Surgeons are only human, and do sometimes make mistakes. At present, the process of assessment, if and when mistakes are made is mostly reactive, but Dr . Teodor Grantcharov, a Toronto surgeon, hopes to bring the black box technology that is common in aviation into the operating room. His latest development, called the surgery box is expected to change the culture of the operating room, and will help surgeons to improve their process. The results seem to hold much potential, as the cause of any errors during surgery can be noted.
In a specially wired operating room, all data, including conversations and movement is recorded. Patient responses such as blood pressure, heart and respiratory rates are also logged. By capturing all of this data, Dr. Grantcharov hopes that the medical community will become more transparent, while the information can be used for analysis and opportunities to improve procedures. He actually began work on the project a few years ago, after being motivated by the manner in which the technology is used in aviation. Black boxes have become vital in air travel, as flight data is used to determine the cause of accidents, which may sometimes be due to human error. The data is also invaluable in the simulation or reconstruction of accidents, so that they can be prevented. By working in consultation with Air Canada, Grantcharov has piloted a program that began earlier this year, at St Michaels Hospital in Toronto.
The prototype black box is actually blue, and works with minimally invasive laparoscopic surgeries. All conversations in the OR are recorded as is the video feed from cameras that are inserted into the body of the patient. Temperatures are logged as well as all nose levels, and it is hoped that all of the information can be used for study in much the same manner that athletes study film.
Each operation is reviewed by a panel of surgical experts, with an eye towards improving the process. Dr. Grantcharov, who performs about 6 operations each weak, says that reviews must be conducted as soon as possible, as there are restrictions on the length of time for which the recordings can be kept. There are no limits on the length of time for which the analysis is maintained, however, due to concerns of privacy; the recording can only be kept for 30 days.
All parts of the process, including preparatory procedures are recorded, and reviews indicate that minor details can have a big impact on the flows of procedures in the OR. The team is also in negotiations with Google, over the use of Google Glass which can be connected to the black box to facilitate recording and feedback in real time.
The partnerships are also seen to be vital to medical industry, which is also involved in generating big data and physician-turned-entrepreneur, Joshua Liu, who is the founder of medical start-up SeamlessMD, believes that the intersection of data and technology can offer an exceptional opportunity to provide better healthcare services.
The concern for privacy should be addressed by regions, but at this time all recordings are maintained in the black box and not distributed. Dr. Grantcharov’s black box is currently being used in pilot projects in some northeastern U.S states and in Denmark, and it is hoped that the use can be expanded to other countries.