Efficiency in the OR is key to quicker, better quality joint replacements in this startup’s eyes

MedCityNews Jan 21, 2013
Efficiency in the OR is key to quicker, better quality joint replacements in this startup’s eyes
As more people, and younger people, are opting for joint replacement surgeries, hospitals are looking for ways to improve the turnover time for these procedures.
Meanwhile, they’re also innovating toward value-based care. With that in mind, a collection of healthcare entrepreneurs who have made careers out of finding ways to reduce wasteful healthcare spending has come together to help hospitals improve efficiencies in total joint replacement procedures.
Although the entire joint replacement process can take up to a year and a half, 40 percent of the cost for providers is concentrated during the short time of the operation, said Lars Thording, vice president of marketing and public affairs for Intralign. The startup has designed a suite of services to help providers who are transitioning to value-based reimbursement models increase the efficiency of the more than 1 million knee and hip arthroscopies that are performed in the U.S. annually.
“What we see is that in that intraoperative sequence, there’s a lot of variability in how much that costs,” Thording said. “There’s a lot of room to create efficiency by creating standards and by putting someone in that room who can make decisions.”
Intralign was founded last fall by executives who built Ascent Healthcare Solutions, a medical device reprocessing and remanufacturing company that was sold to Stryker in 2009. Those same executive also form the core team behind the Alliance Healthcare Partners, an angel fund that invests in early stage companies focused on cutting healthcare costs.
“We’re folks that like to challenge the system and create some fundamental changes because they’re called for,” Thording said. “We look for solutions that aren’t new, fancy devices.”
At the core of its offerings is a Surgical First Assistance service in which Intralign trains and implements surgical assistants to maximize efficiency in the operating room. The idea is that with training specifically for these procedures, surgical assistants will be able to help surgeons make better utilization decisions during a joint replacement; for example, they can make educated decisions about which brand of implant is most appropriate to use and what disposables are needed. They may also be able to reduce the time of a procedure, improve surgeon satisfaction and improve the quality of the procedures performed.
“If you have [a surgical assist] that has the right kind of competency, what you achieve is, frankly, the surgeon becomes more efficient in what he’s doing,” Thording said.
To further optimize joint replacements, Intralign is developing two other components to its service. The first is an analytics solution to help providers identify their biggest cost drivers and manage their spending. The second is a care design service to help them map out the most optimal surgical processes. For example, it might find that a hospital could improve its efficiency in the time it takes to fill out a surgical order, or be more efficient with staff time.
“It’s all about use of data and process redesign,” Thording said. “It’s about eliminating from that intraoperative episode everything that is inefficient and does not drive better quality.”
Those services are part of Intralign’s long-term goal of creating a comprehensive solution that has staying power in a hospital. For now, the team is working on building out its service offerings and implementing the surgical assist solution in more hospitals.
“Consultants leave this big, fat report and two weeks later, everything is back to normal,” Thording said. “We looked at a service solution that can stay with the hospital and create substantial and sustainable changes — one that has staying power.”