The Hoag Orthopedic Institute Surgery Center Beverly Hills (Calif.) recently became the first facility in the Hoag network to add a robot dedicated to spinal surgery.
Alexandre Rasouli, MD, an orthopedic surgeon at Irvine, Calif.-based Hoag's Beverly Hills location and founder of Rasouli Spine, shared with Becker's what role new technology, including robotics and virtual reality, will play in the future of patient care.
Question: Hoag recently acquired its first spine-specific robot. How is this poised to improve patient care?
Dr. Alexandre Rasouli: We see image guidance and robot technology in particular as a stepwise implementation for what we think is next-level tech for spinal surgery. The overall aim is to make surgeries more efficient, and incur less costs, surgical time and blood loss, all in the name of making spine surgery amenable to a same-day/in-and-out-type format where patients can recover at home, recover quickly and return to work within days instead of months. Our aim is to make spine surgery a rapid recovery surgical endeavor. No one wants surgery, but if they have to have surgery, they want to be done with it. They want a quality surgery with enduring results that allows them to get back to work as quickly as possible. If you have tech like a robot that can help to do the surgery in a less invasive way, it's going to be a value add and a good way to make surgery rapid recovery. We are also proud to be able to have the tech available in a surgery center setting, which means we can apply that to our aim of doing more outpatient surgeries and we don't have to hospitalize patients.
Q: What other industry trends are you keeping an eye on right now?
AR: We are excited about and developing motion-sparing tech, which has been on the tips of people's tongues for a decade and a half. Our patients are savvy, and they don't want to have fusions. We agree with them. Fusions have a limited indication anymore and that's for deformed or unstable spines. For the vast majority of patients that come in with either lumbar or cervical, it's either a small procedure or a disc replacement. Disc replacement is becoming more and more accepted and more and more practiced. They are more enduring and durable and more accepted.
Q: Does Hoag have plans to acquire additional robots in the near future?
AR: The next iteration of robotic tech, which today relies on a large footprint, a large screen, a robotic arm, is going to be the implementation of augmented reality or virtual reality. A lot of visual technology is going to be mounted in front of the surgeon's eyes with goggles, so the surgeon need only look at the patient and see the outline of where they need to go instead of constantly looking at a big screen. The next generation of capital investment will be in VR and AR. This new tech will take a surgery that's fraught with radiation, and a surgery that would take an hour, and reduce it to 15 minutes. Not that it'll be rushed, but it'll be done much more accurately in much less time.
Q: What are some of your personal care goals for the next year?
AR: My goal has been, for a few years now, to concentrate more on my patients and less on the bureaucratic, administrative and regulatory parts of being a physician in the 21st century in the U.S. I think one of the biggest negative aspects of having the privilege of being a practitioner in the U.S. these days is the ever-increasing amount of non-patient-related matters. My personal goal is to figure out ways to be more efficient, more involved, reduce clerical and regulatory demand placed on us and concentrate more on patients. That's true for many practitioners, whether you have a private practice, work in a hospital, or have any involvement in healthcare.
Q: What are some ways you are working to combat administrative burden?
AR: There are small things we can do, and technology has helped a lot. These days you can dictate into an iPad and have robust clinical notes. Prepared imaging can be completely digitized, we can communicate with patients in ways we haven't before. Bigger challenges remain regulatory; getting payers and practitioners aligned with what's most appropriate. Trying to save the system money, trying to offer alternatives to hospital settings, hospitals are well funded and they often do not want patients moving to ambulatory settings. If we partner with these entities, we can make what are today's obstacles tomorrow's solutions if we can work together to make the system more enhanced instead of disjointed.