Town hospitals embrace healthcare technology

Banner MD Anderson Hospital
The fear of facing a machine in radiology is reduced when patients have first seen the procedure through virtual reality at Banner MD Anderson Hospital. Tom Blodgett/Community Impact Newspaper

The fear of facing a machine in radiology is reduced when patients have first seen the procedure through virtual reality at Banner MD Anderson Hospital. Tom Blodgett/Community Impact Newspaper

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Using virtual reality, patients can experience their treatment in 3D before they actually undergo radiation. (Courtesy Banner Health)
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(Source: Banner Health/Community Impact Newspaper)
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A chat bot helps patients stay informed about where they stand in the treatment process at Banner Gateway Medical Center's Emergency Department. (Courtesy Banner Health)
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(Source: Banner Health/Community Impact Newspaper)
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Surgery with a DaVinci robot can take longer but is more precise with better outcomes, according to Dr. Yagnesh Patel, Mercy Gilbert Medical Center's medical affairs vice president. (Courtesy Dignity Health)
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A laparoscope is an instrument that uses fiber optics that can be inserted through the abdominal wall to view organs and permit surgery. Its advantages include less cutting, faster surgery, short hospitalization and quick recovery. (Courtesy Y. Olena/Adobe Stock)
Lamont Yoder, CEO of Banner Gateway and Banner MD Anderson, sees an advantage to his hospitals being in a technologically advanced community like Gilbert: It makes the hospitals a cultural match.

This has encouraged the two Banner hospitals to embrace emerging technologies in the field.

“Gateway has always been known as the first one of the facilities to put our hands up and say, ‘Hey, we’d like to try that here,’” said Yoder, who jokes new projects at the hospitals are always on a six-week or six-month time frame. “New technology, new ways of doing things that are more efficient, that are aimed at what consumers want in health care ... We’ve always been the ones to want to innovate in that space.”

Be it the two Banner facilities or at Dignity Health’s Mercy Gilbert Medical Center, technology greatly impacts care, as exemplified by developments from the past two years, or even the past six months.

Employing virtual reality

The term “virtual reality” can conjure images of teenagers experiencing the highest level of gaming or of the military training its soldiers.

But over the past six months, Banner MD Anderson has been using virtual reality to help cancer patients face their fears before undergoing treatment. Patients have the opportunity to use the VR equipment to see what they will be going through during the treatment.

This represents a sharp difference from educating patients through talking to them and handing them a pamphlet when they are feeling fearful, Yoder said.

“[Traditional patient education] is much different than, ‘Come on in. Sit here. Put these glasses on, and with us, let's walk through together and see what this experience is going to be like,’“ Yoder said. “So our patients have been able to live that before they go through it.”

That communication is important when the experience can be complicated, intrusive and confusing, such as with radiation oncology, Yoder said.

With radiation, Yoder said, “some people get strapped in, if it's a head tumor, around their neck and their head. Other people are strapped in in a weird position, and sometimes, it can be for a little bit more time than feels comfortable. The tables tilt, this big machine is moving and flying around you, and it feels like it's coming close to your body. And it's fearful because it’s a cancer diagnosis.”

That is where the 3D virtual reality simulation software comes in. The VR experience is constructed based on the patient’s tumor type and location.

The VR program was originally used for staff education, but Banner Radiation Oncology Regional Director Dr. Amir Sadeghi saw the chance to alter it for use with patients. He assembled a team to do so.

“My passion is for patient education,” Sadeghi said. “They truly understand what we're doing, and it puts their mind at ease a little bit because they're already going through a lot of hardship."
Radiation oncology will not be the only place VR is employed, Yoder said. Banner Gateway is piloting a program for new mothers learning how to breastfeed their babies.



Informing emergency department patients

While some hospitals have used websites or even billboards to show current wait times at their emergency departments, Banner Gateway is taking it a step further in helping people in the waiting room know the answer to, “How long is it going to be?”

Banner developed the Emergency Department Chat Bot with LifeLink, a company outside the health care industry. It addresses what Yoder said is the biggest pain point in visiting the ED: waiting while in need of care.

“What it is doing has been just remarkable, with people that come to the ED and say, ‘I have never experienced anything like this in my life in health care,’ “ Yoder said. “Everyone's used to going, like, ‘Don't go to the ED unless you have to. Now, I'm going to sit here and wait.’ It helps keep them informed.”

But this new service for patients extends beyond just when they should expect to be seen or if there has been a delay.
The chat bot, which works similarly to customer service bots on many websites, can engage with and educate a patient about what will happen next, how long it will be before their test results come back—or even what those test results are before the doctor returns, Yoder said.



Adding precision to surgery

Television has given people a common image of a surgeon working huddled over a patient, with his or her team and the doctor all surrounding the table. Today, however, some doctors may be across the room from the patient while at work.

Those doctors would be at a console, remotely operating a robot that is doing the actual cutting and maneuvering in the patient.

One area where this remote surgery is extensively employed at Mercy Gilbert Medical Center is in gynecological oncology, said Dr. Yagnesh Patel, Mercy Gilbert's vice president of medical affairs.

Surgery using the robot is more efficient and effective, promoting faster recovery, Patel said. That makes it popular in gynecology and urology, though robotic surgery can take longer than conventional surgery.
Such procedures also require surgical robots to have special tools.

“[The robots] have elbows and wrists to it, so you have a better ability to manipulate tissue, and you can move things around. You can actually make smaller incisions. You can dissect or cut through layers of tissues so much better and easier. When we say robotic surgery, the surgeon is driving the instrument, but he or she has the ability to move things in a much more manipulative way.”

This is advantageous when it comes to working in the pelvic area for a woman who has cervical or ovarian cancer, for example, Patel said.
“Cancer is a disease that where you have abnormal tissue that grows into normal tissue, and defining the lines between abnormal tissue and normal tissue is somewhat difficult,” Patel said. “You have to be very careful around the blood vessels, around the nerves, around other organs. You want to get that whole cancer out without damaging the bladder or the nerves from the spine. You can do that more effectively using the robot.”



Addressing weight loss

The American College of Surgeons certified Mercy Gilbert on Nov. 30, 2018 as a “Center of Excellence” in bariatric surgery, which is weight-loss surgery.

In years past, a bariatric procedure, such as a gastric bypass, might have meant the patient would be recovering in the hospital for two or three days, depending on the procedure.

At Mercy Gilbert, however, the use of laparoscopy in bariatrics has improved recovery times. A laparoscope is a fiber-optic instrument with a small camera and light which allows the surgeon to see, through much smaller cuts than in traditional surgery, what is going on inside a patient's body cavity.

“You don't have big incisions,” Patel said. “It's a tiny incision through which surgery is done, and the turnaround time on this—it's very, very quick. People are up and walking almost immediately after surgery. You start them off on some liquid, and If they [are] tolerating that very well, they can go home. Most of our bariatric patients go home the very next day.”

Surgeons first used laparoscopy with gall bladders and gynecology. It is one form of what surgeons call minimally invasive surgery, Patel said.

“The idea of doing surgery minimally invasive is the trend in surgery,” Patel said. “Nobody wants to make big incisions that go through various planes of tissues and open everything up. It’s so much better if surgery goes to [a] small incision and you actually get to what you can from behind.”
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