Senior Content Marketing Manager
Ep. 10: Kayla Schneeweiss-Keene – Using Technology to Improve Patient Outcomes | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
Every healthcare provider aims to achieve the best outcomes at the lowest cost.
But what role does technology play in that mission? Can implementing technology actually improve patient outcomes?
According to Kayla Schneeweiss-Keene BSN, RN, CASC, Administrator at Mann Cataract Surgery Center, the answer is a proven yes.
Kayla is no stranger to implementing new technology. This year she was given the “ASC Innovations Award” at the Texas Ambulatory Surgery Center Society’s Conference for her and her team’s decision to implement the ZEISS ARTEVO Microscope. Here are the other ways technology has positively impacted her center and its outcomes.
💻 Online Pre-Assessment: Giving patients the option to complete their pre-assessment online provides a better experience for the patient and improves data accuracy. With 70% patient usage, this has allowed them to save about 18 hours of nurse time per week, which equates to $2,500-$3,000 of savings per month, and that extra time is reallocated to patient care.
📱 Patient Texting: For pre- and post-op communication, patient texting has helped with day-of reminders and discharge instructions, and has allowed the patient to stay in touch with the surgeon’s office, too.
🚫📝 EMR Implementation: This year, Kayla implemented an EMR and immediately started saving 6-8 hours per week in chart prep alone. That time has been reallocated to patient care and reduced unproductive busy work.
👁️ Laser Cataract Surgery: By offering this alternative, patient recovery time is reduced, patients can see better faster, and overall outcomes are improved.
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear even more tips for how you can use technology to improve patient outcomes!
Episode Transcript
0:00
welcome to this week in surgery centers if you’re in the ASC industry then
0:05
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone before we jump into what you can expect on today’s episode just a
0:32
reminder to please take a second to subscribe to the podcast on whichever platform you’re listening from I’d
0:38
really appreciate it and that way you’ll never miss an episode so what are we getting into today Kayla
0:45
schnewise Keen is the administrator at Mann cataract surgery center and she’s here to talk to us about how we can use
0:52
technology to improve patient outcomes Kayla won the ASC Innovations award at
0:57
the Texas ASE Society show this year after implementing groundbreaking Tech at her surgery center so she has a
1:03
really cool story to share with us and lots of tips in the news recap we’ll cover more cyber security attacks
1:10
patients being charged for my chart messages the pros and cons of pre-filled
1:16
syringes and of course end the new segment with a positive story about medical drones that are saving lives
1:21
hope everyone enjoys the episode and here’s what you can expect on this week in surgery centers
1:28
good night [Music] Kayla welcome to the show
1:34
thank you thanks for having me can you tell our listeners just a little bit about your facility at a high level
1:41
yeah absolutely um we have a few facilities here um in Houston one’s up in north and
1:48
humble ones here in the Museum District we’re building another one in Sugar Land and the one I’m standing in now we just
1:53
moved in in April this past April we were across the street starting in 2007
1:59
and we just built this beautiful brand new building and moved in this past April fantastic and and I understand that
2:06
congrats congratulations are in order uh because you know at this year’s take Texas ASC conference you actually won
2:14
the ASC Innovations award um specifically specifically for
2:19
implementing the the Zeiss artivo microscope did I get that right in terms of pronunciation correct awesome can you
2:27
tell our listeners a little bit about that uh that microscope that that
2:33
technology decision and how that came about yeah absolutely um the microscope is a
2:39
3D technology it’s put up on a 55-inch screen TV and 4k monitor
2:46
um it has a heads up display for marking torque lens alignment and
2:52
um it’s one of the it’s one of the the highest Tech
2:58
Ophthalmology microscopes that that we’ve seen it also hooks up to the the
3:04
iol master that’s done in the practice which is a a piece of testing that’s done for the patients over in the
3:11
practice so it links that information over to us which actually helps a lot of communication and it’s really good for
3:17
ergonomics our doctors I think initially wanted wanted to purchase it because I
3:23
mean years and years of microscope use you have this forward head tilt looking into
3:28
oculars and it does a number on on the back of the neck so the doctors were really intrigued with being able to sit
3:34
up or not ergonomically correct and do cataract surgery
3:39
so that that’s that’s super interesting and and that’s where I wanted that’s what I was curious about is hey this is
3:45
a big expensive piece of technology you know what what was kind of the major problem or opportunity and so it did
3:52
seem like uh you know Dr Health Dr ease of use economics were a piece of it what what
3:59
about kind of patient outcomes did that did that factor in is part of the decision-making process here
4:06
um it does have a better visual field for the doctors um I mean they they already had we had a
4:12
Zeiss microscope beforehand but it wasn’t there in TiVo they already had a 3D view of it
4:17
um they were able to get a bigger picture of it because you now have this big 55-inch screen TV and right in front
4:24
of you um but it’s also was very intriguing for the nursing staff to now see what the
4:30
doctor sees and that we’ll all put on 3D mic uh 3D glasses and it’s it’s
4:35
absolutely phenomenal what you see on that big 55 inch screen TV it’s it’s
4:41
hard to explain it’s really cool to see it got it and so who’s in charge of a
4:46
process like this maybe in terms of kind of the idea generation who who surfaced
4:52
this you know idea or concept of hey we should be looking at upgrading our
4:57
microscope yeah our our doctors um particularly our owners are very much
5:03
into staying ahead of the game and Technology they want to be world-class Tech Technology Center and
5:11
so they saw it and wanted to demo it we brought it in and we demoed it we had
5:17
most of our surgeons demo it and give their opinion that’s one of the things that are that our owners
5:23
fix is successful at they they value the opinion of the other surgeons the
5:28
non-owners as well um so they demoed it they liked it and it was also an easier decision because
5:35
we we knew we were building this building and our previous microscope
5:41
that we were currently using in the old building it was about 15 years old so we knew we were having to buy a new
5:47
microscope anyway and so that decision was kind of easy to make since we’re moving into the new building yeah so so
5:54
the new facility needing to make a capital investment anyway it was really kind of a question of
6:00
um it was it was just that time was perfect timing guys so you’ve got physician
6:08
owners that are staying on top of the technology trends
6:13
that are advocating for this which is great and you mentioned the other stakeholders in the process you know as
6:19
part of the demos and then so forth what what other stakeholders were important to bring on board to make a make a major
