The more than 35 leaders featured in this article are speaking at Becker’s 30th Annual Meeting: The Business and Operations of ASCs, set for Oct. 30 to Nov. 2 at the Hyatt Regency in Chicago.
If you would like to join the event as a speaker, please contact Francesca Mathewes at fmathewes@beckershealthcare.com
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.
Question: What technology do you think will add the most value to ASCs in the next 5 years?
Tami Wacker. Director of Marketing, Outreach and Communications at Advanced Heart an dVascular Center of New Mexico (Carlsbad): Our newly established, small rural cardiology ASC relies significantly on technology for daily operations, a reliance that is expected to continue. Given our rural location, automation technology is essential due to the limited availability of personnel. We utilize automated phone calls to remind patients of upcoming appointments and follow-up post-procedure instructions. Artificial intelligence is increasingly vital, particularly in the billing and coding areas. Whereas spreadsheets and algorithms were previously sufficient for identifying coding issues, in the next five years, we are looking to AI systems not only to detect but also to correct these issues, thereby conserving valuable staff time. Additionally, our ASC is considering the implementation of a radio frequency ID system to improve inventory processing and monitor patient movement within the facility. This advancement will enable us to enhance value-based care and provide superior, patient-centered service.
Neil Mangus. Senior Director of Business Development at Orlando (Fla.) Health: Advancements in Artificial intelligence capabilities are increasing at lightning speed and, I believe, have the greatest potential for impacting ASCs in the coming years. If you think about it, robotics are to the surgeon’s hands as AI is to the surgeon’s brain. Robotics brought enhanced precision and control for surgeons with less invasiveness for patients. AI has the opportunity to support surgeons even more with enhanced detection of positive surgical margins, procedural automations, training and education and more. Aside from the enhancements to care, AI is proving much more accessible and cheaper than robotics, so I envision the adoption of AI will happen much faster than what we’ve seen for robotics. There is no doubt in my mind that AI will have a tremendous positive impact for ASCs from here on out.
Justin Marburger. Director of Surgical Services of Plastic and Cosmetic Surgery Center of South Texas (San Antonio): The technology that I believe will add the most value to ASCs in the next five years is going to be artificial intelligence. Although I have heard countless discussions on this subject and still hold some serious reservations, the potential is undeniable. It is common knowledge that many aspects of the ASC can and should become automated such as the supply chains, scheduling and billing. Let us examine four other opportunities that may or may not have been thought about thus far.
Augmented reality versus virtual reality: Potential to change surgical training and planning wherein the surgeon can practice on virtual representations or view 3D imaging
Telemedicine and remote monitoring: Platforms combined with wearable devices to monitor patients in real time post op will reduce readmission and improve recovery times as well as streamlining pre and post op assessments.
3D Printing: ASCs can benefit from patient specific implants or anatomical models for presurgical planning.
Patient experience technology: Mobile apps aimed at improving the patient’s overall experience such as pre-op education, post-op care reminders/phone calls and appointment scheduling will also enhance patient engagement and satisfaction allowing them to feel involved and an important voice in their care.
Gina Taylor, RN. Quality and Accreditation Program Manager of Harris Health (Houston): I recognize that many people may see AI as the technology that will bring the most value to ASCs. However, I believe that the continued integration of electronic health records in the ASC setting is equally valuable. According to the Ambulatory Surgery Center Association, approximately 54.6% of ASCs reported using an EHR system.
I understand that cost can be a barrier for some ASCs, preventing them from implementing this technology. However, having an EHR in place allows for quicker access to patient information, improving patient care and helping to meet regulatory and accreditation requirements.
In my experience working at an ASC that relied on paper documentation, I found that abstracting data was a manual process, which hindered both efficiency and accuracy. Currently, I support an ASC that utilizes an EHR system, which provides us with data-driven tools to enhance patient safety and the quality of care.
