What is digital surgery, and how can it help transform your hospital?

By Robin Selwitz, Director of Technology and Hospital Systems Projects, Massachusetts Department of Public Health

We hear about digital health everywhere, from remote patient monitoring (RPM) to telehealth and everything in between. With promises to have technology improve overall outcomes throughout the healthcare system, where does surgery come into play? Digital surgery is a somewhat new term, defined for the first time by researchers in 2022, and our understanding of it and how it can help improve hospital surgery outcomes is still evolving. In an age where AI is growing rapidly and taking over many industries, the question remains of what digital surgery is and how can we trust and implement it going forward.

Digital health innovations can be used at various stages throughout the surgery process, such as preoperative planning, post-surgical analysis, and even AI-driven training. Although much is unknown about digital surgery, some impressive results have been evident from the plethora of new technological advancements. For example, using Johnson and Johnson’s MONARCH robotics platform in bronchoscopy, doctors had a 15% improvement in diagnostic yield. Surgical Process Institute, a digital system that can be integrated with any surgical theater to show visualizations of a procedure’s key steps, has been shown to reduce unwarranted variability by up to 45% and reduce surgical time. Augmented reality (AR) glasses used during surgery reduced the muscular fatigue of surgeons’ bodies and improved the accuracy of surgical instrument placement by 35%.

Investing in infrastructure improvements is necessary not only to enable digital surgery and other digital health initiatives, but to reduce cost and waste throughout the hospital system.

What are some of the potential benefits of digital surgery? Access to quality health care in rural America continues to be a concern. With technology such as a robotic platform allowing a surgeon in one location to provide surgery to a patient in another, digital surgery could potentially help close gaps in the rural healthcare system. Robotic surgery benefits both patients and providers alike. Patients can enjoy a faster recovery time and less pain, whereas surgeons can enjoy enhanced dexterity and greater precision. Machine learning (ML) in surgery can help better analyze data and predict outcomes such as surgical site incisions with increased precision. AI and ML can also help hospitals better analyze and learn from large sets of data to better predict outcomes and trends. New technologies can attract new patients as they show the hospital is at the forefront of design and innovation. We have already seen how much technology can be used to bolster in-person health care during the COVID-19 pandemic, as many surgical consults moved online. It is not hard to imagine how much more technology can move us forward in the movement to increase patient access and care.

These advances do not come without risks as well as legal and ethical concerns. No hospital is without concerns about cyber security, and digital surgery is no exception. Many tools such as surgical robots, require connectivity in order to work. In the world of ever-increasing cyber-attacks, the technology used in the operating room (OR) could put patients at increased risk for a targeted cyber-attack. Hospital staff may hesitate to use new technologies, as they fear losing their job to automation. The high costs of these solutions can further health disparities amongst hospitals, as public funded hospitals may not be able to afford the same solutions as better-funded, private ones. In addition, little research has been done on ethical concerns regarding digital surgery.

Overall, it seems that digital surgery is here to stay like other technological advancements. What can you do in your hospital to ensure that these technologies are successful and that you address any concerns? First, it is vital for more research to be put into this area, as it is important to understand the ethical impact on digital surgery and digital health as a whole as we continue to adapt to an increasingly digital age. Hospitals can create a digital health governance team to determine which technology will work best for their hospital and thoroughly evaluate all risks and benefits. When rolling out new surgical technology, less can be more. Hospitals should focus on where they can have the most impact and not try to make too many changes simultaneously to overwhelm an already stretched workforce. As hospitals begin to see the benefits of the surgical technology they have started to use, their concerns around automation and using new technology may be eased. Hospitals can also invest in cybersecurity to ensure minimal risks of cyberattacks. Many hospitals tend to be behind in terms of readiness for digital advances by having outdated data infrastructure. Investing in infrastructure improvements is necessary not only to enable digital surgery and other digital health initiatives, but to reduce cost and waste throughout the hospital system. Hospitals should lean into the unknown as well. While there are many clear benefits to digital surgery, there is still a need for more research and much of that can be learned. Hospital systems can set themselves up to be leaders in innovation in this area by continuing to find new ways to both use and measure the success of digital surgery tools and in developing new research. Providers can adopt new ways to talk about AI and other digital surgery tools with their patients to help ease any concerns. It is exciting to think about what the future holds for digital surgery and healthcare innovation as a whole- we are just beginning!