Welcome!

@DevOpsSummit Authors: Yeshim Deniz, Elizabeth White, Liz McMillan, Jason Bloomberg, Pat Romanski

Related Topics: @CloudExpo, Cloud Security, @BigDataExpo

@CloudExpo: Article

Hospitals and #DataScience | @CloudExpo @LeanTaaS #IoT #API #ITaaS #AI

Four reasons why OR block scheduling is getting overhauled

Operating Room Block Scheduling Needs an Overhaul
By Sanjeev Agrawal, President and Chief Marketing Officer, LeanTaaS iQueue

One minute of utilized operating room (OR) time can be worth more than $70 in revenue and one minute of staffed OR time can cost $50 or more, making underutilized OR time a huge problem. Each year, roughly 51 million surgeries are performed in the 5,000+ hospitals and 5,000+ surgery centers in the U.S. MGMA estimates that the corresponding utilization of operating rooms across these centers is, at best, 55-60 percent.

Given that, for each percentage point of increased utilization, the benefits of an overhaul are considerable. A single OR can deliver more than $100,000 in revenue to a hospital or surgery center. Even for a small hospital or ASC with 8-10 ORs, the value of increasing utilization by 5 percent can easily be in excess of $5 million annually. For large systems, the value of a single OR can run into the tens of millions. If average OR utilization increased by 5 percentage points, more than 2.5 million patients could undergo procedures within the same OR infrastructure.

Root Cause of Underutilization
The process most health systems rely on for managing the complexity of operating room utilization - block scheduling - needs an overhaul. The typical current process usually goes along the following lines:

  • Blocks are assigned to surgeons and service lines and examined on a monthly (sometimes quarterly) basis by the OR committee, which reviews trends in utilization performance by surgeon and service line in order to make informed decisions on the potential reallocation of blocks. The scheduling of the slate of surgeries is then left to the surgeons themselves. Since the OR committee does not have a sufficiently robust, transparent and defensible fact base for allocating OR blocks to different surgeons, there is an inherent subjectivity to the "algorithm" used, which reduces the perception of fairness in the minds of many surgeons. This, in turn, makes surgeons naturally more resistant to releasing their allocated blocks, even if releasing their blocks would aid overall productivity.
  • Perioperative business managers feel a significant amount of pressure from such a system and so try to meet the demands of surgeons who want more block time by identifying low-performing blocks that could potentially be reallocated.
  • Between OR committee meetings, these managers conduct a series of "bilateral" negotiations, persuading some surgeons to release a block in order to meet the legitimate request for additional block time from a new surgeon or a surgeon whose case load has been growing significantly over the past few months.
  • All of this has to be done while keeping other real-world constraints in mind, which could include equipment in a specific OR (e.g., robotics) or calendar constraints (e.g., the surgeon requesting a block can only operate on Tuesdays, and the candidate blocks that could be released are only on Thursdays and Fridays).

Block Scheduling Is Getting an Overhaul
Forward thinking hospitals like UCHealth are leading the charge in giving block scheduling the overhaul it needs. How are they doing it?

The technology exists and is starting to be used: Imagine a series of timely, accurate charts that are automatically - on a daily or weekly basis - "pushed" to the smartphones of every surgeon, their schedulers and the administrative personnel responsible for managing OR utilization. In addition to providing key statistics on utilization, first case on-time starts, cancellations, cases running long, etc., it creates a high level of awareness in the minds of each surgeon about their utilization performance both in absolute terms as well as relative to their peers. Surgeons are data driven, fact based and competitive; accurate, transparent, automated feedback will go a long way toward improving the utilization even if nothing else was to change.

The data exists and is being used: Several factors need to go into determining a fair and equitable allocation of blocks on a periodic basis. Instead of using historical rules for how blocks have been allocated and redistributed, hospitals can now methodically match supply (e.g., regularly underutilized blocks) to demand based on sophisticated forecasting and predictions for blocks, staff and rooms. This is possible because the necessary data exists within the EHR/scheduling system, e.g., historical scheduling data by surgery (the date, time, type, surgeon, room, duration) and the corresponding surgeon-specific performance metrics.

