Becker's ASC Review

37 THOUGHT LEADERSHIP Before adding a robot, do the homework: 2 ASC leaders on when to invest in technology By Marcus Robertson T he presence of robotics in healthcare has been steadily increasing, especially for orthopedic proce- dures. Michael Flierl, MD, orthopedic surgeon, and Amie Henrichs, RN, executive director of UnaSource Surgery Center in Troy, Mich., joined "Becker's ASC Review Podcast" to talk about what ASC leaders need to know about adopting robotics. Question: What advice would you give an ASC that's considering making the leap into robotics? Amie Henrichs: First of all, do the homework. ASCs are typi- cally for-profit businesses. There are a lot of different and creative ways that vendors can work with small businesses to get the technology into their centers. Ensure that you've got committed medical staff that are go- ing to use the technology and will be committed to it, get- ting it not only approved and brought into your organiza- tion, but then going through the learning curve, and sticking that out to make sure it becomes hardwired. Sometimes you have to spend money to make money in these businesses. The cost of the technology, you're going to make that up with the increased demand and the patients that seek you out. That's something that the sales folks will tell you, but it is true. We've seen it now twice with the two different robotic platforms we've introduced here. Dr. Michael Flierl: The numbers are important. So if you are in a small surgery center that does 20 joint replacements a year, robotics might be something you want to think long and hard about. But if you have a fair amount of joint re- placements at your surgery center, you're looking to in- crease that business and you have surgeons asking for it, I think it's a great opportunity. The other thing is, you have to understand where you're at in the market. In a highly competitive market, robotics may really help set you apart from other surgery centers and hos- pital systems. If you are in a large city where everybody and their neighbor has a robotic system, it might not be quite as helpful and might not be a smart business decision. n Q: What are some of the biggest threats to ASCs in your market? Oren Shill. President Elect of California Ambulatory Surgery As- sociation's board of directors and Group President of Surgical Care Affiliates: Shortages of healthcare providers and the ASC workforce is the biggest threat right now. e pandemic created significant staffing challenges for nurses and office staff, and we are also seeing an acceler- ated trend of practice consolidation, an aging healthcare workforce and changes in how physician specialists are focusing their practice. Physi- cian specialists are looking to enhance sustainability of their practices and see a series of benefits from participating in an integrated care delivery system and values-based care models. at means that ASCs must work hard to build awareness of their benefits, attract physician specialists and nurture the connections to value-oriented primary care doctors and payers to reinforce siting of patient cases at ASCs. We are also making investments in talent acquisition, leadership programs and training for clinical and support teams to attract and retain top talent with compelling career growth opportunities. Dr. Gantwerker: By and large the biggest threat is the infiltration of hospital culture into the ASC. In other words, when efficiency and safety are traded for the asymptotic slowing of case turnover and ran- dom delays in processing and tray delivery, not to mention the ever- elusive and disappearing anesthesiologist and/or random checkbox paperwork delays, ASCs become less able to do what they do best. Panna Tailor, RN. Employee Health Nurse Manager at three North- ern California ASCs: e biggest threat is patient's trust in the system. ey are the ones who will spread the word of a particular surgery center. Physician-owned surgery centers also recruit different special- ists or particular specialists depending on the multispecialities or few specialities surgeries. Q: What does it take for ASCs to be successful in the Western market? Ms. LaBouyer: In order to be successful, ASCs need to look ahead. Healthcare is constantly changing and evolving. Patient needs are also evolving. ASCs across the region are expanding current service lines and adding new capabilities. Due to advances in pain management and surgical technology, total joint replacements and spine surgery con- tinue to be a huge area of growth and opportunity. By 2029, total joint outpatient volumes will outpace inpatient volume. So ASCs need to prepare for this by implementing total joint programs, dedicating op- erations teams and clinicians who specialize in this, and working with vendors, facility partners and physician groups to be ready to transi- tion more of these cases into the ASC setting. Additionally, physician specialists need to nurture their connections to value-oriented primary care providers and payers as a way to care for more patients Dr. Gantwerker: In the Western market, ASCs can capitalize on patient demand. By providing an outstanding patient experience, good nursing care and excellent surgeons, patients will opt for a cleaner, better-run outpatient environment for their care. Perhaps the out-of- network model, then, is not dead aer all. Rushing to sign up with all the insurers and racing to the very bottom price-point wise — one or all of these will suffer. It is possible — some competent and savvy group can cut out the insurers altogether and market themselves directly to the patients. But contracting and competing for the lowest price to the point of implosion is not a viable business model. n

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