The Neurosurgery Clinic of the Future: Q and A with Dr. Michael Ivan
Summary
- Dr. Michael Ivan, a University of Miami Miller School of Medicine neurosurgeon, is working toward creating the neurosurgery clinic of the future.
- He uses technology to more accurately evaluate patients long before they’re in the operating room.
- His team is implementing computer vision AI that records everything that happens in the operating room during surgery.
Michael Ivan, M.D., is a neurosurgeon at UHealth—University of Miami Health System and a nationally recognized leader in brain tumor surgery, surgical innovation and the clinical integration of advanced technology.
Over the course of his career, Dr. Ivan, a professor in the Department of Neurological Surgery at the University of Miami Miller School of Medicine, has helped push neurosurgery beyond traditional boundaries. He’s embraced artificial intelligence, advanced imaging, wearable technologies and data-driven care to improve outcomes and quality of life for patients.
Dr. Ivan shares his vision for the neurosurgery clinic of the future, a topic that he presented at the 2025 Congress of Neurological Surgery.
He discussed how technology is reshaping patient interactions, surgical planning, research and long-term recovery while also addressing what must not be lost as medicine becomes increasingly digital.
When people think about advances in neurosurgery, they often focus on the operating room. How do you think about innovation in the clinic itself?
That’s a great question, because the clinic space is often overlooked. One major advancement in the clinic is offering a 3-D holographic imaging of the patients’ right in the exam room setting. Patients sometimes make important decisions about their health without fully understanding their condition. Using 3D avatars allows us to turn complex medical images into clear insights, enhancing communication which can lead to better physician-patient relationships and medical understanding.
Other tools that have enhanced the clinic space are the use of wearable devices and smartphones to track patients after treatment. We’re now able to gather objective data about how patients are functioning in their daily lives, not just how they look during a short clinic visit.
By connecting to patients’ phones, we can monitor things like activity levels and recovery patterns without tracking their location or compromising privacy. This broadens our interaction with patients beyond the clinic and gives us a much clearer picture of how they’re actually doing between visits.
You’ve been involved in research focused on neurocognitive outcomes after neurosurgery. Why is that so important?
Historically, neurological exams focused on very basic questions. Are patients awake? Oriented? Able to talk or move? Those are critical, but they don’t tell the full story. Patients care deeply about memory, executive function, emotional well-being and whether they can return to work and live a normal, fulfilling life.
We’re leading a large clinical trial called the Glioma Connectome Project, which formally evaluates neurocognitive function in brain tumor patients. Using advanced imaging like connectome scans, we’re correlating surgical approaches with long-term cognitive outcomes. The goal isn’t just to help patients leave the hospital. It’s to help them thrive, long term.
Is this approach limited to cancer patients?
The clinical trial itself is focused on glioma patients, but the technology isn’t limited to cancer. We use these tools for benign and malignant tumors alike. Understanding cognition and brain connectivity is relevant across neurosurgery.
How has the philosophy of neurosurgery changed over the course of your career?
When I was training, medicine was very population-based. We’d look at outcomes from hundreds or thousands of patients and decide what generally worked. Over time, we’ve learned—often through failure—that patients are incredibly different. Knowing someone’s diagnosis and age isn’t enough.
Now we’re focused on capturing much more granular data about each patient. That includes imaging, cognitive testing, functional outcomes and recovery patterns. Technology allows us to move toward truly personalized neurosurgery instead of one-size-fits-all treatment.
You’ve mentioned using AI and computer vision during surgery. What does that look like in practice?
We’re about to implement computer vision AI that records everything that happens during surgery. After the case, the system analyzes the procedure in incredible detail—how long each phase took, how often instruments were used, how much time was spent in different areas of the tumor.
This level of detail has never been available before. It helps us understand why different surgeons may approach the same operation differently, and whether those differences matter. Over time, this can help standardize best practices, improve efficiency and ultimately improve outcomes.
How does this data fit into patient care beyond surgery?
When you combine intraoperative data with wearable-device data and long-term outcomes, you start seeing patterns we’ve never been able to identify before. We’re not just looking at snapshots. We’re looking at the entire continuum of care and asking how we can optimize every step.
How is AI being used beyond the operating room?
Right now, AI is being used in specific areas—pathology, MRI interpretation, surgical analysis. The long-term vision is to connect all of these systems. I’m on the advisory board for Medtronic’s major AI initiative in neurosurgery, which aims to collect data every time a patient interacts with a device, from imaging and planning to surgery and follow-up.
The idea is that we learn from every patient. The system continuously updates itself, improving decision-making for the next case. That’s how you get real progress—by constantly learning from real-world data.
The future of neurosurgery is about data, personalization and continuous learning, while preserving the human connection at the center of care.
Dr. Michael Ivan
Can AI actually predict how a tumor will behave?
Yes, and that’s one of the most exciting areas. We recently published work using AI to predict where a tumor is likely to grow months into the future based on advanced MRI sequences. By analyzing dozens of imaging parameters together, AI can see patterns that humans can’t.
When you combine that with connectomic data—understanding what parts of the brain control specific functions—you can make much more informed surgical decisions. It helps us balance tumor control with preservation of critical brain functions.
With all this technology, are there things you don’t want medicine to lose?
Absolutely. There’s no substitute for meeting patients in person, understanding their lives, their jobs, their goals. That context is critical and can’t be captured by algorithms alone.
We’re also seeing patients use AI tools like ChatGPT to self-diagnose. While those tools can be helpful, the data they rely on is often outdated and not specific to the individual. Medicine changes every week. Clinical judgment and up-to-date expertise still matter tremendously.
How important is telehealth in neurosurgical care today?
Telehealth is essential. A large percentage of my patients are coming in for routine follow-ups. Asking someone to drive hours, wait in traffic and spend an entire day for a short visit just doesn’t make sense.
Telemedicine reduces stress, improves access and encourages patients to reach out sooner if something feels wrong. It’s especially valuable after surgery, when travel can be difficult. If academic centers don’t adapt to this expectation of convenience, patients will turn to other models of care.
What does it mean to see major technology companies entering neurosurgery?
It’s incredibly exciting. Companies like Dell, NVIDIA, Apple and others are now deeply involved in medical technology. That level of collaboration hasn’t existed before.
It also helps patients understand what we’re doing. When they hear that their health care system is partnering with trusted technology brands, it makes advanced tools more tangible and relatable. Ultimately, that helps move the field forward.
Looking ahead, how would you summarize the future of neurosurgery?
We’re at a point where technology allows us to make major leaps forward, but only if we integrate it thoughtfully. The future of neurosurgery is about data, personalization and continuous learning, while preserving the human connection at the center of care. When we get that balance right, the potential for patients is enormous.
Tags: AI, artificial intelligence, Department of Neurological Surgery, Dr. Michael Ivan, glioma, Glioma Connectome Project, neurological surgery, technology