6:26
purchase like this um
6:33
I mean they got all the surgeons opinions in in the in the collective group to be able to purchase it so I
6:38
mean if when you’re talking about big stakeholders that was it yeah um when you’re talking about
6:44
profit margin um it was something that we could Market
6:51
right patients always like to see that you have the the top technology so that was that was helpful and to be able to
6:57
Market on our on our website got it so so the idea was hey this could
7:04
this could be helpful for case volume and this could be helpful for kind of brand reputation as well in the
7:10
marketplace yeah pretty much a good way to put it excellent and so
7:17
you know it seems like there’s a lot of buy-in around this any any dissenting opinions whether from Physicians or for
7:23
uh clinical staff or others um the cost was was pretty pricey other
7:31
than that um no I think all the staff uh initially liked it
7:37
um because they were it was a wow factor at first certainly something that we we’ve never seen
7:42
before and we weren’t able to look in the surgeon’s microscope because even the the assistant microscope is not 3D
7:48
and I’m a backup scrub tech so when I’m looking in there I don’t even see what
7:54
the surgeons are seeing so it was a real treat actually to see it cool so the staff staff loved it more more bells and
8:01
whistles um there there’s a cost factor that came into play which which owners are always
8:07
going to think about was there any um you know Revenue kind of
8:12
justification or new case justification that that was required you know to get
8:18
over those cost objections or was it really just the view and belief of the Physicians
8:23
The View and belief of the Physicians that they knew that they wanted it they believed it was going to help them out
8:29
in the long run for for their aspects so it was it was really them fantastic and and what what feedback
8:36
have you gotten from uh patients um you know what what have you seen in
8:42
terms of case volumes what what output has there been around this decision and
8:48
implementation um from the marketing standpoint I think um patients are intrigued that we have
8:55
the one of the best Technologies from the microscope standpoint um
9:01
feedback from the from the staff again there was a wow factor they all like it they like they like looking at at the
9:08
screen and see what seeing what’s going on with the case because when you see what’s going on in the case you can kind of help the surgeon anticipate the next
9:16
step yep great um and so I know I know that technology
9:23
is important and carefully regarded at your facilities and so I want to kind of
9:28
zoom out for a second and talk about technology more broadly and kind of
9:34
break it down across the patient experiment experience so pre-surgery
9:39
across the man facilities have you seen technology that’s been helpful before patients even
9:46
step foot in the facility from a pre-surgery perspective yes absolutely and just to hit on the the other
9:53
previous question how do we get everybody’s buy-in it was also a
9:59
decision that well I I would suggest that when when making a decision to
10:04
purchase equipment to also not only get your non-owner surgeons and put in but also your scrub Tech’s opinions and your
10:11
nurse’s opinions because sometimes they can see it from a different point of view from like a flow perspective and
10:17
they can they can see whether or not this new technology or new way of doing
10:22
things is going to add on five minutes to a case right and so if you if you
10:27
have 40 cases of the day and each of those add five minutes on to it that’s a big deal so you want to be able to to
10:33
get opinions with others not only just your owners absolutely the owners can
10:38
see a benefit but you got to operationally work through the the users right to
10:44
understand like hey what are the real operational repercussions or benefits going to be it makes makes total sense
10:49
yes absolutely and from a pre-op perspective um pre-surgery one of the biggest
10:56
implementations that we have we did a few years ago that was a big hit was a
11:01
pre-screening patient portal for our patients they would patients were able to go in and fill out their their
11:07
medical history and their medication list this was huge because we service the geriatric population and
11:15
on average most of our calls took a nurse 20 minutes each so if you can
11:21
imagine just one day you have 40 patients in one day even 30 patients in one day and each of those calls takes 20
11:26
minutes your staff is all tied up making phone calls right wow so yeah the patient the
11:32
patient portal that we we got also had texting service um and so when we’re talking about a
11:39
pre-screening patient portal this is very good for for high volume centers um because of this reason I mean so we
11:45
have on average 70 percent usage our patients 70 of our patients use use it
11:52
and so it saves us about 18 hours of nurse time per week which is almost a
11:57
half of an FTE and around about 2500 to 3 000 a month
12:02
so it adds up and it pays for itself and that’s fantastic and that’s that’s
12:07
great to see that there you guys kind of Quantified the time savings and the benefit and half of an FTE in a week
12:15
did that result in you um needing to hire less you know nursing
12:21
staff or or did you repurpose that time allocation
12:27
yes around around about that way so um before the patient portal we were
12:33
um pretty much bringing a PRN into the facility on a weekly basis almost daily
12:38
she has to do the pre-op phone calls and then after the after the pre-screening
12:43
patient portal was brought in we didn’t have to bring that person in so it actually might have been might have
12:48
saved us more than a half of an FTE um but looking at our numbers
12:54
from a quantitative standpoint it looked like it was total half tea per week yeah so that’s that’s a great savings and you
13:01
you mentioned that there was an opt-in rate of around 70 which sounds pretty good did you get 70 right off the bat or
13:08
did you have to work up to that well we worked up to that we were actually really nervous about it because I mean
13:13
of course we’re we’re working with the geriatric population and they’re not technology Savvy right and you need a
13:19
computer to be able to fill in all these questions um so we started out probably with 55 60
13:27
percent um implementation usage rate and we actually got our practice involved with
13:35
this so when the counselors were talking to the patients they were mentioning they were giving them a sheet of paper
13:40
or a card saying hey go on go online and pre-register for your surgery and so that helped a lot and that brought
13:46
brought our average up to 65 to 70 percent got it so it was really the counselors
13:52
on the front end of the process saying here’s the here’s the next step here here’s the link
13:58
absolutely and if we didn’t get it in time that texting service that came with it would be able to just detects the
14:03
patient and you send them a reminder say hey just a reminder go go in and uh fill out your patient portal for us I love
14:10
that and then if patients show up without doing the pre-screening online would you do it there at the facility
14:17
we do we have we have a handful of patients per week show up without pre-doing it so we have really uh we
14:24
