Java IoT Authors: Liz McMillan, Yeshim Deniz, Elizabeth White, Roger Strukhoff, Pat Romanski

Related Topics: @CloudExpo, Cloud Security, @DXWorldExpo

@CloudExpo: Article

Hospitals and #DataScience | @CloudExpo @LeanTaaS #IoT #API #ITaaS #AI

Four reasons why OR block scheduling is getting overhauled

Operating Room Block Scheduling Needs an Overhaul
By Sanjeev Agrawal, President and Chief Marketing Officer, LeanTaaS iQueue

One minute of utilized operating room (OR) time can be worth more than $70 in revenue and one minute of staffed OR time can cost $50 or more, making underutilized OR time a huge problem. Each year, roughly 51 million surgeries are performed in the 5,000+ hospitals and 5,000+ surgery centers in the U.S. MGMA estimates that the corresponding utilization of operating rooms across these centers is, at best, 55-60 percent.

Given that, for each percentage point of increased utilization, the benefits of an overhaul are considerable. A single OR can deliver more than $100,000 in revenue to a hospital or surgery center. Even for a small hospital or ASC with 8-10 ORs, the value of increasing utilization by 5 percent can easily be in excess of $5 million annually. For large systems, the value of a single OR can run into the tens of millions. If average OR utilization increased by 5 percentage points, more than 2.5 million patients could undergo procedures within the same OR infrastructure.

Root Cause of Underutilization
The process most health systems rely on for managing the complexity of operating room utilization - block scheduling - needs an overhaul. The typical current process usually goes along the following lines:

  • Blocks are assigned to surgeons and service lines and examined on a monthly (sometimes quarterly) basis by the OR committee, which reviews trends in utilization performance by surgeon and service line in order to make informed decisions on the potential reallocation of blocks. The scheduling of the slate of surgeries is then left to the surgeons themselves. Since the OR committee does not have a sufficiently robust, transparent and defensible fact base for allocating OR blocks to different surgeons, there is an inherent subjectivity to the "algorithm" used, which reduces the perception of fairness in the minds of many surgeons. This, in turn, makes surgeons naturally more resistant to releasing their allocated blocks, even if releasing their blocks would aid overall productivity.
  • Perioperative business managers feel a significant amount of pressure from such a system and so try to meet the demands of surgeons who want more block time by identifying low-performing blocks that could potentially be reallocated.
  • Between OR committee meetings, these managers conduct a series of "bilateral" negotiations, persuading some surgeons to release a block in order to meet the legitimate request for additional block time from a new surgeon or a surgeon whose case load has been growing significantly over the past few months.
  • All of this has to be done while keeping other real-world constraints in mind, which could include equipment in a specific OR (e.g., robotics) or calendar constraints (e.g., the surgeon requesting a block can only operate on Tuesdays, and the candidate blocks that could be released are only on Thursdays and Fridays).

Block Scheduling Is Getting an Overhaul
Forward thinking hospitals like UCHealth are leading the charge in giving block scheduling the overhaul it needs. How are they doing it?

The technology exists and is starting to be used: Imagine a series of timely, accurate charts that are automatically - on a daily or weekly basis - "pushed" to the smartphones of every surgeon, their schedulers and the administrative personnel responsible for managing OR utilization. In addition to providing key statistics on utilization, first case on-time starts, cancellations, cases running long, etc., it creates a high level of awareness in the minds of each surgeon about their utilization performance both in absolute terms as well as relative to their peers. Surgeons are data driven, fact based and competitive; accurate, transparent, automated feedback will go a long way toward improving the utilization even if nothing else was to change.

The data exists and is being used: Several factors need to go into determining a fair and equitable allocation of blocks on a periodic basis. Instead of using historical rules for how blocks have been allocated and redistributed, hospitals can now methodically match supply (e.g., regularly underutilized blocks) to demand based on sophisticated forecasting and predictions for blocks, staff and rooms. This is possible because the necessary data exists within the EHR/scheduling system, e.g., historical scheduling data by surgery (the date, time, type, surgeon, room, duration) and the corresponding surgeon-specific performance metrics.

Forward thinking governance/leadership: Hospital leadership is not just more tech savvy today than it was 10 years ago; an increasing number of CEOs, CIOs, COOs and CMIOs are now not only open to looking at new technologies but are requiring their teams to go through process transformation through data, lean methodologies and sophisticated analytics.

There isn't much choice: The demand for medical services has never been stronger, and it's only going to increase. ORs will have to do more surgeries and get reimbursed less per unit for them.

