AI-Powered Black Box Technology Could Make Surgery Safety

While many have heard of black boxes in the world of aviation, it’s still a new concept for hospital operating rooms. Some people believe they may make surgery safer, and others say it would raise privacy concerns.

According to the MIT Technology Review, it’s a new smart monitoring system that could help doctors avoid mistakes. The operating room equivalent of an airplane’s black box records everything in the OR via panoramic cameras, microphones, and anesthesia monitors before using artificial intelligence to help surgeons make sense of the data.

Teodor Grantcharov, the developer of the AI-powered black box, told the outlet that “as long as the only barrier between success and failure is a human, there will be errors.” Improving safety and surgical efficiency became something of a personal obsession. He wanted to make it challenging to make mistakes, and he thought developing the right system to create and analyze recordings could be the key.

Grantcharov predicts that his system can do for the OR what black boxes did for aviation. The outlet points out that in 1970, the industry was hit by 6.5 fatal accidents for every million flights. Today, that’s down to less than 0.5. “The aviation industry made the transition from reactive to proactive thanks to data,” Grantcharov told the outlet. “From safe to ultra-safe.”

It's worth noting that there’s no true way to determine how often slip-ups during surgeries happen. But some research shows that serious medical errors kill around 22,000 Americans each year. Many of these errors happen on the operating table, from leaving surgical sponges inside patients’ bodies to performing the wrong procedure altogether.

Many medical device companies are already in this space. This includes Medtronic with its Touch Surgery platform, Johnson & Johnson with C-SATS, and Intuitive Surgical with Case Insights.

But most of these are focused solely on what’s happening inside patients’ bodies, capturing intraoperative video alone. The AI-powered black box would capture the OR as a whole, from the number of times the door is opened to how many non-case-related conversations occur during an operation.

According to ArsTechnica, Grantcharov’s black boxes are now deployed at almost 40 institutions in the US, Canada, and Western Europe, from Mount Sinai to Duke to the Mayo Clinic.

In February 2019, Long Island Jewish Medical Center in New York, part of the Northwell Health system, was the first hospital to pilot OR black boxes. Apparently, in the OR, the cameras were "sabotaged." They were turned around and “deliberately” unplugged. It’s worth noting that the black boxes do have identity protection.

For instance, they anonymize people in operating rooms by blurring their faces and cartoonifying their bodies. “The software aggregates and analyzes the data and reports back to the hospitals with insights on protocol compliance, efficiency, safety audits, quality controls, and key video and audio clips for review, annotation, and education. After 30 days, all recordings are erased,” as reported by ARSTechnica.

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