Healthcare Spending Associated with Robotic Equipment

I. Introduction

Technical innovation in healthcare continues to be a top trend within the industry.  Most medical equipment today runs on a digital platform.  With that said, however in today’s society, breakthrough technology delivers benefits for patients and can lead to increases in healthcare cost.  New breakthrough technology offers a broad range of procedures now performed by robot-assisted surgery.  

Robotic surgery is an emerging technology that comes along with several benefits.    The benefits include: minimal scarring, shorter hospitalization and smaller incisions.  The addition of robotic equipment requires hospitals to invest a large amount of money.  Patients will benefit from the cost associated with the purchase of robotic equipment. Frances. Then I would take this section and move it to the last position in the opening format, where you identify the three trends. Leave out the Introduction, and insert thes two paragraphs. The last sentence, in highlights, is a good sentence to end with and then you move to the support of your trend. Which I will label B. 

II. Findings

The top three trends that I researched under the NAICS code of healthcare services were:

Cost associated with healthcare- The major goal of every business is to make a profit.  Several factors contribute to the rising cost in healthcare which makes it difficult for hospitals to sustain financial viability.  

Technological advancements– Since the beginning of time, people and technology continue to evolve.  Providers are searching for the newest breakthrough technology that patients will benefit from.  Whether it’s reducing time patients spend in the hospital, or diagnosing a patient through a computer screen. Frances, I think that this is where robotics would fall—in the technological advancements. I would put this last of the three then you can follow with the examination of the trend to use technological advancements, and focus on robotics.  I would mention robotics in this portion, so that you can easily move to the support of the robotic trend.  You talk about computer screen, which is the first time for this phrase. This is ok, but you need to follow up immediately, in the next sentence, with how robotics ties in with the computer screen. This is a logical step. 

How interest in population health management will grow– The interest in population health management is an equally important trend within healthcare.  Population health management ties into a very important trend on how to lower healthcare cost.  Population health management starts with research to gather data on the patient population.  The data is used to help manage specific diseases within the population.  These actions will help improve the patient population health and the patient satisfactions scores.  The higher the satisfactions scores, the more profit gained.

Start Here: Frances. You are not approaching this in a logical fashion. You are asked to identify three trends in your business that you will do some research on, and then you are asked to pick one trend and examine that in the research paper. As I look at your paper, I would take Findings and move that to the front and make changes, per my comments.

Background

B. Frances. I would have this section labeled Findings, and start with this sentence. You mention robotics and that is a good follow-on to the last sentence of Introduction. 

The first documented use of a robot-assisted surgical procedure occurred in 1985.  The history of robotics in surgery begins with the Puma 560.  In 1988, Davies et al performed a transurethral resection of the prostate using the Puma 560.12.  This system eventually led to the development of PROBOT, a robot designed specifically for transurethral resection of the prostate. While PROBOT was being developed, Integrated Surgical Supplies Ltd. of Sacramento, CA, was developing ROBODOC, a robotic system designed to machine the femur with greater precision in hip replacement surgeries.1 ROBODOC was the first surgical robot approved by the FDA (Castellanos, Desai, Lanfranco, & Meyers, 2004). 

 More recently, in 2000, robot-assisted surgery has been synonymous with Intuitive Surgical, Inc.’s da Vinci system (Fox, 2013).  The surgeon operates the system with a remote-control; the surgeon has the ability to see the action on a screen.Here you are talking about a computer screen, so this is a good follow-up to you statement about a screen.   The device can be sent into the body of the patient via a small incision for surgery.  The Da Vinci system is the only robot with U.S. Food and Drug Administration (FDA) approval to help surgeons perform a number of laparoscopic soft-tissue procedures, including hysterectomies, gall bladder and kidney removals, prostate cancer treatment and heart valve operations (Greenemeier, 2014).  This system continues to grow within the healthcare field.  

The Rising Cost in Healthcare Spending Associated with Robotic Equipment

Healthcare spending continues to rise as surgeons are using more expensive equipment to do surgeries. Furthermore, new technologies such as robotic surgery are growing rapidly. Figure 1 shows the number of robotic surgical procedures performed world-wide from 2000-2012.  Many surgeons have been trained on how to use expensive equipment to perform surgeries. The use of robotic surgical systems is expanding rapidly, in both the United States and Europe.  The number of robot-assisted procedures that are performed worldwide has nearly tripled since 2007, from 80,000 to 205,000 (Barbash, 2010).  The cost of the high tech machinery is costly for the hospital.  Robotic surgical systems prices range from $1 million to $2.5 million for each unit (Barbash, 2010).  Hospitals, patients and regulators may not be getting enough information to determine whether the high tech approach is worth its cost (Evans, 2013).   

Figure 1. (Pinkerton, 2013)

Potential benefits

Frances, this could be a good heading to follow up on Findings. You have increased costs with robotics, so you need to offset the increased costs to the hospital, and to the patient with increased benefits. You give benefits to the surgeon/hospital and the minimally invasive surgery is a benefit to the patient. 

