Insights Series, Issue 31: "The future of interventional services"

Insights Series Issue 31 siemens-healthineers.com/ insights The future of interventional services Advancing robotics in healthcare A thought leadership paper on “Delivering high-value care” co-authored with ECG Management Consultants SIEMENS Healthineers Preface The Insights Series The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. The Series explores emerging issues and provides you with practical solutions to today’s most pressing healthcare challenges. We believe that increasing value in healthcare—delivering better outcomes at lower cost—rests on four strategies. These four principles serve as the cornerstones of the Insights Series. Expanding Transforming Improving Digitalizing precision care patient healthcare medicine delivery experience Our Insights portfolio is an integrated collection of events, speaking engagements, roundtable discussions, and an expanding array of print and digital platforms and products all carefully curated to share ideas, encourage discussion, disseminate original research and reinforce our position as a healthcare thought leader. Please visit siemens-healthineers.com/insights-series Executive summary What is the future of interventional services? Robotic-assisted procedures were first introduced to All in all, the paper concludes that when it comes to surgical suites back in 1992. Their potential was robotic-assisted surgery, the time for skepticism is at an immediately clear, but the unease that greeted their end. The future of surgery and interventional procedures arrival was also manifest. People tended to be some- includes robotics, in one form or another, and organiza- what skeptical about machines that perform surgery, tions that want to successfully meet the many challenges and that feeling has not yet disappeared. To this day, facing them today need to start looking for ways to the leaders of healthcare organizations occasionally embrace that future. wrestle with resistance—their own and that of others—to the notion of investing in certain kinds of robotic technology. This paper examines the future of interventional services and the role of robotics and is based on conversations with healthcare executives from Europe, Israel and the US. It begins by identifying and exploring some of the challenges facing healthcare organizations today, which include: • Rising acuity of patients • Workforce shortage • Increased complexity of procedures • Surgeon and staff protection From there, the paper describes the many ways in which robotic-assisted technology can assist in overcoming these obstacles, ranging from the extraordinary precision and con- sistency offered by these automated systems to increased physician safety because of reduced exposure to radiation and less orthopedic strain. Other benefits include: • Data-driven interventions • Improved patient outcomes • Reputational gain and patient preference • Attracting exceptional interventionalists • Long-term financial advantage Siemens Healthineers Insights Series · Issue 31 3 Introduction The increasing role of robotics in interventional services There is some debate about when the first ever This paper examines the future of interventional services, robotic-assisted surgical procedure was performed. and the increasing role that robotics are certain to play. One that is often cited occurred in 1985, when a robot It takes as a starting assumption that the time for skepti- was used to orient a needle for a brain biopsy. cism about robotics is at an end, and that it is no longer Another is 1992, when a robot was used to assist with a question of if but when. Healthcare organizations face a hip replacement. a number of clear and complex challenges, and there can be no question that technology—specifically robotic Whatever the exact start date, those early breakthroughs technology—holds the key to solving many of them. ushered in a fundamental transformation in healthcare delivery that is being felt more than ever today. Decades after those first breakthroughs, robotic-assisted proce- dures are a common option that surgeons and patients expect to have when determining the best course of action for certain diagnoses. This is not to say that the idea of robots in surgical suites has always been met with enthusiasm. As countless books and movies have made clear, robots and robotics can engender feelings of unease and concern. Notwithstanding that, it is becoming increasingly clear in healthcare circles that the future of interventions very much includes robotics. Around the world, the popula- tion is growing and the number of available health providers is dwindling, which threatens to further diminish access to timely care. Technology presents the obvious solution to these twin problems, and there is growing recognition