Hello. This is Francesca Matthews with the Becker's
ASC review podcast.
I'm thrilled to be joined today by Janet
Carlson,
MSN,
BSN
RN,
vice president of ASC operations at Commonwealth Pain
and Spine Advanced Surgical Institute.
Janet, thank you so much for being here
today.
Thank you for having me, Franchesca.
Absolutely.
To start us off, could you please just
introduce yourself and tell us a little bit
about your background?
Sure. So Janet Carlson.
I am a registered nurse.
I began working in the ambulatory space,
at a multi specialty center in the early
two thousands.
And I've worked in every role in an
ASC, and I've led some very successful surgery
centers. And
now I am in charge with creating,
designing,
operationalizing,
and scaling our ambulatory
operations for Commonwealth Pain and Spine.
And our ASCs
are under
a new name and logo.
It's called Advanced Surgical Institute.
And so I'm currently working right now on
building four ASCs
across three states.
Absolutely. Yeah. It sounds like you're kind of
an ASC jack of all trades, so it'll
be great to get further insights from you.
Sure.
Yeah. What are you what are the top
three trends that you're following in health care
and ASCs today?
You know, I know everyone says AI, but
I really think that's an important component,
as an adjunct
technology
capability to help us better serve our patients.
For example,
you know, having an automated call system with
an integrated AI feature,
that will help be responsive to patient calls
to clinics
and to surgery centers,
keep that communication going with patients because
often they get
frustrated.
They have to, you know, get switched around
to multiple people. They don't end up talking
to somebody. So I think AI is something
that we're just gonna see more increased use
of
in the space as well as,
you know, enhancing our existing workflows.
Another example would be
using AI,
for a template for your
EHR charting in an ASC,
and that would allow you just to populate
specifics to the patient case at hand. But
it would be very helpful
in your your throughput times in an ASC,
reducing some of the manual entry and charting
requirements that you have today.
So AI is one of the things I'm
watching.
Another thing I'm watching
is the increased migration
of higher acuity cases into the ASC space.
Obviously, we know that Total Joints started doing
this,
gosh, twenty years ago, and then spine followed
next.
And now the hot
thing in the newest space for ASC service
lines is cardiovascular,
peripheral vascular, and interventional radiology.
So I'm following those trends as well.
Surgery centers are also
investing in
equipment like,
a DaVinci robot, so then they could offer
some of the higher acuity, minimally invasive, very
precise surgeries
that are traditionally done in the hospital and
now
moving those to
a very concierge setting, very boutique type experience,
bespoke experience for the patient
to the ASC space and get to go
home on the same day.
The other thing that I'm following
are obviously payer
trends, contract negotiations
for compensation
for care provided to our patients and our
ASCs,
and the revenue cycle management process that goes
that follows with it. So making sure that
we're billing and coding correctly upfront.
Again, another plug for AI where you could
start working the claim the minute that the
case is booked on your your surgical schedule,
and then be ready on the back end
if you needed to,
assist arbitration
and looking for the payment for that claim.
Providers should be paid for the work and
the care that they take care of these
patients. And so making sure that you're getting
paid for the actual services that you've done,
is key to your bottom line.
Absolutely. And that definitely,
you know, echoes some of the themes that
we hear from from other ASC leaders here
at Becker's. I'm curious what you're most excited
about right now.
I'm just excited about the growing awareness
overall
in
our country
for what is an ASC.
I think one of the silver linings of
COVID,
was that many people
learned overnight that there are 6,000
smaller independent
hospital like structures
that are like an in little engine that
could that were self self contained and that
we were able to decompress the big
hospitals during COVID.
And I think that that has been a
really great
opportunity for people to recognize
the increasing capacity,
that we have in ASCs to take care
of more complex higher acuity cases.
So I'm excited about that continual migration
away from the hospital,
and that allows us to create space
in the larger health system,
OR hospital settings.
We're creating capacity so that they can truly
focus on the sicker patients, the ones with
multiple comorbidities
that would not be safe and would not
meet our anesthesia selection criteria in our ASC,
rather
keep those people in the hospital and take
the things that are safe and ambulatory
out of that setting
and creating that capacity.
Mhmm. Absolutely.
Definitely feels like,
you know, there's a lot of potential for
for major transformation as as the ASC industry
continues to grow. Right. And it shouldn't it
shouldn't be seen as a a comp competitive
thing. It's really a win win for everybody.
