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Mega trends: Operating Room
of the future, with insights
into the impact of COVID 19
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Getinge Hospital Engineering Forum 2020
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Christophe Homer heads Ipsos’ Medical Devices &
Diagnostics practise in the UK and is passionate about the
intersection of medical devices and diagnostics with
pharmaceuticals to driver better patient care and outcomes. In
particular, he has extensive experience and thought
leadership in the field of biomarker testing in oncology,
understanding the dynamics of platforms, test kit kits and drug
selection of targeted therapies.
With over 10 years of experience, Christophe is highly
practiced in running large global studies across all stages of
product lifecycles, to understand the medical devices and
diagnostics landscapes for our clients.
Christophe’s academic background allows him to quickly
understand highly complex scientific information, whilst being
adept at distilling complex and voluminous results into simple,
actionable recommendation to drive client strategies.
Christophe has a PhD in biochemistry focussed on drug
discovery from the University of Cambridge, UK.
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Welcome to Getinge Hospital Engineering Forum 2020Today’s presenters – ready to guide you through our journey into the world of robotics and how it is impacting the
operating room
Dr. Christophe HomerDirector, Head of Medical Devices & Diagnostics, UK
Hannah Osborn is a passionate leader in the field
of medical devices & diagnostics, often taking the stage to speak at
events focusing on future technology trends, most recently speaking
about the future of the IVD market and ‘Digital Doctor,’ looking at the
use of connected health and telehealth platforms. Hannah heads
Ipsos’ Medical Devices & Diagnostics practise in APAC and is
passionate about improving healthcare outcomes through strategic,
insightful healthcare research.
Hannah has directed large strategic studies mapping medical device
landscapes among payers, healthcare professionals and patients in
APAC for eight years, the EU for 5 years and the US for one year.
Hannah has a particular passion for bringing her consulting strategic
experience together with analytical data-driven market research
techniques for the most meaningful outputs.
Hannah has a medical sciences degree from Oxford University.
Hannah OsbornResearch Director, Medical Devices & Diagnostics, APAC
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The future is
already here…
Imagine a future where surgical robots have become small
and affordable enough to be found even in non-specialised
hospitals and outpatient clinics outside of a major
metropolis...
Imagine a time when these robots can be put onto ‘auto-
drive’ mode to complete certain parts of the operation
faster and more accurately than humans…
Imagine a world where a specialist can conduct operations
in several cities, in multiple countries – all in a day’s work –
from one centralised location…
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The future of the operating room: Robotics
Measuring
the impact
Overcoming
the barriers
Imagining
the future
Understanding
the landscape
1 2 3 4
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COVID-19: How has to future of the OR been impacted by COVID-19?
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Introduction
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Operating rooms (ORs) are one of the most critical areas and highest cost centres of a hospital. This makes
them a prime target for innovation to improve efficiency and precision. The past decade has seen a significant
shift in the use of sophisticated and automated technology in the OR:
We spoke to 10 key opinion leaders in the field of robotics and ran a panel survey with 243 robotics surgeons from
around the globe to learn the impact that robotics has had on OR design, surgical practice and outcomes
High-resolution displays &
surgical cameras
Hybrid
operating roomsSpeech recognition software
Apps (e.g. Touch Surgery)
augmented & virtual realityInpatient and day case surgery Smart hospital design
https://www.mddionline.com/future-digital-surgery
https://www.merraine.com/5-disruptive-technologies-that-are-revolutionizing-the-operating-room/
https://new.siemens.com/global/en/products/buildings/markets/smart-hospitals/operating-room.html
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01Understanding the
landscape
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US, 70%
5EU, 14%
Japan, 4%
ROW, 12%
Understanding the landscape
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OBGYN
CARDIO
GI
URO
ORTHO
SPINE
NEURO
80% Market
Share
Informa Pharma – Robotically Assisted Surgical Devices_Dec 2019
Broadening indications Geographic spread Main players
% Robotically assisted surgical
device sales value 2018
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02Measuring the
impact
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Six drivers of robotic uptake
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The aging population, global burden of disease and subsequent general hospital bed shortage, as
patient recovery time is reduced with robotics
Introduction of less expensive systems and the launch of systems that don’t require use of disposable
instruments is bringing down the per procedure cost, meaning more can afford
Technological advances in robotic systems are enabling more widespread use e.g. haptic feedback,
modular components, availability of portable devices
Increased emphasis on physician and operating room safety significantly reduces and potentially
eliminates the need for intraoperative fluoroscopy
Integration of robotic training into medical residency programs
Regulatory approvals of robotic systems, for additional clinical indications and
in new geographic markets
1
2
3
4
5
6
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Key benefits of robotics
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Improves surgeon performance
Supports more efficient OR use
Improves precision
Enhances ergonomics
Enables difficult procedures
Easier to train on robotics
than anticipated
Easier option compared to MIS
High patient case loads:
Increased patient attraction
Recovery time
is reduced
Less frequent &
complex post-
surgical
complications
There are fewer
7-, 30- & 90- day
readmissions
Pain and
scarring post
operatively are
reduced
General benefits During surgery After surgery
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03Overcoming the
barriers
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Five barriers to robotics
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1 Insufficient clinical evidence
2 Lack of competition means high costs
3 Lack of reimbursement
4 Access to/availability of robotic platforms or trained surgeons
5 Patient acceptance & demand
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Support needed to increase uptake of robotics
Value-added services & maintenance,
including case building for funding, more
contract options, lower cost and/or faster
maintenance, real-time remote trouble
shooting
Better integration with other systems in
the OR and with enhanced imaging
options
Subsidised training & education for
surgeons. Virtual/augmented reality and
simulation training, for nursing & OR staff,
as well as surgeons
Reduce the cost burden. Increasing
competition is expected to bring costs
down, making robotic systems accessible to
medium and small sized hospitals.
