Jane Braithwaite’s latest article, ‘You, Robot?’, published in the Independent Practitioner Today talks about how automation is playing an ever increasing role in the medical practice. Read on …

Could you be automated?

In 2011 – IBM’s Watson computer won the game show, Jeopardy, and is now functioning as a diagnostic device for cancer patients.

robot

What are the implications of automation in the medical world and how far could they reach?

Let’s take an objective look at automation and robots. We’ve already accepted extensive automation in our lives without necessarily having registered radical changes. Seems like self-service kiosks in supermarkets and petrol stations are now omnipresent – albeit irritating devices. Can we imagine life without ATMs? Online banking is a good example of useful automation. Who today would envisage queuing at lunchtime to cash a cheque?

In this article we will review the pros and cons of automation and its potential impact on the medical profession.

What can be automated?

Anything that entails basic hand eye coordination, can be done by mechanical devices. Routine, repetitive and predictable jobs are most suited to automation. The more transactional a task is – the more plausible this process. At the most basic level, automation requires capital investment to replace labour.

Tasks including large volumes of information are perfectly suited to automation as machines are able to organise huge quantities of data. Machines such as iPhones create and process vast amounts of information; we will increasingly use machines to organise and present the said data in a useful way. It’s quite a conundrum.

Tasks and jobs that involve personal contact, interaction, dialogue, debate and negotiation cannot be performed well by a robot.

Is this disruptive, destructive or exciting?

Current jargon on the subject includes disruptive technology and disruptive innovation. New corporations such as AirBnB and Uber have disrupted traditional business models and subsequently enjoyed huge success. It’s fair to observe that whilst these innovative businesses have generated employment and augmented customer satisfaction, they’ve also had a negative impact on incumbent businesses such as London’s traditional black cabs.

A study by the McKinsey global Institute predicted that by 2025 robots could replace 40 million to 75 million Jobs worldwide

Automation will largely affect tasks and jobs that are transactional in nature. Jobs that can’t be automated include those that rely on personal interaction, in which the calibre of customer service is highly relevant. Consider the hotel industry. If you’ve booked into a Travel Lodge, you might be happy to check in with your credit card. If you’re looking forward to a celebratory stay at Claridge’s you would undoubtedly prefer a warm, personal welcome.

Impact on the medical profession

Given that the fundamental nature of a doctor’s work entails personal interaction and empathy, we might assume a minimal impact from automation in the medical field. I would envisage impact occurring in three separate areas:

1. Diagnosis and treatment

2. Robotic solutions as medical devices

3. Automation in the medical environment

Diagnosis and treatment

Automation will be hugely important in the area of diagnosis. As previously mentioned, IBM’s Watson computer is able to suggest diagnoses and treatment options by analysing symptoms, a patient’s medical history and research studies. In this instance – the ability to process large volumes of data is highly significant.

Automation can benefit patients by providing an increased quality and range of treatment options. For example, the iBG star diabetes manager app is a blood glucose meter that can be attached to an iPhone. This enables patients to check blood insulin levels at any location, and obtain results almost immediately.

Automation offers huge possibilities for genomics. Genomics England is an exciting project; whose aim is to sequence 100,000 genomes from 70,000 people. Their latest website statistics shows they have reached 12,256 to date. The data from one sample is equivalent to 100GB or 20 HD movies. The stated aim is to improve diagnosis, especially in cancer. These quantities of data will need to be processed by a computer, and the outcome will be precision medicine, speedy diagnosis and the ability to predict the success of different treatment plans.

Robotic solutions as medical devices

Numerous developments of robotic solutions to medical problems are underway. This is an exciting area and potential benefits to patients could be huge. The ability to provide a prosthetic leg that can monitor and emulate a patient’s walking patterns, is a reality with the Otto Block Microprocessor C leg. The “knee” adjusts accordingly, enabling the user to walk at different speeds, thus increasing safety on stairs and ramps.Public Health Information Network

Eksoskeletons are being employed to assist people with spinal injuries as well as enhancing rehabilitation for those learning how to walk again, for example – after having suffered a stroke.

RFID chips are slowly making an impact in the medical world; the future will see greatly increased usage. At Sanraku hospital in Tokyo patients wear their RFID tag in a wristband. Their injection prescriptions are stored on a chip which is read by a handheld reader; this ensures the correct drugs are prescribed, whilst simultaneously linking back to patient records and the relevant hospital inventory.

Exciting developments

In addition there are also some exciting developments in ophthalmology taking place. An Artificial silicon retina has been used with great success by Dr Chow. The device consists of a 2 mm diameter ASR microchip. It’s a good solution for patients with retinal degeneration and works by converting light energy. As a result, one patient reported significant vision returning, having previously lost their sight entirely.

Robotic hearts have been used for many years as a temporary solution whilst patients await a human heart transplant. A French company called CarMat (an unfortunate name in English) has created a permanent Artificial heart solution. The device runs a five-year lithium battery but its cost is high at $200,000. The benefits in terms of after-care are enormous as the heart effectively monitors itself. The greatest concern with such devices is the possibility of hacking. Also, Dick Cheney had a temporary robotic heart and was so worried about it being hacked that he asked for the Wi-Fi to be disconnected!

Automation in the medical environment

We are destined to see huge changes in the medical environment. From robots delivering patients’ prescriptions on the ward, vast changes in medical secretaries’ and admin staffs’ work practices will undoubtedly ensue.

Taking a wider view of the environment doctors work in, drones will be both innovative and daunting. They are likely to be used increasingly in disaster relief. In 2012, drones were used to deliver small aid packages after the Haitian earthquake. Furthermore, Doctors without borders have also used drones to transport TB test samples to remote villages.

[plsc_pullquote align=”right”]”We are destined to see huge changes in the medical environment.”[/plsc_pullquote]

In the future, we may see drones being used to transport blood products to hospitals and large-scale incidents, along with drugs and defibrillators; the possibilities are limitless.

Within the practice and hospital environment, one of the first developments of automation will most likely be patient appointments. It’s unlikely that many will miss the incessant ringing of practice phones by patients requesting urgent appointments; this will be done automatically!

Many of the administration tasks that are carried out manually at a doctor’s practice, will be automated in the future. These include computer generation of bills subsequent to patient’s appointments, and chasing of payments, if necessary. This could and should be more commonplace.

Will you need a medical secretary? We envisage changes occurring subtly over time, including a slow evolution of the medical secretary’s role. Personal interaction will remain key: someone to meet, greet and reassure nervous patients will always be a fundamental requirement in the private medical world.

We look forward exploring this brave new world with you.

Jane Braithwaite is Managing Director at Designated Medical and regularly contributes to the Independent Practitioner Today publication.

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