Data Deficiencies are Costing You Millions

Part 1  

Unrecognized Costs in Computer-Assisted Surgery:

The Learning Curve

This is Part 1 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 helping our client hospitals with their OR’s clinical and financial data analytics and the associated lessons learned in the process.

As a starting point, let’s focuses on the unrecognized costs in computer-assisted surgery that are either difficult to assess, impossible to ascertain, or frequently neglected.  For these reasons, these areas are often not considered in the “cost” of running a robotic program.

The first–and most costly–is the cost of the robotic learning curve.  Almost all surgeons are already extremely efficient in their laparoscopic or open surgery.  However, in making the transition to robotics, a unique, well defined “learning curve” is associated with every specialty and with every operation. During this learning curve, excessive time in the operating room, excess consumption of supplies, medical malpractice exposure, and risk to the patient usually exist.  It is therefore imperative that a robotic program establish expectations regarding the progression of a “novice” robotic surgeon through this learning curve as well as empower the surgeon with the resources necessary to conquer this learning curve in the expected time/case frame.

To give a concrete example that CAVA frequently sees in the healthcare environment, let’s take an example of inguinal hernia repair.  Hospital X does laparoscopic bilateral inguinal hernia repair with a net margin of +$700/case and completes the operation in about 45 minutes.   When it starts doing the case robotically, that same margin was expectantly negative.  After 100 cases however, that margin is still -$1200/case!  Factors that  contribute to the negative margin include excessive robotic reposable use ($200/case), excessive operative time (60 min/case longer) and excessive supply usage ($600/case).  This example shows how the “urban legend” of robotics that it “costs too much” is perpetuated, but is actually an all-too-common phenomenon in many robotic programs.

CAVA’s advice:  Avoid this happening in your computer-assisted surgical operating room by making sure that you:

  • Define your surgeons’ learning curve
  • Empower your surgeons with the knowledge and resources needed to progress through the learning curve and get out the other side!
  • Monitor your computer-assisted surgical performance to make sure that excellent clinical and financial outcomes are maintained

Next: Part 2…Unrecognized costs in computer-assisted surgery – equipment malfunction and repair.

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