CommonSpirit Health Uses Analytics Technology to Optimize the OR

The health system's new platform replaces manual processes to maximize staffed OR utilization and improve a hospital's bottom line.

A major rollout of technology designed to optimize operating room use is helping drive profits at one of the nation's largest health systems.

The technology, developed by LeanTaaS, replaces manual systems with AI-based automation at Chicago-based CommonSpirit Health, which operates 142 hospitals in 21 states. It targets workflows by providing real-time access to OR availability and scheduling, allowing schedulers and staff to manage OR use more efficiently, reduce potential transcription errors and ease stress for both providers and patients.

Dignity Health, which merged with Catholic Health Initiatives to form CommonSpirit Health, reports that 36 of its hospitals have used the technology and saw an additional contribution margin of 14.5 times the return on investment from May 2019 to December 2020, compared to previous year-over-year measurements.

The driving force behind this deployment is Brian Dawson, MSN, RN-BC, CNOR, CSSM, system vice president of perioperative services. He came to CommonSpirit Health after stints at Sutter Health and Keck Medicine of USC, as well as serving as executive assistant to and chief of staff for the surgeon general of the US Navy.

"In healthcare, I come from three different angles," he says. "One, as a clinician. Two, as a quality leader. And third, I want to grow business. Today in healthcare – and COVID proved this – we make our money from our operating rooms and other procedural areas" like the catheterization lab and interventional radiology.

Brian Dawson, MSN, RN-BC, CNOR, CSSM, system vice president of perioperative services at CommonSpirit Health. Photo courtesy CommonSpirit Health.

Everything else in the hospital "really loses us money," he says. "The longer you stay, the less money we get to keep from insurance or [the Centers for Medicare & Medicaid Services]."

When he joined Dignity Health, Dawson says, nurses were looking through OR schedules and e-mailing opportunities to surgeons in the area.

"One of our hospitals in the Bay Area, Sequoia, had already reached out to LeanTaaS about bringing that tool into their facility," Dawson says. "I had tried to bring the tool into USC when I was working there as a consultant."

Dignity's chief executive officer, Lloyd Dean, and chief operating officer, Marvin O'Quinn, supplied the budget for Dawson to deploy LeanTaaS IQ across 32 hospitals in 2019.

The platform works by prompting surgeons to release unused time, in part by suggesting automatic "release dates" timed to maximize prospects for filling as many of those unused staff operating rooms as possible. They're often marketed to surgeons in the area who haven't previously considered performing surgeries at the hospitals reaching out to them.

"I'm constantly banging on our marketing people to say, 'What are we doing to take volume away from our competitors?'" Dawson says.

The technology, he says, is able to query across all the hospitals in the CommonSpirit network in a defined regional market.

Among the results of the initial deployment: 21% of ORs released by the system ended up being filled. And Dawson says he can do better than that.

"It takes our marketing people to go out to surgeons who don't operate with us to say, 'Can you get into the hospital you operate as much as you want?"' he says. "Their answer is going to be no, right? Then I'm going to turn around and say, well, what day would you like, because I have that day available. So it's a marketing ploy."

As a result, the health system has seen a 153% increase in staffed OR blocks released by surgeons, to drive the higher utilization.

"The data truly speaks to power, sitting in front of a surgeon, going through his or her data," Dawson says. "Once they realize that the data is correct, then they fall in line. And it's the same with leadership."

It's also an important tool in communities that have only one hospital.

"We're in places where healthcare has left," Dawson says.

Dawson calculated the ROI by identifying the number of minutes of OR time the tool unlocked, and he estimated that every minute the tool filled equated to $65 in revenue.

The pandemic, which began in the middle of the rollout, depressed that $65 figure to more like $32, due to plummeting elective surgeries at hospitals nationwide. But Dawson is set to calculate the revenue again this fall, and he expects it to be close to $50 per minute.

At the same time, CommonSpirit Health is expanding the platform to more hospitals in its network.

"The tool's now in all of California, in our two hospitals in Las Vegas, our five hospitals in the Phoenix area, as well as the Pacific Northwest, Texas, Tennessee, the Midwest, and we're about to go into the Kentucky valley around Lexington, as well as four or five hospitals in Arkansas," Dawson says. "Then [we'll add] a handful of hospitals in North Dakota that are using Cerner."

There are some limitations. Small, critical access hospitals with fewer than four ORs are not a good fit yet for the technology.

"The hospitals that are in small rural areas that have less than four rooms and [where] there might be five surgeons that operate there, each of them has their own day, and so outside of collecting data, the tool's really not going to be that advantageous for them," Dawson says.

The tool also allows surgeons to be prompted to release unused dates via either texts or e-mails, he says.

"On average, we are releasing unused surgical time 26 days before the surgery date," he says. "That means that if Dr. Smith normally operates on Tuesday, 26 days before that Tuesday, if he's not going to use it, we're releasing that time to others. That's important. Prior to the tool, our average release time was two or four days. You as a doctor can't get someone ready in two days to fill the gap."

The optimal sweet spot is 14 days, Dawson says.

"But the nice part about the tool and our moving auto-release date is it's now out into the 20s. Which is great. The farther out the better."