Leaders from more than 1,100 hospitals and health systems joined Intuitive 360, a virtual event held Nov. 4-5, 2021, to explore ways to advance the possibilities of minimally invasive care, the breadth of Intuitive’s ecosystem and the benefits and best practices of robotic surgery.
The 22 sessions at Intuitive 360 included keynotes, general sessions, panel discussions and breakout sessions. Below are key points from a keynote featuring Intuitive CEO Gary S. Guthart, PhD, and from sessions featuring senior leaders from prominent health systems.
The Quadruple Aim
Since Intuitive's inception, the company's focus has always been, "Where can we improve outcomes?" As Dr. Guthart explained, Intuitive's desire is to help hospitals and health systems make progress in their pursuit of the Quadruple Aim — improving population health, providing a better patient experience, lowering costs and improving health team well-being. "The goal of robotic-assisted surgery programs," Dr. Guthart said, is "a great set of outcomes and improvement of the Quadruple Aim."
Among steps Intuitive is taking to assist health systems in pursuit of the Quadruple Aim are:
- Making safe, reliable products manufactured at the highest quality
- Ensuring thorough training, including training of Intuitive's staff and training in the field for customers
- Gathering data to measure results
- Continuously improving
Training
Throughout Intuitive 360, health system leaders stressed the importance of initial and ongoing training on Intuitive's technology for physicians and staff.
At the start of the pandemic, Intuitive offered training through consolidated, integrated training centers. But coming to one of these training centers required traveling. "It became clear during the pandemic this wasn't going to work," Dr. Guthart said. "Our team worked closely with our customers, and we pivoted."
New offerings include personalized digital online training, providing virtual reality training and deploying training resources into local regions. "We increased our digital presence in training and increased our physical proximity to customers to help with training," Dr. Guthart said. "We increased convenience and increased accessibility."
Stepwise approach
A consistent theme, emphasized by leaders whose health systems have extensive experience with robotic-assisted surgery, is "begin with a vision," said Jonathan Velez, MD, chief physician and operations executive at Gulf Coast Medical Center in Fort Myers, Fla. "And that vision should be crafted by surgeons and operations."
It is necessary to get strong leadership support for this vision. "It's all about getting buy-in from your executive team, as well as from the OR and nursing staff," said Andrea Pakula, MD, medical director of robotic surgery at Adventist Health in Simi Valley, Calif.
Dr. Guthart said the key to making the vision a reality is "having a stepwise pathway to bring value in the short term and create greater value over time . . . the hardest part is not so much the long-term vision, but the sequence of steps."
Numerous health system leaders agreed. "Everybody wants to just dive right into robotics to do super complex cases. But I think if you do it in a stepwise fashion — start simple, get your team comfortable and go from there — you'll have better success," said David Beffa, MD, general surgeon/acute care surgeon at Sutter Health Medical Center in Sacramento, Calif.
Metrics and costs
Sessions at Intuitive 360 emphasized the importance of data and metrics. Having dashboards provides visibility on key metrics such as quality, volume, length of stay, readmissions, surgical site infections, margins and more.
Measuring costs is obviously critical, particularly since perceptions about costs can be a barrier to robotic surgery adoption. Dr. Guthart said the key cost metric is total cost for an episode of care. At times people focus on material costs, but this is "not the dominant set of costs," Dr. Guthart said, and fails to consider staffing costs, OR costs, capital costs and the costs of complications.
Financial decisions around robotic surgery require a sophisticated cost analysis. Intuitive employs dozens of health economists to help organizations look at their cost data. Intuitive has found "the best run [robotic] programs are cheaper than open surgical programs and often cheaper than laparoscopy," Dr. Guthart said.
This claim was supported by multiple health system leaders during Intuitive 360. "One of the important elements of investing in robotics is the ability to drive costs lower for your surgical procedures," said Howard Kern, president and CEO of Sentara Healthcare in Norfolk. "Data show that your costs are substantially lower . . . on the order of 15 to 20 percent lower."
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To view the presentations from Intuitive 360, click here.