The experimental Smart Tissue Autonomous Robot (STAR) recently sewed a piglet’s gut together using a computer program and camera-based guidance, overseen by a team of doctors and computer scientists from the Children’s National Health System in Washington DC and Johns Hopkins University.
The procedure took 50 minutes, as opposed to 8 minutes when performed by a surgeon, but (unfortunately for doctors) resulted in more evenly spaced sutures and less leakage from the gut. And with iterative improvements, it’s likely that the time difference can be shrunk.
Meanwhile, FDA-approved robotic surgery on humans is making strides as well, though it requires a surgeon to operate the mechanical arm.
Market Trends to Watch for Health Systems and Their Specialty Pharmacies
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
The potential treatment paradigm, highlighted by The Economist this month, raises questions about whether patients will trust robots with their lives, and who is liable if something goes wrong. Another question robots pose: Are doctors in line for a string of layoffs?
At the Health Datapalooza conference in Washington, D.C. this week, Dr. Rasu Shrestha, the Chief Innovation Officer of the University of Pittsburgh Medical Center, who is also a radiologist by training, made comments that weren’t exactly reassuring from the perspective of medical professionals.
“Over the last couple of years as we’ve been rolling out EHRs and clinical information systems, we’ve been really managing all of that and being very careful to not disrupt the culture of how healthcare is practiced,” Shrestha said ominously.
He described the well-known trend toward digitization in healthcare, which could someday eliminate some doctors.
The Funding Model for Cancer Innovation is Broken — We Can Fix It
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
“We’ve spent the last two decades going from analog to digital, but I do not believe it’s going to take another two decades to get to where we need to be. So I believe that we are at the dawn of the computer era in healthcare,” he said. “In the next one, two, three, four years, we’re going to really see all of the disruption coming, and we’re seeing that, not just in the talk that we’re propagating,” he added.
Another, less obvious trend is a growing emphasis on preventive medicine and wellness.
“We’re seeing, and we’ve got data to prove this, that if it’s just about intelligent management of disease and disease processes, it’s still cost acceleration,” Shrestha observed. “But if you focus on wellness, and you focus on living, not just not dying, then it really is cost deceleration. We’re seeing this and we’re investing in that space, so that’s the other trend we’re focusing on.”
Another panelist asked, “So are you guys going to get to lay off a bunch of doctors?”
“Potentially,” Shrestha responded, rather gleefully.
Shrestha’s 200-person team manages a fund called UPMC Enterprises that invests in promising med tech and healthcare IT companies. While the latter advance automization in healthcare, devices like biometric sensors and passive monitors are pushing the frontiers of preventative medicine (and in some cases automization, as evidenced by the STAR robot). These trends led investor Vinod Khosla to famously predict that technology will replace 80% of doctors, leaving mainly specialists behind.
UPMC is both a payer and provider. It “eats its own dog food” Shrestha said, because the institution adopts all of the technology that it funds, making it a “living lab” of new ideas. Companies backed by UPMC Enterprises include population health program management company Evolent Health (which went public last year with a market capitalization of more than $1 billion) and more recently, clinical decision support specialist medCPU.
Later in the panel discussion, Shrestha revisited the robots vs doctors issue that came up earlier. “I’m not sure when we’ll get to the point of firing our physicians, I’m not sure that we will get there, but I do think that they will be repurposed. It’s not man versus machine, to be quite honest, its man versus man and machine, which is the reality of how it’s going to be.”
To that end, Shrestha said that as a result of the $35 million MedCPU financing, UPMC is hiring about 20 engineers in Pittsburgh.
In addition, medical professionals face another, more immediate threat to their careers: old-fashioned cost-cutting at hospitals, if Medical Device Manufacturing Association CEO Mark Leahy is to be believed.
In an interview with The MedTech Strategist prior to the annual MDMA meeting, Leahy recounted a conversation with a hospital CEO from a large health system in Minnesota. Even though devices account for about 4% of hospital expenditure, the CEO apparently told Leahy he’d “‘rather squeeze a little bit more out of you now and delay by 12-18 months that conversation I will have to have with my staff that says ‘Hey, either 10% of you take a pay cut or 10% of you are gone.'”