Is a 20% savings in operational costs hiding in plain sight at your ASC?

Healthcare leaders today are tasked with a difficult to achieve goal — improving efficiency. This mission at its core is simple, but identifying areas for improvement can be burdensome and many practices are unaware of the best next steps.

However, ASCs aren't alone.

IBSS created Watershed Process Management Automation, which automates many processes in a surgery center, from communications to inventory and asset management. Watershed fulfills a variety of functions including:

•    Keeping track of where patients, staff and resources are located, and making sure resources are available when needed
•    Dynamically updating schedules throughout the day
•    Relaying information about what tasks should be completed at what time
•    Automating communications to reduce distractions and miscommunications

"Modern process management methodologies allow organizations to make use of latent capacity that they would otherwise not access by anticipating operational requirements in the moment, automating proactive communications, eliminating a thousand delays and adapting schedules to variability and unanticipated events throughout the day," says Stuart Massey, president and COO of IBSS, Inc., an information technology and consulting services firm.

Many healthcare leaders are eyeing surgery centers as a means to improve efficiency, decrease costs and increase patient satisfaction, which is evident by the influx of new partnerships taking hold in the industry. ASCs are partnering with large health systems and insurance companies to succeed in the value-based healthcare landscape and success for practices of all sizes is heavily contingent on their ability to operate efficiently.
 
Why has healthcare lagged behind other industries in automation?
Healthcare organizations have been slow to adopt automation management systems and other solutions to better manage daily operations due to lack of competition, Mr. Massey notes.

"Traditional reimbursement models have by and large allowed provider organizations to charge incrementally for everything they do," says Mr. Massey. "This has led to a focus on things other than cost — on their markets, novel care techniques, community perceptions and attracting the best talent. Focusing on things that support volume in such an environment makes a lot of sense, particularly when the costs can largely be passed on. Would a broad focus on controlling operational costs improve the bottom line? Absolutely. Cost reductions go straight to the bottom line."

ASC owners and operators simply cannot overlook costs, especially in this moment in healthcare where providers are challenged to do more with less. The healthcare industry is moving toward a pay-for-performance payment model that rewards quality care and removing inefficiencies in a practice's operations. Smoother operations lead to more satisfied stakeholders across the care continuum, an essential element in healthcare today.

This paper will dive into the intricacies of process management methodologies and how ASCs can improve efficiency through automation.

The major gains process management methodologies provide
Technology is a core element of any functioning business today; a practice that fails to integrate technology successfully will find it exceedingly difficult to stay competitive. The plethora of technological platforms available on the market provides physicians a wealth of data to drive clinical decision-making. However, sifting through the massive amounts of data to decipher what is valuable to a patient's individualized plan may be challenging for providers, and may deter them for wanting to implement new systems. Mr. Massey explains process management methodologies give providers the appropriate data at the right time to make better informed clinical decisions.

"We [IBSS] don't just care about what information a clinician needs – we care about when they need it, about how they get access to it and how they even know it exists. Better integrated data means nothing if we expect people to go on a fishing expedition on the off chance there might be some information available to them useful to the task at hand," he explains. "Process management techniques are about looking first at what people are doing, anticipating what they will need and making sure they have just what they need, when they need it."

Improving communication and satisfaction
Ineffective communication between team members can lose practices money and compromise patient safety. CRICO Strategies researchers analyzed 7,149 communication cases between two or more healthcare providers and found communication issues in 57 percent of those cases. The average indemnity for cases involving provider-patient miscommunication was $381,000. Automating processes can help truncate these numbers significantly.  

Detroit neurosurgeon and IBSS Medical Advisor Mark Rosenblum, MD, has served on the provider and administrative side of healthcare for nearly 45 years and sees how Watershed can eliminate these issues. One Mid-Atlantic ASC he visited reported a 25 percent improvement in resource utilization after implementing Watershed process automation.

"It was amazingly quiet and comfortable during turnover times when usually there is chaos," he says. "Watershed is non-disruptive and saves practices' both cost and time. That was pretty remarkable to me. As a consequence of a much more efficient setting which respected their time, a happier staff and a larger case volume, surgeon satisfaction improved more than I've ever seen. With providers, satisfaction translates to engagement.  Engagement means providers will go out of their way to bring more cases to the ASC.  In addition, with the availability of real-time cost analysis and aligned incentives, surgeons will usually assist in case standardization with supply chain offerings and thus dramatically enhance the ASC's bottom line."

Increasing OR case throughput by 25%: An ASC's experience with Watershed
OrthoVirginia, the largest group of orthopedic and sports medicine specialists in the state, had a major communication issue a few years ago. The group's Richmond-based ASC, OrthoVirginia Operatory, was unable to readily share patient information across OrthoVirginia's locations.

"We implemented an EHR with the same company other OrthoVirginia practices used. But, the EHRs didn't communicate," says Ruth Vaiden, RN, the ASC's administrative director of perioperative services and the quality/risk management manager. "It was like we were reinventing the wheel every time a patient came from another practice to the ASC. We started looking for how we could make things smoother for the patient."

In 2014, the surgery center started working with IBSS to automate many of its processes. When the ASC first employed Watershed, its primary goal was to better utilize its ORs. The ASC ultimately increased OR cases per hour by 25 percent using Watershed's automation capabilities.

Staff members also had access to reports detailing information such as per-case cost analysis as well as resource utilization and process metrics that outlined major cost savings opportunities.

"With the reports, I can see how the week is going in terms of the number of cases we have done and the types of cases. I can go into the system and see if we will meet or be over our benchmark," Ms. Vaiden says.

Watershed has improved the surgery center's operations, thereby leading to more satisfied surgeons and staff members. The automation capabilities also play a crucial role in improving the patient experience and increasing patient and caregiver satisfaction through its dashboard notifying families about a patient's progress throughout their surgery. The dashboard will turn green when a patient enters the OR and has black dots showing a patient's status for colorblind family members. The dashboard will give updates continually, indicating when a procedure starts or when a patient is transferred to the recovery room. After implementing Watershed, the ASC's patient satisfaction scores increased significantly, Ms. Vaiden notes.

The untapped potential in process management methodologies
Satisfaction among healthcare's many stakeholders is crucial as a disengaged physician could translate to a poor patient satisfaction rate, thereby potentially detracting from a surgery center's bottom line. A 2017 study published in JAMA found physicians reporting burnout attributed their symptoms to increased clerical requirements and spending a large amount of time on EHR entry. The challenges to both implementing and successfully utilizing EHRs and other technological tools make many providers wary of other solutions.

"EHR implementations continue to consume much of the available IT resources of so many organizations, and that is a barrier to implementing process management and automation systems," Mr. Massey says. "It's not surprising that a long legacy of unpleasant experiences with Healthcare IT solutions leave a bad taste for many."

As detailed throughout this paper, process management methodologies can improve the healthcare experience for the patient and their care team through automating various tasks.

"Process management methodologies help provider organizations to reduce costs while providing more care, and to focus on quality by better managing complexity," says Mr. Massey. "Provider organizations that do this well, that pay attention to lessons long since learned elsewhere, will be well equipped to respond to the shift to value, and in control of their own destiny as they confront whatever the future may hold."

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