In 2011, the President announced the launch of the National Robotics Initiative. U.S. federal agencies (DoD, NSF, NIH, NASA, USDA) followed with a unified campaign to promote the next generation of robotics. These agencies have in the past and will continue to sponsor robotics-related researchers through various funding programs.
Robots and automated systems are being built to co-exist with humans, helping people at work and throughout society. New niche markets have emerged and others expanded based on these funded innovations. The wording of the Initiative cites “co-robots acting in direct support of and in a symbiotic relationship with human partners.”
In the last decade, robots have already proliferated into many areas of the medical field – surgery, materials transport, pharmacy automation, telepresence, prosthetics, and rehabilitation. These systems interface directly with patients in a “standard of care” way through human oversight and FDA approval. Companies responsible, many with government funding prior to the Initiative, have successfully brought their products to market.
More and more, technology is crowding into the care continuum traditionally staffed by medical professionals.
So, what is there to fear about robots in healthcare?
To answer this question and related topics like safety, better outcomes, and replacing doctors with algorithms, it’s important to consider human and tech interaction since the mid-20th century.
There was a time when you could not ride an elevator without an operator. A person was specifically employed to run the start, stop, and speed dials of the elevator. In the Mad Men era, this was a big step up from walking stairs and required an industrial economy expert to serve as your floor to floor concierge. Elevator automation we enjoy today required human “expertise” back then.
Transcontinental air flight used to require additional pilots in the cockpit than the two that are common now. Thanks to smart systems and software, airplanes utilize autopilot in the same way cruise control is ubiquitous in automobiles. Autopilot complements human pilots’ ability to fly and land in bad weather. Performance predictability and safety are at all-time highs.
Additional human-assist technology continues to improve the automobile driving experience. A 2013 high-end vehicle features collision avoidance, lane departure warnings, and voice-activated features. Driverless cars are on the roads now with state laws paving the way for more. Even the grocery store check-out has become automated. You can scan, bag, and pay without a human doing it for you, although a manager stands ready to assist as needed.
What does all this have to do with robots in healthcare?
More automation and robotics are on the way, but keep in mind that their purpose is not to replace humans outright. Robots and related systems mean that less human involvement is required at the point of care. Healthcare providers can spend less time on the mundane and menial tasks and more time focusing on the patient.
For example, during my time as a consultant to Dr. Richard Satava at DARPA, we worked on the futuristic Trauma Pod program. Its purpose was to help make soldiers’ injuries more survivable by utilizing telepresence robotic applications moments after casualty. Doctors could work on a patient remotely from console-to-Pod, performing emergency surgery with all the supplemental capabilities as if they were in a forward medical hospital. My role was to ask the business model and policy questions related to the latest trend – The Operating Room of the Future.
We determined that an implementation scenario in a regular hospital, using the technologies of the Trauma Pod, could take the nurse count from five to just two. The medical automation scenario had the same effect as autopilot for the airplanes. Other benefits included:
• Less manual distractions for doctors and nurses, thus more focused attention on the patient
• Streamlined work flow by elimination of redundant and manual processes
• Supply cost reductions through standardizing product use and choices
• Increased number of surgical patients per day leading to better operating room productivity
• Lower personnel costs
Now, this military medical innovation and related commercial applications may be years away, but such is the nature of DARPA technologies. However, the lesson learned here was that robots in healthcare are about replacing task-oriented work and enabling higher value work for a shortage-prone workforce.
It’s also important to remember that a robot is really an “information system” applied to a certain task. Hence, Intuitive Surgical’s Da Vinci is an information system with arms. A CT Scanner is an information system with eyes, and so on. Therefore, healthcare as we know it may not be overrun by actual robots. Instead information systems behind robotics and automation will co-exist with human expertise promoting better decision making, efficiency, and safety.
How can robotics companies succeed in healthcare?
Don’t focus on the robots alone.
Look past them and see how the platform can be an applied efficiency innovation. For instance, Vecna, a Boston-based company specializing in advanced technologies for healthcare, launched into this space years ago with a robot built for battlefield casualty extraction and mission-assistive operations. Funded by the U.S. Army’s Telemedicine and Advanced Technology Research Center (TATRC), their research, prototypes, and field-ready units were tested and evaluated. But, large scale adoption by the Army did not occur. Instead, significant revenue was realized through hospital-oriented patient engagement solutions. With great leadership and a keen eye on business model innovation, they applied their platform and experience to new target markets and have become respected leaders in the field.
Another company, funded by the NSF, is Love Park Robotics out of Philadelphia. They are bringing smart navigation and destination intent to electric powered wheelchairs. The information system foundational to this robotic innovation features collision & obstacle avoidance just like unmanned vehicles. But, it also promotes “human in the loop” automation – making up for increasing physical impairment and cognitive disabilities of its user base, while at the same time operating safely according to driver intent and override parameters. This is not a self-driving robot wheelchair. It does not seek to replace human capability, but serves to augment it.
The vision of the National Robotics Initiative – “co-robots acting in direct support of and in a symbiotic relationship with human partners” – is already underway. The funding of new ideas in this space is a welcome gesture and will do much to contribute to what’s currently being done. It’s exciting to see how robots and related medical automation systems will create new standards of care in safe and non-threatening ways.