of that fact. Indeed, one recent US-based study showed that from January 2012 through June 2018, the use of robotic surgery for all general surgery procedures increased from 1.8% to 15.1%.2 How it works The most widely used clinical robotic surgical system includes a camera arm and mechanical arms with attached surgical instruments that the surgeon controls while seated at a computer console near the operating table. The console gives the surgeon a high definition, magnified, 3D view of the surgical sites and lesions, and the patient’s unique anatomy.1 4 Issue 31 Siemens Healthineers Insights Series · The challenge How will interventional services be delivered in the future? The decisions facing healthcare leaders are many, and Workforce shortage they are complex. As they plan for how interventional services will be delivered in the future, the ways in Expert clinicians are in short supply, and current trends which these leaders harness robotic technology will suggest that the situation will not be improving anytime go a long way to determining what kind of success soon. Staff shortages promise to be among the greatest they will have overcoming the obstacles they face. challenges for health systems in the years ahead. Part of the problem lies in how long it takes to develop exper- tise. More time studying and learning is less time prac- Rising acuity of patients ticing, and this further reduces the number of available interventional physicians and surgeons. People are living longer. According to the United Nations, the global average life expectancy is 72.9 years,3 and it By 2032, the United States face a shortage of as many as continues to grow. It should come as no surprise that an 23,000 surgeons, with the greatest deficits in surgical increase in life expectancy is associated with an increase specialties that focus primarily on older adults, including in healthcare expenditures, which of course leads to a ophthalmology, orthopedic surgery, urology, cardiovas- rise in the total cost of healthcare.3 As a result of pres- cular and neurology.4 For patients in rural areas, the sure from payers aiming to rein in costs, combined with surgeon shortage is exacerbated by the consolidation of evolving patient preferences and expectations, there is a physician expertise into Centers of Excellence in metro- trend towards moving high-margin, low-acuity surgical politan areas. Simply put, too few surgeons want to work and interventional cases out of hospitals and into lower- in rural areas, leaving many places underserved, particu- cost outpatient settings. larly for specialized interventional and surgical care. As life expectancy across the globe continues to rise, the A growing and aging population, increasingly complex number of people with multiple chronic conditions and health needs, and a projected physician shortage—these comorbidities will also continue to grow. Combined with add up to a problem health systems need to start antici- the migration, mentioned above, of low-acuity patients pating now, because in order to solve it, they will need into ambulatory settings in the community, this will leave to rethink how care is delivered. hospitals with the burden of caring for high-acuity patients who require complex, specialized diagnostic and thera- peutic procedures. Treating higher-acuity, medically Increased complexity of procedures complex patients will require an investment in educating, training, and hiring more specialized physicians, as well In the future, oncological surgical procedures will focus as the adoption of advanced technology and equipment on the removal of much smaller tumors. Precision will be necessary to deliver highly specialized care efficiently key, and superior control and navigation will be demanded. and effectively. According to a medical director and senior partner of a healthcare provider in Israel cellular-based diseases like cancer, infection, etc., will slowly have solutions that are less and less invasive thanks to the combination of drugs Siemens Healthineers Insights Series · Issue 31 5 Life expectancy vs. healthcare expenditure from 1995 to 2014 United States Life expectancy increases Central Europe and Baltics from 75.62 to 78.84 years Life expectancy increases Total healthcare expenditure increases from 71.03 to 76.69 years from $ 3,788 to $ 9,403 Total healthcare expenditure increases from $ 436 to $ 1,598 Central African Republic Life expectancy increases Total healthcare expenditure per capita from 46.25 to 50.62 years is adjusted for price differences between $ countries and for inflation and measured Total healthcare expenditure increases in international-$. from $ 23 to $ 25 Source: Roser M. Ortiz-Ospina E. Ritchie H. Life Expectancy. Our World in Data. October 2019. (ourworldindata.org/life-expectancy) Total projected