Surgery Centers, EHRs and Campfire Coffee: Matt’s Story

If you’re like me, the digital shakeups rumbling across industries interest you. And, this curiosity bumps you into examples while just “doing life.”

It even happens while camping with friends.

While sipping campfire coffee around a picnic table, a friend told me about his new position as a hospital purchasing operations manager at an ambulatory surgery center (ASC). Matt’s story started with the hope and excitement that comes with most new jobs, but soon enough, tarnish crept in around the edges.

His experience reflected the challenges and opportunities happening across ASCs, mostly stemming from digital transformation in healthcare. Here’s his story—and some takeaways.

Setting the scene: Shiny possibilities at a surgery center

Matt was eager to start his new position. It offered great potential to apply his extensive experience in large and midsize healthcare organizations, blending knowledge from his past roles as a clinician (heart surgery technician) and a business professional (medical supply sales and consulting).

The start date came and Matt got to work.

With nine operating rooms, his ASC routinely handles 60+ outpatient procedures per day, ranging from ophthalmological to orthopedic operations. Matt manages a broad range of processes that directly affect how the center serves its patients, staff, attending physicians, and physician owners. He plans, orders, and manages an extensive inventory of medical equipment, supplies, and medications. He ensures that everything needed to perform each day’s scheduled procedures is prepared and ready to go—in the right place and at the right time. Fielding staff and clinicians’ complaints when things don’t run smoothly? Yup, this lands with Matt, too.

Challenges arise: Missing medical equipment, Wi-Fi dead zones, and more

As we continued sipping coffee, Matt’s story took a slightly dark turn. “Surprise” procedures routinely materialized on the next day’s schedule, requiring supplies not in inventory. Emergency orders and rush charges mounted. Inspecting, counting, checking (and rechecking) inventory consumed inordinate chunks of time. Searching for missing equipment became routine. Where was that microscope? Who last saw it? The staff communicated via mobile calls and texts, except when Wi-Fi dead zones interfered. These sorts of problems created staff frustration, reduced staff productivity, and increased costs.

Before taking the job, Matt knew his new employer had not adopted an electronic health record (EHR) system. Having previously worked at large hospitals with advanced implementations, he knew that an EHR would solve most of these problems. Even so, it was more difficult than anticipated to excel at his responsibilities—making the ASC click along as he knew it should—with limited digital capabilities to improve patient care or business operations.

Focusing in: Industry-wide EHR Hesitation

Matt’s experience is not unusual. Widespread EHR adoption remains slow among the ASC community. According to OR Manager, an industry association, “Many ASCs are reluctant to move forward for fear of implementations that are non-conducive to an ASC workflow. ASCs do not usually see patients more than once, so EHRs may seem impractical.”1

There may be another factor. When the Centers for Medicare & Medicaid Services (CMS) began implementing the Patient Protection and Affordable Care Act (ACA), it provided financial incentives for EHR use. However, the agency did not include ASCs. 2

Finding a solution: ASCs and the promise of healthcare digitization

Despite the rationale for holding back, the digitization of ASCs is bound to accelerate. For one thing, the CMS did include physician practices in financial incentive eligibility for EHR adoption. Approximately 87 percent of U.S. office-based physicians use an EHR system.3 And, since physician groups often own or invest in ASCs (as is the case with Matt’s ASC), this will likely spur EHR use.4

Additionally, ASC consolidation and acquisition by hospitals may drive surgery centers toward the EHR systems of affiliated hospitals.5

Further, technology pervasiveness across healthcare is significantly affecting and in some cases, entirely reshaping diagnosis, treatment, and communications. A tremendous amount of information and structured data is now available to guide treatment, assess outcomes, and measure quality of care. Beyond EHRs, digital health tools such as apps and wearable devices are becoming commonplace. To position themselves for the future, ASCs will need to prepare.6

The takeaway: Three considerations for building a better digital healthcare infrastructure

As more ASCs adopt EHRs and embrace digital capabilities, they’ll evaluate options. An OR Manager report commented on the “growing number of vendors either adding ASC-specific EHRs to their product lines or specializing in serving ASCs,” making it easier to find a fit. It also outlined ground rules for selecting an EHR.

Alongside functional evaluation, it’s important to choose the right technology infrastructure. Healthcare professionals are not (and don’t want to be) technology specialists, yet they should keep in mind three top-line considerations for their healthcare digital infrastructure.

Make mobile a standard: When physicians can use tablets/portable devices to chart notes, or patients can easily use apps to access portals, they’re more likely to maximize the benefits of an EHR.

See how via Cisco Mobility in Healthcare

Demand strong security measures: To take advantage of digitization opportunities, healthcare organizations must rigorously attend to security and regulatory requirements to keep their patients, facilities, data, and devices safe, sound, and secure.

Learn more in the Cisco Cybersecurity Strategies for Healthcare white paper

Ensure systems run quickly and effectively: Slow load times and data entry latency frustrate clinicians and staff and eat into limited time, both work time and patient/provider face time. The technology infrastructure supporting the EHR system matters—a lot.

Learn about Cisco’s partnership with a major EHR vendor

Maybe not immediately, but I’d bet that relatively soon, Matt’s ASC will digitize its operations, clinician support, or patient service. (Maybe all three.) When the next group camping trip rolls around, I’ll be eager to chat again with my friend and learn what’s changed.

Better coffee would be nice, too.

1, 2, 4, 5 Online patient records: A trend ASCs should learn to embrace, OR Manager, Vol. 31 No. 1, 2015.

3 National Center for Health Statistics

6 3 Health Care Trends That Don’t Hinge on the ACA, Harvard Business Review