News & Publications

Growth in Global Robotic Market Projected…Will Your Hospital Be Prepared? (Part 1)

Read the healthcare and business media and you’ll regularly how its projected that North America, followed by Europe, will have the largest market for robotic surgery over the next decade due to developed healthcare infrastructure, increasing incidence of chronic diseases and technological advancement in the region. Asia is expected to show high growth in the robotic surgery market in next few years as well due to government initiatives and the rise in awareness about robot-assisted minimally invasive surgeries in this region. However, not knowing how best to design and run an optimized robotic program will be one of the largest limiting factors for hospitals and IDNs, and this is where CAVA Robotics can help your facility.  Let us show you what you MUST know to capitalize on the ROI or computer-assisted surgery in the coming decade.

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.

http://www.modernhealthcare.com/article/20140419/MAGAZINE/304199985

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.

 

http://www.fiercebiotech.com/medical-devices/verb-s-huennekens-unveils-vision-next-gen-robotic-surgery

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.

Data Deficiencies Are Costing You Millions

Part 1: Unrecognized Costs in Computer Assisted Surgery – The Learning Curve.

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 lessons 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.

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

To give a more concrete example that we frequently see 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 started doing the case robotically, that same margin was expectantly negative.  After 100 cases however, that margin is still -$1200/case!  Factors which 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 an all to 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 learning curve, empower your surgeons with the knowledge and resources needed to progress through the learning curve then 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.

Beware: The Dabblers!

Experience Counts!  Be sure to ask the right questions before undergoing a procedure.

https://youtu.be/8yEI9nHZJfg

Robotics Programs in Europe and Asia

Watch this week’s video to open the discussion about Robotic Programs around the world!

https://www.youtube.com/watch?v=slKuUUx534A

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