Medical Futures Lab

Guest posting by Sarah Bakhiet

This semester, my team members and I have been devising a way to reduce the post-operative length of stay of pediatric liver transplant patients. One of the most challenging problems is improving the efficiency of the tasks that must be completed before a patient can be sent home, ranging from preordering prescription medicines to closely monitoring the daily progress of a patient’s recovery. Throughout our brainstorming process, the idea of “robot doctors” has been thrown around jokingly as we rack our brains for any possible solution. Although it isn’t an option for our project, robot doctors have been slowly making their way into hospitals throughout the United States and are expanding the world of telemedicine.

Robot doctors can be defined as robotic devices that assist in optimizing a physician’s ability to treat patients. The aim of robot doctors is not to replace physicians altogether, but rather to enable a physician to practice more efficiently and precisely. One such device is the RP-6 robot (Remote Presence medical robot), created by InTouch Health Inc. Standing five feet tall, the RP-6 robot consists of an interactive screen through which a doctor can communicate from a remote location. Controlled by the physician, it is capable of navigating through a hospital and finding its way to a patient’s room, where the physician can virtually interact with a patient. Doctors are now able to diagnose a patient and provide medical advice from hundreds of miles away.

This technology comes particularly handy in a world where there is a growing demand for doctors that simply isn’t being fulfilled. Furthermore, specialists such as intensivists are especially needed throughout the US, where there are around 6,000 practicing intensivists but more than five million patients that are admitted to Intensive Care Units per year (UCLA, 2013). By allowing physicians to attend to patients from anywhere in the world, robot doctors help increase the number of patients that can be treated and thus alleviate the shortage in physicians. Additionally, they allow for time-sensitive cases to be addressed quickly, such as stroke patients who may not have time to wait for a specialist to arrive before severe brain damage occurs. RP-6 robots have been introduced to several hospitals throughout California, Nevada, and Arizona and are expected to become a valuable asset to many more hospitals (Chea, 2013).

Another type of robotic doctor is the da Vinci Surgical System, which was developed by Intuitive Surgical Systems. The de Vinci is controlled by a surgeon and allows the surgeon to be more precise and less invasive in critical surgeries. It also makes up for human deficiencies, such as hand tremors or limited range of hand motion. Offering so many improvements to surgery, robotic surgeons might be preferred to human surgeons in the future, predicts Tom Meltzer in an article in The Guardian (Meltzer, 2014).

Although not completely autonomous, these medical robots are proving to be a valuable asset to doctors and hospitals. Not only does this technology help meet the demand for physicians, but it also enhances a physicians ability to treat patients with quality care. While robot doctors aren’t an option for my team’s project, they are a becoming a solution for many of medicine’s pressing issues.

[1] http://neurosurgery.ucla.edu/body.cfm?id=1169

[2] http://www.theguardian.com/technology/2014/jun/15/robot-doctors-online-lawyers-automated-architects-future-professions-jobs-technology

[3] https://www.asme.org/engineering-topics/articles/robotics/robo-doctor-will-see-you-now

Guest posting by Rachel Marren

Guest posting by David Lam

Healthcare is an industry affected by a variety of influences. Healthcare practitioners, insurance & pharmaceutical companies, and policy legislators all have a say in how a patient’s health will be impacted. However, the ultimate decider of health remains the patient and their ability to take care of themselves.

The key driver in this conversation is the ability of an individual to make good health decisions. With the rise of social media and the e-Patient movement, patients are given the opportunity to be proactive with their health, and ultimately become more engaged in health decisions.

 “The PC has improved the world in just about every area you can think of. Amazing developments in communications, collaboration and efficiencies. New kinds of entertainment and social media. Access to information and the ability to give a voice people who would never have been heard.” – Bill Gates

 With this paradigm shift comes with many positive components, but nevertheless carries disadvantages as well (such as non-expert medical diagnoses on the Internet). However, trying to stop change is like trying to tell the public not to eat chocolate. It is a futile effort considering that a third of American adults use the Internet as a diagnostic tool. I contend that physicians and other healthcare practitioners should embrace the e-Patient movement and become a part of it.

