Artificial Intelligence and Telemedicine in Neurosurgery

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The pace of advancements in technology is changing many aspects of our daily life. These
advancements are clearly having a significant impact on the landscape of healthcare. We
are beginning to take broad and bold steps in transforming the way we deliver healthcare.
How will these changes affect neurosurgery? How will the patient experience change, and
how will the role of the neurosurgeon change? Given the magnitude of neurosurgical services provided by
our department in 12 hospitals throughout western and central Pennsylvania, the opportunity to gather and analyze large
amounts of patient and procedural data is significant. We have started to evaluate such data with a goal of enhancing our
understanding of the outcomes of the many complex procedures we perform. Considering the challenges in performing randomized
clinical trials in neurosurgery, applying artificial intelligence(AI) may be a strategy to generate answers to complex clinical
questions. I suspect that over the next decade, we will implement AI as a central tool in our everyday practice. The goal will be to
enhance the physician’s ability to accurately diagnose and treat patients with complex medical disorders.
AI may also play a role in actual surgical procedures. Given the potential for significant morbidity associated with certain
neurosurgical procedures, I can see how computer oversight of each surgical step may alert us of imminent danger, or
provide real-time advice on how to perform the next step in an operation with the greatest margin of safety. Cost analysis
will likely play a role in the decision-making process when different options are available.
Another important technological change currently infusing itself into our practice is telemedicine. Given the ample geography
we cover, many of our patients must travel hours to see us. This travel takes its toll in many ways including time, cost, and stress of
travel, particularly for frail patients. In close collaboration with the
UPMC Telemedicine department, we are actively implementing platforms to provide care at remote UPMC telehealth centers
and, at times, even in the comfort of the patient’s home. We are looking to significantly expand the impact of telemedicine as part
of our patient-centric care. At the UPMC Department of Neurological Surgery we embrace
change in order to provide the most advanced care and remain neurosurgical leaders into the future.
Robert M. Friedlander, MD, MA
Chairman and Walter E. Dandy Professor of Neurological Surgery
Co-Director, UPMC Neurological Institut