[LINK] Robots in health care could lead to a doctorless hospital

[Bernard Robertson-Dunn]

Robots in health care could lead to a doctorless hospital
The Conversation
Anjali Jaiprakash
Jonathan Roberts
Ross Crawford
February 9, 2016 6.07am AED
https://theconversation.com/robots-in-health-care-could-lead-to-a-doctorless-hospital-54316

Imagine your child requires a life-saving operation. You enter the 
hospital and are confronted with a stark choice.

Do you take the traditional path with human medical staff, including 
doctors and nurses, where long-term trials have shown a 90% chance that 
they will save your child’s life?

Or do you choose the robotic track, in the factory-like wing of the 
hospital, tended to by technical specialists and an array of robots, but 
where similar long-term trials have shown that your child has a 95% 
chance of survival?

Most rational people would opt for the course of action that is more 
likely to save their child. But are we really ready to let machines take 
over from a human in delivering patient care?

Of course, machines will not always get it right. But like autopilots in 
aircraft, and the driverless cars that are just around the corner, 
medical robots do not need to be perfect, they just have to be better 
than humans.

So how long before robots are shown to perform better than humans at 
surgery and other patient care? It may be sooner, or it may be later, 
but it will happen one day.

But what does this mean for our hospitals? Are the new hospitals being 
built now ready for a robotic future? Are we planning for large-scale 
role changes for the humans in our future robotic factory-like hospitals?

Our future hospitals

Hospitals globally have been slow to adopt robotics and artificial 
intelligence into patient care, although both have been widely used and 
tested in other industries.

Medicine has traditionally been slow to change, as safety is at its 
core. Financial pressures will inevitably force industry and governments 
to recognise that when robots can do something better and for the same 
price as humans, the robot way will be the only way.

What some hospitals have done in the past 10 years is recognise the 
potential to be more factory-like, and hence more efficient. The term 
“focused factories” has been used to describe some of these new 
hospitals that specialise in a few key procedures and that organise the 
workflow in a more streamlined and industrial way.

They have even tried “lean processing” methods borrowed from the car 
manufacturing industry. One idea is to free up the humans in hospitals 
so that they can carry out more complex cases.

Some people are nervous about turning hospitals into factories. There 
are fears that “lean” means cutting money and hence employment. But if 
the motivation for going lean is to do more with the same, then it is 
likely that employment will change rather than reduce.

Medicine has long been segmented into many specialised fields but the 
doctor has been expected to travel with the patient through the full 
treatment pathway.

A surgeon, for example, is expected to be compassionate, and good at 
many tasks, such as diagnosing, interpreting tests, such as X-rays and 
MRIs, performing a procedure and post-operative care.

As in numerous other industries, new technology will be one of the 
drivers that will change this traditional method of delivery. We can see 
that one day, each of the stages of care through the hospital could be 
largely achieved by a computer, machine or robot.

Some senior doctors are already seeing a change and they are worried 
about the de-humanising of medicine but this is a change for the better.

Safety first but some AI already here

Our future robot-factory hospital example is the end game, but many of 
its components already exist. We are simply waiting for them to be 
tested enough to satisfy us all that they can be used safely.

There are programs to make diagnoses based on a series of questions, and 
algorithms inform many treatments used now by doctors.

Surgeons are already using robots in the operating theatre to assist 
with surgery. Currently, the surgeon remains in control with the machine 
being more of a slave than a master. As the machines improve, it will be 
possible for a trained technician to oversee the surgery and ultimately 
for the robot to be fully in charge.

Hospitals will be very different places in 20 years. Beds will be able 
to move autonomously transporting patients from the emergency room to 
the operating theatre, via X-ray if needed.

Triage will be done with the assistance of an AI device. Many decisions 
on treatment will be made with the assistance of, or by, intelligent 
machines.

Your medical information, including medications, will be read from a 
chip under your skin or in your phone. No more waiting for medical 
records or chasing information when an unconscious patient presents to 
the emergency room.

Robots will be able to dispense medication safely and rehabilitation 
will be robotically assisted. Only our imaginations can limit how health 
care will be delivered.
Who is responsible when things go wrong?

The hospital of the future may not require many doctors, but the numbers 
employed are unlikely to change at first.

Doctors in the near future are going to need many different skills than 
the doctors of today. An understanding of technology will be imperative. 
They will need to learn programming and computer skills well before the 
start of medical school. Programming will become the fourth literacy 
along with reading, writing (which may vanish) and arithmetic.

But who will people sue if something goes wrong? This is, sadly, one of 
the first questions many people ask.

Robots will be performing tasks and many of the diagnoses will be made 
by a machine, but at least in the near future there will be a human 
involved in the decision-making process.

Insurance costs and litigation will hopefully reduce as machines perform 
procedures more precisely and with fewer complications. But who do you 
sue if your medical treatment goes tragically wrong and no human has 
touched you? That’s a question that still needs to be answered.

So too is the question of whether people will really trust a machine to 
make a diagnosis, give out tablets or do an operation?

Perhaps we have to accept that humans are far from perfect and mistakes 
are inevitable in health care, just as they are when we put humans 
behind the wheel of a car. So if driverless cars are going to reduce 
traffic accidents and congestion then maybe doctorless hospitals will 
one day save more lives and reduce the cost of health care?

-- 

Regards
brd

Bernard Robertson-Dunn
Sydney Australia
email: brd at iimetro.com.au
web:   www.drbrd.com
web:   www.problemsfirst.com
Blog:  www.problemsfirst.com/blog