Uterine artery embolization is a relatively simple, minimally-invasive procedure for removing fibroids, or non-cancerous uterine masses that occur in roughly half of women of reproductive age.i During the procedure, fibroids are essentially starved from blood supply via catheter-mediated injection of embolic products. Though uterine artery embolization has been shown to be both safe and effective at improving symptoms and has been recommended by the American College of Gynecologists,ii,iii,iv the management… Continue reading Pain Management for Uterine Artery Embolization

Postoperative hypoxemia is a serious yet common condition that requires immediate treatment. It occurs predominantly as the result of gas exchange impairment or abnormalities in breathing control that can result from prolonged sedation by means of general anesthesia or opioids.i Risk factors for post-operative hypoxemia include heart disease, low pre-operative oxygen saturation, and a surgical duration of more than three hours.ii All methods of intervention should seek to maintain oxygen at a target saturation… Continue reading Managing Postoperative Hypoxemia

While randomized controlled trials (RCT) have long been considered the gold standard for evaluating the effectiveness of an intervention or a treatment, they are not always feasible, for instance in evaluating interventions targeted at the population level or when RCTs are deemed unethical. Furthermore, there is often a need to retrospectively evaluate interventions which have already been implemented without randomization or without… Continue reading Interrupted Time Series Design in Clinical Studies

Optimizing the perioperative care spectrum is essential for improving clinical outcomes as well as patient satisfaction. The patient’s progression before, during, and after surgery has significant impacts on patient outcomes, as well as to the hospital at-large. Within each of these stages, opportunities exist to enhance the patient’s experience, such as minimizing the patient’s wait-time… Continue reading Utilization of Operational Analytics in the Perioperative Care Spectrum

In medicine, reimbursement drives change in practice patterns. Bundled payments from Medicare epitomize a heightened value of measurable outcomes. The Merit Based Incentive Payment System (MIPS) directs physicians to report outcomes. Based on these data, bundled payments to practices may be altered (1). Anesthesiologists are uniquely situated to help reduce cost, improve efficiency, deploy protocols… Continue reading Updates on Value Based Care

The market for healthcare has quite a few key features that differentiate it from the concept of the standard market, such as the prevalence of externalities and the existence of the insurance market. These deviations often call for government policies to ensure that healthcare resources are allocated efficiently and equitably (1). In the United States,… Continue reading The Policy Debate over Healthcare

The principles of supply and demand dictate that as the cost for a service increases, demand for the services decreases. While this principle may be applicable to non-life altering decisions like haircuts or car washes, the execution of a quality perioperative care is not so elastic. In virtually all cases when a patient’s health is… Continue reading The Economic Ramifications of the Shift from Inpatient to Outpatient Surgery

Early 2019, the New York Times published a piece titled, “Having Anesthesia Once as a Baby Does Not Cause Learning Disabilities, New Research Shows”[1]. The article explicated the results of a randomly controlled trial that compared neuronal development between infants that were exposed to anesthesia, and the control of infants who had no anesthesia exposure.… Continue reading The Debate on Pediatric Anesthesia and Child Development

In the last ten years there have been significant efforts made toward building a healthcare information technology (IT) infrastructure in the United States that allows for secure and reliable exchange of patient information between healthcare providers, medical professionals, and individual patients. The success of these systems has tremendous implications for the overall health and wellbeing… Continue reading The Challenges of Electronic Health Record Interoperability