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Examining the Impact of Elective Surgery Cancellations Due to COVID-19

June 3, 2021

In mid-March 2020, the American College of Surgeons (ACS) and the Centers for Medicare and Medicaid Services (CMS) recommended postponing or canceling elective surgical procedures. The cancellations were intended to minimize the burden on the healthcare system presented by the COVID-19 pandemic and preserve essential healthcare resources. This temporary ban that lasted through May (and was reenacted in July in hard-hit areas) has created a surgery backlog with far-reaching impacts for both patients and hospital systems. 

For affected patients, it is important to note that elective surgery does not mean unnecessary surgery. The distinction revolves around emergent and nonemergent cases. So even though a patient’s surgery does not qualify as urgent, treatment postponement can produce significant problems. Across surgical specialties, delaying treatment has been shown to result in worse patient outcomes and higher costs. Additionally, patients waiting for surgery face disease progression while simultaneously dealing with challenges such as reduced activity, mobility, and quality of life. Though life, limb, or eyesight may not be immediately threatened, cancellations and subsequent backlogs and delays will negatively affect patient health.

Furthermore, the numbers involved in delayed cases are incredibly high (and growing). Recent studies have attempted to forecast the impact. One study estimated that approximately 30,000 primary and 300 revision hip and knee arthroplasty procedures would be canceled each week that elective surgery bans remained in place. Another study predicts that the orthopedic surgery backlog will exceed one million cases just for spinal fusions and joint replacements (in the most optimistic scenario). Their research and models predict that it will take 7, 12, and 16 months (in optimistic, ambivalent, and pessimistic scenarios respectively) until the healthcare system can perform 90% of regular surgery volumes. 

The financial impact on practices and hospital systems is also substantial. When considering delayed joint replacements alone, US Health systems are estimated to be facing monthly revenue losses of $1.9 billion to $2.7 billion. The American Hospital Association estimates that hospitals will see total losses over this calendar year of $323.1 billion. They also warn that if pandemic surge trends continue, the impact on hospitals and health systems could be even more significant. 

Finding ways to address the challenges of medical practice during a pandemic while enacting solutions to boost efficiency will be critical for providing needed care and regaining lost revenue. Providers, clinics, and hospital systems should consider the following measures: 

1. Establish adequate testing

An effective testing strategy increases the ability to keep patients and staff healthy while reducing the spread of the virus. As many patients avoid the hospital for fear of contracting the virus in a healthcare setting, testing can help restore confidence in resuming care. It can also help avoid more costly shutdowns by ensuring patients are healthy before treatment. 

2. Provide virus-specific communication and education

Asymmetric communication regarding COVID-19 has led to varying levels of confusion and uncertainty for many patients. Receiving direct education from providers and healthcare organizations they trust can help drown out conflicting messages with a reliable, credible source. Articulating extra health precautions taken by clinics and hospitals will help patients know what to expect, how changes will affect their patient experience, and assure them of responsible care. 

3. Utilize Telemedicine 

As providers work to address the surgery backlog and increase efficiency, telemedicine provides a way to minimize unnecessary patient exposure while continuing to provide needed care. The COVID-19 pandemic has accelerated trends in digital health. Patients are much more willing to engage in virtual visits, and many federal restrictions have been lifted to facilitate more widespread adoption. Using telemedicine for consultations or followup, when appropriate, can help providers and patients in the episodes of care that accompany elective procedures.

4. Streamline procedure-specific education and instructions

Time is already a limited resource for medical practitioners. Therefore, it is important for providers to implement practices that make patient education more efficient without compromising the quality of patient interactions. Providing materials that create clarity around conditions, procedures, and preoperative and postoperative instructions will reduce office callbacks, increase compliance and satisfaction, and ultimately, drive better outcomes. 

As clinics strive to safely reopen and remain open, a proactive response to COVID-19 is critical to maintaining the health and safety of patients and healthcare providers. Quality education and communication paired with adequate testing and preventive measures can help enable safer returns and continuations of clinical and surgical practice, work, and education. 

Orca Health’s COVID-19 Testing Solution

As a leader in patient-provider communication, care navigation, and data collection, Orca Health is able to turn their expertise and resources towards fighting the impact and spread of COVID-19. We believe that an effective solution should be not only accurate, reliable, and fast but also affordable and accessible. As such, we have worked to create a solution for medical providers that combines quality testing with patient communication, education, and data collection. 

Available Tests

Orca Biotech has partnered with FDA / EUA approved labs to provide the following products:

FDA / EUA Authorized Saliva PCR COVID-19 Test

  • The testing kit uses a saliva sample to determine active infection of the SARS-CoV-2 virus. 
  • Kits ship with the highest priority postage for fast delivery to your clinic and back to the lab. 
  • Secure digital results are available within 72 hours of the lab receiving a sample.
  • Tests are reimbursed by Medicare and private payers with no copay.

FDA / EUA Authorized COVID-19 IgG/IgM Rapid Test Cassette (Whole Blood/Serum/Plasma): 

  • The test cassette is a rapid chromatographic immunoassay for the qualitative detection of IgG and IgM antibodies to SARS-CoV-2 in human whole blood, serum, or plasma. 
  • Tests are intended for in vitro diagnostic use, including point-of-care, and are administered by a healthcare professional via finger prick.
  • Results are ready within 10 minutes and boast a 99.5% success rate.
  • Tests are reimbursed by Medicare and private payers with no copay.

Patient Communication

We also provide HIPAA-Compliant patient communication, patient education, & health assessment surveys regarding COVID-19. 

This automated tool allows providers to effectively communicate with their patients:

  • COVID-19 Test Results
  • Accurate CDC Patient Education
  • COVID Health Assessment Survey (CVDHA)
  • Health Assessment Tracking & Results
  • PROMIS Global Health Survey 
  • Quarantine Guidance
  • Ability to include other custom surveys

Orca Health’s HIPAA-Secure platform enables patients to access accurate, reliable information from a provider they trust and safely increase patient-provider communication. It also provides a way for healthcare providers to track patient symptoms, evaluate health risks, and encourage informed patient engagement. 

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