Surgical robots are an expensive investment – but are they worth it for ASCs?
Here are five leaders' thoughts on the necessity of surgical robots in the ASC industry:
Noelle Diesfeld, BSN, RN. Senior Clinical Director of Perioperative Services at Scottsdale (Ariz.) Shea Medical Center and Piper Surgery: At Scottsdale Shea Medical Center we decided to move a robot to the outpatient center on campus. We created a list of cases that would be appropriate for the outpatient setting. We vetted the concept through various committees as informational, stating that moving certain patient types to the outpatient setting would create better robotic access within the inpatient setting. Surgeons engaged and started scheduling their lower acuity patients in the outpatient setting. Additionally, we routinely look one to two weeks ahead and move patients from the main operating room grid to the surgery center. We notify the surgeons and allow refusal based on established criteria. Following this change, our overall robotic utilization (a total of six robots) has increased. Notably, the robot in the outpatient environment is at a strong 62 percent utilization.
Alfonso del Granado. Administrator and CEO of Covenant High Plains Surgery Centers (Lubbock, Texas): The one decision from the last year that had the biggest positive impact on our centers was to lease the DaVinci surgical robot. Although the cost per case is much higher on average than the same procedures performed laparoscopically, we had unused time slots that could now be filled productively, and we were able to help one of our partner groups whose members were having trouble booking robotic cases at our partner hospital across the street. We will be performing a second performance review in January to decide whether to continue the program, but so far the financial impact has been positive, and the indirect benefits have been significant.
Raghu Reddy. Administrator at SurgCenter of Western Maryland (Cumberland): The role of robotics will continue to evolve in the coming years in the ASC space. The very word "robotics" will bring capital investment costs to the forefront of decision-making. Currently, there is not a lot of evidence proving that robotics significantly improves clinical results, especially in orthopedics, where some ASCs are adopting robotics. We could see the competitive advantage the robotics bring to an ASC, but the thing to keep in mind is the reimbursement from the payers to cover the entire capital and maintenance costs of the robotic program in the ASC. We should continue to study the evolving clinical evidence for the outcomes before a justification can be made to include robotics and the footprint needed to accommodate this program.
Kern Singh, MD. Co-director of the Minimally Invasive Spine Institute at Rush (Chicago): If you become too heavily reliant on expensive technology, then the transition to the outpatient arena will be very difficult. ASCs don't have the resources or capital to spend a million dollars on the robot when the procedures can be performed without that system. Unless the price drops, which I doubt since hospitals are willing to pay it, the transition will be more painful.
Emily Spooner, CEO of South Florida Same Day Surgery Center (Pompano Beach, Fla): If I won the lottery today, I would purchase a Da Vinci robot and all maintenance contracts and disposables for five years. We would be able to accommodate the bariatric surgeons and their patients' needs. We would be able to increase our volumes and produce even better outcomes in the bariatric space. I would also build out my existing sterilization room, including a new instrument washing machine, ultrasonic and reprocessor.