Michael Powers – The Power of Interoperability & Technology | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
We hear about the concept of interoperability used all the time, but what does it truly mean and look like in practice?
Michael Powers is the Administrator at Children’s West Surgery Center, and he is on this week’s episode to talk about The Power of Interoperability and Technology. Michael and his team have recently undergone an initiative to transition from 5+ software vendors to one, so he’s sharing what that process has been like and what it means for the future of his surgery center. Here are a few highlights from the episode:
➡️ Your surgery center may have inherited tech built for inpatient purposes, and it doesn’t quite meet your outpatient needs. Don’t be afraid to evaluate your options and look for solutions designed for you.
➡️ You must look at the solutions you have with a critical eye – are the vendors making upgrades, improvements, and investing in their own technology? Or are they phasing out our solutions and trying to push you in a different direction?
➡️ Even though you may be adding new tech (ex. Patient texting, online pre-admission, electronic charting, etc.), does the tech speak to one another? Or are you adding more manual work for your staff?
➡️ Take your time and evaluate your options – do your research online, schedule all the demos you can, ask your peers, and even go to local facilities to see what products they’re using. Don’t be shy about doing your homework.
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.
Episode Transcript
0:00
welcome to this week in surgery centers if you’re in the ASC industry then
0:06
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 here’s what you can expect on today’s episode we hear about the
0:33
concept of interoperability all the time but what does it really mean and look like in practice Michael Powers is the
0:41
administrator at Children’s West Surgery Center and he’s also the president of the Tennessee Ambulatory Surgery Center
0:47
Association and he’s here today to talk about the power of interoperability and
0:52
Technology Michael and his team have recently undergone an initiative to transition from five or so different
0:59
software vendors to one so he shares what that process has been like and what it means for the future of his surgery
1:06
center in our news recap we’ll cover what gen Z is looking for in a workplace and a job
1:13
the latest on cyber security attacks in the healthcare industry sustainability
1:18
tips for the or and of course and the new segment with a positive story about
1:23
a new training module built to enhance care for the homeless hope everyone enjoys the episode and here’s what’s
1:30
going on this week in surgery centers
1:35
thank you hi Michael thanks for joining us on the podcast today good morning Eric it’s my
1:42
pleasure to be here before we get into our topic can you share a little bit about yourself with
1:48
our listeners sure um I’ve been in healthcare for 38 years I started out many years ago as a
1:54
restaurant therapist proceeded to get my graduate degree in the MBA I’ve
2:01
mostly been in large Healthcare systems but for the last 10 years I have been an administrator for a
2:08
multi-specialty children’s pediatric Ambulatory Surgery Center in Knoxville
2:13
Tennessee and have had the pleasure of being on the board of our Tennessee Association
2:19
as well as am the current president for Tasca
2:24
awesome that’s great what uh what type of procedures do you perform and and how
2:31
many cases do you typically see in a month um we’re averaging between four and 500
2:37
cases a month so we’re quite busy uh the when you think about the Pediatric population a lot of what we do
2:44
is ear nose and throat followed by Urology uh followed by
2:50
Ophthalmology followed by Oral Surgery dental and very few Orthopedics and very few
2:58
Plastics yeah do you find that um serving a younger population is is is
3:06
different in nature than serving an adult population
3:11
extremely different um you don’t have the adult population you know being having such a high
3:17
anxiety that you know that they cry that they have separating separation anxiety from their
3:24
mom and dad and so we try from the very beginning have created an atmosphere not
3:31
only a physical environment where it’s bright colors and we have special toys
3:36
and iPads and other things to try to distract them the other thing that we do
3:43
uh you know they do receive some medication in the holding room prior to
3:49
going back to the or room to help them calm to help the separation anxiety to
3:55
be less and a smooth transition into the operating room and then obviously
4:01
every patient is important and you never ever when it comes harm but we just feel
4:07
this more strongly that when you’re dealing with
4:13
children we the the bar is raised even higher for us and start making sure that every you
4:20
know every eye is dotted and every T is crossed and the team’s well communicated that we’re very blessed I mean our
4:27
anesthesiologists are all aborted in the Pediatrics um our nurses
4:33
um the majority of them have been with Pediatrics for a very very long time we
4:38
also have been very blessed we have extremely low turnover uh and so people know what they do and
4:46
they do it very very well we also have a process I think works extremely well is
4:52
you know you have two phases of recovery so you have your post anesthesia
4:58
recovery when they’re still really really sleepy and they’re starting to wake up and in the Pediatric world it’s
5:05
a one-to-one you have one nurse for one patient throughout the entire process
5:10
and then whenever they are starting to become alert and waking up then we
5:16
immediately get them into a private room in a second phase recovery with their parents which seems to really have a
5:22
smooth transition and more comforting for the child they have their mom or dad with them and how do you know my comfort
5:29
of them until they’re ready for discharge Church yeah yeah and kind of waking up and seeing that familiar face I would
5:35
imagine makes a huge difference so yeah it’s just interesting because I feel like we’re always kind of talking about
5:41
and thinking about surgery centers from a sense where they’re serving adults and and the elderly population
5:48
um you kind of forget that there’s a lot of children that have surgeries as well so that’s good it sounds like you guys
5:55
have a ton of compassion and kind of take all of that into consideration
6:00
um so I was reading Becker’s a few a few weeks ago and you caught my eye because
6:06
you were featured as the administrator of the week and as I kept reading I
6:11
learned how you were implementing new technology at your Center in the hopes of Greater interoperability which is
6:17
something we really haven’t talked too much on the podcast yet um you know what is it like actually
6:22
cutting out all the different siled technologies that a lot of surgery centers use today what were you
6:30
experiencing at your facility that really drove you to want to make a change
6:36
you know in going back to my Hospital days you know you have you large systems
6:42
whether it be Cerner or epic or you know some of the major ones that people really familiar with and they
6:49
were really focused on uh which 80 90 percent of what a lot of the patient population
