7 Points on Improving ASC Physician Productivity Through Data Analysis

Ajay Chokshi is a vice president at Surgical Care Affiliates and leads the development of the ECO (Every Case Optimized) System profitability platform. He discusses how his company uses data analysis to help physicians improve clinical, operational and financial performance.

1. Clinical quality first.
"Clinical quality is always SCA's first priority, and the ECO System is designed to help our physicians deliver the best clinical care in the most efficient manner possible," says Mr. Chokshi. "Improving physician productivity starts with data and processes that are designed around achieving the highest quality of patient care." For example, the ECO System is designed to monitor the clinical quality of every case performed by tracking hospital transfer rates, wrong site surgeries, burns, falls and case-specific complications, such as post-OR bleeding. The system also applies a data set designed to identify root causes of any variances or adverse events.

2. Capturing the right data.
Mr. Chokshi says the ECO System was developed with the goal of creating a "mini income statement" at the patient level. "Improving physician productivity starts with detailed revenue and cost data and real-time analytics that quickly identify improvement opportunities," he says. He says surgery centers need to capture all direct supply and labor costs specific to a patient and determine the profitability of every case performed to maximize productivity.

3. The common denominator — profit per minute.
The next step is to provide an "apples-to-apples" comparison of physician performance within the ASC, according to Mr. Chokshi. "The metric that we use is profit per minute to adjust for any differences in payment, supply cost, and the duration of the case," he says. "[We designed] ECO System [to] capture the time the case takes from 'wheels-in to cut, cut to close, and close to wheels-out.'"

For example, orthopedic cases tend to reimburse significantly more than ENT cases, so profitability per case may be higher for an orthopedic case; however, ENT cases are very short in duration and tend to be the most profitable on per minute calculation (see Table 1).

4. "Eyes wide open" around cost.
"More often than not, physicians are not aware of the cost details of specific supplies and lower cost alternatives," says Mr. Chokshi. "For example, we have a hand surgeon in the Chicago-area that was using a specific set of supplies to do an endoscopic carpal tunnel that cost approximately $500. After he reviewed the profitability analysis for his cases, he took the initiative to find an alternative that costs $14!"

The same holds true for labor costs and how much money is wasted when a case is delayed. "When we're talking about labor per minute with a couple of RNs and a scrub tech, that adds up very quickly," he says. "Some surgeons will come in late and not understand that labor costs can incur upwards of $15 per minute (when including anesthesia time)." With this example, a surgeon who is 15 minutes late every day can cost the surgery center $225 a day — an expense that adds up significantly over a short period of time. He says data can often serve as a "wake-up call" for physicians who don't realize how supply and labor costs impact profitability.

5. Real-time data helps physicians make meaningful change. Surgery center physicians will benefit tremendously if the center can provide cost data in real time, Mr. Chokshi says. While SCA generally looks at data on a weekly or monthly basis, physicians and company staff members can access data on a real-time basis when they're trying to improve compliance. A physician may not remember a case that happened last quarter, but he or she is sure to remember yesterday's case and might be able to understand why costs were so high if the data is presented immediately.

6. Sharing best practices.
When speaking to physicians about improving productivity, he says SCA starts by discussing benchmarking data and best practices within the "SCA family" of about 150 centers across the country. Every center is slightly different, and comparing physicians from one center to physicians from another center can identify discrepancies between individual surgeons, staff members, specialties, and surgical techniques.

7. Changes in healthcare demand data collection from ASCs. Data collection isn't just important for improving center profitability, Mr. Chokshi says. The healthcare industry is changing, and as payment structures undergo reform, insurance companies and governmental payors are looking to reward low-cost, high-quality providers. Surgery centers have long been hailed as such facilities, but without meaningful cost data, anecdotal evidence is relatively useless.

"This data means we can prove that we're low-cost and high-quality," Mr. Chokshi says. "We're not just talking about it — we can prove it." He says surgeons are very interested in proving they can provide high quality at a low cost because the data attracts patients, assists in negotiating more profitable reimbursement contracts, and benefits surgery centers on a legislative level.

Learn more about Surgical Care Affiliates.

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