Becker's ASC Review

24 Executive Briefing: Executive Briefing: DVT Prevention in ASCs There are higher rates of VTE are seen among these groups: • Adults 80 years of age or older • Male • Black • Medicare insurance as the primary payer • No previous operating room procedures of any kind • Urban hospitals In addition to DVT risk assessment and compression, providers are also charged with educating patients about DVT risks and prevention. "With the move of total joints into surgery centers, they will have to develop DVT prevention protocol post-discharge," says Mr. Park- er. "We are seeing just about every center interested in total joints and they are looking for devices to send home with patients. The mobile devices we have can go home with patients and combined with aspirin, many physicians are beginning to move away from an anticoagulant regimen post-discharge." Making compression mobile In addition to refining the technology to prevent DVT, providers are concerned with the continuum of care. They want to move pa- tients out of the hospital with excellent homecare that will prevent post-surgical complications and readmissions. "All the manufacturers and industry personnel recognize the next thing we need to look at is compression devices in the home," says Mr. Parker. "DVTs occur at home after surgery in most cas- es. To date, the standard of care for post-discharge DVT Preven- tion has been drugs — anticoagulants. But orthopedists don't like anticoagulants namely for their risk of bleeding complications." In 2012, compression became an accepted guideline by Asso- ciation of periOperative Registered Nurses and ACCP standards, and now Compression Devices alone are an accepted standard for preventing DVT. As a result, orthopedic surgeons are now pre- scribing at-home compression devices to prevent DVT and don't have to worry about the risk of bleeding that is associated with anticoagulants. Compression devices are also less expensive than the anticoagulant regimen, however; it is most important to use a Mobile Compression Device post-discharge. Patients cannot take home the hospital-designed devices; they are bulky and don't allow patient mobility and ultimately they are not patient compliant, versus their self-contained, 1/2 pound, Mobile Com- pression Device comparisons, like the DVTLite/Venowave carried by Midwest Medical. The DVTlite Venowave Compression Device is a tubeless, cord- less, battery-operated device. It feels like the patient is being mas- saged when they wear it and they often feel the benefit. The de- vice's peristaltic wave plate continuously moves blood up the calf, which is very different from the pneumatic pumps that squeeze the calf once per minute. "It's easy for the surgeon to see the difference," says Mr. Parker. "Because there is continuous blood movement, there aren't any opportunities for pooling or stasis. If we don't allow the blood to stop moving, there isn't a platform for clots." Midwest Medical's compression device has undergone a flag- ship study and the results were good enough for Blue Cross Blue Shield and Healthnet to create medical policy around it. There is good national insurance coverage for the DVTLite/Venowave device post-discharge and ASCs are now looking at this protocol especially for their discharge total joint cases and also high-risk DVT patients. n "With the move of total joints into surgery centers, they will have to develop DVT prevention protocol post-discharge. We are seeing just about every center interested in total joints and they are looking for devices to send home with patients." — Richard Parker, Midwest Medical CEO Midwest Medical Enterprises is a medical device company headquartered in Atlanta, GA that specializes in offering mechanical prophy- laxis for Deep Vein Thrombosis (DVT) prevention. Our recent efforts have been centered on offsetting the devastatingly grim statistics of DVT and Pulmonary Embolism (PE) in the US through effective homecare devices. We places a great emphasis in not only providing innovative healthcare solutions patients and providers, but also educating and raising awareness to the danger of DVT and PE to save lives. Midwest Medical Enterprises is a leading provider of DVT Prevention Programs nationwide. We focus on creating a strong, long-lasting relationship with each of our clients – facility, physician or patient – that is main- tained throughout all phases of our DVT prevention programs.

• Cover