Technical Challenges in bringing new Technology in

surgery and health diagnosis

With the growth of technology, humans have developed advanced tools
and machines which are very useful in surgery and diagnosis. But, there are
many consequences and challenges that we are facing in bringing new
technology in surgery and health diagnosis which are unavoidable. Bringing
new technology is always challenging to ensure the safety of patients which is
more important and its use in the clinical setting.

While developing new technology, we must require shared responsibility

and a socio-technical approach. Technology should be developed in such a way
that it supports user goals and workflows. We have to ensure that new
technology in surgery and diagnosis must be safe to prevent its horrible
consequences. All technology must be designed in such a way that it can
available for 24x7 when and where it is needed. We have to make sure that
these technologies should be errorless as much as possible and also adopted
by all health centers. This new technology must be work in conjunction with
EHR (Electronic Health Record) to find errors and correct them to make this
technology safer.

 Here are some details about the challenges:

 Challenges in designing and developing new technology:

Sometimes, due to carelessness or mistake of medical staff
patient can get into the trouble. Nowadays, we can see that many times
the patient gets wrong prescriptions of medicine or wrong treatment
because of wrong interpretation of disease or wrong lab reports. We
have to take care about these kinds of errors. To avoid these kinds of
errors we must ensure that this new technology is errorless. In addition,
we need to ensure that doctors have a complete knowledge, experience
to use new technologies and their consequences. To reduce these kind
of errors we have to develop models and methods which are highly
 efficient. Using EHR we can find many error classes automatically.

When we are developing new technologies for diagnosis we may

require to develop apps that run on smartphones or web applications to
collect data that apps must be compatible with the existing system. The
entire process for developing this kind of application should be error-
free. At the least, we have to give some importance to tech components
that are related to surgery and health diagnosis as that of the aerospace,
nuclear, or defense industries because those technologies are using into
a diagnosis of a huge amount of people. Some of the Scandinavian
countries and the United Kingdom, for example, have taken steps
toward developing guidelines and even mandating some processes for
the oversight of health technology. The US Food and Drug
Administration’s recent announcement of a software developer “pre-
certification” program that will certify software developers rather than
individual projects is a step in the right direction that attempts to
balance innovation and safety.

 Challenges during implementation and use

The technology we are implementing should be able to take the

right decision when it is needed and also able to catch errors in the
decision which is already taken by the doctor. Nowadays, Artificial
Intelligence (AI) is being implemented in health diagnosis and also in
 surgery. While implementing it, we must be ensured that it is easy to
use and also has no negative side effects. Because if it generates an
error then patient can lose his/her life and this is not acceptable. It also
should not be complex in use so that doctors can use it correctly.
Nowadays, we have developed systems which can give alerts and
reminders to medical staff. This kind of system requires a response from
the user. Sometimes the medical staff is absent or unaware when the
patient give this kind of alert which can cause trouble to the patient.
When we are developing
Artificial Intelligence (AI) we also have to pay attention to when Artificial
Intelligence has to listen to the humans and when humans have to listen
to Artificial Intelligence. Developers have to pay attention to all of these
kinds of issues.
When we are talking about m-Health which is diagnosis through
mobile, data privacy is also a big concern. Online health applications
store health data along with personal data of patient and it can be stolen
by hackers and misused. And it also violets privacy of patients. So how to
secure and keep data private of patients is also a big challenge for m-
Health.

 Challenges during Evaluation and Monitoring

When we are trying to implement artificial intelligence in surgery
and health diagnosis we have to ensure that we have a rigorous, real-
time system that assesses the safety of that new technology. Today we
do not have any kind of real-time or even close to real-time approach
which can surveillance our technology and give us information about
safety hazards. It is conceptually challenging to take this kind of
measurements. Developers need to work with health experts and
develop a method or tools which can do real-time measurement and
make surveillance more automated and make improvement towards the
safety of the patient.
We are facing many near misses during surgery due to which
patients get into the trouble and even died in worst conditions.
 Nowadays what we see is that because of minor mistakes patients can
get into trouble. Somehow if we can evaluate and monitor this kind of
information then we can get control over this kind of mistakes. But it is
also hard to constantly evaluate and monitor this data manually. It can
be possible only when all health care centers come together to collect
data and evaluate it which seems impossible thing.

