In the developed world, many surgery departments are digitized in at least some basic capacity. Having seen the benefits to patient care that can be provided by electronic scheduling of surgeries (a very simple example: laterality checking,) I can’t imagine electing to get a surgery anywhere that the surgery scheduler picked up a pencil and paper and said, “Let’s schedule your surgery.”
Of course, managing the schedule electronically is just the tip of the iceberg when it comes to the benefits of digitizing your surgery department. Creating robust systems to electronically manage inventory, for example, can lead to millions of dollars of savings in reductions of surgical supply costs.
I have seen the entire spectrum of digitization of surgery departments, but what I believe will bring the next wave of productivity and clinical improvement is the nascent realm of surgery dashboards and analytics. There is a lot of debate about these terms, so I’ll provide my own working definition. For me, a dashboard is a simple view of key metrics updated at least daily, and analytics includes at least the ability to drill down into a level of detail (for instance, individual procedures) to diagnose factors driving performance. Ideally, these two things would work together in one seamless software package that allows users to intuitively move back and forth between each one.
More broadly speaking, a lot of noise has been made of healthcare analytics. However, according to a CEO of a HIMSS Analytics Stage 7 hospital that I heard present at the 2014 ACHE Conference, “People are lined up 12 deep telling you they can sell you analytics and so far we haven’t found it to be true.”
My own research supports this view, and especially so in the surgery management space. But my prediction is that this will soon change. One of the most credible articles I have seen predicting an increase in the use of analytics in surgery is from Health Data Management here.
In order to be a comprehensive tool for surgery management, an analytics package would need to consider operational, clinical, and financial metrics. Operational metrics would probably need to include at least on-time-starts, OR turnaround, procedure volume by service line, and cycle time of patient throughput from Pre-op through PACU. For operational metrics to be useful in a dashboard, they would probably need to be refreshed at least every 15 minutes and ideally much faster since every OR director knows a lot can change in the OR in 15 minutes.
What to include for clinical metrics is less clear. But I envision quality metrics reporting such as SCIP measures as well as measures for post-op nausea and vomiting and antibiotic administration compliance.
And finally, financial metrics would ideally include things like profitability by procedure and the ability to measure anesthesia gas consumption (converted into dollars spent) trendable over time, with the ability to slice the data by case type or individual provider in order to look for opportunities to reduce costs while still providing optimal patient care.
The best dashboards I have seen so far contain operational dashboards and analytics. But I suspect that market demands will stimulate those in the surgery operational analytics space to soon produce robust analytics to help improve clinical and financial metrics as well.
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