Several leaders joined Becker's on a Nov. 1 panel at the 30th annual Business and Operations of ASCs Meeting in Chicago to discuss emerging issues in gastroenterology and patient care technology, from artificial intelligence to new screening tools.
Patient engagement technology
Dean Lehmkuhler, administrator of Indianapolis-based Northside Gastroenterology Endoscopy Center, emphasized that patient engagement technology will have a significant impact on gastroenterology in the coming years.
He noted that this technology is particularly important in gastroenterology because of the detailed communication required for procedure preparation and scheduling.
"If you can definitely communicate a clear message to your patients, your cancellations and no-shows drop tremendously," he said. "That's really important with our practice because when we have holes in the schedule, it really creates havoc for the day, and it's a big loss for us."
Artificial intelligence
Omar Khokhar, MD, a gastroenterologist at Illinois GastroHealth in Bloomington, highlighted the critical role of artificial intelligence, particularly in colonoscopy for polyp detection.
Dr. Khokhar shared that a six-month AI pilot program at his center led to a substantial improvement in polyp detection, with rates increasing from 45% to 56%.
While implementing AI technology is a major financial investment, he noted that it could potentially pay for itself over time. Because the technology is bringing patients back for surveillance exams and generating more pathology, these revenue streams could potentially offset the cost of AI, he said.
Currently, Iterative Health's Skout and Medtronic's GI Genius are two AI-assisted options making waves in the industry. Computer-assisted colonoscopy methods could lead to a 55% decrease in the miss rate of adenomas.
Disposable scopes
Dr. Khokhar also spoke about the potential of disposable scopes to transform gastroenterology procedures in ASCs. Disposable scopes could reduce risks associated with traditional cleaning and sterilization, but the industry still has some way to go in terms of making this technology fully practical and accessible.
"I don't think we're quite there yet," he said. "But eventually, we may be in a position [to adopt disposable scopes], and that would affect a lot of downstream cleaning, sterilization, and related workflows."
Noninvasive screenings
With rising demand for colonoscopies, more noninvasive screening methods will be necessary, explained Emma Gimmel, BSN, RN, director of nursing for Manhattan Endoscopy Center in New York City.
In July, the FDA approved a new screening test for colorectal cancer that only requires a sample of blood. The new Shield test, developed by Guardant Health, detected 83% of colorectal cancers in studies but identified only 13% of high-risk polyps, compared to colonoscopies, which find roughly 95% of these dangerous polyps.
At the beginning of October, the FDA approved the Cologuard Plus test, a next-generation, multitarget stool DNA test approved for patients at an average risk for colorectal cancer. In a trial of 19,000 patients, Cologuard Plus test demonstrated 95% overall cancer sensitivity and 43% sensitivity for advanced precancerous lesions at 94% specificity.
Ms. Gimmel stressed that while these tools can't replace a colonoscopy, they could help lead to more screenings overall.
Cytosponge
Ms. Gimmel also expressed enthusiasm for Cytosponge, a screening tool that detects Barrett's esophagus by sampling cells from the lining of the esophagus. Barrett’s cells can indicate a risk for esophageal cancer.
"I think that's going to be amazing," she said. "Even though these tests are done in the office, they're going to bring more patients to actually sample for dysplasia."
Robotics
Miguel Afonso, MD, clinical director of Gastroclinic in Portugal, discussed the growing interest in robotics within gastroenterology but noted the high costs associated with this technology.
"I see that minimally invasive endoscopic procedures will increase in the next few years," he said. "So I see technology can help us to do more complex and minimally invasive procedures."
Ms. Gimmel echoed these thoughts, specifically mentioning her excitement for magnetic navigation systems.