Professor Shafi Ahmed On The Importance Of Remote Assistance Solutions In Global Surgical Care

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There’s no question that safe and accessible surgical care is an integral part of any functioning healthcare system. But the simple truth is that right now, there is huge global inequity in the provision of essential surgery. 

Although in the last decade or so, awareness and consideration have grown around this universal healthcare challenge, there are as yet no concrete solutions and still much work to be done to level-up access and availability of surgical care.   

Professor Shafi Ahmed is a multi-award-winning cancer surgeon working at The Royal London Hospital and Rods&Cones’ global ambassador. His extensive, high-profile, and international experience has earned him the reputation of being an innovator and futurist, pioneering the use of new technologies to enhance surgical education. 

For this blog post, Professor Ahmed spoke to us about why he believes remote assistance solutions can be important in leveling up surgical skills and improving patient provision across the world. 

Global Needs In Surgical Care

“Rods&Cones provide solutions which can impact the surgical workforce, increase retention, and improve training.”

  • Professor Shafi Ahmed, Global Ambassador, Rods&Cones

It’s now over seven years since The Lancet Commission published its ground-breaking study: Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development

For myself and others in the same field, the study was necessary for one significant reason: it was the first time that the UN had officially recognized safe surgical care, WHO, and other healthcare specialists as a global healthcare challenge – alongside communicable diseases like COVID-19, and non-communicable diseases such as cancer and heart disease. 

The numbers speak for themselves – and at the time the report was published, was largely unrecognized. For instance, in 2010 an estimated 16.9 million lives were lost due to a lack of surgical care. To put that figure into context, it roughly equates to over 30% of deaths worldwide for that year.

Back in 2015, it was clear that something needed to be done to level-up surgical access and provision, especially in lower-middle-income countries (LMICs), where approximately nine out of ten people could not access basic surgical care. Seven years is a long time. So what’s been done since then? 

Sadly, the answer is not much.  

That’s even more alarming when you consider that we’re not talking exclusively about complex and complicated procedures, which require highly specialized surgical expertise. There is a global deficit in the basic provision of surgical and anesthesia care. As I see it, there are three main barriers to overcoming this problem:

  1. Access to safe and affordable surgery.
  2. A lack of surgical workforce. 
  3. Demand for operations exceeding capacity.

In theory, the answer is obvious: increase and improve surgical education and training. The problem, in practice, is how to facilitate that on a global scale. 

Finding New Solutions 

“Rods&Cones has a portable solution that anyone can pick up and use for training and for education. And it can be set up within minutes. It has all the abilities to train remotely.”

  • Professor Shafi Ahmed, Global Ambassador, Rods&Cones

One of the consequences of COVID-19 is that it necessitated, and therefore accelerated, the innovation and implementation of new technologies into clinical practice and education. 

During the pandemic, medical professionals and their patients very quickly adapted to virtual consultations and other remote ways of working in order to work around the imposed social distancing restrictions. Successful use cases validated remote technology as a legitimate healthcare tool and helped to clear the path for future adoption. 

At the same time, data and telecommunication networks continue to increase capacity and transfer rates to the extent that by the end of 2022, smartphones will offer satellite connectivity as an emergency feature. 

This unique set of circumstances – remote technology, tried and tested use cases, and ever-improving connectivity – leave the door wide open for the widespread use of remote assistance technology in medical environments. 

The world needs more surgeons, better trained, and more evenly distributed in countries where they are required most. Remote assistance technology enables the democratization and dissemination of surgical knowledge by connecting a global community of medical experts. It does that in two ways:

  • Tele-proctoring: The monitoring of surgery by an expert from outside the operating room (OR) to evaluate clinical competence.
  • Tele-mentoring: The use of remote assistance and communication technology to support a mentee or peer performing surgery, from outside the OR.

Portable, remote assistance technology enables surgical experts to share and demonstrate their skills and knowledge to peers and residents operating anywhere in the world, from impoverished urban areas to remote rural communities.

Whether educating medical students, or training peers, by leveraging two-way communication and multiple videos feeds in the OR, specialists can reach and educate a broader global community of surgeons. 

From guiding a single surgeon to demonstrating surgical techniques to an audience of thousands, remote assistance can help to improve clinical care education and ultimately patient outcomes. The key question is: how do you make it happen?

Making The Change

“Rods&Cones has a solution to a defined problem the world is facing at the moment. We do global work, improving global access to surgical expertise, and finding solutions for global shortages.”

  • Professor Shafi Ahmed, Global Ambassador, Rods&Cones

To take effect on a global scale, remote assistance in medical environments needs a community of active participants. For that reason, the leads and directors of training institutions and universities need to take the first interest and make the first impact. 

By its very nature, surgery is a highly individualized profession. That’s why sharing expertise is so important to raise the quality of care around the world. Surgery is also mentally fatiguing – so a surgeon doesn’t have the headspace to set up remote assistance themselves. They need an influencer, a trusted advisor – someone with vision.

The fact of the matter is that to fully embed remote technology within clinical practice takes community adoption, and that starts with the curriculum and educational process. Medical education providers needed to embrace remote technology, using it to augment existing processes, add value to the student experience, and validate its potential for improving patient outcomes in the future of global healthcare.

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