Myra Ray, RN. Manager of Surgical Services of Franciscan Health Services (West Point, Neb.): With the ever-growing capability of AI technology, I believe the addition of AI modules to streamline the documentation of physicians and nurses, as well as elevating the accuracy of coding procedures will bring the most value to ASCs over the next five years.
Janet Carlson, RN. Executive Director of ASCs of Commonwealth Pain & Spine (Louisville, Ky.): The technology that I think will bring the most value to the ASC space in the very near future will be the implementation and utilization of electronic health record for ASC specific surgeries and procedures. Combined with electronic charting, inventory management will be integrated to assist ASC leaders with accurate “case-costing” to control medical supply spend and to align surgeon preferences. A well designed EHR will provide ASC specific as well as full enterprise level KPI style reports to assist with the lean and efficient operations of a well optimized ASC. Another helpful technology is the installation and use of automated medication dispensing cabinets designed for ASCs.
Fawn Esser Lipp. Executive Director of The Surgery Center (Franklin, Wis.): Adding a robot for total joints, if you already haven’t done that, may help attract more patients and physicians to your ASC. While it may be a costly investment, you will see your [return on investment]. Advertising to your patients that you use the latest technology is key. We were able to sign a placement agreement, so there were no upfront purchase costs, as long as we perform X number of cases per year. Adding any new technology can be a huge capital cost and can come with challenges, but if done right it is definitely value added. Patients are getting the same service they would in a hospital setting, and surgeons get to use the same technology.
We are looking to add AI in the next couple years to help with patient optimization. As higher acuity patients and more procedures move from hospital to outpatient, it’s key to ensure safety. There are programs being developed that help with algorithms for patient selection, etc.
Natalie Malitz. Operations at Ohio Valley Eye Institute (Evansville, Ind.): We’re just starting to use some of this new tech, so I’m excited to see how it will help us over the next five-plus years. Right now, our main focus is using technology and AI to improve our revenue cycle. Insurance denials and messy data entry have been a challenge, so we’re hoping tech will help with things like prior authorizations, coding and billing errors to reduce denials and speed up reimbursements.
We’ve also automated some patient communication, like intake and paperwork, which has helped lighten the load at the front desk. However, we still keep a personal touch, especially since many patients want a direct point of contact after surgery. We’re curious to explore remote monitoring post-op. For some procedures, like cataract surgery, post-op care can be more hands-off, and patients may prefer to monitor their recovery digitally, especially in the younger generation. Remote monitoring works best for minimally invasive surgeries with low complication risk, where instructions can be shared virtually. This gives patients more flexibility and allows them to manage recovery at home, without taking time off work. That said, it’s not the right fit for every patient or every procedure.
Brett Maxfield, CRNA. Director of Anesthesia and Surgical Services of Teton Valley HealthCare (Driggs, Idaho): There are lots of great new technologies in the horizon that apply directly to patient care, including new devices, new delivery methods and new imaging capabilities, but if I were to use a crystal ball, I would say that the technology that will probably have the largest immediate impact on the ASC setting over the next few years will be the increasing use of artificial intelligence. We are already seeing changes in the way we are scheduling, purchasing, advertising, creating policies and procedures, etc. I see that trend continuing to increase as people become more comfortable with using that technology and start implementing it into the everyday routine of the surgery center.
Maria Todd. Director of Business Development at Red Rocks Surgical Center (St. George, Utah): The next five years represent a transformative period for ASCs, with technologies that can help with price integrity and dynamic pricing, AI-assisted quality monitoring, and compliance-focused documentation tools paving the way for greater efficiency, improved patient outcomes, and competitive differentiation. By adopting these innovations and advocating for tools that address specific ASC needs, administrators can ensure their facilities remain at the forefront of outpatient surgical care.
Maan Fares, MD. Chair of Global Patient Services of Cleveland Clinic: As the ASC increasingly handles more complex procedures typically performed in hospital settings, there will be a growing role for the implementation of additional remote monitoring solutions with a central hub. These devices should maintain a live connection to central anesthesia and postoperative acute care units. This integration will help prevent cardiovascular complications during the immediate postoperative recovery phase and enhance patient throughput. Furthermore, I believe that AI screening tools will play a vital role in effectively triaging patients for the ASCs.
