Can Technology Replace the Clinician? What It Can and Cannot Do
When Silicon Valley venture capitalist Vinod Khosla remarked in 2012 that 80% of the tasks of physicians could be replaced by technology,1 the medical profession was both skeptical and taken aback by this hypothesis. Khosla later clarified this statement, asserting that specific aspects of patient care could be more effectively and accurately performed with technology using sensors, passive and active data collections, and analytics.2 Technology would assist, not replace, elements of the intake process and diagnosis by gathering patient data on their medical history and symptoms, comparing against diagnostic criteria for all known diseases and conditions, and incorporating the latest research for optimal treatment.
While technology has not yet minimized physician workloads to the projected 20%, robotic devices like the da Vinci Surgical System are becoming a common sight in operating rooms for cardiac, oncological, gynecological, and urological surgery. Closed-loop robotic systems for anesthesia such as McSleepy and Sedasys provide alternatives for administration when qualified anesthesiologists are unavailable or need additional support.3 Doctors are not adverse to new technology; a survey of users of the physician social networking website Doximity found that physicians upgraded to new iPhones at a rate four times faster than the general population, and that an estimated 35% of physicians surveyed will be using the new iPhone 6 by Thanksgiving.4 The use of technology in everyday clinical practice and the benefits and limitations remains a topic of debate in the medical profession, hinging on the wide range of circumstances and individual factors for physicians and patients alike.
How Technology Benefits Physicians: Information at Your Fingertips
Launched in October 2011, the iPad Initiative at the Johns Hopkins School of Medicine Internal Residency Program and the Global mHealth Initiative sought to increase clinical efficiency, create new means for instruction of housestaff and medical students on the wards, and improve communication among physicians, nurses, and patients.5 All Post Graduate Year One (PGY1) and PGY2-3 residents on ward services in the Internal Medicine Residency Program were given iPads with an electronic health record (EHR) program pre-installed. Dr. Satish Misra, a cardiology fellow and researcher on the iPad Initiative, has seen numerous benefits in the pilot program for both residents and patients. “The iPad Initiative has improved efficiency among the residents when it comes to the input of notes of orders,” Dr. Misra states. “Previously, residents would need to be in front of a computer in an office or at a station to enter notes and orders into the EHR. Now, residents can perform these tasks anywhere – at a conference, by the patient's bedside, or anywhere on the ward. Another benefit is that the physicians are more visible on the units; the iPads enable doctors to be away from offices and immediately perform tasks related to medical records rather than delay them.” Dr. Misra adds that the iPad gives him greater options for interacting with patients on their cardiovascular conditions and treatment. “I use several apps that provide 3D animations and anatomical models of the heart to help communicate to patients,” he adds. However, Dr. Misra also asserts that the use of technology in medical education and patient care is not always the best method for all. “In medicine, you need to look at the person individually and figure out the best means of communication. We also need to examine how residents and patients learn best, whether visually or by other means, and apply that for the best outcomes.”