Frank Kolisek, MD, of Indianapolis-based OrthoIndy, is laser focused on technological advances in orthopedic care.
Here are three trends he told Becker's Spine Review he pays attention to most:
Note: This response has been edited for style.
Question: What are the top 3 trends you're following in healthcare today?
Dr. Frank Kolisek: Telehealth is interesting as it was fast-forwarded during the pandemic, and it is more accepted now than ever before. This is probably due to both the fact that patients had to be seen but couldn’t come in because of the pandemic and these remote visits were now being reimbursed. Can this technology be used in a way that improves patient access and improves timely care for patients while allowing providers to decrease bricks and mortar and staff and, therefore, overhead, in a time where reimbursement for services rendered continues to go down? That is the big puzzle to figure out. This my 30th year in practice, and it has been a slow downhill slide for reimbursement since I started in 1992 from both government and private insurance companies, so the previous business model of building more facilities closer to “roof tops” in the areas surrounding cities so the patients could receive care closer to home and therefore hiring more staff is not sustainable. Telehealth allows patients to receive care from their kitchen table and can work for some specialties as not all of medicine is actually hands on.
Remote patient monitoring is another interesting area, especially after surgery. Theoretically, monitoring patients' progress more often rather than just every four to six weeks in the office can speed up recovery as it eliminates delays in treatment. For example, if a patient looks good in the office for two weeks and then falls behind at their six-week visit, then we may be able to see this at week three or four and go to Plan B rather than waiting until week six. I say theoretically, because practically the business model has not been worked out. Who pays for the equipment? Insurance companies do not want to pay for something that isn’t “medically necessary” and they no longer pay for things now after surgery that they did pay for 15 years ago. Patients do not want to pay for anything and of course this varies geographically as to average incomes for a county. Certainly, physicians do not want to get into their pockets as their reimbursements for care rendered is going down. Basically, this needs to work out why everyone around the table as at the end of the day it could improve care and lower costs, which is the definition of improved value. I think we all should want this.
Robotic technology is here to stay and it will be very interesting going forward to see how four things play out: First, how will the increase per case costs be handled? Second, what will patient results look like in the midterm compared to “regular” instruments? Third, will it actually improve efficiency and save time for the physicians? Fourth, will this technology allow us to perform certain surges in such a way that we just can’t do without a robot?
This is exciting as in other industries, technology has made things easier, less expensive, better and faster for the consumer, but in medicine, for the most part, technology has increased costs and slowed us down and hasn’t changed what we are able to do. Doing the same thing at a higher cost that slows us down is not ideal. It is past time to have technology that will make our lives easier and more efficient. We may be finally getting there with artificial intelligence and “big” data combined with robotic technology.