 Apart from technological challenges, there are also some other

challenges like weak mind-set of people towards surgery, rare medical
failures, weak economic conditions, a lake of education etc. Nowadays
many medical facilities are unaffordable for general public.

1) Deficiency of infrastructure and manpower

We do not have a sufficient number of doctors and infrastructure in India.

So when someone needs an instant treatment and they do not get proper
treatment then they might get into the trouble. We have many cases in India in
which patient got died because he/she did not get proper treatment in time.
This happens also due to mistakes in surgery.

The deficiency of specialists in rural healthcare is as high as more than

90% in Chhattisgarh, Jharkhand ,and Rajasthan, while being at nearly 86% in
Uttarakhand and Odisha.

The shortage of doctors and medical specialists is due to the inefficiency

of the educational department.

According to WHO (World Health Organization), 57 countries in the

world are facing human resources in a health crisis in which India is on 52nd
rank.

 Here are some examples of the shortage of doctors and medical

specialists.
 The hospital located at Siddharthnagar district in Uttar Pradesh named
"Mahatma Gandhi Smarak district hospital" have only facilities of 100 beds and
there is shortage of doctors due to which patients are pretty much on their
own after 4 p.m. as the only available nurse is kept busy in the labor room and
there is only 5 nurses to provide all the nursing care required at the hospital.

Patient can also get into the trouble due to shortage of technical
instruments which are required in medical treatment.

2) Unmanageable patient load

Due to the shortage of medical professionals in rural and hillside area,

we always find that there is heavy patient load on doctors so because of that
some patients might not get medical treatment properly.

3) Unaffordable medical facilities.

Not everyone can afford medical facilities, in private hospitals. Due to

unaffordable medical facilities many people were pushed under below poverty
line.

4) Literacy and Health Awareness

A big challenge for health sector is patient’s illiteracy or unawareness.

Because of illiteracy patient cannot read and follow instructions which are
written like on syrup bottle or in medical prescription.

 Why patients are afraid of surgery?

Here are some surgery-related issues due to which patients are afraid of
surgery

 Shoulder surgery-related issue.

Major problem is shoulder joint stiffness after immobilization of the

shoulder joint and also if nerve damages during shoulder surgery so it can
cause numbness and tingling in hand.
  Knee replacement related issue

Due to improper alignment of metal implant in knee replacement patients

can face pain and difficulty in walking due to these improper alignment. Here is
one case of improper alignment of knee replacement in one of the hospitals of
Ahmedabad.

Shelby hospital - after doing patients knee replacement patient did not get
monitories properly by doctors and nurses due to which patient got died.

 Spine surgery-related issue.

In the case of lumbar radiculopathy (vertebrae) condition patient might be

face to paralysis of lower limb and urine and bowel incontinence, due to nerve
damage it also may be give tingling and numbness, so that's why patients are
afraid of spine surgery.
  General surgery-related issue.

In any surgery, if blood clot form and it spread into blood vessels and if it
goes to the brain then it causes brain stroke.
 Image Credit:
 https://www.medicinenet.com/total_knee_replacement/article.htm
 https://www.netsolutions.com/insights/top-challenges-facing-mobile-
healthcare-and-how-to-overcome-them/
 https://www.spine-health.com/treatment/spinal-fusion/multilevel-
spinal-fusion-low-back-pain

 Reference:
 https://www.netsolutions.com/insights/top-challenges-facing-
mobile-healthcare-and-how-to-overcome-them/
 https://www.netsolutions.com/insights/top-challenges-facing-
mobile-healthcare-and-how-to-overcome-them/
 “Current challenges in health information technology–related patient
safety” – A journal by Dean F Sittig, Hardeep Singh, David W Bates,
Raj Ratwani, Adam Wright, Enrico Coiera and Farah Magrabi