Mauro Cecchetti, administrator at Constitution Surgery Centers, Newington, Conn., surveyor for the Accreditation Association for Ambulatory Health Care and former administrator at Mid Manhattan Surgi Center in New York, discusses the challenges of adding new technologies to an ambulatory surgery center and ways to make the transition easier on the staff and physicians.
Question: What are some of new procedures and/or technologies that you have added or are planning to add at your eye center?
Mauro Cecchetti: The newest technology recently added at Mid Manhattan Surgi Center is the ORA system, by Wavetec, which provides intraoperative refractive information to the surgeons, allowing them to deliver the best possible vision for their cataract patients. It provides the physicians with a real-time view of the patients' true astigmatism and refractive correction allowing the surgeon to make finite adjustments to the selected implant.
It is very successful, because the center has seen great results with its applications. Now that this technology is established and working well, the center is looking to obtain a Femto second laser for the near future. This type of equipment is capable of simplifying cataract surgery even further. It reduces the potential for complications as a result of the cataract surgical procedure with less trauma introduced to the patient.
Q: What are the most challenging aspects of adding technologies? How can they be overcome?
Dr. Cecchetti: The most challenging aspect [of] the addition of new technology is operating room time and the challenge of balancing the schedule — to allow all the surgeons to utilize the technology without compromising the scheduled cases of the day.
With new technology comes a learning curve where physicians will need more time to adjust to the new additions of the procedure. Because of this learning curve, productivity slows down and will continue to remain slow until surgeons acclimate to the additional steps in the procedure adding more time to the surgical day. Once this learning curve is overcome, productivity will again rise with the benefit of added revenue.
Some physicians will accommodate quicker than others. However, there is nothing anyone can do about potentially avoiding the learning curve. When the ORA system was introduced, our OR time was reorganized to include a cushion in between surgical cases. This temporary adjustment helped reduce the impact on the afternoon surgeon if the morning surgeon ran over his/her time slot.
Q: What are some of the best strategies for getting the staff onboard with new technologies that might change their workflow?
Dr. Cecchetti: Aside from scheduling early staff meetings and keeping the staff informed about the future of the center, one great strategy for getting staff on board with new technology is to make them a part of the training process. Allowing the staff to learn the system and troubleshoot gives them a chance to contribute and make a difference in the outcome of the procedure and overall care of the patient.
Q: What are some points to consider before making the decision to add new technologies?
Dr. Cecchetti: The first thing to consider before entering into any contract is to review the demand from the physician staff and the amount of patients they predict will be eligible to receive the new technology.
The center [should] consider new technology only if enough surgeons show a strong interest and have the patient population to support the additional cost [required] to support the equipment.
Q: What are some of the most exciting new developments in ophthalmology currently?
Dr. Cecchetti: The ORA system is one of the most exciting new developments today. The system is simple to learn, and a well established surgeon can adjust his or her procedure quickly.
Physicians like the ORA system, because it [gets] immediate results with little or no patient contact. The center is looking to purchase a second ORA unit.
Q: How can physician investors ensure they'll realize a return on investment?
Dr. Cecchetti: At [Mid Manhattan Surgi Center], the board reviews all situations thoroughly. Any new developments are discussed amongst the board and voted upon. Nothing is decided hastily and every aspect is thought about, from usage to pricing to what changes may occur as a result of the new technology.
By making careful decisions regarding the addition of new technologies, physician investors can utilize a return on their investment.
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