June 21, 2023

One GI group is finding out in real-time.

Ohio Gastroenterology Group
AT YOUR SERVICE Ohio Gastroenterology Group is leveraging artificial intelligence to improve and enhance communications with patients while freeing human staff to have more meaningful interactions in person and over the phone.

When Ohio Gastroenterology Group, a Columbus-based physician-owned practice with five endoscopy centers, was drowning in tens of thousands of monthly phone calls after the pandemic, its leaders turned to artificial intelligence (AI) for help.

“It was impossible to have enough people to answer every call in a timely manner,” says gastroenterologist and board member Raghuram Reddy, MD. “Lots of voicemails means upset patients, so we had to find solutions.”

Forward-thinking practices over the last decade have gradually implemented text messaging, email and smartphone apps for patient communication, while providing richer information on their websites. Some offer web-based portals through which patients can securely access personal records, providers and other information. Ohio Gastroenterology wants to avoid the weaknesses of these approaches that still frustrate some patients by taking it even further — to provide something more seamless, personalized and easier to use for both the practice and the patient.

It’s doing this via a highly configurable, private and secure patient communications platform that enables providers to develop and implement “smart virtual assistants” powered by conversational AI via web, text and voice. The platform automates communication workflows that humans such as overburdened doctors, nurses and staff previously needed to perform. Dr. Reddy says the platform furthers his vision of providing “directed self-service” to patients.

Last year, Ohio Gastroenterology launched the platform by providing self-serve access to COVID-19 information, insurance coverage and billing processes. To support intake workflows, it later launched automated outreach programs in which interactive virtual assistants deliver pre-op instructions and post-op check-ins. This year, it will implement referral scheduling functionality that enables patients to book recommended appointments digitally.

The practice anticipates self-scheduling will reduce leakage and capture revenue from patients who otherwise might not have scheduled. Still to come is a visual patient assessment tool whose range of images will allow patients to share detailed information about where they are experiencing pain.

Dr. Reddy says Ohio Gastro is simply catching up with how patients interact with almost everything else in life by being available virtually 24/7/365. “You can fly all around the world without talking to anyone, but in most cases, you cannot schedule a colonoscopy or endoscopy without speaking with a human,” he says. The intent is not to eliminate human interactions, but to optimize them. If a patient would prefer to speak to a live human being, that option is always available.

The practice and the platform’s vendor continuously monitor the system to ensure patient satisfaction. “The statistics it generates will tell us if people are getting frustrated, so we’ll know if we need to make changes,” says Dr. Reddy. But it does require significant work on his end to maximize the platform’s capabilities and achieve his vision of directed self-service.

“I want my patients to hear what I think is appropriate, as opposed to whatever is out there on Google,” he says. “All of this takes some intelligence in the background. We made a bank of hundreds of questions where patients can chat and interact with the AI with answers vetted and curated by us, so I know they get the right answers. We provide all the clinical content; the intelligence happens in the background.”

Dr. Reddy estimates the system’s automation of routine workflows can save 45 minutes per provider per day, allowing the practice to see more patients and potentially realize a seven-figure increase in annual revenue.

Answers to three key questions on how to keep your center humming.

Greenwood Endoscopy Center
ON TOP OF IT At Greenwood Endoscopy Center, a dedicated staffer helps control costs by monitoring supply levels, which improves the efficiency of its reordering processes.

Greenwood (S.C.) Endoscopy Center is a relatively small facility that nevertheless performs around 9,500 cases each year. When we asked its director of nursing, Laura Young, RN, what it takes to maintain that level of volume, she pulled back the curtain to reveal the little things her center does to succeed. In the process, she offered surgical leaders several best practices they could try at their facilities.

OSM: What’s a simple process change that has paid off big for you?

Laura Young (LY): We’ve expanded our schedule to allow more patient visits. Extending the schedule enables more patients to come in later in the day at their convenience. Our cases are scheduled every 15 minutes, so adjusting the schedule allowed us to add four patients per room. Four patients per room may not sound like a lot, but it adds up. In fact, those four procedures per room add up to 3,000 more cases for the center each year.