physician shortfall range 139,000 needed 2033 Range 54,100 expected Projected number of physicians 21,800 Source: The Complexities of Physician Supply and Demand: Projections From 2018 to 2033 2018 2021 2033 (aamc.org) 6 Issue 31 Siemens Healthineers Insights Series · “You will have less and less reason to do aggressive procedures in the large number of cases. Many cancer cases will be detected earlier, especially in the richer part of the world or prevented or treated in a way that there will not be a need to physically remove the bulk of tumor.” Medical Director and Senior Partner Healthcare provider in Israel and prevention. Aggressive procedures in the large num- The World Health Organization recognizes that excessive ber of cases will diminish drastically. Many cancer cases exposure to ionizing radiation increases the risk of will be detected earlier, especially in the richer part of the cancer.6 And that risk leads to another. There is the risk world, or prevented or treated in a way where a physical of physical strain and injury from wearing protective lead removal of tumors is simply not necessary anymore.5 for extended periods of time. Interventionalists working more than 10 hours per day and wearing a single-sided In short, surgical procedures will become increasingly lead apron complain of shoulder pain and back pain, and specialized and require greater expertise. Likewise, inter- 47% report body aches due to wearing aprons.7 ventional procedures, such as percutaneous coronary interventions (PCIs), will continue to require a high These twin threats will only further exacerbate the degree of precision and accuracy, navigating complex, projected physician shortage. Health system leaders tortuous blood vessels, and properly sizing and posi- need to eliminate the harm of lead and radiation on sur- tioning stents on the first attempt. Today, significant vari- geons, interventionalists, and other personnel to keep ability exists in interventionalists’ skills. Some are simply their staff healthy. more experienced and skilled than others. This is impor- tant, because there is a real risk to patients undergoing PCI. Many patients requiring PCI have numerous under- lying medical conditions that contribute to their need for PCI, and the longer the procedure takes, the greater the chances of complications and poor outcomes. Extended procedure duration as a result of numerous attempts to cross a lesion, imprecise lesion measurement, and inac- curate stent selection could be addressed through the use of robotics, and reduce the need to repeat the proce- dure in the future. Surgeon and staff protection There is one drawback to the increased utilization of minimally invasive surgery techniques, and that is the requirement for increased imaging during the procedure, which results in more exposure to radiation for the sur- geon and procedural team. Likewise, the increasing com- plexity of interventional procedures that require longer fluoroscopy and image capture times is leading to greater radiation exposure to surgeons and other personnel. Siemens Healthineers Insights Series · Issue 31 7 The solution Clinical implications To overcome these current challenges, future inter- Procedural standardization and automation ventional services will need to be accessible, mini- mally invasive, and data-driven, and the supporting Simply put, surgical robotics can achieve a level of technology will need to be nimble, intuitive, efficient, dexterity and precision when performing complex laparo- and safe. Robotic technology has the potential to scopic tasks that humans cannot. They cannot replace meet all these needs. Currently, surgical robots are humans, but they can augment human capabilities and further along in their evolution than interventional reduce unwarranted variations between surgeons. In a robots, but the application of robotic technology is study comparing traditional laparoscopic surgery and still in its infancy, and there is still significant oppor- robotic-assisted surgery, the latter provided a reduction tunity for development in the future. The growth of in errors at all experience levels.8 According to a medical robotic-assisted procedures and interventions will director and senior partner of a healthcare provider in have clinical, organizational, operational, and finan- Israel, many minimally invasive procedures “can be done cial implications for hospitals—whether these are safer and better using robotic technology. Most of it good or bad will depend on how organizations respond requires skills that are much better robotized than to the opportunity presented by robotic technology. performed solely by surgeons or by humans.” He further positions robots as an intermediary between the surgeons, knowledge, decision-making and an actual, physician activity “that sometimes