Total joint procedures are one of the exciting new service lines being implemented by ASCs across the country. And many orthopedic surgeons argue that ASCs should consider incorporating robotic technology to ensure accurate and high-quality outcomes.
Mark Gittins, DO, of New Albany (Ohio) Surgery Center and Columbus-based OrthoNeuro, is a proponent of implementing robotics in ASCs. New Albany Surgery Center started doing robotic procedures in early 2015.
Question: What kinds of robotic systems have you implemented in you ASC?
Dr. Mark Gittins: We use the Blue Belt Navio system at the ASC. Some of the other systems seemed to require a lot of preoperative imaging, but we felt that the Blue Belt system is better for our ASC because we are able to complete the imaging the day of and it is more cost-sensitive.
We are using the robotic system mostly for partial knee replacement. We have the ability to do hips with the system as well; however, we have not started performing hip procedures as yet. We will also be using the system for spine.
Q: Why did you implement robotic technology in the ASC?
MG: The biggest reason is that we felt we had a very competitive market and we thought this would give us, from an ASC standpoint, the latest technology and the best clinical outcomes. Implementing it doesn't increase our fees, but it helps us do a better job. Procedures are more accurate with the robotics, so it's a win-win. Good results breed good results. Our patients are home by lunchtime and then the patients tell their friends. Good results encourage good word-of-mouth because of which we see more patients.
Q: What steps did you take to implement it?
MG: We first went and saw the robotic unit being used and we did our due diligence. We conducted labs to get comfortable with the technology and had business meetings to analyze the financial aspect. Once we decided on the company, which for us was Blue Belt, we went ahead and bought the technology. We then trained staff members, after the surgeons had been trained and conducted mock-runs and test-runs.
Q: What were some of the challenges you faced and how did you overcome them?
MG: Storage was an issue. Most ASCs don't have a large square-footage and so there isn't much storage space. So we had to teach our staff how to take care of it and where to store it. The system doesn't require much space, but ASCs don't have much to begin with.
Another challenge was training the staff. They were concerned that there would be a complex issue and we solved that with education. They also did some labs with surgeons. Now, they are the biggest proponents of the technology and are telling people in the community to come have their procedures done here with robotics.
Q: Are you seeing a return-on-investment from the technology?
MG: It's too early to tell. But more patients are coming in and investigating the technology, and then they are requesting it. It is exciting and that is a huge return we are seeing. We don't have specific numbers yet but the community reaction is encouraging.
Q: What advice do you have for ASCs looking to implement robotics?
MG: There are a number of considerations. If you haven't done joint replacements in your ASC, you need to develop that program. There is significant growth in the joint replacement market and it is the next frontier for ASCs. If you develop the joints program and have good patient volume, consider investing in robotics. It offers accuracy and improved outcomes. Joint replacement can really drive an ASC and lends itself to good results, but you need good surgeons who want to do it and are willing to do it.