Hospitals rarely lack operating room data. What they lack is data that arrives in time to act on, in the hands of the surgeons and schedulers who make daily decisions, and a governance structure that outlasts the consultants who built it.
San Juan Regional Medical Center in Farmington, N.M., is a 198-licensed-bed hospital in the Four Corners region with 14 operating rooms and an acquired ambulatory surgery center; nearly all of its surgeons are employed, according to its physician informatics executive, Carlo Hallak, MD. Clinicians are hard to recruit there, he said.
In an executive roundtable held during Becker’s 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health on Sept. 15 and sponsored by LeanTaaS, Dr. Hallak described how the hospital replaced spreadsheet-based OR reporting with LeanTaaS’ real-time OR capacity-management platform. The panelists were:
- Austin Trout, senior director of customer outcomes, operating rooms, at LeanTaaS
- Carlo Hallak, MD, physician informatics executive at San Juan Regional Medical Center
Below are four takeaways from the discussion.
Note: Quotes have been edited for length and clarity.
1. The people and the process were in place before the technology arrived.
Dr. Hallak said a prior consulting engagement had already produced the hospital’s OR governance charter, policies and committee membership. Then the consultants left, and the reports left with them. “They solved the big problem for me as an informatician — they created the policies, they created the charter, they created the governance and they decided with the organization who needs to be part of those committees,” he said. “What was missing was the technology.”
When the technology, LeanTaaS’ iQueue for Operating Rooms, did arrive, a physician champion made the data credible. The hospital’s chief anesthesiologist built the numerators and denominators and validated the data for his peers. Surgeons will say the data is wrong and they are doing better, Dr. Hallak said, until a colleague who works beside them in the OR confirms it is accurate. “You need to really find a champion who is in the thick of it, who is directly impacted by the truncated workflows and the complexity,” he said.
2. Real-time access replaced month-old data — once the old spreadsheets were deliberately retired.
Before the platform, Dr. Hallak said, OR committees were contemplating problems rather than solving them. “You’re basically coming to those meetings and you’re contemplating the problem because now you’re looking at data that is a month old — you’re not acting as the issues arise, as the problems arise,” he said. Surgeons can now see first-case on-time starts and open time on a computer or phone and release blocks with a click.
The harder step was ending the parallel process. Health systems pile new products on top of old processes, he said, so the hospital trained the OR nurse director to present live from the dashboards and told teams to stop generating Excel extracts. Attachment to old processes was the only real implementation challenge, he said in response to an audience question.
3. Adoption came on its own, and the data ended the block arguments.
Dr. Hallak said the hospital’s 88% user adoption rate happened naturally. LeanTaaS trained every scheduler across the hospital’s offices, and surgeons began booking cases themselves with the patient in the room. He joked that, in his experience, block time can go to whichever surgeon brings schedulers the “best bagels.” At San Juan, he said, the data has made allocation decisions more transparent and easier to discuss. Blocks also release automatically under the hospital’s auto-release policy if a surgeon does not release them proactively.
During the first 90 days after launch, 71 active users submitted 498 approved requests that were successfully booked into open OR time slots, and the average lead time for cases scheduled in advance was 10 days. This led to a 2x ROI during the first quarter of implementation, as reported by LeanTaaS.
“[Surgeons] never tell you they love it, but they are using it all the time,” he said.
4. An at-risk contract made the decision easier for the CFO.
Dr. Hallak said a small community hospital buying off the shelf rarely gets an exit clause in a 36- or 72-month contract, so LeanTaaS’ agreement to set KPIs and refund fees if outcomes were not met eased the CFO’s concerns.
Mr. Trout from LeanTaaS said the company now aligns on ROI methodology and leading indicators with each client before anything goes live. “We know that at this point no one really has the luxury of purchasing a tool and hoping to figure that out later,” he said. Most customers are not on long-term contracts, he added: “The majority of our customer base has the option to cancel 30 days out.”
What is left is the human part
The technology solved visibility, Dr. Hallak said; the remaining challenge is persuading surgeons to fill the capacity it exposed. The hospital had also implemented a real-time patient-status view; next steps included a block management tool and pushing scheduled cases directly into the EHR.
In closing, Dr. Hallak said he measures success by making his own role less necessary. “I always say I thrive to eliminate myself,” he said — when surgeons, nurses and operational leaders use the platform and request improvements without him having to drive the work, the product has succeeded.
