Welcome!

CMS Authors: Mehdi Daoudi, Rishi Bhargava, Harry Trott, Xenia von Wedel, Carmen Gonzalez

Related Topics: @CloudExpo, Cloud Security, @BigDataExpo

@CloudExpo: Article

Hospitals and #DataScience | @CloudExpo @LeanTaaS #IoT #API #ITaaS #AI

Four reasons why OR block scheduling is getting overhauled

Operating Room Block Scheduling Needs an Overhaul
By Sanjeev Agrawal, President and Chief Marketing Officer, LeanTaaS iQueue

One minute of utilized operating room (OR) time can be worth more than $70 in revenue and one minute of staffed OR time can cost $50 or more, making underutilized OR time a huge problem. Each year, roughly 51 million surgeries are performed in the 5,000+ hospitals and 5,000+ surgery centers in the U.S. MGMA estimates that the corresponding utilization of operating rooms across these centers is, at best, 55-60 percent.

Given that, for each percentage point of increased utilization, the benefits of an overhaul are considerable. A single OR can deliver more than $100,000 in revenue to a hospital or surgery center. Even for a small hospital or ASC with 8-10 ORs, the value of increasing utilization by 5 percent can easily be in excess of $5 million annually. For large systems, the value of a single OR can run into the tens of millions. If average OR utilization increased by 5 percentage points, more than 2.5 million patients could undergo procedures within the same OR infrastructure.

Root Cause of Underutilization
The process most health systems rely on for managing the complexity of operating room utilization - block scheduling - needs an overhaul. The typical current process usually goes along the following lines:

  • Blocks are assigned to surgeons and service lines and examined on a monthly (sometimes quarterly) basis by the OR committee, which reviews trends in utilization performance by surgeon and service line in order to make informed decisions on the potential reallocation of blocks. The scheduling of the slate of surgeries is then left to the surgeons themselves. Since the OR committee does not have a sufficiently robust, transparent and defensible fact base for allocating OR blocks to different surgeons, there is an inherent subjectivity to the "algorithm" used, which reduces the perception of fairness in the minds of many surgeons. This, in turn, makes surgeons naturally more resistant to releasing their allocated blocks, even if releasing their blocks would aid overall productivity.
  • Perioperative business managers feel a significant amount of pressure from such a system and so try to meet the demands of surgeons who want more block time by identifying low-performing blocks that could potentially be reallocated.
  • Between OR committee meetings, these managers conduct a series of "bilateral" negotiations, persuading some surgeons to release a block in order to meet the legitimate request for additional block time from a new surgeon or a surgeon whose case load has been growing significantly over the past few months.
  • All of this has to be done while keeping other real-world constraints in mind, which could include equipment in a specific OR (e.g., robotics) or calendar constraints (e.g., the surgeon requesting a block can only operate on Tuesdays, and the candidate blocks that could be released are only on Thursdays and Fridays).

Block Scheduling Is Getting an Overhaul
Forward thinking hospitals like UCHealth are leading the charge in giving block scheduling the overhaul it needs. How are they doing it?

The technology exists and is starting to be used: Imagine a series of timely, accurate charts that are automatically - on a daily or weekly basis - "pushed" to the smartphones of every surgeon, their schedulers and the administrative personnel responsible for managing OR utilization. In addition to providing key statistics on utilization, first case on-time starts, cancellations, cases running long, etc., it creates a high level of awareness in the minds of each surgeon about their utilization performance both in absolute terms as well as relative to their peers. Surgeons are data driven, fact based and competitive; accurate, transparent, automated feedback will go a long way toward improving the utilization even if nothing else was to change.

The data exists and is being used: Several factors need to go into determining a fair and equitable allocation of blocks on a periodic basis. Instead of using historical rules for how blocks have been allocated and redistributed, hospitals can now methodically match supply (e.g., regularly underutilized blocks) to demand based on sophisticated forecasting and predictions for blocks, staff and rooms. This is possible because the necessary data exists within the EHR/scheduling system, e.g., historical scheduling data by surgery (the date, time, type, surgeon, room, duration) and the corresponding surgeon-specific performance metrics.

Forward thinking governance/leadership: Hospital leadership is not just more tech savvy today than it was 10 years ago; an increasing number of CEOs, CIOs, COOs and CMIOs are now not only open to looking at new technologies but are requiring their teams to go through process transformation through data, lean methodologies and sophisticated analytics.

There isn't much choice: The demand for medical services has never been stronger, and it's only going to increase. ORs will have to do more surgeries and get reimbursed less per unit for them.

