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Feature Article Local Surgeon Develops Smartphone Apps for Patient Care

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When the first iPhone hit the market a decade ago, Cardiothoracic Surgeon Edward Bender, MD, knew exactly what he wanted to do with it.

“It was instantly obvious to me that this was the platform for medical applications, and the sky is the limit,” said Dr. Bender. “I started developing mobile applications that I wanted to use at the bedside.”

An early adopter of technology, Dr. Bender has dabbled in programming since he first got his IBM personal computer in the mid-1980s.

“I’m a hobbyist computer programmer,” he said. “I like to create websites, web applications and utilities at home.”

With the possibilities presented by the iPhone, he set to work creating applications – apps – for clinical settings.

His first medical app was the EuroSCORE, which helps cardiothoracic surgeons predict the risks of surgery for patients. Based on an international database that includes information from millions of patients, EuroSCORE II, the second version of the app, is used worldwide.

In addition to a variety of cardiac risk calculators, Dr. Bender enjoys creating educational apps geared toward practicing or training surgeons. These days, he makes apps for both Apple and Android devices.

One such app, CTSNet, makes surgery videos posted by cardiothoracic surgeons easily available on a smartphone. He has also created apps that walk thoracic surgery residents (doctors undergoing additional training) through clinical scenarios and help residents prepare for board exams.

In 2016, Dr. Bender launched an app for surgical resident evaluation.

At the end of a cardiothoracic surgery, a surgical resident can open the app, select their attending (supervising) surgeon, the kind of surgery, the degree of difficulty and then choose the level of autonomy they feel the attending surgeon gave them during the procedure. When this is done, the attending surgeon gets an alert and answers a similar set of questions, adding notes on the resident’s performance. Then the resident can view the two assessments side by side.

Ten medical schools are using the resident evaluation app. In addition to providing valuable educational insights, the app has also contributed to research. The Journal of Surgical Education recently published an article on a study titled “The Effect of Gender on Resident Autonomy in the Operating Room.” The study found that male surgeons were generally given more autonomy during surgical procedures, and that male attending residents never gave female residents the highest level of autonomy.

“That was one unexpected finding,” Dr. Bender said.

As smartphones are increasingly used by patients and doctors to improve health and health care, Dr. Bender plans to continue developing apps.

“I try to drive our specialty toward higher levels of technological use,” Dr. Bender said. “I’m always soliciting ideas from my fellow surgeons.”