Forward thinking governance/leadership: Hospital leadership is not just more tech savvy today than it was 10 years ago; an increasing number of CEOs, CIOs, COOs and CMIOs are now not only open to looking at new technologies but are requiring their teams to go through process transformation through data, lean methodologies and sophisticated analytics.

There isn't much choice: The demand for medical services has never been stronger, and it's only going to increase. ORs will have to do more surgeries and get reimbursed less per unit for them.

  • Population growth: By 2050, the American population will be over 438 million, up from 320 million in 2015.
  • Demographics: By 2030, over 20 percent of the country is expected to be over 65 years old, up from 15 percent in 2015. This aging population will greatly increase the demand for chronic clinical therapies and surgical procedures. In raw numbers, the Census Bureau estimates that by 2030, when the last proportion of Baby Boomers will hit retirement age, the number of Americans above 65 years of age will hit 71 million - in fact, one in five Americans will be older than 65. Not surprisingly, by 2025, 49 percent of Americans will be affected by a chronic disease and need corresponding therapies.
  • Affordable Care Act: The Affordable Care Act will add another 30 million Americans to the healthcare system by 2025, which means an increase in the demand for operating rooms. Reimbursements will increasingly depend on outcomes and efficacy, quality of care, and patient access. Unless providers increase efficiency in how they process and treat patients, they will need to spend billions in capital spending on new operating room infrastructure.

More healthcare providers are realizing that their operations need a data-driven, scientific overhaul to accomplish efficient and effective OR scheduling. The software and resources are finally available to help achieve such a transformation.

###

Sanjeev Agrawal is president and chief marketing officer of LeanTaaS iQueue. Sanjeev was Google's first head of product marketing. Since then, he has had leadership roles at three successful startups: CEO of Aloqa, a mobile push platform (acquired by Motorola); VP Product and Marketing at Tellme Networks (acquired by Microsoft); and as the founding CEO of Collegefeed (acquired by AfterCollege). Sanjeev graduated Phi Beta Kappa with an EECS degree from MIT and along the way spent time at McKinsey & Co. and Cisco Systems. He is an avid squash player and has been named by Becker's Hospital Review as one of the top entrepreneurs innovating in Healthcare.

More Stories By LeanTaaS Blog

LeanTaaS is a Silicon Valley software company whose offerings rely on advanced data science to significantly improve the operational performance of hospitals and clinics. Using LeanTaaS iQueue in conjunction with their existing EHR's, healthcare institutions are developing optimized schedules that are tailored to each site and can rapidly reduce patient wait times and operating costs while increasing patient access and satisfaction, care provider satisfaction, and asset utilization.

