Lessons Learned in a Hospital Gown: My Robotic-Assisted Surgery
By Marc Wine, MHA
Senior Adviser, U.S. Department of Veterans Affairs, Office of Information & Technology
“Thank you to my surgeon and to the surgical robot, which showed me that even with advanced technology, healthcare can remain personal and personalized.”
It’s my job to help advance innovations for veterans’ healthcare across the nation through information technology. I often suggest that hospital staff step into the patient role in their own institution to better understand and improve the patient experience. Ironically, I recently found myself experiencing firsthand the challenges and apprehension of a patient when I underwent hernia surgery performed by a robot. I came out with a new “reality-based” perspective on technology and patient empathy.
Of course, I had surfed the Internet for descriptions of my particular hernia operation (videos and all) and the robot I would encounter for the first time. I got several opinions on surgeons and approaches and made sure my electronic health record was available to each of my providers. Despite all that, I felt anxious the night before my surgery. Would I be able to wake up easily from anesthesia? How would I feel about having a robotic healthcare provider?
My procedure was just outside of Washington D.C. I felt confident in the skills and interpersonal capacities of my surgeon, an expert in hernia procedures and the robotic surgical system. He is also a veteran and former Army surgeon who understands the work I do for the VA.
On the morning of my surgery…
I was met with unhurried efficiency by the intake administrative specialist who seamlessly worked through my identification, payment operation coverage confirmation, initial consents, and HIPAA privacy understandings. In the surgery suite, I was instantly greeted and my surgical procedure confirmed. Within 20 minutes, I was called into the surgical procedure area and escorted by a welcoming nurse assistant who took my vital signs and health history checks.
At every step of the process, the staff communicated clear expectations and outcome success – and more. I had privacy for changing into my surgical gown, I enjoyed the sociable anesthesiologist discussing the delivery of painless and safe sedation as I eased into the relaxed pre-op mode. I was awake enough to see “my” robot surgeon, which was way larger and more complex than I anticipated. And in every interaction with me, my surgeon and his team spoke in personal yet sensitive ways. They helped me feel less anxious and more in control.
But research still shows that many patients describe a healthcare experience that feels far from personal. I think of this passage by Jan Oldenburg, a leader on consumer health information strategy and patient engagement, an active member of HIMSS and author of the book Engage! Transforming Healthcare Through Digital Patient Engagement:
“Today, for many patients, their experience in the healthcare system resembles sending them to foreign land, giving them directions scrawled in a second language, and pushing them through the door to find a destination called health … Most patients just muddle through on their own, not wanting to appear ignorant, not wanting to bother their providers, or finding communication with their providers a troublesome task.”
I found myself marveling at the quality care I was privileged to receive – and wondering how to make sure it happens for all patients.
What made my experience so good?
In our meetings before the surgery, my surgeon had effectively communicated to me why the robot was needed – and how it performed in ways he couldn’t with his own hands. And the technology allowed him to operate through a few small incisions like traditional laparoscopy, instead of a large open incision that would take longer to heal.
Yes, the robot made it possible for my surgeon to see a 3D, high-definition view inside my body, and operate wristed instruments that rotate with far greater range, stability and flexibility than the human hand. But it was my surgeon’s trained hands – not the robot – in control.
The fact is, robots have become an important part of healthcare. By 2020, up to 30% of all minimally invasive surgery will be performed robotically. In the next decade, we will see sophisticated robotic devices feeding clinical data into the EHR. We will have nanobots embedded in patients and a growing range of robotic devices at the back end of EHR systems.
Better health outcomes & patient experience
Because of the robot, the expert surgeon and his entire hospital team, my experience as a patient met the goals we have for healthcare across the globe: low rate of a recurrence of the underlying hernia, low rate of pain, low rate of surgical risk including from anesthesia, and avoidance of an overnight hospital stay and the accompanying risk of infection.
Just four weeks after surgery, I was fully healed, pain-free and back to my usual athletic activities. But working in healthcare innovations, what I really gained post-surgery was greater empathy for patient health and wellness, including our nation’s veterans and service members. To my surgeon, thank you for your service – as a veteran, a surgeon, a communicator and a deliverer of quality healthcare. And yes, thank you to the surgical robot, for showing me that even with advanced technology, healthcare can remain personal and personalized.