This year, Hartley Medical sponsored the Intrathecal Therapy: Case-Based Learning and Hands-On Skills Training course. As a result, we were able to sit in on the day’s lectures.
Meetings such as NANS do a superb job of curating a wide range of clinical topics. Off-clinical discussions, while relatively rare, are always welcome, and often refreshing. This was the case with Dr. Mehul Desai’s lecture on “Setting Up an IT Practice”
Here are four key takeaways:
Start with Desire
Intrathecal therapy comes with many learning curves, and the commitment of resources can be greater than other treatment options. Because of this, Dr. Desai notes that every physician enjoys his or her first pump implant, but few have the will to push through the difficulties. He explains that establishing an efficient pump program takes practice, and that takes volume, which takes commitment. If you do not wish to make pumps a significant tool for your clinic, the ends may not justify the means.
You cannot do it alone! Or at least you should not. Dr. Desai emphasizes that intrathecal therapy requires around-the-clock readiness and interdisciplinary cooperation. You will need nurses, administrators, billers, suppliers, operating rooms, etc. Working cohesively, especially in an institutional setting, is a challenge you will face.
Those involved should understand, and be comfortable with, the nuances of intrathecal drug delivery systems and the therapy at its many touchpoints. Remember that desire? Well, your partners will need it too.
Understand the Financial Landscape
According to Dr. Desai, fluctuating reimbursement makes medicine one of the unique professions willing to accept less pay for services provided, because each day without payment means diminishing returns.
He advocates using reasonable timelines and expectations to create a business plan that accounts for reimbursement lag and urges practices to “engage industry partners” for guidance. Furthermore, stay abreast of updates and changes to billing codes. What worked yesterday, is not guaranteed today.
Will you implant? Manage? Both?
What infrastructures will you need to successfully perform each of these tasks? What infrastructures will you need to successfully perform these tasks, together? Ask these questions before you engage in IT therapy. The answers are vital to the longevity of your program.
Dr. Desai’s lecture was a welcome break from the clinical deep dives that were customary to the day’s lectures. He spoke as someone who has seen both the benefits of having strong buy-in and understanding, and the pitfalls that come in their absence. He also spoke as someone whose desire has seen him through headaches and enabled him to use IT therapy to positively affect the lives of his intrathecal pump patients.