As health experts, practitioners carry weight with their words and have the capability to mold the future paradigm. Their role would not be dispensing cut-and-dry medical advice; after all, you cannot ignore medicolegal liability and pathology complexity. Rather, it could be to join online communities and rally them toward safer ways of technology utilization.

Furthermore, doctors could be proactive online to dispel health myths, and redirect individuals to a reliable source of information. Google’s Knowledge Graph initiative is a perfect example of this on a large scale. Doctors partnered with the search engine corporation to compile, curate, and review information that would be conveniently displayed to patrons who search for health material. This new, accurate standard of information can adjust for the dynamic nature of medicine, and stands to improve the public’s access to reliable medical information.

Sources:
http://www.kevinmd.com/blog/2014/02/physicians-ready-epatient-movement.html
http://www.kevinmd.com/blog/2010/09/epatients-expert-diseases.html
http://www.kevinmd.com/blog/2013/05/give-medical-advice-twitter.html
http://www.kevinmd.com/blog/2013/06/health-information-online-trust-doctor.html
http://www.kevinmd.com/blog/2013/02/dr-google-tips-patients-diagnose-online.html
http://www.kevinmd.com/blog/2011/03/guiding-patients-online-physician-responsibility-digital-age.html
http://33charts.com/2015/02/google-health-knowledge-engine.html

Guest posting by Alisa Momin

A recent study done by Health Affairs¹ shows a dramatic inconsistency in hospital ratings across different rating systems. The study looked at four well-known national ranking systems:

(1) the US News & World Report “Best Hospitals” list,

(2) HealthGrades (“America’s 100 Best Hospitals”),

(3) the Leapfrog Group (“Health Safety Score”), and

(4) Consumer Reports (“Health Safety Score”).

The results of the study showed that not a single hospital scored on the top of all four lists; only 10 percent of hospitals that were highly rated in one list were again rated highly on any one of the other lists. In fact, in several cases, a hospital was nearly at the top of one list and also at the bottom of another list!

I find this to be very interesting and also highly concerning. In a time where patients are becoming more and more engaged in their healthcare and actively using the internet and reports like the ones above to choose the best hospital to meet their needs, this situation can be unnecessarily confusing and at times alarming. From the hospitals’ point-of-view, this can also hinder the process of improving their healthcare quality: they won’t know what they’re doing wrong.

So why is this happening? According to the report, we don’t have a clear and consistent definition of quality healthcare. There is no agreement between the national rating systems on which methods to use and what performance factors to measure in order to determine quality. So should we standardize healthcare ranking practices?

Representatives from the ratings companies say no. They attest that if each hospital has positive and negative aspects to their care, then patients will want to use the ratings that most directly cater to their unique needs. Ben Harder (managing editor and director of healthcare analysis for U.S. News & World Report) argued, “If just one rating system existed, [patients] would have less information to use in choosing a provider.” In addition to the impasse from ratings companies, fear—of ending up at the bottom of the list—is also obstructing the path to uniform ranking measurements.

At the very least, I believe the ranking lists need to specify exactly what makes a hospital deserve the rank it has been assigned on any list: good qualities, bad qualities, exactly which specialties are highly ranked and which are not, and why. This would build patients’ trust in the ranking systems. The information provided to patients needs to be more detailed and also comprehensive. In addition, ranking systems should consider adding sections where former and current patients can further detail their experience at said hospital, much like a “ranking blog”. Facilitating interaction between patients can further the cause of the e-patient while also helping rank more personal properties of the hospitals. If the goal is to bring patients to the best quality care they can get for themselves, let’s not stop halfway.

 2014-15 US News “Best Hospitals”²

 Example of US News’ “Best Hospitals”. Is this detailed enough information? Can patients easily use this information to compare and pick the best facility for themselves?³

Sources:

[1] http://mobihealthnews.com/41039/study-finds-vast-disagreement-between-healthcare-quality-rating-lists/#more-41039

[2] http://health.usnews.com/health-news/best-hospitals/articles/2014/07/15/best-hospitals-2014-15-overview-and-honor-roll

[3] http://health.usnews.com/best-hospitals/area/mn/mayo-clinic-661MAYO/patient-satisfaction

Guest posting by Andrew Dumit

Click here to watch video submission.