Welcome!

Weblogic Authors: Yeshim Deniz, Elizabeth White, Michael Meiner, Michael Bushong, Avi Rosenthal

Related Topics: @CloudExpo, Cloud Security, @DXWorldExpo

@CloudExpo: Article

Hospitals and #DataScience | @CloudExpo @LeanTaaS #IoT #API #ITaaS #AI

Four reasons why OR block scheduling is getting overhauled

Operating Room Block Scheduling Needs an Overhaul
By Sanjeev Agrawal, President and Chief Marketing Officer, LeanTaaS iQueue

One minute of utilized operating room (OR) time can be worth more than $70 in revenue and one minute of staffed OR time can cost $50 or more, making underutilized OR time a huge problem. Each year, roughly 51 million surgeries are performed in the 5,000+ hospitals and 5,000+ surgery centers in the U.S. MGMA estimates that the corresponding utilization of operating rooms across these centers is, at best, 55-60 percent.

Given that, for each percentage point of increased utilization, the benefits of an overhaul are considerable. A single OR can deliver more than $100,000 in revenue to a hospital or surgery center. Even for a small hospital or ASC with 8-10 ORs, the value of increasing utilization by 5 percent can easily be in excess of $5 million annually. For large systems, the value of a single OR can run into the tens of millions. If average OR utilization increased by 5 percentage points, more than 2.5 million patients could undergo procedures within the same OR infrastructure.

Root Cause of Underutilization
The process most health systems rely on for managing the complexity of operating room utilization - block scheduling - needs an overhaul. The typical current process usually goes along the following lines:

  • Blocks are assigned to surgeons and service lines and examined on a monthly (sometimes quarterly) basis by the OR committee, which reviews trends in utilization performance by surgeon and service line in order to make informed decisions on the potential reallocation of blocks. The scheduling of the slate of surgeries is then left to the surgeons themselves. Since the OR committee does not have a sufficiently robust, transparent and defensible fact base for allocating OR blocks to different surgeons, there is an inherent subjectivity to the "algorithm" used, which reduces the perception of fairness in the minds of many surgeons. This, in turn, makes surgeons naturally more resistant to releasing their allocated blocks, even if releasing their blocks would aid overall productivity.
  • Perioperative business managers feel a significant amount of pressure from such a system and so try to meet the demands of surgeons who want more block time by identifying low-performing blocks that could potentially be reallocated.
  • Between OR committee meetings, these managers conduct a series of "bilateral" negotiations, persuading some surgeons to release a block in order to meet the legitimate request for additional block time from a new surgeon or a surgeon whose case load has been growing significantly over the past few months.
  • All of this has to be done while keeping other real-world constraints in mind, which could include equipment in a specific OR (e.g., robotics) or calendar constraints (e.g., the surgeon requesting a block can only operate on Tuesdays, and the candidate blocks that could be released are only on Thursdays and Fridays).

Block Scheduling Is Getting an Overhaul
Forward thinking hospitals like UCHealth are leading the charge in giving block scheduling the overhaul it needs. How are they doing it?

The technology exists and is starting to be used: Imagine a series of timely, accurate charts that are automatically - on a daily or weekly basis - "pushed" to the smartphones of every surgeon, their schedulers and the administrative personnel responsible for managing OR utilization. In addition to providing key statistics on utilization, first case on-time starts, cancellations, cases running long, etc., it creates a high level of awareness in the minds of each surgeon about their utilization performance both in absolute terms as well as relative to their peers. Surgeons are data driven, fact based and competitive; accurate, transparent, automated feedback will go a long way toward improving the utilization even if nothing else was to change.

The data exists and is being used: Several factors need to go into determining a fair and equitable allocation of blocks on a periodic basis. Instead of using historical rules for how blocks have been allocated and redistributed, hospitals can now methodically match supply (e.g., regularly underutilized blocks) to demand based on sophisticated forecasting and predictions for blocks, staff and rooms. This is possible because the necessary data exists within the EHR/scheduling system, e.g., historical scheduling data by surgery (the date, time, type, surgeon, room, duration) and the corresponding surgeon-specific performance metrics.

Forward thinking governance/leadership: Hospital leadership is not just more tech savvy today than it was 10 years ago; an increasing number of CEOs, CIOs, COOs and CMIOs are now not only open to looking at new technologies but are requiring their teams to go through process transformation through data, lean methodologies and sophisticated analytics.

There isn't much choice: The demand for medical services has never been stronger, and it's only going to increase. ORs will have to do more surgeries and get reimbursed less per unit for them.

  • Population growth: By 2050, the American population will be over 438 million, up from 320 million in 2015.
  • Demographics: By 2030, over 20 percent of the country is expected to be over 65 years old, up from 15 percent in 2015. This aging population will greatly increase the demand for chronic clinical therapies and surgical procedures. In raw numbers, the Census Bureau estimates that by 2030, when the last proportion of Baby Boomers will hit retirement age, the number of Americans above 65 years of age will hit 71 million - in fact, one in five Americans will be older than 65. Not surprisingly, by 2025, 49 percent of Americans will be affected by a chronic disease and need corresponding therapies.
  • Affordable Care Act: The Affordable Care Act will add another 30 million Americans to the healthcare system by 2025, which means an increase in the demand for operating rooms. Reimbursements will increasingly depend on outcomes and efficacy, quality of care, and patient access. Unless providers increase efficiency in how they process and treat patients, they will need to spend billions in capital spending on new operating room infrastructure.