@DevOpsSummit Stories
"DX encompasses the continuing technology revolution, and is addressing society's most important issues throughout the entire $78 trillion 21st-century global economy," said Roger Strukhoff, Conference Chair. "DX World Expo has organized these issues along 10 tracks with more than 150 of the world's top speakers coming to Istanbul to help change the world."
"I think DevOps is now a rambunctious teenager – it’s starting to get a mind of its own, wanting to get its own things but it still needs some adult supervision," explained Thomas Hooker, VP of marketing at CollabNet, in this SYS-CON.tv interview at DevOps Summit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"I will be talking about ChatOps and ChatOps as a way to solve some problems in the DevOps space," explained Himanshu Chhetri, CTO of Addteq, in this SYS-CON.tv interview at @DevOpsSummit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
Your homes and cars can be automated and self-serviced. Why can't your storage? From simply asking questions to analyze and troubleshoot your infrastructure, to provisioning storage with snapshots, recovery and replication, your wildest sci-fi dream has come true. In his session at @DevOpsSummit at 20th Cloud Expo, Dan Florea, Director of Product Management at Tintri, provided a ChatOps demo where you can talk to your storage and manage it from anywhere, through Slack and similar services with Tintri's web services architecture and APIs. Impress your DevOps team with smart and autonomous infrastructure.
"We are an IT services solution provider and we sell software to support those solutions. Our focus and key areas are around security, enterprise monitoring, and continuous delivery optimization," noted John Balsavage, President of A&I Solutions, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
DevOps at Cloud Expo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to wait for long development cycles that produce software that is obsolete at launch. DevOps may be disruptive, but it is essential.
"At the keynote this morning we spoke about the value proposition of Nutanix, of having a DevOps culture and a mindset, and the business outcomes of achieving agility and scale, which everybody here is trying to accomplish," noted Mark Lavi, DevOps Solution Architect at Nutanix, in this SYS-CON.tv interview at @DevOpsSummit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
DX World EXPO, LLC., a Lighthouse Point, Florida-based startup trade show producer and the creator of "DXWorldEXPO® - Digital Transformation Conference & Expo" has announced its executive management team. The team is headed by Levent Selamoglu, who has been named CEO. "Now is the time for a truly global DX event, to bring together the leading minds from the technology world in a conversation about Digital Transformation," he said in making the announcement.
Internet of @ThingsExpo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal and enterprise IT since the creation of the Worldwide Web more than 20 years ago. All major researchers estimate there will be tens of billions devices - computers, smartphones, tablets, and sensors - connected to the Internet by 2020. This number will continue to grow at a rapid pace for the next several decades. With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo in Silicon Valley. Learn what is going on, contribute to the discussions, and ensure that your enterprise...
SYS-CON Events announced today that Calligo, an innovative cloud service provider offering mid-sized companies the highest levels of data privacy and security, has been named "Bronze Sponsor" of SYS-CON's 21st International Cloud Expo ®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Calligo offers unparalleled application performance guarantees, commercial flexibility and a personalised support service from its globally located cloud platforms. Through its four pillars of focus, Calligo delivers a platform that businesses can trust to deliver the high level of service and protection they expect and is lacking in many cloud offerings.
SYS-CON Events announced today that DXWorldExpo has been named “Global Sponsor” of SYS-CON's 21st International Cloud Expo, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Digital Transformation is the key issue driving the global enterprise IT business. Digital Transformation is most prominent among Global 2000 enterprises and government institutions.
SYS-CON Events announced today that Datera, that offers a radically new data management architecture, has been named "Exhibitor" of SYS-CON's 21st International Cloud Expo ®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Datera is transforming the traditional datacenter model through modern cloud simplicity. The technology industry is at another major inflection point. The rise of mobile, the Internet of Things, data storage and Big Data are challenging the existing design patterns of the Data Center. The increase in complexity of managing legacy systems alongside new systems is beyond the ability of most IT departments. This leads to multiple tiers of storage and high economic costs, during a time in which IT is expected to do more with less.
"With Digital Experience Monitoring what used to be a simple visit to a web page has exploded into app on phones, data from social media feeds, competitive benchmarking - these are all components that are only available because of some type of digital asset," explained Leo Vasiliou, Director of Web Performance Engineering at Catchpoint Systems, in this SYS-CON.tv interview at DevOps Summit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
