Eric Schmidt, chairman of Google, speaks of the “age of augmented humanity.” If we let computers do the things they do well, this will free up humans to be better at the things they do well. “The computer and the human each does something better because the other is helping.”
A win-win use of automation appears to be dispensing drugs in hospitals. The University of California, San Francisco (UCSF) has a team of robots that fills prescriptions for its medical center. Orders are submitted electronically. The drugs are retrieved from a secure, sterile environment. The dosage is as exact as a computer is logical. Medications are packaged for each patient – even assembled into 12-hour packets for the day. This eliminates possible errors by both pharmacists and nurses.
According to UCSF:
By using robots instead of people for previous manual tasks, pharmacists and nurses will have more time to work with physicians to determine the best drug therapy for a patient, and to monitor patients for clinical response and adverse drug reactions.
The dean of UCSF’s School of Pharmacy concurs:
The beauty of this robotic pharmacy system is that the pharmacist is taken out of that mechanical aspect of pharmacy practice, and they can use their intellect to be sure that the patients at the bedside are getting absolutely the right medicine.
It’s sort of like using scanners to buy groceries or to check out books at the library. It may put some people out of work, but hey. That’s the price we pay for the age of augmented humanity.
This video of the robots in action is actually quite good.
Robotic prostate surgery: To a hammer, everything looks like a nail
The use of robots for prostate cancer surgery, on the other hand, is a win for hospitals financially, but an unnecessary loss of a prostate for some patients. According to an article just published in the journal Medical Care, once a hospital purchases a robot that performs prostate surgery, the number of patients referred to surgery goes up. Not only is this unfortunate for some patients (the side-effect is usually impotence), but it’s not good for containing the costs of health care. Robotic surgery typically costs $2000 more than regular surgery. It doesn’t appear to add any benefits, and the results are possibly worse.
The reason for the increase seems to be “If you’ve got it, use it.” The lead author of the study, Dr. Danil Makarov, is quoted in the Times as saying: “If you’re a hammer, everything looks like a nail. … If you have the technology, it will get used.’’
From the Times: (emphasis added)
Surgical robots are expensive. A surgical robot used for prostate cancer costs $1 million to $2.25 million, according to the N.Y.U. study. In addition, hospitals spend $140,000 annually for a service contract and $1,500 to $2,000 per patient on disposable instruments.
“If you’re a hospital and you get a robot, clearly you want to use it,’’ said Dr. David Penson, a study co-author and director of the Center for Surgical Quality and Outcomes Research at Vanderbilt University. “There are some real pressures here that have nothing to do with science,” he said. “We have this interplay of patients’ fascination with technology coupled with business interests on the part of the hospital and device makers, pushing people to try a new technology perhaps before it’s been fully tested.’’
According to Dr. Makarov:
[W]hile financial incentives are likely to play a role in which treatments are promoted, patients also often want the newest technological advance, and hospitals are simply responding to that demand.
Poor hospital. “The patient made me do it.” Actually, there’s probably some truth to this claim. But I suspect patient demand is a small part of what’s going on here.
When computerized robots perform prostate surgery they are doing what they do well. Unfortunately one of the things humans do all too well these days is extract profits from the practice of medicine.
Video here, with muzak (I recommend watching without the sound). Not for the squeamish.
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Creating an epidemic of cancer among the healthy
Resources:
Image: medGadget
Karin Rush-Monroe, New UCSF Robotic Pharmacy Aims to Improve Patient Safety, UCSF, March7, 2011
Liz Gannes, Eric Schmidt: Welcome to “Age of Augmented Humanity,” Gigaom, September 7, 2010
Danil V. Makarov et al., The Association Between Diffusion of the Surgical Robot and Radical Prostatectomy Rates, Medical Care, April 2011, Vol 49, Issue 4, pp. 333-339
Tara Parker-Pope, Hospitals With Robots Do More Prostate Cancer Surgery, The New York Times, March 11, 2011
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