Latest / Becker’s Healthcare Podcast / Scaling Neurosurgery Through AI, Data, and Innovation with Dr. Samuel Browd

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Scaling Neurosurgery Through AI, Data, and Innovation with Dr. Samuel Browd · Becker’s Healthcare Podcast

• 0:02
  - There's a version of AI in health care
• 0:04
  - that lives mostly in press releases,
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  - pilot programs, partnership announcements,
• 0:09
  - theoretical
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  - And then there's the version that lives in
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  - the work, the CIO trying to get a
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  - the revenue cycle leader weighing automation against accuracy,
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  - the CISO who knows that every new integration
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  - is a new attack surface.
• 0:28
  - Becker's eleventh annual IT and revenue cycle conference
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  - is built for the people doing that work.
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  - More than 2,500
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  - executive level attendees,
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  - 600 plus speakers,
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  - and four days of sessions designed around the
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  - real operational questions behind
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  - AI, cybersecurity,
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  - revenue cycle performance, and digital health.
• 0:48
  - Join us September 14 through the seventeenth.
• 0:51
  - For the agenda and event details,
• 0:53
  - visit beckershospitalreview.com
• 0:55
  - and click on the events tab in the
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  - upper right.
• 0:59
  - This is Scott Becker with the Becker's Healthcare
• 1:01
  - podcast. Hey. I'm thrilled today to be joined
• 1:04
  - by a brilliant pediatric
• 1:05
  - neurosurgeon.
• 1:06
  - We're joined today by doctor Samuel Browde.
• 1:09
  - And doctor Browde is also an entrepreneur, a
• 1:12
  - thinker,
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  - an an idea person.
• 1:15
  - Doctor Browde, can you take a moment and
• 1:17
  - and tell us a little bit about your
• 1:19
  - career, about the University of Washington?
• 1:21
  - Also, I know you were a Gator at
• 1:23
  - one time, maybe a little bit about the
• 1:24
  - University of Florida too. But but tell us
• 1:26
  - about yourself and your career.
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  - Well, it's been an amazing,
• 1:31
  - ride the last, you know, 20.
• 1:33
  - I I got very interested early on in
• 1:35
  - my career,
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  - in particular around one of the diseases that
• 1:39
  - we're treating,
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  - hydrocephalus.
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  - As I looked around, it felt like there
• 1:43
  - was an ability to leverage new technologies to
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  - treat the kids that were coming in, for
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  - hydrocephalus,
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  - which is one of the most common things
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  - we do in neurosurgery. And I had a
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  - great fortunate experience to walk over to bioengineering,
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  - find an amazing engineer who,
• 2:01
  - thought about, the problem with me.
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  - We ended up spinning up a company, and
• 2:06
  - that whole process of trying to ideate and
• 2:09
  - and and bring things to patients was so
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  - exciting and felt like I was really, you
• 2:14
  - know, able to impact, you know, many, many
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  - more people than I could one to one,
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  - you know, in neurosurgery, which I love doing.
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  - But it was an amazing experience, and so
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  - I've had a great fortune to be able
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  - to do this multiple times through the University
• 2:31
  - efforts
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  - with collaborators,
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  - around the country. And, you know, I just
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  - think that, you know, we're in this amazing
• 2:37
  - moment with technology and how that's gonna touch
• 2:41
  - patients going forward. It's just an exciting time
• 2:43
  - to think about innovation in in health care.
• 2:47
  - Is most of your innovation around the pediatric
• 2:50
  - neurosurgery
• 2:50
  - area or other areas?
• 2:53
  - And talk about what you're most excited about
• 2:55
  - currently
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  - in terms of innovation.
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  - So it's my the places that I've worked
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  - have actually been fairly broad. So we work
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  - specifically within neurosurgery,
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  - not just pediatrics, but,
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  - broadly technology,
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  - in the neurosurgery
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  - space.
• 3:11
  - I've done work in sports safety. So we
• 3:14
  - had,
• 3:15
  - done a company called Vysys. So if you
• 3:17
  - look at Patrick Mahomes, the helmet he was
• 3:19
  - wearing in the Super Bowl is something
• 3:22
  - I sketched on a napkin, a super fun
• 3:24
  - project,
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  - that ultimately
• 3:26
  - shifted the entire industry to, you know, better
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  - safety around, sports. And that was really the
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  - inception of that was to try and make
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  - it safer for kids to, you know, play
• 3:37
  - contact sports.
