'It's all about scale': 3 ASC leaders discuss key advances in the outpatient setting

Three leaders in the ASC space shared insights into what innovations have improved efficiency in their practices.

Louis Levitt, MD, vice president and secretary at The Centers for Advanced Orthopedics in Bethesda, Md.; Daniel Hoeffel, MD, a St. Paul, Minn.-based orthopedic surgeon in private practice in St. Paul, Minn.; Michael Ast, MD, an orthopedic surgeon at Hospital for Special Surgery in New York City discussed advances in the ASC industry during an Oct. 24 keynote at the Becker's ASC Review 26th Annual Meeting in Chicago.

Dr. Ast said fluid management was highly effective in getting rid of the early hypotension and dizziness that patients experience postoperatively.

"It completely changes both the physiologic side but also the emotional and mental side of it," said Dr. Ast. "The ideas of no such thing as NPO, hydrating up until the time of surgery and making it very practical has really helped get rid of the early hypotension that we used to see with limited early mobilization."

For Dr. Hoeffel, it's all about scale. The implementation of digital care navigation — leveraging technology to manage the patient through the episode of care — has been instrumental in increasing efficiency in his practice, and also led to improved patient outcomes.

"For the patient, it becomes about these constant touch points and they feel the love. From a scale perspective it's about not having to deal with hundreds and hundreds of phone calls," Dr. Hoeffel said. "The call volume to my practice through my care coordinator went down 30 to 35 percent. You owe it to yourself to think about digital care navigation."

When Dr. Levitt began practicing in Baltimore over 34 years ago, there was no 23-hour stay approval for joint replacements in the outpatient setting. They used medications to solve blood clotting and postoperative pain issues and managed patient expectations.

"We trained our patients into believing that they in fact could do this because we believed they could do it. I think altering patients' expectations and a full staff on board to believe it can be done made this happen," Dr. Levitt said.


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