bring them into pre-op area we have a computer right there and they’ll sit down there with their family member and fill it out
14:30
love it so both are options but over time through best practices and tips and tricks you’ll be able to tick up the
14:36
percentage that fill it out online before they come it’s fantastic I mean it’s better for the patient as well from the patient standpoint there’s less wait
14:43
time for them because I mean sometimes they’re they’re taking 30 minutes to fill it out right and when they’ve
14:49
already had it complete they have a faster flow in the back nobody likes to grab
14:55
the pencil and the clipboard and fill those things out at the day of so sounds like a win all the way around so so
15:02
that’s the pre-op side what about day of surgery uh we talked about the the mic
15:07
the microscope which is a big one any other technology or software that you found to be helpful from a day of
15:13
surgery perspective so we we have a lot of changes this year now I’m just opening a new center but we
15:20
also implemented a new EMR this year um so that that alone saved our front
15:26
desk time from uh chart prepping it saved them probably six to eight hours of chart prepping uh per week
15:33
um from a cost standpoint that was that was great and then from a patient standpoint it’s they can come in and
15:40
um check in at the front desk quicker than than before with paper we’re also
15:47
implementing prepayments we haven’t started it yet but um the theory behind
15:53
it is I mean if you think about it when patients come in one of the most stressful things that
15:58
one of the most special I mean they’re already stressed out from surgery right yeah but they’re also stressed out for payments I mean that’s a good chunk of
16:06
change that they’re about to to give up sure so it’s stressful right it’s a stressful thing so if we can take that
16:12
one stress off the patient and then get collect prepayments by the time they get
16:18
to the surgery center a couple days later then that one strap that’ll be one less stress for them and then it’s it’s
16:25
help improving the patient experience honestly that’s where we’re going with it got it got it so each are in
16:30
prepayments I wanna ask you follow up about each of those on the EHR side you mentioned it saves six
16:38
to eight hours per week in terms of chart prep did I get did I get that right correct
16:43
fantastic and what what specific pieces of the chart prep is it the hey we’re
16:50
not having to enter in information twice is it is it make it easier to to
16:56
actually go in and you know get get you know you’re not having to physically kind of put the charts in different
17:02
places like what about the sharp rep is most helpful well when we were on paper
17:07
they would print out packets right of the whole chart and they would have to Flap stickers patient information
17:13
stickers on every single one of those paper pieces of paper and if you imagine there’s probably about 13 or 14 sheets
17:21
of paper per chart and so they’re slapping on stickers I mean that that took like
17:27
a lot of just busy work time just slapping on stickers to a patient’s chart
17:32
yep especially when you you have a busy 30 40K stay
17:37
sure and so that’s 68 hours does that help the nursing staff do more cases
17:43
spend more time with patients spend more time on lunch breaks how did
17:49
they repurpose that those Time Savings it helps our front desk to be able to to focus more on the patient and and be
17:55
able to do other tasks got it that’s great okay and that’s the EHR side and then
18:03
the prepayment side you mentioned there’s the benefit the patients there’s the benefit
18:08
probably from a Time Savings again of not spending much time kind of registering a patient on the front on
18:15
the front end um what percentage do you expect will kind
18:20
of pay prepay versus time of service hmm we’re hoping 100 but
18:27
um I think we would be happy with about 70 wow 70 is fantastic and again are you
18:34
planning on using kind of texting and some of the reminders that you guys have done and you know part of the pre-screening process there
18:41
we’re not quite sure yet and we’re kind of in the the pre-planning phase of this
18:47
awesome so we haven’t really implemented it yet we’ll have to check check back in with
18:52
you and and uh see how it goes on on the prepayment side but definitely see the benefits there
18:58
um what about post-surgery Kayla what what technology have you seen from a
19:04
post-surgery perspective you know that benefits the center the benefits patients
19:09
yep I also hit on um I’ll go back just real quick and hit on one other technology that we have during surgery
19:15
and so here at Main Eye Center we have laser cataract surgery and this is a
19:23
huge benefit not only for the patients but for the surgeons as well so laser
19:28
cataract surgery what it does it makes a three perfect 360 degree circle in the
19:35
capsule to me of the of the patient’s eye which is the bag that the patients cataract or lens sits in
19:42
um and the doctor has to get into the bag to be able to remove the lands well once once you create a perfect 360
19:50
degree circle it helps um the lens once you once you
19:56
insert the artificial lens it helps it Center it and which gives the patient a better outcome not only that it also
20:04
fragments the lens so um for cataracts we grade them from difficulty a OnePlus is kind of a soft Cataract and a four
20:10
plus is kind of a hard cataract we can turn a four plus cataract into a two plus cataract with this laser and what
20:17
that does it makes it easier for the surgeon to extract the Cataract and it also makes it the recovery time better
20:22
for the patient because when the Cataract is softer it’s less um vibration in the eye from
20:29
the fake machine that we’re taking out the Cataract with which means less inflammation for the patient’s eye
20:35
better recovery so the patient sees better faster wow fantastic
20:41
it sounds like a great great clinical benefit there huge
20:48
yeah if we move on to the post-surgery side anything there that’s been implemented or you guys have seen
20:55
success with it man um I would say again the patient portal
21:00
um so the the patient portal also provides um post-op reminders for the patients and it also allows them to stay
21:09
in touch with the surgeon’s office in case they have questions um which we’ve found is is been a
21:15
benefit instead of having the patient call a call center and and be hung up on the on the line or waiting in line to
21:23
get in touch with somebody it’s been helpful fantastic and do you do you guys have to
21:29
spend much time on you mentioned prepayments do you have to spend much time on post payments
21:36
no so um we collect up front 100 of the time I don’t allow patients
21:43
to go back without collecting seems like a good seems like a good policy I’ve certainly talked to other centers that
21:50
don’t always get it or don’t don’t get the full amount of time of service and have to spend you know a lot of times on
21:55
the on the back end doing the calls and leaving the voicemail so yeah yeah it’s hard enough um to get collecting payments from the
22:02
insurance um let alone patients so it’s it’s a definitely an absolute good policy to
22:09
have is to collect payment upfront love it okay so final question for you here
22:14
Kayla we do this with all of our guests what is one thing that our listeners can do this week to improve their Surgery
