Digitizing the operating room in Fairbanks, Alaska: “The more we use Proximie, the more uses we find for it.”

Digitizing the operating room in Fairbanks, Alaska: “The more we use Proximie, the more uses we find for it.”

Rachel Piszczek is the director of Perioperative Services at the Surgery Center of Fairbanks, Alaska – a remote location that was already difficult for medical device reps to visit before the Covid pandemic. They have now been using Proximie for more than a year, dramatically increasing the ability of reps to provide remote guidance during surgery.

The COVID pandemic made things very hard for us out in Fairbanks, Alaska. We had to cancel a large number of elective surgeries, and reduce our caseload to a very low volume of urgent cases – so that meant we were only doing one or two cases a day. We wanted to keep all our staff because it’s really hard to recruit, train and keep staff out here, and we knew things would pick up after the pandemic. So we started looking into cost savings with our implants, which was something we hadn’t done before.

One of our lead surgeons, Dr. Mark Wade, an orthopedic surgeon and sports medicine specialist and the only physician in Fairbanks that has performed cartilage implants, had the original idea to explore how we could potentially use a remote surgical tool to support us. We were consulting with a company called OptioSurgical who were advising us on ways to cut implant costs, and Dr. Wade suggested that a platform like Proximie could help us do this. We have loved it ever since, as it has proved to be not just an amazing tool to reduce our implant costs, but now our medical device reps don’t have to fly up to Alaska for every case – they can simply attend virtually. Not only that, but we’re now able to record cases which we can later use for training purposes, which is a great help considering how hard it is to ensure availability of training resources in such a remote location. Any new staff that join us can now be trained more quickly, and the recordings can also be used as a means of refining technique by our existing staff.

For our reps, things are so much easier now. It used to be the case that they would take a four-hour flight from Seattle to Fairbanks, which would then mean they have to get a hotel room, stay the night and fly back the next day. Without Proximie, several days would be wasted with all the travelling required to attend a case that lasts just a few hours. It’s not financially feasible for them to make trips like that regularly, but with Proximie they can now attend to multiple cases in that same timeframe, without ever having to necessarily even leave the comfort of their homes. So instead of taking several days out of their time with air travel and overnight stays, Proximie enables them to attend virtually. It’s now possible for us to interact more frequently and receive more guidance from our reps than ever before.

Last autumn, Dr. Wade, performed a shoulder replacement surgery. We have a rep named Michael who always supports Dr. Wade on his cases, who doesn’t have to travel too far because he flies up from Anchorage, Alaska. But this time he had recently undergone elective eye surgery and had to stay home. We offered him the opportunity to virtually attend using Proximie if he was feeling up to it, so he could just sit on his couch and watch and listen. He jumped at the chance.

Everything was going well during the shoulder replacement procedure, but towards the end Dr. Wade was having some difficulty getting one of the implants in due to an idiosyncrasy of the patient’s anatomy. Michael – recovering on his sofa at home – was able to help Dr. Wade through the issue, going through all the options and possibilities before finally advising him to open another implant that went in perfectly, after which the patient went on to make a full recovery. Without Michael being virtually present for the procedure thanks to Proximie, we still had the necessary expertise on hand at the precise moment we needed it.

In another instance, a different doctor was carrying out an ACL reconstruction on a paediatric patient, but it wasn’t something he had carried out that frequently. Another surgeon flew up from Spokane to assist in the operating room, but we also had a couple of different reps and medical professionals that were coming to support. I felt that the operating room was starting to get clogged up with people, so we used Proximie to streamline physical presence in our OR.

Meanwhile, I’ve joined the case via Proximie in my office and have it pulled up while I’m doing my work, so I can hear what’s going on. All of a sudden, I might hear that they need something they don’t have in the room and I can run and get it for them and communicate to them through Proximie. At the same time, we’re recording the procedure so that we can subsequently review cases, meaning we can review and hone our technique for the next procedure.  

We’ve used Proximie to educate and train new staff as well, and will be continuing to do so in the future. It’s extremely helpful that we can use it to store recordings of cases with our surgeons, because it’s so much better than watching a knee replacement on YouTube. Our recordings are made by our staff, using our equipment, so it’s really a much better guide for new staff members than anything made anywhere else could be. It’s really useful to be able to watch yourself back and see how you work. It’s a great exercise that they’ve given me very good feedback on.

The more we use Proximie, the more uses we find for it. Initially our only goal was to save money on implants so that we could keep our staff on during COVID. But now, it’s just becoming this major tool that we are able to use in all manner of ways to improve our practice, and we haven’t looked back since. It’s just such an awesome system.

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