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  - I've gotten very interested in the last decade
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  - in artificial intelligence, computer vision, machine learning. We
• 3:44
  - think that those technologies are absolutely gonna transform,
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  - obviously, health care and neurosurgery
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  - for me in particular.
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  - The idea of brain computer interface and how
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  - we're able to really understand,
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  - data and leverage this technology is,
• 4:00
  - so compelling. And I just think, you know,
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  - there's this massive friendship that's gonna happen. So
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  - I've been putting the majority of my energy
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  - into,
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  - domains,
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  - that use computational
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  - tools,
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  - not just in neurosurgery, but more broadly in
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  - the neurosciences.
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  - So I think it's just a fun, amazing
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  - time we're living in now, and the possibilities
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  - just, you know, are endless.
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  - Where do you see the most practical applications
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  - coming? And then where do you see big
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  - changes coming in sort of, let's say, pediatric
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  - neurosurgery?
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  - Because we're we're facing a huge shortage of
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  - neurosurgeons.
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  - I assume in pediatric neurosurgery, just as much
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  - or more.
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  - Where do you see small and big changes
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  - over the next five to ten years?
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  - Well, you know, a big part of my
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  - thesis has been that, you know, we
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  - sit on tremendous amounts of data that have
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  - information that inform how we're gonna treat and
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  - take care of patients, really allow the democratization
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  - of of medicine more broadly.
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  - And so I've been very interested in, you
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  - know, how do we acquire this data? How
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  - do we process the data? How do we
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  - make it available to clinicians,
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  - surgeons to not only make them individually better
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  - at what they do, but to scale that
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  - knowledge more broadly
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  - so that it can be applied not, you
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  - know, just in The United States, but around
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  - the world. And that spans a variety of
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  - different things. I think we talk a lot
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  - about EMR data, but I've been particularly interested
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  - in
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  - other types of datasets,
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  - that are very germane for neurosurgery. So interoperative
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  - data, you know, we acquire
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  - massive amounts of data that's, you know, very
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  - rarely
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  - leveraged. So that's surgical video as an example.
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  - We do a lot of work acquiring,
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  - physiologic data on patients. This is EEG data.
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  - So we think that those type of datasets
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  - combined with,
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  - data in other domains is really gonna be
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  - where the, you know, I think the transitions
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  - happen in medicine. Right? As we start
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  - to see relationships
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  - and variables
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  - arise and start to develop tools that, you
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  - know, make people, I think, better at the
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  - job that they do. And that that to
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  - your question of scale, is what will drive
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  - scale.
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  - So how do we take, you know, pediatric
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  - nurses? There's probably a 150 of us nationally
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  - who do academic pediatric neurosurgery.
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  - How do you start to scale, you know,
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  - these folks, especially in the domains where we
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  - do the majority of our work, hydrocephalus,
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  - understanding, evaluating these kids within computational
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  - tools and ways we're gonna analyze
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  - imaging and
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  - clinical parameters.
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  - It's gonna change very rapidly, and I think
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  - scale, at least our ability to assess and
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  - take care of the kids.
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  - That's fantastic
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  - in terms of that scale and the hope
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  - that we could take care of people at
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  - scale.
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  - Is is neurosurgery
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  - cranial adult area seems like there's significant shortages
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  - in lots of places in the country.
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  - Is that the same in pediatrics, and is
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  - that a fair assessment on adult
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  - cranial surgery with neurosurgery?
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  - Yeah. I think it's it's a real issue
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  - of of workforce and capacity, especially as, you
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  - know, populations
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  - grow. We you know,
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  - the University of Washington, we've only recently expanded
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  - to where we have
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  - four residents a year. Right? So
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  - this is seven year training program. It's very
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  - arduous. And trying to keep a workforce
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  - out there that is scalable,
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  - I think, is gonna require a lot of
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  - these,
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  - technologies to come forward because we need to
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  - amplify
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  - broadly, like, what an individual can do, just
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  - their capacity. And I think the current
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  - methodology of just see more patients and that's
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  - the way we're gonna grow and scale is
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  - is really challenged. And so I think this
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  - is where technology is gonna play a huge
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  - role of being able to assess patients
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  - and really figure out, like, who needs neurosurgical
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  - intervention.
