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Tech Strategies for Service Lines

Joe Cantlupe, for HealthLeaders Media, February 13, 2012
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The 175-staffed-bed Methodist Willowbrook Hospital in Houston, an enthusiastic supporter of robotic surgery, has shown an increased patient load as a result of the technology. It is still compiling data, but preliminary evidence shows that patients are recovering quicker and there has been greater volume, says Patricia Worley, RN, BSN, director of surgical services for the Methodist Hospital System.

It has been important for the hospital system to use the robot for a wide variety of procedures, with its largest volume in its gynecological program and then general surgery, while building volume in bariatrics, Worley says, noting that the robotic surgery system has been used in 300 cases from August 2010 to November 2011. "Our robot is used very frequently," she adds. "We are very efficient with turnovers," adding that sometimes the robot is used for three to four cases a day.

While the hospital system is still evaluating data, preliminary information supports findings of a "decreased length of stay for inpatient cases of up to two days, which could offset the charges needed to support the da Vinci use," she says.

Despite the necessary capital investment needed for the robot, the hospital "community wanted it," she says. "It was a win-win situation. Our CEO was very supportive, and we branched out into the urology program. There have been so many interested surgeons getting trained in it across specialties. The docs have been interested, and it has taken off."

Simply having a robot is a hook for patients' interest in the hospital system, Worley adds.

"We have noticed that patients are seeking use of the da Vinci when choosing physicians and hospitals that have one and/or are trained on the robot," she says. "Patients are reading bout it; they recognize the bigger cases and know that recovery times will be less … They are going to the doctors' offices and asking, ‘Do you use the robot?'"

Success key No. 4: CT scans
The Moffitt Cancer Center is using CT scans to detect lung cancer tumors after recent studies showed that they are more effective than standard x-rays.

The hospital's use of the CT scans for lung cancer screening reflects a new terrain for many healthcare systems. While some hospitals and radiology programs are using the high-tech scans in hopes of saving the lives of lung cancer patients, others are not because of continued debate over whether benefits outweigh risks. For that reason, insurance companies have been reluctant to cover the scans.

Despite the insurance issues, the Moffitt Cancer Center is using the scans, and the program has been successful in delivering more patients, says Fontaine.

Moffitt began its program after participating in a study that found screening certain heavy smokers and ex-smokers could significantly reduce their chances of dying from lung cancer.  Using CT scans to screen smokers for lung cancer cuts the risk of death from the disease by about 20%, according to a National Cancer Institute study.

"Sometimes you can't wait for the government and insurance companies to make improvements," Fontaine says. "If we think as a physician and cancer institution that we can help our patients, we're going to offer it."

The NCI study, called the National Lung Screening Trial, was conducted on people at high risk of developing lung cancer to compare the differences in death rates between smokers aged 55 to 74 who had been screened annually with low-dose helical or spiral CT versus the conventional chest x-ray. The trial was developed over more than a decade and involved at least 53,000 people. Moffitt was one of 33 study sites that participated.

Lung cancer is especially deadly and difficult to diagnose and treat. More than 157,000 people annually die annually from the disease. CT scans are seen as more likely to spot small tumors compared to chest x-rays.

Armed with the study showing good outcomes from the CT scans, Moffitt Cancer Center is now offering low-dose CT lung cancer screening to patients. It is targeting people ages 55 to 74 who have had a 30-year history of one pack a day cigarette smoking. Pulmonologists at the hospital's cancer program discuss the screening with patients.

The promise of CT screening lies in the early detection of lung cancer when it is most curable, and the tool will save lives, Fontaine says.

Under the program, it is important that interdisciplinary teams evaluate the CT scans to minimize any unnecessary procedures and follow-ups such as biopsies and surgeries, he says. The results are evaluated by a lung cancer tumor board, which includes oncologists, pulmonologists, pathologists, and surgeons.


This article appears in the February 2012 issue of HealthLeaders magazine.


Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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