Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 1-3, 2017 in Washington, DC. Find out more about this forum at www.usnewshot.com.

1. Minimally Invasive Surgery
Cynthia Deyling, MD, MHCM, FACP
Chief Quality Officer, Cleveland Clinic
@CindyDeylingMD

2. Minimally Invasive Surgery
• Standard of Care
• Outcomes meet or exceed open approaches
• Cost and Value?
• Research conflicts?

3. AppropriatenessPatient selection
Shared decision making
Skilled specialistsVendor Influence

4. Measurement
• Define minimally invasive
• Procedure-level volume thresholds
• Referral center considerations
• Contraindications and appropriateness
• Coding limitations
• Structural elements
• Shift to outpatient procedures

5. Possible Approach
• Case volumes and outcomes by approach rather than
percentage thresholds
• Establish volume thresholds based on national
benchmarks
• Minimizes need to develop robust exclusion criteria

6. Key Takeaways
• Patient-centered
• Avoid unintended consequences
• Competency
• Graduate Medical Education