At FutureMed, Richard Satava, MD gave an impressive presentation that touched on everything from breakthroughs in surgical robotics to plasma medicine. He is a professor of surgery at the University of Washington Medical Center, but he also helped pioneer the surgical robotic system that eventually became Intuitive Surgical’s da Vinci.
Early in his talk, Dr. Satava stressed the need for a new scientific methodology. While the scientific method has served us well and will do so going forward, it has limitations. In the future, we should expand our reliance on simulation technology, which “takes our current information technologies out of the present and brings them into the future.” Simulation technology, once it is able to mimic human biological processes, would disrupt the clinical trial process. “Right now, it costs $200 million dollars and 20 years to go through a complete, randomized clinical study.” But in the future, clinical trials won’t be based on “blood and guts,” they’ll be based on bits and bytes. And they will be much more accurate and faster to carry out.
And, we should look more carefully at outliers generated from scientific research, he said. “That may be the key to the next revolution.”
A Virtual Person
Dr. Satava stressed the need for information-based representations of patients in medicine. “We need to have a new kind of electronic medical record,” he said. A medical record should include a personal body scan with data embedded into it. As an example of this, he pointed to the holomer: (HOLO-graphic M-edical E-lectronic R-epresentation) developed by DARPA. In particular, patients should have such a scan done when they are well. That way, when they are ill or have an injury, a new scan can be done and compared against the previous data. When a person is ill or injured, it is the change in status that is the important factor.
When this technology is mature, it could allow someone to virtually test a drug or medical device before actual use. This simulation technology could be made accurate by marrying it with genomics, physiological, and other related data.
The government has already considered this technology “from a different direction” in its virtual autopsy research. The military can use information gleaned from such virtual autopsies to change its tactics on the battlefield. It could, for instance, use this data to develop more-effective armor in its vehicles.
The Power of Robotics
As surgical robotic technology evolves, it will become an increasingly important point of integration for healthcare delivery. The technology, which Dr. Satava explained is better characterized as an “information system” than a robot, will help save time, increase efficiency, and collect important data. At present, 95% of the potential of the da Vinci robot is squandered. All of the data that it is generating when a surgeon moves his hand or looks at an image is thrown away, he says. “That should be shared over the healthcare enterprise.”
In addition, robots could be used in the OR to replace scrub nurses, who pass surgical tools to surgeons. Nurses have more important things to do, like interacting with patients, Dr. Satava explained.
Dr. Satava noted that one of the fundamental changes about the information age is it represents a move away from physical objects to information and energy. “Energy is going to be a very important part of the future of medicine,” he reasoned. This form of medicine will be able to harness the power of plasma (as in an energy cloud) with handheld instruments at room temperature. In the plasma cloud are charged particles that can work directly on individual cells and at the molecular level. The budding field gives physicians the power to turn on and turn off specific molecules to, for instance, influence coagulation times and wound healing. It also can be used to kill biological agents. “At this moment in time, there is no known biological agent that is resistant to plasma exposure for 30 seconds,” he said. He surmised that plasma medicine represents one of the “most exciting new areas in addition to genomics” in modern medicine.
For more from Dr. Satava, check out this TEDx video: