Technology Frontiers - Humans and Machines: Healthcare


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This article is excerpted from a Economist Intelligence Unit report, Humans and machines: The role of people in technology-driven organisations. The report was published on 5th March 2013 to coincide with the "Technology Frontiers 2013" summit, hosted by The Economist Events. Both the report and the summit are sponsored by Ricoh.

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Technology Frontiers - Humans and Machines: Healthcare

  1. 1. SMART SYSTEMS, SMARTER DOCTORS Humans and machines in healthcare SMART SYSTEMS, SMARTER DOCTORS* Humans and machines in healthcare There are few instances in our lives when we place Creativity plus efficiency greater trust in the abilities of our fellow humans than Robots in surgery are a dramatic example of how in surgery. Even in relatively safe procedures, invasive technology can help healthcare professionals become surgery carries an inherent degree of risk. From a more creative as well as efficient in the effort to doctor’s perspective, there are specific challenges to improve patient care. And much more efficient overcome in trying to minimise the degree of they will need to become if healthcare systems are invasiveness, not the least of which is our basic to meet the daunting challenges facing them. In biological makeup. “The advantage of open surgery is Europe, for example, the costs of providing care to that you [the surgeon] have full use of your wrists and ageing populations are soaring, while governments fingers, which means a large degree of freedom and remain intent on maintaining near-universal levels potential articulation,” explains Dr Michael Hsieh, a of provision. To achieve this amidst tight public professor at Stanford University School of Medicine in financing will require vast improvements in efficiency California and an expert in robot-enhanced surgery. in all facets of healthcare operations. Making better “Another advantage is that you have a three- use of the myriad technologies coming available—in dimensional view, with depth perception,” he adds. areas ranging from diagnostics to telehealth and others—is central to this objective. Nearly nine in It is here that advances in robotics are creating ten health executives surveyed for this study1 agree striking new possibilities that augment the that there remains enormous room for technology-led capabilities of humans. Dr Hsieh has been conducting efficiency gains in their organisations. so-called multi-port robotic surgery for some time: guiding robotic arms into a patient’s body through Unfortunately, the ease with which surgeons like Dr several tiny incisions about the size of a keyhole. This Hsieh are interacting with new technologies is less accelerates recovery times and reduces scarring. The visible elsewhere in the sector. IT—and particularly next frontier is the potential for single-port surgery. the types of systems which connect the back office to In certain cases this may enable surgeons to avoid any the hospital floor or doctor’s surgery, or provide the scarring at all, by entering via the navel, while further information necessary for effective patient care—has speeding recovery. made slow inroads in healthcare in comparison with other sectors. The reasons are varied, but simple Such technologies are not supplanting the role, human resistance to change and difficulty in adapting skills or creativity of surgeons; instead, they are to new technologies are prominent among them. Six of augmenting surgeons’ abilities, freeing them to * This article is excerpted from a forthcoming Economist Intelligence Unit make advances that humans cannot accomplish on report, Humans and machines: The role of people in technology-driven organisations. The report will be published on 5th March 2013 to coincide their own. “Robotic technology is not inhibiting with the “Technology Frontiers 2013” summit, hosted by The Economist Events. Both the report and the summit are sponsored by Ricoh. human creativity,” agrees Dr Hsieh. “If anything, it 1 A survey of 432 senior executives was conducted online in November andSponsored by: has perhaps expanded our horizons by allowing us to December 2012. Of the 40 respondents from healthcare, biotechnology and pharmaceutical organisations, roughly one-third hail from North America, conceive of new ways to conduct old operations, or one-third from Europe and one-quarter from Asia-Pacific. Almost half (48%) ways to take completely new approaches to disorders. hold C-suite or board positions, with the rest being other senior managers. Over half of the organisations (57%) have annual revenue in excess of I would say that creativity has been enhanced.” US$500m, with 28% having US$10bn or more. 1 | © Economist Intelligence Unit 2013
  2. 2. SMART SYSTEMS, SMARTER DOCTORS Humans and machines in healthcare every ten healthcare respondents—more than in other Employees’ adaptation to new technology will likely sectors—say their organisations have become heavily improve, and operational and cost efficiency along reliant on technology in just the past three years, with it, but will there be a sacrifice in the types an indication of how recent significant technology of human creativity and imagination needed for penetration has been in some parts of the sector. Two- truly effective patient care? Our survey-takers are thirds report one or more instances of employee failure optimistic on this score. Close to 70% believe that to learn a new technology in the past six months, increasing technology intensity has made their suggesting that health employees’ interaction with employees more, not less, creative in developing ideas new technologies remains anything but smooth. for new health services and products, and 