could be performed better by a system that is motorized. And today we’re hardly using this power at all.”5 Robotic-assisted cardiac and neurological interventions, as with surgical procedures, have the potential to utilize Artificial Intelligence (AI) and sophisticated sensors so that proceduralists can effortlessly and efficiently navigate the unique and intricate vasculature of chronically ill and medically complex patients, potentially reducing procedure duration and errors and improving clinical outcomes. Data-driven interventions Data-driven interventions can determine patterns within surgical procedures to improve best practices and a surgeon’s accuracy to a submillimeter precision. Surgical robots are equipped with dozens of miniature sensors and cameras that can measure the force being exerted and the position of the robot’s arms inside the patient. The data generated from these sensors allows the 8 Issue 31 Siemens Healthineers Insights Series · surgeon to make better decisions in real time, with ing for long hours wearing lead aprons in the cath lab, increased accuracy, thereby reducing the chances of robotic PCI provides an opportunity to comfortably sit in complications. an ergonomic chair at a workstation that is already radia- tion shielded. Robotic-assisted surgery can make a real Over the next 10 years, powered by embedded sensing difference by reducing musculoskeletal strain, cut down and AI collected data, robotic systems and imaging on radiation exposure, and possibly prolong careers. devices will be increasingly integrated, resulting in greater automation of procedures, reduced operator vari- ability, improved efficiency, and better patient outcomes. Improved patient outcomes The goal is not to enable a robot to perform complex surgeries and interventional procedures without human Robotic-assisted surgery makes it possible to perform involvement, but rather to use robotic technology to procedures using a minimally invasive approach, when improve the surgeon’s and proceduralist’s capabilities otherwise an open surgical procedure would be required. and provide higher-quality care to patients. The technology enables surgeons to be extremely accu- rate during complex procedures, while only requiring incisions the size of a dime. Smaller incisions are associ- Increased physician safety ated with fewer complications, a decreased infection risk, and a shortened recovery time compared to traditional Surgical robots are designed to eliminate the threat of surgery.11 Currently, patient quality outcomes are equiva- harm posed by lead and radiation on surgeons, interven- lent for robotic-assisted and traditional minimally inva- tionalists and other cath lab personnel. The technology sive surgeries.12 As the technology continues to evolve, has successfully proven to decrease radiation exposure, the next generation of surgical and interventional robots reduce the use of lead aprons, and cause fewer ortho- will be smaller, more precise, and more user-friendly, pedic work-related injuries compared to traditional inter- which is expected to translate into improved patient ventions.9,10 For cardiologists who’ve spent years stand- outcomes across all specialty areas. Surgical robotics in PCI To learn more about how surgical robotics are currently used in PCIs, see the following article: Siemens Healthineers Insights Series, issue 30: The case for robotic-assisted PCI—What is the value for healthcare executives? Siemens Healthineers Insights Series · Issue 31 9 Organizational, operational, and financial implications Reputational gain and patient preference Many of the new generation of surgeons will have completed years of training in robotic-assisted proce- A hospital’s reputation is built on the range of services it dures. Now in practice, they expect—and require—access provides, the quality of its clinical outcomes, and the to robotic technology wherever they choose to work. quality of its patients’ overall experience of care. A reality Health systems with robotic capabilities will be better that hospitals must face is that patients can no longer positioned to readily attract and recruit junior specialists, be taken for granted. They are increasingly informed especially important during times of physician shortage.14 consumers who research organizational capabilities and offerings, review publicly reported quality and care experience ratings and rankings, and read physicians’ Long-term financial advantage biographies before selecting where to go for care. Informed patients often seek care at hospitals or with Hospital leaders are looking for high-value approaches physicians that offer the latest and most advanced tech- that improve patient outcomes and experience while nologies and services. Hospitals that have invested in maximizing hospital and physician value. They