22:20
Center I would say
22:26
patient experience um because patient experience I’m in this this can go in multiple different
22:33
directions but when you have when your patient experiences a really good surgical day
22:39
and they’re going to go out and tell their friends and that’s word of mouth right that’s going to bring more patience into your facility I truly
22:47
believe word of mouth is probably your best marking your marketing strategy for any Center
22:53
not only this your patient experience is going to stem from your surge in
22:59
leadership so from a search and standpoint no matter if they want to be
23:04
a leader or not when they slap that MD on that behind their name they’re
23:10
automatically a leader and so that it’s huge for surgeons to understand that if if they’re good leaders to their staff
23:17
their staff are going to have a more positive day and they’re going to give
23:22
the patients more positive experience as well so it’s kind of like a Snowball Effect
23:28
love it and I’ve I’ve seen studies that affect in other Industries as well where
23:34
it’s like hey that the happier businesses employees or staff are there’s actually a proven correlation
23:40
many times to kind of happier that the customers are so that that makes totals that makes total sense and I love it
23:46
absolutely leading from the top advice there so that’s a great one
23:53
Kayla thanks so much um for being on this week this is a great episode and I look forward to
23:58
keeping in touch thank you for having me I appreciate it good night
24:04
[Music] as always it has been a busy week in healthcare so let’s Jump Right In two
24:11
weeks ago we shared a story about an ASC that fell victim to a Cyber attack continuing with that topic and this
24:18
article by Healthcare dive they’re sharing even more insights around cyber attacks and perhaps the most alarming
24:25
statistic is this one 89 of healthcare organizations surveyed experienced at
24:31
least one Cyber attack in the last 12 months so I just wanted to share three important call outs and reminders from
24:39
this story there are four primary types of cyber attacks we have Cloud compromise
24:46
ransomware supply chain compromise and business email compromise
24:52
out of those who cited a ransomware attack 67 percent reported an impact to
24:57
Patient Care and 24 percent reported a rise in mortality rates which is
25:03
extremely concerning the second reminder as we likely head into a recession and you try to find new
25:09
ways to tighten the purse strings experts are concerned that Healthcare orgs will cut cyber security budgets
25:16
first so I know it can be tempting but it is just not worth the risk some
25:21
Health Systems report having to spend up to a hundred million dollars just to recover from a successful attack so
25:27
don’t roll the dice and lastly just because your ASC might be small compared
25:33
to large hospitals or other Health Care Systems it doesn’t mean you will fly under the radar it’s actually the exact
25:39
opposite a tax on smaller organizations are on the rise because it’s assumed that they have their guards down and
25:45
less security measures in place so I hate to start this off all doom and gloom but the data is telling us now
25:52
that now is the time to be more Vigilant than ever when it comes to your cyber security
25:58
this next story is interesting and causing quite the debate should patients
26:04
be charged for sending my chart messages within the last few months a few
26:09
different hospitals have actually started billing patients for some types of messages sent over this patient
26:15
portal examples of those they’re charging for would be inquiries about new symptoms medication adjustments new
26:22
prescriptions and really anything that requires extensive time reviewing a patient’s
26:28
medical history before they can give a response the plan is that the fee will actually
26:34
be billed to the patient’s insurance insurance company with out-of-pocket costs for people on Medicare ranging
26:40
from about three to ten dollars and then the cost for patients without insurance will be a flat rate of 35 dollars
26:48
um to put it in perspective Northwestern Medicine in Chicago said that over the course of three months they only charged
26:55
for less than one percent of my chart messages so it’s obviously not a big chunk at all but as you can imagine
27:02
patient rights Advocates are not happy about this and they say it’s just another way for health care to nickel
27:09
and dime patients um for ASC specifically who are considering
27:15
implementing a patient portal in 2023 or already have one or even for those who
27:20
have two-way patient texting exchanges it’s just something to remain aware of in theory we wouldn’t find ourselves in
27:28
this situation and would actually invite the two-way patient dialogue and patient inquiries to ensure better outcomes but
27:36
I am really curious to hear how you feel about this is it fair to charge in order
27:42
to protect the doctor’s time or does it feel kind of morally icky to discourage
27:48
patients from reaching out in a manner that we built for them to do exactly that so please share your thoughts on
27:55
HSC Pathways LinkedIn post I would love to hear them our third story today is from outpatient
28:02
surgery magazine and it’s all about pre-filled syringes it’s my understanding that these
28:08
syringes are more common in the hospital space than Asus right now but perhaps that will start to change some of the
28:15
benefits shared um were Superior safety reduced errors reduced infections significant Time
28:23
Savings and reduced waste the only real calm that was shared in the article was
28:28
cost um in a recent study is trying to counteract that argument of cost they
28:35
found that the use of manufacturer prepared pre-filled ready to administer
28:41
syringes can actually reduce health care costs by decreasing errors compared with
28:46
the traditional vial and syringe method specifically the study found that manufacturer prepared pre-filled
28:54
RTA syringes were associated with an estimated Savings of roughly a hundred
28:59
and eighty two dollars per Administration with a 94 reduction in
29:04
errors now this was just one study so take it for what it is but the numbers are certainly eye-catching considering
29:11
we’re always trying to reduce spend and talking with some of my colleagues I don’t have a clinical background so I
29:18
needed to kind of ask some other people who do what they thought about this and they agreed with the benefits previously
29:24
stated but also shared an additional cons concern that diversion prevention would need to be top of mind as well and
29:31
keeping those large orders secure so again please join us in this
29:37
discussion on HSC Pathways LinkedIn post I would love to know if this is something your AC would try or have
29:43
tried in an effort to keep patients safe and cost slow
29:48
and to end our new segment on a positive note medical drones are saving lives and
29:54
coming to a sky near you England’s national health service has
29:59
started delivering chemotherapy drugs to the Isle of Wight via drones
30:04
by car and Ferry it takes four hours to deliver them but by drone it only takes
30:09
30 minutes and for life-saving drugs that have a short shelf life that’s a
30:15
huge win it not only saves time but it also saves Fuel and money and reduces
30:20
carbon emissions um two other examples in Africa drones have been used to reach remote
