In recent months, several payer groups have adopted policies designed to shift elective procedures, including joint replacement surgeries, to ASCs. From private insurers to CMS, migrating these procedures to ASCs is an attractive option as they seek to control costs. On top of this, the nation’s population is aging, with nearly 20 percent of Americans expected to be over the age of 65 by 2030.1 For ASCs, this momentum shift will create challenges as they look to meet this potential increased patient demand on facilities.
More than ever, ASCs will need to identify processes and tools that increase efficiency and make complex procedures predictable and routine, all without sacrificing the patient experience. For many, the solution will come from robotics. Surgical robotics have already gained a foothold within hospitals and many ASCs, where they have demonstrated their ability to enhance surgical accuracy – but increased demand will likely make robotics and other technology solutions a more attractive investment for ASCs in the coming year.
Becker's ASC Review recently spoke with Louis Amiot, Vice President and General Manager – Development Engineering for Worldwide Robotics at Zimmer Biomet to get his take on the positive impact robotics and technology can have on ASCs.
"Of course, as I lead the development of robotics technology for Zimmer Biomet, I am incredibly passionate about the role that robotics can, and must, play as we seek to make orthopedic surgeries more streamlined, more routine and more accessible for patients and healthcare professionals alike. But we cannot innovate thoughtfully in a vacuum and the experiences, needs and insights of experienced surgeons are invaluable in our work each day,” said Mr. Amiot.
David W. Miller, MD*, a seasoned orthopedic surgeon who performs joint replacement surgeries assisted by the ROSA® Robotics System from Zimmer Biomet, sees extreme value in using surgical robots for outpatient joint replacements. In this article, he shares a unique perspective about what ASCs should consider when investing in robotics.
Surgeon-centered solution
Dr. Miller has been an early adopter of surgical robotics; in fact, he was the first physician to complete a knee replacement using the ROSA Robotics System in the United States.
"With a surgical robot, like ROSA, I can simply be more accurate and spend more of my energy focusing on the patient because I know that the robot is going to help streamline the complexity of these procedures," Dr. Miller said. "What's important is that a robot cannot replace a good surgeon – but a robot can take that good surgeon and make them excellent."
Working with healthcare professionals like Dr. Miller, Zimmer Biomet has fine-tuned its robotic tools to augment and enhance the work they do, seamlessly integrating into their workflow and giving them the added confidence that they are making the right decisions for patients because those decisions are rooted in solid data.
For an ASC, this confidence and increased accuracy may translate to improved patient satisfaction, fewer complications and an overall increase in efficiency. But beyond that, robotics is opening up new treatment options that can broaden the services that ASCs can use to differentiate their practice. For example, Zimmer Biomet recently updated its ROSA Robotics System, adding the ability to perform partial knee arthroplasty procedures in addition to total knee replacements.
"We know that, in the United States, at least, partial knee replacements are not performed as often as total knee procedures despite offering a faster recovery and more natural sense of movement for many patients. The procedure can be perceived to be more complex than traditional total knee surgery, but the increased accuracy and reproducibility afforded by a robot such as ROSA gives surgeons confidence in performing the procedure and makes it a more viable option," said Dr. Miller when asked about this new functionality. "And again, the robot empowers the surgeon by providing data, intended to support decision-making for the patient. The system can be seamlessly switched between partial and total knee capabilities, so we can default to the less invasive option but still perform a total knee replacement if it becomes necessary."
Enabling more personalized care
Robotic solutions have the added benefit of ensuring that each patient gets a tailored experience, powered by data and tuned to their own anatomy, medical history and other concerns.
For instance, when surgeons use ROSA Robotics, one of the first things that happens is the creation of a 3D imaged bone model of the patient’s anatomy, allowing them to For ASCs, Robotics Delivers Increased Efficiency without Sacrificing Patient Experience 42 Executive Briefing: more effectively understand and communicate the patient’s condition and which treatment options might work best.
"Having a robot assisting me in the operating room gives me a deeper understanding of each patient – even as I’m able to work more quickly," Dr. Miller added when asked about how the imaging and data analytics capabilities of ROSA affect his ability to personalize his approach to each patient. "Having a tool that lets you assess data pre- and intra-operatively ensures that you’re as accurate as possible for each patient. This means that you can marry efficiency and reproducibility with the type of individual attention that makes patients undergoing these procedures truly feel the more personalized care they have received.”
