Insights and innovation from the evolving role of the CFO

Surgical advancements are driving hospitals and health systems to innovate their surgical service lines in order to stay competitive, attract physicians and patients and drive revenue.

During a July Becker's Hospital Review webinar sponsored by Intuitive, three healthcare CFOs discussed how their organizations are using data to help develop and sustain financially viable robotic service lines. Panelists were:

  • Scott Fought, CFO, providers, acute & ambulatory care, ProMedica (Toledo, Ohio)
  • Vincent McDermott, senior vice president of finance and CFO, Newton-Wellesley Hospital (Newton, Mass.)
  • Jerry Yang, vice president and CFO of operations, MultiCare Health System (Tacoma, Wash.)

Three key takeaways were:

1.) Establishing a sustainable robotics program starts with laying the right foundation. There is an important distinction between a hospital with a robot and a hospital with a fully developed, strategically focused robotics program. Hospitals that set their sights on the latter can set themselves up for success. Financial leaders can team up with lead surgeons who can educate them on the value and benefits of robotics and establishing a full program.

"As I was educated by our clinician and physician leadership, I understood this was something we had to look at strategically for quality reasons, patient outcomes, patient preference and surgeon recruitment," Mr. Fought said. "If we didn´t do something, we were going to lose cases to our competitors."

2.) Quality data and metrics are key to quantifying success. Because success in healthcare is measured across multiple dimensions, it is important that metrics used to track robotics programs, such as productivity and utilization, feed into a broader view of how robotics programs impact higher-level goals. Some of those downstream goals are:

  • Overall cost of care, including length of stay, readmissions and costs associated with surgical site infections
  • Operational efficiency, measured in terms of increased operating room capacity and access to patient care units, including by expanding robotic programs into community hospitals
  • Patient outcomes
  • Surgeon quality metrics

"The ability to marry up our productivity and utilization data with our cost data to get at cost per case [helps] as we continue to plan for the shift to value-based care, where the total expenditure over the episode of care becomes critically important," Mr. McDermott said.

3.) To grow market share, offer surgeons a roadmap and set tiered expectations. Robotics is an area in which many surgeons are interested and want to experiment. In fact, it is a main recruitment and retention tool, including for training residents. "We can't underestimate the desire of physicians wanting this service. Part of it is meeting the demand of society and another part is meeting the demand of what surgeons want in their training. I don't think you can be a modern current hospital without providing this type of access to the machines, [otherwise] you're going to lose market share," Mr. McDermott noted.

Nevertheless, not all surgeons are well suited for participating in a robotics program. Mr. Yang said it is crucial to understand who are the right providers with the right intent and "the right carpenters to use the tool." Once those physicians are identified, Mr. Yang advocates for setting high-level expectations in terms of volume and quality, then giving them autonomy to work and grow the program within those guidelines. "As we hit certain tiers and hit certain triggers, we invest more and we discuss what's the next level," he said.

With one of the aims of value-based care being reducing variation, there is one more benefit to a fully developed minimally invasive robotics programs: standardization.

"Robotic surgery gives us the opportunity to be really good at standardization as opposed to being left to the individual talents and techniques of our surgeons that may be applying things a little differently on a case-to-case basis," Mr. McDermott said. He concluded with a prediction: "While we won't demand full standardization, there will be a migration continuing toward it."

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