30:25
communities delivering vaccines for malaria tuberculosis and polio and in
30:31
Sweden drones are being um used to bring defibrillators to patients who are actively experiencing
30:37
cardiac arrest and beating the ambulances to the scene so I know drones have raised some
30:44
privacy concerns since their Inception but when used properly in these scenarios they’ve really done some
30:50
incredible incredible work and have saved lives so we love to see any new
30:55
technology any new innovation so this is a really cool story
31:00
and that news story officially wraps up this week’s podcast thank you as always
31:05
for spending a few minutes of your week with us make sure to subscribe or leave a review on whichever platform you’re
31:11
listening from I hope you have a great day and we’ll see you again next week
31:18
[Music]
welcome to this week in surgery centers if you’re in the ASC industry then
0:05
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone before we jump into what you can expect on today’s episode just a
0:32
reminder to please take a second to subscribe to the podcast on whichever platform you’re listening from I’d
0:38
really appreciate it and that way you’ll never miss an episode so what are we getting into today Kayla
0:45
schnewise Keen is the administrator at Mann cataract surgery center and she’s here to talk to us about how we can use
0:52
technology to improve patient outcomes Kayla won the ASC Innovations award at
0:57
the Texas ASE Society show this year after implementing groundbreaking Tech at her surgery center so she has a
1:03
really cool story to share with us and lots of tips in the news recap we’ll cover more cyber security attacks
1:10
patients being charged for my chart messages the pros and cons of pre-filled
1:16
syringes and of course end the new segment with a positive story about medical drones that are saving lives
1:21
hope everyone enjoys the episode and here’s what you can expect on this week in surgery centers
1:28
good night [Music] Kayla welcome to the show
1:34
thank you thanks for having me can you tell our listeners just a little bit about your facility at a high level
1:41
yeah absolutely um we have a few facilities here um in Houston one’s up in north and
1:48
humble ones here in the Museum District we’re building another one in Sugar Land and the one I’m standing in now we just
1:53
moved in in April this past April we were across the street starting in 2007
1:59
and we just built this beautiful brand new building and moved in this past April fantastic and and I understand that
2:06
congrats congratulations are in order uh because you know at this year’s take Texas ASC conference you actually won
2:14
the ASC Innovations award um specifically specifically for
2:19
implementing the the Zeiss artivo microscope did I get that right in terms of pronunciation correct awesome can you
2:27
tell our listeners a little bit about that uh that microscope that that
2:33
technology decision and how that came about yeah absolutely um the microscope is a
2:39
3D technology it’s put up on a 55-inch screen TV and 4k monitor
2:46
um it has a heads up display for marking torque lens alignment and
2:52
um it’s one of the it’s one of the the highest Tech
2:58
Ophthalmology microscopes that that we’ve seen it also hooks up to the the
3:04
iol master that’s done in the practice which is a a piece of testing that’s done for the patients over in the
3:11
practice so it links that information over to us which actually helps a lot of communication and it’s really good for
3:17
ergonomics our doctors I think initially wanted wanted to purchase it because I
3:23
mean years and years of microscope use you have this forward head tilt looking into
3:28
oculars and it does a number on on the back of the neck so the doctors were really intrigued with being able to sit
3:34
up or not ergonomically correct and do cataract surgery
3:39
so that that’s that’s super interesting and and that’s where I wanted that’s what I was curious about is hey this is
3:45
a big expensive piece of technology you know what what was kind of the major problem or opportunity and so it did
3:52
seem like uh you know Dr Health Dr ease of use economics were a piece of it what what
3:59
about kind of patient outcomes did that did that factor in is part of the decision-making process here
4:06
um it does have a better visual field for the doctors um I mean they they already had we had a
4:12
Zeiss microscope beforehand but it wasn’t there in TiVo they already had a 3D view of it
4:17
um they were able to get a bigger picture of it because you now have this big 55-inch screen TV and right in front
4:24
of you um but it’s also was very intriguing for the nursing staff to now see what the
4:30
doctor sees and that we’ll all put on 3D mic uh 3D glasses and it’s it’s
4:35
absolutely phenomenal what you see on that big 55 inch screen TV it’s it’s
4:41
hard to explain it’s really cool to see it got it and so who’s in charge of a
4:46
process like this maybe in terms of kind of the idea generation who who surfaced
4:52
this you know idea or concept of hey we should be looking at upgrading our
4:57
microscope yeah our our doctors um particularly our owners are very much
5:03
into staying ahead of the game and Technology they want to be world-class Tech Technology Center and
5:11
so they saw it and wanted to demo it we brought it in and we demoed it we had
5:17
most of our surgeons demo it and give their opinion that’s one of the things that are that our owners
5:23
fix is successful at they they value the opinion of the other surgeons the
5:28
non-owners as well um so they demoed it they liked it and it was also an easier decision because
5:35
we we knew we were building this building and our previous microscope
5:41
that we were currently using in the old building it was about 15 years old so we knew we were having to buy a new
5:47
microscope anyway and so that decision was kind of easy to make since we’re moving into the new building yeah so so
5:54
the new facility needing to make a capital investment anyway it was really kind of a question of
6:00
um it was it was just that time was perfect timing guys so you’ve got physician
6:08
owners that are staying on top of the technology trends
6:13
that are advocating for this which is great and you mentioned the other stakeholders in the process you know as
6:19
part of the demos and then so forth what what other stakeholders were important to bring on board to make a make a major
6:26
purchase like this um
6:33
I mean they got all the surgeons opinions in in the in the collective group to be able to purchase it so I
6:38
mean if when you’re talking about big stakeholders that was it yeah um when you’re talking about
6:44
profit margin um it was something that we could Market
6:51
right patients always like to see that you have the the top technology so that was that was helpful and to be able to
6:57
Market on our on our website got it so so the idea was hey this could
7:04
this could be helpful for case volume and this could be helpful for kind of brand reputation as well in the
7:10
marketplace yeah pretty much a good way to put it excellent and so
7:17
you know it seems like there’s a lot of buy-in around this any any dissenting opinions whether from Physicians or for
7:23
uh clinical staff or others um the cost was was pretty pricey other
7:31
than that um no I think all the staff uh initially liked it
7:37
um because they were it was a wow factor at first certainly something that we we’ve never seen
