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forward slash beckers podcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we're recording live at the thirty
first annual business and operations of ASCs.
I'm currently joined by doctor Benjamin Levy, who
is a gastroenterologist
and a clinical associate of medicine at the
University of Chicago.
Thanks for being here. Let's have you kick
us off by sharing a little bit more
about yourself and your work in the ASC
space.
Well, thanks for having me.
I'm always excited to come to this conference
and, learn from my colleagues from around the
country and brainstorm
about trends and how to just practice medicine
better and more efficiently.
I am a gastroenterologist
at the University of Chicago,
and
I have been involved with,
they have, ASC called Ingalls
Same Day Surgery.
And
I scoped there on Fridays,
and it's been a really amazing experience,
to help try to make things more efficient
and to improve
the delivery of health care to an even
higher level. It's always amazing at the University
of Chicago.
Our system is so well organized.
But over the past couple years,
I've been thinking a lot about trends in
GI, and I'm excited to talk with you
about that today.
Awesome. Well, thanks for being here. And let's
start our conversation with the ASC market. Because
in The US, it's projected to reach $60,800,000,000
by 2030
and continues to experience strong year over year
growth. So from your perspective, what is the
most significant
trend and market forces driving this expansion, and
how should ASC leaders be preparing today?
Well, I think there are several things going
on.
The most exciting thing is that we
recently changed the
recommended screening age to begin screening colonoscopies
based on age, and we lowered the age
from 50 to 49. Now there are 19,000,000
new Americans that need to be scoped all
of a sudden,
between those ages of 45 and 49.
And
because of that, we're seeing a huge,
growth in the number of of colonoscopies
that we're doing. So you add that to
the mix of the patients we're already screening
of 50 and older,
and there's a huge demand.
The advantage of ASCs
over,
performing
colonoscopies
in a hospital is that,
many times, not all the time, but many
times, we're able to improve the efficiency,
the turnaround times.
ASCs are are able especially if you're building
out a new ASC,
you're able to think about how to
really work on the turnaround time, try to
get anesthesia,
to be able to see the patients really
quickly.
And while we're writing the notes, have the
anesthesiologist
working on the next patient. And there are
many ways that we're able to get ASCs
super efficient.
And also the use of propofol has allowed
us to do more procedures in the day
because of the turnaround times, easier sedation,
letting the gastroenterologist focus on patient care.
So it's super exciting.
The reason that we re reduced the age
from 50 to 49
is that the American Cancer Society,
first
noticed
a blip
and increased the number of early
onset
of colorectal
cancer cases,
especially around the age of 49. So the
thought was, if we begin screening age 45,
we can try to remove the polyps before
they turn into a cancer.
So I think this is the biggest opportunity,
at least in GI,
for our growth.
And our job is to make sure that
we are able to
fully schedule at ASCs
and to take advantage of the opportunity
when a provider goes there to try to
do as many
procedures as we can and to
try to minimize
any patient cancellations,
to try to make that patient experience really,
really awesome.
And a lot of that has to focus
on
the care that we do
before the patient gets there, make sure that
the instructions are super clear, make sure there's
really good communication between the ASC
and the patient
and an anesthesia
anesthesiology
team and the patient.
But this is a really exciting time. At
the same time, you know, we're always fearful,
about any kind of, reduction in in
reimbursement for our procedures.
So, you know, fortunately, we have our societies
that are trying to advocate for patients and
make sure that,
our insurance
covers
this really important great care that we're providing
to prevent colon cancer.
And I'm I'm involved,
with American College of Gastroenterology,
and there are a lot of gastroologists, you
know, who are involved with our national organization.
So this is a really, really exciting time,
as we just try to improve and prevent
colon cancer.
One hundred percent. So shifting gears slightly from
AI and robotic surgeries to advanced EHR systems,
technology remains both a make or break factor
and a critical driver of ASC operations at
scale. So how do you see deeper tech
integration shaping the way ASCs deliver care and
manage their business over the next few years?
So this is a super exciting time for
the integration of AI into our workspace.
