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TECHNOLOGY


Rein in Surgical Case Coordination Inefficiencies Cloud-based technology can help ASCs overcome fragmented case communication issues BY GAVIN FABIAN


Designed to be efficient, ASCs


provide a more


focused and specialized approach to surgeries with- out the costly overhead typ-


ical in a hospital environment. The result is high-quality care with better patient satisfaction. When it comes to surgical case coordination, however, the natural evolution of technology and communi- cation has created a fragmented mess involving email, text messages, phone calls, white boards and word of mouth. These outdated methods are time con- suming and error prone and greatly increase the risk of miscommunication and missed documentation.


The challenge of coordinating a


surgery begins at the physician’s office when it is determined that a patient needs surgery. The physician’s office faxes a scheduling form to the ASC, and once an opening is found, the two organizations exchange a series of phone calls to confirm the case. Sur- gery center staff then manually enter the information received from the phy- sician’s office into the center’s practice management system. Any changes to the schedule require additional phone calls because phy- sicians’ offices typically do not have access to a surgery center’s practice management system. The physician’s office also needs to provide ancillary documents, including consent forms, labs, preoperative documentation and more, which it faxes to the surgery cen- ter. Keeping track of which documents were received and which are outstand- ing is a tedious job for both the surgery center and physician office staff. Changes can happen after a surgery is scheduled, and everyone involved with the case—including physician


office staff, nurses, surgeons, anesthe- siologists, vendor reps and others— must be kept current. Did the patient complete anesthesia documentation? Has the patient’s insurance been veri- fied? Can the anesthesiologist make it to the case? Does the vendor rep know the materials manager needs special equipment to arrive by a specific time? Is appropriate staffing secured? Which preop nurse is assigned to the case? A surgical procedure requires many people and steps, and when relying on outdated communication methods, it is easy to miss someone or something in that process. When miscommunica- tion happens, patient flow could be dis- rupted, patient satisfaction and safety could be at risk and revenue can be lost.


A Quick Fix


Despite the real risks associated with not having a centralized place for everyone involved in a case to access real-time information, many centers


18 ASC FOCUS NOVEMBER/DECEMBER 2017|www.ascfocus.org


are content to leave things as is. Why? While not perfect, legacy communica- tions methods—faxes, phone calls and message boards—are what they have always used. It is what they know. Other centers try creative solutions to minimize case coordination prob- lems, like deploying ad-hoc tools such as iCloud calendars, Google calendars and Google spreadsheets. These tools are popular workarounds because, unlike a practice management sys- tem, they can be shared with as many people as needed. While they offer some improvement, they are limited and come with their own set of prob- lems. For example, because they are not Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant, only basic information, such as surgical dates and the procedure description, can be shared. Because these tools lack the required security mechanisms, patient health informa- tion (PHI) cannot be attached. Addi- tionally, tracking important details, like patient safety alerts, resource requirements and task assignments, is not possible using these workarounds.


A Better Way Advances in cloud-based technology provide an ideal fix for otherwise time- consuming, error-prone processes like surgery communication. Streamlin- ing the surgical case communication and coordination process alleviates unnecessary delays and cancellations, improves efficiency and quality of care. Similar to a project management


tool, surgery case coordination sys- tems streamline tasks by providing an at-a-glance view of where a patient is during the scheduling process. Any changes are instantly shared via text


The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.


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