Advancing IT Propelling Pediatric Surgery

Children's National Medical Center using $150 million gift from Abu Dhabi government to improve medical outcomes by using technologies like GPS and 3D graphics to customize procedures.

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But the use of medical imaging technologies such as low-radiation CT scans combined with special algorithms can be used to get "dynamic 3D representations of the spine ahead of time, so that there's much less guesswork in surgery," he said.

"People with different backgrounds and expertise could build algorithms to look at the CT scans of scoliosis patients, to see the turn of the spine," he said, providing surgeons with more visual and other information than is currently available about individual patients.

Also, the application of technology that provides real-time displays on a screen of the patient's spine during the actual surgery could also help surgeons know "where their surgical tools line up to the target," such as the insertion of screws, he said.

"We tend to think of surgery as what goes on in the operating room," Safdar said. "But surgery is a round trip that starts and ends with the patient," he said. That includes multiple visits to doctors, specialists, labs, and other testing facilities to make diagnosis and plans for surgery.

"Along the way, a lot of technology isn't leveraged at all," he said. That includes the bringing together of information that comes from lab tests, medical images, electronic health records (EHRs), and other sources.

"It's much easier for a patient to schedule an international flight than a CT scan," he said, because of the delays in information getting where it needs to be and having it communicated to those who need it.

"Many EHRs aren't even indexed," he said. Even though information like a patient's allergies might be contained in an EHR, unless you know where to look for allergies, clinicians often can't find the information quickly. "Different [clinical] teams document information in different ways," even in EHRs, he said.

"Many [users of EHRs] are not using basic tools like indexing," he said. "The holy grail in surgery is to take advantage of the entirety of information that's available about a patient," he said. But that's not done today, he said. Doing so can help surgeons provide more personalized care to patients, helping improve outcomes, including faster recoveries and fewer complications.

Another aim of the institute is to develop or improve asynchronous real-time communication so that clinicians and other medical experts can better collaborate and share information in real-time, rather than rely on phone tag or e-mail, he said. Instant messaging isn't used in healthcare because it's not secure enough for exchanging patient's medical information. New developments in presence technologies could bolster communication among clinicians during patient procedures, he said.

As for the team of bioengineers, technologists, and clinicians being assembled for the institute, "our goal is to work in the same location, share expertise," so that care and outcomes are improved not only for children treated at Children's National Medical Center, "but for all children," he said.