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December 19, 2024
Bariatric departments lose more than $1M of revenue annually due to referral to surgery leakage. For example, a recent analysis conducted by a leading U.S. health system revealed that of 1000+ patients who were referred for bariatric surgery, 30% completed the surgery within one year, 30% dropped out of the process, and 40% are still in progress but have been in the process for more than one year. Therefore, 70% of the patients registered did not make it to the operating room within a year. So, if the profit per surgery is approx. $6k per patient and 700 potential patients do not make it to surgery, this equates to $4.2M of lost revenue.
Wait times for bariatric surgery in Canada are the longest of any surgically treatable condition and vary significantly from province to province. A significant proportion of the wait time experienced by patients referred to bariatric surgery is between referral and consultation with a specialist. Patients in most provinces wait for two years or more, and the wait can be as long as four to five years. Typically, wait times between consultation with a specialist and surgery is six to 12 months.
It's not surprising that patients drop out of the process, or it takes more than a year from registration to surgery given the current labour-burden, time-consuming process today. The process of obtaining a bariatric surgery referral, completing insurance requirements and subsequently undergoing surgery is complex, often including multiple visits with different providers in different health systems over a period of several months. From referral received to surgery booked is a time-consuming manual process that often involves multiple surgical coordinators manually reminding and nudging bariatric surgery patients to book and complete pre-surgical consults, diagnostic tests, weight loss programs, and appointments, and tracking patient compliance. While patients have no way of knowing or tracking their status throughout the clearance process, and often losing motivation along the way.
Today, once referrals are received, the first step is for patients to meet with surgery coordinators who identify a myriad of pre-surgery appointments required. This can be daunting and often overwhelming for patients.
With the North American bariatric surgery market expected to grow with a CAGR of 5.3% between 2023 – 2028 and elective surgeries including bariatric surgery on the rise post-pandemic, it's time for health systems to digitally transform their approach to referral to surgery. Factors such as the increase in obesity patients, the high prevalence of type-2 diabetes and heart diseases, and increasing public awareness about bariatric surgery and government initiatives to curb obesity are expected to boost the market's growth.
According to a research letter, titled “Use of metabolic and bariatric surgery among US youth” and published by JAMA Pediatrics, “more young people between the ages of 10 and 19 are undergoing weight-loss surgeries.” This emerging trend has prompted the American Academy of Pediatrics to call for “more access to the procedure for kids and teens struggling with obesity.” Among the findings, the study showed:
- Metabolic and bariatric surgeries rose significantly in the first 2 years of the pandemic.
- In 2021, 1,349 youths between the ages of 10 and 19 underwent metabolic and bariatric surgery, a 19% increase compared to 2020.
- Among adults, 207,834 weight-loss surgeries were performed in 2021, a 24% increase from 2020.
We often hear that patients lose patience wading through the clearance process. They feel overwhelmed with the need to know when to book their pre-surgery appointments, they lose track of what appointments need to be booked and when, they are highly reliant on reminder phone calls from surgical coordinators, and the strain of playing telephone tag takes it toll, and eventually, patients decide to either cancel their surgery or they remain an open referral for months on end as coordinators manually follow up with them to nudge them towards completing their remaining surgery landmarks.
On the other hand, bariatric surgery coordinators are bogged down with managing referrals manually through their own personal Excel spreadsheets to track when a patient has completed a landmark, where they are within the process, and are repeatedly calling patients to remind them of the landmarks that need to be completed before surgery. The result? Staff burnout, lost patients or worse, and delays in care that compromise health outcomes.
There is a better way to manage referrals to surgery to increase surgical throughput, capture more revenue, and deliver a better patient experience. Leveraging technology to automate the entire process from insurance eligibility to pre-op to post-op helps patients navigate through the process keeping them motivated and educated to ensure they remain on track throughout the clearance phase completing their landmarks promptly - right through to recovery.
Five Reasons to Automate Bariatrics Care Delivery
For bariatric surgery candidates, care delivery starts during the referral to surgery stage. During this phase of the care journey, surgery candidates are required to complete several landmarks including psychiatric evaluations, EKGs, labs, ultrasounds, x-rays, blood work, endoscopy, meetings with dieticians, weight-loss consultants, and more. Digital Care Journey platforms enable bariatrics teams to automate care delivery by engaging, connecting, and monitoring patients before, during, and after hospitalization. They go beyond simple communications to deliver personalized, interactive patient education pre-and post-surgery, automated reminders, dynamic to-do lists, check-in surveys, resource library, and algorithms that provide step-by-step guidance to patients throughout the entire episode of care.
