Coronavirus Pandemic: After Effects in the Operating Room
Coronavirus has already changed the face of healthcare. We see operating rooms and surgical procedures adapting in three ways in response: Increased pre-surgical planning, and more video conferencing and remote post-surgical patient engagement.
Covid-19 was first detected in December 2019 in Wuhan, China and has since been declared a worldwide pandemic. The virus and measures to prevent its spread have impacted almost every area of modern life, especially healthcare. The entire industry, most notably healthcare workers, have had to adjust. Surgeons all over the globe have had to develop new protocols, postpone elective surgical procedures, and implement virtual communication with their patients and colleagues.
Will there be a ‘new normal’ for the operating room (O.R.) and the workflows surrounding surgery? How might surgery and operating room roles change in the face of coronavirus after effects? And how can current technologies be adapted and expanded upon in the wake of this pandemic? Here are three ways we anticipate that surgery may change:
Increased preoperative planning
Preoperative planning—using computer software to plan the surgery before it takes place—is already common today in most areas of surgery.
“In the future, there may be a greater push to take advantage of the preoperative phase of surgery, since planning can be done in the office with minimal contact with other clinicians.”
The review of these plans with colleagues, for example at tumor board meetings during which a team of clinicians discusses a patient’s treatment, may now also move online. Secure cloud computing, which is already in use in hospitals and clinics today to discuss cases remotely, may be used to share surgical plans safely even locally.
Infection prevention in surgery is consistently a top concern for O.R. teams. Preoperative planning for non-emergent cases mitigates infection risk and preserves resources. Reviewing preoperative imaging and patient history concurrently is critical to assessing the susceptibility of the patient to infection, the need for intubation, and whether the aftercare pathway can be altered to preserve intensive care unit (ICU) capacity.
Even for cases which might not typically be planned, such as degenerative spine surgery, planning from the safety of the surgeon’s office will likely become common practice in the wake of coronavirus. Intraoperative complications increase O.R. time, strain staffing, and increase infection risk for all involved. Preoperative patient-specific planning can help O.R. staff avoid these pitfalls.
In addition to surgery infection prevention, preoperative planning is a time investment which can increase the efficiency of the procedure itself. With an impending bottleneck of procedures due to elective surgery cancellations, future O.R. efficiency will be more critical than ever. Hospitals will certainly be turning to operating room efficiency best practices.
Video conferencing during surgery
As if out of nowhere came coronavirus and healthcare workers have been struggling to quickly adapt to new protocols and workflows. In some of the most affected regions, surgeons from other disciplines have been pulled into critical care roles or even different hospitals to support.
Changing operating room staff roles and eliminated in-person handover can lead to suboptimal communication in an already tense environment.
“Conferencing infrastructure allows surgeons to look into the operating room and communicate with staff from anywhere within the hospital network or even from their personal PCs and mobile devices.”
This enables experts who may fall within a higher risk bracket to avoid exposing themselves to Covid-19 by checking in on their surgeons remotely. Streaming procedures to teach groups of medical students and residents facilitates the continuation of education even in the face of reduced O.R. attendance.
The benefits of involving expert surgeons from anywhere or streaming procedures to augment medical education has long-term potential that will extend beyond the current pandemic.
Increased remote patient engagement
Physical distancing does not mean reduced patient oversight. Patients still need care, and clinicians are still eager to provide that care however they can. As with most industries today, the medical field has also experienced a shift toward remote communication. One result of the coronavirus pandemic is the embracing of virtual patient engagement. Non-emergency appointments and long-awaited specialists appointments have now moved online whenever possible, creating a new era of virtual healthcare.
As patients and healthcare providers interact remotely, there is potential for real-life accumulation of patient-reported data to track the efficacy of surgeries. With remote patient monitoring, patients will be able to complete questionnaires from the comfort of their homes instead of sitting in sterile waiting rooms. Physicians, too, can engage with their patients post-surgery, increasing knowledge of the effect of treatment on the patient’s quality of life.
“In addition to patient reported outcome data, more forms of digital healthcare communications may be on the horizon to ensure the industry’s preparedness in the future.”
In the spirit of ex malo bonum, Covid-19 has put healthcare front and center. This can be viewed as an opportunity to durably set the focus on patients as beneficiaries of increased preoperative planning, integrated O.R.s, and remote patient-centered outcome reporting.
The good news about these changes that will inevitably come to the operating room is that the technology already exists. With increased usage in response to a new healthcare environment, hospitals, healthcare workers and patients can expect greater efficiency, safety and insights on the horizon.