It’s no secret that the healthcare industry has seen rapid innovation but questionable adoption over the past decade. At times, I’ve even found myself doubting the technology my hospitals have encouraged us to adopt. This often looks like being informed after a decision has been made to choose an “off the shelf” solution from our electronic health record (EHR) that is “good enough.” Many times, the “good enough” solution is poorly designed, clunky to use, and lacks incentive or reinforcement to change behavior, so clinicians like myself don’t use them. And it’s not for a lack of desire to engage, they just don’t work well enough to be worth the effort. While many of the advances from EHR tools like Epic’s MyChart and large language models (LLMs) are progressive and exciting, not an insignificant number of them fall short of the mark for surgeons and what would actually improve our day-to-day experience to better our patient care practices.
However, the problem does not lie in the capabilities of these tools – many have shown promise of disrupting the status quo of healthcare operations and improving the lives of healthcare staff. The real problem for clinicians lies in the lack of collaboration and inclusion throughout the developmental process with health systems and solution developers.
Today’s AI solutions are often designed and implemented with limited clinician input, limiting adoption and true impact. In other areas, however, this has not been the case. Consider the space of medical devices. The U.S. has long been a leader in this space, and the products developed have been transformative for patient care and the daily lives of surgeons. Why has this been the case? I would argue that the success of this industry has been predicated on the depth of the relationship between surgeons and industry partners.
For example, novel tools like surgical augmented reality (AR) glasses, which included surgeon participation through stages of development, are disrupting the teaching of complex surgeries and show promise to meaningfully improve surgical planning and intraoperative technique for orthopedics and neurosurgery. Not unlike robotic surgery, this product was designed with and for surgeons. And like robotics, when it solves a significant need and is best of breed, we can expect surgeons everywhere to embrace the new technology. The trouble is that our technical colleagues know how to build beautiful products, but most have not worked within the four walls of healthcare, very seldom within the operating room. As a result, they do not know what will work or what is sufficient to drive engagement. That’s why they need our calibration, and the best ones seek it out.
The ultimate truth is that developing a proper solution requires a partnership: between clinicians and technologists.
Why has collaboration crumbled?
For one, medical software has been treated differently than medical devices, even though the healthcare operations that software affects have an equal impact on patient quality to the physical tools we use between close and cut. The other is that the default position for some has been to accept whatever the EHR offers as “good enough” without vetting whether or not it meets the need to drive clinical adoption. Too frequently, there is a blind faith that the EHR can be the best at everything, instead of adopting an open and curious mindset that welcomes competition as a vehicle to drive advancement.
To be fair, there are bright spots inside the health system, with some technologists that do actively listen to their clinicians, seek what is optimal, not just what is perceived as easy, and actively engage the partner community with an open mind. We as clinicians also hold some responsibility. The sad truth is that there has been some disillusionment from surgeons who have lost faith that real change will be made after spending hours giving feedback in endless committees. These committees often don’t deliver the change clinicians are looking for. At best, EHR vendors will take what we ask for and give us half of an ideal solution, and at worst, promise us to provide a full solution that will be delivered in an indeterminate timeline.
Health systems haven’t implemented the right surgical solutions to deliver ROI
On the other hand, health system executives are feeling added pressure to incorporate new tools into their tech stacks to address inefficiencies and improve patient care, but they often don’t delegate decision-making authority to the clinical staff, who will be the primary users of these tools.
Many tools are depicted as groundbreaking to health systems but often offer basic recommendations without providing actionable next steps or impacting clinical decision-making. Take EHR platforms, for instance. They all claim to improve patient care by providing quicker access to the millions of healthcare data points available. Still, they often don’t have the ability to make the data useful to us and our patients. If a surgeon isn’t able to contact a patient until 3-5 days before surgery and doesn’t have adequate time to catch instructions that might have been missed, like stopping a medication, surgery will be delayed, causing additional distress during an already difficult time for patients. Additionally, the reign of EHR vendors, who push their tools on hospitals, has limited space for competitive innovation. This has created an atmosphere of poorly integrated and inefficient products that hospital staff are tasked to learn how to use.
How can healthcare innovators prioritize collaboration?
We have reached a crossroads, but the path forward is clearer than ever. The industry yearns for collaboration and a larger emphasis on surgeon participation in creating groundbreaking solutions. Surgeons need to voice their opinions when selecting the tools that impact patient care, and developers will need to shift their focus to developing solutions that solve real-world challenges in surgery.
By nature, surgeons are tinkerers and when allowed to contribute to the tools that can be used daily, they can drive fundamental improvements in care. A change in collaboration is needed; however, until that approach is more regularly considered, the healthcare industry will continue to struggle with technology adoption, and surgeons will continue to operate in an environment riddled with inefficiencies.
Photo: Dmitrii_Guzhanin, Getty Images
Dr. David Atashroo is Chief Medical Officer, Perioperative, at Qventus. In this role he leads the design and direction of the Qventus Perioperative Solution, which uses AI and automation to optimize OR utilization and drive strategic surgical growth. He holds a doctorate in medicine from the University of Missouri-Columbia and trained in plastic surgery at the University of Kentucky before completing his postdoctoral fellowship at Stanford University School of Medicine. In addition to his role at Qventus, Dr. Atashroo continues his clinical practice at the University of California-San Francisco.
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