Thomas Parent, MD. Lake Oconee Orthopedics (Greensboro, Ga.): The move to electronic health records is inevitable and necessary to ensure continued compliance and ongoing monitoring. Additionally, anything to streamline processes in the day-to-day administrative duties that take time away from patient care will ultimately add the most value.
Sapna Thomas, MD. Medical Director of Gastroenterology of University Hospitals Cleveland Westlake Health Center: I think AI is going to make the most impact when it becomes affordable for ASCs to implement. From polyp detection and characterization to answering patient questions about prep, results and post-procedure phone calls. This will help make ASCs more efficient. However, we must ensure that the provider-patient interaction and relationship is not lost.
Manoj Mehta, MD. Medical Director of Endoscopy Center of the North Shore (Evanston, Ill.): It is a little bit of a long shot, given how entrenched the big device manufacturers are in her current healthcare system, but there is a possibility that disposable scopes will once again become a hot topic. The impetus for this is progressive miniaturization and camera technology, largely driven by the cell phone market. The concerns about infection also support this option. Don’t forget about the huge environmental impact of reprocessing endoscopic equipment, not to mention the manpower. Combine all these things, and there is a definite market for well constructed disposable or recyclable endoscopes. If this happens, it will be a game changer in efficiency for ASCs. Whether or not it will happen at all, really depends on how hard the big three will push back. Just remember, we had the same discussion at one point in history regarding electric cars and the big four auto makers, and look where we are today.
Omar Khokar, MD. Gastroenterologist of Illinois GastroHealth (Bloomington): Artificial intelligence, if deployed correctly, will add value. We are already using it for the detection of polyps during colonoscopy and it’s only a matter of time until we use it to detect pre-malignant conditions of the upper GI tract. From a referral funnel perspective, AI bots can and should be implemented to scour our referral queues and highlight those on our screening lists that may be higher risk for cancer and should be screened more expeditiously.
Truptesh Korthari, MD. Associate Professor of Medicine at the University of Rochester (N.Y.) Medical Center: The use of endoscopic ultrasound in the ASC setting in the next five years will be beneficial for patients but the question is, will it be beneficial to institutions or private practice based on reimbursement?
Benjamin Levy, MD. Gastroenterologist at University of Chicago Medicine: There are several innovative technologies that ASCs should invest in to help improve care:
No. 1, I recommend investing in the larger high definition LED endoscopy screens that help gastroenterologists see more easily. I have really enjoyed using a new Optik View LCD screen on wheels that makes endoscopy so much more fun because of the screen clarity. This huge flat screen with anti-reflective protective glass and LED (I have been using the Full HD 42 inch and love it) helps display sharp images from our high definition colonoscopes and EGD scopes with amazing clarity. The enormous screen on wheels improves turn-around efficiency and provides optimal ergonomics to prevent repetitive musculoskeletal injuries to the endoscopist such as neck and back strain. The larger screen also helps the tech and nurse apply gentle abdominal pressure during procedures by helping to watch the procedure more easily.
No. 2, ASCs could also purchase an AI-assisted endoscopy platform such as GI Genius to help gastroenterologists identify polyps more easily. A recent AI-assisted endoscopy study presented at the ACG 2024 Annual Scientific Meeting showed that the platform could slightly improve adenoma detection rates in patients with positive stool tests such as Cologuard (MT-sDNA) or fecal immunological testing. Additional research is needed to fully assess AI-assisted endoscopy platforms success at improving adenoma detection rates.
Rick Ngo, MD. General Surgeon of Texas Surgical Specialists (Sugar Land): Software (AI-driven or not) that will optimize materials management/supply chain/surgical preference cards for ASCs. It is imperative that ASCs maximize patient safety/clinical quality, increase patient/provider/staff satisfaction, and decrease cost, inefficiency and waste.
