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Editor's Page: Pardon the Disruption
Embrace the disruptive technologies that are changing surgery.
Dan O'Connor
Publish Date: September 3, 2015   |  Tags:   Editors Page
OR Excellence

Marriott Rivercenter San Antonio, Texas Oct. 13-16

Ideas That Work Power Hour: 50 Practical Pearls in 60 Minutes If you like the popular "Ideas That Work" section of the magazine, you won't want to miss this action-packed hour at OR Excellence. Leslie Mattson, RN, BSHM, a healthcare consultant at ALM Surgical Solutions in Macon, Ga., and author of the popular blog "A Scrub's Life," will present creative workarounds that are sure to streamline your day. You'll leave this session with 50 great time- and money-saving ideas you can implement in your facility as soon as you return to work. Here's the first Idea That Works: Register now at orexcellence.com to see Ms. Mattson live at the beautiful San Antonio Marriott Rivercenter.

Just as Google replaced libraries, Uber replaced taxis and Netflix replaced video rental stores, surgery is full of its own disruptive technologies, like outpatient total joints, Accountable Care Organizations, percutaneous laparoscopic surgery and 3D printing. There's dropless cataract surgery, and one day we might have eye drops replacing cataract surgery.

A technology is disruptive when it displaces an established technology and shakes up the industry, like laparoscopy and regional anesthesia combining to create the minimally invasive surgical movement. A disruptive technology can also be a groundbreaking product that creates a completely new industry, like the surgical robot and bariatric surgery.

This thing you do called outpatient surgery is perhaps healthcare's ultimate disruptive technology. When the first pioneering surgeons struck out on their own and built freestanding surgical centers that were designed to siphon off the most profitable patients, hospitals had a curious response. Rather than accept change and embrace the efficiencies of the same-day surgical model, hospitals tried in vain to resist what clearly was the more efficient, economical and preferred way to run a surgical business. It was like the typewriter trying to shoo away the personal computer.

Just as Sears gave way to Wal-Mart, many all-purpose hospitals watched specialized surgery centers pass them by. Today, of course, outpatient surgery is as much a part of the hospital culture as it is at ASCs. The lessons here are:

  • Be responsive. Don't let innovative ideas leave you in their wake. When you sense something unusual, a better mousetrap that can't be ignored, stand up and take notice.
  • Be daring. You don't beat your competitors by being more efficient at the same processes, but by discovering new processes. It's not a me-too game.
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Like Uber, does it make sense for facilities within the same health system to share surgical equipment with each other?

  • yes82%
  • no18%

SOURCE: Outpatient Surgery Magazine, August 2015, n=285

Which brings us to what could be the latest disruptive technology to hit surgery. A new software company called Cohealo wants to bring the sharing economy to the operating room. It hopes to do for capital equipment what Uber has done to transportation — streamline it using the sharing economy. The premise: Health systems share medical equipment. Rather than each of the 5 hospitals in a health system buying an "underutilized asset" like a laser cataract system or a fracture table, for example, they all share one.

"Medical equipment is a major financial blind spot for hospitals and health systems," says Mark Slaughter, CEO and founder of Cohealo, who used to sell robotic and laparoscopic surgical equipment. "They often spend tens of millions of dollars annually on medical equipment purchases and rentals. But this equipment sits idle almost 60% of the time and its use is typically limited to a single hospital site. With Cohealo, health systems can manage their equipment centrally and make it available on-demand across all of their facilities — wherever and whenever it is needed."

Cohealo might make the capital equipment manufacturers shudder, and it's fair to wonder about the logistical challenges. Are you going to want to loan your 3D C-arm to your sister facility across town? What if they break it? And how many of these things can be safely moved, anyway?

But what if it catches on? Are you going to be brave enough to abandon your traditional ways, or will you still be dialing the rotary phone while everyone else is on their cells? They call it disruptive for a reason. But it only hurts for a little while.