LAUSR

THE SARS-Cov-2 (COVID-19) pandemic is a societal catastrophe with an unparalleled global impact on how we live, work, teach and play. In the United States, with the declaration of a national emergency and restrictions on nonessential medical care, the health care system is under great strain. While there are immediate challenges to overcome in prioritizing and increasing clinical activity, this crisis also presents us with a unique opportunity to fundamentally reexamine how we practice in order to improve and possibly even transform patient care. Urinary stone disease accounts for a considerable portion of the clinical workload for many urologists in this country and it consumes significant resources. In addition, unplanned health care utilization, such as emergency department (ED) visits after ureteroscopy (URS) and shock wave lithotripsy (SWL), occurs frequently and is emerging as an important quality indicator. Drawing on the Michigan Urological Surgery Improvement Collaborative (MUSIC), which has a clinical registry of more than 13,000 URS and 7,000 SWL procedures, we sought to identify the strengths, weaknesses, opportunities and threats to the future of kidney stone care as a result of the COVID-19 pandemic (see figure).