Focus: Lower surgery costs
Rising health care costs are an ongoing concern for the American people and health care providers. Yet cost reduction must be achieved in a way that maintains patient safety and does not negatively impact physicians’ decision-making or limit treatment options.
Washington University vascular surgeons have worked closely with purchasing teams at Barnes-Jewish Hospital on two major projects to reduce the costs of endovascular devices, including wires, balloons and stent grafts used to treat blood vessel disorders.
“Physicians are very conscious of treatment costs,” says surgeon Jeffrey Jim, MD, MPHS. “You want to be cost efficient, but deliver good care and achieve the best results.”
In 2015, surgeon Patrick Geraghty, MD, and interventional radiologists worked with Andrew Pierce, director of operations for Barnes-Jewish Hospital’s perioperative services, to reduce costs for patients with peripheral vascular disease undergoing endovascular treatment. Physicians and hospital leaders agreed to reduce the number of vendors from three to just one primary vendor that manufactured devices all providers used and liked. Volume allowed further price reductions, and the end result is that the hospital saves $200,000 annually, while maintaining access to novel and unique therapies.
Recently, Section Chief Luis Sanchez, MD, the Gregorio A. Sicard Distinguished Professor of Vascular Surgery, and Jim were thought leaders of a BJC HealthCare-wide vascular surgeon group that selected stent grafts for endovascular abdominal and thoracic aortic repairs. Such grafts are costly, but the hospital negotiated with vendors to develop uniform pricing among stent graft manufacturers to keep flexibility and allow patient-centric treatment options. Surgeons use the devices at all BJC hospitals offering the surgery, and Barnes-Jewish perioperative director Pierce projects savings of more than $200,000 annually.
Standardization of the vena cava filter insertion procedure also is resulting in reduced costs for hospital patients who have blood clots in their legs or lungs but cannot use blood thinners. That protocol was part of a patient safety project by former vascular surgery fellow John Maijub, MD, who graduated in 2018. Jim served as project advisor. In a one-year period, the hospital achieved a 10 percent cost savings.
“The next question is whether we can standardize more procedures in the same way,” says Jim.
Highlights
Vascular Surgery Chief Luis Sanchez, MD, and Cardiac Surgery Chief Marc Moon, MD, were the first in the United States to implant an endovascular stent graft that spans the entire aortic arch. The stent allows blood flow to the two carotid arteries supplying blood to the brain, and the surgeon performs a bypass of the third artery supplying blood to the left arm. The procedure is currently in feasibility trials at three other centers.
Vascular surgeon Mohamed Zayed, MD, PhD, and Clay Semenkovich, MD, chief of the Division of Endocrinology, Metabolism and Lipid Research, have identified a unique phospholipid profile that is more abundant in the carotid arteries of patients who have diabetes. These lipids, and the enzyme that makes them, have been found to contribute to the progression of peripheral arterial disease (PAD). The research, published in the April 2018 issue of The Journal of Lipid Research, could potentially lead to new therapies to decrease PAD progression and reduce the risk of limb loss.
Vascular surgeon Sean English, MD, who received the 2017 Wylie Scholar Award from the nonprofit Vascular Cures organization, continues his work defining the role of IL-6 in the development and rupture of abdominal aortic aneurysms (AAAs). English is working with Robert Gropler, MD, Yongjian Liu, PhD, and Kooresh Shoghi, PhD, to evaluate the theranostic abilities of two TSPO and CCR2 radioligands to predict AAA rupture and also halt AAA growth. He also is collaboratively developing a novel treatment approach that stabilizes the AAA wall in a large animal model, with the hope of translating this work into the first minimally invasive medical therapy for smaller aneurysms in humans.
Focus: Lower surgery costs
Rising health care costs are an ongoing concern for the American people and health care providers. Yet cost reduction must be achieved in a way that maintains patient safety and does not negatively impact physicians’ decision-making or limit treatment options.
Washington University vascular surgeons have worked closely with purchasing teams at Barnes-Jewish Hospital on two major projects to reduce the costs of endovascular devices, including wires, balloons and stent grafts used to treat blood vessel disorders.
“Physicians are very conscious of treatment costs,” says surgeon Jeffrey Jim, MD, MPHS. “You want to be cost efficient, but deliver good care and achieve the best results.”
In 2015, surgeon Patrick Geraghty, MD, and interventional radiologists worked with Andrew Pierce, director of operations for Barnes-Jewish Hospital’s perioperative services, to reduce costs for patients with peripheral vascular disease undergoing endovascular treatment. Physicians and hospital leaders agreed to reduce the number of vendors from three to just one primary vendor that manufactured devices all providers used and liked. Volume allowed further price reductions, and the end result is that the hospital saves $200,000 annually, while maintaining access to novel and unique therapies.
Recently, Section Chief Luis Sanchez, MD, the Gregorio A. Sicard Distinguished Professor of Vascular Surgery, and Jim were thought leaders of a BJC HealthCare-wide vascular surgeon group that selected stent grafts for endovascular abdominal and thoracic aortic repairs. Such grafts are costly, but the hospital negotiated with vendors to develop uniform pricing among stent graft manufacturers to keep flexibility and allow patient-centric treatment options. Surgeons use the devices at all BJC hospitals offering the surgery, and Barnes-Jewish perioperative director Pierce projects savings of more than $200,000 annually.
Standardization of the vena cava filter insertion procedure also is resulting in reduced costs for hospital patients who have blood clots in their legs or lungs but cannot use blood thinners. That protocol was part of a patient safety project by former vascular surgery fellow John Maijub, MD, who graduated in 2018. Jim served as project advisor. In a one-year period, the hospital achieved a 10 percent cost savings.
“The next question is whether we can standardize more procedures in the same way,” says Jim.
Highlights
Vascular Surgery Chief Luis Sanchez, MD, and Cardiac Surgery Chief Marc Moon, MD, were the first in the United States to implant an endovascular stent graft that spans the entire aortic arch. The stent allows blood flow to the two carotid arteries supplying blood to the brain, and the surgeon performs a bypass of the third artery supplying blood to the left arm. The procedure is currently in feasibility trials at three other centers.
Vascular surgeon Mohamed Zayed, MD, PhD, and Clay Semenkovich, MD, chief of the Division of Endocrinology, Metabolism and Lipid Research, have identified a unique phospholipid profile that is more abundant in the carotid arteries of patients who have diabetes. These lipids, and the enzyme that makes them, have been found to contribute to the progression of peripheral arterial disease (PAD). The research, published in the April 2018 issue of The Journal of Lipid Research, could potentially lead to new therapies to decrease PAD progression and reduce the risk of limb loss.
Vascular surgeon Sean English, MD, who received the 2017 Wylie Scholar Award from the nonprofit Vascular Cures organization, continues his work defining the role of IL-6 in the development and rupture of abdominal aortic aneurysms (AAAs). English is working with Robert Gropler, MD, Yongjian Liu, PhD, and Kooresh Shoghi, PhD, to evaluate the theranostic abilities of two TSPO and CCR2 radioligands to predict AAA rupture and also halt AAA growth. He also is collaboratively developing a novel treatment approach that stabilizes the AAA wall in a large animal model, with the hope of translating this work into the first minimally invasive medical therapy for smaller aneurysms in humans.