The future of medical robotics: How technology will improve health outcomes

The cutting edge of medicine is often thought to be about the latest pharmaceutical or biotech molecule that will cure cancer or address a genetic variation responsible for rare diseases.

These are crucially important elements to solving catastrophic illnesses, but another type of technology is quietly developing that will change how the medical community interacts with patients in primary care and specialty settings.

Efforts like Forward and One Medical pursue a concierge style approach and work to solve issues with access while offering patients more time with their clinician. Other ventures like Iora Health focus on underserved populations, at least in part. The last several years have seen a tremendous amount of investment and activity in developing telemedicine to also address the access to care issue. Initial outcomes research is mixed, but there is a sense that telemedicine is here to stay given the tremendous regulatory changes in progress at both the state and federal levels (not to mention the positive trends in reimbursement programs for these incremental v. supplemental services).

However, perhaps the most interesting and exciting innovation in health care that stands to dramatically change how we interact with our clinicians is medical robotics. Today, we visit a clinic or connect by video chat with a clinician and are able to review our symptoms and receive guidance on next steps. The clinical visit of the future will involve much more, including more lines of software code and more technology hardware than is being composed for autonomous vehicles. Here is why:

Imagine for a moment the process of building trust with your clinician when you meet them for the first time in an urgent care or primary care setting. There is typically the standard cadence of pleasantries and questions about medical history, allergies, current medications, and then often an open-ended question about what brings you in today. After some dialogue, and possibly a need for diagnostic tests, you would likely receive guidance about what the issue is and a suggested treatment plan (or instructions about what to watch for and when to come back if symptoms persist/worsen). Sound familiar?

In stark contrast, the preliminary clinical visit of the future will be conducted by a physical robot, shaped like a human, who (yes, who, because we will relate to their personalities) will know more about you before either of you start talking. Your vital signs (temperature, heart rate, blood pressure, breathing rate) will be measured by the robotic clinician using infrared and retinal scan technology, among other methods still in development. A few quick moves and within seconds your new robotic confidant will know the composition of your sweat, and therefore your hydration level and the status of certain organ functions. An entire range of other clinical data that will be used to help assess your health in that moment (and how it has been trending over time as it integrates with data from your phone, home and environment in general), as well as your medical history that thankfully is no longer stored in multiple disparate locations

The new health ecosystem will be built around the individual patient’s daily habits. Successful primary care, after all, needs to be integrated into our lives in order to be effective. As a medical community, we truly need to understand the choices our patients are making in their daily lives to be able to impact health outcomes over time. The robotic framework for care delivery will by necessity be at the center of a new ecosystem and based on your customizations, will be available to you 24/7 in a telemedicine format. The need to visit a clinic and interact “in the flesh” will be reserved for those circumstances when proximally collected clinical data is necessary to complete an assessment.

With major advances in human computer interaction research and natural language processing, we will be able to interact more effectively with robotic clinicians to develop the type of trust that comes free from judgment and is highly customized to one’s personality. Envision a future in which your robotic care provider is 100% focused on interacting with you. The capabilities would be endless and as you adapted to interacting with a friendly, supportive robot, you might benefit from feeling a sense of complete engagement versus our current system in which roughly 50% of a clinician’s time might be spent documenting the visit (no more spending half of your 12 minute visit looking at the doctor’s scalp or the back of a computer monitor).The clinician of the future would in fact be the computer masked by impressive user design and an interface that changes based on what it senses you need at that moment. In a way, the emotional intelligence of the robot might one day surpass the capabilities of a human to detect all the subtle clues about your state of mind (ever so slight squinting of eyes, spike in brain activity in a certain region of your brain signaling anxiety or a lack of understanding, racing heart beat, active release of stomach juices, barely detectable sweating and surface skin temperature — the list goes on).

Robotics in health care today are largely procedural based efforts. Intuitive Surgical’s Da Vinci robot is arguably the most advanced surgical robot on the market. Using radiofluorescence technology, the device helps surgeons to recognize the difference between blood vessels and urine carrying structures, for example, so as to decrease the incidence of medical errors. However, even these advanced robots are operated by humans and are less about their emotional intelligence and connection to the patient than the robots of the future will be in the primary care setting.

The key will be in how the robotic clinician achieves the human connection with you and is able to deliver high quality care based on real time analytics that compare your medical issue to a vast database of patient-reported outcomes and objective measures aggregated by a network of robotic providers. Take for example the young child who might be far more engaged (and distracted!) by a robot whose face is instantly transformed into the child’s favorite animated character. Suddenly a visit to the doctor is less reliant on the skilled pediatrician’s ability to gain the trust of the child and successful engagement is achieved through a revolutionary new paradigm for diagnosis and treatment.

The addition of a scalable technology resource to our primary care system would enable my clinical colleagues and me the ability to spend more time with patients in areas that cannot be managed by a robotic clinician. Activities such as grocery shopping tours with patients, home visits with your primary care clinician to understand a patient’s living environment, and physical activity involving the guidance of a care team would suddenly be more possible. Achieving deep personal relationships that are motivated toward partnering with patients to improve daily choices and practice healthy behaviors are some of the synergistic outcomes that might result from allowing our clinicians to focus efforts where it matters most. Investing time and energy in solving social determinants of health is crucially important in optimizing chronic disease management and preventing new disease.

Ultimately, our health care system should be, and in many ways is, about doing what is best for the patient. The rapidly evolving health care landscape will soon have to offer additional options for how patients engage with their care providers. Some functions will by necessity remain reliant on the touch of a real human’s hand and incredibly skilled mind; but in many cases, we will be able to augment patient care and achieve new horizons in clinical outcomes through enhanced technical means. As we look to the future and work together to achieve improved access in rural areas of our country, expand capabilities for the underserved, and to improve the ability to drive behavioral change that has been proven time and again as the number one way to alleviate chronic conditions both in management and prevention, it will be important to incorporate leading technologies such as robotic clinicians into our daily efforts. Thankfully, we live in exciting times and are able to recognize a future that holds great promise for pushing the boundaries of what is possible in health care.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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