Kubernetes is an open source system for automating deployment, scaling, and management of containerized applications. Kubernetes was originally built by Google, leveraging years of experience with managing container workloads, and is now a Cloud Native Compute Foundation (CNCF) project. Kubernetes has been widely adopted by the community, supported on all major public and private cloud providers, and is gaining rapid adoption in enterprises. However, Kubernetes may seem intimidating and complex to learn. This is because Kubernetes is more of a toolset than a ready solution. Hence it’s essential to know when and how to apply the appropriate Kubernetes constructs.
As enterprise cloud becomes the norm, businesses and government programs must address compounded regulatory compliance related to data privacy and information protection. The most recent, Controlled Unclassified Information and the EU’s GDPR have board level implications and companies still struggle with demonstrating due diligence. Developers and DevOps leaders, as part of the pre-planning process and the associated supply chain, could benefit from updating their code libraries and design by incorporating changes.
"I'm here to leverage my secret sauce, which is using outsourced development and the company that I utilize is delaPlex Software and they've basically allowed me to win Fortune 500 companies," noted Justin Witz, CTO of FRA and PlanTools, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
SYS-CON Events announced today that DXWorldExpo has been named “Global Sponsor” of SYS-CON's 21st International Cloud Expo, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Digital Transformation is the key issue driving the global enterprise IT business. Digital Transformation is most prominent among Global 2000 enterprises and government institutions.
In his opening keynote at 20th Cloud Expo, Michael Maximilien, Research Scientist, Architect, and Engineer at IBM, discussed the full potential of the cloud and social data requires artificial intelligence. By mixing Cloud Foundry and the rich set of Watson services, IBM's Bluemix is the best cloud operating system for enterprises today, providing rapid development and deployment of applications that can take advantage of the rich catalog of Watson services to help drive insights from the vast trove of private and public data available to enterprises.
SYS-CON Events announced today that EnterpriseTech has been named “Media Sponsor” of SYS-CON's 21st International Cloud Expo, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. EnterpriseTech is a professional resource for news and intelligence covering the migration of high-end technologies into the enterprise and business-IT industry, with a special focus on high-tech solutions in new product development, workload management, increased efficiency, and maximizing competitive edge.
DevOps is often described as a combination of technology and culture. Without both, DevOps isn't complete. However, applying the culture to outdated technology is a recipe for disaster; as response times grow and connections between teams are delayed by technology, the culture will die. A Nutanix Enterprise Cloud has many benefits that provide the needed base for a true DevOps paradigm. In their Day 3 Keynote at 20th Cloud Expo, Chris Brown, a Solutions Marketing Manager at Nutanix, and Mark Lavi, a Nutanix DevOps Solution Architect, explored the ways that Nutanix technologies empower teams to react faster than ever before and connect teams in ways that were either too complex or simply impossible with traditional infrastructures.
"We began as LinuxAcademy.com about five years ago as a very small outfit. Since then we've transitioned into more of a DevOps training company - the technologies and the tooling around DevOps," explained Doug Vanderweide, an instructor at Linux Academy, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"NetApp's vision is how we help organizations manage data - delivering the right data in the right place, in the right time, to the people who need it, and doing it agnostic to what the platform is," explained Josh Atwell, Developer Advocate for NetApp, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
SYS-CON Events announced today that Massive Networks, that helps your business operate seamlessly with fast, reliable, and secure internet and network solutions, has been named "Exhibitor" of SYS-CON's 21st International Cloud Expo ®, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. As a premier telecommunications provider, Massive Networks is headquartered out of Louisville, Colorado. With years of experience under their belt, their team of engineers can navigate the Carrier Ecosystem for your IT team acting as an extension of your business, producing a hassle-free experience.
SYS-CON Events announced today that Cloud Academy named "Bronze Sponsor" of 21st International Cloud Expo which will take place October 31 - November 2, 2017 at the Santa Clara Convention Center in Santa Clara, CA. Cloud Academy is the industry’s most innovative, vendor-neutral cloud technology training platform. Cloud Academy provides continuous learning solutions for individuals and enterprise teams for Amazon Web Services, Microsoft Azure, Google Cloud Platform, and the most popular cloud computing technologies. Get certified, manage the full lifecycle of your cloud-based resources, and build your knowledge based using Cloud Academy’s expert-created content, comprehensive Learning Paths, and innovative Hands-on Labs.
SYS-CON Events announced today that Cloudistics, an on-premises cloud computing company, has been named “Bronze Sponsor” of SYS-CON's 21st International Cloud Expo, which will take place on Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Cloudistics delivers a complete public cloud experience with composable on-premises infrastructures to medium and large enterprises. Its software-defined technology natively converges network, storage, compute, virtualization, and management into a single platform to drive unprecedented simplicity in the data center. Customers can start with a base infrastructure and scale to multi-site and multi-geo infrastructures with predictable economics and performance.