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figure and not based on the total number of cataract cases you do.” “I think ASCs that will do best with the technology are the ones that are refractive-driven,” she adds. “These are centers that are using a lot of premium intraocular lenses, doing LASIK and implantable collamer lens procedures. Their main intent and goal is to get pa- tients out of glasses, so they are provid- ing all of these elective services.”
Survey Your Physicians It also is worthwhile to conduct a survey of your cataract surgeons on their antici- pated use of the laser, Sheffler advises. “Find out how many of your sur- geons think they would do these pro- cedures and how many cases they proj- ect,” he says. “We did that at SurgiSite Boston, cut that number of projected cases in half and then determined, based on the amount of cases, how much money each physician would be charged for each procedure to cover the expense of the unit, the disposables, the personnel and everything associated with the laser. We did an analysis and came up with a number. Then we went to the medical staff and said, ‘If you want to do these cases, this is what the cost is going to be based on our projec- tions. How do you feel about this price? If you feel you can’t support it, then we shouldn’t buy the unit.’”
Consider Space Requirements Arjoyan says another important consid- eration is whether your ASC has a good space for the technology. “At least for our laser, we had to consider room requirements,” she says. “We had to reconstruct one of our rooms and make sure the laser fit prop- erly and the parameters for temperature requirements were adequate. The space, the footprint of the laser and where it’s going to go: these are just a few impor- tant considerations. Some people place the laser in an operating room (OR); we have a dedicated room for it. Then we
We wanted the laser because it was the newest, best technology and provides optimal care for the patient.”
—Vickie Arjoyan, RN, Specialty Surgical Center
had to figure out the patient flow in or- der to operate efficiently.”
Research the Options There are a number of different femto- second laser models on the market, and ASCs would be wise to carefully con- sider the options, Sheffler says. “We formed a committee within
SurgiSite Boston to research the dif- ferent machines,” he says. “The people that were selected were independent of one of the ASC’s physicians who pro- vided services to a femtosecond laser developer to ensure all machines were independently looked at. We also had a group of doctors that traveled around and visited other facilities to study which lasers they thought were the best and would be the best for us.” Sikes says it is worth spending time
to not only research the models, but re- ally understand the technology. “We visited a physician in Texas
using a femtosecond laser and spent a day in surgery with him,” she says. “We watched the laser, watched the surgery that followed and were able to talk to
patients as well as engineers and the physician about the technology.” Once you conduct your due dili- gence, it is time to make a decision—a decision that should include your entire medical staff, Sheffler says. “Since this was such a big purchase,
the information was reported to the medical staff owners and then a vote was taken on whether we should buy a femtosecond laser,” he says. “That was voted affirmatively, and then a vote was held on which machine to purchase. In- cluding our entire medical staff in these decisions was important.” Do not rush to make a decision, Ar-
joyan advises. “We had several meet- ings with our physician partners and carefully went over all of the different lasers,” she says. Securing physician buy-in also is critical, Sikes says. “You want to have physician champions; not just one. You don’t want to make this investment and just have one physician embracing it. Make sure you definitely have buy-in from those physicians that operate in the ASC.”
ASC FOCUS JULY 2013 15
PHOTO COURTESY OF OPTIMEDICA
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