And it's just,
you know, you hear the word site neutrality
all the time, and that talks about the
payment,
for the care provided in the ASC. But,
you know, understanding that we're not there to
cannibalize
all the cases that, happen in the hospital,
that there's so many things that need to
be done and safely done for the patient
in the hospital. But there are so many
things, and that list is expanding every day
over who we can take care of in
the ASC, and that's really what I'm excited
about.
Mhmm. Absolutely. And it also just seems like,
you know, as
The US population becomes
sort of older and and Mhmm. Sicker, it's
there's
plenty of room for for everyone in the
market there, and it seems like there's, yeah,
just, like, a lot of potential for,
you know, more and more,
efficiently operationalized,
patient care flows and whatnot.
Right.
You and you mentioned that you're kind of
spearheading,
the ASC project at Commonwealth right now. I'm
curious how how you're thinking about growth over
the next twelve months.
Well, we're very strategic about our thinking, and
we're looking at the demographics,
for each market where we have clinics. And
the goal
is to provide services often in
underserved rural areas where,
these people,
patients have to drive multiple hours to get
to a larger metropolitan
area where there's health care. And so
as a as a company and as a
team, we're going into these,
hard to reach places and providing services in
the in their community.
And when we do that and we establish
ourselves there and the referral patterns with other
providers
in that area,
we're then able to
drive
synergies
and build an ASC strategically,
in a market where we've got multiple clinics
that can support it.
And so
we are expanding,
and we are going to those markets where
we can whether it's a CON state or
not, because, like I said, I'm working across
three states right now.
Two of the states do not have a
c o n law, and one of the
states does.
And so that changes a little bit about
how we execute and plan for that space.
But
one of the things that I think is
exciting in the next twelve months are some
of the
statewide,
or state specific c o n law changes
or amendments that are coming.
This is going to relax,
a lot of the
existing restrictions around developing or adding a new
service line to an existing ASC.
This is going to allow ASCs to be
truly multi
specialty
and meet the needs of the community and
offer these independent surgeons
a place to do cases.
Oftentimes, independent surgeons
don't have
guaranteed block time in a health system if
they're not employed with the health system. And
so ASCs are the perfect
solution for those surgeons who are looking for
a home and looking for guaranteed block time.
Absolutely.
Yeah. For sure. And I'm curious. Is there
anything else I haven't asked about today that,
you think is important in this conversation?
I think that we've covered most of the
topics. I could talk for a very long
time
about ASCs. There's so much going on. It's
such a dynamic space.
I think another topic that is worth exploring,
possibly another conversation, is
the partnership with with anesthesia
and how to optimize a patient preoperatively.
And so that way,
we can
with an elective procedure, we could plan to
have a patient
taken care of. And since it's elective, there's
no rush, but we can optimize the patient
for a really great experience on the day
of surgery, but also very importantly,
postoperatively
in their recovery journey.
So that's that is something that,
I'm following closely is is how to best
provide care to these patients and make sure
they have
excellent outcomes,
because we're now required to
collect patient satisfaction scores,
and we'd like to make sure that the
patients are having a wonderful experience. They're satisfied.
Is there anything we could do to improve
their experience or anything we could have done
better?
That feedback is very valuable, but that's a
new, requirement for 2025
for ASCs is the requirement to collect and
report your patient satisfactions.
So
ASCs
routinely have very, very high patient satisfaction scores,
and I think this is an opportunity for
the ASC community to show off
those numbers and the experience that we provide.
Absolutely. And I know,
just in my anesthesia
element, there's I've heard the term kind of
the perioperative
home a lot in recent months. And just
as technology,
you know, advances, as more cases come to
the ASC, kind of a lot of anesthesia
professionals thinking of themselves more as, you know,
somebody who's guiding the patient through those, you
know, before and after stages, not just showing
up for the procedure. So that's definitely That's
right. Something that's developing.
Yeah. They're they're an integral part of the
whole,
patient experience
and,
really contribute to the patient optimization preoperatively
as well as
to the
outcomes postoperatively,
which we are obviously very interested in.
Absolutely.
Well, that is actually all I have for
you today, Jen. Thank you so much for
joining us.
It has been an absolute pleasure speaking with
you, and I look forward to connecting with
you again in the future.
Absolutely. Thank you again, Franchesca, for hosting me.
Appreciate it.
Of course. Thank you. Have a good one.
You too. Bye bye. Bye.