ASCs are one of healthcare's fastest evolving care settings. Needs are changing rapidly and challenges are emerging for surgeons, surgical teams and patients.
During a September podcast hosted by Becker's Hospital Review and sponsored by DePuy Synthes, The Orthopaedics Company of Johnson & Johnson, two ASC leaders from DePuy Synthes — Andrie Leday, III, vice president of US Ambulatory Surgery Centers, and Ryan Van Puffelen, senior manager of U.S. Ambulatory Surgery Centers — discussed how effective management of ASCs can address trends and pain points in today's market.
Four key takeaways were:
- ASCs see changing patient demographics and increased levels of knowledge. People are seeking knee and hip replacements earlier in life. The average joint reconstruction patient today is a middle-aged adult who still enjoys hiking, biking and mountain climbing. "Patients want to continue those activities as soon as possible after surgery, without limitations, complications or pain," Mr. Leday said. "The ASC setting could be ideal for those individuals."
Patients also have access to more information than ever. They expect in-depth conversations regarding implants, the techniques that will be used during procedures and more. Surgeons must be armed with the right information and resources.
- As value-based payment programs gain traction, surgeries are shifting to the outpatient setting. On the reimbursement side, more commercial payers are rolling out value-based payment programs, which is playing a role in driving procedures to ASCs. DePuy Synthes provides customized solutions that streamline the surgical experience, lower the cost of surgery and save the healthcare system money.
- Surgeons and ASC administrators need solutions to better manage day-to-day logistics. This includes pre-operative planning, operating room activities, case turnover and sterilization. DePuy Synthes' advanced case management (ACM) offering uses a mix of image-based and AI algorithms to predict the most likely implant size range for primary joint replacement surgeries. "By leveraging a digital platform, ACM ensures that orthopedic surgeons receive the right mix of devices and tools for each patient. This minimizes waste and expedites setup time in the OR. Based on outcomes from nearly 100 hospital and ASC implementations of the system, we've seen a 60 percent reduction in instrument sterilization costs," Mr. Leday said.
- New technologies are helping reduce the burden on ASC surgeons and improving efficiencies. DePuy Synthes' KINCISETM Surgical Automated System, for example, can reduce surgeon fatigue during total joint procedures by eliminating the repetitious use of surgical mallets. A recent study found that 66 percent of surgeon participants had reduced muscle fatigue while using the KINCISE* System. Using a system like KINCISE may also help reduce OR costs. "Research revealed that when KINCISE was used for total hip arthroplasties, procedure times were reduced by about eight minutes per case**. That can lead to significant savings over time, given the significant growth that's expected in total hip procedures," Mr. Van Puffelen said.
DePuy Synthes works with ASCs on their processes, technologies and workflow solutions based on three pillars: clinical excellence, economic value and operational support. "Implementing simple, reproducible processes leads to an overall increase in value for ASCs," Mr. Van Puffelen noted. "It's not so much the one percent improvement that you make every day; it's what that one percent can multiply to over the course of time."
Listen to the podcast here.
*Ferrari E, Khan M, Mantel J, Wallbank R. The assessment of muscle fatigue in orthopedic surgeons, by comparing manual versus automated broaching in simulated total hip arthroplasty. Proc Inst Mech Eng H. 2021 Jul 20:9544119211034386. doi: 10.1177/09544119211034386. Epub ahead of print. PMID: 34281446.
**Bhimani AA, Rizkalla JM, Peters Jr PC, Kitziger KJ, Schubert RD, Gladnick BP. Surgical Automation Reduces Operating Time While Maintaining Accuracy for Direct Anterior Total Hip Arthroplasty. Presented at AAHKS, Dallas Nov 7-10th 2019.