7:42
before and we weren’t able to look in the surgeon’s microscope because even the the assistant microscope is not 3D
7:48
and I’m a backup scrub tech so when I’m looking in there I don’t even see what
7:54
the surgeons are seeing so it was a real treat actually to see it cool so the staff staff loved it more more bells and
8:01
whistles um there there’s a cost factor that came into play which which owners are always
8:07
going to think about was there any um you know Revenue kind of
8:12
justification or new case justification that that was required you know to get
8:18
over those cost objections or was it really just the view and belief of the Physicians
8:23
The View and belief of the Physicians that they knew that they wanted it they believed it was going to help them out
8:29
in the long run for for their aspects so it was it was really them fantastic and and what what feedback
8:36
have you gotten from uh patients um you know what what have you seen in
8:42
terms of case volumes what what output has there been around this decision and
8:48
implementation um from the marketing standpoint I think um patients are intrigued that we have
8:55
the one of the best Technologies from the microscope standpoint um
9:01
feedback from the from the staff again there was a wow factor they all like it they like they like looking at at the
9:08
screen and see what seeing what’s going on with the case because when you see what’s going on in the case you can kind of help the surgeon anticipate the next
9:16
step yep great um and so I know I know that technology
9:23
is important and carefully regarded at your facilities and so I want to kind of
9:28
zoom out for a second and talk about technology more broadly and kind of
9:34
break it down across the patient experiment experience so pre-surgery
9:39
across the man facilities have you seen technology that’s been helpful before patients even
9:46
step foot in the facility from a pre-surgery perspective yes absolutely and just to hit on the the other
9:53
previous question how do we get everybody’s buy-in it was also a
9:59
decision that well I I would suggest that when when making a decision to
10:04
purchase equipment to also not only get your non-owner surgeons and put in but also your scrub Tech’s opinions and your
10:11
nurse’s opinions because sometimes they can see it from a different point of view from like a flow perspective and
10:17
they can they can see whether or not this new technology or new way of doing
10:22
things is going to add on five minutes to a case right and so if you if you
10:27
have 40 cases of the day and each of those add five minutes on to it that’s a big deal so you want to be able to to
10:33
get opinions with others not only just your owners absolutely the owners can
10:38
see a benefit but you got to operationally work through the the users right to
10:44
understand like hey what are the real operational repercussions or benefits going to be it makes makes total sense
10:49
yes absolutely and from a pre-op perspective um pre-surgery one of the biggest
10:56
implementations that we have we did a few years ago that was a big hit was a
11:01
pre-screening patient portal for our patients they would patients were able to go in and fill out their their
11:07
medical history and their medication list this was huge because we service the geriatric population and
11:15
on average most of our calls took a nurse 20 minutes each so if you can
11:21
imagine just one day you have 40 patients in one day even 30 patients in one day and each of those calls takes 20
11:26
minutes your staff is all tied up making phone calls right wow so yeah the patient the
11:32
patient portal that we we got also had texting service um and so when we’re talking about a
11:39
pre-screening patient portal this is very good for for high volume centers um because of this reason I mean so we
11:45
have on average 70 percent usage our patients 70 of our patients use use it
11:52
and so it saves us about 18 hours of nurse time per week which is almost a
11:57
half of an FTE and around about 2500 to 3 000 a month
12:02
so it adds up and it pays for itself and that’s fantastic and that’s that’s
12:07
great to see that there you guys kind of Quantified the time savings and the benefit and half of an FTE in a week
12:15
did that result in you um needing to hire less you know nursing
12:21
staff or or did you repurpose that time allocation
12:27
yes around around about that way so um before the patient portal we were
12:33
um pretty much bringing a PRN into the facility on a weekly basis almost daily
12:38
she has to do the pre-op phone calls and then after the after the pre-screening
12:43
patient portal was brought in we didn’t have to bring that person in so it actually might have been might have
12:48
saved us more than a half of an FTE um but looking at our numbers
12:54
from a quantitative standpoint it looked like it was total half tea per week yeah so that’s that’s a great savings and you
13:01
you mentioned that there was an opt-in rate of around 70 which sounds pretty good did you get 70 right off the bat or
13:08
did you have to work up to that well we worked up to that we were actually really nervous about it because I mean
13:13
of course we’re we’re working with the geriatric population and they’re not technology Savvy right and you need a
13:19
computer to be able to fill in all these questions um so we started out probably with 55 60
13:27
percent um implementation usage rate and we actually got our practice involved with
13:35
this so when the counselors were talking to the patients they were mentioning they were giving them a sheet of paper
13:40
or a card saying hey go on go online and pre-register for your surgery and so that helped a lot and that brought
13:46
brought our average up to 65 to 70 percent got it so it was really the counselors
13:52
on the front end of the process saying here’s the here’s the next step here here’s the link
13:58
absolutely and if we didn’t get it in time that texting service that came with it would be able to just detects the
14:03
patient and you send them a reminder say hey just a reminder go go in and uh fill out your patient portal for us I love
14:10
that and then if patients show up without doing the pre-screening online would you do it there at the facility
14:17
we do we have we have a handful of patients per week show up without pre-doing it so we have really uh we
14:24
bring them into pre-op area we have a computer right there and they’ll sit down there with their family member and fill it out
14:30
love it so both are options but over time through best practices and tips and tricks you’ll be able to tick up the
14:36
percentage that fill it out online before they come it’s fantastic I mean it’s better for the patient as well from the patient standpoint there’s less wait
14:43
time for them because I mean sometimes they’re they’re taking 30 minutes to fill it out right and when they’ve
14:49
already had it complete they have a faster flow in the back nobody likes to grab
14:55
the pencil and the clipboard and fill those things out at the day of so sounds like a win all the way around so so
15:02
that’s the pre-op side what about day of surgery uh we talked about the the mic
15:07
the microscope which is a big one any other technology or software that you found to be helpful from a day of
15:13
surgery perspective so we we have a lot of changes this year now I’m just opening a new center but we
15:20