6:55
coming through is in patients right and then you’ve seen a growth in the outpatient world but mainly uh it’s you
7:04
know it could be PT or whatever so their their needs are different
7:10
um I have never really seen in my past year especially on the hospital side
7:15
that these large software companies really had a focus or a really great
7:21
product for outpatient surgery so being in this facility whenever I
7:26
started working here 10 years ago they were using a product that they started
7:32
with and this Center is now this month actually celebrating its 20th
7:39
anniversary for 20 years nice and then you know thank you and in that 20 years we have served over 80 000 patients
7:47
and so we’re we’re going to celebrate later this month but what I discovered coming here is so we
7:54
you had this uh business software that was able to do
8:00
obviously your registration your or scheduling your billing uh keeping up
8:06
with that um your accounts uh posting for your accounts from the
8:13
patient billing Pro population um but that was pretty much all that it did the other piece was
8:21
you know you’re only allowed a so many number of people that you paid for that
8:27
have access to the system and as we’ve been growing it was be very common that
8:33
we would say oh do you need this product can I have it for a few minutes you know why I need to look something up
8:41
and so we were having to share and when we looked at adding more users it just
8:47
was not cost effective it did not make sense and this product being as the age that
8:53
it was they were maintaining it to function and it functioned very well
8:58
from a stability standpoint but there was no upgrades no changes Etc so we
9:04
ended up uh really having paper charts
9:10
having this one old system to cover those functions that I mentioned
9:17
to um you know me saying how can we try to
9:23
eliminate some of the manual work that we’re doing to more of utilizing either
9:29
a social media or other kinds of software applications
9:36
to better communicate with their patients and families and to be more efficient
9:41
and so the the next thing we added was we added an online pre-admission medical
9:48
questionnaire instead of calling every single patient and we were calling them
9:53
and trying to get Mom or Dad on the phone and try to ask them this long questions and either a they went answer
10:01
B it would go to voicemail or C the voicemail wasn’t set up and you were
10:07
just or sometimes you call mom and she’s in a grocery store you know pushing a buggy in and with the kid and just
10:14
wasn’t convenient to answer all these questions and so there’s a lot of callbacks callback callbacks so
10:20
creating this working with this system of where we could just send out to Mom
10:27
and Dad and we originally did it from the physician’s office in a brochure
10:32
to say here go online here’s the link go fill out this medical questionnaire
10:38
you know and answer it and you can do it at your convenience and then we monitored and our goal was
10:44
you know um seven calendar days or five business days prior to the date of surgery that
10:50
they would have that completed if not then we were prompting them that they really need to get that completed
10:56
because as you know in an Ambulatory Surgery Center if they have any kind of complications comorbidities or whatever
11:03
they’re not a candidate for to come and we’re blessed that we have a
11:08
children’s hospital right here in town that they would go there if they needed to have the procedure done
11:14
and so that was the first thing we did and it was I mean huge in the amount of
11:20
work that it took off of our pre-admission nursing staff
11:25
and then the next step we went to was um getting a another separate
11:33
um texting platform that we began to text patients
11:39
and so we get texts from if we need him to contact the business office for
11:44
discuss deductibles or out of out-of-pocket expenses uh the pre-admission nerves could text that
11:51
they had questions and needed you know once they reviewed their medical questionnaire um and then
11:57
we always the day before surgery because you’re always having additions
12:02
subtractions cancellations so the day before surgery is when we really put all of our patients in order when they’re
12:09
coming how we’re going to do our day to make it most efficient as possible so the day before surgery then we’re
12:16
texting NPO instructions which they’ve already had in writing before as well as
12:22
their arrival times to the center now obviously on the front end we get permission to text them and they give us
12:29
either opt-in or opt out um and then lastly is we were doing
12:36
not electronic charting but paper charting and at the end of the day when the patient was discharged then dogs
12:42
those charge were being scanned into a another software that was a digital
12:49
repository for all of our records then we could Shred the paper and then everybody you know can have access if
12:55
they needed to see an old record to anyone okay so even though we had
13:01
continued to uh Advance utilization of you know
13:08
what technology offers us today you know you had four or five six
13:14
different vendors and applications and software and not everybody was talking
13:20
to one another and seeing that our
13:26
Core Business Office Software System was aging and getting
13:33
older and there was no upgrades or whatever to me the Ronnie was on the law that
13:39
eventually this was going to be phased out sure so we so we began actually a year
13:45
ago thinking doing research talking a lot of my colleagues to see what they’re using
13:52
where they’re at um and then doing uh demos and asking a
13:57
lot of questions and seeing things and we even went to some local facilities
14:03
ASC friends of mine to look at products that they had and were using to help us
14:09
narrow down what we thought would be the best product for us that will allow us
14:14
over time not only improve day one but slowly phase in these other things so
14:21
that we can have one vendor if you will one application that had I’ll have all
14:28
of this for us and think about staff they wouldn’t need six or seven different passwords they’re you know
14:34
they are have to learn five or six different systems that we can all be
14:39
housed within one so having that long term goal and and living in that world
14:45
brought us to as I stated you know when I was talking to Beckers of really
14:51
focusing on um not just where do we want to go this year but where we see yourself in three
14:58
years and five years and finding a vendor that we believed would have that
15:04
flexibility to grow with us yeah absolutely and I think I think
15:10
that’s the only path forward right especially when you talk three years five years with all the different
15:16
outcomes that are coming and all the different reporting and measures it’s like you have to have these systems that
15:22
speak to one another so that when it’s time to pull these reports and metrics and and plan for the future you have the
15:28
data and the systems that speak to one another so that you’re you’re able to do so
15:33
were when you so you knew you had to make a change how did you start socializing that with your staff to get
15:40
all of them on board or were they just so frustrated with the day-to-day that they were welcoming change
