Digital Health in Action - The Rise of Robotics in Healthcare

According to a market research report, the global healthcare robotic systems market—which includes surgical robots, rehabilitation robotics, assistive robotics, application robotics, non-invasive radio surgery robots, pharmacy robots and others—is set to expand to $3.764 billion by 2018 from a base of $1.781 billion in 2013, growing at a CAGR of 16.1%.

Increased popularity of minimally invasive surgeries, improvements in accuracy of surgical robots, reduction of complication rates and significant savings in pre- and post-operative care costs are the key factors expected to fuel the growth of this market in the coming years.

Most experts, however, believe that this is more than normal incremental growth expected from a sunrise sector. With robotic systems getting cheaper, smaller and more energy-efficient, the healthcare industry could be nearing an adoption threshold and may soon witness a boom.

New Technologies and New Applications

Robotic systems are increasingly augmenting and replacing humans in many functions of the healthcare industry such as diagnosis, food service, medication distribution, surgeries and infection control.

The costs of these systems are dropping swiftly and the technological convergence of robotics with imaging systems are opening up hitherto unforeseen new applications in healthcare.

Proponents of robotics argue that they increase precision, boost operational efficiency, deliver better clinical outcomes, cut labor costs and replace humans in potentially dangerous situations. Robotic systems also assist in or completely take over tasks that are otherwise perceived as dull, boring and too repetitive.

Doctors are increasingly adopting robot-assisted surgery as they’re touted to provide greater precision, lower trauma, accurate identification of problem areas in the body and an ability to work at microscopic scale.

While surgical and interventional robotic systems like da Vinci are well known, other types of robots are increasingly taking over various important roles in the healthcare facilities such as:

• Disinfecting operating rooms, patient rooms and emergency facilities
• Collecting, preparing and sorting medications
• Transporting medication supplies, meals, linen and waste
• Collecting, analyzing and storing laboratory samples
• Caring, supporting and helping elderly and disabled people
• Facilitating virtual medical consultations via telemedicine robots
• Assisting paraplegics gain mobility via exoskeleton-powered systems

At the Craigavon Area Hospital, a medication dispensing robotic system patrols over a mile and a half of shelves identifying correct medications using lasers and barcodes and then delivers them to a transport trolley. The system can tirelessly work through the day and night and restocks and reorganizes over 850 shelves of medications.

Robotic Nursing Assistants (RoNA) built by Hstar Technologies can lift patients weighing 500 pounds or more in a failsafe manner and reduce patient falls and injuries thus increasing workplace safety and mobility.

Autonomous Guided Vehicle (AGV) systems that can deliver supplies, meals, medications, linen and other goods throughout hospitals can currently run for more than 10 hours at a stretch and cost between $25,000 and $140,000 depending on capabilities.

Automatic and portable ultraviolet (UV) light and hydrogen peroxide vapor (HPV) disinfectant robots have become very popular in recent times and are being employed to disinfect patient and operating rooms.

A new generation of surgical robotic systems—such as Navio PFS, used in partial knee replacement surgeries—have made it economically feasible for many hospitals to employ robotics in outpatient partial knee replacement surgeries. The systems have significantly improved the precision of the alignment of bones and the management of adequate soft tissue balance in knee replacements.

For large laboratories, robotic systems that manage and prepare specimen tubes for sample testing and track them throughout the entire testing process have reduced testing turnaround times and improved efficiency. They also reduce exposure of laboratory technicians to bio-hazardous materials.

Sterile processing robotic systems that clean, sort, inspect, count and repack medical instruments are in advanced stages of development and may hit the market within one or two years. Such a system would reduce and may even eliminate exposure of hospital workers to various blood-borne pathogens.

And within surgical and interventional robotic systems, technological breakthroughs such as capsule robot systems, robotics with advanced 3D imaging systems and surgical telemanipulation systems have vastly expanded the applications of healthcare robotics and will continue to drive the growth of the market in the near future.

The entry of new systems such as Titan Medical’s SPORT has brought down costs of surgical robotic platforms to less than $1 million in a market currently dominated by da Vinci—which costs anywhere from $1.5 to $2.3 million per installation. The newer systems are also touted to have a smaller footprint and increased mobility.

Analysis of Market Trends and Growth Drivers

As we can see, robotic systems may eventually permeate many functions and domains across the healthcare ecosystem. Some of the short, mid and long term factors that will affect this trend are –

• Technological advances in computing power, miniature precision sensors, and application programming are accelerating the adoption of healthcare robotics by making healthcare robots more sophisticated, precise, efficient and affordable.
• Aggressive marketing by robot manufacturing firms is putting hospitals in a fix. If they don’t buy the latest machine, patients may perceive them to be behind the times and may choose a hospital with advanced robotic systems irrespective of economic considerations. 
• Patients are increasingly opting for minimally invasive surgical procedures that minimize trauma and shorten the hospital stay. Many such procedures may require robotic assistance.
• With most of the developed nations graying faster than developing countries, governments will increasingly subsidize and encourage healthcare robotics not only to improve productivity but also to offset regional differences in skilled healthcare labor availability and costs.
• As prices fall and performance improves, robots may graduate from hospital environments to the at-home personal service domain. They may eventually gain more acceptability from the general populace and take on the roles of care-giver, nursing assistant and companion—especially in elder care.
• By assisting humans in some instances and replacing them in others, robotic systems offer tangible cost savings to healthcare organizations. Boring, repetitive and hazardous tasks could increasingly be taken over by robots.

Things Hospitals Should Consider

As robotics permeate healthcare, hospitals may find themselves dedicating increasing amounts of budgets to robotic systems and should keep several factors in mind before making an investment.

• Most healthcare robotic systems are not one-size-fits-all solutions. Hospitals need to factor in logistics, footprint, technological maturity, maintenance costs and additional infrastructure requirements when buying a robotic system.
• Irrespective of the robotic system being considered, all stakeholders who are likely to be impacted by the system should be consulted and a deliberate team-based approach should be followed in decision-making. 
• Hospitals should thoroughly review the manufacturer’s reported system capabilities:

1. State of the technology
2. Safety measures
3. Regulatory approvals for the technology
4. Regulatory requirements for using the technology
5. Departmental and interdepartmental impact
6. Additional staffing needed
7. Staff training and physician training requirements
8. Service and maintenance needs
9. Accompanied IT needs and infrastructure
10. Additional infrastructure needed to deploy the system

• Cost-benefit analyses should comprehensively cover equipment costs, supplies costs, reimbursement projections, patient acceptance and satisfaction, staff acceptance and satisfaction and the impact on clinical outcomes and readmission rates. 
• When using disinfectant robotic systems that emit vaporized solutions, hospitals need to follow proper protocol to prevent toxic vapors from leaking to other areas. Remotely controlled systems should be able to issue warning signs before being deployed for use.
• Healthcare professionals, especially surgeons, may be reluctant to quickly accept new and unfamiliar surgical robotic systems. There could also be concerns about problems related to the surgical protocol. Hospital management should ideally secure a clear buy-in from all the stakeholders who are likely to be affected by the introduction of robotic systems.

As robotic systems continue to advance, the healthcare industry may soon be witnessing a robotic boom.

Our Digital Health in Action Series covers various sectors of the Digital Health Landscape to show the impact that digital health is making on healthcare across the world, and provides an analysis of current market drivers and predicted trends.