James Lynch, MD, is founder of SpineNevada in Reno, where he is chairman and CEO, as well as partner and director of spine services at Westchester, Ill.-based Regent Surgical Health.
A spinal neurosurgeon for more than 25 years, Dr. Lynch participated in the closing keynote interview at the Becker's Spine, Orthopedic and Pain Management-Driven ASC + the Future of Spine virtual event June 19, sharing his thoughts on innovations and opportunities in spine services.
Click here to view the full interview and access several other chats, panels and workshops held during the event.
In this excerpt, Dr. Lynch discusses spinal navigation, telemedicine and the importance of building a practice that provides the full spectrum of patient care.
Note: Responses have been lightly edited for clarity.
Question: What innovations are you most excited about in spine in the next five years?
Dr. James Lynch: Navigation is one of the most important developments over the years and has really come to fruition as a baseline platform. Navigation is akin to what MRI did to imaging back in the 1980s. Advancements in navigation have allowed us to get to the next level in robotics. The next level that I'm excited about is augmented reality and Augmedics' xvision Spine System. It's really X-ray vision that allows [surgeons] to look at a 3D image of the spine without looking at a screen. It's very hands-on and has all the advantages of a neuronavigation platform, yet it's a lot more cost-effective, which is [ideal] for hospitals in this current climate. We're just starting to use it in our practice in Reno, and I'm really looking forward to it.
Q: Where do you see the biggest opportunities for spine surgeons on the current landscape?
JL: We have to prepare for the future now. I think building a musculoskeletal differentiated practice with the whole spectrum of patient care is important. I think the isolated silos of practice — whether it's surgery, pain management or PM&R — working individually is going to change, except if you're in remote areas. There's a rapid transformation occurring. That may not be in months, but certainly over the next three to five years. I think focusing on partnerships or investments in an ASC platform is a natural transition for this. Currently, about 10 percent to 15 percent of spine cases are being done in an ASC platform, which is far too low. Some projections have this at 35 percent to 40 percent over the next few years.
Q: What technologies do you think will become more prominent as a result of the COVID-19 pandemic?
JL: COVID-19 has really revolutionized telemedicine. If we look at telemedicine going forward, there are so many barriers to that in the past. Patients were not all that into it. There were also concerns about data sharing, regulations, cost and payments. But CMS really came in and has changed [telemedicine] entirely. While there may be some restrictions of the technology after the pandemic, I believe it's front and center. Patient adoption has been huge. We did telemedicine over five years ago. It cost over $10,000 to reach out to the remote areas in Nevada, and now you can do it on an iPhone or an iPad with no added cost.
We've been working with TelePT for years. We also partnered with an Irish group, which offers customizable, remote physical therapy. We've been using it in our practice to good avail over the last four years, but the big issue was trying to get the insurance companies to adapt it and pay for it. The COVID-19 crisis has really fast-forwarded the technology, and I think telemedicine will continue to be huge. What would traditionally take years to change the mindset of providers, patients and the community occurred within a one-month period, and now it's standard accepted practice.