Stephen Lupe, MD. Director of Behavioral Medicine in the Department of Gastroenterology, Hepatology & Nutrition at Cleveland Clinic: The future of ambulatory surgery centers is on the brink of significant advancements. With surgery evolving, there is a clear trend towards more procedures being conducted in ambulatory settings. This shift is not only enhancing the safety of surgeries but also increasing the efficiency of care delivery. Artificial intelligence is set to play a pivotal role in this transformation, particularly in diagnostics, logistics, and patient management. By leveraging AI and machine learning, healthcare professionals can improve diagnostic accuracy, optimize treatment selection and streamline surgical processes. While AI will never replace the expertise of surgeons, it will undoubtedly enhance their productivity by handling tasks like suturing and incision-making under their guidance. Moreover, AI integration in procedures such as colonoscopies and endoscopies empowers clinicians to identify areas of concern swiftly and accurately, elevating the quality of care provided. The ability of AI to analyze patient data effectively enables the customization of treatment plans based on individual characteristics and demographics, thereby improving patient outcomes. Furthermore, digital interventions supported by AI are revolutionizing post-operative care by aiding in behavior modification, dietary adjustments and overall healing processes. These programs not only recommend healing-focused diets but also address barriers to adherence, complemented by cognitive behavioral therapy techniques. By incorporating strategies to activate the parasympathetic nervous system, patients are equipped with the tools to overcome obstacles and accelerate their recovery journey.
Harel Deutsch, MD. Co-Director of Rush Spine Center (Chicago): We are currently using navigation for spine surgery. Some ASCs have navigation currently. I believe that navigation will be ubiquitous and, in conjunction with AI and robotics, will be essential for spine surgery in the future in the ASC setting.
Anthony Tortolani, MD. Professor Emeritus of Clinical Cardiothoracic Surgery at Weill Cornell (N.Y.) Medical College: Artificial intelligence assistance in subcellular research, notably in radiology and pathology, is leading to earlier diagnosis in cancer and arteriosclerotic diseases thus allowing for safe and effective invasive interventions to proceed in ASCs. Additional AI can assist in the integration of ASCs with hospital systems and physician organizations through its ability to accumulate data and conclusions that can affect the utilization of limited resources, nurses and anesthesiologists, supply chain requirements, the use of hospital beds and costly advanced equipment.
The confluence of massive data acquisition and interpretation accumulated by AI requires appropriate guardrails established by integrated leadership of researchers, clinicians and administrators and is now leading to rapid application affecting financial concerns, professional satisfaction and most importantly improving care and outcomes by utilizing earlier, less invasive, and more effective interventions.
Earl Kilbride, MD. Orthopedic Surgeon of Austin (Texas) Orthopedic Institute: The growth of ASCs over the next five years will be tremendous. Orthopedically speaking, adding technology to current surgical techniques will be in the forefront. When it comes to total joint replacements, the use of robotics, computer assisted techniques and AI to determine outcomes will add value. A second technological advance will be the neuromodulation space. The implants will get smaller and the surgical techniques will get more efficient.
George Cybulski, MD. Clinical AI Leader of Humboldt Park Health (Chicago): No surprise that artificial intelligence platforms will become more and more utilized in ASC operations. The opportunity for AI lies with the ability to link together the many separate functions that can be better connected to enhance safety, quality, efficiency, outcomes and reimbursement for ASC procedures. Connecting pre-authorization, implant requests, scheduling, consent for surgery, billing and follow-up will be the difference maker for success as more spine and total joint procedures are performed in ASC settings.
