Becker's ASC Review

31 ORTHOPEDICS Endoscopic procedure a first at DuPage Medical Group's new ASC By Alan Condon T he first endoscopic microdiscectomy procedure at Du- Page Medical Group's new ASC in Westmont, Ill., was performed by Ashish Patel, MD. Endoscopic microdiscectomies offer many benefits for the treatment of herniated discs, such as smaller incisions, reduced blood loss and increased visualization to the spinal canal and nerves while minimizing the risk of muscle damage, according to a May 10 news release. "One of the main advantages is that patients experience reduced trauma to their surrounding tissues and ligaments due to the surgical technique, enabling them to return home the same day and experience a faster recovery after surgery," Dr. Patel said. The ASC, which opened in January, plans to add more endo- scopic spine surgeries in the future, as well as laminectomy and anterior cervical discectomy and stabilization procedures. DuPage has two other ASCs in Lombard and Naperville, Ill. n Hackers remove patient files from New York orthopedic group's computer systems By Alan Condon O rthopedic Associates of Dutchess County in Poughkeepsie, N.Y., recently began no- tifying patients that their protected health information was exposed by a hacking incident. The practice said it discovered suspicious activity on its computer systems March 5. Its investigation re- vealed that an unauthorized user infiltrated its network on or about March 1 and encrypted certain systems. The hacker also claims to have removed and/or have viewed certain files, the practice said. The files exposed in the incident contained patient Social Security numbers, names, addresses, birth dates, medical record numbers and patient ID num- bers, according to the practice. The FBI and HHS were notified of the incident, and the practice said it is updating its security policies and procedures to prevent recurrences. n Why more spine surgeons are looking to invest in ASCs By Alan Condon S pine surgeons investing in surgery centers have the potential to realize significant profit in the coming years as procedures continue to shi from inpa- tient to outpatient settings. A recent survey of academic spine surgeons found that 49 percent had investments in ASCs, with the surgeon-owned market segment projected to increase at a compound annual growth rate of 4.9 percent between 2017 and 2024. Currently, there are more than 180 ASCs that perform minimally invasive spine surgery in the U.S. e effects of the COVID-19 pandemic, the need to reduce healthcare costs and physicians' desire to control the surgical environment are expected to drive outpatient growth in the next five years. ASCs tout faster recoveries and more specialized care, particularly for specialties such as spine and orthopedic surgery, which are oen provided in private and boutique healthcare environments. is year, CMS removed 67 spine codes from its inpatient-only list, compared to six the previous year, and plans to completely phase out the list by 2024. Recognizing that higher acuity cases can be performed safely and at lower costs at ASCs, both CMS and commercial payers are encouraging more cases to be done at outpatient settings. Recent advances in technology have helped make this possible. Augmented reality technologies are begin- ning to break into the spine industry, offer- ing enhanced visualization designed to help surgeons perform procedures in less time with less complication risks. Augmented and virtual reality technologies also have the added benefit of facilitating training of staff and surgeons. "Medical device companies will have to adapt to this new normal and offer services to sur- geons to help them transition their practice to the outpatient space," said Alok Sharan, MD, of NJ Spine and Wellness in East Brunswick. "This will include not only minimally invasive tools, but also digital training tools, AR/VR technologies to train surgeons and staff, along with digital tools that will allow surgeons to do remote patient monitoring postop." Robotic-assisted surgery is also picking up speed, but spine robots cost roughly 10 times the price of current AR systems on the market and take up far more space in the operating room. But many surgery centers see these technologies as necessary tools to attract top surgical talent. e price and size factors of spine robots will not deter ASCs from investing in robots, but may affect hospitals that "expect to lose an in- creasing number of spine cases over the next five years," Vladimir Sinkov, MD, of Sinkov Spine Center in Las Vegas, told Becker's. "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," Dr. Sinkov said. "Outpa- tient migration of spine surgery will encour- age surgery centers to rent or purchase surgi- cal robots and other advanced technology to drive that exodus even faster." Robots and other surgical technologies are set to become more prominent at ASCs, as surgeons, payers and patients continue to push more pro- cedures to the outpatient environment. n

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