da Vinci-assisted surgery, a minimally invasive surgery modality, can improve patient care, expand access to MIS for physicians and patients, lower costs and boost capacity and throughput.
World-class robotics programs have shown that purposeful implementation is key to success and requires comprehensive training, communication of the patient benefits to the entire care team, and technology platform standardization.
In a May virtual session hosted by Becker's Hospital Review and sponsored by Intuitive, three leaders from ProMedica — an integrated healthcare system in northwest Ohio and southeast Michigan with 13 hospitals and 2,100 physicians, including 67 active da Vinci surgeons across 10 specialties — discussed how ProMedica has implemented Intuitive's da Vinci robotic technology and the importance of standardization and storytelling. Presenters were:
- Kent Bishop, MD, chief medical officer and president, ProMedica Physicians Group
- Thad Wadsworth, president, ProMedica Bay Park Hospital in Oregon, Ohio
- Adam Walter, MD, gynecologist and oncologist, ProMedica
Four learnings were:
- Expanding access must start with a commitment to reducing open surgery, made possible through da Vinci robotics. "Our goal is to ensure surgeons can maintain da Vinci as a first-choice intervention regardless of when or where a procedure is scheduled," Dr. Bishop said. At ProMedica, expanded access is a 24/7 strategy that includes outpatient strategies, a robotic block schedule and programmatic oversight. "I estimate that approximately one-seventh of open surgeries can be reduced to a minimally invasive approach," Dr. Bishop said. "For us to really expand access, we have to make sure we have capable teams and the right technology in the right place."
- Critical to the efficient, effective use of da Vinci robotics is standardization and training. Walter said that when his organization had three or four overlapping platforms, it was difficult to navigate between them. "Being able to upgrade and standardize our da Vinci fleet made it much simpler to acquire the skills as a surgeon and reduced variability at every level. That allowed us to do more cases more efficiently," he said.
- Minimally invasive surgeries deliver a host of benefits. "We love minimally invasive surgery because it allows us to do better for our patients," Dr. Walter said. Patient morbidity and mortality numbers decrease, as well as readmission rates. It improves surgeon lifestyles and shifts care to lower-cost settings, which benefits payers. "It's a win-win-win . . . It allows us to provide safe, reliable, high-quality, repeatable care across multiple surgeons in a lower cost setting," he said.
- Organizations must share the complete patient story about how da Vinci robotics is a key part of the mission. The two primary objections to da Vinci robotic surgery are that surgeries take too long and are more expensive. "One powerful way to overcome these objections and drive alignment is keeping the patient experience front and center," Mr. Wadsworth "Our first step was to educate and align nurse leadership, surgical teams and anesthesia. All parties needed to understand how da Vinci robotics is vital to reducing open surgeries as well as the role it plays in the bigger strategic plan."
"For example, Dr. Tahir Jamil routinely does hernia cases in an hour or less, which is below the national average," Mr. Wadsworth said. "Dr. Jamil is improving the margin per case using da Vinci technology. His patients are going home faster, experiencing fewer complications, having lower readmission rates and requiring less opioids. But perhaps more importantly, with da Vinci, patients have a better total patient experience."
According to Dr. Bishop, "At ProMedica, we want to deliver the best care for our patients with the best technology in the right place at the right time, every single time. The data and technology provided by Intuitive has been invaluable to achieving those goals." It's why since 2007, ProMedica has used da Vinci to assist over 22,000 patients with minimally invasive surgery.
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