  • Population growth: By 2050, the American population will be over 438 million, up from 320 million in 2015.
  • Demographics: By 2030, over 20 percent of the country is expected to be over 65 years old, up from 15 percent in 2015. This aging population will greatly increase the demand for chronic clinical therapies and surgical procedures. In raw numbers, the Census Bureau estimates that by 2030, when the last proportion of Baby Boomers will hit retirement age, the number of Americans above 65 years of age will hit 71 million - in fact, one in five Americans will be older than 65. Not surprisingly, by 2025, 49 percent of Americans will be affected by a chronic disease and need corresponding therapies.
  • Affordable Care Act: The Affordable Care Act will add another 30 million Americans to the healthcare system by 2025, which means an increase in the demand for operating rooms. Reimbursements will increasingly depend on outcomes and efficacy, quality of care, and patient access. Unless providers increase efficiency in how they process and treat patients, they will need to spend billions in capital spending on new operating room infrastructure.

More healthcare providers are realizing that their operations need a data-driven, scientific overhaul to accomplish efficient and effective OR scheduling. The software and resources are finally available to help achieve such a transformation.

###

Sanjeev Agrawal is president and chief marketing officer of LeanTaaS iQueue. Sanjeev was Google's first head of product marketing. Since then, he has had leadership roles at three successful startups: CEO of Aloqa, a mobile push platform (acquired by Motorola); VP Product and Marketing at Tellme Networks (acquired by Microsoft); and as the founding CEO of Collegefeed (acquired by AfterCollege). Sanjeev graduated Phi Beta Kappa with an EECS degree from MIT and along the way spent time at McKinsey & Co. and Cisco Systems. He is an avid squash player and has been named by Becker's Hospital Review as one of the top entrepreneurs innovating in Healthcare.

More Stories By LeanTaaS Blog

LeanTaaS is a Silicon Valley software company whose offerings rely on advanced data science to significantly improve the operational performance of hospitals and clinics. Using LeanTaaS iQueue in conjunction with their existing EHR's, healthcare institutions are developing optimized schedules that are tailored to each site and can rapidly reduce patient wait times and operating costs while increasing patient access and satisfaction, care provider satisfaction, and asset utilization.

