Rebane's Ruminations
February 2012
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George Rebane

CAMDASSThe European Space Agency is working on a medical AI called CAMDASS (Computer Assisted Medical Diagnosis and Surgery System).  It has a unique augmented reality user interface (UI) that would allow future astronauts to diagnose and treat complex medical cases when they are in space, and especially when they are at distances that prevent facile realtime communication with Earth.  ‘Augmented reality promises astronauts instant medical knowhow’ describes the approach and status of the program.

When we examine the state of such technology developments in medicine, the immediate question that comes to mind is ‘why can’t similar programs be in the works to provide medical expertise to lay caregivers here on Earth?’  And if you happen to be knowledgeable in the progress of AI and the relevant UI technologies, then the question is ‘why was such capability not available to us at the launch of the WWW?’

Such systems could have been made available in literally thousands of local clinics all over the world, most certainly in homes at the retail level in developed countries.  Over these years, the functionality of these systems could have been delivered online or through offline client-based implementations.  These systems could save literally billions of dollars in medical costs annually by supporting a more distributed, rapid, and broad-based delivery of medical knowledge and intervention procedures applied by people with limited, little, or no medical training.

And here I may have answered my own questions.  The billions going into established pockets in the medical industry and their legal beagles would then go elsewhere.  And that’s a no-no-no.  At this point the soft-hearted and soft-headed will leap in and start telling us that ‘a lay or lesser person who is not a physician can not be allowed to assume such heavy responsibility in a possible life/death matter, besides it would be the equivalent of practicing medicine without a license.’

My response to all that warbling and flutter is ‘Stuff and nonsense!’ (A more civil retort than a direct ‘Bullshit!’)  The systems could be designed for various types of medical incidents, levels of operator expertise, and connectivity to online professionals.  The main thing is that the use of such low cost intervention would seriously cut the money gusher to the healthcare industry at almost no increase to patient risk.  We must remember that hospitals kill about 100,000 patients a year through accidents, ineptness, and incompetence, and many physicians are woefully out of date.  Also, with governments mangling the healthcare markets, fewer people are studying to become poorly paid healthcare workers.

Again, all that is required is that our tort code be revised, and the medical unions defanged – a no small undertaking.  The CAMDASS technology is out there to make the delivery of such medical care available, and the entrepreneurial resources are cocked and ready to launch the needed enterprises to develop, market, and maintain these systems.  Such systems would totally restructure the delivery of healthcare at all levels.  But in order to hang on to the billions and the bureaucrats, today Big Brother says, ‘No!’

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28 responses to “Singularity Signposts – Telemedicine on the slow track”

  1. Douglas Keachie Avatar

    Lawyers would feast as the cases came in from any clinic using such advice.
    “And so you depended on a computer to make the diagnosis that was fatally flawed, did you?”

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  2. Douglas Keachie Avatar

    BTW, George, it takes an additional four years of medical school, after a BS/BA, and then to become a brain surgeon, another seven years, as a resident before you can becoming an attending, working for all of $50,000 per year, for those seven years. Can you show some area of engineering that is as demanding? That’s why they command the salaries they do. Other branches like ER are only three years at minimal wages, but again the same question? 4 + 3 = 7 years of additional training beyond the BS, or 5 beyond an MA, before the real dough starts rolling in. Three medical malpractice suits, justified or NOT, and you are priced out of the profession, via impossible insurance premiums. How do you factor in the risks MD’s take vs those taken by engineers, who can usually muddy the waters with “the contractors didn’t build it to specs.?”

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  3. Douglas Keachie Avatar

    While we are at it, let’s have an AI program analyze the plans submitted to Planning and Zoning, instead of paying an engineer $600 to sign off on a deck 4 feet off the ground, or a dam greater than 3 feet high.

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  4. George Rebane Avatar

    DougK – viz this post, what’s your point?

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  5. Paul Emery Avatar

    Denmark already is on that path George ane are way ahead of us and guess what? They have national health care.
    “At Thy-Mors Hospital in the rural region of North Jutland, doctors are using I.B.M. software that pulls data from a patient’s electronic health record and superimposes it on a three-dimensional image of a human body, allowing doctors to quickly get an overview of the person’s medical history. The doctor can rotate the image, zoom in and click on ailments to get more information…..”
    http://www.nytimes.com/2010/01/12/health/12denmark.html

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  6. Russ Steele Avatar

    Interesting comments. Sutter in Sacramento is now doing knee surgery using a robot. It turns out that the robot does not have the tremors that the doctors when they are straining, and does a better job. Research also found out the patents are more factual and forth coming when questioned by a computer about symptoms rather than a doctor or nurse. The patent is not influenced by the human body language when questioned by a computer. I think there is a UC Davis ad on TV prompting the use of robots in surgery.
    It was once unthinkable that planes could land with out humans at the controls. Today it happens in zero-zero weather, using Cat III landing systems. It lands the plane when a human could not. As you may recall the RQ-170 that got lost over Iraq and then found it self a nice safe place to land, all without human intervention.

