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Ambulatory surgery centers can aid managed care in closing gaps in services, smooth adoption, and coordinate training.
Speaking at the World Congress 2019 Care Coordination & Technology Congress earlier this year Richard Wild, MD, JD, chief medical officer of CMS noted that using digital technology to better coordinate patient care can help to save money and deliver more efficient care.
One of the healthcare stakeholder groups that has embraced digitization is the ambulatory surgery center (ASC) industry. ASCs are increasingly attractive choices for managed care as a means of ensuring high-quality, efficient outpatient surgical care. In 2005, 59% of outpatient surgeries were performed in hospital outpatient settings and 41% in ASCs; by 2020, that number is expected to be reversed, with only 40% of outpatient surgeries performed in hospital settings. Research shows that patients at ASCs are less likely to seek emergency room or hospital inpatient care after a procedure, and the ASC infection rate is half that of hospitals.
To ensure that the gains resulting from ASC technology are sustainable and yield meaningful benefits for managed care organizations, ASCs with business acumen are taking deliberate steps to train staff on using electronic systems correctly and consistently.
Today, most ASCs function as sophisticated, technologically complex health organizations, using electronic practice management software solutions. Though there’s a significant gap compared to large health systems, the ASC industry is also moving toward greater adoption of fully integrated electronic health records (EHRs). Advancements in technology have led to great improvements for ASCs in terms of timely and accurate billing and collection. Technology has subsequently benefitted the managed care provider organizations in terms of cleaner claims, identification of gaps in care or areas of improvement, and comprehensive cost data to demonstrate savings.
With most technology-related challenges, the primary barrier to smooth adoption is confusion about functionality. Managed care organizations working with ASCs must take the time to prioritize staff education and training. The Office of the National Coordinator for Health Information Technology (ONC) offers training tips for office staff and clinicians on EHRs, including using vendor training to develop an internal core group of “super users’- staff who can navigate EHRs quickly and support other internal staff and clinicians.
However, ASCs should also establish a regular pattern of training and updates for other users in order to maximize IT benefits. To ensure that health IT is not underutilized or abandoned, ASCs should revisit user roles on a regular basis. Rather than constantly shopping around for new IT resources, it is recommended that ASCs focus on training to ensure that staff understand how to use existing platforms effectively. This is especially important as clinical personnel are promoted or change roles. As a best practice, user role assignments should be reviewed at least quarterly and “as needed” when there are personnel changes. Even when lateral moves occur, such as a nurse moving from pre-op to post-op, user roles should be reviewed and updated.
ASCs should use software systems that demonstrate cost-savings. Research already demonstrates that ASCs can be up to 60% less expensive than hospitals, so creating incentives for patients to have their procedure done in the most appropriate setting-ASC or hospital-is critical to ensuring that the managed care system works as intended.
Safe and secure cloud-based platforms also help ASCs safeguard personal health information, prevent avoidable data breaches, and comply with privacy regulations-critical considering recent healthcare breaches. Using cloud-based technology over traditional servers can also ensure data is still available in the result of a disaster such as flooding or earthquakes, which can knock out decades worth of healthcare information if these modes of storing data are not properly backed up.
By prioritizing IT standardization and software systems that align incentives at contracted ASCs, managed care organizations can benefit from the market shift to outpatient surgery centers in the form of better patient outcomes, effective onboarding in the event of staff turnover, and ultimately, cost savings.
Tara Vail, MBA, is the chief operating officer of HST ASC Software, the top-ranked software solutions company for the ASC industry. She has deep expertise in helping healthcare organizations leverage information technology to improve operational efficiency and optimize revenue cycle management.