Month: October 2016

MIT Technology Review Provides More Insights into Future of Robotics

This article provides some fascinating insights into the future of where one emerging robotic technology vendor in the surgical robotic space may be going, and the concepts here are very exciting.  To what degree these ideas will be realized commercially is not known yet. However, the undeniable fact is that over the next 5 years or so, there will be significant evolution to what we know as surgical robotics today.  Hospitals that either have a robotic program, or who are considering starting one, MUST be thinking down the road as they acquire technology, develop contracts, create program structure, and manage all aspects of their robotic program. CAVA is poised to assist any hospital is meeting these critical resource, training, and operational challenges.  Preparing for the future in surgical robotics today is one of the many things CAVA provides to all our clients.
Take a look into the future…

Robotics in Smaller Hospitals? MUCH Better Guidance is Needed!

Here’s an interesting piece on the challenges small hospitals face in assessing whether to invest in a robotic program.  CAVA encounters stories like this one regularly. What you read here is fairly typical of the approach many small hospitals take.  Be warned, however, there is MUCH MORE any small hospital should be aware of in making a go/ no-go decision to get into into robotics than the info presented here. While this article provides insight into some of the questions, the understanding here is VASTLY incomplete. Determining cost-effectiveness is a complex 21-element algorithm. CAVA can help any smaller hospital considering a robotic program to approach this optimally.  The difference can be measured in months vs years to program success (if at all), as well as hundreds of thousands, if not millions of dollars, in bottom line impact.


A Sneak Peek…Get Ready!

A sneak peek into some of the exciting advances in the computer-assisted surgical environment over the next decade. CAVA approaches the design and optimization of all our client’s robotic programs with a vision to the future, meaning that hospitals must establish robotic program design, governance, and infrastructure that is agnostic to the technology vendor. There is much evolution and new competition coming to computer-assisted surgery!  Get ready.



Data Deficiencies Are Costing You Millions (Part 2):

Part 2: Unrecognized Costs in Computer Assisted Surgery – Equipment Malfunction and Repair.

This is the first in a series highlighting how gaps in data collection, data analysis or cost accounting leads to unrecognized financial losses in laparoscopy and computer assisted surgery.  This series draws upon CAVA Robotics extensive experience in assisting hospitals with their operating room clinical and financial data analysis and the lessions learned.  Today’s discussion focuses upon unrecognized costs in computer assisted surgery that are either difficult to assess, impossible to ascertain or frequently neglected.  For these reasons, they often are not considered in the “cost” of running a robotic program.

Several years ago, CAVA encountered a request from a hospital to evaluate costs that were not being fully represented in the financial analysis of each robotic surgical case.  As a beginning robotic surgical program, scope repairs were frequent and reposable instrument dysfunction was high.  The full breadth of the costs associated with the issue and the underlying factors influencing these events were unrecognized.

Together, we discovered that scope repair costs were underappreciated.  Due to a multitude of factors including staff training, sterile processing and scope handling, the incidence of scope repair was much higher than anticipated.  The total cost though of such repairs were very high.  Scope repair provided by the vendor despite a maintenance contract approached $9k/incident and over $60,000/year!

Unfortunately, reposable malfunction was much more difficult to quantify.  When an instrument malfunctioned, it was sent back to the vendor for evaluation.  The vendor determined the reason for the malfunction and whether the unused “lives” of the reposable instrument remaining were able to be credited back to the hospital.  In the cost accounting software and methodology of the hospital, keeping track of these incidents was challenging.  Our own analysis of the reasons for instrument failure however revealed several things.  Surgeon error and potential internal collisions were frequently a cause of instrument malfunction as indicated by things such as fracture of the “shaft” of the instrument.  Perhaps more worrisome was that most of these events often went unrecognized during the operation.  Another cause can be attributed to excessive or improper handling and processing of the reposable instruments.  This brought to light important changes in turnover and sterile processing protocol that are important to maximizing the life of these reposables.  The last cause is unknown in which a specific cause for instrument malfunction could not be found.  This includes things like a cable being displaced, the instrument not responding well and the scissors not cutting well.

CAVA’s advice:  avoid untracked costs of computer assisted surgery by keeping track of such “under the radar” costs and repairs.  More importantly, have the processes in place such as handling of reposables and scopes in all departments such as the operating room and sterile processing because the consequences can be significant.

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