Bringing Closed Loop Automation to Healthcare

One of the topics I hear frequently from the health IT community is about barriers to innovation. From my perspective, closed loop automation is a huge issue that we face and will have to deal with. We clearly allow closed loop automation in other parts of our lives, yet somehow we have this reverence and reluctance to do it in healthcare. Why?

Everyone I have ever run across in the healthcare industry—from my previous role as a doctor to the role in technology—is dedicated to goodness, kindness, and supporting their patients. Yet the process is so complicated we inadvertently, systematically hurt people over and over again. The only way to cure this is to automate the automatable.

And just what is automatable? It’s a moving target, but here’s a start:

• Respirator settings: We've talked about very simple things like automating respirator settings. Why should I as a doctor, since I have an output in mind, monitor the physiology of a patient in a stable manner? Algorithms, through experience, could do this a whole lot better than a junior doctor. I want to use the power of the most senior doctor built into the algorithm and teach the respirator to be as smart as possible and then actually learn with individual physiologic feedback and how it responds to that patient to maintain a parameter.

• IV pumps: As with respirators, we could do the same with IV pumps. The IV pumps would have Ethernet or wireless connections that can talk to the electronic medical records that can talk to lab data. Why not have the pump start to deliver a drug like heparin? In this scenario, a nurse can't make a mistake and a doctor can't inadvertently write the wrong order. By the 80/20 rule, we'll default to the average most of the time, anyway. Let machines help us where they can.

The benefits of closed loop automation are many, but freeing doctors and nurses from mundane tasks that are repeatable would be a game changer. That’s one of the biggest alterations we can make towards improving the delivery of care worldwide.

Maybe it's a big transition, but we need to trust the machines. They can do a really good job at certain things. I'm not asking the machines to think for us; but where things follow well developed patterns allowing that process to occur makes sense. Naturally, there will be resistance from those who see automation as a threat to job security. It has happened in other industries where automation replaces human activity. That’s to be expected.

But at the end of the day, a robot can paint a car better than a human can. A robot can be better at welding. There are things that closed loop automation can do better in healthcare and we need to give it a try.

What do you think? How would closed loop automation be viewed in your facility?