Leveraging Artificial Intelligence and Computer Vision to Deliver Surgery at Scale in a Post-COVID-19 World

COVID-19给我们的卫生保健服务带来了巨大压力。在这种情况下，决定优先考虑医院应对COVID-19的能力并取消计划中的手术，以释放关键资源，是唯一的选择。然而，这一决定将对我们的社会和医疗体系产生持久的影响；210多万患者的手术被取消（[The Independent, 2020] b[0]），其中33%是骨科手术（皇家外科学院）。由于等待名单已经很长（英国骨科协会，2020年），这些新的，增加的取消将造成前所未有的负担，在2019冠状病毒病爆发后持续数年，患者可能等待数年的治疗，获得所需支持的机会有限。当手术恢复时，医疗保健提供者将需要继续保护“高危年龄组”免受COVID - 19的影响，避免不必要的医院预约，并将住院人数降至最低。技术可以支持医院提供骨科手术的规模不断扩大，从而节省医疗保健专业人员的时间并降低护理成本。远程监控的引入可以保证脆弱患者的安全，促进日间病例手术，减少并发症和亲自预约。准确的临床评估关节功能（活动范围）是监测骨科患者的关键组成部分。该评估支持从康复到康复进展的决策。传统上，这种评估是由外科医生或物理治疗师使用测角仪亲自进行的。我们开发了使用计算机视觉人工智能的技术，可以通过智能手机摄像头远程访问。这种独立验证的技术可以为临床团队提供远程关节功能评估所需的信息。我们建议通过我们成熟、成熟的数字骨科患者参与平台来生产这项技术，该平台已经部署在英国领先的骨科中心（NHS和Private），以提供端到端解决方案来远程管理患者并使其得到广泛采用。这种专有的首创技术将为目前正在等待手术而没有手术日期的患者提供即时益处，同时支持医疗保健提供者提供更大规模的骨科手术，并保护高危患者免受COVID-19的侵害。这项技术将把每年40%的关节置换手术（20万例）的住院时间从3晚减少到1晚，从而为NHS每年带来1.2亿英镑的潜在生产力收益，并将NHS 780万创伤和骨科门诊中的10%转移到虚拟世界，从而进一步带来1250多万英镑的收益。[0]: https://www.independent.co.uk/news/uk/home-news/coronavirus-nhs-operations-cancelled-cases-deaths-hospital-a9464726.html

COVID-19 has placed our healthcare services under extraordinary pressure. The decision to prioritise hospital capacity for COVID-19 and cancel planned surgery, to free up crucial resources, is the only option under these circumstances. However, this decision will have lasting consequences for both our society and healthcare system; 2.1+ million patients have had their surgery canceled, ([The Independent, 2020][0]), 33% of which are orthopaedic surgery (Royal College of Surgeons).With waiting lists already long (British Orthopaedic Association, 2020), these new, added cancellations will create an unprecedented burden, lasting years beyond the outbreak of COVID-19, with Patients potentially waiting years for treatment, with limited access to the support they need.When surgery returns, healthcare providers will need to continue to protect the "at risk age group" from COVID 19, avoiding unnecessary hospital appointments, and keeping inpatient admissions to a minimum.Technology can support the increased scale at which hospitals deliver orthopaedic surgery, freeing up healthcare professionals' time and reducing the cost of care. The introduction of remote monitoring can keep vulnerable patients safe, facilitate day case surgery and reduce complications and in-person appointments.Accurate clinical assessment of joint function (range of motion) is a key component to monitoring orthopaedic patients. This assessment supports decisions from rehabilitation to progress with recovery. Traditionally this assessment is delivered in-person by either a surgeon or physical therapist using a goniometer.We have developed technology using computer vision AI that can be remotely accessed through a smartphone camera. This independently-validated technology can provide clinical teams with the information they need to carry out assessments of joint function remotely.We propose to productise this technology through our mature, established digital orthopaedic patient engagement platform, that is already deployed within leading orthopaedic centres in the UK (NHS & Private), to deliver an end-to-end solution to remotely manage patients and enable widespread adoption.This proprietary, first-of-a-kind technology will provide immediate benefits to patients who are currently awaiting surgery without an operation date, whilst supporting healthcare providers deliver orthopaedic surgery at greater scale and protecting at-risk patients from COVID-19\.This technology will contribute to potential productivity gains of £120+ million per annum in the NHS by reducing the length of in-patient stay from 3 nights to 1 night for 40% of annual joint replacement procedures (200,000) and a further £12.5+ million by moving 10% of the 7.8 million of NHS trauma and orthopaedic outpatient clinics to virtual.[0]: https://www.independent.co.uk/news/uk/home-news/coronavirus-nhs-operations-cancelled-cases-deaths-hospital-a9464726.html