Tom Hui, founder of ASC software company HST Pathways, provides EHR and data management help for more than 700 surgery centers across the U.S. Here, he shares his thoughts on ASC tech trends, IT security and more.
Note: Responses have been lightly edited for style and clarity.
Question: What technological advances do you think are on the horizon for ASCs?
Tom Hui: A major technological advancement on the horizon for ambulatory surgery centers is the 5G telecommunications network. It’s the next generation of technology, promising broader bandwidth and faster connectivity that is both more reliable and redundant. Particularly in the ASC setting, much of health care is visual — CT scans and MRIs, for example. These types of images require strong bandwidth. Telecommunications companies will need to roll out the technology necessary to meet increasing demand.
Another area ASCs can expect to see advances in is interoperability. The last few years have largely been an experimental phase to figure out which models work best. The next phase will be standardizing best practices. The business proposition for interoperability doesn’t exist quite yet. For the most part, it currently translates to a higher cost to consumers. Systems with interoperability are pursuing the low-hanging fruit right now, mainly sharing demographics and insurance information to collect money faster. Evolving capabilities in this area will allow ASCs to capture and look at trends in clinical health outcomes to further advance patient care.
Q: What do you think are the top opportunities in the ASC market?
TH: Being early to the market as a trailblazer presents interesting opportunities for health systems of all types. The downside is that administrative support to accompany these endeavors takes time to evolve. There are great opportunities on the health IT side arising from surgery centers venturing into new market models that need innovative solutions to support forward thinking.
Another opportunity for the ASC market comes as a result of healthcare financing. Medical tourism is becoming more popular as individuals with high-deductible plans seek solutions that make the best financial sense. If a patient cannot afford the procedure they need in one place, they will go somewhere else. With high-deductible plans, patients are not limited to the choices within their network since they are footing the cost of the procedure themselves. Surgery centers looking to establish themselves as leaders in these different areas will need timely and accurate data to both help them stand out from competitors and streamline practices to keep their costs competitive.
Q: How do you think the ASC industry is going to grow in the next three to five years?
TH: Over the next three to five years, additional current procedural terminolgy codes will likely be approved by the government for payment in the surgery center setting. Cost containment on a national scale necessitates the development of efficient ways to provide medical care without dropping safety and quality standards. ASCs are already very cost-effective and safe. Expect to see a higher volume of patients and procedures moving to this setting.
Hospitals are also changing their business models, relying on community providers to help with reaching the patients they serve. Whereas surgery centers were once viewed by hospitals as the competition, hospitals are now changing their perspectives and trying to find a role for them as part of their community provider network.
As our population ages, the demand for orthopedic procedures such as knee replacements and shoulder surgeries will increase. The orthopedic specialty will likely experience major growth in the coming year and be a core service of the ASC industry.
Q: What are your thoughts on ASCs' role in the health IT landscape?
TH: Health IT not in an experimental phase anymore — there are proven best practices for EHR technology, and relying on vendors to mitigate cybersecurity problems is the norm. ASCs are also learning the cost-benefits of working with a vendor rather than trying to go it alone. Using a company like HST Pathways allows for economies of scale, since a large number of surgery centers using services allows us to spread the costs, but would be very expensive services for an individual center. This makes it much easier for ASCs to predict and plan for operating costs, and removes the onus of hiring an IT person.
Finally, cyber threats and cybersecurity will continue to grow more sophisticated and more problematic. Cyberattacks accompanied by demands for a ransom are hitting businesses of all sizes. LAN-based systems for the independently owned and managed ASCs are particularly vulnerable because they just simply don’t have the resources, expertise or money to keep up with the latest prevention technology. Whether one pays or not, it is highly disruptive. It is not a question of “if,” but “when” and “who” will be attacked. ASCs will need to consider what types of technologies can protect them from these threats, and how to ensure it continually evolves to address new advances in cyberattacks.