Becker's ASC Review

13 ORTHOPEDICS An implementation hurdle in endoscopic spine By Carly Behm E ndoscopic spine surgery comes with some hurdles such as the learning curve. But a greater barrier facing spine surgeons wanting to add endoscopic technology is the implementation itself, Kai-Uwe Lewandrowski, MD, said. Dr. Lewandrowski discussed this challenge and how surgeons can tackle it in an upcoming episode of the "Becker's Spine and Orthopedic Podcast." Note: This is an edited excerpt. Question: Clinically speaking would you say endoscopic decompression is mature enough to scale? Dr. Kai-Uwe Lewandrowski: Absolutely. We spent the last 10 to 12 years developing clinical evidence on the application of the endoscopic minimally invasive decompression in an outpatient setting. We worked up the patient selection criteria, we published clinical protocols. Come to find out, thinking that was the most significant hurdle in terms of insurance authorization, but it actually wasn't performing the endoscopic surgery. We've done some survey work that revealed that the main hurdle is actually logistical and implementation. Q: Can you dive deeper into that? This idea that the barrier is implementation and what can surgeons do to address that? KL: We developed some content to help surgeons with the discussions locally in the surgery center. But what it comes down to is that the cost for the capital equipment is high. The endoscopes have high maintenance costs. They don't last that long. They last on average, 35 to 50 surgeries, then they're essentially broken. So, when you look at all the hidden costs, which include sterilization, reprocessing, cleaning, they sound like trivial issues, but for surgery centers, they can turn into real problems where they just don't have the staffing to process these scopes on time, so that this ASC can make money in a hospital setting. You may be competing with other service lines that are racking up costs. So, integrating the endoscopic technique platform is not as trivial, and we've learned that from multiple service studies that we've done nationally and internationally. n What orthopedic practices need to stay competitive By Cameron Cortigiano W ith patient expectations higher than ever, orthopedic practices are looking to the integration of robotics within joint replacement surgeries and offering an after-hours schedule as top priorities in meeting demand. This joint replacement surgeon and orthopedic MSO executive recently connected with Becker's to share these must-haves for orthopedic practices going forward to remain a top option for patients. Question: What is one service or capability you believe every orthopedic practice will need to offer to stay competitive? Jennifer Bido, MD. Hip and Knee Replacement Surgeon and Adult Reconstruction Specialist at Endeavor Health Orthopaedic & Spine Institute (Elmhurst, Ill.): As technology continues to advance, it is increasingly shaping how orthopedic care is delivered. One capability that will be essential for orthopedic practices is the ability to offer robotic-assisted surgery. Robotic technology has the potential to enhance surgical precision and promote more consistent outcomes. As patients become more comfortable with technology in their everyday lives, they also expect their care to reflect the most up-to-date, evidence-based approaches. Over time, having access to these advanced surgical tools will be an important part of providing high-quality orthopedic care. Judy Eustace. Senior Vice President, Strategy and Growth of United Musculoskeletal Partners (Atlanta): In today's world, regular business hours are not always convenient for patients. Patients are busy with their jobs and families, and therefore every orthopedic practice needs to offer a strong, reliable after-hours infrastructure that provides avenues to schedule on weeknights and weekends. At UMP, our practices' websites offer online scheduling 24/7 and referred patients receive texts with an online scheduling link so that patients can book an appointment whenever they have time, not just when our practices are open. Integrating an AI voicebot into our telephones further offers patients more options to reschedule and place prescription refills at any time of day. While all of these routes capture revenue and ensure that the practice stays competitive, they also offer flexibility and practicality to patients — a win-win for both patients and practices. n "A significant opportunity for future alignment would be for payers to partner directly with physicians in developing efficient, high-value sites of care," he said. "Such investment could fundamentally transform the payer-provider relationship and accelerate the transition toward truly value-driven healthcare delivery." In an industry where many value-based initiatives fail to achieve sustainability, the Rothman–IBX collaboration stands as a durable model. It demonstrates that when physicians and payers align around quality, efficiency and patient-centered care, meaningful and lasting improvements can be achieved. n

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