15:47
um it was mixed some were uh welcome to change because they could see
15:53
you know the some of the frustrations that we had with the existing system especially
15:59
um not enough access for users and you know the new systems is
16:06
unlimited users I mean and so I mean that right there seems small but it was
16:11
a big big deal your people who I think use this more than anyone else
16:17
especially initially is your business office they’re doing the registration you know
16:22
they’re doing the or schedules they’re doing the billing they’re doing the posting they’re doing the communication
16:28
they’re making sure you know the emails the cell and phone numbers all this data and everything up front is accurate
16:35
they’re doing the insurance verification of benefits which I didn’t even talk about that our old system was
16:42
you know they would have to go on the website look up that individual person find out you know what their benefits
16:50
were and create this manual sheet on you know where they were in their deductible
16:55
what we were having done what was the you know the allowable baseball in our contract rate
17:01
for now we’ll be able to do that you know just by simply through the system so again highly effective highly
17:09
efficient a lot less manual labor on the individuals but I think
17:16
um just encouraging people um that we believe that it’s either
17:22
going to be now or it’s going to be in the near future we’re going to make a change and so let’s be proactive and
17:29
let’s do it and and I think also they trusted us
17:34
that we did our homework we took our time we do our did our due diligence and then the other two things
17:41
we did is we took some of our key staff to some local facilities
17:46
that was used in a product that we felt like was the one that we wanted to go with
17:51
so that they could see it and then lastly is I spent a lot of
17:57
energy and time and I would say go on an overboard but I made sure that they had
18:04
a lot of Hands-On training and accessibility during that whole
18:10
process of leading up to and the first couple of days of go live were that you
18:17
know they were never in a secret swim situation sure
18:23
yeah so and that makes sense how so I’m getting how you know true interoperability will impact your
18:29
staff’s day-to-day what about from the patient side how do you think they are
18:35
impacted by having this technology and in all of your systems speaking to one
18:41
another I I think it’s it’s not going to be as
18:47
um visible to them because you know we still text them that’s going to be the
18:53
same the questions that we ask them that’s all going to be the same so all the pre-work is going to be the same how
18:59
we handle them from a patient care perspective internally is going to be the same I think the only thing that we
19:07
haven’t um done yet it’s in the future is with
19:13
the system that we have we’ll be able that we can set up an or board where
19:18
they will be able to visually know their child’s in eor their child’s in recovery
19:23
and will be able to have a visceral communication that today they don’t have
19:28
it’s more of you know we will let them know verbally um especially if it’s a long case how
19:36
things are going and we’ll talk to them via phone but I I think that’s something
19:41
new in the future that will help them but again thinking about our patient
19:46
population and the families I think since we didn’t add anything new to them
19:53
then it’s it’s pretty seamless for the patient and family side sure definitely
20:00
makes sense and since you’ve kind of started down this journey have you seen
20:05
any immediate benefits or Direct Time Savings direct Financial savings that you can report on I know it hasn’t been
20:12
too long but um initially Financial savings I’m going to say no
20:19
um uh but efficiency and staff satisfaction absolutely so efficiency
20:28
part is we have actually decreased from an average of eight minutes to five minutes for registering patients
20:36
which shocked me we did that within two or three weeks
20:41
um the other thing is that like I said it’s small but we have unlimited users
20:46
that can access the system so no more of like I said asking someone hey can you
20:52
get off so I can get on to look and do something and then I’ll give it back to you I mean we don’t have that anymore
20:59
um and then it’s it’s just very more up-to-date in fact
21:05
of being very intuitive on how you maneuver if you’re used to using Google
21:10
if you’re used to using a computer then it is it is um more up to date and being able to put
21:18
patients on the or schedule being able to rearrange that is so much easier than the older system
21:26
um so I think efficiencies just in the use of it uh efficiencies in its design
21:33
um efficiencies in uh it’s anybody can access it
21:40
um and we’ve been able to I think in those
21:45
ways um utilizing the testing system and all the patients that we register are
21:52
already automatically in the texting system so we just pull up the patient right there’s their cell number we can
21:58
text them whatever we want to obviously we have Tim plated formatted texts that
22:04
are common about everybody and then but we also can make it unique based ones or
22:10
anything special that we need to communicate to them so um we’re in the final phases of bringing
22:18
up the insurance verification piece to go online uh you know we’ve had to do a little bit
22:24
of integration with that um I I think
22:31
it’s it’s definitely people once they started to see it and once they start to
22:37
get where we’re going and its capabilities then it just it built excitement it built among the staff and
22:46
I think that became um uh just uh
22:52
was shared and as as one person got excited then another person see that
22:57
excitement and then they would start getting excited and it sort of spread in a very positive way
23:02
yeah yeah that’s great um okay I think that was all the questions
23:09
we had today but we do this every week with our guests what is one thing our
23:15
listeners can do this week to improve their surgery centers
23:22
I think that for me is um
23:27
number one is for us the the focus it’s hard to find
23:35
staff Staffing shortages is a big deal so ensuring that you’re competitive on
23:42
compensation 401K matching um you know things that you can do you
23:48
could do small things uh just last week we brought in a coffee truck and paid
23:54
um for everybody to get a coffee or a hot chocolate or whatever just to sort of celebrate some of the um uh things
24:02
that we’ve accomplished I think from an administrative side to Surgery Center side obviously
24:08
if you want to be extremely successful work in your or schedule
24:14
maximum knowing what your most profitable cases are maximizing that knowing your fastest
24:21
Physicians giving them two rooms to flip back and forth work in the or schedule
24:27
and such that you’re doing cases that make you the most money that you don’t have gaps and that you’re doing as many
24:34
cases as you can per day I think that’s foundational number two is we work and
24:41
we rework every three years every contract that we have to get fee
24:47
increases so I think staying on top of that and and again you got to know your
24:53
business and if you don’t know what your most profitable and your most common
