When our endoscopy center moved into its new location in 2003, we had a chance to start from scratch and design an efficient, high-volume facility that would let our business evolve as gastroenterology's clinical, regulatory and financial landscape changed. A lot has happened in the last five years, including reduced Medicare reimbursement for ASCs, the arrival of EMRs and technical advances allowing for better viewing and imaging of the GI tract. Here's how we've addressed these changes with a creative mind and become more efficient along the way.