@ThingsExpo Stories
Consumers increasingly expect their electronic "things" to be connected to smart phones, tablets and the Internet. When that thing happens to be a medical device, the risks and benefits of connectivity must be carefully weighed. Once the decision is made that connecting the device is beneficial, medical device manufacturers must design their products to maintain patient safety and prevent compromised personal health information in the face of cybersecurity threats. In his session at @ThingsExpo...
"We're a cybersecurity firm that specializes in engineering security solutions both at the software and hardware level. Security cannot be an after-the-fact afterthought, which is what it's become," stated Richard Blech, Chief Executive Officer at Secure Channels, in this SYS-CON.tv interview at @ThingsExpo, held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
SYS-CON Events announced today that Grape Up will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct. 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Grape Up is a software company specializing in cloud native application development and professional services related to Cloud Foundry PaaS. With five expert teams that operate in various sectors of the market across the U.S. and Europe, Grape Up works with a variety of customers from emergi...
Detecting internal user threats in the Big Data eco-system is challenging and cumbersome. Many organizations monitor internal usage of the Big Data eco-system using a set of alerts. This is not a scalable process given the increase in the number of alerts with the accelerating growth in data volume and user base. Organizations are increasingly leveraging machine learning to monitor only those data elements that are sensitive and critical, autonomously establish monitoring policies, and to detect...
SYS-CON Events announced today that Massive Networks will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Massive Networks mission is simple. To help your business operate seamlessly with fast, reliable, and secure internet and network solutions. Improve your customer's experience with outstanding connections to your cloud.
Everything run by electricity will eventually be connected to the Internet. Get ahead of the Internet of Things revolution and join Akvelon expert and IoT industry leader, Sergey Grebnov, in his session at @ThingsExpo, for an educational dive into the world of managing your home, workplace and all the devices they contain with the power of machine-based AI and intelligent Bot services for a completely streamlined experience.
Because IoT devices are deployed in mission-critical environments more than ever before, it’s increasingly imperative they be truly smart. IoT sensors simply stockpiling data isn’t useful. IoT must be artificially and naturally intelligent in order to provide more value In his session at @ThingsExpo, John Crupi, Vice President and Engineering System Architect at Greenwave Systems, will discuss how IoT artificial intelligence (AI) can be carried out via edge analytics and machine learning techn...
With tough new regulations coming to Europe on data privacy in May 2018, Calligo will explain why in reality the effect is global and transforms how you consider critical data. EU GDPR fundamentally rewrites the rules for cloud, Big Data and IoT. In his session at 21st Cloud Expo, Adam Ryan, Vice President and General Manager EMEA at Calligo, will examine the regulations and provide insight on how it affects technology, challenges the established rules and will usher in new levels of diligence a...
In the enterprise today, connected IoT devices are everywhere – both inside and outside corporate environments. The need to identify, manage, control and secure a quickly growing web of connections and outside devices is making the already challenging task of security even more important, and onerous. In his session at @ThingsExpo, Rich Boyer, CISO and Chief Architect for Security at NTT i3, discussed new ways of thinking and the approaches needed to address the emerging challenges of security i...
SYS-CON Events announced today that Datera, that offers a radically new data management architecture, has been named "Exhibitor" of SYS-CON's 21st International Cloud Expo ®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Datera is transforming the traditional datacenter model through modern cloud simplicity. The technology industry is at another major inflection point. The rise of mobile, the Internet of Things, data storage and Big...
An increasing number of companies are creating products that combine data with analytical capabilities. Running interactive queries on Big Data requires complex architectures to store and query data effectively, typically involving data streams, an choosing efficient file format/database and multiple independent systems that are tied together through custom-engineered pipelines. In his session at @BigDataExpo at @ThingsExpo, Tomer Levi, a senior software engineer at Intel’s Advanced Analytics ...
SYS-CON Events announced today that Datera will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Datera offers a radically new approach to data management, where innovative software makes data infrastructure invisible, elastic and able to perform at the highest level. It eliminates hardware lock-in and gives IT organizations the choice to source x86 server nodes, with business model option...
With 10 simultaneous tracks, keynotes, general sessions and targeted breakout classes, Cloud Expo and @ThingsExpo are two of the most important technology events of the year. Since its launch over eight years ago, Cloud Expo and @ThingsExpo have presented a rock star faculty as well as showcased hundreds of sponsors and exhibitors! In this blog post, I provide 7 tips on how, as part of our world-class faculty, you can deliver one of the most popular sessions at our events. But before reading the...
SYS-CON Events announced today that CA Technologies has been named "Platinum Sponsor" of SYS-CON's 21st International Cloud Expo®, which will take place October 31-November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. CA Technologies helps customers succeed in a future where every business - from apparel to energy - is being rewritten by software. From planning to development to management to security, CA creates software that fuels transformation for companies in the applic...
SYS-CON Events announced today that GrapeUp, the leading provider of rapid product development at the speed of business, will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place October 31-November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Grape Up is a software company, specialized in cloud native application development and professional services related to Cloud Foundry PaaS. With five expert teams that operate in various sectors of the market acr...
Internet of @ThingsExpo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal and enterprise IT since the creation of the Worldwide Web more than 20 years ago. All major researchers estimate there will be tens of billions devic...
In his session at 21st Cloud Expo, Carl J. Levine, Senior Technical Evangelist for NS1, will objectively discuss how DNS is used to solve Digital Transformation challenges in large SaaS applications, CDNs, AdTech platforms, and other demanding use cases. Carl J. Levine is the Senior Technical Evangelist for NS1. A veteran of the Internet Infrastructure space, he has over a decade of experience with startups, networking protocols and Internet infrastructure, combined with the unique ability to it...
From 2013, NTT Communications has been providing cPaaS service, SkyWay. Its customer’s expectations for leveraging WebRTC technology are not only typical real-time communication use cases such as Web conference, remote education, but also IoT use cases such as remote camera monitoring, smart-glass, and robotic. Because of this, NTT Communications has numerous IoT business use-cases that its customers are developing on top of PaaS. WebRTC will lead IoT businesses to be more innovative and address...
In his opening keynote at 20th Cloud Expo, Michael Maximilien, Research Scientist, Architect, and Engineer at IBM, discussed the full potential of the cloud and social data requires artificial intelligence. By mixing Cloud Foundry and the rich set of Watson services, IBM's Bluemix is the best cloud operating system for enterprises today, providing rapid development and deployment of applications that can take advantage of the rich catalog of Watson services to help drive insights from the vast t...
SYS-CON Events announced today that Elastifile will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Elastifile Cloud File System (ECFS) is software-defined data infrastructure designed for seamless and efficient management of dynamic workloads across heterogeneous environments. Elastifile provides the architecture needed to optimize your hybrid cloud environment, by facilitating efficient...