24:58
cases are then um you have to very closely watch the
25:03
contracts you negotiate because they will sort of want to stay budget neutral
25:09
but what you want is you want the cases that you do the most of
25:14
to to make the highest profit off of sure so having that data and knowing
25:19
your business and then lastly is everything that you can to control your
25:26
expenses so I mean you know the bottom line is you got to have happy employees
25:31
happy employees will make happy positions and happy patients
25:37
and then if you want to be profitable is knowing your business working your or schedule
25:43
increasing your revenues and decreasing your expenses I mean that’s it’s basically what I call your very basics
25:50
in football of just blocking and tackling really well every day in and
25:55
out and I think staying connected you know through your associations through your
26:00
state or the national associations having other administrators or other
26:06
individuals that you network with and talk with I I find very invaluable
26:12
yeah I agree and I think HST Works closely with a lot of the associations we love working with with Tennessee and
26:19
it’s amazing how much the associations do at the state level on behalf of their
26:25
members in all surgery centers it’s really impressive so kudos to you
26:31
um all right Michael thank you so much I appreciate all your time and expertise and can’t wait to see uh what the future
26:38
holds for you guys thank you it’s my pleasure and you have a wonderful day you too thank you
26:47
[Music] as always it has been a busy week in
26:53
healthcare so let’s Jump Right In LinkedIn recently published their 2023
26:58
workplace learning report and revealed that members of gen Z which is defined by the U.S census as
27:05
those born between 1997 and 2013. prioritize job security competitive pay
27:13
and a good work-life balance when considering job opportunities they also value workplace diversity and
27:20
inclusivity prefer clear communication and feedback and value company
27:25
transparency and social responsibility so why does this matter the average age
27:32
of a nurse in the U.S right now is 52. so as more of our experienced nurses are
27:39
looking to retire or maybe even just pick up less shifts surgery centers and
27:44
other health care facilities need to understand how to attract and retain younger nurses and leaders and as Jen’s
27:51
ears are now either fully part of the workforce or are just considering what their career might be employers need to
27:58
focus on providing these key elements in their workplace culture so that younger
28:03
staff and those just coming out of college or those who are working looking for a career will will consider working
28:11
at their surgery centers or Health Care Facilities so I highly recommend checking out the article and the full
28:17
report we will link both in the episode show notes so you can easily find them
28:23
a recent report by Moody’s investor service highlights the increasing importance of cyber security Investments
28:30
for healthcare organizations so this topic is nothing new and the
28:35
report notes as we all know that Healthcare orgs are particularly vulnerable to cyber attacks due to the
28:42
large amounts of sensitive patient data that they naturally handle and store and
28:47
a Cyber attack will not only cause Financial loss but will also cause reputational damage and legal
28:53
liabilities so for perspective Federal Federal records indicate that Health
28:59
Care breaches have exposed 385 million patient records from 2010 to
29:05
2022 and that 89 percent of Health Care Providers typically suffer a Cyber
29:11
attack over any given 12-month time frame so the good news is that the report found that Healthcare
29:17
organizations are increasing their investments in cyber security measures such as data encryption employee
29:23
training and software and Hardware updates and that is becoming more common that these Healthcare orgs are
29:30
Outsourcing their cyber security functions to third-party vendors that specialize in this area
29:36
uh one interesting call out that I thought was important was that investors are increasing increasingly asking
29:43
Healthcare organizations about their cyber security strategies so previously maybe it was something they asked but it
29:49
wasn’t um didn’t hold as much weight as it does today um and also investors will be less
29:55
likely to put money into organizations that do not have strong cyber security measures in place
30:02
um so we have reported on stories like this before and will continue to do so as this is one area that unfortunately
30:10
you can’t just get away with the Senate and forget it mindset and you must stay on top of it as things are constantly
30:17
evolving in our third story from outpatient
30:22
surgery magazine they are highlighting the environmental impact of Health Care operations and the potential benefits of
30:29
practicing more sustainability so every Healthcare facility contributes
30:35
significantly to environmental pollution and waste uh this includes greenhouse
30:41
gas emissions waste generation water usage single-use medical devices
30:46
packaging materials uh and the list goes on and on but one specific call out in
30:52
this article is gloves the article states that if you’re serious about sustainability
30:59
um you better be focusing on your glove purchasing practices so why call out
31:05
this single item according to a senior strategist at Healthcare without harm
31:10
they’re one of the highest volume products in healthcare they have significant resource in
31:16
greenhouse gas use associated with them they naturally generate large amounts of
31:22
waste they contain chemicals that are concerning and have a problematic supply chain so it is a bad day to be a club
31:30
and I think gloves in general might need a PR team after this article but everything that they shared really does
31:37
make sense um but the good news is that Healthcare without harm did release a step-by-step
31:42
guide called new sustainability criteria for examination and surgical gloves and
31:48
they lay out exactly what you should be looking for in your vendors uh what example would be you know does this
31:55
supplier um like what’s going on with their packaging processes are they sustainable
32:01
um is everything recyclable uh recyclable are they only using materials
32:07
um that are necessary you know no extra fluff stuff like that um so overall this article serves as a
32:14
reminder of the importance of sustainability practices um in perioperative settings and I do
32:20
encourage every Surgery Center to adopt environmentally sustainable practices in their operations wherever they can and
32:27
we also have a great podcast episode we did with Adam Hornback on real ways to
32:33
reduce waste and increase recycling that came out in December 2022 if you are
32:38
interested in learning more about this topic and to end our new segment on a positive
32:45
note Yasmeen LaTour an assistant professor at Villanova University College of Nursing has developed a
32:53
training module for healthcare providers to enhance care for the homeless the
32:58
module aims to increase knowledge and awareness of the unique Health needs and challenges faced by homeless individuals
33:05
and provide strategies for effective communication and empathy the program
