ROBOTICS & AI - FACE OF NEW HEALTH
Information technology development in healthcare has been rapidly moving from products to services to solutions. The present decade is one of medical platforms focused on real-time, outcomebased care. The next decade is moving towards medical solutions – using Artificial intelligence (AI), robotics, and virtual and augmented reality – to deliver intelligent solutions for both evidenceand outcome-based health and focusing on collaborative, preventative care. This drastic confluence is leading to AI and robotics defining the face of new health.
The ever-growing healthcare industry is going through a human resources crunch and this has led everyone to look to robotics and automation as a potential solution. This situation also leads to a bigger question- how much can be automated? Artificial intelligence (AI) and robotics have increasingly become a part of our eco-system and are being adopted in equal measure in the healthcare space. However, the idea of a doctorless hospital still comes with a lot of uncertainty and concern. Are we ready yet to let a medical robot with AI probe us, make a diagnosis and prescribe a treatment plan suitable for our condition? Ethical and sustainable growth of technology adoption is also in question. It is only fair to assume that if these robots take the role of our primary surgeons, human clinicians will be jobless.
According to a survey by Markets and Markets in May 2017, the market for AI in healthcare is expected to grow from $667.1 million in 2016 to $ 7,988.8 million by 2022, growing at a CAGR of 52.68 per cent during the forecast period. Swaminathan Vangal-Ramamurthy, General Manager of the Robotics
Business Division at Omron Asia Pacific says, “AI and robotics are already viewed as important components in driving advanced healthcare. At the heart of this transformation is the ability of AI and robotics to ease the manpower crunch, especially in taking on the more mundane, repetitive or simple tasks.”
In a number of hospitals in Asia, robots are already being used for logistical purposes. Equipped with navigation capabilities, these robots can transport documents, medicines and linen to different parts of the hospital. Hospital staff can then focus on more important tasks such as patient care.
Swaminathan further says, “AI and robotics have also entered into drug discovery. Earlier this year, the University of Cambridge reported that a robot scientist named Eve played an instrumental role in discovering a possible antimalarial drug. This, along with her ability to carry out thousands of tests, led to her discovery of Tricolan, a common ingredient in toothpaste that could possibly limit the spread of malaria.”
AI and Robotics in diagnostics and treatment
AI is already being used to detect many deadly diseases, such as cancer, more accurately and in their earlier and more treatable stages. An excellent example is the stats presented by the American
Cancer Society, according to which 12.1 million mammograms are performed annually in the US, but a greater proportion of these mammograms yield false results, resulting in 1 in 2 healthy women being told they have cancer. Review and translation of such mammograms is 30 times faster and with 99 per cent accuracy with the use of AI, thus reducing the need for unnecessary biopsies as well as reducing the uncertainty and stress of a misdiagnosis.
On the horizon, Microsoft is developing computers programmed for use at a molecular level to start fighting cancerous cells as soon as they are detected. They are also doing research for using
AI to interpret online search engine behaviour, for example, at the point where someone might research symptoms online long before they approach their physician.
Healthcare providers have adopted robotics technology since a while back. According to Frost & Sullivan, the global personal robot market, including ‘care-bots’, could reach $17.4 billion by 2020, driven by rapidly ageing populations, a looming shortfall of care workers, and the need to enhance performance and assist rehabilitation of the elderly and physically handicapped. Japan is leading the way with onethird of the government budget on robots devoted to the elderly. The Japanese ‘care-bot’ market alone is estimated to grow from $155 million in 2015 to $3.728 billion by 2035 (source: Japanese Ministry of Economy, Trade & Industry).
Robots are also making a decent place in elderly care. In Singapore, where the Health Ministry estimates that it needs to fill 9,000 medical support positions by 2020 to meet rising demands of an aging population, robots are also being tested in hospitals, especially for porter services – delivering items from point to point. Nursing homes in China have started using robots to provide care for the elderly. One such great example is RoBear. This is a nursing-care robot that is able to lift and move patients in and out of bed into a wheelchair, help those who need assistance to stand, and even turn patients in bed to prevent bedsores.
