Becker's ASC Review

In addition to connecting his facility and switching between rooms, Dr. Dean uses NUCLeUS to create a collaborative training and education environment – regardless of where he or his audience is located. As someone who has developed several procedures, he understands how medical education is similar to an apprentice program. Fellows learn and replicate procedures, and once they are practicing independently it is often difficult to successfully adopt new techniques and technologies, which are typically tied to better patient outcomes. As an educator, Dr. Dean feels an obligation to provide surgeons with a way to safely learn new procedures. With NUCLeUS, he isable to do just that. "Having the ability to broadcast, proctor and show other surgeons my cases – and conversely to have them show me their cases – instills a sense of confidence and helps with the adoption of new techniques," Dr. Dean said. He added, "With NUCLeUS, I can showcase four feeds, which is especially helpful when compared to conventional systems that highlight only one feed. On the fly, I can immediately send the NUCLeUS broadcast through any of the major video and collaboration platforms. In addition, there's no lag, which is essential for a surgeon learning in real time." In fact, when a recent research and development presentation was nearly called off due to flight cancellations, Dr. Dean was able to support the 8 hours of live demonstrations through NUCLeUS. He described the situation and said it ultimately allowed a broader audience to access the information. "No one had to leave or spend time traveling and we were able to bring in additional surgeons to watch. While it's never exactly the same as being in-person, it's pretty close," explained Dr. Dean. One of Dr. Dean's favorite features of NUCLeUS is the ability to simultaneously and securely record four feeds that include a timestamp. He explained, "I record an endoscopic feed showing my hands and how I'm holding the endoscope, the neural monitoring and navigation. Having this information so readily available enables me to go back and do research studies. Having the timestamp provides continuity that allows me to playback a procedure and see exactly when a patient did well or didn't do well and then I can investigate further or see what was different." Furthermore, as COVID shifts the landscape for patient care, Dr. Dean leverages NUCLeUS' remote capabilities for telemedicine. Sometimes Dr. Dean is at his facility and patients are remote and other times patients are at the facility and Dr. Dean is offsite. This allows him to provide "nearly the same level of services remotely and minimize patient contact and potential exposure, which is critical for elderly and immunocompromised individuals." While many other healthcare facilities were shutting down as a result of the pandemic, Dr. Dean was able to continue seeing and caring for patients through the use of technology including NUCLeUS and Sony's PTZ cameras. As COVID changed doctors' approaches to patient visits, Dr. Dean quickly pivoted 42% of his office visits to telehealth with virtually no downtime or ramp up due to his use of PTZ cameras. He was able to facilitate remote case observation for 129 cases. Additionally, Dr. Dean employed telehealth to evaluate 96 patients prior to surgery, avoiding the unnecessary risk of possible COVID exposure or transmission. Dr. Dean is also able to see his higher risk patients remotely, while a skeleton staff conducts audiometric evaluations and other diagnostic tests in the office to minimize risk of transmitting COVID. Additionally, he increased his ability to move higher acuity cases to the office to avoid a closure that could have potentially detrimental effects on his patients. Ultimately, he maintains, "Prior to NUCLeUS' implementation, I was able to perform 64 cases in the office. In 2020, that number grew 52% to 133 cases and in 2021 it rose to 167 cases, marking a 21% year over year increase – during a pandemic. I'm grateful that this technology allowed me to continue to practice medicine and provide quality care while maintaining continuity of care throughout the pandemic and associated shutdowns." Another element of NUCLeUS that is transforming Dr. Dean's operations is its IP-based workflow. As IP technology becomes more cost-effective, video-over-IP is increasing in adoption because it's modality neutral, easy to set up, works with existing infrastructures and provides minimal latency. Dr. Dean shared, "IP protocols allow me to be more efficient and break down physical walls. I can move things from one room to another, with one system, over a protected network. In the future, I envision a tele-fellowship program that will leverage IP technology to connect clinics nationwide, that would allow medical professionals located around the country to work as if they were all in the same medical office building or room." When choosing NUCLeUS, Dr. Dean cited his confidence in Sony as another selling point. He said, "Sony's dedication to quality and the end product is unsurpassed. They're a well-established corporation that has gotten where they are by delivering on promises. I appreciate their willingness to work with me, understand my challenges and evolve the NUCLeUS solution to further meet my needs and the needs of the healthcare community." While Dr. Dean believes that using new technology can allow surgeons to be safer and more efficient, ultimately, the true measure of success is better patient outcomes. Dr. Marc Dean Ear and Sinus Institute Fort Worth, Texas

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