More healthcare providers are realizing that their operations need a data-driven, scientific overhaul to accomplish efficient and effective OR scheduling. The software and resources are finally available to help achieve such a transformation.

###

Sanjeev Agrawal is president and chief marketing officer of LeanTaaS iQueue. Sanjeev was Google's first head of product marketing. Since then, he has had leadership roles at three successful startups: CEO of Aloqa, a mobile push platform (acquired by Motorola); VP Product and Marketing at Tellme Networks (acquired by Microsoft); and as the founding CEO of Collegefeed (acquired by AfterCollege). Sanjeev graduated Phi Beta Kappa with an EECS degree from MIT and along the way spent time at McKinsey & Co. and Cisco Systems. He is an avid squash player and has been named by Becker's Hospital Review as one of the top entrepreneurs innovating in Healthcare.

More Stories By LeanTaaS Blog

LeanTaaS is a Silicon Valley software company whose offerings rely on advanced data science to significantly improve the operational performance of hospitals and clinics. Using LeanTaaS iQueue in conjunction with their existing EHR's, healthcare institutions are developing optimized schedules that are tailored to each site and can rapidly reduce patient wait times and operating costs while increasing patient access and satisfaction, care provider satisfaction, and asset utilization.

IoT & Smart Cities Stories
The challenges of aggregating data from consumer-oriented devices, such as wearable technologies and smart thermostats, are fairly well-understood. However, there are a new set of challenges for IoT devices that generate megabytes or gigabytes of data per second. Certainly, the infrastructure will have to change, as those volumes of data will likely overwhelm the available bandwidth for aggregating the data into a central repository. Ochandarena discusses a whole new way to think about your next...
DXWorldEXPO LLC announced today that Big Data Federation to Exhibit at the 22nd International CloudEXPO, colocated with DevOpsSUMMIT and DXWorldEXPO, November 12-13, 2018 in New York City. Big Data Federation, Inc. develops and applies artificial intelligence to predict financial and economic events that matter. The company uncovers patterns and precise drivers of performance and outcomes with the aid of machine-learning algorithms, big data, and fundamental analysis. Their products are deployed...
Dynatrace is an application performance management software company with products for the information technology departments and digital business owners of medium and large businesses. Building the Future of Monitoring with Artificial Intelligence. Today we can collect lots and lots of performance data. We build beautiful dashboards and even have fancy query languages to access and transform the data. Still performance data is a secret language only a couple of people understand. The more busine...
All in Mobile is a place where we continually maximize their impact by fostering understanding, empathy, insights, creativity and joy. They believe that a truly useful and desirable mobile app doesn't need the brightest idea or the most advanced technology. A great product begins with understanding people. It's easy to think that customers will love your app, but can you justify it? They make sure your final app is something that users truly want and need. The only way to do this is by ...
CloudEXPO | DevOpsSUMMIT | DXWorldEXPO are the world's most influential, independent events where Cloud Computing was coined and where technology buyers and vendors meet to experience and discuss the big picture of Digital Transformation and all of the strategies, tactics, and tools they need to realize their goals. Sponsors of DXWorldEXPO | CloudEXPO benefit from unmatched branding, profile building and lead generation opportunities.
Digital Transformation and Disruption, Amazon Style - What You Can Learn. Chris Kocher is a co-founder of Grey Heron, a management and strategic marketing consulting firm. He has 25+ years in both strategic and hands-on operating experience helping executives and investors build revenues and shareholder value. He has consulted with over 130 companies on innovating with new business models, product strategies and monetization. Chris has held management positions at HP and Symantec in addition to ...
Cell networks have the advantage of long-range communications, reaching an estimated 90% of the world. But cell networks such as 2G, 3G and LTE consume lots of power and were designed for connecting people. They are not optimized for low- or battery-powered devices or for IoT applications with infrequently transmitted data. Cell IoT modules that support narrow-band IoT and 4G cell networks will enable cell connectivity, device management, and app enablement for low-power wide-area network IoT. B...
The hierarchical architecture that distributes "compute" within the network specially at the edge can enable new services by harnessing emerging technologies. But Edge-Compute comes at increased cost that needs to be managed and potentially augmented by creative architecture solutions as there will always a catching-up with the capacity demands. Processing power in smartphones has enhanced YoY and there is increasingly spare compute capacity that can be potentially pooled. Uber has successfully ...
SYS-CON Events announced today that CrowdReviews.com has been named “Media Sponsor” of SYS-CON's 22nd International Cloud Expo, which will take place on June 5–7, 2018, at the Javits Center in New York City, NY. CrowdReviews.com is a transparent online platform for determining which products and services are the best based on the opinion of the crowd. The crowd consists of Internet users that have experienced products and services first-hand and have an interest in letting other potential buye...
When talking IoT we often focus on the devices, the sensors, the hardware itself. The new smart appliances, the new smart or self-driving cars (which are amalgamations of many ‘things'). When we are looking at the world of IoT, we should take a step back, look at the big picture. What value are these devices providing. IoT is not about the devices, its about the data consumed and generated. The devices are tools, mechanisms, conduits. This paper discusses the considerations when dealing with the...