This is part two of MobiHealthNews’ two-part series that highlights the evolution of innovations that changed healthcare over the past several decades.
Keeping patients safe is a top priority for hospitals and health systems. According to The Leapfrog Group, a watchdog organization, medication errors are the most common mistakes in hospitals, contributing to nearly 7,000 deaths annually.
In part two of MobiHealthNews‘ series on innovations that changed healthcare, we examine how automated dispensing cabinets streamline the medication delivery process and reduce medication errors.
We also explore how robotic surgery leads to faster patient recovery times, how AI tools help radiologists analyze images with greater accuracy and efficiency, and how smart screens keep patients and their families engaged and informed about their care.
Automated dispensing cabinets
Dispensing cabinets, medication carousels and medication dispensing robots have been around since the 1980s and began as medication pill counters in the retail setting, according to Scott Anderson, director of member relations for the section of pharmacy informatics and technology at the American Society of Health System Pharmacists (ASHP).
In the hospital setting, pharmacists use automated dispensing cabinets to track inventory and ensure drugs are where they need to be for the patient and for nurses to administer them – not in the pharmacy but on the patient floor.
“Those machines helped streamline that compared to just having a cart fill sitting in a patient’s room,” said Anderson. “We were able to add some technology to it. I think where we have really seen dispensing cabinets become important is the medication safety part of it.
“Instead of just having a code cart with any medication – it could be in the wrong spot so you could grab it by accident – having it come out specifically for what you are asking it for adds an element of safety to it,” said Anderson.
Anderson said efficiency has significantly increased since the advent of automated dispensing cabinets compared to the pharmacists’ manual cart fill checking process.
“It allows us to do more clinical review and more patient interaction. That is where we really see the value,” said Anderson.
“That time efficiency and being able to shift our service is where the dispensing cabinets really have had a benefit.”
Robotic surgery
Conceptually, robots have been around since the 1980s and were first used in the military. However, widespread use of robots began in the early 2000s.
According to the American College of Surgeons (ACS), the overall use of robotic surgery has grown significantly over the past 25 years.
A study published in JAMA Network revealed that robotic surgery increased from 1.8% in 2012 to 15.1% in 2018. Additionally, the use of robots with specific procedures increased even more over that same period. For example, the use of robotic surgery for inguinal hernia repair grew 41-fold, from 0.7% to 28.8%.
Early on, robotic surgery was frequently used in urologic and gynecologic surgical procedures.
Now it is being used even more in various fields, including cardiology and orthopedics.
Dr. Ross Goldberg, a general surgeon based in Miami, defines robots used in surgery as three-dimensional video platforms with multiple operative arms to enhance minimally invasive surgery.
“Robotic surgery is on the spectrum of minimally invasive surgery. It does things that humans cannot. For example, [robots] can do things that the human wrist cannot do. Robotic surgery has enhanced what we can do laparoscopically and allows the surgeon to work in a field in a much tighter area,” Goldberg told MobiHealthNews.
Goldberg said a robot in the surgical suite also functions as a big computer; it records all the data and provides the surgeon with information. For example, it knows how many instruments were used, how many times and how long. It also knows the movements a surgeon makes.
Because surgery can be taxing on a surgeon’s body, robotic procedures can make it easier for a surgeon to sit at a console. According to Goldberg, this could potentially extend a surgeon’s career.
“In the appropriate cases, minimally invasive surgery has shown that there are smaller incisions. We are able to get patients up and around quicker, out of the hospital faster, and recovery is faster. From the patient’s perspective, there is improvement in quality of life and enhanced recovery,” Goldberg said.
AI in radiology
Artificial intelligence is becoming more pervasive in healthcare, and nowhere is its presence more evident than in radiology.
Dr. Bernardo Bizzo, associate chief science officer at the American College of Radiology (ACR) Data Science Institute, says that since 2016, there has been an increase in AI tools used both inside scanning devices, such as CT, ultrasound, MRI and X-ray machines, and as standalone software solutions.
“When you look at how AI is being used in healthcare, specifically when talking about software as a medical device, radiology is definitely at the head of the pack,” Bizzo told MobiHealthNews.
According to Bizzo, based on data from the ACR AI Central database, about 60% of regulated AI tools available in the U.S. are imaging processing tools for tasks such as improving the quality of images, assessing anatomical structures like the brain or the heart, and assessing breast density on a mammogram.
AI is also used for computer-aided triage functions. These AI tools help prioritize and notify the physician about urgent findings on imaging exams, such as detecting strokes or pneumothorax.
“Studies show that AI tools can help radiologists analyze images with greater accuracy and more efficiently on very specific, narrow tasks,” Bizzo said.
For example, suppose you detect and measure lung nodules or identify urgent brain findings, such as a stroke on a CT scan. In these cases, AI can potentially detect those findings earlier with greater reliability.
According to Bizzo, AI tools may support early interventions, potentially improving patient outcomes and survival rates in certain conditions.
He said the new wave of generative AI solutions holds significant promise for improving patient care but will require health systems to implement local validation and monitoring processes to ensure these tools perform as intended.
Bizzo stressed that AI-enabled medical devices are not standalone diagnostic tools and require interpretation by an expert.
“A board-certified radiologist must review their results when used for image interpretation,” Bizzo said.
Smart screens
Although smart screens or digital whiteboards are not in every hospital room, they are on track to becoming a standard feature.
The whiteboard started as a way to share information about an individual, the family’s needs, and immediate and pressing care needs that everyone needs to be aware of.
“As technology is continuing to develop, we are seeing this push across the country, especially with new hospitals that are looking to become hospitals of the future,” Oriana Beaudet, vice president of innovation at the American Nurses Enterprise (ANE), an umbrella organization of the American Nurses Association, told MobiHealthNews.
If clinicians have access to “incredible” technology, Beaudet asks why that experience should differ for patients or family members.
“Those new screens and monitors that are in patient rooms are simultaneously being used for communication about a patient’s condition, but also there is a chance for individuals to receive education information, dietary requirements and virtual consultations with a nurse or clinician,” Beaudet said.
While smart screens are necessary for receiving and delivering care, they also serve as an essential interface between technologies.
“The technology has to seamlessly fit into the environment. That is the trend. We have to make sure that we have a seamless deployment of technology and that the technology is integrated and embedded within the environment,” Beaudet said.
According to another report from The Leapfrog Group, hospitalized patients, on average, experience one medication error per day. Although some of these errors may be benign, many can cause significant harm or even death.
The annual Leapfrog Hospital Survey rates how well hospitals use technology to order and administer medication to patients safely.
Two measures included in the survey are computerized physician order entry and barcode medication administration.
Barcode medication administration was found to reduce potential adverse drug events by 50%.
In part one of the series, we examined how barcodes, electronic health records and smart IV pumps made medication administration safer and more efficient.
Over the years, automated dispensing cabinets made it easier for pharmacists to track drug inventory and allow them to conduct clinical reviews and patient interactions, while robotic surgery is expanding into new areas and allowing surgeons to operate more efficiently.
While artificial intelligence is increasingly becoming a part of healthcare, its presence is powerful in radiology.
There is a substantial body of evidence that these technologies, when used properly, are part of an ecosystem that helps reduce medical and medication errors and saves lives.
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