When Rajiv Sethi was first trained as a surgeon, he approached it like a craft. He trained under a surgeon who taught him how to do certain procedures, and he started his own practice.
Sethi, who is executive director of the Center for Neurosciences and Spine at Virginia Mason Franciscan Health in Seattle, now is training a new generation of surgeons interested in using robotic surgery, augmented reality and predictive analytics. Not all surgeons are comfortable with this shift in culture.
“If you think about how a robot now is going to do part or most or all of your surgery, there are a lot of folks that are maybe a little bit older than me that are very, very uncomfortable with that,” Sethi said. “We’re taking the artisan out of it and we’re making the standardizable parts really the future of how physicians are trained.”
Sethi’s comments were part of a broader discussion at AdvaMed’s MedTech Conference on Monday about the use of digital technologies in healthcare and some of the barriers to adoption. These new technologies have implications not just for surgeons, but for nurses, pharmacists, paramedics and other health professionals.
“There’s this fear of losing your capability. Your identity. This is what you’ve done the last 25, 50 years, and now suddenly something else is going to do it for you — that’s the challenge,” said Bakul Patel, Google’s senior director of global digital health strategy and regulatory, and former digital health officer for the Food and Drug Administration.
Christian Eusemann, vice president of research and innovation for Siemens Healthineers, said the company sees “love yet fear from AI,” in that providers love what the technology does, but worry about the future of their jobs. One example is a feature the company implemented that automatically positions patients for CT scans to get the correct amount of radiation.
“Initially, there was a lot of fear by the technologists, like ‘oh this is the start of AI taking away our job,’” Eusemann said. “But now, because it’s really integrated in a way that they don’t even think about it anymore, they really appreciate it. They love it.”
No panacea
Although digital technologies promise to improve patient care and lighten clinicians' workloads, they are not a one-size-fits-all solution for the problems hospitals currently face. Developers of medical software must be wary of bias that can be introduced by data, said Robert Cohen, president of digital, robotics and enabling technologies for Stryker.
“Some people say, ‘Hey, why don't you just get all that data from the hospital and just work with the hospital? Well, the phenotype of those patients at the hospital is not necessarily typical for all levels of income, demographics and things like that. And just inherently by going to that hospital, by getting a couple of thousand patients, you already have inherent bias,” Cohen said.
Furthermore, getting all of that data in one place — information from surgical equipment, patient records from a hospital, doctor’s office and physical therapist — is currently very difficult. It doesn’t all exist in one place, and people in the U.S. are trying to figure out the rules of data acquisition and data use, meaning each facility can have a different policy, Cohen added.
Technology also can’t solve all of healthcare’s labor problems, a point that was emphasized by a historic strike of Kaiser Permanente workers that paused just before the conference.
Shawna Butler, a nurse economist and host of a podcast on nursing innovation, pointed to high vacancy rates and turnover rates at hospitals and more clinicians leaving the profession after just a few years.
“One of the really scary stats for me that digital technology is not going to help [is] the average tenure in an ICU for nurses. It used to be 10 years … we're down to like two and a half,” Butler said.
At major medical systems, instruments can’t be sterilized fast enough because there just aren’t enough people — a problem that technology is also unlikely to solve, Sethi said.
“Is this going to overburden an already burdened workforce, where we don't really have an answer right now to, in my healthcare system, that 450 positions that are open, and there's just no applicants for these jobs?” Sethi said. “And these are people that are going to check you in, these are going to be people that walk you back to your colonoscopy, these are going to be people that recover you after you wake up — these jobs are not being filled. And so this is where I see the importance of empowering the workforce being a very, very key part of how we think about digital in the future.”
