AI Poised to Help CMOs Make Inroads in the Surgical Field

There are several opportunities to introduce AI tools into operating rooms.

Up to this point, AI tools are not being widely used during surgical procedures. The technology has made more of a splash in the pre-operative and post-operative settings.

However, Miami Cardiac and Vascular Institute, part of Baptist Health South Florida, is examining ways to introduce AI tools into the operating room. Tom Nguyen, MD, chief medical executive of Miami Cardiac and Vascular Institute, says his surgeons are using an AI tool to generate risk profiles for their patients.

Historically, according to Nguyen, they had risk calculators that could use the patient's age, comorbid conditions, and other factors to determine a risk profile after the patient had surgery.

"Those risk calculators did not take into account the patient's Zip code, the particular surgeon, the time of the surgery, and a host of other factors," Nguyen says. "AI can use machine learning to predict more outcomes."

Risk calculators that use regression analysis to generate risk profiles have been available for more than a decade, but the AI tool that Miami Cardiac and Vascular Institute is using is more powerful, according to Nguyen.

"Unlike regression models," Nguyen says, "AI can add more variables and personalize the predictive risk for each individual patient."

AI has taken hold in the perioperative arena, according to James Blum, MD, chief health information officer at The University of Iowa.

Ahead of surgery, some surgeons are using AI for imaging to look for defects or tumors that have metastasized, Blum says.

"After surgery, there is monitoring in the hospital with predictive algorithms for people suffering deterioration," Blum says. "There is also remote patient monitoring that is being used after sending surgical patients home with algorithms that can show when they are getting into trouble."

AI opportunities in the operating room

In the future, AI will assist surgeons during procedures, according to Blum and Nguyen.

"We have worked with a company that uses AI to make surgeries safer," Blum says. "Essentially, this AI tool monitors things that are going on during an operation and provides feedback."

AI will help anesthesiologists in the operating room as well, Blum explains.

"There are technologies being used in Europe to maintain the blood level of the anesthetic and calculations for individual patients," Blum says, "particularly if an anesthetic is being given as an IV infusion."

In the future, the da Vinci robot will likely have AI features that could make it a better assistant to the surgeon, according to Blum.

Nguyen is bullish on the future of AI tools in the operating room, particularly in robotics.

"Just as with automated driving, you could have AI do almost automated procedures," Nguyen says. "There have been studies to use AI to watch an operation then alert the surgeon not to take a certain action or alert the surgeon that they are doing something out of sequence."

One of Nguyen's responsibilities is looking for opportunities to improve operational efficiency, which could be a near-term application of AI at Baptist Health South Florida.

"We are working with some companies that have AI technology that will help us understand our current operational efficiency, understand where the gaps are, and help guide us to become more efficient," Nyugen says.

Miami Cardiac and Vascular Institute is exploring AI technology that could manage the counting of supplies in the operating room, where every single sponge and needle must be accounted for. The concern is that an object could be inadvertently left inside a patient.

"Those counts are done by people," Nguyen says. "Every time you rely on a person, you are subject to variability and subject to inaccuracy."

According to Nguyen, there is a piece of AI technology that involves using a camera that takes pictures of all the needles and counts them. In complex cases that can have as many as 300 needles, the technology can be a big help.

"If your count is wrong, you must go around the room and try to find the missing needles," Nguyen says. "You may have to take an X-ray to make sure you did not leave a needle in the patient's body."

Nguyen is excited about AI, and he believes it will transform medicine.

"We need to approach it with cautious optimism," Nguyen says. "We need to have components in place to ensure that AI does not spiral out of control."

Considerations for AI adoption in the surgical realm

When adopting AI tools in the surgical setting, healthcare organizations must make sure that patient information is secure, according to Nguyen.

"In using AI, you use many data points for each patient," Nguyen says. "Something we are very cognizant of and have committees adjudicate is how we use patient information."

Additionally, healthcare organizations should not impose AI tools on their surgeons, Blum explains.

"You need to understand your surgeons' needs, and you need to understand their pain points," Blum says. "You should avoid finding a tool, acquiring it, then telling surgeons to use it."

Healthcare organizations should find an AI solution and pair it with a surgeon champion, according to Blum.

"The best way to adopt AI technology in the surgical field is to have the right technology with the right surgeon," Blum says, "who can then champion that technology throughout the organization."