33:10
has been tested in Philadelphia so far and has received positive feedback from health care providers who reported
33:17
feeling more confident and prepared to provide care to homeless patients and
33:22
the goal is that this module can be implemented in healthcare facilities across the country to improve health
33:28
care for the homeless population and that news story officially wraps up
33:33
this week’s podcast thank you as always for spending a few minutes of your week with us make sure to subscribe or leave
33:40
a review on whichever platform you’re listening from I hope you have a great day and we’ll see you again next week
33:49
thank you [Music] why are you keeping me
welcome to this week in surgery centers if you’re in the ASC industry then
0:06
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 here’s what you can expect on today’s episode we hear about the
0:33
concept of interoperability all the time but what does it really mean and look like in practice Michael Powers is the
0:41
administrator at Children’s West Surgery Center and he’s also the president of the Tennessee Ambulatory Surgery Center
0:47
Association and he’s here today to talk about the power of interoperability and
0:52
Technology Michael and his team have recently undergone an initiative to transition from five or so different
0:59
software vendors to one so he shares what that process has been like and what it means for the future of his surgery
1:06
center in our news recap we’ll cover what gen Z is looking for in a workplace and a job
1:13
the latest on cyber security attacks in the healthcare industry sustainability
1:18
tips for the or and of course and the new segment with a positive story about
1:23
a new training module built to enhance care for the homeless hope everyone enjoys the episode and here’s what’s
1:30
going on this week in surgery centers
1:35
thank you hi Michael thanks for joining us on the podcast today good morning Eric it’s my
1:42
pleasure to be here before we get into our topic can you share a little bit about yourself with
1:48
our listeners sure um I’ve been in healthcare for 38 years I started out many years ago as a
1:54
restaurant therapist proceeded to get my graduate degree in the MBA I’ve
2:01
mostly been in large Healthcare systems but for the last 10 years I have been an administrator for a
2:08
multi-specialty children’s pediatric Ambulatory Surgery Center in Knoxville
2:13
Tennessee and have had the pleasure of being on the board of our Tennessee Association
2:19
as well as am the current president for Tasca
2:24
awesome that’s great what uh what type of procedures do you perform and and how
2:31
many cases do you typically see in a month um we’re averaging between four and 500
2:37
cases a month so we’re quite busy uh the when you think about the Pediatric population a lot of what we do
2:44
is ear nose and throat followed by Urology uh followed by
2:50
Ophthalmology followed by Oral Surgery dental and very few Orthopedics and very few
2:58
Plastics yeah do you find that um serving a younger population is is is
3:06
different in nature than serving an adult population
3:11
extremely different um you don’t have the adult population you know being having such a high
3:17
anxiety that you know that they cry that they have separating separation anxiety from their
3:24
mom and dad and so we try from the very beginning have created an atmosphere not
3:31
only a physical environment where it’s bright colors and we have special toys
3:36
and iPads and other things to try to distract them the other thing that we do
3:43
uh you know they do receive some medication in the holding room prior to
3:49
going back to the or room to help them calm to help the separation anxiety to
3:55
be less and a smooth transition into the operating room and then obviously
4:01
every patient is important and you never ever when it comes harm but we just feel
4:07
this more strongly that when you’re dealing with
4:13
children we the the bar is raised even higher for us and start making sure that every you
4:20
know every eye is dotted and every T is crossed and the team’s well communicated that we’re very blessed I mean our
4:27
anesthesiologists are all aborted in the Pediatrics um our nurses
4:33
um the majority of them have been with Pediatrics for a very very long time we
4:38
also have been very blessed we have extremely low turnover uh and so people know what they do and
4:46
they do it very very well we also have a process I think works extremely well is
4:52
you know you have two phases of recovery so you have your post anesthesia
4:58
recovery when they’re still really really sleepy and they’re starting to wake up and in the Pediatric world it’s
5:05
a one-to-one you have one nurse for one patient throughout the entire process
5:10
and then whenever they are starting to become alert and waking up then we
5:16
immediately get them into a private room in a second phase recovery with their parents which seems to really have a
5:22
smooth transition and more comforting for the child they have their mom or dad with them and how do you know my comfort
5:29
of them until they’re ready for discharge Church yeah yeah and kind of waking up and seeing that familiar face I would
5:35
imagine makes a huge difference so yeah it’s just interesting because I feel like we’re always kind of talking about
5:41
and thinking about surgery centers from a sense where they’re serving adults and and the elderly population
5:48
um you kind of forget that there’s a lot of children that have surgeries as well so that’s good it sounds like you guys
5:55
have a ton of compassion and kind of take all of that into consideration
6:00
um so I was reading Becker’s a few a few weeks ago and you caught my eye because
6:06
you were featured as the administrator of the week and as I kept reading I
6:11
learned how you were implementing new technology at your Center in the hopes of Greater interoperability which is
6:17
something we really haven’t talked too much on the podcast yet um you know what is it like actually
6:22
cutting out all the different siled technologies that a lot of surgery centers use today what were you
6:30
experiencing at your facility that really drove you to want to make a change
6:36
you know in going back to my Hospital days you know you have you large systems
6:42
whether it be Cerner or epic or you know some of the major ones that people really familiar with and they
6:49
were really focused on uh which 80 90 percent of what a lot of the patient population
6:55
coming through is in patients right and then you’ve seen a growth in the outpatient world but mainly uh it’s you
7:04
know it could be PT or whatever so their their needs are different
7:10
um I have never really seen in my past year especially on the hospital side
7:15
that these large software companies really had a focus or a really great
7:21
product for outpatient surgery so being in this facility whenever I
7:26
started working here 10 years ago they were using a product that they started
7:32
with and this Center is now this month actually celebrating its 20th
7:39
anniversary for 20 years nice and then you know thank you and in that 20 years we have served over 80 000 patients
7:47
and so we’re we’re going to celebrate later this month but what I discovered coming here is so we
7:54
you had this uh business software that was able to do
8:00
