Imagine a future where a wide range of surgeries, no matter how complex, could be conducted remotely, a future where a patient in dire need of help could access the most highly regarded specialists in any area of medicine regardless of where on the globe that person may be.
In 2019, Dr. Ryan Madder from Spectrum Health performed a series of simulated remote percutaneous coronary interventions (PCIs) via a control station outside of Boston. The robotic devices he was manipulating were in New York City and San Francisco. The robots successfully performed the procedure, which involves a catheter being used to place a small structure called a stent to open blood vessels in the heart that have been narrowed by plaque buildup, a condition known as atherosclerosis.
A year earlier, Dr. Tejas Patel completed the first-in-human remote PCI cases in India, with about 20 miles between the physician and his patients.
Both of these breakthroughs were achieved using the CorPath GRX System from Massachusetts-based firm Corindus, the world’s first medical device to bring robotic precision to percutaneous coronary and vascular procedures that has been cleared by the U.S. Food and Drug Administration (FDA).
“In 2018, we received clearance from the FDA for the first automated movement designed for the CorPath GRX platform called ‘Rotate on Retract’ (RoR),” explained Doug Teany, Chief Operating Officer at Corindus. “This movement rotates the direction of the guidewire automatically when the physician makes a retract command with the controlling joystick, consolidating a process that once took multiple steps into one.”
RoR marked the first in a planned series of automated movements that Corindus has named technIQ.
“Each movement in the series will re-create a highly skilled maneuver that increases efficiency and optimizes the quality of care,” explained Doug. “That includes four entirely new movements that have already generated positive results in early use. They will continue Corindus’ advancement of autonomous navigation within entire procedures to maximize the benefits of robotic precision.”
This robotic precision allows physicians to move medical devices at extremely small increments — in fact, they can track movements as small as one-tenth of a millimeter. Not only does this give physicians a level of precision that the human hand alone could not match, but it provides something incredibly important that shows where medical devices such as stents should be placed for the optimal patient outcome: Data.
Data-driven health care
“Data is the most valuable commodity in medicine,” Doug said. “Complex procedures such as PCIs benefit tremendously from relevant data.”
And data has the potential to expand the scope of what Corindus is already achieving, facilitating procedural automation.
“Today, most cardiologists rely on personal experience from previous cases they have performed or observed firsthand,” explained Doug. “Our goal is to provide physicians with a more robust set of data from their colleagues around the world that will allow them to make more informed decisions and, ultimately, create a higher standard of care for cardiovascular intervention.”
Building a data platform that powers procedural automation will take the knowledge of a physician who performs thousands of cases per year and extend those techniques and expertise to every case.
“It also standardizes care at a very high level by utilizing the most efficient movements of the catheter and guide wire through the vasculature,” Doug said. “Offering physicians data that compares similar cases empowers the robotic system to help guide the physician around certain challenges and treatment algorithms that have the best outcomes. Additionally, automation will allow physicians to treat more patients by making procedures more efficient.”
Indeed, by incorporating technology like artificial intelligence, the robotic system will be able to learn from experience and adjust to new inputs, allowing it to perform the same movements that some of the best physicians in the world perform to overcome challenges when treating patients. This will allow physicians to focus their attention on case strategy and respond to problems as they arise. Automation will also standardize the way procedures are done to a very high level of quality, which gets to the overarching goal of robotic automation — making cases safer, faster, and more effective while reducing trauma on the patient.
The path to success
Creating innovations this incredible comes with unique challenges.
“We are cognizant of the challenge of protecting patient privacy, which is paramount when focusing on data-driven work in health care,” Doug said. “One of our challenges comes from accessing and leveraging data while appropriately protecting privacy. We view that as extremely important and have made it an intrinsic part of our development approach.”
Ultimately, however, Doug is confident that no obstacle is too large to prevent Corindus from realizing its future vision of health care — and that improved access to data will only pave the way to success.
“Data has always played a pivotal role in delivering health care to patients, but the future will be characterized by much larger quantities of data traveling much more quickly. For instance, with the advent of 5G wireless connections, we will have the data speed and bandwidth necessary to perform remote robotic, or telerobotic, interventions in areas of the world that lack access to specialized care today,” he explained.
Indeed, modern telecommunications will provide the infrastructure to support massive data exchanges and allow Corindus to reach more patients than ever before. While those early breakthroughs performed by Dr. Patel were the first to demonstrate the feasibility of performing a PCI remotely, the additional data capability of 5G presents new opportunities for imaginative treatment options that reach patients in underserved areas.
“By bringing data that we simply don’t have available today to a patient treatment scenario, we can improve the quality of decision-making within the procedure and mitigate risk for the patient,” Doug concluded. “This is incredibly powerful. The more you know, the better you can treat. Improved access to data insights is impacting nearly everything in our world, from making our automobiles safer to helping grocery stores stock the shelves more efficiently. In health care, however, that data might just save lives.”
Lindsay James is a journalist and copywriter with over 20 years’ experience writing for enterprise business audiences. She has had the privilege of creating all sorts of copy for some of the world’s biggest companies and is a regular contributor to The Record, Compass, and IT Pro.