Talking Shop with Dr. Edward Bender, cardiothoracic surgeon, Saint Francis Medical Center

Dr. Edward M. Bender, cardiothoracic surgeon and section chair of Cardiothoracic Surgery at Saint Francis Medical Center, recently developed five applications for the Apple iPhone to help doctors and patients predict the risks associated with heart surgery. The apps range from free to $3.99 on the iTunes App Store. Some of his apps are downloaded up to 100 times each day. Bender has been at Saint Francis for 13 years and was the first doctor in the area to use the da Vinci robotic surgery system to perform open heart surgery.

Q: What inspired you to create an iPhone app?

A: I'm a hobbyist computer programmer. I like to create websites, web applications and utilities at home. I still remember when I got my first IBM XT. For me it's a form of creativity. With the iPhone, you present the user with a cinematic experience while being productive at the same time.

Q: How did you begin the process of designing the apps?

A: The ARMUS Corp. maintains a database used to calculate the risks of cardiothoracic surgery. One day, I just cold-called them and found out they were dying for portable apps. I e-mailed them a Quicktime movie I'd made then went out to California and spent a few hours talking with them. They helped develop what the graphics should look like. Most people use an app for 30 to 90 seconds, so you want it to be a quick and efficient experience. I had other heart surgeons test the app including doctors from the United States, South Africa and Australia.

This is one of the graphic screens on Dr. Edward Bender´s heart surgery risk calculator app available on the iTunes App Store. (Fred Lynch)

Q: How are your apps helping doctors and their patients?

A: If I'm talking to a patient and they want to know their chances of [surgical] complications, I can just whip this out and tell you how your case compares to the other 4 million in the database. Everybody knows what to expect before the procedure. I've got all the numbers at my fingertips and the patients and their families can have the data, too. It gives patients peace of mind to know they're not straying from what the rest of the world is doing. We're looking at 50 to 70 different data points to predict the risk of having to stay on a ventilator, suffering a stroke, developing an infection, or having to stay in the hospital longer than two weeks. All those factors play a role in the judgment of a surgeon.

Q: Are advances in technology improving patient care?

A: From the 30,000-feet view, yes. But it's hard to see it every day when you're working with patients. Over time and numbers of patients, we are improving. It's like needing glasses, you don't know you could see better until you put them on. When I was a resident at the University of Colorado, I thought we were advanced then. We think we are advanced now, but 15 to 20 years from now, we'll look at the iPhone and think floppy disk.

Q: What kinds of challenges do technological advances, like robotic-assisted surgery, present to doctors?

A: The challenge lies in trying to overcome your comfort zone. As a surgeon you do the same procedure every day and you do it well. There is a lot of inertia to keep doing the same thing. We have to adopt proven technologies as they become proven. If we can do the same thing for a patient with little inconvenience, it's incumbent upon us to learn to perfect these techniques.

Q: What should we all know about heart disease in the United States?

A: Heart disease is the No. 1 cause of death in the United States. Most of it is caused by lifestyle and genetics. Each year in the United States there are 7,000 bypass surgeries performed, and twice as many angioplasties and stints. With my Heart Surgery Risk application, patients can see where their risks lie and take an active role in their own health care.