In the ASC setting, this level of personalization may result in more satisfied patients and more predictable surgeries, both of which may make it possible for an ASC to treat more patients and see a measurable return on their investment in these technologies.
Compatibility matters
ASCs typically have their own existing processes and it’s important for a robotic system to seamlessly integrate into that workflow.
"In my experience, the learning curve for robotics is actually quite low," said Dr. Miller. "Surgeons and staff quickly see the value of accuracy and reproducibility. This isn’t about replacing any expertise or practice but refining it in a way that raises the standard of care across the board."
"At Zimmer Biomet, we believe that a major driver in raising that standard are the insights that can be gleaned from data that carries across the patient journey and is critical to ensuring that surgeons and care teams can make the best possible decisions for patients," added Mr. Amiot.
Earlier this year, Zimmer Biomet introduced a connected intelligence suite of integrated robotics and digital health technologies under a platform called ZBEdge. This offering of products runs the gamut from telehealth solutions to analytics platforms to robotics solutions. For instance, while ROSA provides exceptional support in the operating room, they have designed it to take advantage of other datadriven products and services like the company’s clinical analytics platform OrthoIntel® Intelligence Platform and patient engagement services like mymobility® with Apple Watch®. With this connected suite of solutions, surgeons can access data insights from pre, intra- and post-surgery sources to truly understand what might be happening as a patient recovers and makes progress toward regaining their mobility.
"Beyond this, our more than 45 years of clinical heritage in partial knee arthroplasty doesn’t just mean that we know this space well, it means that we already have products that are clinically proven and trusted in ASCs across the country – whether it’s our technology solutions, or our implants that surgeons already know and trust. With the new ROSA Partial Knee system, for instance, we have designed it for compatibility with Persona® Partial Knee, our clinically proven implant which has become a trusted solution for surgeons since it launched in 2017," said Mr. Amiot.
Mr. Amiot also added that just as Zimmer Biomet wants to ensure that robotics enhance, not replace, surgeons and care teams that ASCs have invested in, the company also wants to make sure that they can work with the implants, devices and services that ASCs already know and trust.
A competitive edge
Technology is an ever-evolving process, and every ASC has its own budget, its own priorities, and its own timeline for making investments. It’s important to note that when they do make that investment, it’s sustainable and can grow with the practice and their patient demands. To that end, Zimmer Biomet provides multiple financing solutions for ASCs to acquire capital equipment, including ROSA Robotics, without significant cash outlay.
"Robotics will become the standard in the next five years or so and those who do not make that transition will find it challenging to remain competitive,” Dr. Miller said, referencing the increased demand for joint replacement procedures at ASCs. “Robotics are a capital expense that allows ASCs to grow, and it’s becoming easier than ever to justify the spend as these systems become more robust. The issue will increasingly be not having a robot in an ASC, as more people see that these tools can result in greater patient satisfaction and a more efficient practice.”
To learn more about the ROSA Robotics System and how it can fit into your ASC, please visit ZimmerBiomet.com.
1 United States Census Bureau. (2014 May 06) Fueled by Aging Baby Boomers, Nation’s Older Population to Nearly Double in the Next 20 Years, Census Bureau Reports [Press release]. https://www.census.gov/ newsroom/press-releases/2014/cb1484.html#:~:text=%22The%20 United%20States%20is%20projected,Census%20Bureau’s%20Population%20Projections%20Branch.
This material is intended for healthcare professionals. Distribution to any other recipient is prohibited. Zimmer Biomet does not practice medicine. Patients must have a compatible smart phone to utilize mymobility. Not all patients are candidates for the use of this product and surgeons should evaluate individually to determine which patients are appropriate for therapy at home. All names used in the mymobility app examples are fictitious. No identification with actual patients or health care professionals is intended or should be inferred. iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. The Zimmer Biomet Connected Health mymobility Application. © 2021 Zimmer Biomet *Paid Zimmer Biomet Consultant