Swaminathan emphasises the need of robots to lessen the strain on already-stretched healthcare systems. “In Australia, there is an increasing number of aged care facilities that have started using robots to perform duties such as transporting linen, medical supplies and meals. This efficient delegation of tasks enables staff to focus more on providing quality care to patients”, he says.
Dr Chuan Kit Foo, Head of Media Affairs, Bayer Pharmaceuticals Division Asia Pacific says, “As a pharmaceutical company, we see very clear applications across the entire value chain for AI because of its ability to analyse large amounts of data and draw inferences by comparing various data sets. AI can improve decision making across the entire value chain and the potential patient benefit is as massive as potential efficiency savings. In addition, AI and other digital technologies such
as wearables, connected devices, and telemedicine can help drive greater patient engagement.”
Are we ready?
The benefits are numerous
- higher precision allows for smaller incisions, lowers the risk of complications and speedier recovery times - there are also associated risks. Wilson Tan, Senior Director, IQVIA Analytics, Medical Devices & Diagnostics Asia, says, “The recent wave of development has been more focused on robot assisted surgeries. There is the additional risk of equipment malfunction. Robot assisted surgery typically takes significantly longer, and is also much costlier to perform the procedure (slightly mitigated by shorter recovery periods and lower complication rates leading to shorter postoperative hospital stays).” However, he does believe that robotics and AI is the way to go. “We are still in the nascent days, but this development has great promise in improving outcomes, especially when coupled with AI and big data. Currently it is hard to make the cost-effective argument for robot assisted surgeries. However, the possibilities offered justifies the continued development. While the potential benefits outweigh the risks, more comprehensive data is required to better understand the risks and how to mitigate”, he says rhetorically.
Though robotics technology, and the role it will have in health and health care, is still evolving, research shows there is a growing enthusiasm among consumers to engage with new technologies for their health care needs. But it seems those in developed economies with entrenched health care systems show some reluctance to embrace AI and robotics compared those in emerging economies with mixed health care coverage. One primary concern amongst common population in regards to robotic treatments is that unlike surgeons, they are not able to change surgical course should
the patients’ condition change, or an alternative procedure be better suited. The apprehension also lies in the fact that robotization may lead to an increase in unnecessary interventions, or take focus away from patient expectations. However, the common perception is changing and public is more open and willing to engage with a non-human healthcare provider. In a recent survey by PwC on public willingness, a significant percentage of respondents were highly willing to choose certain treatments, tests or services administered by an AI or robot and there was widespread agreement about these services across the countries surveyed.
So, will this lead to an era of surgeons being replaced by robots? The concern is legitimate but unwarranted. Swaminathan looks positive, “The healthcare industry is the perfect example of how robots have not taken over the jobs of hospital attendants, nurses, doctors and surgeons. In fact, robots come in as an aid for these workers so that they can do their job better, or workers can be reskilled to be able to perform jobs that provide more value-add.” Robots are only going to work handsin-hands with the healthcare professionals in the coming future. Tan agrees, “It is unlikely in the near future for surgeons to be replaced. These robots can only help the surgeon perform specific tasks faster in offering improved precision, better imaging and navigation. The surgeon is still needed to perform the surgery.”
Commercialization and Investment opportunities
Given the long-term view, and the potential of AI and robotics, where should the investment go? Kuldeep Singh Rajput, CEO & Founder, Biofourmis Pte Ltd. says, “Investing in health is always a long- term prospect, whether it is a matter of training a doctor, developing a new drug, building a new facility or developing AI and robotics. Already AI is coming of age, and the AI healthcare market is poised for dramatic growth. Frost & Sullivan predicts that the AI market for healthcare will increase by 40 per cent between 2014 and 2021 and they estimate growth from $633.8 million to $6.662 billion. According to CB insights, healthcare is the hottest area of investment within AI. They identified over 100 companies that have raised equity funding round since January 2013. From insights and analytics, imaging and diagnostic, drug discovery to remote patient monitoring and virtual assistants, AI is poised to impact every aspect of health care.”
