Emerging technologies are changing, and will continue to change the practice of medicine in dramatic and significant ways, according to AUA President J. Brantley Thrasher, MD, FACS, Professor and the William L. Valk Chair of the Department of Urology and Co-Director of Operative Services at the University of Kansas Medical Center.
Dr. Thrasher delivered his Presidential Address, “Artificial Intelligence, Robotics and the Future of Urology,” during Saturday morning’s Prime Time plenary session.
“The future of urology remains bright. Demand for urologic services continues to grow nationwide and we continue to train the best and the brightest,” Dr. Thrasher said. “Urologists have historically been early adopters and adapters of new technology, such as shock wave lithotripsy, lasers and robotics. And ongoing advances in machine learning, automation and robotics will continue to change for the better the way we practice urology.”
Big data continues to be big news, he said, bringing increased computing power and increasingly sophisticated statistical modeling that have revolutionized the use of data.
“The 2011 McKinsey Report, for example, suggested that $300 billion in annual value was leveraged by big data,” Dr. Thrasher said. “Additionally, health care artificial intelligence (AI) funding was $2.14 billion across 323 deals in a five-year period between 2012 and 2017. Those deals increased by 31 percent in 2016 and are on track to reach a six-year high as of 2017.”
The practice areas most impacted by these ongoing technological advances are diagnosis and treatment planning, monitoring patients, online consultation, and data mining and quality improvement, Dr. Thrasher said.
“Machine learning and computer-aided image recognition in radiology and pathology, for example, will take on the repetitive tasks of reading slides and reading x-rays, and will change the way we practice medicine,” Dr. Thrasher said. “Researchers working in Australia and New Zealand used machine-learning algorithms to predict tumor location on multiparametric MRI (magnetic resonance imaging) with 70 to 87 percent accuracy. In another project, people are working with IBM to teach the supercomputer Watson to guide cancer treatment, identify early cancers and conduct genomic analysis.”
Meanwhile, wearable and implantable biosensors are being used to monitor blood glucose and lytes, pregnancy and fertility, drug and alcohol, urine, sexually transmitted diseases, tumor markers and HIV. These capabilities may allow for earlier hospital discharge and home monitoring, and evaluation of the need for an emergency room visit.
“In the area of online consultations, a British company has developed a medical AI app to triage users’ health conditions,” Dr. Thrasher said. “When tested in 2016 it achieved 92 percent accuracy. The user reports symptoms to the app, which are then checked against a database of diseases and the app recommends a course of action. It also offers video consultation with a general practitioner, reminds patients to take meds and even follows up to see how they are feeling.”
Dr. Thrasher said robotics also offer numerous possibilities, some of which are already being applied to teaching, telementoring and simulation, and may potentially play a role in credentialing and testing. Emerging robotic technologies include microrobots for better visualization or diagnostics, nanorobots for drug delivery and to aid fertility, and robots that can disinfect.
“Hospital-acquired infections will affect one out of 25 patients and one in nine will die, accounting for about $30 billion a year in health care costs,” Dr. Thrasher said. “A company in Texas has developed a robot that uses high intensity ultraviolet light generated by xenon flash lamps to disinfect an operating room or ward by causing cellular damage to bacteria, viruses and bacterial spores.”
Dr. Thrasher said the AUA has undertaken a number of research and education initiatives to encourage and promote technological progress, including 29 Research Scholar Awards using outcomes data with seven that have used big data; the implementation of a new course from the AUA Office of Research on Big Data in Urology Research; seven instructional courses on robotics and new technology; and the recent formation of an AUA New Technology and Imaging Committee.