8 things to know about adding new technology and techniques to your spine practice

Written by Adam Schrag | March 24, 2017 | Print  |

With an increasing emphasis on technological advancements and innovative surgical techniques, surgeons face a constantly evolving cycle of learning and adapting. Therefore, when spine practices add new technologies and begin utilizing new surgical techniques, physicians, executives and surgical team members must constantly remain up to speed. Here's what healthcare professionals should know about adding new technology and techniques to spine practices.

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1. New technology should have real benefits for the patient and potential for future growth. In January 2013, after incorporating robotic technology into his Houston-based spine practice, Richard Francis, MD, highlighted the justifiable benefits of acquiring new technology and investing time and effort to fully understand it. He cited safety as his primary reason for acquiring and utilizing technology at his practice.


"Anything that allows you to navigate the spinal cord safely is better," he said "It comes to the heart of the procedure because no matter how well we do, if you don't have a safe outcome, it's all for nothing."


It's also important to take the long view and recognize that the medical field is increasingly impacted by technological advancements. A surgeon's role in the operating room will likely evolve hand-in-hand with technology. Dr. Francis said, "The way that robotic surgery is done now, in the sense that we describe it, the robot shows us where to place the implants. I believe in years to come, we will have the capability of the robot to place the implant itself. Whether that's something we want to do or not is another topic of discussion, but the capability is on the horizon. That's the area we are going to develop most in the near future."


Its vital physicians stay up-to-date with the field's technological advancements and learn to adapt with all developments.


2. Be prepared when old systems show their age. As equipment becomes outdated or providers need new technology to address changing patient needs, practice or ASC leaders search for vendors willing to serve and support a cost-conscious strategy. Don't be caught by surprise with a suddenly outdated or broken system and no reserves in the budget for a capital purchase.


There are steps you can take ahead of time to develop relationships with technology vendors to achieve the best deal possible with future purchases:


  • Being upfront about budgeting helps them establish and maintain strong and lasting relationships with technology vendors when the time comes to upgrade.
  • Firm repayment plans and tiered repayment structures are creative solutions that can be shaped to work with a practice's capital budget.


3. Determine how new technology fits into your practice's budget. Make sure new technology purchases fit into the practice's budget and will be cost-effective. New systems often come at premium costs and should demonstrate a significant improvement over the current system to justify those costs. If the technology is cost-effective, you still don't want to bankrupt the practice with a new capital purchase. There are financing options, but don't begin exploring those opportunities before fully understanding how new technology will fit into the practice or ASC's budget. Map out the potential return on investment to see how long it could take for the technology to become cost-neutral.


4. Don't be fooled by marketing. Make sure your decisions are based on science as opposed to competition or a marketing tag claiming a newly released product is the greatest, according to Srdjdan Mirkovic, MD, of NorthShore Orthopaedic Institute in Evanston, Ill. He recommends studying the basic science behind any new technique to fully understand its impact. Demand the company provide peer-reviewed data on how the technique compares to the current gold standard in terms of quality care and cost. In some cases, a higher upfront cost could lead to savings on the back end, but those savings are only relevant if the patient outcomes are similar or improved.


"Note if the new technique prioritizes the length of surgery," he said. "We always strive for a quicker surgery, but not to the detriment of basic science and a better surgical outcome."


5. Seek guidance from more experienced surgeons in the field and those who have tried the technique. Although physicians of all ages should ask questions, young physicians are highly encouraged to seek guidance from older, more experienced counterparts. Observing experienced physicians' techniques will help young physicians improve their surgical abilities.


In discussing key concepts for young orthopedic and spine surgeons to practice, Jonathan P. Braman, MD, of Minneapolis-based University of Minnesota's department of orthopedic surgery said, "Many times, the mentor does not even know why they have done something and will have to find a way to articulate the rationale for something that simply comes naturally to them after years of practice. The experience is good for both of you."


6. Communicate and cooperate with hospitals. To avoid overpaying for new technology, it's worth comparing available products and working with the hospital and new technology evaluation committee and confirm a trial of the technology. Although every hospital's technology review and purchase process is different, it's important to partner with the hospitals to show how the new technology will benefit patients and conduct a trial period before making a full purchase.


Jeffrey Wang, MD, of Los Angeles-based Keck Medicine of USC said, "After a reasonable number of procedures are finished, we review the results to ensure that it is safe, effective and that there were no hidden costs. I think surgeons need to work within the current systems that are in place at their institution in order to create a reasonable, logical process to bring new technology into the operating room."


7. Is the operating room staff prepared? New technologies and techniques will be much more effective and worthwhile if members of the operating room staff are fully capable of handling them. Trial runs in the cadaver lab at a medical school offer a surgical team the chance to improve its ability to utilize a new technique before using it in a real surgery. Purnendu Gupta, MD, of Chicago-based Shriner's Hospital for Children suggests "critically [evaluating] the outcome. When embracing new technology and techniques, we should always confirm that we are improving patient care and outcomes."


8. Stay patient and strive for continued improvement. Surgeons take time away from their regular practice to train in a new technique and then invest heavily in the technology to perform that technique for their patients. The learning curve for any new technique takes time and it's easy to become frustrated and decide to revert back to the old technique. However, consider whether the new technique could ultimately deliver a better outcome to patients before fully abandoning those efforts.


"Give it time as you will not perfect the technique after two attempts or even five attempts, but you will get to the point where it becomes easier," said Brian Gill, MD, of Nebraska Spine Hospital in Omaha during an October 2016 interview with Becker's Spine Review. "Every year I strive to learn a new technique."


In the same article, Brian R. Gantwerker, MD, of The Craniospinal Center of Los Angeles recommended consulting with colleagues or collecting information regarding a new technique from an experienced individual. Although successfully performing a new technique may be difficult to accomplish initially, physicians ought to keep trying and improving until they're able to fully rely on the technique.


More articles on practice management:

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