In its first virtual meeting, MDG Boston2 crushed it with a panel discussing innovative MIS medical technologies. In the first part of the panel, Dr. Sajani Shah, chief, Division of MIS/Bariatric Surgery at Tufts Medical Center, discussed the Tufts transformation from open surgery to laparoscopy to surgical robotics and its future change to Surgery 4.0 Digital/Hybrid.3 These advances will reduce technical complexity, cut costs, and increase efficiency while potentially altering the point of care for some MIS procedures. Bryce Klontz, CEO of New View Surgical4 moderated the panel, which also included a CTO from a robotics company and an MDG Boston board member who is a subject matter expert in orthopedic surgery.
Why This Is Important
During the WMIF, it was estimated about two percent of all healthcare visits were virtual pre-pandemic; this number grew to approximately 60 percent since the early days of the COVID-19 outbreak in the U.S. It was also stated, “What the world would have taken five years to achieve was accomplished in five weeks,” regarding virtual care and the U.S. patient population. It was further explained, post-COVID, the percent of telehealth visits would decline, but not by much, and estimated in the future, 50 percent of healthcare would be performed virtually (Table 1).
Expect Change at the Hospital Bedside
We all agree that digital technology will transform healthcare, but one important area will be at the bedside—where patients recover from surgery or are treated for acute health conditions. Large flat-screen TVs will be used for multiple forms of communication. Using video conferencing, patients can be monitored by their physicians, physicians can communicate with clinical staff or families, and families can check in and speak with patients. In a welcome change to the electronic medical record (EMR), audio will be deployed at the bedside, recording clinician orders for medication, a change in patient care, or instructions regarding lab work. Ambient voice technology means clinicians will no longer have to multi-task, speaking with patients while typing on a keyboard. This behavior is one of the biggest complaints from clinicians about the EMR. Many miss the patient interaction they require to provide an enhanced level of care.
Audio/video features establish a foundation for AI-based digital health. Long overdue tracking services will help locate medical devices, such as patient imaging tools like bedside MRI,5 which is still in the FDA approval cycle. These devices will be a boon that, when available, will help patients who are critically ill. In addition, although physicians will not like it, GPS locators will be useful to track them down in the hospital. Also of value will be to track the patient location in the hospital to increase efficiencies for clinical staff and to reassure concerned family members.
Expect Change in the Medtech Supply Chain
At the WMIF, the audience of medical device leaders was polled on a variety of topics. One of the questions asked was, “In the next three years, will domestic medical supply chains compared to international supply chains: nominally grow, shrink, significantly grow, or stay the same?” The results were impressive and directive (Table 2). Now is the chance for medtech suppliers to take advantage of this rare opportunity, because medtech purchasing is acknowledging its over-dependence on global sources. For example, the pharmaceutical industry’s goal of reducing cost in the short-term yields supply issues during emergency events like COVID-19. It is estimated 80 percent of active pharmaceutical ingredients (APIs are the part of any drug that produces the intended effects) come from overseas—usually China or India. Also, it is reported that India sources approximately 70 percent of APIs from China. A global catastrophe such as COVID-19 has far reaching effects when the healthcare industry is overreliant on a single source. Medtech can learn from this.
Machine Learning and AI Will Broaden the Boundaries of Hospitals
We are still in an infancy period with regard to hospital AI, and although the field is still emerging, AI has substantial potential to address at least four major issues in the healthcare system. First, AI will push the boundaries of human performance. For example, Google Health has developed an algorithm that predicts the onset of acute kidney injury up to 48 hours before the issue occurs. In current medical practice, these types of injuries often go undiagnosed until after the incident. During the MDG meeting, Dr. Shah provided another example. She believes robotic surgery is a stepping stone to Digital Surgery 4.0 and views it as a bridge between laparoscopic and digital surgery. She said variation in surgery is one of the biggest drivers of robotics and digital surgery will be skill agnostic. She also believes greater robotic autonomy and machine learning will help achieve these goals.
Second, while AI supporters say AI will democratize medical knowledge and excellence, detractors say it will commoditize this expertise. No matter what you believe about the outcome, AI can share the performance and expertise of specialists to supplement the diagnoses of primary care physicians, especially those practicing in rural areas where specialists are relatively rare.
Third, AI can automate the grind of computer tasks in medical practice. AI will assist healthcare providers who spend an enormous amount of time entering data into EMRs and typing on keyboards, especially while examining patients. Future AI programs will identify the most relevant information in EMR records and synthesize it all into structured data. This would certainly prove to be a significant time saver for healthcare providers.
Finally, AI can manage patients and medical resources to better allocate those resources. For example, AI programs will be able to predict which service lines need additional short-term staffing. AI data management will identify patients who can benefit most from limited medical resources. It is controversial but a fact of life—how can hospitals identify revenue-maximizing practices? AI can help them accomplish this goal, which helps financially struggling hospitals stay solvent, instead of closing their doors.
How Many U.S. Hospitals Are Closing?
Since 2010, more than 100 rural hospitals have closed their doors in the U.S. and an additional 430 are at risk of closing.6 There are life and death implications for rural communities, who have seen mortality rates increase by 5.9 percent.
The Medi-Vantage Perspective
While COVID-19 has been, literally, a killler, it is also pushing us to our limits to seek out new ways to conduct the business of medical devices efficiently. Expect your hospitals to begin asking about the supply chain for your products. Be proactive and build your sales presentations with data on the supply chain of your product as compared to those of your competitors. Having a domestic supplier has become a valued feature.
Maria Shepherd has more than 20 years of experience in medical device marketing in small startups and top-tier companies. After her industry career, including her role as VP of marketing for Oridion Medical, where she boosted the company valuation prior to its acquisition, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing, business strategy, and innovation research for the medical device, diagnostic, and digital health industries. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses and is a member of the Aligo Medtech Investment Committee (www.aligo.com). She can be reached at 855-343-3100. Visit her website at www.medi-vantage.com.