ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: (On-Demand) | July 2022-Ming Xu

Ming Xu_Setting up a POEM practice

Pdf Summary

The author, Dr. Ming-Ming Xu, Chief of Service at Kaiser Permanente West Los Angeles in California, discusses the process of setting up a POEM (Peroral Endoscopic Myotomy) practice in an HMO (Health Maintenance Organization) setting. The advantages of an HMO include an integrated health care system with no pre-approval or billing authorization needed and a large referral base. However, there are challenges to building a new program, such as limited volume and the need for buy-in from regional GI and surgery chiefs.<br /><br />The author details the steps taken to establish the POEM program, including getting approval from the IRB (Institutional Review Board) to practice and recruiting patients. They also highlight the importance of a multi-disciplinary team and the use of technology, such as endoflip and manometry, in the clinic workflow.<br /><br />The author provides a list of do's and don'ts when setting up a POEM practice, including using a referral checklist, limiting initial cases to treatment-naive patients, and developing proctoring/mentor relationships. They emphasize the importance of educating referring GI and PCP about achalasia (a disorder affecting the esophagus) and post POEM expectations on diet and symptoms.<br /><br />Overall, the author stresses the importance of a multi-disciplinary approach, streamlining processes, and building volume and expertise in order to successfully set up a POEM practice in an HMO setting.

Keywords

POEM practice

HMO setting

integrated health care system

referral base

establishing POEM program

multi-disciplinary team

technology in clinic workflow

referral checklist

achalasia

streamlining processes