Here are five ways Digital Care Journey platforms automate the bariatrics referral to surgery process:
1. Keep patients motivated and on track with insurance milestones through automated pre-surgery nudges and prompts
Eliminate the need for spreadsheets, ongoing phone follow ups and manual interventions. Automatically deliver reminders, progress tracking surveys, and just-in-time education to ensure patients complete all insurance criteria faster (tests, assessments, etc.). Digitally guide and track the progress of patients as they schedule, coordinate, and upload results for pre-surgery milestones to achieve clearance faster, shorten the time to surgery, increase the number of surgeries performed weekly, monthly, and annually, and to accelerate the path to revenue.
2. Empower Coordinators and Schedulers
Eliminate the need for manual tracking and frequent phone calls. With a centralized dashboard that displays patient progress, combined with turnkey integration with EHR systems, the entire clinical care team – RNs, Coordinators, Nurse Practitioners, and Directors - can quickly see at a glance which insurance milestones have been completed and which are still outstanding on a patient-by-patient basis. Enabling them to quickly identify where patients are in the process and how to appropriately guide them to the next milestone to complete.
Receiving alerts for patients who have fallen off-track and to measure patient compliance with pre-op assessments, exams, and consultations reducing the manual efforts and constant follow up. A consolidated view of the entire patient population accessible by all surgical coordinators and nurse practitioners provides a bird’s eye view of where each patient is within the clearance process, what tasks need to be completed and when, and which patients need assistance.
Technology has the potential to increase surgical volumes by streamlining workflows, optimizing operational efficiencies and reducing staff burden. According to a recent report published by McKinsey & Company, estimates still suggest a potential shortage of 200,000 to 450,000 nurses in the United States, with acute-care settings likely to be most affected. Automating and streamlining workflows augments the workload of existing resources enabling them to focus their time and effort on patient-care.
3. Record, Access, and Track Patient and Procedural Outcomes
Automate the process of recording, accessing, and tracking appointments scheduled, completed, and outstanding by enabling patients to self-report the completion of tests/assessments and upload their results, eliminating the need for surgery coordinators to chase down and hunt for results. Clinical teams can digitally see at a glance the patient's progress and view exam results for the entire patient population. Minimize the time clinical teams are spending on outbound and inbound phone calls, manual reminders, and nudges.
Access to reporting, and analytics gives teams the ability to predict surgical volumes, identify bottlenecks, and decrease surgical wait times.
4. Deliver Personalized Interactive Patient Education
Schedule more surgeries faster by delivering interactive patient education that patients can access 24/7 on their own smartphone, tablet or computer rather than paper-based booklets that patients often lose or misplace. Set clear expectations through automated education about all the appointments and tests patients need to complete, including comprehensive education to explain the importance of completing each milestone. Clear expectations and explanations increase patient motivation to complete each step in the process.
Once a patient consents for surgery, digital care journeys can also provide personalized education about what to expect before, during, and after surgery. This increases patient compliance with preoperative exercise, diet, and behaviour therapy, and be aware of follow-up requirements and potential lifestyle changes.
Virtual care is a cost-effective alternative to connect with patients who are physically, socially, or mentally isolated, and engage with them by providing step-by-step guidance through their entire episode of care. Digital Care Journeys accessible on smartphones, tablets, and/or computers make it easy for patients to track their weight, food intake, exercise, activities, sleep patterns, and record symptoms. Patients with access to Digital Care Journeys tend to make fewer phone calls to their care teams as they can self-manage symptoms at home.
5. Increase conversion to surgery and shorten time to surgery
Automate and streamline workflows to motivate patients, decrease wait times, improve patient satisfaction, and empower staff. The chasm between bariatric surgery candidates and the scheduling of bariatric surgery is presently greater than expected. Leveraging technology to automate follow ups, prompt patients throughout the surgical journey can close the gap and increase the conversion to surgery, shorten wait times and increase revenue potential.
Read how Ohio State University Wexner Medical Center Reduced Referral to Surgery by 1.5 Months.
In Summary
With Digital Care Journeys, health systems can reduce outbound and inbound phone calls, control referral to surgery revenue leakage, optimize staff time, keep patients informed throughout their surgical journey, and successfully guide patients through the entire referral process from initial consultation to completion of all landmarks. Digital health platforms provide providers with a user-friendly way to connect, educate and support large cohorts of patients on the bariatric surgery pathway with accurate information and guidance.
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