Introduction: 2020 introduced an unbelievable set of stressors, both for patient health and for the health of the economy.
It is clear that hospitals and health systems will not return to the status quo as businesses reopen in the midst of a continuing uptick in COVID-19 cases, but will instead face a “new normal,” including additional cleaning protocols that necessitate longer turnover time between patient cases, social distancing requirements that change the look and feel of the waiting rooms and hallways, and strategic scheduling that requires adjustments to hours of operation to help lower patient volumes or bottlenecks. Ambulatory surgery centers (ASCs) that are able to thrive in this environment will need to be nimble in the midst of uncertainty in order to come out strong on the other end.
The following recommendations will help surgery centers remain agile during uncertain times, including technology considerations that can ensure ASCs are prepared both in the short-term and future for unexpected changes to business-as-usual.
Be ready for changing regulations: Local, state, and national guidelines are changing quickly with the issuance of federal waivers, changes to reimbursement, and adjustments to normal regulatory requirements. ASCs need to monitor the changing rules for their industry to stay in compliance, while also being positioned to take advantage of emerging opportunities. ASCs would be wise to follow guidance issued by the Centers for Medicare & Medicaid Services on how to resume elective procedures that were postponed due to the COVID-19 outbreak, as well as similar joint guidance issued by the American Society of Anesthesiologists, American College of Surgeons, Association of periOperative Registered Nurses, and the American Hospital Association and a statement from the Society for Ambulatory Anesthesia.
By acting in partnership with local officials and under the guidance of state agencies, national medical societies, and the Centers for Disease Control and Prevention (CDC), ASCs have proven their ability and willingness to evolve their operations in pursuit of broader public health goals.
Focus on good communication. Within this rapidly changing environment, there will likely be a high level of uncertainty. This means internal communication with ASC teams and external communication with patients must be purposeful, frequent, and effective. Remote schedule management can help ASCs swiftly address changes if a patient is symptomatic, tests positive for COVID-19, or must be rescheduled for another reason. Patient-texting can ensure good customer service even if the usual care team is working from their living rooms.
Consider permanent remote operations processes.
When shelter-in-place orders were issued, there was a rapid switch to virtual “work from home” setups where possible. However, that meant remote employees couldn’t easily access paper patient or financial records, or securely log into on-premise servers. Cloud-based software systems have long been proven safe and reliable, both in allowing secure access to electronic health records and revenue cycle management tools. Some ASC administration functions can easily be done remotely, such as billing for new cases, collecting on outstanding patient accounts receivables, working insurance denials, and doing pre- and post-op follow up with patients. As more health systems move to keep healthy patients home as long as possible, the adoption of technology-driven tools to enable remote work functions will be critical.
Implement smarter resource planning. During the halt on elective surgeries last spring, many outpatient surgery centers took time to conduct inventory reviews and update plans for supply chain management. Even before the rise of coronavirus, inventory management in the surgical setting was complicated — a 2018 study by Cardinal Health showed that 40 percent of healthcare providers had canceled a surgery and 69 percent of providers had rescheduled a surgery due to a lack of medical supplies. With new requirements for personal protective equipment (PPE) and challenges with medication and PPE supply chains, inventory management is more important than ever. Technology solutions to help plan and track inventory is critical in ensuring that supplies are sufficiently stocked well ahead of time and can sustain fluctuations in volume.
Ensure pricing is fair and accurate. As the nation works toward curbing the pandemic, fluctuations in the supply chain can translate to skyrocketing prices for critical items undergoing a shortage, such as N95 masks, industrial-grade cleaning supplies, and disinfectants. The right technology can help notify outpatient surgery centers when they may be getting price-gouged for certain purchases, if alternative brands are available at a lower price, or if certain supplies are running out more quickly than they might have in the past. It can also help administrators identify trends among providers in ordering patterns to help with course correction in real time.
Promote care settings outside of the hospital. Many hospitals and health systems were reorganized to prepare for a potential surge in ICU caseloads, with regulatory policies shifting to support these changes. ASCs were considered a kind of relief valve — a space that could take on increased patient volume to preserve hospital settings for critical COVID patients. Moving forward, ASCs should continue to offer an important non-hospital healthcare space that will reduce the risk of surgery patients being exposed to COVID-19. A software solution that is able to remain nimble in its design features can help ASCs wishing to take advantage of Hospital Without Walls opportunities, helping ensure ASCs remain instrumental and relevant.
Implement centralized security. Cybersecurity has always been of utmost importance when it comes to securing patient data, made even more important in the shift from onsite administration to remote work. In any cybersecurity approach, human error continues to pose a major risk. Human error can be as simple as forgetting
to log out of a network, leaving a USB on a desk top, or accidentally providing information to a fake email. Cloud-based security (vs. onsite) can manage threats in real time without the limitations of physical resources, such as storage space or memory. Cloud-based security policies ensure that solutions to address the latest and more imminent threats to data are updated, applied, and distributed automatically.
Support scalability. The volume of elective surgeries will likely fluctuate depending on the course of the pandemic. However, those procedures that were canceled this year will need to be accommodated as patients decide it is safe to move forward and surgery centers increase their operations. This will bring a related increase in data required to manage additional image uploads, patient health records, and reimbursement interfaces. Software platforms must be scalable to easily manage this changing volume, both now and in the future. This includes the ability to handle the high load of data commonly required in the surgery setting, such as high-resolution imagery.
2020 has been challenging in ways we could have hardly imagined, and the end of this pandemic still seems a long way off. By taking this time to examine pain points and structure system reopenings to remedy challenges that existed prior to the emergence of COVID-19, ASCs, managed care organizations, and health leaders can create lasting positive changes from this experience — not just for a healthier society, but also for a stronger healthcare system.
This article is sponsored by HST Pathways. It was written by Tom Hui, CEO and Founder of HST Pathways, a leader in cloud-based technology solutions.
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