Technology COMMENT with MARK SLACK WOMENS
Advancing safety and efficiency in the OR
Mark Slack, a co-founder and the Chief Medical Officer of CMR Surgical discusses the the future of surgery, including the impact of robots, big data, artificial intelligence and value-based medicine. He predicts there will be a major shift to minimal access surgery in the short term, and digital technologies will drive improvements in efficiency, patient safety and outcomes.
In the next 5-10 years, I think we are going to see a complete swing of surgery from manual laparoscopic surgery and open surgery to robotic minimal access surgery – even more so than we are currently. This will be supported by digital programmes such as clinical registries, with large data groups which will continue to grow, and will provide unparalleled insights into surgery which can ultimately be used to enhance patient safety. Robotic surgery will undoubtedly have a major impact on the future of surgery. It will enable a greater number of surgeons to perform laparoscopic surgery at a high level, including complex procedures that would otherwise more than likely be performed using open surgery such as hysterectomies, nephrectomies, pyeloplasties and abdominal wall reconstructions. This will encourage a greater uptake of minimal access surgery, given all the known benefits that it provides to the patient population including reduced complications, less pain and a quicker recovery time. The computational power of big data will enable the management of databases that will give us more insights into clinical outcomes and clinical care, and also enable us to manage the health system more efficiently. With the advent of big data, people are becoming aware of the complications associated
with surgery. As the public become aware that surgery can be associated with negatives, there will be a drive towards increasing surgical standards and that drive will be led by the public. Surgeons will be questioned, so there will be a greater emphasis on better training and standardisation to support improved patient outcomes. There is an increased emphasis on better delivery of service and more emphasis on
reduction of complications. We are all constantly surrounded by the need to manage the costs of medicine. So, there will be a drive towards value-based medicine, so not the delivery of medicine at any cost, but the delivery of medicine at affordable cost – and technologies such as robotic surgery can support this. Operating theatres are very expensive commodity within the healthcare system. They also spend a lot of their time not functioning and therefore there can be huge inefficiencies in the theatre system. There’s no value if a theatre is not working for 40% of the day while patients are being fetched or delivered, or theatres are being cleaned, so there needs to be a greater drive towards efficiency around the theatre groups. This can be helped by computer systems and AI programmes that help drive efficiency in everything from the movement of patients between wards and theatres, the cleaning of theatres in between cases and the streamlining of operations to keep their time down to a minimum. These digital programmes will also involve relevant clinical and procedural databases, which will be delivered as insights to surgeons around how many cases they’re doing, the efficiencies and the outcomes. As an example, here at CMR Surgical, we have connected clinical context with procedural information through the Versius Connect app, which enables a surgeon’s data to be shared with them and also be accessible on their mobiles or their laptops, so they can work towards a greater surgical efficiency and better surgical outcomes for their patients. By enabling surgeons to access this data with relevant context, we are also providing a means to demonstrate the efficiencies of operating robotically through areas such as reduced theatre time or reduced bed days for example – or even software that highlights when maintenance will be required to minimise the downtime of a robot – all of which can be used to demonstrate the value of a robotic system such as Versius from an economic perspective, linking back to value-based healthcare.
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