face an surgical robots often differentiate themselves from interesting decision over the adoption of robotic tech- competitors by marketing their technological capabilities nology. For some health leaders, the return on invest- and highlighting the patient benefits. Hospital leaders ment may take longer than they are willing to accept. must consider the intangible benefits of early adoption Other leaders, however, will understand and appreciate of new and evolving technology, including robotic- the value robotic technology provides in terms of soft assisted interventional equipment. dollars. They will have the vision to see how AI and robotic- supported tools can improve overall efficiency, increase patient access, and enhance patient outcomes. They will Recruiting exceptional interventionalists understand how the technology can attract physician talent and differentiate their services and capabilities in At their core, physicians are scientists, and as such, they the market. These health leaders will explore these often want to be on the forefront of technology and inno- advanced technological opportunities. And in so doing, vation. Surgeons in particular—and especially the newest in preparing for the future of interventional services, generation of surgeons—tend to believe that robotic- they will set their organizations apart from the laggards. assisted technology gives them a competitive edge. According to a President of a healthcare provider in the UK: “Our physicians want to be on the cutting edge of where technology is. That they see the future. And they see the future as actually having this capability, which in their mind, actually enhances their ability to do the proce- dures that they do. It gives them a differential in regard to their own capabilities and comparison to their colleagues or comparison to another institution.“13 10 Issue 31 Siemens Healthineers Insights Series · Conclusion Exploring the use of robotic- assisted technology There has been a clear increase in robotic-assisted Robotic-supported interventions and surgical procedures interventions in recent years. The oldest and most do not remove humans from the care delivery process— widely used surgical robot system is Intuitive’s da Vinci instead, these advancements in technology and science robot, with more than 5,300 systems installed world- will improve clinical quality, patient and clinician safety, wide. The system has been used in more than seven and access to lifesaving and life-extending services. million surgeries.15 Importantly, Intuitive’s core patents Exploring the use of robotic-assisted technology across have begun to expire, triggering increased competi- numerous platforms and specialties, and investing in the tion for robot innovation and patents. Many compa- research, education, teams, and processes necessary to nies are actively developing and implementing new implement and integrate this technology, is a process robotic systems, with applications for use in cardio- that will take time. Healthcare organizations that take vascular, neurological, and oncological procedures. these steps now will see clinical, organizational, and financial benefits on their investment in the long term. What that means is that over the next 10 years, we can expect robotic systems to evolve and become more sophis- ticated, with the ability to do more things and do them better. These systems will be increasingly integrated to provide improved efficiency, and greater adoption and use cases. Most importantly, they will provide better patient outcomes, which means the demand for these systems, by patients and payers, will grow. Hospital lead- ers must create an environment in which this technology innovation can flourish, or they risk being left behind. S V Robotics Long-term benefits are clinical, opera- tional, and financial returns on your investment. Siemens Healthineers Insights Series · Issue 31 11 Guidance for C-suite executives in conversations about the future of interventions Below are guiding questions that hospital administrators might consider asking to help inform their decision to invest in robotic technology. 1 What current procedures could be performed 6 What variability exists in the technical skill and using robotic-assisted technology? proficiency of our proceduralists and surgeons? 2 How long do these procedures typically take? 7 Which surgeons and proceduralists are proponents of robotic technology? How are they perceived by their peers? 3 What variability exists among providers who 8 What is our reputation in the community? perform the same procedures? How might we differentiate ourselves? 4 How long does it take patients to recover, and 9 What is the Board of Trustees’ understanding and how does that align with their expectations? support of robotic technology? 