  • Population growth: By 2050, the American population will be over 438 million, up from 320 million in 2015.
  • Demographics: By 2030, over 20 percent of the country is expected to be over 65 years old, up from 15 percent in 2015. This aging population will greatly increase the demand for chronic clinical therapies and surgical procedures. In raw numbers, the Census Bureau estimates that by 2030, when the last proportion of Baby Boomers will hit retirement age, the number of Americans above 65 years of age will hit 71 million - in fact, one in five Americans will be older than 65. Not surprisingly, by 2025, 49 percent of Americans will be affected by a chronic disease and need corresponding therapies.
  • Affordable Care Act: The Affordable Care Act will add another 30 million Americans to the healthcare system by 2025, which means an increase in the demand for operating rooms. Reimbursements will increasingly depend on outcomes and efficacy, quality of care, and patient access. Unless providers increase efficiency in how they process and treat patients, they will need to spend billions in capital spending on new operating room infrastructure.

More healthcare providers are realizing that their operations need a data-driven, scientific overhaul to accomplish efficient and effective OR scheduling. The software and resources are finally available to help achieve such a transformation.


Sanjeev Agrawal is president and chief marketing officer of LeanTaaS iQueue. Sanjeev was Google's first head of product marketing. Since then, he has had leadership roles at three successful startups: CEO of Aloqa, a mobile push platform (acquired by Motorola); VP Product and Marketing at Tellme Networks (acquired by Microsoft); and as the founding CEO of Collegefeed (acquired by AfterCollege). Sanjeev graduated Phi Beta Kappa with an EECS degree from MIT and along the way spent time at McKinsey & Co. and Cisco Systems. He is an avid squash player and has been named by Becker's Hospital Review as one of the top entrepreneurs innovating in Healthcare.

More Stories By LeanTaaS Blog

LeanTaaS is a Silicon Valley software company whose offerings rely on advanced data science to significantly improve the operational performance of hospitals and clinics. Using LeanTaaS iQueue in conjunction with their existing EHR's, healthcare institutions are developing optimized schedules that are tailored to each site and can rapidly reduce patient wait times and operating costs while increasing patient access and satisfaction, care provider satisfaction, and asset utilization.