65% say the same about conceiving ideas to improve processes. Failure to overcome difficulties in how doctors, nurses, administrative and other staff interact What’s my problem, Watson? with technology can have expensive consequences. A look at medical diagnostics may help explain such A salutary lesson was the 2011 scrapping of optimism. It is an area where technology promises the UK’s £12.7bn effort to introduce electronic to enhance the abilities of health professionals, patient records. A range of factors plagued the improving efficiency in the process. Diagnosis relies on the fundamental human capacity to draw on❝ diverse pieces of information about patients—from how they describe their symptoms, to their prior medical history, to how they physically appear—and make an assessment of their likely condition. TheThere will always be the need for a human to decide lion’s share of our survey respondents (43%) pointand act in more complex situations.” to diagnostics as the area of healthcare where theMark Coeckelbergh, assistant professor, University of Twente and managing director, retention of human intuition is most critical.3TU Centre for Ethics and Technology Much work is under way to bring machine learning and computing power to bear in diagnosis, in order implementation, but the thorniest was trying to to maximise the power of data. The potential is clear: convince doctors to accept and adopt new processes. systems such as IBM’s Watson supercomputer can “read” (Germany, France and the Netherlands have a million medical textbooks in just three seconds, experienced similar failures, although in Denmark while also sucking in diverse other information, from such problems appear to have been surmounted.2) insurance claims to electronic medical records, to Beyond resistance to change, problems in connecting enhance its diagnostics calculations. Rick Robinson, systems in different parts of the health service an executive architect at IBM, notes that as many as also undoubtedly play a role in such episodes. In 50,000 papers are published each year in the field of our survey, sector executives point to such system diabetes alone. “No human clinician can keep up with disconnects as among the toughest challenges they that,” he says. The result is inevitable errors. Studies face with technology. Another major challenge, suggest that doctors misdiagnose conditions as much as according to the respondents, is that processes are 10-15% of the time.3 not being written quickly enough to keep pace with technology advances. There is no suggestion, however, that such systems would fully replace the role of humans in diagnosis. 2 Future-proofing Western Europe’s healthcare: A study of five countries, Economist Intelligence Unit, September 2011. 3 How doctors think, Jerome Groopman, 2007. Which statements best characterise the challenges you face in dealing with technology? (top responses; % of respondents from healthcare, biotechnology and pharmaceutical industries) 45 38 20 20 15 Technology is evolving Systems are not connected It results in a loss of More of my time is spent It makes too much more quickly than our to each other in the work-life balance and free with technology than with information available processes business mental space people Source: Economist Intelligence Unit survey, December 2012. 2 | © Economist Intelligence Unit 2013
  3. 3. SMART SYSTEMS, SMARTER DOCTORS Humans and machines in healthcare In which of the following activities is the need for retaining a role for human imagination or intuition most critical? (top responses; % of respondents from healthcare, biotechnology and pharmaceutical industries) Diagnosing patients’ illnesses/injuries 36 Developing new treatments and/or medicines 32 Instructing other medical staff on patient treatment 28 Monitoring patients 20 Evaluating medical practitioners 20 Evaluating hospitals or care centres 16 Administering medicines 12 Managing patient records 8 Improving administrative processes 8 Source: Economist Intelligence Unit survey, December 2012.❝ “I think there will always be the need for a human to the basic and time-consuming manual processing decide and act in more complex situations,” says Mark of information so that they can focus on where they Coeckelbergh, an assistant professor at the University are needed most—patient care. “This is not just a of Twente (Netherlands) and managing director financial challenge,” explains George MacGinnis, aThe demographic of the 3TU Centre for Ethics and Technology. More telehealth expert at PA Consulting, speaking aboutchallenge is fundamentally, there are wide-ranging challenges to healthcare organisations in the UK. “The current way overcome, ranging from issues of accountability to of working is not sustainable from a future workforcesuch that the rethinking the fundamental processes of healthcare. perspective; there simply aren’t going to be enoughcurrent way of doctors and nurses either domestically or available toworking ... is not Pressure to automate recruit from overseas.” While technology may augment human potentialsustainable.” in some healthcare domains, in others it is being It is also an area where many see less need for humanGeorge MacGinnis, telehealth viewed as a means to free up people to perform imagination or intuition: less than one-fifth ofexpert, PA Consulting other activities. In this context, the case for those polled in the sector think monitoring patients remote patient monitoring and other elements of requires these capacities; and only 9% think the “telehealth” is clear. The aim is to free clinicians from same of administering medicines. Both areas are ripe The newly digital doctor Q. Will a traditional physical exam be replaced? There will certainly be more data analysis, but a physical exam will still be useful. My physical