obviously your registration your or scheduling your billing uh keeping up
8:06
with that um your accounts uh posting for your accounts from the
8:13
patient billing Pro population um but that was pretty much all that it did the other piece was
8:21
you know you’re only allowed a so many number of people that you paid for that
8:27
have access to the system and as we’ve been growing it was be very common that
8:33
we would say oh do you need this product can I have it for a few minutes you know why I need to look something up
8:41
and so we were having to share and when we looked at adding more users it just
8:47
was not cost effective it did not make sense and this product being as the age that
8:53
it was they were maintaining it to function and it functioned very well
8:58
from a stability standpoint but there was no upgrades no changes Etc so we
9:04
ended up uh really having paper charts
9:10
having this one old system to cover those functions that I mentioned
9:17
to um you know me saying how can we try to
9:23
eliminate some of the manual work that we’re doing to more of utilizing either
9:29
a social media or other kinds of software applications
9:36
to better communicate with their patients and families and to be more efficient
9:41
and so the the next thing we added was we added an online pre-admission medical
9:48
questionnaire instead of calling every single patient and we were calling them
9:53
and trying to get Mom or Dad on the phone and try to ask them this long questions and either a they went answer
10:01
B it would go to voicemail or C the voicemail wasn’t set up and you were
10:07
just or sometimes you call mom and she’s in a grocery store you know pushing a buggy in and with the kid and just
10:14
wasn’t convenient to answer all these questions and so there’s a lot of callbacks callback callbacks so
10:20
creating this working with this system of where we could just send out to Mom
10:27
and Dad and we originally did it from the physician’s office in a brochure
10:32
to say here go online here’s the link go fill out this medical questionnaire
10:38
you know and answer it and you can do it at your convenience and then we monitored and our goal was
10:44
you know um seven calendar days or five business days prior to the date of surgery that
10:50
they would have that completed if not then we were prompting them that they really need to get that completed
10:56
because as you know in an Ambulatory Surgery Center if they have any kind of complications comorbidities or whatever
11:03
they’re not a candidate for to come and we’re blessed that we have a
11:08
children’s hospital right here in town that they would go there if they needed to have the procedure done
11:14
and so that was the first thing we did and it was I mean huge in the amount of
11:20
work that it took off of our pre-admission nursing staff
11:25
and then the next step we went to was um getting a another separate
11:33
um texting platform that we began to text patients
11:39
and so we get texts from if we need him to contact the business office for
11:44
discuss deductibles or out of out-of-pocket expenses uh the pre-admission nerves could text that
11:51
they had questions and needed you know once they reviewed their medical questionnaire um and then
11:57
we always the day before surgery because you’re always having additions
12:02
subtractions cancellations so the day before surgery is when we really put all of our patients in order when they’re
12:09
coming how we’re going to do our day to make it most efficient as possible so the day before surgery then we’re
12:16
texting NPO instructions which they’ve already had in writing before as well as
12:22
their arrival times to the center now obviously on the front end we get permission to text them and they give us
12:29
either opt-in or opt out um and then lastly is we were doing
12:36
not electronic charting but paper charting and at the end of the day when the patient was discharged then dogs
12:42
those charge were being scanned into a another software that was a digital
12:49
repository for all of our records then we could Shred the paper and then everybody you know can have access if
12:55
they needed to see an old record to anyone okay so even though we had
13:01
continued to uh Advance utilization of you know
13:08
what technology offers us today you know you had four or five six
13:14
different vendors and applications and software and not everybody was talking
13:20
to one another and seeing that our
13:26
Core Business Office Software System was aging and getting
13:33
older and there was no upgrades or whatever to me the Ronnie was on the law that
13:39
eventually this was going to be phased out sure so we so we began actually a year
13:45
ago thinking doing research talking a lot of my colleagues to see what they’re using
13:52
where they’re at um and then doing uh demos and asking a
13:57
lot of questions and seeing things and we even went to some local facilities
14:03
ASC friends of mine to look at products that they had and were using to help us
14:09
narrow down what we thought would be the best product for us that will allow us
14:14
over time not only improve day one but slowly phase in these other things so
14:21
that we can have one vendor if you will one application that had I’ll have all
14:28
of this for us and think about staff they wouldn’t need six or seven different passwords they’re you know
14:34
they are have to learn five or six different systems that we can all be
14:39
housed within one so having that long term goal and and living in that world
14:45
brought us to as I stated you know when I was talking to Beckers of really
14:51
focusing on um not just where do we want to go this year but where we see yourself in three
14:58
years and five years and finding a vendor that we believed would have that
15:04
flexibility to grow with us yeah absolutely and I think I think
15:10
that’s the only path forward right especially when you talk three years five years with all the different
15:16
outcomes that are coming and all the different reporting and measures it’s like you have to have these systems that
15:22
speak to one another so that when it’s time to pull these reports and metrics and and plan for the future you have the
15:28
data and the systems that speak to one another so that you’re you’re able to do so
15:33
were when you so you knew you had to make a change how did you start socializing that with your staff to get
15:40
all of them on board or were they just so frustrated with the day-to-day that they were welcoming change
15:47
um it was mixed some were uh welcome to change because they could see
15:53
you know the some of the frustrations that we had with the existing system especially
15:59
um not enough access for users and you know the new systems is
16:06
unlimited users I mean and so I mean that right there seems small but it was
16:11
a big big deal your people who I think use this more than anyone else
16:17
especially initially is your business office they’re doing the registration you know
16:22
they’re doing the or schedules they’re doing the billing they’re doing the posting they’re doing the communication
16:28
they’re making sure you know the emails the cell and phone numbers all this data and everything up front is accurate
16:35
they’re doing the insurance verification of benefits which I didn’t even talk about that our old system was
16:42
