Eisenhower Desert Orthopedic Center completed its expansion in 2021. The ambulatory surgery center in Rancho Mirage, Calif., helps free up operating rooms for other needs at the nearby Eisenhower Medical Center.

May 24 2022
Patient-Centered Care

Why Healthcare Organizations Want to Expand Ambulatory Surgery Centers

Healthcare providers are building new ambulatory surgery centers or expanding existing facilities for outpatient surgery.

Like many healthcare providers, Eisenhower Health has seen a surge in demand for outpatient surgeries, and because of it, the organization recently expanded and modernized its surgery center with additional operating rooms and state-of-the-art technology.

The healthcare system in Rancho Mirage, Calif., completed a three-year, $68 million expansion of its Eisenhower Desert Orthopedic Center in 2021, which doubled its space to 110,000 square feet and quadrupled the number of operating rooms from two to eight.

Technology is woven throughout to make the patient experience as seamless, safe and efficient as possible, from scheduling appointments and surgeries to postoperative care, says Dr. Stephen O’Connell, president and chairman of Eisenhower Desert Orthopedic Center.

During arthroscopic surgery, for example, new surgical instruments with cameras provide clear, magnified views of the surgical area on large 4K monitors at the operating table. Surgeons capture images during surgery; afterward, they use Apple iPad devices to send personalized videos to patients showing the procedure’s steps.

“I can say, ‘We fixed the tendon with no problems, as you can see. Now, don’t forget to wear your sling. Keep ice on your shoulder, and we will see you in two days to change the dressing and start therapy,’” O’Connell says. “I then send off the email, and it’s there before the patient gets home.”

Dr. Stephen O’Connell

Dr. Stephen O’Connell, President and Chairman of Eisenhower Desert Orthopedic Center, offers insight into his ambulatory surgery center. Photography By Matthew Furman

Health systems have increased investments in ambulatory surgery centers to provide patients a more affordable, convenient and personalized alternative to hospitals for their outpatient surgeries, all while delivering high-quality care.

The COVID-19 pandemic has accelerated the healthcare industry’s move to outpatient care, including home healthcare. But there are other growth drivers for ASCs: Medical and technological advances, such as arthroscopic and robotic surgery, enable minimally invasive procedures, allowing patients to go home the same day, which reduces the risk of infection because they don’t require hospitalization.

ASCs are also more convenient than hospitals and offer a more intimate setting that provides patients more personalized care, according to a McKinsey report. For example, patients using ASCs don’t have to navigate a crowded or large hospital. ASC staff are focused on patients’ needs and don’t have to worry about emergencies.

READ MORE: Learn how providers are strengthening community care.

“The setting is more patient friendly and less chaotic. There are no intercoms blaring and no emergency room with trauma patients. Fewer people also cuts down on infections,” says Jeffrey Flynn, vice president of the New York State Association of Ambulatory Surgery Centers and chief operating officer of Gramercy Surgery Center in New York.

It also costs less for providers to build and operate ASCs, which results in lower costs for patients and insurance providers.

Technology is critical to the success of surgery centers, ASC administrators say. The mix of computers, mobile devices, medical equipment and software integrated across the network and IT infrastructure enables ASCs to operate more efficiently and improve care.

Technology Is at the Center of Ambulatory Surgery

Eisenhower Desert Orthopedic Center’s expansion frees up the operating rooms for other surgical needs at the nearby 437-bed Eisenhower Medical Center.

In the past, orthopedic surgeries accounted for about 40 percent of s­urgeries at the medical center. With the expansion, 80 percent of the organization’s orthopedic surgeries can now be done at the surgery center, executives say.

The expanded surgery center has 23-hour recovery rooms for patients who need it and 22 patient exam rooms equipped with a computer and IP phone. About 170 clinical and administrative staff work onsite, including two full-time IT staffers.

“We have a lot of surgeries happening at the same time, so we can’t afford downtime,” says recently retired Eisenhower Health CIO David Perez.

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The IT department has equipped the center with technology that is standardized throughout the organization, which simplifies management and the user experience, he adds. That includes Dell and HP desktop and notebook computers, HP printers, and Cisco switches and Wi-Fi equipment. The center also uses Epic electronic medical record software, which is used throughout the system.

The center upgraded its operating rooms with new video-assisted surgical equipment. Before, surgeons using arthroscopes or fluoroscopes had to crane their necks to use a 15-inch monitor to guide their surgery. Today, they use 30-inch and 80-inch 4K Samsung displays that are hooked up to PCs. “Now, in our ergonomically designed suites, we’re looking at the surgery with high-definition 4K monitors, which is better for the surgeon and the patient,” O’Connell says.

Wi-Fi is important because clinicians and administrative staff are mobile, O’Connell adds. He uses the Epic private medical chat feature to collaborate with other doctors and staff. “It allows us to communicate instantaneously,” he says.

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Improving Patient Care with Health IT at ASCs

Intermountain Healthcare, a Utah-based health system with 24 hospitals and 225 clinics, is making ASCs a bigger part of its strategy. It owns four ASCs and is developing several more across Utah, Idaho and Nevada that it plans to open within the next three years. Intermountain is investing in ASCs because of patient demand but also to improve the value of care, says Mike Clark, CEO of McKay-Dee Hospital in Ogden, Utah, and the executive lead of ASCs at Intermountain. “Our mission is to help people live the healthiest lives possible. Part of that is access to healthcare and providing healthcare at a lower cost,” Clark says.

Saltzer Health, a provider owned by Intermountain, recently opened the Saltzer Surgery Center in Meridian, Idaho, a 22,500-square-foot, multispecialty facility with five ORs and one procedure room.

When choosing and deploying technology, administrators and IT staff at Saltzer focused on fully integrating medical equipment with hardware and software to streamline operations and improve patient care and safety, says Bridgette Berkeley, the center’s nursing director.

For example, in ORs, surgeons use video-assisted surgical instruments. Monitors for blood pressure and other vital signs are connected to the wired Cisco network, and the data is automatically uploaded to the EMR, leaving nurses to focus on patient care instead of entering the data, she says.

Source: UnitedHealth Group, “Performing Joint Replacements in Ambulatory Surgery Centers Could Help 500,000 People Avoid Overnight Hospital Stays and Save $3 Billion Annually,” December 2020

The organization standardized on an ASC-specific, cloud-based software suite that features an EMR, charting system and practice management system, enabling staff to do everything they need, says Sean McCallister, Saltzer Surgery Center administrator. “Our EMR has the capability and versatility to accomplish everything we do here. It’s seamless,” McCallister says.

Saltzer Center staff also standardized on iPads, Lenovo ThinkPad laptops, virtual desktops on 10ZiG zero-client devices, and Dell monitors. They also employ the collaboration tools used by the larger Saltzer Health organization, including Microsoft SharePoint for document sharing, Microsoft Outlook for email and calendaring, and Microsoft Teams for video calls and messaging.

“It makes it really convenient to find our team members and coordinate care throughout,” Berkeley says.

Overall, the technology enables Saltzer Surgery Center to operate efficiently and improve patient outcomes, McCallister adds. “It helps our caregivers better serve patients, and ultimately makes for better patient care, less expensive care and improved patient satisfaction,” he says.

Courtesy of Eisenhower Health

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