also implemented a new EMR this year um so that that alone saved our front
15:26
desk time from uh chart prepping it saved them probably six to eight hours of chart prepping uh per week
15:33
um from a cost standpoint that was that was great and then from a patient standpoint it’s they can come in and
15:40
um check in at the front desk quicker than than before with paper we’re also
15:47
implementing prepayments we haven’t started it yet but um the theory behind
15:53
it is I mean if you think about it when patients come in one of the most stressful things that
15:58
one of the most special I mean they’re already stressed out from surgery right yeah but they’re also stressed out for payments I mean that’s a good chunk of
16:06
change that they’re about to to give up sure so it’s stressful right it’s a stressful thing so if we can take that
16:12
one stress off the patient and then get collect prepayments by the time they get
16:18
to the surgery center a couple days later then that one strap that’ll be one less stress for them and then it’s it’s
16:25
help improving the patient experience honestly that’s where we’re going with it got it got it so each are in
16:30
prepayments I wanna ask you follow up about each of those on the EHR side you mentioned it saves six
16:38
to eight hours per week in terms of chart prep did I get did I get that right correct
16:43
fantastic and what what specific pieces of the chart prep is it the hey we’re
16:50
not having to enter in information twice is it is it make it easier to to
16:56
actually go in and you know get get you know you’re not having to physically kind of put the charts in different
17:02
places like what about the sharp rep is most helpful well when we were on paper
17:07
they would print out packets right of the whole chart and they would have to Flap stickers patient information
17:13
stickers on every single one of those paper pieces of paper and if you imagine there’s probably about 13 or 14 sheets
17:21
of paper per chart and so they’re slapping on stickers I mean that that took like
17:27
a lot of just busy work time just slapping on stickers to a patient’s chart
17:32
yep especially when you you have a busy 30 40K stay
17:37
sure and so that’s 68 hours does that help the nursing staff do more cases
17:43
spend more time with patients spend more time on lunch breaks how did
17:49
they repurpose that those Time Savings it helps our front desk to be able to to focus more on the patient and and be
17:55
able to do other tasks got it that’s great okay and that’s the EHR side and then
18:03
the prepayment side you mentioned there’s the benefit the patients there’s the benefit
18:08
probably from a Time Savings again of not spending much time kind of registering a patient on the front on
18:15
the front end um what percentage do you expect will kind
18:20
of pay prepay versus time of service hmm we’re hoping 100 but
18:27
um I think we would be happy with about 70 wow 70 is fantastic and again are you
18:34
planning on using kind of texting and some of the reminders that you guys have done and you know part of the pre-screening process there
18:41
we’re not quite sure yet and we’re kind of in the the pre-planning phase of this
18:47
awesome so we haven’t really implemented it yet we’ll have to check check back in with
18:52
you and and uh see how it goes on on the prepayment side but definitely see the benefits there
18:58
um what about post-surgery Kayla what what technology have you seen from a
19:04
post-surgery perspective you know that benefits the center the benefits patients
19:09
yep I also hit on um I’ll go back just real quick and hit on one other technology that we have during surgery
19:15
and so here at Main Eye Center we have laser cataract surgery and this is a
19:23
huge benefit not only for the patients but for the surgeons as well so laser
19:28
cataract surgery what it does it makes a three perfect 360 degree circle in the
19:35
capsule to me of the of the patient’s eye which is the bag that the patients cataract or lens sits in
19:42
um and the doctor has to get into the bag to be able to remove the lands well once once you create a perfect 360
19:50
degree circle it helps um the lens once you once you
19:56
insert the artificial lens it helps it Center it and which gives the patient a better outcome not only that it also
20:04
fragments the lens so um for cataracts we grade them from difficulty a OnePlus is kind of a soft Cataract and a four
20:10
plus is kind of a hard cataract we can turn a four plus cataract into a two plus cataract with this laser and what
20:17
that does it makes it easier for the surgeon to extract the Cataract and it also makes it the recovery time better
20:22
for the patient because when the Cataract is softer it’s less um vibration in the eye from
20:29
the fake machine that we’re taking out the Cataract with which means less inflammation for the patient’s eye
20:35
better recovery so the patient sees better faster wow fantastic
20:41
it sounds like a great great clinical benefit there huge
20:48
yeah if we move on to the post-surgery side anything there that’s been implemented or you guys have seen
20:55
success with it man um I would say again the patient portal
21:00
um so the the patient portal also provides um post-op reminders for the patients and it also allows them to stay
21:09
in touch with the surgeon’s office in case they have questions um which we’ve found is is been a
21:15
benefit instead of having the patient call a call center and and be hung up on the on the line or waiting in line to
21:23
get in touch with somebody it’s been helpful fantastic and do you do you guys have to
21:29
spend much time on you mentioned prepayments do you have to spend much time on post payments
21:36
no so um we collect up front 100 of the time I don’t allow patients
21:43
to go back without collecting seems like a good seems like a good policy I’ve certainly talked to other centers that
21:50
don’t always get it or don’t don’t get the full amount of time of service and have to spend you know a lot of times on
21:55
the on the back end doing the calls and leaving the voicemail so yeah yeah it’s hard enough um to get collecting payments from the
22:02
insurance um let alone patients so it’s it’s a definitely an absolute good policy to
22:09
have is to collect payment upfront love it okay so final question for you here
22:14
Kayla we do this with all of our guests what is one thing that our listeners can do this week to improve their Surgery
22:20
Center I would say
22:26
patient experience um because patient experience I’m in this this can go in multiple different
22:33
directions but when you have when your patient experiences a really good surgical day
22:39
and they’re going to go out and tell their friends and that’s word of mouth right that’s going to bring more patience into your facility I truly
22:47
believe word of mouth is probably your best marking your marketing strategy for any Center
22:53
not only this your patient experience is going to stem from your surge in
22:59
leadership so from a search and standpoint no matter if they want to be
23:04
a leader or not when they slap that MD on that behind their name they’re
23:10
automatically a leader and so that it’s huge for surgeons to understand that if if they’re good leaders to their staff
23:17
their staff are going to have a more positive day and they’re going to give
23:22
the patients more positive experience as well so it’s kind of like a Snowball Effect
23:28
love it and I’ve I’ve seen studies that affect in other Industries as well where
