This may sound ironic coming from a neurosurgeon but, seriously, deploying artificial intelligence in medicine doesn’t have to be brain surgery. Nearly half of operating rooms are already well on their way to some form of AI integration. And while the potential for AI advancements in healthcare gets a great deal of attention as venture capitalists flock to the next promising application, it’s time to discuss how we can reach AI transformation in healthcare by engaging clinicians who see the potential in AI (and believe in its value) from both a clinician and patient perspective.
AI applications in a clinical setting have the power to analyze massively complicated, multiple interrelated variables and understand sequences of events or patient variables. The North Star of our approach needs to be focused on improving patient outcomes, making care more accessible and reducing costs across the board. We also must engage with physicians using the technology — the surgeons and medical technicians who are the data engineers of our profession. The current state of AI surgical development reflects momentum from technologists and data innovators, but their efforts are not quite yet aligned with the needs of the end users. While AI has significant transformative potential and fully autonomous surgery is something our industry can aspire to, there is a lot we can accomplish in the conversation around AI in the meantime. This means technologists need to collaborate with healthcare providers to align in our approach to embracing AI.
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The message is loud and clear: AI will continue to be an industry game changer — and it’s making big promises along the way. Seventy two percent of business leaders believe that AI technology is a “business advantage” so it’s no surprise that companies like Amazon, Callaway, Nike, Starbucks and others are utilizing this technology in their business models. Amazon uses AI to make personalized product recommendations for customers and has Alexa-enabled voice shopping that can predict customer needs. Meanwhile golf company Callaway is using AI to prolong drives and increase the speed of a ball, claiming their technology can analyze 10,000 repetitions through machine learning.
How can AI be leveraged in the focused area of spine surgery?
The current clinical and economic outcomes of spinal surgery are variable based on a number of inputs including but not limited to surgeon, surgical approach, facility, and implants used, even when the patient type and condition are the same. The goal should be to collect, analyze and eventually prescribe the best treatment for a patient that will optimize both clinical and economic outcomes. Because this situation has so many inputs, we need to use AI to determine the best approach and in order to do so, we must collect operative data.
It’s estimated that the AI market for surgery will reach $225.4 million by 2024, up from $69.1 million in 2019. However, despite these significant opportunities, there is still an uncrossed chasm between AI and the healthcare system. For example, tech giant Google has stumbled with different iterations of its plan to ‘expand the power of AI in medicine’ by using AI technology to alleviate global physician shortages, improve access to modern imaging and diagnostic tools, genomic analysis, electronic health records and advanced detection for life threatening illnesses. There’s no shortage of aspiration when it comes to using AI in medtech, but there’s a real concern that it’s being overhyped and is under-delivering on what can reasonably be accomplished in this space – especially without meaningful collaboration from all stakeholders.
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Big tech: Big promises
Oftentimes when people think about the future of AI in medicine, they envision a Hollywood-inspired, dramatized perception of surgery that involves fully-autonomous machines running a human-less operating room. It’s true that the tech industry does have a tendency to muse about the future of doctorless, AI-driven medicine. However, AI itself is not a standalone solution, and the more those of us in the space can directly emphasize the importance of collaboration and coordination between these technologies and the medical professionals who would utilize them, the more effective and understood this future can become. AI in the OR will continue to require human intervention to ensure it is used correctly, to verify results, and to troubleshoot errors. Developing partnerships and generating interest in AI solutions with the folks in the operating room who will be using the products is the key to meaningful innovation and driving forward better healthcare outcomes.
An example of such collaboration is the partnership between clinicians at the Mayo Clinic and IBM. The Mayo Clinic has been using AI in different ways for the last 30 years. They’ve experimented with workflow optimization, natural language processing and clinical trials management. In 2014, the Clinic partnered with IBM’s AI platform Watson to develop a cognitive computing system to improve enrollment in oncology clinical trials. With so many ongoing clinical trials occurring at any given time, it was challenging for a provider to be aware of all of them and provide their patient with the appropriate options for their condition. Through AI, they were able to pull pertinent information to the forefront and resulted in increased enrollment in the three cancer groups where the AI was being tested.
This illustrates the incredible potential that exists for tech giants to collaborate with surgeons to develop AI solutions in healthcare, but it has been a rocky road. For example, despite decades of development and collaboration with healthcare providers, IBM’s Watson AI solution was later proven to be unprofitable and was sold off in pieces for about $1 billion. While Google shuttered its health record service after only three years, they pivoted in a different direction, and are now exploring using smartphones and AI to monitor heart and eye health. We’ve been building the foundation to develop new technologies across industries for decades and it’s time to apply what has been learned from trial-and-error development. We all know that innovation can be turbulent but by applying what we’ve learned from these stumbles and leveraging the expertise between tech companies and surgeons, we can develop meaningful solutions to improve patient and business outcomes across the board.
Surgeons are poised to seize the opportunities afforded by AI technology. Healthcare operates within a multi-matrixed environment where it’s difficult to achieve scale and maintain margins. Surgeons understand this complex environment far better than anyone outside the industry ever could. But in order to be successful, AI needs to drive value in the system. How we’re using data needs to be impactful to patient outcomes and the economics of healthcare. Technologists wading into improving surgery need surgeons – not just to buy the technology, but to help develop it. They need to get surgeons involved on the ground floor of innovation. They need to understand the complexities of the healthcare industry – both on the patient treatment side and on the production innovation side. It’s time for an era of physician-technologist collaboration in order to get serious about AI innovation in medtech – clinicians are ready and willing.
Picture: DaevichMikalai, Getty Images
Dr. Samuel Browd is the Co-founder and Chief Medical Officer at Proprio, Professor of Neurological Surgery at the University of Washington, and board-certified attending neurosurgeon at Seattle Children’s Hospital, Harborview Medical Center and the University of Washington (UW) Medical Center. He received his M.D., Ph.D. at the University of Florida, completed neurosurgical residency at the University of Utah, and Pediatric Neurosurgery Fellowship at the University of Washington/Seattle Children’s Hospital. He also completed a research post-doctoral fellowship on functional magnetic resonance imaging and operative navigation.
In co-founding Proprio alongside University of Washington’s Sensor Systems Labs’ Dr. Joshua Smith, UW MBA graduate Gabriel Jones, and computer vision specialist James Youngquist, Dr. Browd sought to leverage the emerging technologies of AR/VR and AI to revolutionize the way surgeons navigate human anatomy. Proprio was created with a mission to use technology and data to transform surgical care and improve outcomes.