5 How do we evaluate the technical skill and proficiency of our proceduralists and surgeons? Access the guiding questions online to assess for yourself where you stand. Follow the QR code for a 10-min self-assessment. 12 Issue 31 Siemens Healthineers Insights Series · Suggested follow-up on siemens-healthineers.com/insights • Siemens Healthineers Insights Series, issue 30: The case for robotic-assisted PCI—What is the value for healthcare executives? Available at: siemens-healthineers.com/ insights/news/robotic-assisted-pci-healthcare- executives • ECG Consultants Thought Leadership Article: Cardiac Catheterization in the ASC: Strategic Considerations for Hospitals and Health Systems. Available at: ecgmc.com/thought-leadership/ articles/cardiac-catheterization-in-the-asc-stra- tegic-considerations-for-hospitals-and-health- systems i Information: The Siemens Healthineers Insights Series is our preeminent thought leadership platform, drawing on the knowledge and experience of some of the world’s most respected healthcare leaders and innovators. It explores emerging issues and provides practical solutions to today’s most pressing healthcare challenges. All issues of the Insights Series can be found here: siemens-healthineers.com/insights-series Contact: For further information on this topic, or to contact the authors directly: Sandy Myerson, RN ECG Management Consultants slmyerson@ecgmc.com Annegret Thomas Global Head of Executive Customer Engagement at Siemens Healthineers annegret.thomas@siemens-healthineers.com Siemens Healthineers Insights Series · Issue 31 13 About the authors Sandy Myerson, RN Annegret Thomas Associate Principal Global Head Executive Customer Engagement ECG Management Consultants Siemens Healthineers A visionary, results-oriented healthcare executive and Annegret has over 20 years of medical imaging know-how, registered nurse with more than 25 years of broad clinical with 15 years of marketing and leadership experience at and operational experience, Sandy is known for deliv- Siemens Healthineers. Her background is broad and ering innovative and strategic approaches to improving encompassing having worked in four different business clinical operations, fiscal performance, and the care units such as magnetic resonance, molecular imaging, experience for patients and providers alike. A former ED angiography and in central marketing & sales operations and flight nurse, chief nursing officer, and chief patient in Germany and in the United States. Prior to her roles at experience officer, Sandy has a master of business Siemens Healthineers she successfully developed and administration degree in healthcare administration and implemented an MR didactic curriculum for the radiology a master of science in healthcare financial management program at the University of Dusseldorf. As part of the Euro- from Temple University. She earned her bachelor of pean Team at Marconi Medical Systems she contributed science in nursing degree from Pennsylvania State to the overall European market development in MR uti- University. Sandy is a member of Sigma Theta Tau Inter- lizing her clinical background from her professional expe- national Honor Society of Nursing, the American College rience of several years as a certified radiographer. She has of Healthcare Executives, and the American Organization professional authored articles and a radiology compen- for Nursing Leadership. dium with case studies for residents and radiographer. Morgan Leske Reto Merges Senior Consultant Global Head Expanding Precision Medicine ECG Management Consultants Siemens Healthineers Morgan’s experience working with organizations across With more than 10 years’ leadership experience in the healthcare industry gives her firsthand knowledge of healthcare marketing, Reto Merges has a strong track the financial and operational challenges faced by hospi- record in building effective teams for clinical and innova- tals and health systems. Before joining ECG, Morgan was tion marketing. In addition, he has four years of work a senior consultant at IBM Global Business Services, experience in China, ramping up efforts for research where she worked on a variety of projects focusing on collaborations in China and South Korea. He holds a strategic planning, process improvement, and project degree in electrical engineering and information tech- management. Morgan has a master of health services nology from the Karlsruhe Institute of Technology, administration from the University of Michigan and a Germany, and has studied at the Nanjing Normal Univer- bachelor of science degree in healthcare management sity, China. His scientific background is in the field of and policy, with a minor in health promotion, from medical imaging, where he has authored many publica- Georgetown University. tions and holds multiple patents. 