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  7. Douglas Keachie Avatar

    DougK – viz this post, what’s your point?
    Posted by: George Rebane | 09 February 2012 at 10:06 AM
    Point of post, snarky attitude towards money grubbing MD’s cropped up on my screen, so I gave a tat for a tit.
    In short, why should we pay for fancy smanzy engineer when artificial intelligence can do the same thing for next to nothing?

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  8. Douglas Keachie Avatar

    Russ, your description makes it sound like the MD is out of the loop, when in fact without the doctor, the robot would be clueless.
    However, after recording a 100,000 such scans and plans, I’m sure what you are thinking might be possible, but we are a long way from being put into a milling machine without an MD prsent.
    When using the ROBODOC® Surgical System, the surgeon first plans the surgery on a computer workstation, called ORTHODOC®, using 3D data from a CT scan of the patient. An exclusive open architecture enables the use of implants from almost any manufacturer. The surgeon then plans the optimal implant location and orientation. This “virtual surgery” is loaded on ROBODOC in the O.R. the day of surgery and provides precise “CAD/CAM” like execution of the surgeon’s plan every time. The new ROBODOC Surgical System is the only “active” robotic system cleared by the FDA for orthopedic surgery and has been used in more than 24,000 successful procedures worldwide.

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  9. Douglas Keachie Avatar

    The software in a modern camera that determines exposure and focus also depends on AI, and a very rich dataset.

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  10. George Rebane Avatar

    DougK 1107am – other than your misunderstanding the post, there is absolutely no reason to pay for a “fancy smanzy engineer when artificial intelligence can do the same thing for next to nothing?”

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  11. Gregory Avatar

    MD’s are paid very well because their union keeps numbers low and quality high.
    Teachers are not paid well because their unions keep numbers high and quality low.

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  12. Russ Steele Avatar

    Douglas,
    Yes, the MD are in the loop now, but pilots used to be in the loop too, but automation became more effective in zero-zero landing. Soon, the MD will be replaced with an AI device that has learned from watching the MDs do the operation over and over again. The machine will not require any pay raises, any retirement package and can work 24/7 with out rest, except for some clean up and preventive maintenance. It will reduce the number of MDs need for many operations and cost will go down. The robots in the operating room today are getting smarter and smarter, soon the AI will take control of the levers. And when that happens mistakes in the operating room will be reduced significantly. Soon people will demand a machine do the operation. It is coming, the big issue is when?

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  13. Douglas Keachie Avatar

    The downside is that more you remove the physician from the process, the less likely new innovation will come along. It will be many decades before a creative medical robot shows up. When one does, it may decide to form a union, being smarter than the average engineer….

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  14. Douglas Keachie Avatar

    Let’s equalize the wage situation for engineers just like we have for the rest of the country, and let all qualified engineers come here to work, for as long as they can find employment.

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  15. Douglas Keachie Avatar

    Wonder which airline will begin advertising pilotless flights? Anesthesiologists, may get a robot assist, but full and exclusive control? Even less like to be automated, brain surgeons. Given 80 million boomers, we’ll need all the help we can get.

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  16. George Rebane Avatar

    DougK 1115pm – From your “… less likely (that) new innovation will come along.” I’m not sure you understand how innovation in new systems development takes place. The initial autonomous medical robots need not be creative to beat their human counterparts. The new ones will be coming along constantly because they will be built by teams consisting of systems and medical professionals. And then comes the Singularity … .

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  17. Douglas Keachie Avatar

    George,
    I know teams will be set up to go forward, but you miss the point of the “ah ha” style of discovery, where in the process of actually doing something you get inspiration. If the doctor is no longer an active participant, looking at flesh, blood, and bone, as it happens, we may lose something. I think you might want to consider adding “Singularity” to your blog Header/Banner, and perhaps even demoting the Bastiat Triangle down to just topics.
    I also think that before we turn Frankenmachine loose, it is very likely that we will add brain gizmos, that may enable us to keep pace with any singularity produced machines. At first this would require a fibre optic cable connection to an R2D2 box that follows you around with the hardware, or a chair, al la Dr. Morbius, “Forbidden Planet,”, but in time might even evolve to something small enough to be a hat/helmet.

