Dan Durrie, MD of iOR Partners
An exclusive Tech Tribune Q&A with Dan Durrie, MD (founder and Chairman of the Board) of iOR Partners, which was honored in our:
Tell us the origin story of iOR Partners – what problem were you trying to solve and why?
At over four million annual procedures, cataract surgery is the most common surgery performed in the United States. With an aging population, volume is expected to increase three percent per year reaching six million procedures by 2030. Most cataract surgeries are performed in multi-specialty ASCs, which de-prioritize cataract surgery in favor of more lucrative surgeries such as cardiac and musculoskeletal. As a result, ophthalmic surgeons have limited access to an OR, a backlog of cases and a long-term capacity problem.
As surgical procedures evolve, they become safer and more effective, and when this happens, they often move out of the hospital or outpatient surgery centers and into a physician’s office-based surgery (OBS) suite.  This is a common evolutionary development in medicine that is known as a Point of Service Change. The impetus for starting iOR Partners was to help ophthalmic surgeons adopt this point of service change and adapt to an office-based surgery model.
In late 2018, I had a chance encounter with two colleagues in this field, and we discussed the unmet need surrounding ophthalmic OBS and how it benefits all key stakeholders – patients, physicians, and payors. By bringing surgery into the office, physicians can seamlessly integrate clinic and surgery, providing the highest level of safety, more personalized patient care, and at a lower cost. As an ophthalmic surgeon, I had the knowledge and contacts necessary to address the clinical side of the process, and my partners contributed the industry and business know-how. We developed a comprehensive, turn-key approach from building and designing the iOR Suite®, staffing, training, accreditation, supply management, safety and quality management, as well as all administrative and business-related functions including day-to-day oversight.  Ophthalmic surgeons were poised to make this transition, but as is often the case in medicine, few surgeons had the business acumen or time to manage the business and administrative functions necessary to adopt this model.
What was the biggest hurdle you encountered in your journey?
While OBS is picking up momentum, it is not yet the norm. We’re at the point where almost every client is the first in their community to express interest in this model and make the decision to go for it. Doctors see it as something new, and even in this specialty that is known for attracting innovative thinkers, change can be frightening. In medicine, disruptive ideas tend to attract pushback from factions that are committed to maintaining the status quo. Those concerns will lessen as stakeholders become familiar with the data supporting the safety of ophthalmic OBS.  Reimbursement is another hurdle. Since inception, we have been advocating on behalf of our surgeon partners for the Centers for Medicare and Medicaid Services (CMS) to establish an OBS Facility Code, just as ASC’s utilize an established CMS Code for facility fees. While iOR Partners has been successful in collecting reimbursements from all major payors in the form of an enhanced professional fee, a standardized OBS code would be a clear, direct, and more efficient way for Medicare to reimburse practices with OBS suites.
What does the future hold for iOR Partners?
Currently, we have over 80 medical practices under contract across 35 states. What started out as mainly assisting doctors in their transition to OBS has grown into a mission to support the overall OBS movement in ophthalmology, as well as other specialties that have approached us for guidance. We are the only company focused specifically on ushering in this inevitable Point of Service change in healthcare.
 We have our work cut out for us because we want to make sure that it’s done right and meets several important criteria. First, OBS has to be safe, and we have the data showing that OBS ophthalmic surgery is as safe or safer than when it is performed in hospital out-patient departments or ambulatory surgery centers. Second, the procedures performed in OBS settings have to be effective, and cataract surgery has a solid record of being one of the most effective surgical procedures across the entire healthcare continuum. Next, these OBS sites must be convenient and accessible, especially to rural patients who all too often must travel inordinate distances for surgical care. Finally, we are dedicated to making OBS cost effective and environmentally friendly. Cataract surgery is growing significantly because of the aging baby boomer population. As we move forward, we need to keep the costs under control while providing a higher volume of care, and OBS is an ideal solution.
What are your thoughts on the local tech startup scene in Kansas City?
Focusing specifically on healthcare startups, I think the Kauffman Center for Entrepreneurialism, the Stowers Institute, and the two Medical Schools we have in the Kansas City area, where iOR is based, are ripe with many opportunities for healthcare development. Today, there is more local financing available for startup businesses in the healthcare arena than ever. In funding iOR Partners as a company, we have been able to find excellent investors within the Kansas City region and that is extremely gratifying. I’ve been here in Kansas City for 35 years and I was frustrated for a while because we were not seeing significant entrepreneurialism in healthcare, but that is turning a corner. There is a growing spirit of entrepreneurialism in Kansas City that is fueling a lot of health-care innovation, and it is a very exciting time.
What’s your best advice for aspiring entrepreneurs?
In professions like medicine, it’s rare to get sufficient business training, so when I went back to business school at the Kellogg School of Management at Northwestern University several years ago, it was a real eye-opener for me. I think the most important thing for any aspiring entrepreneur is to understand that they need to have more than a good idea. Over 95% of all great ideas never make it to the market. I highly recommend finding opportunities for entrepreneurial training within our community, and there are several , especially when you consider online learning options. I think it’s crucial for aspiring entrepreneurs to identify and really appreciate the steps that lead to becoming successful in business and also to explore how businesses have failed so they can learn from that. My advice is to implement a strategy that includes identifying an unmet need, coming up with a good idea for a way to satisfy that need, and then creating a business plan that works. Essentially, entrepreneurs need to make sure that we don’t let good ideas die on the vine because of lack of strategy.