Issue link: https://beckershealthcare.uberflip.com/i/936525
15 Dr. Richard Chua: I believe that the integration of image guidance and robotics will be the next big thing in spine surgery over the next five to 10 years. e ability to improve accuracy of instrumentation placement, reduce X-ray exposure to the patient, surgeon and staff, as well as the ability to more efficiently correct deformities will result as robotics, engi- neering and surgeon adoption become more feasible. Dr. Michael Musacchio: Over the next five years, we will see a full conversion to 3-D navigation in spine surgery, further simplifying procedures, and that will mostly benefit patients in need of correcting deformities. Meanwhile, 3-D printing and custom implants are providing a better fit for patients, resulting in potential cost reductions. Dr. James Sanfilippo: Partnering with healthcare systems will allow surgeons to open more access for patients, especially in systems that are self-insured. rough centers of excellence, co-management agreements, or through clinically integrated networks, surgeons and systems can come together to also lower costs of care by reducing variations in preop- erative, perioperative and postoperative protocols, reducing system waste and using data analytics to drive best practices. Partnering with vendors can also drive down the cost of care, but this requires both the surgeons and the system to be tightly aligned. Dr. A. Nick Shamie: Stem cell therapy is still very experimental in the treatment of spinal conditions, but we look forward to regenerative med- icine having an impact in the spine field in the way we treat our patients … and even perhaps being able to cure certain conditions. Dr. Kern Singh: EHR will continue to take a toll on small or individ- ual practices. e cost to keep these systems up to date, the numerous government mandated requirements and the loss in clinical productivity will continue to challenge small orthopedic and neurosurgical groups, forcing them into further consolidation with large health consortiums. Dr. Vladimir Sinkov: Innovative and entrepreneurial physicians who value their independence will continue to thrive and adapt to the ev- er-changing landscape of medicine in the U.S. If things continue as they are, however, and if the government passes more laws that are aimed at destroying private practices, such as the ACA, fewer and fewer physicians are going to be willing to keep up the fight. William Taylor, MD. Director of Spine Surgery at UC San Diego Health System: Pressures from payers will continue to stymie delivery of innovative care; this occurs through non-approvals and roadblocks to new procedures. Many institutions consider only costs that are par- titioned into unchangeable sectors (operating room, hospital, instru- mentation). ey fail to see savings in other budgets and don't consider improved patient outcomes in decision-making. Dr. omas Schuler: Data collection will lead big data and payers and industry to standardize payments and availability of devices. e problem comes from a negative impact on customized care. is data collection will lump care and not individualize it. In cancer therapies, the shi is toward customized treatment for specific genetic markers. Spine will go the opposite direction, with current attempts at data collection and payers' current desire to decrease utilization of essential treatments. Dr. Christian Zimmerman: ere will be a renewed interest in post- operative management and extramural services, such as home health and physical therapy, to assist patient recovery. Surgical approval rates (locally) have plateaued due to increased awareness of presurgical accomplishments or failure to significantly improve with conservative measures. Most large health systems have justifiably cut costs of implant- able instrumentation to levels equitable to all companies with standing contractual agreements. Negotiations centered on further cuts may come with prospective agreements. Dr. John Finkenberg: e best opportunity for spine surgeons should be to get more involved with their societies. Your career will pass by before you notice, and the accumulated national/international knowledge our colleagues have must be shared for the ultimate benefit of our patients. n DSM is the global leader in biomedical solutions, trusted by our partners to shape the future of biomedical materials and regenerative medical devices. Our innovative spine solutions are focused on enhancing patient outcomes.