A Digital Ecosystem Using Artificial Intelligence Solutions in Musculoskeletal Health Care

Abstract

The number of artificial intelligence (AI) use cases relevant to health care has continued to increase substantially because technology has evolved. For orthopaedic surgeons and musculoskeletal providers, the onus has expanded beyond learning about these tools conceptually and shifted toward understanding how to use them in everyday clinical workflows. There is a perceived opportunity cost from ignoring these use cases and, similarly, an operational cost from excessively implementing AI tools without thoughtful consideration of how they may impact patient care. This infographic shows how orthopaedic surgeons may leverage various AI solutions to create a digital ecosystem that portends efficiency and value. Before a patient formally establishes care with a physician, AI solutions leveraging agentic frameworks may assist with scheduling appointments based on screening criteria, informing patients of outstanding laboratory or imaging requests, and curating physicians’ schedules. During appointments, physicians can leverage ambient scribes, which listen to patient‐physician encounters and automatically synthesize clinical notes, to make visits more efficient. Furthermore, more recent iterations of scribes automatically codify diagnoses and treatments using International Classification of Diseases, 10th Revision and Current Procedural Terminology and prepopulate orders. The Hospital for Special Surgery, Cleveland Clinic, and Kaiser Permanente, among many others, have used these pipelines to reduce administrative burden and allow more time for direct patient interactions. Multimodal models trained on vast amounts of imaging data may allow for intelligent diagnosis of musculoskeletal pathologies; however, several advanced solutions allow physicians to create “digital twins” and model patient‐specific pathology to guide surgical techniques and predict optimal placement of grafts, implants, and/or tunnels. Postoperatively, physicians can leverage practice‐specific guidelines to create asynchronous chat agents to increase adherence to rehabilitation guidelines. Wearable devices allow real‐time transmission of motion data to help physicians understand recovery trajectory and progress against milestones. Important ethical questions remain. Patient privacy is paramount, requiring enterprise agreements with AI vendors to ensure data remains Health Insurance Portability and Accountability Act‐compliant. Furthermore, systems need to implement governing boards, regular audits, and safety guardrails to ensure data safety and appropriate model performance. Significant literacy gaps remain among patients in underserved communities, so physicians must consider equitable AI implementation. As models progress in capability and speed and become less costly, physicians have exciting avenues to optimize clinical workflows and free more time for empathetic, patient‐guided care.