5 Keys to a Thriving Gastroenterology ASC
Strategies for helping improve your ambulatory surgery center’s efficiency and performance
As a physician owner with a stake in an ambulatory surgery center (ASC), you want to treat your patients effectively, but you also need to keep your financial metrics healthy. You need to keep up with emerging medical research and guidelines, while also watching for changes in the regional and national business climate.
It can be a difficult balance to strike, especially as you also need to look internally to streamline your processes and keep your team on the same page. If you find yourself struggling to keep up, it might be time to make some changes to help you operate more efficiently and effectively.
In this article, we’ll look at five key ways you can leverage technology, processes and people to help keep your ASC thriving.
1. Efficient, all-in-one gastroenterology software
On a daily basis, the tool that you use most frequently may not be an endoscope, probe or snare at all—it just might be your ASC gastroenterology software. In fact, your choice of software can have a huge impact on the way your practice operates.
If you’re bogged down with too many clicks or poor staff communication, it can take hours out of your week that could be spent caring for patients or following up on billing issues.
But what features, specifically, should you be looking for to help you avoid this?
First of all, look for ASC gastroenterology software that was actually designed for GI. Many gastroenterologists who try to adopt generic or primary care systems for writing endoscopy reports find themselves searching for workarounds at every turn and scrolling through fields that don’t apply to their specialty.
But some systems, like gGastro® Endoscopy Report Writer (ERW) from Modernizing Medicine® Gastroenterology, come with comprehensive GI workflows and content built in, including findings, interventions and therapeutics. This helps you move through your day faster. Plus, when you’re implementing the system, you don’t have to spend days or weeks building GI templates, although you have the option to customize if you choose.
Second, look for a single solution for all your units and practice settings. With a true all-in-one ASC gastroenterology system, all areas of your practice can use it, from doctors to nurses to billing managers to executives and administrators. Plus, it can directly connect to your office and even your hospital if you use the same system there.
If you have separate EHR and practice management (PM) systems within your ASC or at your office, your vendors may be able to send limited data between the systems through an interface. However, an interface—also called a system bridge—is not a direct integration, and many types of data may not be able to flow through it. Plus, implementing and maintaining bridges can be expensive, and trying to piece together different solutions from different vendors that all work differently can get a bit messy.
A better, smoother solution is to choose endowriter, EHR and PM software for your office and ASC that are all part of a single system made by a single vendor. This is known as integration rather than interfacing, and it allows information to flow more seamlessly between all of them.
In gGastro, this makes it possible to speed up documentation. The endoscopy report writer (ERW) system not only knows what information you may need as a gastroenterologist, but also can pull key data from your office records, display it for easy visibility and populate it where applicable. When you have this automation and can access the information you need when you need it, it can help you see more patients at your ASC with less day-to-day paperwork frustration.
An all-in-one system for clinical, financial and operational tasks can help make operations much smoother for your office and billing staff as well. Some gastroenterology software vendors even include analytics software, a Nursing Notes module, a built-in MIPS solution and patient engagement tools as part of their comprehensive suite of solutions.
With a seamless flow of information between departments and locations, you can save clicks, sticky notes and phone calls, helping you get more done with less frustration for everyone—including patients. When you’re more efficient, you have more time to not only see more patients, but also keep wait times shorter and add a personal touch that helps keep patients satisfied and coming back.
2. Insights into your performance
Your gastroenterology ASC is a business. Just as Fortune 500 companies are always tracking metrics like customer acquisition cost, sales growth and debt to equity ratio, you need to be able to take ownership of your numbers and leverage them.
When you know how you’re doing in each area of your business, you can see where you’re doing well, where you may need to improve and which steps you can take toward improvement.
To help you achieve this, look for an ASC gastroenterology software suite that includes powerful analytics software. This doesn’t just mean the ability to export raw data to a spreadsheet—it means robust dashboards with charts and graphs that you can filter in real time to get the insights you need.
You should be able to drill down all the way from enterprise level to provider level to individual patient level. In addition, you should be able to track metrics across the clinical, financial and operational areas of your practice, including these and many more:
- Quality indicators and documentation, such as adenoma detection rate
- Provider average task completion time
- Endo room turnaround time
- Performance by provider and facility
- Patients lost to follow-up for specific diagnoses
- Same-day appointment cancel rate by scheduler and location
- Patient referral sources by patient lateness
Some reporting tools, such as gInsights™, can distribute reports and provider scorecards automatically, helping you save even more time.
