SeamlessMD Podcast – Episode 37 – Technological advances to enhance recovery after cardiac surgery



In this episode of the SeamlessMD Podcast, Dr. Joshua Liu, CEO at SeamlessMD & Marketing colleague, Alan Sardana, review a recent publication from the Journal of Hospital Management and Health Policy, “Technological advances to enhance recovery after cardiac surgery“*. See the full show notes below for details.

*Lobdell KW, Appoo JJ, Rose GA, Ferguson B, Chatterjee S. Technological advances to enhance recovery after cardiac surgery. J Hosp Manag Health Policy 2021.

Guest(s): Dr. Joshua Liu (@joshuapliu), Co-founder & CEO at SeamlessMD

Episode 37 – Show notes:

[0:41] Introducing the article in review: “Technological advances to enhance recovery after cardiac surgery” by Dr. Kevin Lobdell1, Dr. Jehangir Appoo2, Dr. Geoffrey Rose1, Brian Ferguson3, and Dr. Subhasis Chatterjee4,5,6;

[3:14] Why technological advancements in surgery are important for solving issues related to costs, risk, and quality;

[4:00] How technology can address the Institute for Healthcare Improvement (IHI)’s “Quadruple aim” strategy to address the growing concern for healthcare costs, which are as follows:

1) Better outcomes;

2) Improved patient experience;

3) Improved clinician experience;

4) Reduced costs;

[8:17] Why Dr. Liu believes we focus too much on technology when considering innovations in healthcare, how great innovations are not necessarily technological such as Enhanced Recovery After Surgery (ERAS), which is a model of care where clinical team members are coordinated in delivering effective, standardized & evidence-based protocols proven to help patients recover faster while sparing opioids, and how technology can be used to complement effective innovations for further enhancement;

[17:19] Discussing technological advancement #1: Data as a platform (DAAP) – the foundational component for a technological ecosystem; a system that compiles data together into one centralized platform;

[20:58] Discussing technological advancement #2: Wearables and the Internet of Medical Things – Devices such as smartwatches that track, with increased reliability & accuracy, various data points such as blood pressure, heart rate, heart rate variability, etc.

[21:30] How the Stanford University Apple Heart Study (n=400,000) monitored patients using Apple smartwatches, found 2,161 patients with an irregular heart pulse, and diagnosed roughly 720 patients with AF, allowing for earlier diagnosis and treatment of their condition;

[25:00] How wearables improve patient access to medical information (e.g. patients who are hard-of-seeing can use wearables to track heart rate without needing to see/read);

[26:47] Discussing technological advancement #3: Intelligent Computing – Artificial Intelligence capable of sensing, engaging, reasoning, making decisions, and even learning based on data;

[27:00] How intelligence computing can be divided into three areas: Prescriptive (explaining what we should do), Descriptive (explaining what happened), and Proscriptive (explaining what will happen in the future) and how machine learning is assisting SeamlessMD with real-time readmission prediction and Natural Language Processing (NLP) to reflect common free-text themes that patients discuss back to providers;

[36:43] Discussing technological advancement #4: Complex modeling – When computers use mathematics and physics to simulate complex predictions (e.g. simulating biological systems), and how this technological advancement can support nuanced education for healthcare;

[38:43] Discussing technological advancement #5: Simulation (Augmented Reality & Virtual Reality) – A computer-generated simulation of a three-dimensional image or environment that can be interacted with in a seemingly real or physical way;

[39:15] How simulation can be used in Healthcare for education; giving physicians hands-on experience in a variety of situations rather than only teaching the theory behind various procedures;

[42:00] Discussing technological advancement #6: Virtual assistants – Individuals or technology (e.g. Chatbots) that provide professional administrative, technical, or creative assistance to clients remotely (e.g. in healthcare: scheduling appointments, navigating hospital websites, sending reminders);

[47:18] Discussing technological advancement #7: Additive manufacturing (i.e. 3D printing) – The construction of a three-dimensional object from a CAD model or a digital 3D model, and how additive manufacturing can help increase efficiency while decreasing costs (e.g. in healthcare: building prototypes, custom implants, anatomical models, etc.);

[48:25] Discussing technological advancement #8: Telehealth and remote monitoring – An alternative to face-to-face patient-physician interactions;

[49:15] How the article authors view the “four pillars of remote patient monitoring”:

1) Engagement, via video visits, messaging, collecting patient data, and other pathways;

2) Secure audiovisual (A/V) interface for patients to communicate back-and-forth with their physicians and see their own data;

3) biosensors to allow physicians to collect data in a way that supersedes traditional physical exams;

4) data management & analytics capable of applying AI to collected data;

[55:12] Discussing technological advancement #9: Cybersecurity – the state of being protected against the criminal or unauthorized use of electronic data, or the measures taken to achieve this;

[56:00] How, with increased volumes of patient data, there is an increased emphasis on security (e.g. two-factor authentication and password managers such as LastPass or 1Password);

[57:44] How the aforementioned technological advancements are attributed to various phases of care:

Table 1: Lobdell KW, Appoo JJ, Rose GA,
Ferguson B, Chatterjee S. Technological advances to enhance
recovery after cardiac surgery. J Hosp Manag Health Policy

[1:03:17] Why these technological advancements are not intrinsically valuable in and of themselves and need to be successfully integrated into patient/provider workflows to be beneficial;

1Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC, USA;
2Libin Cardiovascular Institute, University of Calgary, Calgary, ALB, Canada;
3Arena Labs, Westlake, OH, USA;
4Divisions of General and Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA;
5Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, USA;
6CHI St Luke’s Health – Baylor St Luke’s Medical Center; Houston, TX, USA;

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