Multicenter Evaluation of Time, Operational, and Economic Efficiencies With Preloaded IOL Delivery System in the U.S., Canada, and France
Purpose
To evaluate potential time and economic efficiencies by surgical facilities through the transition from manually loaded (Manual) intraocular lenses (IOLs) to the TECNIS iTec Preloaded (iTec) IOL for routine cataract surgeries.
Methods
Multicenter, observational, pilot study of facility workflows and costs associated with routine cataract removal and IOL insertion with and without the iTec. To evaluate the operational impact, intraoperative time and motion data was collected both before and after adoption of the iTec by third party observers. Time and motion data was collected for all OR staff. In Canada (1OR setup), and France and USA (2OR setup), a minimum of 20 cataract surgeries were observed pre- and post-iTec, for a combined minimum of 40 cataract surgeries at each site. Facility cost reports and accounting data were also collected from each site.
Results
The iTec led to significant reductions in total case time [USA = -9.4%, p<0.001; France = -6.2%, p<0.05; Canada = -12.0%, p<0.001] and surgeon lens time [USA = -17.4%, p<0.001; France = -31.9%, p<0.001; Canada = -43.7%, p<0.001]. The time savings observed improved throughput across all sites (USA = +4.0%; France = +5.7%; Canada = +9.9%). In OUS sites, the capital/labor cost efficiencies resulting from additional throughput is estimated to reduce mean cost/case (France = -2.4% and Canada = -4.2%). In USA, additional throughput has revenue implications and is estimated to increase profit by 5.3%.
Conclusion
The iTec reduces total case time and total surgeon time thereby allowing for improved
throughput and site economics. In OUS sites, an additional case/day reduces the average
cost/case while in the USA, an additional case/day increases annual profit.