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  - We do a lot of stuff, like, even
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  - in my own practice where I spend a
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  - tremendous amount of time,
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  - doing things that probably don't leverage the skill
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  - set that I've developed. And so I think
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  - these computational
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  - tools
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  - will create efficiencies as maybe the first place
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  - where it allows scale. And I think this
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  - applies to not just, obviously, pediatric neurosurgery,
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  - but adult neurosurgery. And then there's the next
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  - layer, which gets very compelling is how do
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  - you take some of these skills
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  - that we have and replicate them? So, like,
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  - endovascular
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  - neurosurgery is a really interesting space where robotics
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  - is starting to come in. So can you
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  - take an individual who may be in one
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  - city
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  - and allow them to perform,
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  - you know, coiling of an aneurysm
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  - as an example
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  - in an outlying hospital. Like, these are things
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  - that need to happen to scale
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  - the capability of an individual
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  - surgeon and really make them more omnipresent and
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  - able to bring those skill sets that they've
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  - learned over such a tremendous, you know, you
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  - know, long period of training
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  - to many, many more people.
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  - Thank you. And and and talk about you've
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  - had this brilliant career in neurosurgery.
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  - What advice would you give to emerging surgeons?
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  - You know, I tell our residents that they're
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  - so lucky. They're coming into neurosurgery at a
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  - time when the field is, at least from
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  - my perspective, gonna massively change. Right?
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  - How we start to digitize
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  - what's been, you know, an analog profession for
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  - for, you know, the the history of neurosurgery.
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  - What are these tools that are gonna come
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  - in that are gonna allow them to be,
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  - you know, better at what they do? And
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  - the thing that I really tell these young
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  - folks is that
• 9:40
  - they're in a position to think about how
• 9:42
  - the evolution of nursery is is gonna look.
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  - Right? How are they ideating?
• 9:48
  - How are they working and enabling industry to
• 9:51
  - come in and build
• 9:53
  - these next generation of devices and tools and
• 9:56
  - computational
• 9:58
  - algorithms that are really gonna kinda do this
• 10:00
  - frame shift that we see coming to medicine
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  - broadly and, you know, again, in particular, my
• 10:05
  - focus around neurosurgery.
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  - So
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  - I think it's these folks. And it's fascinating
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  - to me too that all the residents coming
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  - in, they've grown up in a different generation.
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  - Right? They're sort of the the kids who
• 10:17
  - grew up in mobile. They grew up understanding
• 10:20
  - sort of the power of cell phones and
• 10:23
  - those as, you know, computational
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  - devices, and they all wanna
• 10:27
  - really engage in in AI. It's been fascinating
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  - seeing, you know, folks as we've interviewed this
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  - next, you know, generation of of surgeons coming
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  - through it. It's,
• 10:37
  - it's really their world to change, and I
• 10:40
  - think they're all very excited about that. So
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  - I'm I'm really encouraged,
• 10:45
  - as this next generation comes through, how they're
• 10:48
  - gonna participate.
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  - Thank you. And and how much do you
• 10:52
  - see artificial intelligence changing the world of neurosurgery?
• 10:56
  - It seems like an area there will be
• 10:58
  - significant impact. Take a moment and tell us
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  - where you see that. And And, also, if
• 11:02
  - you got a chance to visit with Patrick
• 11:03
  - Mahomes at all and give him any advice
• 11:05
  - on on the Chiefs and where they're going
• 11:07
  - in the future.
• 11:09
  - Alright. I'll take the, I'll take the AI
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  - one first.
• 11:13
  - You know, again, we sit on massive amounts
• 11:14
  - of data that are not really leveraged,
• 11:17
  - to the point that they could be at
• 11:19
  - this stage. And so I think AI is
• 11:20
  - gonna come in and allow us to do
• 11:22
  - a variety of different things. So we're already
• 11:24
  - seeing
• 11:25
  - examples of this. Like, you know, I personally
• 11:27
  - have been very excited about brain computer interface.
