1. Planning for EMR implementation. Surgery centers, for the most part, lag behind hospitals in EMR implementation because of financial and staffing restraints. In addition, the government has yet to provide financial incentives for ASCs to implement EMR, and there are far fewer companies that specialize in ASC EMR software. But according to Beverly Kirchner, owner and CEO of Genesee Associates, “Looking at and adopting an EMR system today is imperative for survival in 2014 and on. The data [that] surgery centers will report to CMS and [other bodies] can not be accurately obtained manually, and the hours it will take to obtain the data manually will potentially cost more than the software in the long run.”
She advises ASC administrators to start looking at EMR vendors, educating themselves on meaningful use requirements, looking at the hours it will take to train staff and asking more EMR-experienced administrators about their experiences.
2. Scheduling staff members and procedures efficiently. Closely monitoring when staff members and procedures are scheduled minimizes, if not entirely eliminates, down time between procedures and cuts out unnecessary staffing expenses, says Kathie Stewart, administrator at Cascade Spine Center in Tualatin, Ore. “Each physician at our spine center has a template that’s built into our practice management system, and those templates determine how many patients there will be in one hour and what procedures will be done so that we can efficiently move patients around,” Ms. Stewart says. “There’s no down time between patients, but it also allows enough time for procedures and keeps everyone on time.”
3. Researching equipment and supply needs early on. Angie Laux, administrator of Bellin Orthopedic Surgery Center in Green Bay, Wis., extensively researching equipment and supply needs early and often is essential to keeping the surgery center on the path to future financial success. “We are trying to work with many different vendors because there are so many instruments and equipment available for orthopedics, so we’ve really done a lot of homework to see what the best available options are at the best prices,” Ms. Laux says. “As you can imagine, every surgeon has their own set of instruments they want to use, so the challenge is trying to find equipment/instruments that work well with all the physicians but at good prices. For example, we’ve finally decided that we were going to order from two vendors to get two different kinds of ACL trays for our physicians.”
Ms. Laux warns researching equipment and supply needs for a newer surgery can be challenging because case volume is constantly changing. “Our case volume has been incrementally increasing every month, so the challenge is the timing of when to bring in new instruments and equipment because it’s all going to be based on case volume,” she says. “You need to closely monitor and take very educated guesses on when volumes are going to increase.”
4. Starting or continuing a dialogue with local hospitals. If surgery centers haven’t already entered into a partnership, alignment or joint venture with local hospitals, they should begin a dialogue about the best way for the two entities to collaborate on the provision of healthcare. The partnership doesn’t necessarily need to encompass a financial agreement. The dialogue should focus on providing a consistent umbrella of care for the patients and position the surgery center as a potential partner for future ventures, such as ACOs.
