A central component of the telemedicine practice at Boston Children’s Hospital is its TIMS Consultant system – a platform for real-time video and audio collaboration during surgeries and diagnostic procedures. Using TIMS Consultant, cardiac surgeons in operating theaters at BCH wear advanced head cameras with ancillary lamps to capture/share a live feed of high-resolution video (with limited lag time) of the patient’s chest cavity.

As only a limited number of people can fit into an Operating Room – streamed video via the TIMS Consultant platform is then securely shared directly from the operating table to others in remote locations including:
  • Offices of other BCH colleagues/cardiac specialists
  • Remote advisors (including cardiac surgeons at other children’s’ hospitals)

This advanced video and audio system creates a helpful communications connection commonly known as “Telementoring” which allows the local surgeon to be mentored by a more expert surgeon (located anywhere in the world).

For optimum patient outcomes, TIMS Consultant also supports “Telestration”- a technique that allows a remote surgeon to use an electronic drawing tablet (e.g. computer screen or iPad) to make illustrative marks on the local surgeon’s video monitor. Thus, both local and remote surgeons share the same view through telestration: helping participants highlight anatomical anomalies, or pinpoint where to make an incision.

Additionally, video and audio from surgical sessions can be recorded and played back immediately, or at another time for these purposes:
  • Compliance and documentation
  • Program sharing at medical conferences
  • Distribution to medical school students for distance learning and on-demand curricula

Through its affiliation with Harvard Medical School, the Boston Children’s telehealth system is also being used to enable Residents and Fellows to create 3D models of heart images incorporating CT and MRI scans. Surgeons have found that advanced imaging systems working in concert with robotic arms, wrists, and other precision instruments, along with haptic feedback technologies (for a crucial sense of touch), enable complex extracardiac and intracardiac procedures to be performed. “Novel Surgical Approaches” like robotics and enhanced visualization practiced at BCH were out as 1-of-5 “high priority recommendations” in a 2005 report from the National Heart, Lung, and Blood Institute’s (NHLBI) Working Group on Future Directions in Cardiac Surgery.

Telesurgery—Enlightening a Brighter Future for Medicine

As demonstrated in the use cases at both Kaiser Permanente and Boston Children’s Hospital, the practice of telesurgery yields numerous and significant benefits for multiple parties in the surgical experience (hospitals, surgeons, patients and families). Here’s a list of 12 of thosebenefits...

12 Benefits of Telesurgery for Hospitals: By eliminating barriers caused by time and place, Telesurgery improves access to medical expertise and delivers these twelve benefits:
    1. Enables surgeons located in different facilities to engage and collaborate in real time
    2. Facilitates just-in-time telementoring between one or more experts during technically challenging procedures
    3. Allows high-definition live medical video to be shared simultaneously with multiple medical professionals
    4. Video supports the roll-out of new procedures by broadcasting an expert performing and narrating the new procedure to colleagues based in different locations (within a healthcare provider’s network of care centers).
    5. Through telementoring: accelerates learning for medical students in training, and in assisting and training new surgeons (seeing is believing)
    6. Residents and fellows can experience many more live clinical encounters than they would via typical legacy programs (which limit access)
    7. Better patient outcomes through access to superior surgical teams; minimization of medical errors, complications, tissue injury, and post-op trauma
    8. Reduces need for long-distance travel (for both patients and physicians), along with travel-associated costs and potential dangers (e.g. delays)
    9. Connects hospitals in underserved rural communities with more experienced medical specialists in well-equipped hospitals in urban locations
  10. Minimizes medical professionals’ exposure to radiation and viruses via remote participation
  11. Cost of Care reductions through new operational efficiencies and faster patient discharges
  12. Video recording provides documentation and compliance to protect against malpractice risks and fraud
 

NOTE: The dozen examples itemized above do not represent a comprehensive list of value delivered to hospitals through the use of telesurgery.
We’d be interested in hearing from others on YOUR personal experiences.

Let us know: What additional benefits of telesurgery have YOU seen?