OSM: What cost-cutting initiatives can work for a GI center?

LY: Cost control is crucial for any GI center, and opportunities to shave off a little here or there always present themselves to facility leaders who are willing to put in the effort. One endoscopy center I know cut down on costs related to medical waste that added up to an extra $800 monthly. The director simply audited what employees and doctors were tossing into medical waste bags and found plenty of materials that didn’t belong there, such as cups and gloves. She then re-educated staff on what was supposed to be in the waste, and that ended up saving the GI center quite a bit of money in the long run.

We’ve enacted a few strategies of our own here. For instance, we have a dedicated employee who’s in charge of managing supplies. She keeps our supply room incredibly organized so we can see what’s getting low, as well as what we have too much of so we can back off in terms of ordering those items. We also work closely with our sales reps to determine if and when we should change products. While the products we purchase don’t change, different vendors could certainly offer more attractive prices.

OSM: Staffing is a challenge for virtually every surgery center. How do you ensure cases aren’t cancelled due to lack of staff?

LY: We have our base staff, but we also have PRN staff to call if anyone is out sick, on maternity leave, or unavailable for whatever reason. Having a dependable pool of backups is a must for any high-volume ASC. It ensures you’re never in a situation where you’re forced to close a procedure room simply because you don’t have enough nurses or techs.

Fortunately, we’ve never had too much trouble recruiting nurses and techs. We use Indeed, social media and local newspapers as our primary recruiting channels, with varying results. Social media has worked exceptionally well because we can put a job ad post up and if someone shares it, the reach could be limitless.

Preventing accidents in GI surgeries impacts costs, patient satisfaction and employee safety.

Stryker

Under the current standard of GI care, polyps can be lost, canisters might need to be changed mid-procedure, and staff are more likely to be exposed to hazardous materials. It goes without saying – the GI space has its challenges. However, technology exists to help address those challenges.

Connie Hall, RN, is a certified gastroenterology nurse at a busy facility that has adopted a constantly closed waste management system.¹ Not only did canisters have to be changed during a procedure – occasionally two to three times – but a lost polyp meant manually searching through the waste.

“The way you had to go through canisters to find a missing polyp, now that’s a day you don’t want to repeat very often,” Hall recalls. The facility she works at performs hundreds of colonoscopies per month. Therefore, a switch to a closed waste management system could potentially make a huge impact on time as well as accidental spills.

For most of her career, Hall worked with wall suction canisters but knew there had to be a better way to dispose of GI waste. She was on the design team at her new facility when it purchased Stryker’s Neptune Waste Management System. A constantly closed waste management system with integrated specimen collection (and back-up trap) like Stryker’s new Neptune S helps prevent lost polyps^** and protect staff from biohazardous fluid exposure because it reduces the need to empty canisters during a procedure.

Not only does a closed waste management system help address challenges in the GI space, but Hall also believes it contributes to staff retention. Nurses who come to work at her facility are amazed they don’t have to be exposed to GI waste.

“Unfortunately, too many people don’t know what the options are for GI,” Hall says. She has introduced colleagues at other facilities to the innovative technology of a constantly closed system as well. Facilities that adopt a constantly closed waste management system can help protect their staff from splashes and spills, reduce lost specimens and improve reputation because safety is prioritized.

Stop searching through GI waste for lost polyps (2 mm or larger). Stryker’s Neptune S Waste Management System has integrated specimen collection and a back-up trap. Join us on our Journey to Zero^* lost polyps^** at safeor.com.

Notes: ^*Zero splash and spills, zero airborne contaminants, zero smoke, zero retained surgical sponges, zero blind spots, zero trips and falls, zero drug diversion, zero maternal harm, zero lost polyps, zero exposure, and zero doubt messages are not guarantees and are aspirational in nature.
^**Polyps 2 mm or larger

References:
1. This is a paid interview with a Stryker nurse consultant, conducted March 22, 2023, on behalf of Stryker.