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Hospital Trends Update in the Orthopedic Space Since COVID

Healthcare organizations across the country lost approximately $54 billion in net income over the course of 2021.

Maria Shepherd, President and Founder, Medi-Vantage05.23.23

Is there anything COVID-19 hasn’t changed in the hospital, including the orthopedic OR? During the pandemic, the demand for medical devices and capital equipment shifted due to the need for more equipment in hospitals to treat COVID-19 patients, such as IT for telehealth infrastructure, personal protective equipment (PPE), etc. This resulted in a significant boost to a segment of the medical device capital equipment market, as demand for products like ventilators and monitors skyrocketed. For other medical device capex, the pandemic forced hospital and ambulatory surgery center (ASC) budgets for medical device capital equipment such as the Mako surgical robot, ultrasound technologies, and C-arms into significant sales declines due to postponed or cancelled procedures, increased expenses for PPE and COVID-related treatments, and financial strain from emergency preparedness efforts. Some hospitals delayed or postponed purchases of non-essential medical devices to conserve resources, such as capital equipment that could have its usable life extended by a year or more with low risk or consequences. However, the exact impact on hospital budgets for medical device capital equipment varied depending on the severity of the pandemic in specific regions and the financial stability of individual hospitals.

Why This Is Important

Orthopedic device companies, such as J&J’s DePuy and Stryker, are responding, especially to ASC needs. Stryker estimates 10% of joint replacement procedures are being performed in ASCs and expects that number to double by 2028. DePuy Synthes, on the other hand, estimates that figure is closer to 21%; the firm has created an ASC team to provide customized solutions to aid professionals in that space—programs for buying capex and guidance on coding and reimbursement.¹

Nurses, the unsung heroes of the healthcare industry, also took a hit. Stress and burnout from the relentless work throughout the pandemic have been a major blow for nurses and other healthcare workers, and it could cause many to leave their jobs. Thirty-four percent of nurses stated it was highly likely they would give notice by the end of 2022 (Table 1).² According to data collected in Medi-Vantage strategy research, many orthopedic nurses are now working at ASCs because the pay is higher and they do not get shifted around from department to department as they had routinely been at hospitals.

Opportunity Exists

Hospitals report there seems to be no light at the end of the tunnel on nurse staffing. There are abundant job openings (Table 2), heavy use of premium-priced travel nurses, and the typical difficulties seen with onboarding new nurses.³

Since this problem isn’t going away anytime soon, medtech companies can offer a solution to hospital and ASC customers by making products simpler to use, easier to assemble, and require fewer people to assist surgeons and interventionalists while performing procedures. This is easier said than done; it requires looking at the unmet needs of the OR or the interventional suite in an entirely new way. In addition, there are digital tools that can assist with this process.

Presentations at the JP Morgan Healthcare meeting in San Francisco this past January offered further confirmation the open positions problem would continue.⁴ Staffing is still an issue, and hospitals have ramped up their international searches to reduce their reliance on expensive temporary hires. Pay escalation in other industries, as well as the desirability (and unattainability for nurses) of remote work makes staffing an ongoing issue for healthcare organizations for the long term.

Even before the pandemic, healthcare executives forewarned of a nursing shortage at hospitals. Then, recurrent surges of COVID-19 made the situation catastrophic, owing to nurse fatigue and moral distress. Moral distress is classified as a psychological response to morally challenging situations such as situations where nurses face ethical issues that have no morally acceptable responses and feel powerless to act in accordance with internal values.⁵

In September 2021, the results of a survey of critical care nurses (n=6,500) presented by the American Association of Critical Care Nurses, showed that 92% of respondents reported COVID-19 had “depleted nurses at their hospitals, and, as a result, their careers will be shorter than they intended.” Further, 66% said they were contemplating departing nursing because of their COVID-19 experiences, and 76% said patients who were unvaccinated “threatened nurses’ physical and mental well-being.”⁶

Where Are Orthopedic Nurses Going?

Knee and hip replacements are the fastest-growing orthopedic procedures for ASCs and the percentage change to those figures compared to pre-COVID is astonishing. It is also important to note CMS started covering knee replacements at ASCs in 2020 and hip replacements in 2021, a factor that is known to significantly drive growth.¹

The Medi-Vantage Perspective

According to the American Hospital Association, healthcare organizations across the country lost approximately $54 billion in net income over the course of 2021.⁷ This includes the positive impact of the $176 billion in CARES Act funding from 2020. It’s time to open up those voice of the customer manuals and start looking at the unmet needs surrounding the procedure to see how we can develop our devices to reduce the number of full-time employees or staff members required to assist the surgeon or interventionalist. This is not an easy process, but it can be done and the end result is a more competitive medical product with added savings that can be calculated on a budgetary impact model to show to the value analysis committee.

References

Maria Shepherd has more than 20 years of leadership experience in marketing in small startups and top-tier companies. After her industry career, she founded Medi-Vantage, which provides marketing and business strategy and innovation research for the medical device industry. Shepherd can be reached at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.