you know they would have to go on the website look up that individual person find out you know what their benefits
16:50
were and create this manual sheet on you know where they were in their deductible
16:55
what we were having done what was the you know the allowable baseball in our contract rate
17:01
for now we’ll be able to do that you know just by simply through the system so again highly effective highly
17:09
efficient a lot less manual labor on the individuals but I think
17:16
um just encouraging people um that we believe that it’s either
17:22
going to be now or it’s going to be in the near future we’re going to make a change and so let’s be proactive and
17:29
let’s do it and and I think also they trusted us
17:34
that we did our homework we took our time we do our did our due diligence and then the other two things
17:41
we did is we took some of our key staff to some local facilities
17:46
that was used in a product that we felt like was the one that we wanted to go with
17:51
so that they could see it and then lastly is I spent a lot of
17:57
energy and time and I would say go on an overboard but I made sure that they had
18:04
a lot of Hands-On training and accessibility during that whole
18:10
process of leading up to and the first couple of days of go live were that you
18:17
know they were never in a secret swim situation sure
18:23
yeah so and that makes sense how so I’m getting how you know true interoperability will impact your
18:29
staff’s day-to-day what about from the patient side how do you think they are
18:35
impacted by having this technology and in all of your systems speaking to one
18:41
another I I think it’s it’s not going to be as
18:47
um visible to them because you know we still text them that’s going to be the
18:53
same the questions that we ask them that’s all going to be the same so all the pre-work is going to be the same how
18:59
we handle them from a patient care perspective internally is going to be the same I think the only thing that we
19:07
haven’t um done yet it’s in the future is with
19:13
the system that we have we’ll be able that we can set up an or board where
19:18
they will be able to visually know their child’s in eor their child’s in recovery
19:23
and will be able to have a visceral communication that today they don’t have
19:28
it’s more of you know we will let them know verbally um especially if it’s a long case how
19:36
things are going and we’ll talk to them via phone but I I think that’s something
19:41
new in the future that will help them but again thinking about our patient
19:46
population and the families I think since we didn’t add anything new to them
19:53
then it’s it’s pretty seamless for the patient and family side sure definitely
20:00
makes sense and since you’ve kind of started down this journey have you seen
20:05
any immediate benefits or Direct Time Savings direct Financial savings that you can report on I know it hasn’t been
20:12
too long but um initially Financial savings I’m going to say no
20:19
um uh but efficiency and staff satisfaction absolutely so efficiency
20:28
part is we have actually decreased from an average of eight minutes to five minutes for registering patients
20:36
which shocked me we did that within two or three weeks
20:41
um the other thing is that like I said it’s small but we have unlimited users
20:46
that can access the system so no more of like I said asking someone hey can you
20:52
get off so I can get on to look and do something and then I’ll give it back to you I mean we don’t have that anymore
20:59
um and then it’s it’s just very more up-to-date in fact
21:05
of being very intuitive on how you maneuver if you’re used to using Google
21:10
if you’re used to using a computer then it is it is um more up to date and being able to put
21:18
patients on the or schedule being able to rearrange that is so much easier than the older system
21:26
um so I think efficiencies just in the use of it uh efficiencies in its design
21:33
um efficiencies in uh it’s anybody can access it
21:40
um and we’ve been able to I think in those
21:45
ways um utilizing the testing system and all the patients that we register are
21:52
already automatically in the texting system so we just pull up the patient right there’s their cell number we can
21:58
text them whatever we want to obviously we have Tim plated formatted texts that
22:04
are common about everybody and then but we also can make it unique based ones or
22:10
anything special that we need to communicate to them so um we’re in the final phases of bringing
22:18
up the insurance verification piece to go online uh you know we’ve had to do a little bit
22:24
of integration with that um I I think
22:31
it’s it’s definitely people once they started to see it and once they start to
22:37
get where we’re going and its capabilities then it just it built excitement it built among the staff and
22:46
I think that became um uh just uh
22:52
was shared and as as one person got excited then another person see that
22:57
excitement and then they would start getting excited and it sort of spread in a very positive way
23:02
yeah yeah that’s great um okay I think that was all the questions
23:09
we had today but we do this every week with our guests what is one thing our
23:15
listeners can do this week to improve their surgery centers
23:22
I think that for me is um
23:27
number one is for us the the focus it’s hard to find
23:35
staff Staffing shortages is a big deal so ensuring that you’re competitive on
23:42
compensation 401K matching um you know things that you can do you
23:48
could do small things uh just last week we brought in a coffee truck and paid
23:54
um for everybody to get a coffee or a hot chocolate or whatever just to sort of celebrate some of the um uh things
24:02
that we’ve accomplished I think from an administrative side to Surgery Center side obviously
24:08
if you want to be extremely successful work in your or schedule
24:14
maximum knowing what your most profitable cases are maximizing that knowing your fastest
24:21
Physicians giving them two rooms to flip back and forth work in the or schedule
24:27
and such that you’re doing cases that make you the most money that you don’t have gaps and that you’re doing as many
24:34
cases as you can per day I think that’s foundational number two is we work and
24:41
we rework every three years every contract that we have to get fee
24:47
increases so I think staying on top of that and and again you got to know your
24:53
business and if you don’t know what your most profitable and your most common
24:58
cases are then um you have to very closely watch the
25:03
contracts you negotiate because they will sort of want to stay budget neutral
25:09
but what you want is you want the cases that you do the most of
25:14
to to make the highest profit off of sure so having that data and knowing
25:19
your business and then lastly is everything that you can to control your
25:26
expenses so I mean you know the bottom line is you got to have happy employees
25:31
happy employees will make happy positions and happy patients
25:37
and then if you want to be profitable is knowing your business working your or schedule
25:43
increasing your revenues and decreasing your expenses I mean that’s it’s basically what I call your very basics
25:50
in football of just blocking and tackling really well every day in and
25:55
out and I think staying connected you know through your associations through your
