Preparation for surgical procedures is complex and expensive even before a patient enters the operating room. Through an optimization process at University of Missouri Health Care, the Cerner ITWorksSM client worked together with Cerner to standardize procedures, reducing costs by more than $55,0001 from January - May 2020. This work is part of a larger effort between MU Health Care and Cerner to look for various opportunities for clinical, operational and financial performance improvement across the health system.
Every surgeon has a preference card that lists the supplies needed for each procedure they perform. Variations in supplies between surgeons for the same procedure can raise costs. MU Health Care and Cerner began seeking opportunities to standardize preference cards for surgeries.
“Cerner prepared an analysis of the preference cards to show what items were common to all of us, and which items were not,” said Ted Choma, MD, orthopedic surgeon. “They also showed the relative costs associated with preparing for the same surgery, and what that cost variation looked like across our different surgeons.”
The data surprised some surgeons. Several realized they had items on their preference cards they did not use.
“Once the surgeons saw the difference in cost between their procedures and the other surgeons’, they were happy to help save money and standardize cards,” said Amanda Crocker, surgical technician. “The surgeons were part of the process when making decisions about cost savings.”
MU Health Care leaders standardized the process for five common surgeries. From the start of the program in January - May 2020, the health system saved $57,422 across 187 surgeries.1 The biggest savings came from knee replacements, which saved MU Health Care more than $23,000.2 Laminectomy discectomy, a surgery that pulls cartilage out of the spine, saw the largest percentage savings, with a 19%3 drop in costs.
Realizing the successes, health system leaders and Cerner are continuing the optimization across other surgeries.
“We will continue to meet with surgeons, standardize all the preference cards in our system and utilize a governance team for new preference card changes,” said Crocker.
1 Savings of $8,470 for ureteroscopies, $5,104 for laminectomy discectomies, $5,616 for laparoscopic gastric sleeves, $15,132 for hip replacements, and $23,100 for knee replacements.
2 Comparing baseline average cost of $6,123 per surgery across 542 procedures from July 1, 2018-March 4, 2020 to $5,353 average per procedure across 30 surgeries from March 5, 2020-May 17, 2020.
3 Comparing baseline average cost of $1,190 per surgery across 140 procedures from July 1, 2018-December 31, 2019 to $958 average per surgery across 22 procedures from January 1, 2020-May 17, 2020.