Sean Gipson. CEO and Division President of ASCs for Remedy Surgery Center (Hurst, Texas): We live in a world that is racing to constantly improve efficiency, how can we do it better and quicker, and value, how can we improve a process spending less for the overall process at the same or better outcome. Robotic-assisted surgery is popular in larger hospital systems, however, the reduction of capital pricing on the robots is making robotic surgery accessible in today’s outpatient surgery centers. The drivers for robotic surgery are manifold. Accurate precision, the minimally invasive nature and ability to reduce recovery times. Developing technology is making substantial advancements in more cost effective and smaller scale robotic systems that are expected to emerge, making the systems more accessible to the ASC market.
The win in this case is reduced complication rates, faster recovery and enhanced surgical precision.
The common buzz word around almost any business today is AI. AI is being used throughout the healthcare field as well; to include ambulatory surgery centers. ASCs are finding that AI can be used to assist with decision-making, predictive analytics and workflow optimization. Machine learning algorithms can analyze patient data, predict surgical outcomes, as well as identify high-risk patients. These factors all lend to potentially improving clinical outcomes and reducing readmission rates and/or post-surgical emergency room visits all in a fraction of time that it takes our surgical teams. The win in this scenario is improved diagnostic accuracy, personalized treatment plans and reduced errors.
Amanda Ryan, DO. Interventional Cardiologist of Advanced Heart and Vascular Center of New Mexico (Carlsbad): The most appropriate and efficient way to incorporate AI into healthcare in our ASCs is certainly at the forefront of debate and technology advancement in the foreseeable future. 3D imaging, robotics and virtual reality simulators are rapidly progressing and will provide a wealth of opportunities to improve ASCs care delivery. The challenges include balancing cost, efficiency, safety, and cybersecurity while integrating these technologies.
Tara Good-Young. CEO of PDI Surgery Center (Windsor, Calif.): Technology that holds promise for adding both patient and provider value in ASCs over the next five years is the expansion of procedures being completed with minimally invasive techniques due to invested innovations continuing to evolve robotics. Additionally, advanced data gathering and analytics utilizing refined AIwill give facilities and providers more granular, meaningful insight from operational and functional data, faster. Enhanced speed and capabilities to scrape, sort, categorize, and report data enables report production and review to happen closer to “real-time” reducing the lag time between discovery and response to identified opportunities or hazards. Coupled with continued advancement in the internet of things, this reporting can integrate equipment and inventory management for efficiency, as well as expand into monitoring and responding to environmental conditions in operating rooms, optimizing surgical conditions, further improving SSI reduction and prevention.
Alan Wagner, MD. Ophthalmologist of Wagner Kapoor Institute (Virginia Beach, Va.): AI-assisted scheduling with associated supply chain and staffing management refinement!
Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group: Unfortunately, many ASCs today don’t have electronic health records, that would be a huge first step in the right direction.
Past that, robotic-assisted surgical systems and surgical navigation will become a requirement for large MSK/orthopaedic-focused ASCs as many younger physicians expect to have this technology. Historically, this technology has been cost prohibitive but systems are becoming more affordable and more ASC friendly robotic systems are emerging. I also think we will see many ASCs adopt AI-driven tools that help automate and enhance the revenue cycle. Payers continue to apply scrutiny to ASCs and bringing in AI technology to help automate and supplement our revenue cycle teams will be a necessity.
Lastly, as more ASCs adopt EHRs and other technologies there becomes a greater opportunity to integrate supply chain management platforms. This technology will be critical in the future to ensure case costing, supply optimization, and implant charging happens seamlessly. Investing in some or all of these technologies not only increases patient outcomes but also, enhances efficiency and helps with financial stability in the evolving ASC landscape.
Vijay Sudheedra, MD. President of Narragansett Bay Anesthesia (Providence, R.I.):
1. Artificial intelligence: Al is anticipated to revolutionize ASC operations by optimizing preoperative assessments, patient selection, and postoperative monitoring. It can enhance decision-making, resource allocation, and surgical outcomes through predictive analytics.
2. Integrated EHR: Integrated EHR systems will improve communication and care coordination among healthcare providers, ensuring seamless care transitions. Advanced EHR functionalities, such as predictive analytics and decision support tools, will further enhance patient safety and operational efficiency.