exam, Dr Eric Topol is an American cardiologist, geneticist however, has changed dramatically. Since December and researcher. Named “Doctor of the Decade” by the 2009 I have not used a stethoscope to listen to a Institute for Scientific Information for his research heart. Why would I bother when I can use a high- contributions, he is the author of “The Creative resolution ultrasound, which is a pocket device in Destruction of Medicine: How the Digital Revolution my coat? So the stethoscope will eventually go, but Will Create Better Health Care”. I don’t believe technology could ever replace the doctor-patient relationship in terms of empathy, Q. How will technology change the role of doctors? compassion and understanding. Today doctors control everything. They order in the data, the scans and any tests required. But Q. Can technology reduce the pressure on tomorrow, the individual will drive that. Individuals overburdened health systems? will come to doctors—whether physically or I think so. We are going to level the playing field, and virtually—with information in hand seeking their this should mean the demand for doctors lessens. guidance. Individuals will also have information More and more things can be done remotely, or by well beyond what was formally obtainable today— individuals on their own, as long as there is Internet for example, blood pressure readings for every coverage. There will be times where you need a minute of the last two weeks, or glucose levels for hospital and the physical presence of a physician, every minute of the last month. Those prospects are but that need—which puts pressure on health exciting. systems—will be dramatically reduced over time. 3 | © Economist Intelligence Unit 2013
  4. 4. SMART SYSTEMS, SMARTER DOCTORS Humans and machines in healthcare prospects for technology: from scales that monitor The pain of disruption patients’ weight and fl ag up possible risk conditions to Much of the wrenching change that healthcare automated alerts reminding people to take their pills. organisations are destined to undergo over the next several years will be driven by technology. Robotics in Such technologies hold clear potential not only surgery or video consultations between doctors and to free up personnel, but also to improve patient patients may get the headlines, but less exotic data outcomes and quality of life. Mr MacGinnis cites the analysis, knowledge sharing, website management example of patients with certain heart conditions who and other systems will be at least as instrumental must weigh themselves daily to look for early signs of in creating the efficiencies that must be gained excess fluid retention. This can be automated with the across under-pressure health systems. Technology help of an Internet-enabled scale that alerts doctors disruption is part of almost any conceivable scenario of any worrying changes. for healthcare reform in the coming years.4 Encouragingly, there is little fear in the industry that Pressure on healthcare professionals to adapt to telehealth would somehow curtail the role of carers technology change will thus remain relentless. How or nurses, or lessen their societal value. “There are well they adapt will rely to some extent on the skill certain things where you need emotions and where (and speed) with which processes are written to guide you need improvisation, imagination,” explains Mr the interaction. The views of the health practitioners Coeckelbergh. This is borne out in a variety of specific and experts, and the examples, presented in this healthcare implementations, such as wide-ranging article, provide grounds for optimism that the work at University Hospital Birmingham (UHB) in the frictions which have plagued interaction between UK to use technology to improve clinical decision people and technology in this sector will be smoothed support and increase process automation. “Contrary out, and that human creativity will not be sacrificed to negative perceptions, we’ve seen individuals in the process. Which is a good thing, because health empowered, obtain greater autonomy and achieve organisations will need all the creativity their greater job satisfaction,” says Steve Chilton, UHB’s employees can muster to deliver the effective and ICT director. He argues that such developments have cost-efficient care their patients will require and their pushed the role of human workers up the value chain, stakeholders will demand. while new roles have emerged as a result, such as within process analytics. “Technology-led automation 4 A variety of scenarios for how healthcare reform may play out in Europe are presented in The future of healthcare in Europe, Economist Intelligence Unit, and development have freed up creativity,” he says. March 2011. About the sponsor Whilst every effort has been taken to verify the accuracy Ricoh provides technology and services that can help of this information, neither The Economist Intelligence organisations worldwide to optimise business document Unit Ltd. nor the sponsor of this report can accept any processes. Offerings include managed document services, responsibility or liability for reliance by any person on production printing, office solutions and IT services. this white paper or any of the information, opinions or conclusions set out in the white paper. London New York Hong Kong GenevaImage: © 20 Cabot Square 750 Third Avenue 6001, Central Plaza Boulevard des London 5th Floor 18 Harbour Road Tranchées 16 E14 4QW New York, NY 10017 Wanchai 1206 Geneva United Kingdom United States Hong Kong Switzerland Tel: (44.20) 7576 8000 Tel: (1.212) 554 0600 Tel: (852) 2585 3888 Tel: (41) 22 566 2470 Fax: (44.20) 7576 8476 Fax: (1.212) 586 0248 Fax: (852) 2802 7638 Fax: (41) 22 346 93 47 E-mail: E-mail: E-mail: E-mail: 4 | © Economist Intelligence Unit 2013