The Urology Center of Colorado: Bob Asinof, CEO

by HCE Exchange on August 19, 2010

Creating a center of excellence that provides concentrated medical services is no small task. Just ask Bob Asinof, CEO of The Urology Center of Colorado (TUCC), an outpatient urology center focused exclusively on treating urologic patients. Staffed by 16 urologists, two radiation oncologists, and approximately 130 other employees, TUCC provides residents in the Denver, Colo. metropolitan region, well as several nearby states, with comprehensive outpatient imaging, radiation oncology and surgery for the treatment of everything from kidney stones to prostate cancer.

“The concept of excellence is always at the forefront of everything we do,” Asinof said. “We didn’t create the center primarily because we thought we could make more money or beat the competition. We created TUCC truly to be a center of excellence.”

The vision for TUCC that began in the late 1990s became reality in 2006 with the merger of Western Urologic Associates, where Asinof served as administrator, and Colorado Urology Associates. TUCC opened in December 2006, in a new, 60,000 square foot, three-story building. Total project cost, from buying the land to building and equipping the facility, was about $25 million, he said.

The facility consists of a surgery center, a radiation oncology department, a research department, an imaging center, a clinical lab and a pathology lab. Asinof, who was named CEO of TUCC following the merger, started his tenure with Western in 1992.

Mission

Even before TUCC was built, organizers established the center’s mission, which Asinof said drives every decision – Excellence in Urology.

“In terms of the type of staff we hired, the programs and services we developed, the technology we incorporated and the facility we built, all decisions were driven by one thought which was ‘Did it meet that standard of absolute excellence?’” he said.

There are four visions within the excellence mission. One is to provide exemplary care to patients and referring physicians. The second is practicing superior urologic medicine and urologic surgery. The third is to foster a collaborative environment to maximize patient care, education and clinical research. The fourth is to operate the premier, full-service outpatient urology center in the United States. More short-term goals are established on an annual basis, Asinof added.

“Every decision we make, both tactically and strategically, has to meet our mission and vision,” he said.

Quality, Convenient Care

For those involved in the formation of TUCC, it was important to offer premium medical care in a way that was convenient to patients in the region.

“Everything a patient needs in outpatient urology can be done at one location,” Asinof said. “Sometimes we’re able to treat complex cases in the same day.”

Traditionally, a patient suffering from a kidney stone would go to a hospital emergency room, be seen by an emergency physician, stabilized, treated with pain medication, maybe have a CT scan, and then be instructed to make a follow-up appointment with their physician. Surgery might follow at a later date to remove the stone.

“Now, there are instances where a patient will come in during the morning with a stone, be worked up with a CT scan and seen by the urologist, given the appropriate pain medication and we do the surgery the same day here at TUCC,” he said. “In terms of convenience and service, treating the patient this way is a cost-effective alternative to a visit to the hospital.”

Quality control at TUCC is managed through a Quality Improvement Risk Management Program, where the department heads and medical directors meet monthly to discuss any quality incidents. TUCC also developed medical standards and protocols for every type of treatment and case in the center. These standards, in the process of being copyrighted, are maintained in a printed document and staff members are notified of any updates.

Management Philosophy

The organization is run primarily by an executive committee of the board, comprised of seven physicians, the CEO, the COO and the Clinical Director. This committee meets twice every month. In addition, all of the physicians hold monthly meetings with the management team.

“One thing that we emphasize here is continuous communication,” Asinof said. “Because we’re all in one center, we all work for TUCC and we see each other all the time, this environment has fostered communication.”

Capital Investments

Most of TUCC’s capital investments were made within the past three years, with a large portion allocated for electronic medical records (EMR). While the organization contracts with an outside firm to manage its IT infrastructure, it also employs two internal staff members who handle the management and training of staff in the facility’s IT systems.

Other technology investments also included imaging devices to equip the radiology and oncology portion of the center.

Industry Partnerships

One of the organization’s goals when TUCC was built was to be a beta site for new technology. With that, Asinof said they don’t limit their industry partnerships to just one or two vendors. For example, in the area of radiation oncology, the center works with Varian Medical Systems; in terms of imaging and EMR they work with General Electric. For the latest lithotripter, a device that uses high-energy shock waves to fragment and disintegrate kidney stones, the center turned to Dornier MedTech.

Programs

In addition to providing technologically advanced urologic care, TUCC is involved with clinical research, conducting about 12 drug studies at any one time.

The center has also developed four support groups for bladder cancer, interstitial cystitis, prostate cancer and spinal cord injury/condition patients. During monthly meetings, the groups discuss the latest thoughts and ideas for treating their respective conditions, as well as provide mutual support.

TUCC created a 501 (c)(3) foundation in 2008, which conducts free cancer screenings in communities throughout Colorado, provides assistance to urologic patients in need and includes a Medical Education Scholarship Program.

Challenges

With current and potential government regulation, Asinof is looking at more cost-management and cost-control initiatives, particularly with an eye toward declining reimbursements. More than 50 percent of TUCC’s patients are covered by Medicare and, with Baby Boomers reaching Medicare eligibility, he anticipates that the center’s Medicare patient list could increase to two-thirds.

“That impacts us financially as well as with regulations,” he said. “We’re trying to retain more cash to ride out some of that down the road.”

Ability to Change

Another way TUCC is able to provide excellence is in its ability to be flexible and willing to change. Asinof said that this isn’t always possible in the hospital sector, where the size of the organization can lead to too much bureaucracy when it comes to making changes.

“That’s the one thing that we have tried to stay away from as we have continued to grow,” he said. “We’ve tried to maintain a lean, flexible and responsive organization.”

-by Kathy Knaub-Hardy

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