“We have an enormous problem that is often not beginning on street corners; it is starting in doctor’s offices and hospitals in every state in our nation.” This quote comes from the recent interim report by the Commission on Combating Drug Addiction and the Opioid Crisis. Since 1999, the number of opioid overdoses in the U.S. has quadrupled. Over that same period, the amount of prescription opioids sold has quadrupled as well. With a substantial portion of the population experiencing chronic pain and more than 650,000 prescriptions dispensed every day, the medical profession must employ every available strategy to address the tragic human and economic costs of opioid misuse, abuse, and dependence. One such tactic is to avoid the need for prescription opioids in the first place, or to limit a patient’s pain management need to a very short duration.
Scientists have been fascinated with the workings of the human nervous system dating back to the time of Hippocrates and well before. Today, as members of the healthcare community gain a greater understanding of the system—how to treat its disorders and protect its integrity—interest in the topic continues to grow. The American Clinical Neurophysiology Society (ACNS) has been a leader in education and training for the past 70 years, and its recent annual meeting continued this tradition. SpecialtyCare was pleased to present two new research studies at the event to advance the community’s understanding of intraoperative neuromonitoring (IONM) and its impact on patient health and safety.
The American Society of Neurophysiological Monitoring (ASNM) is “dedicated to the advancement of quality neurophysiologic monitoring services for neuroprotection.” Stated more simply, it’s all about patient safety. SpecialtyCare is deeply committed to supporting the Society and its mission to grow the profession, provide educational forums, develop quality standards, and build partnerships with allied healthcare professionals. As part of this commitment, members of our team serve in leadership roles with the ASNM and recently contributed several presentations at the organization’s Annual Meeting in May, an event celebrating 40 years of neuromonitoring.
Evidence-based patient blood management (PBM) strategies offer significant clinical benefits. Conservation techniques, in particular, help minimize the use of allogeneic red blood cell transfusion, which has been shown to increase the risk of postoperative complications, readmissions, and mortality among patients. Because of the importance of this area of study, SpecialtyCare researchers continue to drill down and analyze the perfusion and autotransfusion cases in SCOPE, the SpecialtyCare Operative Procedural Registry™, to examine the impact of various strategies, develop best practices, and improve patient outcomes.
To strengthen alignment among multiple surgical disciplines, the American Society of ExtraCorporeal Technology (AmSECT) and the American Association for Thoracic Surgery (AATS) teamed up to present a terrific joint learning opportunity, holding AmSECT’s 55th International Conference in conjunction with the Centennial Meeting of the AATS in Boston. The integrated program was designed to improve care by bringing surgeons, perfusionists, and other experts together to foster effective communication and coordination in the operating room. The combined meeting was a great example of collaboration that advances quality through evidence-based learning and improvement. We are proud to have been part of this special event.
Collaborating and sharing research findings and best practices with other medical professionals is one of the great pleasures of working in healthcare. Recently, the American Academy of Cardiovascular Perfusion’s 38th International Meeting gave SpecialtyCare’s Medical Office team members the opportunity to present two new papers to the perfusion community. One of the studies examines “The Effect of Ultrafiltration on End-Cardiopulmonary Bypass Hematocrit during Cardiac Surgery.” The purpose of this research was to evaluate the effect of ultrafiltration on end-cardiopulmonary bypass hematocrit by cardiac surgical procedure type. The findings are summarized in today’s blog.
Ultrafiltration is thought to reduce morbidity and the risk of red blood cell transfusion, however very few studies have examined the relationship between ultrafiltration and the overall risk of intraoperative RBC transfusion. Using data from the SpecialtyCare Operative Procedural Registry (SCOPE™), our study looks at a population of nearly 98,000 adults undergoing cardiac surgery at 197 hospitals to evaluate the effects of ultrafiltration volume removed during CPB on the relative risk of receiving an intraoperative RBC transfusion. Recognizing the findings of our own previous work, we were especially interested in testing potential differences between male and female patients in the effects of ultrafiltration.
From a healthcare perspective, the only thing we can be certain of in 2017 is that there will be uncertainty. For healthcare administrators, there is uncertainty around how to manage changes in provisions of the Affordable Care Act, Bundled Payments for Care Improvement (BPCI), and the Medicare Access and CHIP Reauthorization Act (MACRA). Restructuring Medicare and Medicaid could have a significant impact on planning, implementation, and payments for providers. But, regardless of the new format, healthcare providers like SpecialtyCare will always have an obligation—both to their patients and their customers—to improve value by providing high-quality care while containing costs.
On October 26, 2016, SpecialtyCare acquired Sentient, a highly regarded intraoperative neuromonitoring provider. We’re thrilled to welcome the people of Sentient to our team. We believe we’ll be a great fit together, both clinically and culturally. Combining our talent and experience will enhance our collective strengths and create new opportunities to advance patient care and drive clinical quality, which reduce costs for our patients and customers.
Our intraoperative neuromonitoring (IONM) research studies show that IONM helps keep patients safe during surgery, decreases complications, and reduces costs associated with the use of analgesics, length of hospital stay, neurorehabilitation, and long-term chronic care. One such study, Neurologic Outcomes Following Differential Resolution of Neuromonitoring Alerts during Extradural Spine Surgery, examines the relationship between reversal of intraoperative neurophysiologic change and neurologic outcome following segmental spine surgery.