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Becker’s Healthcare Podcast
Janet L. Carlson, MSN, BSN, RN, NE-BC, FACHE, Vice President of ASC Operations at Commonwealth Pain & Spine | Advanced Surgical Institute
00:12:58
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- [00:00]
A
Hello, this is Francesca Matthews with the Beckers 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.
- [00:18]
B
Thank you for having me, Francesca.
- [00:20]
A
Absolutely. To start us off, could you please just introduce yourself and tell us a little bit about your background?
- [00:27]
B
Sure. So, Janet Carlson. I am a registered nurse. I began working in the ambulatory space at a multi specialty center in the early 2000s. 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.
- [01:15]
A
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. Yeah. What are the top three trends that you're following in healthcare and ASCS today?
- [01:29]
B
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 get switched around to multiple people. They don't end up talking to somebody. So I think AI is something that we're just going to 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 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 joint started doing this, gosh, 20 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 da Vinci robot, and 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 up front. Again, another plug for AI where you could start working the claim the minute that the case is booked on 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.
- [04:47]
A
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.
- [05:00]
B
I'm just excited about the growing awareness overall and 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 a little engine that could, that were 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.
- [06:29]
A
Absolutely. Definitely feels like a, you know, there's a lot of potential for major transformation as the ASC industry continues to grow.
- [06:38]
B
Right. And it shouldn't be seen as a 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.
- [07:16]
A
Absolutely. And also just seems like, you know, as the US population becomes sort of older and sicker, it's, there's plenty of room for everyone in the market there. And it seems like there's yeah, just like a lot of potential for, you know, more more efficiently operationalized patient care flows and whatnot. You and you mentioned that you're kind of spearheading the ASC project at Commonwealth right now. I'm curious how you're think thinking about growth over the next 12 months.
- [07:50]
B
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 company and as a team, we're going into these hard to reach places and providing services 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 con 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 12 months are some of the statewide or state specific con 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?
- [10:06]
A
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?
- [10:15]
B
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 is possibly another conversation, is the partnership 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 is something that I'm following closely, 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.
- [11:54]
A
And I know just in the 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 something that's developing.
- [12:19]
B
Yeah. 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.
- [12:38]
A
Absolutely. Well, that is actually all I have for you today. Jen. Thank you so much for joining us. It's been an absolute pleasure speaking with you, and I look forward to connecting with you again in the future.
- [12:49]
B
Absolutely. Thank you again, Francesca, for hosting me. I appreciate it.
- [12:53]
A
Of course. Thank you. Have a good one.
- [12:55]
B
You, too. Bye. Bye.