Becker's Spine Review

9 THOUGHT LEADERSHIP part of the consolidation discussed above. Nevertheless, proposed changes in restricted covenants, frustration with the hospital employment model and increasing desire for physician autonomy could all play a role in decelerating or reversing this long-term trend. is is an issue which deserves monitoring in the strategic planning of physician-led practices and organizations. James Wylie, MD. Associate Medical Director for Hip and Knee Preservation at Intermountain Healthcare (Salt Lake City): 1. e biggest trend I am looking at in healthcare is the transition from fee-for-service based payment to value based care. Given the cost of healthcare in the U.S. there needs to be a fundamental change in how it is financed. Rather than paying for care when people are sick, it is much more financially viable for the system to value preventive care that keeps people healthy. e problem is that the majority of our healthcare landscape is built on a fee- for-service model. is will require fundamental changes in the finances of our healthcare system to divert resources to preventive care and payment based on giving high-quality care at a low cost. It also requires integrated systems that control the payer, the infrastructure/hospital/ASC and the physician acting as a team to provide high-quality care at low cost rather than maximize the profit for each part of the system in its own silo. n Does ChatGPT have a future in spine? 3 surgeons weigh in By Carly Behm C hatGPT has already been used by some health systems to ease clinical burdens. However, not all spine surgeons are keen to utilize the artificial intelligence software in their own practice. Editor's note: Responses were lightly edited for clarity and length. Question: To what extent do you see AI tools like ChatGPT being used at your practice for documentation or billing? Harel Deutsch, MD. Midwest Orthopaedics at Rush (Chicago): I've heard of doctors using ChatGPT to write appeal letters for medical procedure denials with literature references. I've heard of other services that "listen" to visits and provide documentation of the medical visit. Ultimately, I think ChatGPT artificial intelligence-type tools will be mostly used by insurance companies to evaluate billing and approve surgeries and procedures rather than using nurses or doctors to review cases. Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (Livonia, Mich.): ChatGPT is an artificial intelligence program that has the ability to identify, interpret and analyze patterns and trends in complex clinical data sets and can be used to predict patient outcomes. In regards to documentation and billing, the use of artificial intelligence should be cautioned. Artificial intelligence programs like ChatGPT mirror intuitive human conversation but cannot replace the duty and diligence delivered by a professional healthcare provider who is dedicated to their documentation and accurate billing. It is projected that the algorithms can help fill in gaps with patients to answer questions and translate medical discussion for better patient comprehension. I do foresee many repetitive medical tasks such as pre-authorizing insurance, follow-up on unpaid bills, and maintaining medical records will be supported by ChatGPT-type automated software systems. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): For the most part, our billing and even coding steps entail time-tested templates and consistent repetition. Applying key words and formulating entire pathways are certainly present, relied upon and usable. Reinforced learning in spinal surgery is serviceable especially in a larger, enduring spinal practice. The many variables of complex spinal work make up the intuitive, artistic portion of this equation and require much more focus in surgery and description to arrive at acceptable outcomes. Thought conclusion through a repetition platform could also assist in the future. The expectant result of technology and its wanton dominance is again reason for pause. n What the shift to outpatient care means for the orthopedic industry By Riz Hatton E ight orthopedic surgeons connected with Becker's to discuss what the shi to outpatient care means for the orthopedic industry. Editor's note: Responses have been lightly edited for length and clarity. James Abbott, MD. Orthopedic Surgeon at Best Surgery & erapies (Cincinnati): It means providing more complex surgeries like total joint replacements and spine fusions with an outpatient model that can still leave the patient feeling safe and supported in their recovery process. To better accomplish this, we need innovative ways to manage patients with virtual coaching and monitoring systems that allow patients to have questions answered quickly and also develop safety net protocols for post-op patients to avoid issues turning into unnecessary emergency department visits. is will allow patients to shop around for the best experience, technique, and technology advancements when selecting a center for surgery and then control their

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