26:00
state or the national associations having other administrators or other
26:06
individuals that you network with and talk with I I find very invaluable
26:12
yeah I agree and I think HST Works closely with a lot of the associations we love working with with Tennessee and
26:19
it’s amazing how much the associations do at the state level on behalf of their
26:25
members in all surgery centers it’s really impressive so kudos to you
26:31
um all right Michael thank you so much I appreciate all your time and expertise and can’t wait to see uh what the future
26:38
holds for you guys thank you it’s my pleasure and you have a wonderful day you too thank you
26:47
[Music] as always it has been a busy week in
26:53
healthcare so let’s Jump Right In LinkedIn recently published their 2023
26:58
workplace learning report and revealed that members of gen Z which is defined by the U.S census as
27:05
those born between 1997 and 2013. prioritize job security competitive pay
27:13
and a good work-life balance when considering job opportunities they also value workplace diversity and
27:20
inclusivity prefer clear communication and feedback and value company
27:25
transparency and social responsibility so why does this matter the average age
27:32
of a nurse in the U.S right now is 52. so as more of our experienced nurses are
27:39
looking to retire or maybe even just pick up less shifts surgery centers and
27:44
other health care facilities need to understand how to attract and retain younger nurses and leaders and as Jen’s
27:51
ears are now either fully part of the workforce or are just considering what their career might be employers need to
27:58
focus on providing these key elements in their workplace culture so that younger
28:03
staff and those just coming out of college or those who are working looking for a career will will consider working
28:11
at their surgery centers or Health Care Facilities so I highly recommend checking out the article and the full
28:17
report we will link both in the episode show notes so you can easily find them
28:23
a recent report by Moody’s investor service highlights the increasing importance of cyber security Investments
28:30
for healthcare organizations so this topic is nothing new and the
28:35
report notes as we all know that Healthcare orgs are particularly vulnerable to cyber attacks due to the
28:42
large amounts of sensitive patient data that they naturally handle and store and
28:47
a Cyber attack will not only cause Financial loss but will also cause reputational damage and legal
28:53
liabilities so for perspective Federal Federal records indicate that Health
28:59
Care breaches have exposed 385 million patient records from 2010 to
29:05
2022 and that 89 percent of Health Care Providers typically suffer a Cyber
29:11
attack over any given 12-month time frame so the good news is that the report found that Healthcare
29:17
organizations are increasing their investments in cyber security measures such as data encryption employee
29:23
training and software and Hardware updates and that is becoming more common that these Healthcare orgs are
29:30
Outsourcing their cyber security functions to third-party vendors that specialize in this area
29:36
uh one interesting call out that I thought was important was that investors are increasing increasingly asking
29:43
Healthcare organizations about their cyber security strategies so previously maybe it was something they asked but it
29:49
wasn’t um didn’t hold as much weight as it does today um and also investors will be less
29:55
likely to put money into organizations that do not have strong cyber security measures in place
30:02
um so we have reported on stories like this before and will continue to do so as this is one area that unfortunately
30:10
you can’t just get away with the Senate and forget it mindset and you must stay on top of it as things are constantly
30:17
evolving in our third story from outpatient
30:22
surgery magazine they are highlighting the environmental impact of Health Care operations and the potential benefits of
30:29
practicing more sustainability so every Healthcare facility contributes
30:35
significantly to environmental pollution and waste uh this includes greenhouse
30:41
gas emissions waste generation water usage single-use medical devices
30:46
packaging materials uh and the list goes on and on but one specific call out in
30:52
this article is gloves the article states that if you’re serious about sustainability
30:59
um you better be focusing on your glove purchasing practices so why call out
31:05
this single item according to a senior strategist at Healthcare without harm
31:10
they’re one of the highest volume products in healthcare they have significant resource in
31:16
greenhouse gas use associated with them they naturally generate large amounts of
31:22
waste they contain chemicals that are concerning and have a problematic supply chain so it is a bad day to be a club
31:30
and I think gloves in general might need a PR team after this article but everything that they shared really does
31:37
make sense um but the good news is that Healthcare without harm did release a step-by-step
31:42
guide called new sustainability criteria for examination and surgical gloves and
31:48
they lay out exactly what you should be looking for in your vendors uh what example would be you know does this
31:55
supplier um like what’s going on with their packaging processes are they sustainable
32:01
um is everything recyclable uh recyclable are they only using materials
32:07
um that are necessary you know no extra fluff stuff like that um so overall this article serves as a
32:14
reminder of the importance of sustainability practices um in perioperative settings and I do
32:20
encourage every Surgery Center to adopt environmentally sustainable practices in their operations wherever they can and
32:27
we also have a great podcast episode we did with Adam Hornback on real ways to
32:33
reduce waste and increase recycling that came out in December 2022 if you are
32:38
interested in learning more about this topic and to end our new segment on a positive
32:45
note Yasmeen LaTour an assistant professor at Villanova University College of Nursing has developed a
32:53
training module for healthcare providers to enhance care for the homeless the
32:58
module aims to increase knowledge and awareness of the unique Health needs and challenges faced by homeless individuals
33:05
and provide strategies for effective communication and empathy the program
33:10
has been tested in Philadelphia so far and has received positive feedback from health care providers who reported
33:17
feeling more confident and prepared to provide care to homeless patients and
33:22
the goal is that this module can be implemented in healthcare facilities across the country to improve health
33:28
care for the homeless population and that news story officially wraps up
33:33
this week’s podcast thank you as always for spending a few minutes of your week with us make sure to subscribe or leave
33:40
a review on whichever platform you’re listening from I hope you have a great day and we’ll see you again next week
33:49
thank you [Music] why are you keeping me
Don’t miss out on the good stuff – Subscribe to HST’s Blog & Podcast!
Every two weeks we’ll email you our newest blog posts. No fluff – just helpful content delivered right to your inbox.