The age of technology improves patient care

Published 09/16/2019

The 1980s brought a surge of new technology to South County Hospital. By 1986, a year after the CT scan arrived, the hospital also had a mammography machine, the CGR Sonographic 500T.

It was described as “one of the most sophisticated in the state,” serving approximately 2,600 women a year.

The MRI was the next big innovation, arriving in 1991, and Albert C. Henry Jr., chairman of the South County Hospital Foundation, hailed it as “the exciting magnetic resonance imaging technology that will provide physicians greater definition in the diagnosis of soft-tissue abnormalities without invasive surgery.”

Today doctors would find it hard to imagine a world without these diagnostic imaging tools. Whereas the hospital's first doctors had only X-rays, the physical examination, and exploratory surgery to rely on, now doctors have quick access to high-definition pictures of internal organs and processes.

Sharper images

The technology used by cardiologists has also evolved greatly since the days of black-and-white ultrasound images.

When Dr. Neil Brandon joined the hospital staff in 1990, the SPECT (special photon emission computerized tomography), a form of nuclear imaging using gamma rays, was a new addition to the Nuclear Medicine Department. He also became the first to use esophageal echocardiograms at the hospital. Then Dr. David J. Broza brought echocardiogram stress testing when he arrived in 1994.

But Dr. Brandon is most proud of the hospital's efforts in thrombolytic therapy, the “clot-busting” medication administered to ER patients having a heart attack.

In 1992, the federal government set a guideline of 30 minutes for the time between a patient's arrival at the ER and the administration of the medication.

The hospital, under the leadership of President Ralph Misto, was able to reduce that time to 12 minutes.

“We addressed the delays at every step in the process,” Brandon recalled, and by ringing a code, all the people involved would convene on the ER, including an extra nurse, a pharmacist, and a respiratory therapist.

“We used to joke, but it was really quite true,” Brandon said. “If you were in the parking lot of Rhode Island Hospital and had a heart attack and if you got in your car and drove to South County Hospital, you would get the thrombolytic therapy quicker” than if you waited in the Rhode Island Hospital ER.

Today, the protocol has changed again, as ER physicians refer cardiac patients immediately to the catheterization labs at area hospitals equipped for angioplasty.

Robotic surgery

Technology entered the Operating Room as well, transforming the work of surgeons. Early surgeons like Dr. John Paul Jones and Dr. Thomas Nestor would surely be amazed at the role that computers and robotics play in today's OR.

By 1994 the hospital's surgeons were performing laparoscopic surgery with fiber optic cameras inserted through incisions “the width of a fingernail,” according to the annual report that year. It was being used for vaginal hysterectomies, appendectomies, hernia repair, and even some orthopedic surgery.

Other treatments that have evolved at the hospital include radiation, offered since 2005 in a partnership with South County Radiation Therapy; dialysis, offered at the hospital since 1994; and infusion therapy at the South County Health Cancer Center, which recorded more than 1,000 treatments in the first two months after it opened in November 2016.

A global leader in orthopedics

A new 10-bed Orthopedics Center was dedicated in 2007, and it would become the nexus of cutting-edge technology.

In 2010, South County Hospital invested in the Mako robotic arm-assisted system. This system combines computerized ‘mapping’ of a patients knee or hip that allows the surgeons “pinpoint accuracy” to target only the damaged tissue and install a replacement joint that replicates each patient’s natural structure.

Using the Mako technology, recovery time for patients who have had knee or hip replacements was reduced dramatically, with most patients up and walking the same day as their surgery.

Dr. Robert Marchand and his colleagues from Ortho RI pioneered the use of Mako robotic-assisted surgery for hip and knee replacements, performing more than 8,000 surgeries between 2010 and 2019 earning South County Hospital the distinction of performing the most hip and knee procedures than any other hospital in the world and performing the largest volume (approximately 36 percent) of orthopedic surgeries performed in Rhode Island.

Nine years after introducing Mako surgery to Rhode Island, South County is still the only hospital in the state offering Mako robotic technology.

South County Health Institute for Robotic Surgery

In June 2018, South County Hospital made a further commitment to the future with acquisition of the daVinci Xi Surgical System. Featuring three-dimensional high-definition images, the system enhances laparoscopic surgery and was introduced for urologic and general surgeries performed by Dr. Joseph Renzulli, chief of urology, and Dr. Joseph Brady, general surgeon.

In January 2019, orthopedic spine surgeon Dr. Ian Madom of Ortho Rhode Island performed the first robotic-assisted spine surgery in Rhode Island.

These technologies and the capabilities they offer to improve patient outcomes motivated the investment in equipment and the 3experts who use them. With the three robotic systems in use, as well as other advanced technologies that assist in the diagnosis and treatment of numerous conditions, the Institute for Robotic Surgery was formed, giving patients a single resource to get the best care possible.

Dr. Lisa Rameaka, the hospital's chief medical officer, summed up the hospital's commitment to technology: “These devices, in the hands of our highly trained, experienced surgeons, are improving outcomes for patients, shortening recovery times for some procedures, and making it possible for patients to enjoy a healthier life.”

Next: Computerized recordkeeping becomes the norm for the hospital and its physicians.