Patient used AI to find Providence's innovative heart surgery. What role should the technology play in health care?
As artificial intelligence becomes more ingrained in society, more people may look to the technology to influence health decisions — for good or ill.
The 78-year-old Powers is grateful to the new technology for bringing him to Sacred Heart. But AI's reliability remains uncertain, and Powers' surgeon warns against counting on it over a doctor's advice.
"I think it is very helpful to do your own research," Providence Heart Institute surgeon Justin Reeves said. "But I also think you have to understand that you may not come to a conclusion that is in your best interest. You still need the input of someone who's an actually trained professional in the field."
Powers first discovered his heart condition last spring after feeling some pressure in the chest while mowing the lawn of his Post Falls home. Within a few days, he was in the emergency room, which found a blocked artery putting him at high risk of a heart attack. The hospital in Coeur d'Alene scheduled his open-heart surgery the following week.
The prospect of his chest being opened and the long recovery associated with the surgery scared Powers and his wife. They had seen friends go through similar procedures and how slow the recovery could be. They had just bought a new home in southern Idaho, and the surgery could have delayed or prevented their upcoming move.
"It was terrifying," wife Pamela Powers said. "I was just so worried for him."
Over the weekend ahead of the surgery, Jim Powers looked online for other options in the area. Before he could look through his Google results, the platform's AI assistant recommended a new robotic, microscopic surgery conducted by Sacred Heart.
The Spokane Providence Heart Institute is one of the few programs in the country offering minimally invasive coronary artery bypass grafting surgery. The traditional surgery opens the chest and divides the sternum, and the heart is temporarily stopped while surgeons sew in new arteries.
The robotic procedure, which Providence has offered for the past 1 1/2 years, works by making a 5-centimeter incision between the ribs. Surgeons use microscopic robotics to graft the artery while the heart continues to beat.
"There are many benefits compared to the other surgery," Reeves said. "You avoid dividing the bone. You don't have to use the bypass machine to stop the heart. Because of that, we see people recover two to three times faster than they generally would."
According to Reeves, patients typically recover from the robotic surgery within two weeks, while it can take months for the bone to heal from open heart surgery.
Two weeks after the procedure, Jim Powers could not be better.
"I've had no pain. I've been up and about," he said last month just before his appointment two weeks after the procedure. "I haven't used any painkillers at all,"
His wife added she "had trouble getting him to rest."
Not being too savvy with the internet, Jim Powers doubts he would have found out about the surgery if it had not been for the AI summary.
"I think it's just tremendous," he said. "It is tremendous what technology can do these days. I remember just digging through the internet to find this stuff, but the fact AI popped it up on the first inquiry was extremely helpful, especially for folks who aren't really familiar or comfortable with a computer."
While the use of AI is helpful in this context, it may also lead elderly individuals down false rabbit holes. AI can present incorrect information if the model is not trained on a data set with correct information.
Reeves said Jim Powers used the technology the right way to inform his decisions but ultimately relying on expert advice. The retiree was the first individual among Reeves' patients to cite AI, but the internet is often a tool patients use to diagnosis themselves. Sometimes when the internet convinces someone of a particular treatment, it can be difficult to change their mind, he said.
"Someone came to me wanting a robotic surgery, and he was just a really bad candidate for it," he said. "And a really high-risk candidate for the surgery. I tried to convince him, but all his research on the internet led him to falsely believe this was the best option. And it was very difficult to convince him otherwise."
Reeves has not personally used AI in his practice, but providers are increasingly using the technology, not just patients. It has been adopted especially by fields of medicine that require physicians to compare large data sets to find anomalies in patients.
University of Washington Chair of Radiology Dushyant Sahani believes AI can be especially useful in his field during cancer screenings.
"Physicians are overwhelmed with managing the data," he said. "And we want the physician to focus more time with the patient and provide them the best experience. Health care is one of the best human endeavors, but it's also a journey of data. And in the modern world, we have so much data, but we need a better way of using this data for appropriate decision-making."
Sahani is a co-founder of UW's Institute of Medical Data Science, which supports health care-related artificial intelligence initiatives.
AI also can help triage and prioritize care. Often, medicine's role is to decide how to prioritize patients who need care first or need more care, as well as assist in administrative tasks such as writing notes following a doctor visit or helping patients schedule their appointments.
Spokane Providence, the largest health system in Spokane, uses AI to complete administrative tasks and assist medical professionals in diagnosis at Sacred Heart and other facilities.
"Providence is taking a thoughtful, responsible approach to integrating artificial intelligence across our health system," Providence spokesperson Jen York said. "Years of investment in digital infrastructure already have positioned us to safely scale generative AI tools that support caregivers, enhance patient care, and prevent burnout. While AI holds great promise for transforming health care, our top priority remains the safety and privacy of our patients."
MultiCare Deaconess Hospital introduced several autonomous robots that use AI to traverse the hospital and deliver supplies and complete menial tasks.
While stressing the need for careful implementation, Reeves is hopeful AI and the internet broadly will provide patients with better care and more informed health care options.
"I do actually think that it could be helpful," Reeves said. "It helps us to get connected to where the patient looks for information. But there is still a lot of judgment necessary, and I think we're pretty far off from using it in the day-to-day of what we do in the operating room."
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