OBS vs. ASC: Options for Providing Care

Like many ophthalmologists, Irfan Ansari, MD has experienced difficulty getting surgical time for his patients at Bluegrass Eyecare Center in Lexington, Kentucky. Block time was limited, cases were often bumped with little notice, and accommodating patients’ schedules became nearly impossible. For those reasons, Dr. Ansari decided to build his own ASC to better serve his patients.

In 2019, he started the process of building an ASC in Frankfort, Kentucky, a Certificate of Need (CON) state. Acquiring a CON is a rigorous process in itself and Dr. Ansari soon learned it was the first of many hurdles in building an ASC.  The CON approval took approximately one year, followed by several more regulations for the buildout, many of which do not pertain to eye surgery.  He shares more details about this process in this Ophthalmology Management article.  

During his ASC project, Dr. Ansari discovered the concept of office-based surgery (OBS). He leveraged the idea of performing office-based surgery in his Lexington location while his ASC was being developed.  “I worked with iOR Partners and implemented my OBS in less than six months. I had planned to use it for the next six months until I opened my ASC, however, the ASC took another three years to complete because of governmental regulations. So, I am quite happy that I opened an OBS when I did,” says Ansari. 

OBS Benefits the Surgeon, Patients, and Staff at Bluegrass Eyecare Center 

The Bluegrass Eyecare Center launched its iOR Suite in 2020. Since then, Dr. Ansari and his staff have experienced many benefits of the transition to OBS.  

Exceeding Safety Standards with Physician-Centric Care 

OBS facilities follow the same safety standards and obtain the same accreditation as ASCs.  “I think OBS might even be safer because the ophthalmologist fully controls patient care under their physician’s license, which gives us complete ownership. I feel like ASCs and hospitals are more concerned with guidelines, even when those guidelines may not pertain to the type of surgery we are doing. As physicians, we are far more concerned with the actual safety of our patients, and we take all extra, correct, and pertinent steps to ensure safe outcomes,” says Dr. Ansari.  

A Re-imagined Patient Experience 

The staff at Bluegrass Eyecare Center has built a rapport with their patients, and they can carry this through the whole patient journey. Surgery is scheduled when most convenient for the patient, and the practice can offer financial flexibility. “I have several patients who are private-pay, and if I do the surgery at a hospital or local ASC, it will cost them an arm and a leg. Instead, we can provide a low-cost option at the OBS so they can get the care they need,” says Dr. Ansari. 

On surgery day, patients are impressed with the simplified process. Arrival time to discharge is typically less than two hours, compared to other outpatient facilities, which can take up to four hours. 

Maximized Efficiency & Productivity  

Dr. Ansari has seen a rapid increase in workflow efficiency, particularly as his clinic staff gains expertise in caring for surgical patients. The team has learned to be just as efficient, if not more so, than a two-room ASC.   

An inherent benefit of his OBS is having a surgical staff that only needs to learn his preferences and techniques, not those of the ten or more other surgeons at the ASC. This has improved team cohesion and efficiency at his practice.  Dr. Ansari shares how he optimized his OBS workflow in this blog post. 

Dr. Ansari sees the need for all three options for providing care – OBS, ASC, and hospitals.  His ASC eventually opened in February, 2023 which he uses for Frankfort patients and the OBS for Lexington patients. He expects office-based surgery to grow as alternatives are needed to meet patient demand. “As I speak to colleagues and even patients, OBS is becoming recognized as a standard of care, and I hope that trend continues.”  

Bluegrass Eyecare Center just celebrated the 3rd anniversary of OBS.  Congratulations on more than 2,300 successful outcomes in your iOR Suite!