While the COVID-19 pandemic is far from over, the ASC industry is finding innovative ways to get back to the business of handling procedures unrelated to the virus. I recently had the opportunity to talk to two gastroenterology surgeons, Jeff Williams, MD a surgeon-owner at Athens Gastroenterology in Athens, GA and George Jenkins, MD, a surgeon-owner at Carolina Digestive Disease/Palmetto Endoscopy in Columbia, SC. We discussed strategies GI surgeons are deploying to get back to pre-COVID-19 case levels, and what they are doing to maximize efficiency and profitability along the way.
“During the past three months, our case numbers dramatically decreased,” said Williams. “People were afraid to come in because of COVID, so we quickly pivoted to telemedicine and developed new protocols. To get back to fully functioning, we had to ensure the safety of the patient first and foremost.”
“We’re taking every precaution: checking temperatures before people enter the building and ensuring that all staff are wearing N95 masks, the patients wear masks, and the family members do not come into the waiting room,” added Jenkins. “The physicians actually go out to the parking lot with a mask on to talk to the family member about the results of the procedure.”
Pivot to Telemedicine
One lasting side effect of the COVID-19 pandemic may well be the rise of telemedicine. In fact, Healthcare IT News reports that nearly three-quarters of Americans surveyed said they would consider using telehealth to be remotely screened for COVID-19, and two-thirds said the pandemic has increased their willingness to try virtual care. Both Williams and Jenkins identified telemedicine early on as an essential tool for their ASCs in the face of COVID-19. And, while neither was implementing telehealth prior to the pandemic, both see a role for it going forward.
“Medicine is a slow-moving vehicle and COVID basically put the foot on the accelerator to move telemedicine forward,” Williams said. “I got into it very quickly. I got our billing people involved. I prefer to see the patient in person, but I think moving forward, telemedicine is going to be ingrained.”
Addressing the Backlog
Playing “catch up” with patients who were scheduled for important GI procedures but postponed during the first three months of COVID-19 is important both to patient health and to an ASC’s financial health.
“We’ve been vigilant about keeping a log of patients that we would have seen March, April and May when we were not doing screening colonoscopy,” explained Jenkins. “We’ve been contacting those patients and getting them in as fast as we can – especially the unhealthier patients or patients that needed to be looked at due to a positive cologuard or anemia, for example.”
Williams is taking a similar approach at Athens Gastroenterology . “Within the next few weeks I’m probably going to open up Saturday hours to relieve the backlog,” he said.
ASC leaders are looking across many areas of their business to maximize efficiency through their COVID-19 recovery, including using mid-level professionals such as nurse practitioners and physicians assistants to see patients in their centers as appropriate, working effectively with anesthesia partners, and leveraging the advantages of doing procedures in the ASC setting – away from a hospital environment made even busier and riskier by COVID-19.
My perspective has been that anesthesia ought to be playing a helpful role, particularly from an efficiency perspective.
Jenkins agreed: “Anesthesia has helped efficiency in a number of ways, including upper endoscopies.”
Williams echoed Jenkins’ thought: Our anesthesia team has been an integral part of my surgical center. We look to them to go over our patients to make sure that nothing was missed on our end. For instance, their ASA classification, did they have pulmonary problems, or cardiac problems that need to be addressed? They’ve been a major asset to me and my practice.”
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