How a surgical robotics service line can shore up hospital finances, improve quality and drive an exciting vision for the future

Implementing a minimally invasive surgery (MIS) program can make a positive impact on hospital finances and help lower the total cost of care while improving health outcomes.

MIS programs can also unlock attractive new opportunities for organizations to expand strategically.

At the Becker's Hospital Review CEO + CFO Virtual Forum, three leaders in nursing, finance and operations from Sharp HealthCare (San Diego) discussed how surgical innovation can drive unexpected returns on investment and how Sharp propelled itself into the future by adopting a creative MIS acquisition approach. Panelists were:

  • Fahd Benjalil, CFO/COO, Sharp Coronado
  • Susan Stone, senior vice president of health system operations, and system CNO, Sharp HealthCare
  • Christopher Walker, COO, Sharp Memorial

Three key takeaways were:

1.) MIS can enhance hospital economics and help lower the total cost of care. Hospital margins have suffered enormously during the past few years and many hospital and health system leaders feel they have exhausted available cost-cutting measures. Investing in MIS programs can give hospital economics a boost thanks to gains in efficiency and quality.

"When we started the MIS program at Coronado, we had built the pro forma for X number of robots to be paid off within two years — and we paid it off within 10 months," Mr. Benjalil said. The accelerated return on investment was realized through a chain of downstream savings, including faster OR turnover times, fewer surgical site infections, fewer blood transfusion procedures, lower utilization of intensive care, shorter lengths of stay compared to open and laparoscopy-based surgeries, higher throughput due to greater use of outpatient services and fewer readmissions and reoperations.

2.) Data can be used to support improvements in care quality and financial performance. By engaging with Intuitive as a partner, Sharp benefited from Intuitive's data-generation and visualization capabilities, and gained actionable insights for quality and financial improvements. Sharp accomplished this by being able to access in real time granular information, dashboards and data reports, which shed light on how surgeons were doing on quality and efficiency metrics. 

One of the most revealing observations from Sharp's experience was that the greater use that surgeons make of Intuitive's da Vinci robots, the more skilled and confident they become about performing MIS and as a result, the less time they spend on each case. Over time, there was a 35 percent reduction in the time that each surgeon spent on the da Vinci console. 

The data also allowed leaders to explore cost variation across providers in the Sharp network and identify opportunities to drive down costs without compromising quality.

3.) By leveraging a creative MIS acquisition and program expansion approach, provider organizations can prepare for a medical technology-powered future. "We started [Sharp's MIS program] at one small hospital, where we had partnerships with doctors and Intuitive was sharing their data reports," Ms. Stone recalled, picking up on the importance of data. The learnings from that early experiment were then propagated across Sharp's hospital network, which is how the value of the robotics surgery program spread throughout the entire organization.

Despite the interest that Intuitive's MIS program had awakened, simply following a traditional capital acquisition approach would have taken the organization far too long to acquire enough consoles to meet demand. 

Mr. Walker said a decision was made to use a mix of creative contracting partnerships with Intuitive, including an operational lease model, to absorb the cost of utilization. "That translated into us being able to perform thousands of more robotic surgery cases per year, which drove true growth for our organization." 

Sharp's MIS program has enhanced hospital economics, improved the total cost of care, helped boost revenue and laid a foundation for an innovative, technology-driven future.

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