@ThingsExpo Stories
"There's plenty of bandwidth out there but it's never in the right place. So what Cedexis does is uses data to work out the best pathways to get data from the origin to the person who wants to get it," explained Simon Jones, Evangelist and Head of Marketing at Cedexis, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Digital Transformation and Disruption, Amazon Style - What You Can Learn. Chris Kocher is a co-founder of Grey Heron, a management and strategic marketing consulting firm. He has 25+ years in both strategic and hands-on operating experience helping executives and investors build revenues and shareholder value. He has consulted with over 130 companies on innovating with new business models, product strategies and monetization. Chris has held management positions at HP and Symantec in addition to ...
Enterprises have taken advantage of IoT to achieve important revenue and cost advantages. What is less apparent is how incumbent enterprises operating at scale have, following success with IoT, built analytic, operations management and software development capabilities - ranging from autonomous vehicles to manageable robotics installations. They have embraced these capabilities as if they were Silicon Valley startups.
In their session at @ThingsExpo, Shyam Varan Nath, Principal Architect at GE, and Ibrahim Gokcen, who leads GE's advanced IoT analytics, focused on the Internet of Things / Industrial Internet and how to make it operational for business end-users. Learn about the challenges posed by machine and sensor data and how to marry it with enterprise data. They also discussed the tips and tricks to provide the Industrial Internet as an end-user consumable service using Big Data Analytics and Industrial C...
René Bostic is the Technical VP of the IBM Cloud Unit in North America. Enjoying her career with IBM during the modern millennial technological era, she is an expert in cloud computing, DevOps and emerging cloud technologies such as Blockchain. Her strengths and core competencies include a proven record of accomplishments in consensus building at all levels to assess, plan, and implement enterprise and cloud computing solutions. René is a member of the Society of Women Engineers (SWE) and a m...
When talking IoT we often focus on the devices, the sensors, the hardware itself. The new smart appliances, the new smart or self-driving cars (which are amalgamations of many ‘things'). When we are looking at the world of IoT, we should take a step back, look at the big picture. What value are these devices providing. IoT is not about the devices, its about the data consumed and generated. The devices are tools, mechanisms, conduits. This paper discusses the considerations when dealing with the...
DXWordEXPO New York 2018, colocated with CloudEXPO New York 2018 will be held November 11-13, 2018, in New York City. Digital Transformation (DX) is a major focus with the introduction of DXWorldEXPO within the program. Successful transformation requires a laser focus on being data-driven and on using all the tools available that enable transformation if they plan to survive over the long term.
To Really Work for Enterprises, MultiCloud Adoption Requires Far Better and Inclusive Cloud Monitoring and Cost Management … But How? Overwhelmingly, even as enterprises have adopted cloud computing and are expanding to multi-cloud computing, IT leaders remain concerned about how to monitor, manage and control costs across hybrid and multi-cloud deployments. It’s clear that traditional IT monitoring and management approaches, designed after all for on-premises data centers, are falling short in ...
With privacy often voiced as the primary concern when using cloud based services, SyncriBox was designed to ensure that the software remains completely under the customer's control. Having both the source and destination files remain under the user?s control, there are no privacy or security issues. Since files are synchronized using Syncrify Server, no third party ever sees these files.
Cloud-enabled transformation has evolved from cost saving measure to business innovation strategy -- one that combines the cloud with cognitive capabilities to drive market disruption. Learn how you can achieve the insight and agility you need to gain a competitive advantage. Industry-acclaimed CTO and cloud expert, Shankar Kalyana presents. Only the most exceptional IBMers are appointed with the rare distinction of IBM Fellow, the highest technical honor in the company. Shankar has also receive...
In his session at 21st Cloud Expo, Carl J. Levine, Senior Technical Evangelist for NS1, will objectively discuss how DNS is used to solve Digital Transformation challenges in large SaaS applications, CDNs, AdTech platforms, and other demanding use cases. Carl J. Levine is the Senior Technical Evangelist for NS1. A veteran of the Internet Infrastructure space, he has over a decade of experience with startups, networking protocols and Internet infrastructure, combined with the unique ability to it...
"Cloud Academy is an enterprise training platform for the cloud, specifically public clouds. We offer guided learning experiences on AWS, Azure, Google Cloud and all the surrounding methodologies and technologies that you need to know and your teams need to know in order to leverage the full benefits of the cloud," explained Alex Brower, VP of Marketing at Cloud Academy, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clar...
Andrew Keys is Co-Founder of ConsenSys Enterprise. He comes to ConsenSys Enterprise with capital markets, technology and entrepreneurial experience. Previously, he worked for UBS investment bank in equities analysis. Later, he was responsible for the creation and distribution of life settlement products to hedge funds and investment banks. After, he co-founded a revenue cycle management company where he learned about Bitcoin and eventually Ethereal. Andrew's role at ConsenSys Enterprise is a mul...
Internet-of-Things discussions can end up either going down the consumer gadget rabbit hole or focused on the sort of data logging that industrial manufacturers have been doing forever. However, in fact, companies today are already using IoT data both to optimize their operational technology and to improve the experience of customer interactions in novel ways. In his session at @ThingsExpo, Gordon Haff, Red Hat Technology Evangelist, shared examples from a wide range of industries – including en...
"Space Monkey by Vivent Smart Home is a product that is a distributed cloud-based edge storage network. Vivent Smart Home, our parent company, is a smart home provider that places a lot of hard drives across homes in North America," explained JT Olds, Director of Engineering, and Brandon Crowfeather, Product Manager, at Vivint Smart Home, in this SYS-CON.tv interview at @ThingsExpo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
Rodrigo Coutinho is part of OutSystems' founders' team and currently the Head of Product Design. He provides a cross-functional role where he supports Product Management in defining the positioning and direction of the Agile Platform, while at the same time promoting model-based development and new techniques to deliver applications in the cloud.
DevOpsSummit New York 2018, colocated with CloudEXPO | DXWorldEXPO New York 2018 will be held November 11-13, 2018, in New York City. Digital Transformation (DX) is a major focus with the introduction of DXWorldEXPO within the program. Successful transformation requires a laser focus on being data-driven and on using all the tools available that enable transformation if they plan to survive over the long term. A total of 88% of Fortune 500 companies from a generation ago are now out of bus...
delaPlex is a global technology and software development solutions and consulting provider, deeply committed to helping companies drive growth, revenue and marketplace value. Since 2008, delaPlex's objective has been to be a trusted advisor to its clients. By redefining the outsourcing industry's business model, the innovative delaPlex Agile Business Framework brings an unmatched alliance of industry experts, across industries and functional skillsets, to clients anywhere around the world.
Business professionals no longer wonder if they'll migrate to the cloud; it's now a matter of when. The cloud environment has proved to be a major force in transitioning to an agile business model that enables quick decisions and fast implementation that solidify customer relationships. And when the cloud is combined with the power of cognitive computing, it drives innovation and transformation that achieves astounding competitive advantage.
Headquartered in Plainsboro, NJ, Synametrics Technologies has provided IT professionals and computer systems developers since 1997. Based on the success of their initial product offerings (WinSQL and DeltaCopy), the company continues to create and hone innovative products that help its customers get more from their computer applications, databases and infrastructure. To date, over one million users around the world have chosen Synametrics solutions to help power their accelerated business or per...