14 Issue 31 Siemens Healthineers Insights Series · References 1. Lane T. A Short History of Robotic 6. Ionizing radiation, health effects and 10. Maor E. Eleid MF. Gulati R. Lerman A. Surgery. Annals of the Royal College of protective measures. World Health Sandhu G. Current and Future Use of Surgeons of England vol. 100. Issue 6 Organization. April 29, 2016. Robotic Devices to Perform Percutane- _ sup, Pages 5-7. May 2 2018. Available from: who.int/news-room/ ous Coronary Interventions: A Review. Available from: doi.org/10.1308/ fact-sheets/detail/ionizing-radiation- Journal of the American Heart rcsann.supp1.5 health-effects-and-protective- Association. Vol 6. No. 7. July 24, 2017. measures Available from: doi.org/10.1161/ 2. Research and Markets. Surgical Robots JAHA.117.006239 Market by Products, Application, Region, 7. Livingstone RS. Varghese A. Keshava SN. Company Analysis, & Global Forecast. A study on the use of radiation- 11. Mayo Clinic. Robotic Surgery. February 2021. protective aprons among intervention- Available from: mayoclinic.org/tests- Available from: researchandmarkets. ists in radiology. Journal of Clinical procedures/robotic-surgery/about/ com/reports/5265134/surgical-robots- Imaging Science 8. 34. 2018. pac-20394974 market-by-products-application 8. Zihni A. Gerull WD. Cavallo JA. Ge T. 12. Ashrafian H. Clancy O. Grover V. Darzi A. 3. Roser M. Ortiz-Ospina E. Ritchie H. Life Ray S. Chiu J. Brunt LM. Comparison of The evolution of robotic surgery: Expectancy. Our World in Data. Oct 2019. precision and speed in laparoscopic and surgical and anaesthetic aspects. BJA: Available from: ourworldindata.org/ robot-assisted surgical task perfor- British Journal of Anaesthesia. Volume life-expectancy mance. Journal of Surgerical Residency 119. Issue suppl_1. Pages i72–i84. 223:29-33. March 2018. December 2017. 4. Merritt Hawkins. Physician Shortages in Available from: doi.org/10.1016/j. Available from: doi.org/10.1093/bja/ Medical Specialties in 2021: An Inside jss.2017.07.037 aex383 Look. March 16, 2021. Available from: merritthawkins.com/ 9. Jia Q. Chen Z. Jiang X. Zhai Z. Huang M. 13. President of a healthcare provider in news-and-insights/blog/healthcare- Li J. Operator Radiation and the Efficacy the UK in discussion with the authors. news-and-trends/physician-shortages- of Ceiling-Suspended Lead Screen September 2021. in-medical-specialties-in-2021-an- Shielding during Coronary Angiography: inside-look/ An Anthropomorphic Phantom Study 14. Dyrda L. Why Emante Health Built a Using Real-Time Dosimeters. Scientific Robotics Program. Becker’s Health IT. 5. Medical Director and Senior Partner of a reports vol 7 42077. July 19, 2019. healthcare provider in Israel in discus- Available from: doi.org/10.1038/ Available from: beckershospitalreview. sion with the authors, September 2021. srep42077 com/healthcare-information- technology/dr-edward-tangchitnob- why-emanate-health-built-a-robotics- program.html 15. Intuitive. Intuitive for Patients: Robotic-assisted surgery as a minimally invasive option. ECG Management Consultants Available from: davincisurgery.com With knowledge and expertise built over the course of nearly 50 years, ECG is a national consulting firm that is leading healthcare forward. ECG offers a broad range of strategic, financial, operational, and technology-related consulting services to providers, building multidisciplinary teams to meet each client’s unique needs—from discrete operational issues to enterprise-wide strategic and financial challenges. ECG is an industry leader, offering specialized expertise to hospitals, health systems, medical groups, academic medical centers, children’s hospitals, ambulatory surgery centers, and healthcare payers. Part of Siemens Healthineers’ global enterprise services practice, ECG’s subject matter experts deliver smart counsel and pragmatic solutions. Siemens Healthineers Insights Series · Issue 31 15 At Siemens Healthineers, we pioneer breakthroughs in healthcare. For everyone. Everywhere. By constantly bringing breakthrough innovations to market, we enable healthcare professionals to deliver high-quality care, leading to the best possible outcomes for patients. Our siemens-healthineers.com/ portfolio, spanning from in-vitro and in-vivo diagnostics to insights-series image-guided therapy and innovative cancer care, is crucial for clinical decision-making and treatment pathways. Built on a history of innovation going back more than Did you enjoy the read? Make sure to subscribe to 125 years and with unique strengths in patient twinning, our newsletter to always receive the latest thought precision therapy, as well as digital, data, and artificial leadership insights. intelligence (AI), we are well positioned to take on the biggest challenges in healthcare. 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