Dr. Glenn Harper, chief of surgery for Ascension Seton Williamson in Round Rock, is no stranger to complex surgical procedures. As a neurosurgeon, his work demands precision.
A new piece of technology—the Medtronic O-arm—introduced at the hospital just months ago increases the safety margin for patients, Harper said. By creating three-dimensional images of a patient’s spine during the surgical procedure, the technology provides an extra layer of visualization to guide his work.
“It’s incredible,” Harper said. “The technology has precision you wouldn’t believe.”
The Medtronic O-arm is just one example of high-tech health care in Round Rock and Pflugerville hospitals. Leveraging technology can enable physicians to be more efficient in the way they deliver care, said Aaron Miri, chief information officer with Dell Medical School.
“Medicine has come a very long way with technology,” Miri said. “But a piece of tech alone is not going to solve the world’s problems. When it comes to health care, what will solve problems is making a patient better fast and making the clinician smarter and more efficient.”
Dr. Eric Acheson, a general surgeon who focuses on bariatrics—intestines, colons, gallbladders and the like—completed his 1,000th robotically led procedure this year. Acheson said he was the first surgeon in Williamson County and the second in Central Texas to reach this milestone.
“Initially, I adopted [robotically led procedures] case by case,” Acheson said. “Now that I really understand how to fine-tune it, I haven’t seen many cases where I can do a better job without the technology.”
The robot—a da Vinci Xi—is in such high demand by surgeons at Ascension Seton Williamson that the hospital will add a second machine to its operating rooms in July.
But the enthusiasm for robotics has not always been the case for general surgery, Acheson said. The discipline was one of the late adopters of robotic technology in the medical field.
“Initially, there was some pushback,” he said. “But as more surgeons use robotics, they’re finding that it helps. We can do surgeries cleaner and more efficiently. That’s why you’re seeing it take off across the country.”
To conduct a surgical procedure with the da Vinci Xi, Acheson sits across the room from the patient and peers into two high-powered cameras that present a three-dimensional image. He controls the robot—which has surgical instruments attached to four arms hovering above the patient—with a series of buttons and foot pedals.
Among the benefits, using a robot allows him enhanced visualization and greater control, Acheson said. Quicker recovery time and less pain for his patients is another gain.
He described a case of a 16-year-old boy who had been involved in an accident, resulting in a perforated intestine. A typical response to this would involve a large incision, an exploratory procedure called a laparotomy, with a long hospital stay and a severe restriction on activity level afterward, Acheson said.
However, with the use of robotics, Acheson was able to explore and repair the injury with a few small incisions, sending his patient home the following day cleared to play football as soon as he felt up to it.
“That made a big difference for him, compared to what’s standard across the country,” Acheson said.
Ushering in intensive care
In preparation to launch an intensive care unit this summer, Baylor Scott & White Medical Center Pflugerville will debut its first robot. The RP-VITA will connect via video doctors who specialize in intensive care with patients at the Pflugerville hospital.
“This robot is going to give the city of Pflugerville and the surrounding area access to intensive care,” said Amy Wilkins, director of nursing for Baylor Scott & White Medical Center Pflugerville. “With the touch of a button, we’ll have an intensivist at a patient’s bedside.”
The robot is equipped with a powerful camera lens to assess pupil size and auditory features to evaluate lungs. The intensive care doctor will control the robot remotely, taking measurements as needed to evaluate a patient.
“The biggest piece for the patient is a fast outcome,” Wilkins said. “I don’t have to call a doctor and then wait for the doctor to call me back.”
With buzzwords such as“robots” and “artificial intelligence,” images from science fiction movies are easy to envision. However, the RP-VITA robot amplifies resources and connects people, rather than replacing the need for doctors, nurses and other staff, Wilkins said.
“Technology is not here to replace humans,” Miri said. “I’m a firm believer that technology is a tool, never a replacement.”
Every inpatient bed at Baylor Scott & White Medical Center Pflugerville is equipped with sensors. Designed to detect potential falls, the beds alert nurses on a smart phone if a patient moves in a precarious way. Simultaneously, an alarm is activated inside the room and in the hallway above the patient’s door. The bed speaks to the patient in one of four languages—English, Spanish, French or Arabic—to tell them that help is on the way.
“Falls are very important to keep track of,” Miri said. “Not only are they costly, but more importantly they lead to very bad outcomes for patients. If a patient is elderly or ill, they can break bones or damage internal organs. It’s a major issue for quality, not to mention cost.”
Baylor Scott & White Medical Center Pflugerville has had zero falls with injury to date. The Pflugerville facility is leading the way for Baylor Scott & White as the first within the health care system to utilize the sensor beds, Wilkins said.
“It’s our job to keep our patient safe,” Wilkins said. “If I can keep even one patient from falling, the bed has paid for itself.”
Falls cost millions of dollars to facilities every year. If patients are injured in a fall, their hospital stay is often prolonged by an average of six days, according to the National Institutes of Health.
“If a patient falls in your facility, that is going to cost you a lot of money, because you’re looking at increased time that they need to get better,” Wilkins said.
While not as flashy as robots and talking beds, Miri said one of the most useful changes in the medical field over the past decade is advances in health information technology.
Nationwide, the majority of health service systems have made the switch from paper records to electronic records, Miri said.
“Now that a patient’s records are electronic, we have all this data,” he said. “The question becomes, ‘How do we use the data to take care of a patient in a pragmatic and wholistic way?’”
New tools are emerging for patient communication. Local health care systems are leveraging everything from smart phone apps to interactive medical records.
Baylor Scott & White Medical Center Pflugerville is home to the health system’s largest implementation of touch screen displays to date. The screens display a variety of data from a patient’s electronic health record—including lab results, medications, vital signs, appointment reminders, immunizations, annual screenings and allergies. During a clinic visit, a physician and a patient can view the materials on the screen together.
“So much of the time, health care is an auditory exchange of information,” Wilkins said. “A doctor or nurse orally relays information to the patient. This interactive technology incorporates a visual element to help patients understand their condition.”
Systemwide, Baylor Scott & White also utilizes an app where patients can schedule an appointment, message a provider, check their account balances and more. This type of technology—embraced by a growing number of health care systems—can provide an ongoing conversation between patient and provider, Wilkins said.
Remote patient monitoring
Ascension Seton Williamson offers a suite of services called remote patient monitoring. This technology is designed for patients who are cleared to leave the hospital but have a chronic disease—such as congestive heart failure or diabetes—and therefore need additional support to manage their conditions at home.
“This is a bridge to safely transition from hospital to home,” said Dr. James Geracci, chief medical officer at Ascension Seton Williamson.
Remote patient monitoring connects patients with nurses who can message, call or video call the patient.
“This allows us to intervene when necessary and also to keep our patients safe,” Geracci said.
Remote monitoring is designed to help decrease the number of readmissions to Ascension Seton Williamson, Geracci said.
“There’s a huge cost—both to the patient and the system—for readmission to the hospital,” he said.
In April, the hospital referred over 180 patients to the program. Data is still being collected on the patients; however, Geracci said he is confident the technology will prove to decrease readmissions to the hospital.
“That’s a great use of technology, not just for technology’s sake, but truly patient-centered technology that makes health care better and more satisfying for patients,” Geracci said.