Bridging practice to innovation was the underlying message of this year’s meeting of the American Society of Anesthesiologists in San Francisco held this past Oct. 13 to 17. Over 10,000 anesthesiologists and other health care professionals from around the world participated.
The conference chose a keynote speech on harnessing innovation by best-selling author and tech entrepreneur Josh Linkner (@joshlinkner)
“Health care is in the midst of upheaval, with new technology and trends in patient care. By applying fresh and proven approaches to innovation, anesthesiologists can drive more meaningful results and adapt to changes in the field,” said Linkner.
“Look around your practice and ask yourself: ‘What’s the thing that needs to be let go of to make room for something new?’” Linkner added.
Rousing his audience for that mindset makeover for the survival of anesthesiologists, many were inspired, but not all. To Los Angeles anesthesiologist Karen Sibert, M.D. (@KarenSibertMD), the keynote “felt too slick, and had very little actual content that inspired me with ideas to redefine my practice for the future.”
Maybe Linkner’s examples to drive his points did not fully resonate with some anesthesiologists who are beset with issues related to policies, bundled payment systems, perioperative surgical home requirements and practice-related concerns (e.g. extubation and re-intubation of the difficult Airway) or even the opioid crisis.
“Tech entrepreneurs come and go, but healthcare and sick patients are here to stay. We need more down-to-earth help, a rational dose of hope, and a little less hype, please,” Sibert wrote in her blog.
Anesthesiologists draw inspiration from practical ways that will help them manage, treat, engage and care for more patients in less time and limited resources. To talk about how investments in tech startups turned Detroit around is a “wow,” but to anesthesiologists, that is not relevant tech talk. To them, it is about the latest advances in the relief of pain and total care of surgical patients prior to, during, and after surgery.
Anesthesiologists’ tech is how wearable and other devices address monitoring gaps in averting patient deterioration and reduce re-admissions, thus improving perioperative safety. Where, when and how to engage the patient - that is their technology platform.
Anesthesiologists’ tech is what will help reduce day-of-surgery cancellations, improve clinical outcomes, and increase revenues. Their talk is more about innovations on patient care.
Outside of the keynote, the tech talk that occurred amongst Anesthesiologists at that annual meeting was more on a discussion on “recent innovations in digital, data and device technologies, which afforded the possibility to create further transformative changes in health care.” There was also a study presented on the potential of virtual reality to reduce children's anxiety, pain. And there was a session on “Smart Monitors, Nanoparticles and Big Data: Emerging Technology in Perioperative Medicine.”
But Linkner’s message to embrace innovation, and to not overestimate risks in trying something new as it translates to the practice of anesthesiology, was heard. Dr. Helgi Johannsson (@traumagasdoc) tweeted: “If we don’t adapt to new technology we will fail. We have to keep up or we become irrelevant - just as important in healthcare as in other sectors.”
Technological advancements are part of modern anesthesia. And anesthesiologists, probably more than most, have embraced these trends. But being innovative, creatively disruptive, embracing advances take more than words. In the practice of anesthesiology it requires hard clinical facts.
Jonathan Tan, M.D. and Lara Brewer, PhD, reviewed how data are being used to drive innovation and technology development within anesthesiology and perioperative medicine. Tan and Brewer are from the Departments of Anesthesiology and Critical Care & Biomedical and Health Informatics, The Children’s Hospital of Philadelphia; and from the University of Utah Health’s Departments of Anesthesiology and Bioengineering respectively.
“Clinical data are central to innovation whether the focus of innovation in anesthesiology and perioperative medicine is in advancing clinical research, earlier detection of disease, medical device development, real-time monitoring for patient safety, development of algorithms for predicting adverse clinical events, or improving the efficient delivery of health care,” wrote Tan and Brewer in their article.
They presented their review during the Society for Technology in Anesthesia (STA) Annual Meeting last January 2018. “In our current health care environment, defined by limited resources and a value-based approach to clinical practice, having data on hand to demonstrate a need, value, and tangible outcomes in a cost-effective manner is key for decision-making,” said Tan and Brewer.
During the same STA annual meeting Ameer Majeed, consultant anesthesiologist at King Faisal Specialist Hospital and Research Centre, Riyadh, in his presentation, "Technology in Anesthesia: Crystal balling the future", noted that artificial intelligence, nano-medicine, genomics, and robotics are the technological innovations up ahead.
Majeed listed artificial intelligence for clinical decision-making, and telemonitoring among others; nano-medicine for drug delivery, and nano-robot surgeon; robotics for surgical robots, anesthesia robots, and drones; and, genomics for Do-It-Yourself (“DIY”) biotechnology and genomic medicine.
The drivers for change, he added will be “changing demographics, rising healthcare bills, and evolution of functional medicine.”
But here and now, Majeed said that as perioperative medicine is the pathway to better surgical care, its evolution is seen from pre-op anesthesia assessment, exercise testing and preparation to enhanced recovery after surgery and integrated care for the elderly.
“Unless we re-engage with the wards to provide care before and after surgery, we will lose relevance. A retreat to the operating theatre will be to the detriment of the specialty,” said Majeed.
Anesthesiologists innovate, adopt and adapt to new ways of thinking and doing things, when it’s relevant to them and their patients. The technology that they need and want, is one that will not replace them but what they can use to be able to brand the level of care that they provide. A technological platform that makes use of their voice and not change it.
A technology that doesn’t change the way that anesthesiologists think about practicing medicine, but rather complements it. Again the last thing that they need is a motherhood statement like this, but practical and real examples of tech that help anesthesiologists accomplish their goals in patient care more easily to grow the footprint of their practice.
So, LifeWIRE Anesthesiology.