One of the most exciting things,
that has come down recently is, the event
of,
computer
assisted detection of colon polyps. And there are
several different companies that are creating this software.
The first company that really got involved in
GI in this, particular
space,
was,
GI Genius.
And, basically, it puts a little box
around a potential colon polyp. And it's up
to the gastroenterologist to decide whether it's actual
polyp or not and to remove it.
But I like to think of it as,
like, an extra set of eyes in the
room. So you have the gastroenterologist looking at
the screen, looking for polyps.
You should be having your tech and nurse
at the same time, especially your tech, trying
to look for polyps.
But this is, like, a third set of
eyes in the room.
And I kinda think of it as Top
Gun, you know, in the flying scenes when
you see, like, a box over the their
target that they're trying to to look for.
And this is the same kinda thing.
And and the technology
is probably gonna get even better.
But this is especially helpful for patients
who
have polyps that are harder to see. Sometimes
they're flat lesions. Sometimes if there's a residual
stool in the colon,
it's it's a really great opportunity to be
able to highlight these polyps.
And I kind of also think of this
as, like, the iPhone the first version of
the iPhone. So it's a groundbreaking
technology, revolutionary,
but the technology is gonna keep getting better
as we feed it more information.
And especially since there's some competition
in this environment,
I I feel like the technology is gonna
get better and better. Another
amazing,
AI,
created
software that we at the University of Chicago
have been using for the past year is,
a bridge, which is basically ambient
dictation.
So,
there are now apps, and there are a
bunch of different companies
that have, created these apps for doctors to
use.
And, basically,
it uses AI technology
to write notes
as a template. We still go back and
edit the notes
after,
we've seen the patient.
But, basically,
we use the software
to be able to facilitate better conversations with
the patient.
So
it will know
whose voice is the patient, whose voice is
the patient advocate if they have a family
member there, and who's the physician, and if
there's nursing interaction,
it's able to tease all that out. Now
there's several
amazing opportunities when we use the software. First
of all, it just allows for more natural
conversation between the physician
and the patient.
Instead of having our heads buried at the
computer, we're able to to talk with them,
have a more natural conversation.
It also picks up our little small details.
And if we're typing I'm not super fast
typer, but, you know you know, when we're
listening to patients, we're looking for big things
that are, like, super important. But, occasionally, like,
a patient will put you know, mention a
date,
and it'll pick it up more easily. So
it kind of, like, lowers our stress level
when we're seeing patients because we know that
the software is gonna pick up all these
dates, and we don't have to worry about,
like, typing them out.
If there's ever any question,
we can also go back and and look
at the type version of, what the patient
said word word for word. And the the
software kinda summarizes the patient conversation and organizes
it in a really incredible way.
You know, me, like a lot of gastrologists
and physicians naturally, were a little bit hesitant
to use the software initially because we have,
like, you know, we've been trained to write
really good notes. But it is amazing
what the software is able to do. One
of my favorite things is that it summarizes,
everything that we discuss and helps us with
the patient discharge summary with a list of
instructions for the patient to do, any important
phone numbers for them to reach if if
we mentioned it during the the patient visit.
I don't know. Separately from that. So that's
frequently used in clinic, but it's really helpful.
And the reason I mentioned it's in ASC
space is that,
I think that it better prepares patients for
colonoscopies because it picks up on all the
information. You know, if we tell patients to
avoid eating fruits, vegetables, and salads for four
days before the procedure, it'll pick that up
and put that in. So you don't have
to just rely on the patient reading
the patient handout, which is important that we
give patients to prepare, but they can actually
see it in their note. They can see
in their patient discharge summary. In addition to
that,
super exciting invention,
is now
there are companies that are developing software where
we can during the middle of a colonoscopy
procedure, an EGD procedure, we can
actually dictate
things that will show up in the report.
There's a company called Endosoft that has this
Argus software.
And,
you know, it's gonna speed up the documentation
for our procedures at both ASCs and in
the hospital.
And
I look forward to, you know, in the
future having this technology
rolled out more on a national level because
I think it's gonna to improve
our day. It's gonna make things a lot
more accurate,
so we don't have to recall everything after
the procedure.
