The convergence of automation and artificial intelligence (AI) is set to transform the nature of work across multiple industries. In the October 18, 2017 issue of Nature, the editorial board called for scientists to examine the workforce implications of automation. We answer this call through an examination of the impact automation will have on the peri-operative environment. The use of technology and automation is not a novel concept in the Operating Room (OR), with existing use ranging from ventilators which dynamically respond to patient respiratory patterns to monitors that calculate and capture various physiologic parameters. More recent innovations include the widely accepted da Vinci(™) surgical system, the use of RFID tecnology used for surgical tool tracking, and the controversial Sedasys machine designed for patient administered sedation. While there have been many technological advances throughout the late 19th to early 20th century, more recently these changes have augmented the surgical environment without significantly altering the workforce. Recent advancements in robotics, AI and machine learningsmay put an end to this period of workforce stability. The incorporation of reinforcement learning algorithms in pharmacological robot software to rapidly and significantly augment robot performance could lead to extensive disruption in the use of anesthesia for sedation. Likewise for Surgeons and OR staff, the highly repetitive nature of many peripheral surgical assistant tasks, such as those of the surgical technologist, lends itself to innovation. Though automation introduces a unique set of health and safety considerations, it could also lend itself to enforcement of safety mechanisms, such as procedural checklists. While current peri-operative workforce projections have focused on the impact of the aging population on future needs, few studies have examined the potential implications of automation in the peri-operative environment. In this concept level abstract, we propose further study of the future of the surgical workforce in the context of the aforementioned advances to guide recommendations for stakeholders and policymakers on how to best adapt to the rapidly evolving technological workforce in the OR.



Author: John Pearson

Coauthor(s): Elijah J Bell III, Chethan Sarabu, Heather Lyu

Status: Project Concept