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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 4
UTSMC established a policy based on the cold hard facts generated
by its EMR: Surgical service block times that fall below 10% of the
hospital's average utilization rate for 3 months are reallocated to spe-
cialties with case volumes that justify more time in the OR.
The data isn't necessarily used as punishment. In fact, some sur-
geons or services might not be aware they're lagging behind in certain
performance measures. "We don't say you ought to do this," says Dr.
Foglia. "We find a reason that they would find value in." Fixing block
time utilization benefits surgeons' reimbursements, too, right?
That initial pushback you faced during the system's rollout? It'll be
replaced with a hunger for data staff and surgeons need to make
change happen. For example, Dr. Foglia says EMRs can identify sur-
geons with the highest supply spending. Now consider the most frugal
surgeons. Are they achieving positive clinical outcomes? Bringing the
facility's mean spending down to the level of the cost-conscious docs is
where real savings happen. It also creates a partnership between the
surgeons and the facility's leadership as both work in concert to slash
expenses.
Dr. Foglia's hospital performs about 14,000 cases in the main OR
and about 6,000 cases in the facility's surgery center. Hospital leader-
ship wants to move about 1,500 outpatient cases to the ASC, which
would improve patient satisfaction and free up time in the main ORs
for adding or expanding surgical services. By shifting cases and rely-
ing on EMRs to improve operations management, the hospital's
administration expects to increase surgical volume by 4% over the
next decade without adding another OR — which would have cost
roughly $7 million. "We'd rather use those dollars to improve the cur-
rent perioperative services," says Dr. Foglia.
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