Anesthesiology as a field presents an interesting topic of study for those both in the profession and outside of it. Owing to its critical role in surgical operations, the specialization has a wide-reaching effect on other areas of medical study. As such, we’re taking some time to look at the field in greater depth and see not only where it is at present, but also where it is going in the near future. To aid in this analysis, we’re pairing it with a look at the career of Dr. Alddo Molinar. As a well-respected anesthesiologist himself, he makes for an excellent point of focus when discussing the field at large.
Let’s first take a brief look at the professional background of Dr. Alddo Molinar to better understand the expertise of practitioners of this specialty. Like many medical doctors, the anesthesiologist showed a natural aptitude early in life that helped direct him towards a high-achieving career. After witnessing the devastating toll that illness took on several family members, the future doctor resolved to use that aptitude to pursue a career in medicine to help alleviate suffering in others.
The road to that career was a long one, spanning through his undergraduate studies, medical school, and finally residency and a fellowship. Those last two endeavors both took place at the world-renowned Cleveland Clinic, where he was able to get a firsthand appreciation at how the field of anesthesiology is practiced at its highest levels. His time at the clinic not only encompassed training in his primary field, it also included a range of subspecialty trainings. These included stints in both the neurological and cardiovascular intensive care units. He also underwent training in critical care medicine.
This broad range of trainings helped the doctor develop his understanding of the wider field of medicine. Since, as we’ll see, anesthesiologists are often involved in operations that touch on many different fields, this broad understanding has been a key part in allowing him to effectively carry out his professional responsibilities. This includes allowing him to better coordinate with other doctors and medical professionals inside and outside the operating room.
Since it plays a large role in the work of an anesthesiologist, it can also be helpful to get a better understanding of a typical operating room environment. That environment can lend itself to a certain level of controlled chaos, drawing comparisons to a busy airport. Like an airport, many professionals are required to work in close collaboration with one another in order to reach a common goal. If one part of the process were to break down, other areas would suffer and the team as a whole might be unable to complete the operation successfully.
In the context of this metaphor, Dr. Alddo Molinar has compared anesthesiologists to pilots. It is up to them to successfully take off at the beginning of an operation, by making sure the patient is properly anesthetized, and then to land the plane, so to speak, at the end of the operation. Not only does this collaboration take place with the professionals in an operating room, an anesthesiologist often works in multiple operating rooms at once. This requires a careful and organized approach that takes into account the needs of different procedures, patients, and operating teams.
One important part of the collaboration outlined above is the need for anesthesiologists to monitor patients throughout an operation. This monitoring requires doctors to be aware of vital signs such as blood pressure, heart rate, and ventilation to ensure patients aren’t having an adverse reaction to their anesthesia. By some estimates, anesthesiologists are tasked with monitoring up to 40 different patient data streams at once during an operation. The doctor can then use this data to make important decisions in real-time during a surgical procedure.
While the monitoring of this large amount of data is a necessary part of the profession of anesthesiology, it also can be somewhat unwieldy at times and can contribute to medical errors. For this reason, among others, the development of processes to improve patient monitoring and reduce errors has been a key focus of innovation in the field of anesthesiology.
Decision support systems
That search for increased innovation has led to the development of what’s known as decision support systems. Though these systems have been in use for some time, the positive results they have helped achieve in the operating room have contributed to projections of increased usage moving forward.
Put simply, these systems utilize electronic dashboards to help doctors make decisions based on data being received from patient monitoring. Rather than have that monitoring be handled through many different systems with different standards, a decision support system can present relevant data to doctors in a quick and efficient manner. This can aid their ability to make key decisions by improving accuracy and decision speed.
Such a system can also provide alerts to an anesthesiologist if it detects a worrying development within the data it is monitoring. These alerts can help inform a doctor’s decision, though they are still just information to be interpreted as the medical professional sees fit. This helps to illustrate how there is still room for improvement in these systems insofar as it is up to manufacturers to decide the manner and frequency with which to display alerts. Too many alerts may serve as a distraction to doctors, while too few may defeat the purpose of the system itself. As new systems continue to be developed in this space, they will continue to help evolve the practice of anesthesiology.
Information management system
As we’ve seen, decisions inside the operating room can be greatly affected by real-time data that results from the monitoring of a patient. The effective use of this data can result in a higher degree of medical care. Another component that can contribute to quality of care is data that is pulled from records. A wide range of important data can be contained in patient records such as allergies, past drug reactions, past operations, and more. Such records can represent a critical point of study for an anesthesiologist as they can help them better plan their approach once inside the operating room.
Since records can play such a critical role in the health outcomes of a patient, it is also important for an anesthesiologist to take proper records during an operation for present and future use. Such record-keeping can note important aspects of the data that is being monitored in real-time for use in other medical contexts down the line, such as postoperative management. However, while it is important, record-keeping can represent a significant draw on a doctor’s resources away from more immediate patient needs. In the context of an operating room, any draw on resources can serve as a weak point that can negatively contribute to a patient’s health outcome.
To help alleviate some of the downsides of record-keeping, medical facilities now often utilize information management systems to help automate record-keeping efforts. Such systems function as an integrated database ideally encompassing a patient’s medical records from their range of different medical procedures. With this information, an anesthesiologist can better determine a plan for anesthetization during an operation and for postoperative management.
Such systems also can help to automate the record-keeping process to allow anesthesiologists to focus on more pressing patient needs during an operation. The ability of this technology to take the record-keeping burden off of medical professionals is a key contributing factor to its adoption by a wide range of medical facilities. By automatically logging important data, these systems can leave doctors confident that records will be available down the line without the need to divert their attention away from a patient during an operation.
One issue that still affects the systems above is the disparate rates of adoption by medical facilities. While some facilities use such technologies to the fullest of their capabilities, others are lagging behind. This can lead to gaps in levels of patient care.
Another challenge in the integration of these technologies is the number of different systems in use at present. Since the idea of information management systems is that they can provide all of a patient’s medical records when needed, it can be counterproductive if different medical facilities utilize different systems. This is especially true if those systems don’t easily collaborate with each other.
As we’ve seen above, the field of anesthesiology has plenty of exciting developments that are serving to move it forward. The use of technologies such as decision support systems and information management systems are two examples of the direction the field is taking. Looking to the above information, along with the work of Dr. Alddo Molinar, provides a great indication of how the field of anesthesiology is evolving best practices to perform at even greater heights.