Today, there can be significant differences in surgical outcomes – not only in different parts of the world but even within the same hospital – directly affecting patient care and patient economics. hospital based on complications, readmission, and duration of surgery.
PROBLEM
Although hospitals understand that there is inherent variability in outcomes, ranging from postoperative complications, reoperation, readmissions, length of stay, etc., the solution remains unclear. Why is this? Some experts say that it directly points to the data. There are missing data from hospital analyzes to evaluate outcomes.
PROPOSE
Ketan Badani is vice president of urology and robotics at Mount Sinai in New York City. He understands this well. And he reached out to supplier Theator to help solve the problem.
Theator is a medical IT company that leverages proprietary AI to address disparities and diversity in surgery and improve outcomes.
“Today, there is no way to routinely and automatically capture all minimally invasive and robotic surgical procedures,” says Badani. “Current technologies require employees to remember to press record, then often require a USB drive to download video from the operating room’s camera system and upload that video to the hard drive.
“The videos then need to be structured in order to conduct any meaningful analysis,” he continued. “This process is time-consuming and adds difficulty to something that technology can solve.”
The new AI platform automates the entire process without adding cameras or sensors to the OR. SaaS technology automatically and regularly records all minimally invasive and robotic surgery video, de-identifies it, and structures the video according to procedural steps. It catalogs intraoperative events (e.g. bleeding), safety landmarks, procedure complexity, etc.
“It’s not just about structuring the procedure steps – it also analyzes the complexity of each case, when any surgical events such as bleeding occur, when safety milestones are reached,” explains Badani. safety, when the camera is outside the body and more,” explains Badani.
He continued: “To really understand the impact of surgical techniques, tools, procedure complexity, etc and how they affect the patient’s recovery, you need to connect the surgical video to patient results, stored in the EHR system”.
The EHR contains a postoperative note, which is a written document of what happened during surgery. However, because these notes are made in retrospect, they are often not entirely accurate.
“This is a widely reported issue in the industry, and it was important for us to find a new way to fact-proof and structure our surgical data in an unbiased and accurate way, and in real time, so we can ensure the timeliness of the data,” said Badan.
“The AI platform solves this problem by connecting surgical video with patient results through one-way integration with EHRs, allowing us to ultimately understand, for example, which surgical approach delivers. optimal outcomes, where there may be an opportunity to standardize a certain practice across the hospital system to reduce variability in postoperative complications and ways we can improve surgical quality. art,” he added.
MEET CHALLENGES ONLY
Mount Sinai installed Theator’s technology ahead of the Society of Urological Robotic Surgeons (SURS) annual meeting, to be held at Mount Sinai Hospital on December 9-10, 2022. Live procedures are broadcast from the operating room to an auditorium of more than 300 surgical attendees, who can watch the surgery in real time and interact directly with the surgeon.
“For the first time, using AI technology, these operations were transmitted with real-time AI-powered annotations generated by the Surgical Intelligence Platform,” Badani recalls. “With annotations such as surgical steps, intraoperative events, and safety landmarks, these insights are broadcast as they emerge during surgery, along with the surgical video, in complete detail. totally correct.
He continued: “This is the first time this capability has been shown at a surgical conference and demonstrates the ability of a vendor to use AI to power the structure of surgical videos in real time. real with high accuracy.
The technology, he adds, goes a step further – connecting post-surgery with patient outcomes – to help Mount Sinai correlate and better understand how what goes on during surgery can affect the process. recovery so staff can improve patient outcomes across the board.
RESULT
Mount Sinai presented a briefing on the use of Theator’s Surgical Intelligence Platform technology at the American Urological Association’s annual meeting in May 2023.
“We believe the use of AI has tremendous potential to transform surgical care today,” Badani said. “In the field of urology, surgical robots are already being used every day to enhance our efforts, enabling us to perform minimally invasive surgery with greater precision using more versatile tools. .
“However, while hardware innovation in OR has improved dramatically over the course of my career, for the most part it just stops there,” he continued. “But now, with this AI, the active digitization of OR has arrived.”
With the vast amount of data left on the OR floor every day, literally hours and hours of surgical video is neither recorded nor analyzed to identify trends, patterns and ways to improve, he added. improving patient care, the industry is doing its own harm.
“It can’t be done manually – we need the help of technology,” he says.
“And this technology needs to be thoughtfully built,” he continued. “It needs to be clinically relevant, have the highest security and privacy standards in the industry, and not be tied to a specific camera system or tool but instead be agnostic to those what we’ve got, to help surgeons and hospitals better prepare for a particular case, a patient’s recovery, and to help surgeons make the best decisions for their patients Surname.”
TIPS FOR OTHER PEOPLE
“First and foremost, any AI technology you plan to use in OR should have achieved the highest security and privacy certifications in the industry – HITRUST and SOC2TypeII,” advises Badani. “We are dealing with highly confidential information and it should be treated as such.
“Secondly, the AI needs to be at least as accurate as a human, ideally more, and it needs to unearth the findings without significant delay,” he continued. “The insights provided need to be clinically relevant, actionable, and digestible in a way that supports health systems that can improve care for their patients.”
Not all AI systems provide these important guarantees, he added, and hospital staff and healthcare systems must be diligent in finding the right system.
“The manual effort to record, catalog and annotate surgical videos is laborious,” he concludes. “So much so that it basically doesn’t happen in most institutions. Enabling a digital platform to both organize and analyze surgical video is crucial for hospitals and surgeons alike.” to exploit this powerful and untapped data.”
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