Training, education and reducing costs are the main support needed; value-added services, such as
case building for funding and maintenance contracts/remote monitoring of systems would also give a
boost
More system upgrades, both software and
technical improvements to make robots
more precise, smaller & easier to use
63% 63% 80%
51% 53% 54%
% of surgeons who spontaneously
mentioned training in the survey:
% of surgeons who spontaneously
mentioned training in the survey:
8% 16% 17%
12% 13% 21%
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04Imagining the future
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Imagining the future
Increasing access
Increased competition &
price reduction
Increasing indications
for robotics
Getting ‘smarter’
Improved connectivity
and remote control
roboting
Artificial intelligence &
automation
Increased use of data/
smart systems
Advancing design
Digital imaging
New/Updated innovations
e.g. single port access
Miniaturization and
migration out of the OR
Peripheral technology
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Most likely and impactful trends: Global panel data
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Use of AI to automate parts of robotic surgery is ranked as the most likely to happen in the next 2-3
years and most likely to have a significant impact. Smaller robots are highly likely to happen in the
short term, but impact is limited. The US particularly expects further enhanced images to come soon
8%
16%
15%
6%
12%
15%
12%
25%
5%
7%
14%
14%
10%
14%
5%
26%
Most impactful on surgical practise
5%
7%
9%
12%
13%
15%
16%
23%
7%
8%
15%
8%
8%
11%
16%
26%
Display technology showing patient stats
Video capture with automated report
Further enhanced imaging
Integrated data to make real-time decisions
Augmented reality / simulator-based training
Remote consulting system
Smaller, more portable platforms
AI/ machine learning & automation
Most likely to happen 2-3 years
% of respondents ranking each advancement 1st
USA EUROPE
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Expected impact of COVID-19
Positive/ increase in use a minority report
an increase in use and awareness, as robotic
surgery has less contact so is seen as safer;
especially so in Spain
Funding for new platforms is expected to
decrease; Reimbursement is largely not
expected to be affected
Reduction in procedure volume only
urgent/ emergency cases are being conducted
and elective procedures are postponed and/or
being prioritised by urgency.
Germany seems to be the least affected
European country.
New protocols are being introduced:
1. Patient selection criteria are more stringent
with each case being presented to a surgical
committee
2. Patient preparation and screening to include
COVID-19 tests
3. Infection control is stepped up with airseal
devices, negative pressure ORs & bio-cleaning
COVID-19 has seen a drastic reduction in caseload, as elective surgeries are being postponed; new
protocols are in place around patient selection, testing for COVID and infection control
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Led by the US for volume &
APAC for growth
Intuitive dominates: 80% share
OR design of the future will be
smarter and more tech savvy
with enhanced functionality in
lighting & imaging
1. General beliefs: easier to train & use
robotics than MIS; higher case load
2. During surgery: Enabling technology
for difficult surgeries, improved precision
& ergonomics, more efficient use of OR
3. After surgery: fewer & less complex
complications, faster recovery, fewer re-
admissions, pain & scarring reduced
1. Insufficient clinical evidence
2. Cost/Affordability: due to lack of
competition & adequate gov.
reimbursement
3. Access/Availability to robotic
platforms, trained surgeons
4. Patient acceptance & demand &
now lower surgical volumes
In conclusion
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Landscape in a nutshell… Key impacts concentrate around… Barriers to overcome…
1. Increasing access Increasing
indications for robotics, Increased
competition & price reduction
2. Getting smarter Data/smart systems,
connectivity/remote control, AI &
automation
3. Advancing Design digital imaging,
miniaturization, new innovations
Slow down of R&D activity
Reduce procedure volumes
New protocols
Access to funding
Increase M&A activity
Pockets of increased use &
awareness
Expected trends centre on... Covid Impacts …
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Q&A
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Thankyou.