One report that may be particularly useful at your gastroenterology ASC is average endo flowthrough. With an all-in-one endoscopy report writer and practice management system, you can have each step of the process automatically time stamped and analyze your averages.
This can allow you to spot bottlenecks and work to correct them, helping you increase patient volume while reducing the exasperation that can come with waiting. And that’s just one way analytics can help you improve your gastroenterology ambulatory surgery center.
3. Well-negotiated payer contracts
For your business, few things affect your revenue quite as directly as the contracts you negotiate with payers.
If you’re opening a new ASC, keep in mind that payers often try to pay new ASCs lower than existing ASCs. You may need to put in some time and effort to push back, and it may take months of negotiations, but it’s worth it to secure reasonable reimbursement and terms.
Before you begin negotiating your first contracts, try to estimate what your case level and costs will be for each type of procedure you perform. Based on this, you can estimate your breakeven point, which helps give you an idea of what types of reimbursements you should be looking for.
If you anticipate performing very high volume, you may be willing to accept lower reimbursements, and vice versa. However, when your ASC is just starting out, it can be difficult to accurately estimate these numbers—case volume in particular—so make sure to leave a considerable margin of error.
In addition, take care to read the entire contract carefully. Pay attention to rates given for procedures, even if you don’t currently perform them. When negotiating contracts, payers often list extremely low rates for procedures outside the ASC’s specialty, such as joint replacement surgery for a gastroenterology ASC.
This may not seem like a concern at the time. However, if your gastroenterology ASC becomes successful, you may eventually want to consider expanding to include other specialties and types of procedures.
And if these artificially low joint replacement rates are in your contract, payers are allowed to point to them as “market rates” when negotiating with orthopedic ASCs, even though they’re artificially low. This can cause more issues down the road, so it may be worth bringing up the low rates in your negotiations with the payer.
When renegotiating existing payer contracts, you may be able to leverage insights from your gastroenterology analytics software to help you negotiate favorable rates. If you can aggregate quality and cost metrics that demonstrate your ASC’s effectiveness and efficiency, payers may be more open to offering higher reimbursements.
4. An engaged patient base
Ultimately, your patients is a business, and your patients are your clients.
Getting medical treatment isn’t quite the same as patronizing a restaurant, movie theater, or department store, but healthcare is becoming more consumerized every day. Increasingly, patients are reading online provider reviews and doing research to try to get the best service for the best price.
In this environment, your goal is to deliver the best experience and value that you can and to keep patients engaged with you, so they keep coming back and recommend you to other patients. There are a few different tools available that can help you do this.
Your patients have busy lives, just like you. It can be easy to forget about appointments, which can mean missing important treatment while also wasting valuable time in your calendar.
In fact, a recent report by Medbridge Transport found that one patient no-show per day can cost an ASC tens of thousands of dollars each year. If an ASC spends $100 in payroll, equipment, rent and utilities for each scheduled patient and has one no-show five days a week for 52 weeks, it adds up to a $26,000 annual loss.
Fortunately, studies have found that patient reminders can be highly effective in reducing no-shows. Whether through call, text or email, they can provide patients with a convenient way to confirm, cancel or reschedule appointments. With an all-in-one software system, patient responses can automatically update their appointment status in your practice management system.
And for your practice, this automated system can be much more efficient and cost-effective than having staff call each patient to remind them and input their response manually.
Patient check-in kiosk
From the moment patients walk in the door, you can show them that you’re a cutting-edge practice committed to delivering topnotch care by handing them an iPad instead of a hefty stack of paper forms.
With an easy-to-use patient check-in app like gKiosk™, patients can fill out their information fast, and it will populate into your endowriter system. From there, your staff can simply review and accept it instead of reentering all the information manually.
Thanks to this reduction in data entry, gKiosk can save up to 15 minutes per new patient. This helps you shorten wait times while freeing your staff up to tackle more important tasks.
