3 ways collaborations can help outpatient total joint programs achieve success

ASCs are constantly striving to improve patient satisfaction, while confronting inventory limitations and avoiding complications. Strategic collaborations can help ASCs overcome these obstacles in the outpatient setting.

In a June 5 webinar sponsored by Smith & Nephew and hosted by Becker's ASC Review, three experts on outpatient total joint replacement explained how industry collaborations can drive quality outcomes, savings and growth in the ASC space.

Here are three ways ASCs can leverage collaborations:

1. Effectively consolidate service lines. When the physicians behind Chicago-based OrthoIllinois began their outpatient joint replacement program, they encountered limitations in terms of sterilization, equipment preparation and instrumentation processing. OrthoIllinois wanted to consolidate service lines to improve operational flow, so the group solicited proposals from vendors.

The results were surprising, according to orthopedic surgeon Geoffrey S. Van Thiel, MD, of OrthoIllinois.

"Cost is a much more complex topic than the absolute price of an implant. It's very difficult to compare apples to apples or product offerings across companies," he said. "The deal structure was perhaps more important, or at least as important, as absolute pricing."

After finding few companies provided products across all service lines for ASCs, the group negotiated with large companies better suited to meet their equipment needs. In turn, these large firms partnered with smaller companies to offer a complete proposal.

OrthoIllinois ultimately selected Smith & Nephew for its strong proposal and understanding of the center's goal. With one Smith & Nephew representative managing all OrthoIllinois service lines, the center has increased case volume, streamlined inventory and improved revenue stream.

"We have one of the broadest and deepest product and technology portfolios uniquely positioned to help ASCs, whether it's joint replacement, robotics, sports medicine, trauma and extremities; even ear, nose and throat, and wound management. We can leverage all of these divisions as one company," said Josh Christensen, Smith & Nephew's vice president of ASC initiatives.

2. Capture the clinical value of robotics. For OrthoNeuro in New Albany, Ohio, the NAVIO◊ Robotic-assisted Surgical System was integral to facilitating outpatient arthroplasty cases in a competitive market, according Mark Gittins, DO, an orthopedic surgeon at the center.

The group felt Navio could improve outcomes and combat patient dissatisfaction. Using this system, physicians can place components where they should be, Dr. Gittins said. According to Dr. Gittins, the system enables precise cuts and allows surgeons to do multiple implants and cases with the same set of instruments.

"Our goal is to do eight to 10 total joints a day with [Navio]. We're able to move the [system] back and forth between the two rooms," he said. "It's economically sound compared to other robotic systems, and we've seen a favorable [return on investment] on this program."

OrthoNeuro's first 70 unicompartmental knee arthroplasty procedures using Navio had an average procedure time of about 16 minutes. The first 40 total knees clocked in at about 30 minutes, and times decrease as the team gets more efficient, Dr. Gittins said.

With these clinical advantages, Dr. Gittins predicts ASCs will increasingly adopt robotics over manual methods.

3. Facilitate total joints in the ASC setting. Another resource called patient match technology can help ASCs overcome equipment limitations for outpatient arthroplasty, according to orthopedic surgeon Michael Ast, MD, of New York City-based Hospital for Special Surgery.

Patient match technology can "significantly limit the amount of equipment necessary to do a knee replacement," he said. "It promotes efficiency in setup and sterilization, in case efficiency itself, and also has some clinical benefits without violation of the intramedullary canal." Smith & Nephew's patient match technology, VISIONAIRE◊ Cutting Guides, is available to ASCs.

When performing arthroplasty in an ASC — where reputation is everything — complications must be avoided at all costs. Devices shown to help decrease post-surgical wound complications include antimicrobial barrier dressings, such as ACTICOAT◊ Antimicrobial Barrier Silver Dressing and the PICO◊ Single Use Negative Pressure Wound Therapy System, according to Dr. Ast.

As ASCs grow their outpatient total joint programs, effective joint collaborations become even more important, Dr. Ast said. ASCs can control costs through programs such as Smith & Nephew ASC GO!™ Program and learn about new techniques by observing other centers.

"I encourage everybody to lean on your industry partners," Dr. Ast said. "Utilize them for what they know. Utilize them for connections that they have because they can really make this whole process significantly smoother."

To learn more about Smith & Nephew and industry collaborations, listen to the webinar here and view the webinar slides here. 

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