23:34
it’s like hey that the happier businesses employees or staff are there’s actually a proven correlation
23:40
many times to kind of happier that the customers are so that that makes totals that makes total sense and I love it
23:46
absolutely leading from the top advice there so that’s a great one
23:53
Kayla thanks so much um for being on this week this is a great episode and I look forward to
23:58
keeping in touch thank you for having me I appreciate it good night
24:04
[Music] as always it has been a busy week in healthcare so let’s Jump Right In two
24:11
weeks ago we shared a story about an ASC that fell victim to a Cyber attack continuing with that topic and this
24:18
article by Healthcare dive they’re sharing even more insights around cyber attacks and perhaps the most alarming
24:25
statistic is this one 89 of healthcare organizations surveyed experienced at
24:31
least one Cyber attack in the last 12 months so I just wanted to share three important call outs and reminders from
24:39
this story there are four primary types of cyber attacks we have Cloud compromise
24:46
ransomware supply chain compromise and business email compromise
24:52
out of those who cited a ransomware attack 67 percent reported an impact to
24:57
Patient Care and 24 percent reported a rise in mortality rates which is
25:03
extremely concerning the second reminder as we likely head into a recession and you try to find new
25:09
ways to tighten the purse strings experts are concerned that Healthcare orgs will cut cyber security budgets
25:16
first so I know it can be tempting but it is just not worth the risk some
25:21
Health Systems report having to spend up to a hundred million dollars just to recover from a successful attack so
25:27
don’t roll the dice and lastly just because your ASC might be small compared
25:33
to large hospitals or other Health Care Systems it doesn’t mean you will fly under the radar it’s actually the exact
25:39
opposite a tax on smaller organizations are on the rise because it’s assumed that they have their guards down and
25:45
less security measures in place so I hate to start this off all doom and gloom but the data is telling us now
25:52
that now is the time to be more Vigilant than ever when it comes to your cyber security
25:58
this next story is interesting and causing quite the debate should patients
26:04
be charged for sending my chart messages within the last few months a few
26:09
different hospitals have actually started billing patients for some types of messages sent over this patient
26:15
portal examples of those they’re charging for would be inquiries about new symptoms medication adjustments new
26:22
prescriptions and really anything that requires extensive time reviewing a patient’s
26:28
medical history before they can give a response the plan is that the fee will actually
26:34
be billed to the patient’s insurance insurance company with out-of-pocket costs for people on Medicare ranging
26:40
from about three to ten dollars and then the cost for patients without insurance will be a flat rate of 35 dollars
26:48
um to put it in perspective Northwestern Medicine in Chicago said that over the course of three months they only charged
26:55
for less than one percent of my chart messages so it’s obviously not a big chunk at all but as you can imagine
27:02
patient rights Advocates are not happy about this and they say it’s just another way for health care to nickel
27:09
and dime patients um for ASC specifically who are considering
27:15
implementing a patient portal in 2023 or already have one or even for those who
27:20
have two-way patient texting exchanges it’s just something to remain aware of in theory we wouldn’t find ourselves in
27:28
this situation and would actually invite the two-way patient dialogue and patient inquiries to ensure better outcomes but
27:36
I am really curious to hear how you feel about this is it fair to charge in order
27:42
to protect the doctor’s time or does it feel kind of morally icky to discourage
27:48
patients from reaching out in a manner that we built for them to do exactly that so please share your thoughts on
27:55
HSC Pathways LinkedIn post I would love to hear them our third story today is from outpatient
28:02
surgery magazine and it’s all about pre-filled syringes it’s my understanding that these
28:08
syringes are more common in the hospital space than Asus right now but perhaps that will start to change some of the
28:15
benefits shared um were Superior safety reduced errors reduced infections significant Time
28:23
Savings and reduced waste the only real calm that was shared in the article was
28:28
cost um in a recent study is trying to counteract that argument of cost they
28:35
found that the use of manufacturer prepared pre-filled ready to administer
28:41
syringes can actually reduce health care costs by decreasing errors compared with
28:46
the traditional vial and syringe method specifically the study found that manufacturer prepared pre-filled
28:54
RTA syringes were associated with an estimated Savings of roughly a hundred
28:59
and eighty two dollars per Administration with a 94 reduction in
29:04
errors now this was just one study so take it for what it is but the numbers are certainly eye-catching considering
29:11
we’re always trying to reduce spend and talking with some of my colleagues I don’t have a clinical background so I
29:18
needed to kind of ask some other people who do what they thought about this and they agreed with the benefits previously
29:24
stated but also shared an additional cons concern that diversion prevention would need to be top of mind as well and
29:31
keeping those large orders secure so again please join us in this
29:37
discussion on HSC Pathways LinkedIn post I would love to know if this is something your AC would try or have
29:43
tried in an effort to keep patients safe and cost slow
29:48
and to end our new segment on a positive note medical drones are saving lives and
29:54
coming to a sky near you England’s national health service has
29:59
started delivering chemotherapy drugs to the Isle of Wight via drones
30:04
by car and Ferry it takes four hours to deliver them but by drone it only takes
30:09
30 minutes and for life-saving drugs that have a short shelf life that’s a
30:15
huge win it not only saves time but it also saves Fuel and money and reduces
30:20
carbon emissions um two other examples in Africa drones have been used to reach remote
30:25
communities delivering vaccines for malaria tuberculosis and polio and in
30:31
Sweden drones are being um used to bring defibrillators to patients who are actively experiencing
30:37
cardiac arrest and beating the ambulances to the scene so I know drones have raised some
30:44
privacy concerns since their Inception but when used properly in these scenarios they’ve really done some
30:50
incredible incredible work and have saved lives so we love to see any new
30:55
technology any new innovation so this is a really cool story
31:00
and that news story officially wraps up this week’s podcast thank you as always
31:05
for spending a few minutes of your week with us make sure to subscribe or leave a review on whichever platform you’re
31:11
listening from I hope you have a great day and we’ll see you again next week
31:18
[Music]
Don’t miss out on the good stuff – Subscribe to HST’s Blog & Podcast!
Every month we’ll email you our newest podcast episodes and articles. No fluff – just helpful content delivered right to your inbox.