Digitizing the OR: The role of AI & AR/VR as disrupters in surgical care
Published Feb 05 2020 02:59 PM 2,887 Views

Written by: Fatima Paruk, MD, MPH 


Question 1:  How can AI potentially reduce clinician burnout and attrition amongst surgeons?  


Today, we face a worldwide shortage of surgeons: over 5 billion people lack access to surgical care, resulting in approximately 18 million deaths annually (https://www.who.int/surgery/en/ ).  Making matters worse, is despite the inadequate number of clinicians in the surgical workforce, surgeons are leaving traditional clinical practice due to burnout at an alarming rate.  According to a recent AMA survey, surgeons top the list for clinician burnout, with the top contributors being too many bureaucratic tasks such as charting, paperwork, and redundant tasks – resulting in potentially avoidable medical errors, lower patient satisfaction, decreased productivity and loss of morale and professional effort.   


The good news is that we can help to reverse the trend of clinician burnout by incorporating AI and robotics into surgical care with novel technique, that produce both superior outcomes and greater clinician job satisfaction.  The benefit from AI and robotics has the potential to increase efficiency, prevent error in the operating room, enhance operative equipment, optimize technique. In addition, AR/VR can be leveraged to enable superior training and real-time collaborative care when combined with telehealth platforms, facilitating optimal, personalized medicine intra-operatively.   


Question 2: How can AI improve efficiency for surgeons?  


AI can play a key role in mitigating case delays due to equipment.  With operating room time costs of up to $100 per minute, OR delays are costly and frustrating (https://www.ajmc.com/newsroom/what-are-the-implications-of-the-costs-of-operating-room-time).  Major contributors to case delays include slow operating room turnover, previous cases running behind schedule, unforeseen cancellations of cases, and instrument processing delays. Utilizing advanced AI scheduling which takes into account factors such as room or staff availability, patient consents, pre-op tests, and physician preferences combined with IoT or device management information, such as device battery life, and servicing schedules of necessary equipment can help mitigate case delays and optimize case throughput. There is also the potential for mitigating the risk of critical equipment shortages with 3-D printing of personalized implants or creating other specialty-printed instruments for specific cases.   


Question 3: Where are some of the opportunities in the development of AR/VR for surgeons? 


AR/VR has the potential to enhance the surgical experience for surgeons and benefit patient outcomes.  Prior to performing new procedures, devices such as the HoloLens (AR) can be utilized for training purposes simulating realistic experiences for surgeons in-training as they learn to perform new procedures.  For experienced surgeons, AR/VR can be utilized to try products and procedures with multi-dimensional imaging as they consider adopting innovative tools.   


When combined with EHRs and telehealth platforms, AR/VR will facilitate improved cross-specialty collaboration and can change how intra-operative consultations are performed AR/VR can be utilized to provide technical assistance intra-operatively, enhancing safety and reducing error with real-time alerts or clinical decision support during cases.   


Surgical subspecialists or expert technical assistants are consulted intra-operatively in the event of unforeseen challenges.  Often these experts are outside of the immediate hospital setting.  With the HoloLens, specialist consultation can be enabled by transmitting multi-dimensional interactive images to wherever a remote consulting physician or technical expert may be, enabling the consulting expert to “see” what the primary surgeon is seeing in the OR.  This can reduce time spent in the operating room and decrease infection risks by eliminating unnecessary traffic within OR’s.  


Additional benefit could be gained if AR was integrated with EHR documentation systems, leveraging voice to text capabilities to automate documentation for inter-operative events or consultations, reducing administrative and documentation burden for clinicians while increasing efficiencies and revenue.  


This is just the tip of the iceberg of what AI can do for digital surgery, want to hear more or discuss further, feel free to reach out to me. 


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- Fatima Paruk, MD, MPH, US CMIO, US Health & Life Sciences 

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