Dr. Charles Branch Jr.: Imaging, patient engagement big opportunities in spine post-pandemic

Laura Dyrda -  

Charles Branch Jr., MD, executive director of the spine service line at Wake Forest Baptist Health System in Winston-Salem, N.C., says the pandemic has put some surgeries and technology purchases on hold for now, but there are big opportunities in imaging and video visits as the spine field emerges from the pandemic.

Question: How has the pandemic affected your practice and plans for the future?

Dr. Charles Branch Jr.: I have experienced over a 50 percent reduction in my surgical caseload during the last month. In some ways we are fortunate because many of our spine cases involved patients who are developing neurologic deficit or disabling pain and this allowed us to move forward with time sensitive surgeries in these patients. In general these were one- and two-level decompression or fusion cage cases but did not the multilevel deformity projects.

We also continued with our trauma and tumor spine cases so overall we did not experience the devastating reduction in volume that some other specialties in our institution did. While extended future plans seem to be stable, the near term planning is disrupted by the uncertainties with testing, patient confidence in a healthcare system that is safe and in some cases a reconsideration of the disabling nature or extent of their pain. Unfortunately economics have put an almost complete hold on capital purchases so our anticipated robotic and imaging platforms will be put off for the time being.

Q: What are the most exciting opportunities for you moving forward?

CB: I believe the most intriguing opportunity involves the seamless integration of imaging and video telehealth visits. While there has been a rapid increase in access to video telehealth, the availability of imaging from outside institutions that are not in the network is still problematic. I believe this opens an opportunity for an entrepreneurial solution to allow for outside imaging to link up with video telehealth. This environment also encourages the widespread use of wearable or other home patient monitoring technology that gives us better or more evidence-based patient outcomes and will ultimately add significantly to our decision-making capacity.

Q: What does the "new normal" look like for spine surgeons?

CB: The new normal for spine surgeons will include more patient engagement through technology. It is quite possible that holographic imaging of patients in their home setting will allow for a more complete telehealth visit. Our clinic visits of the future will be a mixture of telehealth and face-to-face patient visits and the proportions will be driven by the practice type and patient demographics. In the near term, I am concerned that there will be a constriction in new technology availability for spine surgeons given the dramatic losses that healthcare systems have endured and will continue to expect in the future and in the weeks ahead. On the other hand, I believe we will be able to generate better and more evidence-based outcomes that will guide our decision making or give us valuable predictive analytics in the future.

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