A data-first strategy to recovering surgical volumes [PODCAST]

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“The first step to hospital recovery is the collection and analysis of data. Organizations that effectively leverage data to optimize surgery can see rapid, quantifiable, and sustained improvements in metrics that directly link to operational efficiency and associated financial benefits. The current situation presents a unique opportunity for hospitals to implement new tools to recalibrate how surgical services are evaluated, delivered, and experienced by the patient and provider. Doing this now will accelerate resolving the backlog, better positioning the organization to handle the day-to-day schedule moving forward with unprecedented confidence and clarity.

Heading down the path now to leverage historical and current data will enable health care organizations to create a robust, data-driven, surgical management plan to overcome the backlog created by the pandemic. A data-first strategy will also allow hospitals to better prepare for future disasters and re-establish a solid revenue stream sooner. Who knows? They may even grow market share.”

Michael Woods is a health care executive.

He shares his story and discusses his KevinMD article, “Surgical volumes are still down. A data-first strategy is the key to recovery.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Mike Woods. He is a health care executive, and he wrote the KevinMD article “Surgical volumes are still down. A data-first strategy is the key to recovery.” Mike, welcome to the show.

Michael Woods: Thank you. Thanks for having us. Really appreciate it.

Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?

Michael Woods: Sure. Yeah, appreciate it. Well, I’m a board-certified, fellowship-trained surgeon with a master’s in business, which is always a little dangerous. I’ve had a nontraditional career in that I spent 15 years in clinical surgery, five in global clinical development in the pharmaceutical industry with J&J and Novartis, a handful of entrepreneurial ventures that in the process proved Edison’s comment about a thousand ways to fail, and really over the past 20 years have focused on patient safety at the front line of care, including consulting use of a socio-technical approach to look at culture, process, and technology in complex environments like health care.

But over the past 10 years, I’ve really focused on user experience at the intersection of health information technology and patient safety, and leveraging that technology. But I think, sort of long story short, while my path has been really nontraditional, it prepared me to do what I’m doing at Caresyntax, which is help deliver safer, smarter surgery in a complex, dynamic environment while supporting sort of that value-based care focus.

Kevin Pho: So I’ve talked to a lot of physicians who make that transition from clinical medicine into industry or nonclinical roles. Now tell me, what would you say are some of the biggest challenges that you face in making that transition?

Michael Woods: Physicians, I think, often assume that they are their role, right? So I went to college, went to medical school, did my surgery residency, went to fellowship, 14 continuous straight years, and I never thought I’d do anything but surgery. Somewhere along the line there, I discovered that I had other interests, and that the skill set that allowed me to successfully become a surgeon or physician was really not about medicine. It was about the ability to set and achieve goals. And I think every physician has that skill set, right, because they made it through.

And I think the limitation is a belief that I can only do surgery, or I can only do medicine, or I can only do, fill in the blank. And so I guess what I’ve learned is that if you have a goal and you have an interest, because you were very successful becoming a physician, you can probably get to where you want to be. I mean, you’re a perfect example of that, right? You’re an internist, and here you run one of the most successful social media platforms in health care.

Kevin Pho: For those physicians who are interested in making that transition out of clinical medicine and perhaps into some type of leadership role, into industry, what would you say is your biggest actionable tip for them?

Michael Woods: More education is never wrong, right, whether it’s formal or otherwise. I think that the business degree, the master’s in medical management, really shifted my career. It allowed me to understand a lot of what I may not have quite understood as well as I did when I was, for example, in the pharmaceutical industry as a clinical physician, and how to connect the dots as it relates to creating value. But I think it’s really just the willingness to take a risk.

Kevin Pho: All right, so let’s transition now into the KevinMD article that you wrote. It’s titled “Surgical volumes are still down. A data-first strategy is the key to recovery.” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Michael Woods: The reason why we decided to write it is because we noticed such a dramatic difference between what was evolving during the COVID crisis and the shutdown of elective cases, obviously worldwide, but certainly in the U.S. The way that evolved for us is that on our digital surgical platform, we have a software application called Insight, and during that period of COVID, we collected 1.1 million cases from our clients and over 60 facilities.

What we were able to see, comparing it to the McKinsey report of almost 25, representing almost 25 of the beds in the United States, is that our clients actually did 40 to 45 percent more cases during COVID because they had a better understanding of the dynamics of their operational environment. So they were able to re-engage more quickly with the use of that data. They were able to better manage their staff and their capacity as it related to their operational availability. And by the 31st of December of 2020, all of our clients were actually fully back to roughly the same capacity that they were at during that first one and two phases of COVID.

And so it really highlighted for us the value of being able to leverage data from the EHR, from the electronic health record, that is not easy to use. It’s not easy to use the tools, and a lot of those tools, without naming names. But pointed into our system, where there are a lot of metrics that are just built in to help understand things like turnover, capacity, and block time, has really enabled that success.

One of the shocking things in just writing the article, Kevin, was a comment in the McKinsey paper that 50 of the health care organizations that were part of that study indicated they weren’t even interested in looking at steps to increase surgical capacity once the crisis was over to address that backlog. But paradoxically, 80 percent of those same systems thought they’d grow market share. So it was an interesting paradox to me.