Patient portals have become standard among EHR and ERW systems, but not all offer the same functionality. Look for a patient portal that lets patients complete intake forms online before they come in, so they have little or nothing left to fill out in the waiting room.
Also, after the visit, some patient portals allow patients to view and pay their balances online. This provides an alternative to paper bills and phone calls that can be quicker and more convenient for both your staff and your patients.
How do you know whether your patients are truly engaged and satisfied? And if you suspect that you’re falling short, how can you identify where to improve?
Perhaps the easiest way to do this is to ask patients directly through patient surveys. Sent out automatically after an appointment, patient surveys can provide patients with a simple, fast way to provide feedback.
If they had a positive experience, the service can also direct them to leave a review online. And if they weren’t satisfied, the survey provides a constructive, private way for them to express their thoughts and feelings, while letting you know that you care about giving them a great experience.
5. A well-trained, committed team
Zig Ziglar once said, “You don’t build a business. You build people, and people build the business.” This certainly holds true when you’re putting together your ASC gastroenterology team of medical professionals and staff.
For instance, you’ll want to choose a front desk manager who you can count on to be friendly and kind to patients while staying on task and getting all the necessary paperwork done. Their exceptionally warm manner may leave a lasting impression that makes patients look forward to their next visit and leaves them less disgruntled if, say, a billing mixup occurs.
Ultimately, for your business to grow and develop, you need to make sure that the people in your ASC have the right training, the right tools and the right attitude to create an effective and positive business environment.
You can come up with the best processes in the world for efficient ASC operations, but if people aren’t following them, it doesn’t matter.
Set up clear processes and workflows for each area of your practice, and make sure each member of your team clearly understands them. If they need additional knowledge to be able to complete a certain task correctly, have another member of staff train them, or sign them up for an educational course or conference.
Sometimes, people may understand how a process is supposed to work, but they may run into roadblocks in following it because they lack the necessary tools.
An all-in-one gastroenterology software suite can go a long way in supporting your staff and making sure you’re all on the same page, thanks to the seamless communication it can bring.
Going back to the previous point, make sure you have super users in place who are able to train other staff members on how to properly use your ASC gastroenterology software.
In addition, once you have the right software in place to help improve your workflow, you can actually leverage insights from your analytics software to identify even more areas to improve.
When choosing and developing your team, keep in mind the type of organizational culture you want to create at your ambulatory surgery center.
A fun, courteous, supportive culture can make you, your team and your patients look forward to coming into your ASC, while a negative environment can drive people to leave.
A laid-back, slow-paced culture may be at odds with your desire to see as many patients as possible, so you may want to focus on being proactive and results-oriented. At the same time, don’t push so hard for efficiency that you lose your focus on people and positivity.
Just make sure that your team is dedicated to delivering great patient care, following your designated processes and constantly working to improve them.
Likewise, make sure all of your physician partners are committed to their investment in this business. It can sometimes be difficult for everyone to bring in the case volume they promised since it can be hard to accurately estimate in advance, but a spirit of teamwork and commitment goes a long way to driving volume.
Plus, having efficient, easy-to-use ASC gastroenterology software can help reduce physician burnout while giving physicians more time to put towards bringing in new cases.
With the right people working together in a positive, results-oriented environment, your ASC can be a good place to be for both you and your patients.
For doctors, owning a stake in an ASC gastroenterology can be an important opportunity to branch out as an entrepreneur while serving patients and doing work you love. And for the American healthcare system, ASCs can save billions of dollars per year due to their efficiency and cost-effectiveness compared to hospital outpatient departments (HOPDs).
But it’s not easy to succeed.
By implementing the five strategies we’ve covered in this blog post—from all-in-one software to favorable payer contracts—you can help position your ASC to operate like an effective business, while also delivering quality patient care. This, in turn, can help keep your ASC thriving for years to come.
Julie C. Servoss, MD, MPH
Dr. Julie Servoss is the Medical Director of Gastroenterology and is a board-certified gastroenterologist and internist. She received her bachelor of arts in human biology with honors from Stanford University, her medical degree from Harvard Medical School and her masters in public health from the Harvard School of Public Health. Dr. Servoss completed her internship and residency in internal medicine and her fellowship in gastroenterology at the Massachusetts General Hospital. Learn more about Dr. Servoss.