AI is currently the fastest growing health investment area, with researchers and clinicians looking to the technology to aid in training, research, early detection, diagnosis, treatment, and even end of life care. Alongside AI, robotics is another booming market in tech. According to IDC, the overall market has been growing at a compound rate of 17 per cent a year and will be worth $135 billion by 2019, with a boom taking place in Asia, Japan and China. Tan
says, “As with any new technology, the high cost of development leads to high cost of implementation and resulting low Return on Investment. Hospital administrators find it hard to justify the investments required. Specifically referring to robot assisted surgeries, surgeon training is a slow process. Investment opportunities lie in helping to speed up this process. Clinicians and hospital administrators need data supporting and quantifying the claim of improved outcomes. Patient pathways from diagnosis to treatment need to be redefined, supported by data.” The introduction of robotics has opened up new opportunities by allowing businesses to create new applications. This has led to an increase in innovative possibilities exponentially rather than linearly.
Safety of Health Information
Health information is very sensitive, and needs special protection under privacy laws. With the advent of AI and robotics in the healthcare sector, investment in information protection is imperative. Tan takes it with a pinch of salt. “In the longer term, AI together with big data and wearables has significant potential in healthcare, from helping people stay healthy, to more effective screening and early detection, augmenting diagnosis and improved treatment. This potential is limited at present due to the challenges in accessing and managing the available data. The immediate opportunity is in improving the efficiency, targeting the overload on the healthcare systems globally. The consistent shortage of physicians, allied health professionals, hospital beds and infrastructure can be alleviated by improving the efficiency via big data analytics and automation, in line with how the logistics industry has been affected.”
What is next?
It is evident that robots are going to be a mainstay in the healthcare and medical industry. They are already making an impact at basic porter services levels, and making a difference in drug discovery and care for the elderly. However, the true value that robotics will bring to the industry is yet hard to determine.
While there are exciting advances in healthcare robotics, there are some challenges inherent that should be considered. Tan adds, “One challenge limiting adoption is the lack of good outcomes data. Investments in generating this data can help drive adoption, and more importantly create the feedback loop to uncover and mitigate potential risks.”
The governments also need to create quality standards and a regulatory framework which are applicable to and obligatory for the entire healthcare sector, as well as the appropriate incentives for adopting new approaches. Also, the private sector developing AI and robotics need to create solutions to solve the big issues of demand and resource that every health system faces. In essence, by providing AI and robotic-driven solutions, the private sector has the opportunity to disrupt healthcare for the good.
Needless to say, AI and robotics technology will certainly continue to advance. Swaminathan says, “AI and robotics can lead to new possibilities, and the first step is for leaders in the healthcare sector to accept and examine where these technologies can be best deployed, and where they can bring the best benefits.” With teams in corporate and university research labs making progress daily in robotics, we may just be a day away from the next break through.
THE GOVERNMENTS NEED TO CREATE QUALITY STANDARDS AND A REGULATORY FRAMEWORK WHICH ARE APPLICABLE TO AND OBLIGATORY FOR THE ENTIRE HEALTHCARE SECTOR, AS WELL AS THE APPROPRIATE INCENTIVES FOR ADOPTING NEW APPROACHES. ALSO, THE PRIVATE SECTOR DEVELOPING AI AND ROBOTICS NEED TO CREATE SOLUTIONS TO SOLVE THE BIG ISSUES OF DEMAND AND RESOURCE THAT EVERY HEALTH SYSTEM FACES. IN ESSENCE, BY PROVIDING AI AND ROBOTICDRIVEN SOLUTIONS, THE PRIVATE SECTOR HAS THE OPPORTUNITY TO DISRUPT HEALTHCARE FOR THE GOOD.