3. Cloud-based IT solutions: Cloud computing offers scalability, cost-effectiveness, and secure access to patient information. It enables real-time updates, collaboration among staff and improved data management. These solutions are critical for enhancing operational efficiency and compliance with data security regulations.
4. Minimally invasive and robotics application: Advances in minimally invasive techniques supported by technology like navigation systems will reduce recovery times and allow ASCs to handle more complex procedures traditionally performed in hospitals
5. Patient Engagement Platforms: Personalized Care Plans. AI can analyze individual patient data to create tailored treatment and recovery plans, improving outcomes and patient satisfaction.
AI’s ability to continuously learn and improve from data inputs positions it as a technology that can drive ongoing enhancements in clinical and operational realms.
Les Jebson. Regional Executive of ASC Operations for Prisma Health (Greenville, S.C.): In the next five years, I think artificial intelligence will have a significant impact on ASCs, enhancing both operational efficiency and patient care. This will occur primarily in the following areas:
1. Front-desk automation — phone call management, procedure scheduling, payer requirements will all be performed by digital workforce solutions.
2. Optimization of patient scheduling and case throughput — optimal times for procedures through forecasting from historical surgical data (incision to close, [post-anesthesia care u]nit recovery, etc.).
3. Enhancing clinical decision support — real time intraoperative information sharing to the surgical care team regarding relevant patient medical history, test results and supplies.
4. Robotics, imaging, and AI will work in unison with the surgeon to through analyses of preoperative scans, 3D modeling and minimally invasive pathways for the surgeon.
Kathleen Hickman, RN. Administrator at Dutchess ASC (Poughkeepsie, N.Y.): I feel that data analytics in conjunction with artificial intelligence will streamline processes and produce comprehensive, meaningful data to assist with day-to-day operations, forecasting and trending. Also, the ability to move towards more and more minimally invasive surgical procedures through advanced medical technologies will present more opportunities for growth in the ambulatory surgical setting.
Brent Ashby. CEO and Administrator at Jankat Services (Pueblo, Colo.): I think that ASCs will start embracing EMR technology more readily in the next five years than they have in the past. Many ASCs continue to use paper charting, but the technology for digital records has improved dramatically and will help provide more efficiency and better access to data. Along those lines, if I were to predict the future I would say that AI is going to play a role in some fashion as well. What that will look like is hard to predict, but that technology is evolving so rapidly that I believe it will work its way into the medical arena soon. We are already seeing AI programs being used for dictation and transcription, so there is likely more to come.
Dean Lehmkuhler. Administrator at Northside Gastroenterology Center (Indianapolis): I believe that robot technology for surgery will make the largest impact on ASC’s productivity resulting in a great value improvement for ambulatory surgery centers.
Bruce Feldman. Administrator of Eastern Orange Ambulatory Surgery Center (Cornwall, N.Y.): The technology that I think will add the most value to ASCs in the next five years is that which is driven by artificial intelligence. AI is going to allow for more definitive decision making in identifying specific areas for surgical accuracy leading to the ability to do higher level acuity and complex cases in the ASC setting. It is going to have a huge impact on enhancing surgical technique leading to better outcomes and improved quality of care. AI will also enhance the ability to generate 3D printing of implants for joint replacement and other similar devices which will lower the cost per case for doing these procedures in the ASC setting.
Greg DeConciliis, PA-C. Administrator of Boston Outpatient Surgical Suites. As we continue to see a rise in expenses, in particular staffing, supply and implant costs, it will be increasingly important to cut costs. The primary reason is to communicate to physicians and staff any available opportunities for cost savings on particular procedures. In addition, technologies that enhance efficiency and throughput are going to be key for success. Improving patients’ journeys throughout the facility impacts the bottom line, as well as patient satisfaction. Finally, compliance will always be king, and ensuring that we have software to enhance compliance, and streamline our operations surrounding compliance, are critical in balancing a healthy ASC and a healthy life.
