Increasing surgical services revenue is a top priority for most health systems, but reliance on manual operating room scheduling and operational inefficiencies can impede these efforts.
Often, poor block utilization means critical OR time goes unused.
Hospitals and health systems are turning to analytics software and artificial-intelligence-based technology to help maximize OR access and increase surgical case growth, which means more OR access to help patients get timely medical care.
Phoenix-based Banner Health, one of the largest nonprofit healthcare systems with 132 ORs across its network, faced the challenge of optimizing its ORs to meet growing surgical demand and accommodate more cases despite having fewer schedulers while also reducing headaches for perioperative and clinical staff.
"As the healthcare environment just gets more and more complex, we really started looking to say, 'How do we streamline our processes to allow us to get our patients timely care?' But, at the same time, how do we not overburden our teams, whether it's the surgeons' offices, our schedulers and periop teams? How do you find that balance where you can streamline that process across the board," said Nirav Patel, M.D., medical director of surgical and procedural services at Banner Health, in an interview.
"What we found was a lot of this being done manually. A lot of faxes, a lot of communication misses and a lot of things being done by 'gut.' We started to look for a partner who could help us from a technology perspective. The aim was not to take away all the expertise we had, but to optimize it and have technology streamline processes that were pretty mundane," said Patel, a trauma acute care surgeon at Banner's University Medical Center in Phoenix.
Banner Health leadership saw opportunities to leverage technology to modernize OR scheduling and operations with the potential for measurable return on investment. The team reviewed several vendors with an eye toward an enterprisewide platform that addressed several key needs. The technology needed to be capable of rapidly addressing future challenges such as pre-admission testing, have di-directional electronic health record APIs, which reduce the need to log into multiple applications, and artificial intelligence and machine learning models that were configurable, according to the health system.
Banner Health decided to work with AI-powered operations software provider Qventus. The company developed technology that automates care operations in both OR and inpatient settings.
"What we were looking for was not just technology; we were looking for a partner. We wanted a partner who would actually work with us, work with our teams and help us, from a technology perspective, build a product that could be a value-add and also be sustainable," said Patel, whose roles at Banner Health include serving as a physician executive for surgical specialties at Banner Medical Group and an associate professor of surgery at the University of Arizona College of Medicine – Phoenix.
The health system piloted Qventus' perioperative solution at four of its largest facilities.
Six months post-go-live, Banner Health reported strong initial results, proving out the potential for AI-based automation tech to maximize OR access, unlock OR growth and reduce staff burden.
The health system, which operates 33 hospitals across six states, now plans to roll out the solution enterprise-wide.
“The results after the first six months have far exceeded our expectations. The solution has increased access to the OR and streamlined the process of block management. The OR teams can schedule cases in real-time, rather than be put on a list and wait for confirmation on availability. This has also positively impacted their patient’s care as they can look ahead and schedule their surgery before leaving the doctor’s office," said Nicole Fiore, senior director of division operations for surgical specialties at Banner Health.
Bi-directionally integrated into the EHR, the software provides a comprehensive view of OR availability to schedule cases in time slots that may otherwise go unused. The solution uses predictive analytics and an extensive data set, including external market data, for model training which enables actionable real-time insights, according to the company.
The technology has helped to improve surgical scheduling and utilization as Banner Health added 2.1 additional cases per OR per month.
More than 359 hours of OR block time have been released early per month. Banner gained 97% year-over-year improvement in case minutes performed within the released block time.
And, Banner Health reports that it broke even in two months on the investment.
The adoption of Qventus' perioperative solution also enables Banner to maximize the use of its robotic assets to meet the demand, according to executives. As a result of the six-month pilot, the health system was able to add 13 more cases per surgical robot per month.
Qventus worked with Banner Health leadership to identify where OR time was going unused, freeing up those spaces for patients who need it. This helped improve efficiencies, allowing the health system to predict and meet the evolving needs of patients seeking care, Patel noted.
"Our motto is 'making healthcare easier so life can be better,'" Patel said. "So we looked at it from the perspective of, 'Are we truly making healthcare easier, or are we just adding technology?' We worked together to identify primary metrics. We created a clear, defined endpoint, and we defined value together."
He added, "It's about optimizing our workforce and using our workforce to the capabilities that they are gifted to do versus mundane tasks. If we can truly optimize some of these processes that are amenable to automation, we're making all our teams rise to a different level. At the same time, what we are going to accomplish at the end is getting patients taken care of more timely and taking care of more patients."
The opportunities for AI in hospital operations
Tackling hospital operational inefficiencies could be the biggest opportunities for AI and machine learning in healthcare, according to Mudit Garg, co-founder and CEO of Qventus.
Garg previously worked as a consultant at McKinsey & Company where he focused on working with hospitals on process and performance improvements.
"Having grown up outside of the U.S., my view of the U.S. healthcare system was always one where if you want the rarest of rare diseases treated, this is where you go. And, in many ways that came true. I saw world-class equipment, world-class therapy and world-class clinicians in every hospital I went to," Garg said in an interview. "But when I saw how everything was held together, and how all the burden of coordinating the logistics landed on the patients and staff, it was just unbelievable. The countless examples of things that people were chasing and trying to put up with."
Garg recognized the tremendous amount of waste in the healthcare system and the potential for technology to simplify all the menial, repetitive tasks.
"Just stepping back and looking at that, it just made me believe that, yes, we have some issues and incentives, and we want to change incentives in the U.S. healthcare system. But if all we do is change incentives, we'll just find new ways of wasting money," he noted.
An engineer by background, Garg saw the potential to use data, AI and automation to simplify healthcare operations. Qventus' platform leverages generative AI, ML and behavioral science to predict operational bottlenecks, recommend remedies and automate processes.
In March 2022, Qventus snagged a $50 million growth investment to roll out its tech in more hospitals and health systems. Thomas H. Lee Partners and healthcare improvement company Premier Inc. backed the round, along with Thedacare and existing investors Bessemer Venture Partners, Mayfield Fund and Norwest Venture Partners.
The company offers its solution to providers to automate aspects of care operations like access and patient flow, decreasing length of stay spent in the hospital and freeing up space for more patients while reducing provider burden.
Building partnerships with technology vendors that are more relationship-driven rather than transactional represents a fundamental shift and will be key for health systems going forward, Patel contends.
As Banner Health rolls out the perioperative solution across its enterprise, it will continue to focus on key metrics of surgical cases
growth and utilization efficiency, which opens up more access to surgical care for more patients, Patel noted.
"We are continuing to focus on access because if we're not opening access, then we're not enabling timely care. As we get more experienced with this technology, as our teams get more familiar with it, we're starting to explore other areas of efficiency. We're starting to explore how we can start leveraging more opportunities for optimization and efficiency and using technology to streamline a lot of our direct patient interface processes as well," he said.