Technology drives vascular future

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Decades ago, “picture” phones were an idea straight out of science fiction. As the saying goes, the future is now. FaceTime and Skype are common; similar technology permits doctors to visit patients via telemedicine.

In other health technological advancements, “wearables” track steps, heart rates and more. Scientists mull over artificial intelligence. A Society for Vascular Surgery (SVS)-branded app is being developed for those overseeing Supervised Exercise Therapy (SET) for patients with peripheral arterial disease (PAD).

An educational session at the Vascular Annual Meeting (VAM) is set to cover such digital health advancements. Entitled “Digital health advancements in vascular surgery,” Judith Lin, MD, chair of the SVS Health Information Technology Task Force, and Donald Baril, MD, SVS Program Committee member, will co-moderate the session and panel discussion, set for 4:30 to 6 p.m. Wednesday, June 17.

Edward Brown, MD, founder and CEO of the Ontario Telemedicine Network, will present “Virtual care: The front door to patient-centered care.” The network has conducted more than 1 million virtual visits with 353,000 patients in Canada.

Although telemedicine is focused on primary care, it may be performed in all medical and surgical specialties. Brown is an emergency room physician and a past president of the American Telemedicine Association. Thus far, the surgical field has not embraced telemedicine as widely as have other healthcare providers, she said. With more than 200 virtual care visits of her own completed, Lin knows telemedicine works.

“You can engage patients, see patients virtually, have face-to-face conversations,” she said. With certain platforms, both patient and surgeon can view the imaging simultaneously, allowing the surgeon to point out various areas of concern—such as a blood clot or aneurysm—on ultrasound or computerized tomography (CT) scans.

Telemedicine could permit surgeons to expand their practices and offer second opinions to patients even in other states, she said. Qualified physicians can see patients in multiple states through the Interstate Medical Licensure Compact, depending on a particular state’s telemedicine laws and participation in the consortium. “The ramifications are enormous,” said Lin. “Ultimately, it’s going to help the patients. They don’t have to drive or travel far.”

Other topics for the session include using mobile device apps in vascular care; translating tracked activity into outcomes, interventions and surveillance for PAD; using artificial intelligence (AI) to risk-stratify vascular patients.

Apps and wearables are already part of the present. The SVS SET app is expected to be available by June and will be featured at the session.

Surgeons may be able to manage care with help from point-of-care and portable ultrasounds, such as devices that connect to mobile phones and permit specialists to view imaging. “Physicians can see what therapy might be needed” said Lin.

“We have a lot of data. But can we leverage AI to predict those patients at higher risk of re-intervention after endovascular aneurysm repair? Could AI assess normal versus abnormal structures on a CT scan or ultrasound study? Using patient risk factors, can AI predict which patients are more likely to develop limb loss from PAD? Can AI evaluate physicians for appropriate use in peripheral vascular intervention and venous ablation? There are lots of possibilities.”

Lin pointed to the anticipated vascular surgeon shortages of the future. “Physicians are spread too thin. We need to leverage digital health technology to take better care of our patients and improve wellness among physicians.”

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