clarity. Jeffrey Carlson, MD. Orthopaedic & Spine Center (New- port News, Va.): I think hospitals will become more heavily involved at ASCs and partner with physicians to create these centers with a better patient experience. The patients are driving this. Physicians are having that direct patient care, understanding what the patients need and what the patient expectations are. A lot of patients, especially over the past year, don't want to have surgery at a hospital. That's some- thing that physicians hear as they discuss surgery with their patients. Physicians having that direct patient care are able to guide that care and manage the needs of the patient. Daniel Lieberman, MD. Phoenix Spine & Joint. Hospitals are not going to stay on the sidelines. They can't let their golden egg leave the goose. They're going to have to be heavily involved in ASCs, so they're going to be another stakeholder that will get even more fired up and involved in our industry. Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Hospitals have been expecting this trend to come for a while. What is interesting is how it has slowed down innova- tion. For example, I approached a hospital in Las Vegas about purchasing a robot to perform minimally invasive spine surgery and increase volume at that hospital. But they expect to lose so many elective spine surgery cases over the next five years to ASCs and expect very little cases to be done in the hospital, so they didn't want to invest in the technology. That's somewhat of a defeatist attitude that I've seen some hospitals take. Other hospitals are investing in surgery centers so they can secure some profit from the partnership. Hospitals still have a lot of capital they can invest, where surgery centers are typically starved of capital, which is why it makes sense to partner. In my opinion, outpatient migration of spine surgery will encourage surgery centers to rent or purchase surgical robots and other advanced technology to drive that exodus even faster. n 3 ASC leaders on adopting new technologies By Carly Behm H ere's how three ASC leaders strategize when it comes to adding new tech- nologies, from surgical equipment to management tools: Becky Ziegler-Otis. Administrator at Ambu- latory Surgery Center of Stevens Point (Wis.): We are always looking for new technology to enhance our efficiency and effectiveness while maintaining a safe environment at our surgical center. ere are so many opportunities avail- able with new technology that we try to strat- egize based on factors such as staff efficiencies, cost savings, government mandates and patient satisfaction. We stage adopting new technolo- gies so that it is not overwhelming to the center operations in order to foster success. When we identify a new technology, key stakeholders who would be impacted by the new technology participate in vendor presentations to determine as a cohesive group if it provides significant benefit for the center to further pursue. Beyond the initial presentations, the stakeholders are involved in further discussions as well as in implemen- tation strategies. Once a new technology is adopted, those who are using the technology are provided an overview as well as education as needed. Time frames are established for implementation, and mechanisms are set up for feedback as issues/concerns are identified throughout the implementation phase. Joleen Harrison, BSN, RN. Administra- tive Director of Mankato (Minn.) Surgery Center: We touch base with our surgeons on a regular basis to see what they may be think- ing about innovative upcoming procedures changes they see in their specialty, especially around budget time. Some of the surgeons do clinic strategies to bring in patients with new equipment or techniques. As always, we do our return on investment on equipment and if the procedures are covered in the ASC, which also helps in the decision-making process if we can adopt the new technology. We also ensure the surgeon's training is completed and privileges have been approved by the govern- ing body for the new technology. Raghu Reddy. Administrator at SurgCenter of Western Maryland (Cumberland): We are technology-driven except for an EMR at our ASC, and we are continuously evaluating our technology needs. We are waiting for a deci- sion from our hospital partner to finalize their EMR implementation, and we would imple- ment our EMR around the same time, which will be 2023 or sooner. We leverage technol- ogy to minimize the dependence on paper and Excel spreadsheets. e adoption of newer technology creates efficiencies, along with the people and processes we have in place. e beauty of technology is to have access to reports and insights to evaluate our business, clinical operations and decision-making. No one can debate the need for technology when it comes to regulatory compliance as well. n