It's in real time. You can describe things,
and it's just
it it's gonna create a situation where you
have much more efficient care
and
accurate information being documented in the note in
real time.
Absolutely.
And with 60% of health systems considering ASC
joint ventures and many ASCs already partnering with
systems in their communities,
what opportunities do you see for collaboration, whether
with other providers or vendors, to strengthen patient
care and operational efficiency?
Well, I will use our system as, an
example.
I think that anytime you have collaboration, it's
it's a really great idea because you can
pool knowledge and resources,
and hopefully make things more efficient and just
better for patients overall.
So, you know, at the ASC that I
work out on Fridays,
you know, it's a lot of
physicians
who are doing procedures from the University of
Chicago, but there are also some private practice,
physicians as well that use the center.
And, you know, it's it's
a great opportunity
to have the university
have another space where you can do procedures,
sometimes in a more efficient, manner. But it
also allows universities
to be able to expand
quickly into other demographics and other geographic areas
in whatever city you live in. So for
instance, you know, my my main practice is
in Hyde Park at the University of Chicago,
and I love I love going down there.
But it's super cool to go out to
the suburbs and to see a totally different
patient population.
And it allows the ASCs to really be
able to maximize their efficiency because you have
a pool of doctors that are trying to
do more and more and more procedures,
especially as we expand,
and, you know, any kind of university,
that's in the same kind of position, you
know, nationally.
You know, you're able to to partner with
ASCs and to try to increase the volume
of the number of procedures and also take
care of patients in other geographic areas
and outlying areas or maybe
the other the other huge advantage
is that
when we find
a cancer
or we find some unusual pathology,
it also drives patient care to the main
campus.
And so it allows our colorectal surgeons and
oncologists to have even more patients to be
able to take care of, because we're identifying
cancers.
And,
you know, we're we're identifying things for our
advanced endoscopy team, when we need their help.
And so it's able to increase the number
of kind of specialized procedures that are done
on our main campus. And the ASCs, in
turn, really like it because it it really
makes sure that their ASCs are full.
And we're doing procedures every day of the
week, and we're maximizing the use of all
their OR rooms.
So it's very beneficial for all parties.
And,
you know, I encourage,
ASCs to look at these partnerships,
and I also encourage
the academic centers to try to wanna partner
with them
because it just provides better care and, hopefully,
expedites
the, the time from clinic,
seeing a patient, whether it's a primary care
doctor ordering direct colonoscopy
or whether they see us in clinic as
a gastroenterologist in clinic. It will expedite the
time from clinic to actually doing their procedure.
Absolutely.
Well, doctor Levy, is there anything we didn't
touch on today or any final thoughts you'd
like to share as we wrap up our
conversation?
Yeah. So I think this is an an
exciting opportunity for growth of ASCs
and growth in gastroenterology
in general.
The other
thing that I wanted to point out this
morning is that,
you know, in order to make things really
efficient and to make sure that the patient
really understands what's going on, I think it's
important for us to slow down in clinic
and make sure that we spend an adequate
amount of time with patients preparing them from
their prep, have the nurses also work with
the patient,
in clinic whenever possible,
have really great handouts that are easy to
understand on all reading levels,
whenever possible, to try to have,
handouts in languages,
that
you're,
frequently encounter in your patient population.
And in addition to that, super helpful thing
that we have incorporated at the University of
Chicago is to have a nursing navigator,
especially for patients who have a history of
poor prep.
I think that the patients
are greatly
benefiting from the service. And,
we we currently work with three amazing nursing
navigators who have all worked in the GI
space. They have a lot of experience, and
we're getting a lot better patient outcomes in
terms of better preps,
because of their assistance and and a lot
fewer cancellations.
So I would encourage everyone to use nursing
navigators as much as possible. They're a great
resource.
Wonderful. Well, thank you so much for joining
me today on the Becker's Healthcare podcast and
sharing these thoughts and insights. Again, we are
recording live at the thirty first annual business
and operations of ASCs.