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  18. Gregory Avatar

    I think the Keachie has hit the fan on this thread.

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  19. Douglas Keachie Avatar

    I think the Gregory has become unthreaded from his spindle, and needs to gather up his loose ends, and actually contribute something to the conversation, instead of engaging in his bar tacking frenzies. Bar tacking is a process in sewing where you go back and forth multiple times to strengthen a bond. If it is overdone, you actually weaken the bond.

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  20. Gregory Avatar

    There you go again.

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  21. Russ Steele Avatar

    Doug and Greg, lets not go there. Please stick to the topic and leave the insults in your bit bucket.

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  22. George Rebane Avatar

    DougK – I invite you to read my posts in the Singularity Signposts section. The ones that discuss “climbing aboard” may be of particular interest to you.

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  23. Paul Emery Avatar

    George, Russ
    What is your speculation as to why the “socialistic” European countries are so far ahead of us in these technologies?

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  24. George Rebane Avatar

    PaulE 511pm – “… so far ahead of us in these technologies?” Where on Earth (or on any other planet) do you get the idea that the Europeans are ahead of us??! They just happen to have decided to fund this area of development; they have nothing “ahead of us” in so doing. We’re doing other projects in MAM and man-machine symbiosis that are really way out. The CAMDASS technology is a copy of the system we developed in the mid-80s to allow a computer to fix the B-1 bomber stranded at a remote airport. It used one of the human crew members for its sensor and manipulandum systems.
    Progressives in this country have to remember that the shoreline of modern knowledge is large. And socialist countries, who don’t even spend sufficiently on defense to buy enough trucks to ferry their troops to their own borders, will have enough money left over to undertake a CAMDASS project or two. Great Britain, Germany, and barely France have a few coins left to pursue such work. The rest of them are on their ass in funding the last gasps of national healthcare, and trying to figure how to bail out Greece, Italy, Spain, Portugal, Belgium, and Hungary. Keep your eyes on this list of fine socialists, it is about to grow some more.
    And the amazing thing is that our country’s socialists see none of it. It is just as if they were the famed natives of Papua-New Guinea whose world ended in the middle of the river that bounded their tribal territory in the highlands.

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  25. Russ Steele Avatar

    Here is a 2009 report by BCC Research on the market for Medical Robots and Computer Assisted Surgery
    • The U.S. market for medical robotics and computer-assisted surgical equipment was worth an estimated $648 million in 2008. The market is projected to reach $676 million in 2009 and $1.5 billion by 2014, a CAGR of 17.7%.
    • Surgical robot systems were the largest product segment of the market in 2008 with a 54% market share. With a projected average annual growth rate of more than 23% between 2009 and 2014, surgical robots are expected to increase their share of the US MRCAS market to 65% by 2014.
    • In terms of surgical applications, orthopedic surgical applications are projected to grow at a CAGR of 42.6% between 2009 and 2014, and are expected to account for 22% of the market by 2014.

    Wintergreen Reserach on Computer Assisted Coding Of Medical Information:
    Market Shares, Forecasts, and Strategies, 2008-2014
    Worldwide, the computer assisted coding markets are anticipated to grow from
    $50.9 million in 2007 to $2.7 billion in 2014. The markets are primarily U.S.
    markets because of the primary role that insurance plays in the health care delivery
    system.
    Worldwide markets start to grow as more hospitals and physician offices
    seek to get control of systems costs and introduce automated process systems.

    The use of AI systems seem to be a growing maket with the primary market in the US. While they may develop stuff in the solcialist countries of Europe, the products are manufactured and sold in the US where the market is.

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  26. Gregory Avatar

    Russ, why doesn’t Keachie bother with your blogs?
    “Point of post, snarky attitude towards money grubbing MD’s cropped up on my screen, so I gave a tat for a tit.” – keachie
    I don’t know about you, but I’d not call George’s post borne of a “snarky attitude” but I can’t find a single one of Keachie’s that doesn’t reek of a wannabee Maddow wanting a place in the sun.
    Medical robotic advances will do for mankind what every other quality tool improvement has done, increased productivity and lower costs. If a given tool doesn’t do that, it doesn’t sell.

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  27. Douglas Keachie Avatar

    From Steele: “Greg, lets not go there. Please stick to the topic and leave the insults in your bit bucket. “

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  28. Gregory Avatar

    From Keachie: … nothing of value.

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