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A transformative shift is occurring in orthopedic operating rooms. While some orthopedic surgeons once considered AI-assisted surgical navigation tools to be superfluous, an increasing number of orthopedic surgeries are being made easier, safer and less expensive due to enabling technology.
Based in Seattle, Washington, the medical technology company Proprio is developing what it calls a “new way of seeing” with its proprietary platform, a highly sophisticated surgical navigation system that combines artificial intelligence, computer vision, augmented reality, virtual reality and robotics. Neurosurgeon Samuel Browd, M.D., Ph.D., is the company’s co-founder and Chief Medical Officer.
We spoke with Dr. Browd about artificial intelligence in orthopedics. Specifically, we asked about the newfound importance of AI within the interoperative orthopedic space, how his company is leveraging the technology to create better outcomes for patients and improve the lives of surgeons, and what the future may hold for the orthopedic industry’s relationship with AI.
Why is AI needed in the orthopedic O.R.?
Dr. Browd: The application of artificial intelligence in a clinical setting creates an increased capability to amalgamate highly complex, multidimensional variables, or understand sequences of events or patient characteristics.
Data is everywhere inside the operating room, but has been severely underutilized. We have a huge opportunity to capture it in an intentional way, segment it into strategically informed action and ultimately, improve patient outcomes through enhanced surgical insight, performance and feedback.
What are the primary ways you see AI being used in the O.R. of the future?
Dr. Browd: We’ve relied on other static modalities, including the MRI and CT scan, for decades, and while more recent technological developments have gotten us closer to imaging advancements, we still have quite a distance to go.
These modalities have served us well, but they don’t get us closer to collecting the high-quality varieties of data that we will need to apply to artificial intelligence for more sophisticated, real-time modalities.
We should be looking to develop intelligent, intuitive imaging technologies that collect clean, informative datasets that we can utilize to fuel truly effective AI. While much conversation has centered on AI within surgical robotics, the conversation needs to be steered toward data enabling human performance first.
Enabling AI through comprehensive data strategy creates increased opportunities for healthier data collection, processing and assessment, which in turn can provide surgeons with enhanced opportunities to learn from their procedures, share their insights with their peers (and the next generation), and provide opportunities for increased evaluation and optimization. If AI-enabled technologies allow us to see the surgical scene and collect information in new ways, we have an opportunity to perform — and learn — surgery like never before.
With the increasingly disparaging surgeon shortage (and the even more drastic shortage of specialty surgeons), being able to democratize our knowledge, develop timely insights and create pathways for increased learning and understanding is absolutely critical if we want to remain optimistic in delivering high-quality care for the next generation.
What are the top hurdles for AI adoption by industry, surgeons and hospitals?
Dr. Browd: In order for AI to be widely adopted by the healthcare industry as a whole, we must first focus on interoperability and data sharing. The healthcare industry has seen significant progress when it comes to information sharing with interoperability in mind, but there is still work to be done.
Rather than focusing on the exchange of information between healthcare providers, we must also pay attention to the ways in which the information is shared, such as data management and cleaning.
In my daily work as a surgeon, it has become apparent what medical providers need and want in their daily work. There is a pressing need for expanding and unifying the data collection process, and everyone — from surgeons to hospitals to payors to patients — could all benefit from a more streamlined, intuitive, strategic approach.
There are clear ways to account for patient privacy but bring to light meaningful and important data that can be used to drive our field forward, ensure the highest quality and significantly reduce costs.
We’ve heard a lot of excitement about AI and AR — enabling technology in general — from some orthopedic companies and surgeons. Orthopedics and spine are notorious for the slow adoption of technologies, though. Where do you think AI technology will be five years from now? Ten years from now?
Dr. Browd: New, emerging technologies have advanced spine surgery in a variety of ways, but none of them are collecting significant volumes of data in an intentional way that will enable us to provide more personalized care and develop new technologies.
The next five to 10 years will see a full transformation of the operating room, moving from a largely analog and radiologically based set of imaging modalities to compelling new technologies that take advantage of the hyper-fast progress we are seeing in computational fields outside of medicine.
The ability to see better, navigate the surgical scene with precision, and amass and analyze troves of data will transform how surgery is performed, taught, documented, assessed and billed. Most importantly, patient outcomes will improve.
To speak to your technology specifically, what challenges is Proprio seeking to solve?
Dr. Browd: Proprio’s goal is to dramatically improve clinical and economic outcomes by unlocking both the ability to capture advanced data and the potential of that data to inform more predictive and prescriptive intelligence in surgery. With our technology, surgeons will no longer need to rely on a mix of legacy tools, including microscopes, loupes, monitors and radiological imagery, that all pull attention away from the patient while reducing accuracy.
Proprio is developing a sensing and imaging platform for collecting and leveraging data collected during surgery. The proprietary technology allows the company to analyze data from images captured pre-, intra- and post-surgery.
How does the technology work?
Dr. Browd: Using advancements in light field, computer vision and other emerging, intelligent technologies, the Proprio Paradigm system synthesizes views from multiple inputs for navigating anatomy and surgical environments in 3D. Using light field imaging technology, we can capture high-definition intraoperative images to fuse with preoperative scans, applying emerging technology, like computer vision and machine learning, to unlock the data’s greatest potential so the surgeon can see more, do more and achieve more without interruption.
How is it different from other technology on the market today?
Dr. Browd: Proprio is developing the most complete, multimodal, sensing and imaging platform for collecting and leveraging data collected during surgery. Our proprietary technology allows us to analyze data from images captured pre-, intra- and post-surgery.
Providing the surgeon with next-generation navigational technologies, situational awareness and clinical/surgical decision support augments the surgeon’s native capabilities and amplifies their knowledge base during a surgery.
Proprio is designed to make the good surgeon great and the best better. Our system will help guide the spinal surgeon in real-time by providing continuous feedback to obtain the idealized global spinal alignment — the holy grail for spine surgery and an example of precision/personalized surgery.
What is Proprio’s clinical and regulatory timeline?
Dr. Browd: 2022 continues to be a milestone year for Proprio, and we can’t wait for the year’s second half to unfold. We anticipate submitting our product to FDA for approval before the end of this year.
