The problems in today's health-care system keep Orlando entrepreneur Pranam Ben up at night.
Problems like how can we make sure surgeons don't perform the wrong surgeries on the wrong patient, or why do patients have to repeat their health history every time they see a new provider.
The 37-year-old software engineer is dreaming up solutions.
One of those solutions is about to be showcased at the HIMSS14 conference, a gathering of more than 35,000 health-care IT professionals from around the world, which will meet in Orlando, Feb. 23-27.
Ben will be demonstrating AiR, a hands-free, voice activated software that scrubbed-up surgeons can use in the operating room to make sure they're doing the right procedure, on the right body part, on the right patient before they cut.
AiR also helps them be sure that when they're done, they don't leave anything they shouldn't behind â€“ inside the patient.
While these errors may seem unthinkable, they happen more often than consumers might expect.
In Florida hospitals alone, during the year ending last September, 61 patients had surgery on the wrong body part, according to the Florida Agency for Health Care Administration, which tracks hospital and doctor errors. (Fourth-quarter numbers are not yet available.)
Surgeons performed the wrong procedure on 11 patients, and in four cases operated on the wrong patient altogether, during the same 12-month period.
Meanwhile, they performed 73 operations to go back in and remove objects they had left behind â€“ such as sponges and surgical instruments.
Though lower-tech systems (like patients and providers writing in marker "Yes" on the body part where surgery will be) are in place to prevent these mistakes, they aren't good enough. The error rate should be zero, Ben said.
"It's horrendous for the patient," said Ivan Reyes, CEO of the Broward Medical Center, in Pompano Beach, where he runs two surgical centers that have beta tested AiR. "It's pathetic that it happens."
Clermont Surgical Center also uses the software.
The idea for AiR and other patient improvement technologies took shape at The Garage, the company Ben founded two years ago. Based in downtown Orlando, the company's open floor plan is in a hip industrial-like space, with walls of used brick, ceilings with exposed ducts, a ping-pong table, and lots of calculations scribbled on windows in fluorescent markers.
The privately owned company is largely self-funded, said Ben, who also had financial help from a couple of private investors.
The Garage has 10 full-time employees locally and 32 in India, said Ben.
The company's name is a tribute to all the technology companies - Yahoo, Apple, Amazon - that, like garage bands that became rock legends, started in the garage.
"We've all experienced difficulties with our health-care system," he said. "Technology is the best weapon that I have to eliminate these issues. Health care is not a nice experience."
Before moving to the United States 10 years ago from India, Ben got his bachelor's degree in engineering and took a six-month software training program. He began working on health-care software exclusively when he came to the states. He developed a software company and sold it in 2010 to an Atlanta IT firm. He stayed on board with that firm for a little more than a year, then started The Garage.
As the HIMSS conference will attest, Ben is not alone in his pursuit of technological solutions to improve patient care. AiR is one of three programs he has on the launch pad.
AiR interfaces with a hospital's existing electronic patient records. When the surgical team enters the operating room, they see a list of patients on a big monitor who are scheduled for surgery in that room that day. The surgeon uses his or her voice to call up the patient's record by name.
The patient's record pops up, and the team makes sure he's the right patient. Then they go through an automated checklist to verify what's being done and where.
"The system automatically picks up all the patient's data, notes and images from the hospital's electronic records, which makes it very handy," said Reyes.
AiR doesn't replace any timeout protocols already in place, but adds another layer of patient protection, Ben said.
The checklist also has the team account for all foreign objects, such as sponges and clamps, then it videos the procedure.
"Most doctors like it," said Reyes, though initially some resisted. They were uncomfortable with the surveillance.
"I just told them, you want do surgery here, this is how we do things," said Reyes, who sees this technology as another step toward the quality measures hospitals claim to be striving for.
Ben hopes once he introduces AiR at the conference it will take hold in hospitals nationwide. To get there, he is looking for a partner. "We're looking to use their bandwidth to get to market faster and in a bigger way," said Ben.
Reyes is spreading the word, too: "It's a pretty hot system and keeps everyone one in check," he said.
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The frequency with which surgeries on the wrong body part or the wrong patient occurs in Florida might surprise you. Here's how many such surgical errors occurred in the 12 months through September 2013.
Surgery performed on the wrong site: 61
Surgery performed on the wrong patient: 4
Wrong surgery performed: 11
Surgery performed to remove foreign object left from prior surgery: 73
Source: Florida Agency for Health Care Administration