Kevin Pho: Now, in your view, what were the biggest obstacles preventing hospitals from getting back on track when it came to surgical volumes? What were the specific variables that were preventing them from doing that?

Michael Woods: Pick the obstacle, right? I mean, nursing staff shortages for a variety of reasons, whether they were single caregivers of children or otherwise. The workforce was impacted. But again, what we have seen in comparing, and even in implementing new clients, looking at where they are with the current system, either using their own electronic health record data versus us taking 12 months of their data, putting it into our system, and showing them where the opportunity is, I think it’s just the ability to understand more quickly the dynamics of the environment and adjust accordingly, right? So it wasn’t that the clients that we have didn’t lose volume. They just maintained higher levels of those volumes, and then once the second phase started to wane, they were able to gear up more quickly.

Kevin Pho: Now, take us through an example story or a case study of one of your clients. Maybe give a picture before, and how your platform looked at the variables to smooth their transition back into pre-pandemic surgical levels. So tell us a case study.

Michael Woods: Well, I can give you a very concrete case study that actually was pre-COVID, around an organization. And the operational metrics, of course, sort of impact the financial health of our organization on many levels. So one example is anesthesia staff. A client was running, well, I’ll just hypothetically use fake numbers and names, but 20 operating rooms, and they were staffing those operating rooms fully with anesthesia. When we got a hold of their data, what we were able to show them is that they actually only needed to be staffing, say, 16 of those operating rooms, and so they were overpaying on their anesthesia contract by $2 million.

That’s a pre-COVID example. The aggregated data from the COVID period, I didn’t specifically look into our larger clients to see how they were translating differently from a year before, the 2019 period, to 2020, other than looking at the recovery.

Kevin Pho: Do you think that there are any lessons that are going to persist post-pandemic? Anything you think is going to have any persistent change, when and if this pandemic ends, when it comes to surgical volumes?

Michael Woods: Yeah, I mean, one of the things, it’s not even persisting, of course. And it’s stating the obvious, but with the Delta variant, things are actually likely to get worse. And I think making no change and expecting a quick recovery as it relates to reestablishing surgical volumes, which is 50, 60 percent of the hospital’s revenue, is simply not a viable option. You can’t put your head in the sand and simultaneously plan to grow.

And so I think establishing a proactive plan to look at your data, understand your staffing models, understand where you have excess capacity, and understand the ability, through a surgical digital platform of some description, to leverage those things is going to be critical. And I don’t know, I mean, who knows what the federal government is going to do, but there may not be the financial bailout that happened during the first one, and so this could well end up being a double whammy on organizations. So I guess “be proactive” is the key.

Kevin Pho: And just give me a little bit of context. In general, a typical hospital in the United States, how much do they actually look at the data without using your services or products? What do hospitals typically do?

Michael Woods: Actually, I believe hospitals generally pay a great deal of attention to the data that’s coming out of whatever tool they have. Again, what we have found is that often the data is either, number one, largely inaccurate because of data entry error, or because of data mapping issues, or fill in the blank, or two, the tool just doesn’t provide them with the kind of analytics that allow them to make decisions. And so in Insight, for example, the data is quasi real-time. They’re understanding every 24 hours what is going on within their system as it relates to improving those operational metrics.

The other things are the ability to, for example, understand where block time is being released. I know it sounds very simplistic, right? But building in kind of real-time alerts that say, “Hey, Dr. Woods,” or, “Mike Woods hasn’t filled his block, and that’s 48 hours from now,” just firing an alert to the nursing staff to follow up, and if I’m not filling that, then releasing that so that it can actually be scheduled with somebody who is able to utilize that time. And so the throughput becomes more consistent, being able to use those operating hours between 7 a.m. and 3:30 p.m.

Kevin Pho: We’re talking to Mike Woods. He’s a health care executive. He wrote the KevinMD article “Surgical volumes are still down. A data-first strategy is the key to recovery.” Mike, what’s your take-home message that you want to leave with the KevinMD audience?

Michael Woods: I think one is that industry is not the enemy. I’ve been in the pharmaceutical industry, the consulting industry, and health information technology, and nobody can legitimately distance business goals from financial goals, but it doesn’t mean that we’re trying to achieve different goals. And Caresyntax is very much about delivering better-quality care consistently. And so I would just say, look for partnering in a way that’s constructive.

Caresyntax is really trying to kind of shift that culture from using data for punitive purposes, as an Air Force friend of mine said, a “rank and spank” culture, to leveraging it for real, pure improvement, right? And the primary goal of all quality and safety reporting systems really is to make the consequences of a caregiver’s actions real, not for punitive purposes, but for unambiguous understanding around the consequences of outcome, right, and how to improve that. And so we’ve built a systematic way to do that, and we’re looking for like-minded folks to partner with us.

Kevin Pho: Mike, thank you so much for sharing your time and insight, and thanks again for being on the show.

Michael Woods: All right, thanks so much. I appreciate it, Kevin.

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