• 11:30
  - I spent a lot of energy around that
• 11:32
  - domain. So how we're doing computation around brain
• 11:35
  - signals and what we're able to do with
• 11:37
  - that is dramatically changing. And even in the
• 11:40
  - last couple months, some of the things that
• 11:41
  - we've done
• 11:42
  - look foundationally
• 11:43
  - different than the way signal processing has been
• 11:46
  - done, how we understand the brain, how we
• 11:48
  - understand the connections in the brain. It's just
• 11:51
  - one example of where I think these tools
• 11:54
  - allow us to look in high dimensional,
• 11:56
  - spaces
• 11:57
  - that as humans, like, we just can't do
• 11:59
  - very well. And so we're seeing this, you
• 12:02
  - know, as an example in in surgery looking
• 12:05
  - just at histology. Right? We're able to do
• 12:07
  - and there's companies being formed to look at,
• 12:09
  - you you know, tissue that's come out of
• 12:11
  - the Operating Room in real time to do
• 12:13
  - diagnostics.
• 12:14
  - That allows us to do better surgeries, have
• 12:17
  - better receptive margins, things like this. I think
• 12:20
  - the robotics in neurosurgery is really in its
• 12:23
  - infancy. We see that in spine,
• 12:26
  - right now, but those tools are
• 12:28
  - very early days. And so all of these
• 12:30
  - things are really gonna, I think, make the
• 12:33
  - outcomes of surgery much better, allow us to
• 12:36
  - assess patients,
• 12:38
  - more readily. And, you know, I think outcome
• 12:40
  - metrics, how we're tracking and understanding that are
• 12:43
  - gonna be evolving very quickly. And so it's
• 12:47
  - it's such a an amazing thing to think
• 12:49
  - about how these tools are gonna just transform
• 12:52
  - our practice.
• 12:53
  - In terms of Patrick,
• 12:55
  - you
• 12:56
  - know, I get my, football knowledge from him,
• 12:59
  - so I don't know if there's a lot
• 13:00
  - of advice I can give him other than
• 13:01
  - to wear a a really good helmet, which
• 13:03
  - he's he's been doing, fortunately, for years.
• 13:07
  - No.
• 13:09
  - Fantastic.
• 13:10
  - Doctor Brown, I wanna thank you for joining
• 13:12
  - us. I guess one last question. Are you
• 13:13
  - a Husky fan or a Gator fan? And
• 13:15
  - where do you sit on that?
• 13:18
  - You know, I spent ten years in Gainesville,
• 13:21
  - and, my allegiance to the Gators is very
• 13:25
  - strong. But I I love our Husky team
• 13:27
  - out here out here too. And, when
• 13:30
  - they've,
• 13:30
  - if they ever get a chance or more
• 13:32
  - recently to play, so that's gonna be a
• 13:34
  - tough one for me.
• 13:36
  - One last question along those lines. Steve Spurrier,
• 13:39
  - Tim Tebow,
• 13:41
  - who are your favorite all time Gators?
• 13:46
  - You know, Tebow is,
• 13:48
  - is absolutely,
• 13:50
  - amazing. But, I entered Gainesville
• 13:53
  - during the era of, Emmett Smith. And so
• 13:56
  - Emmett's, probably one of my all time favorites
• 13:58
  - for sure.
• 14:00
  - An amazingly
• 14:01
  - durable back and incredible career. If you watch
• 14:03
  - him in the Cowboys documentary,
• 14:05
  - the special about Jerry Jones and so forth,
• 14:07
  - he comes across really well and really fantastic.
• 14:10
  - We've had him speak a couple times at
• 14:12
  - Becker's meetings, and what a pleasure of a
• 14:13
  - person. Love it. Yeah. He's an amazing guy.
• 14:16
  - It really a nice, nice person. Doctor Brad,
• 14:19
  - I wanna thank you for joining us on
• 14:21
  - the Becker's Health Care podcast. It's amazing career,
• 14:23
  - amazing what you're doing. Thank you so much
• 14:25
  - for joining us. Scott, thanks for having me.
• 14:27
  - I appreciate it.