There are several cost associated with the use of robotic equipment, but there are also several advantages with the use of the equipment.  Surgeons who use the robotic system find that for many procedures it enhances precision, flexibility and control during the operation and allows them to better see the site, compared with traditional techniques.  Often, robotic surgery makes minimally invasive surgery possible.  The benefits of minimally invasive surgery include: fewer complications, such as surgical site infection, less pain and blood loss, quicker recovery, smaller, less noticeable scars (Robotic surgery, 2017).   Many patients who undergo medical procedures with the use of robotic surgery may have the capability of returning back to work shortly after receiving surgery.  

Hospitals and surgeons benefit from robotic surgery as well.  The surgeon can generate more money for the hospital by performing several surgeries in one day.  The surgeon has the capability of performing surgeries while sitting down, which delays exhaustion.    Lastly, the use of robotic equipment cuts labor cost.  The system does the work, so the surgeon doesn’t require the help of several different staff.  All benefits come with issues. 

Issues

Frances. Issues are an important item, but again  you locate it in the wrong place. See end for suggestions.

As robotic surgery expands, several issues will follow.  It’s vital that surgeons and support staff are trained properly on how to operate the equipment because the equipment may fail during a surgery.  Timely maintenance helps improve efficiency.  Problems resulting from surgery using robotic equipment–including deaths–have been reported late (Evans, M., & Kaiser Health, 2013).  The machinery malfunctions causes legal issues for the hospital.  

Not to mention, the hospital also loses money when payment rates are negotiated with insurance companies. The payment that the hospital receives may not be the amount the hospital charges for the surgery. Payments below cost would result in a loss to the hospital.

As stated previously, altogether, robotic is an emerging trend that offers several potential benefits and issues.  Hospitals need the money to purchase the exciting emerging machinery.  Up to this point, however, no sufficient evidence has been provided to prove that the investment is worth the cost. 

III. Conclusion

In conclusion, there are several advantages and disadvantages associated with the use of robotic-assisted surgeries.  Robotic equipment comes with a huge price tag along with the cost associated with the maintenance.  Robotic surgery is a new innovation in technology that is being investigated and is currently on a preliminary trial.  Trials conducted should be performed through population health management.  Patients should be aware of the dangers associated with the use of the equipment for surgery.  The use of the equipment could malfunction during surgery and cause dangerous wounds to the patient.   When patients are harmed, this opens up the hospital to ethical and legal issues.Again, you make a very good point about problems with robotics, but you introduce it in the conclusion. This should be up front when you are talking about robotics, and then you offset this problem with positives—minimally invasive surgery, recovery, etc etc.   Robotic equipment also requires the hospital to make an investment.  Hospitals can gain profit to purchase equipment from earning high patient satisfaction scores, managing population health and monitoring spending. 

Frances. You will probably have a hard time following my suggestions, but I have a more difficult time in trying to follow your discussion in your paper. 

Start with the three trends that you want to research. Settle on the trend you will discuss at the last part of this section, the first, and provide good transfer sentences from one paragraph to another.

Follow with the introduction of robotics. Your graph is fine. Support and discuss and then move to other points on robotics. Give a negative or problem, and then suggest the positive side. Do this three-four times with different thoughts about robotics. Format the major headings, and sub-headings if you wish. Follow whatever APA format you are using. Then comes to:

The conclusion, where you bring together the supporting items and reach a conclusion. Do not introduce any new thoughts in the conclusion.

You have a good subject. You  write well. What  you are not doing is making an outline and then seeing if each point in your outline follows the previous point to the conclusion. 

Sorry for the detail, but you need to know how to do this. In your career you are going to be doing this again and again—sometimes in writing and sometimes orally. In each case everything  has to be in a logical order. Otherwise the listener/reader will have a hard time following your thought—Like I Do. 

Fail to Meet—make the changes and you will jump to the top of the grading system.

David

References

Barbash, G., & Glied, S. (2010, August 19). New technology and health care costs – The case of robot-assisted surgery. Retrieved July 25, 2017, from http://www.nejm.org/doi/full/10.1056/NEJMp1006602#t=article

Castellanos, A. E., Desai, J. P., Lanfranco, A. R., & Meyers, W. C. (2004, January). Robotic surgery: (2004). Robotic surgery. Annals of surgery, 239(1), 14–21. Retrieved on July 30, 2017 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356187/

Evans, M., & Kaiser Health. (2013, November 01). Mishaps and deaths caused by surgical robots going underreported to FDA. Retrieved July 30, 2017, from http://www.pbs.org/newshour/rundown/mishaps-and-deaths-caused-by-surgical-robots-going-underreported-to-fda/

Greenemeier, L. (2014, February 11). Robotic surgery opens up. Retrieved July 29, 2017, from https://www.scientificamerican.com/article/robotic-surgery-opens-up/

Pinkerton, S. (2013, November 17). The pros and cons of robotic surgery. Retrieved July 30, 2017, from https://www.wsj.com/articles/the-pros-and-cons-of-robotic-surgery-1384550504Robbins, A. (2015, April 17). The problem with satisfied patients. Retrieved July 25, 2017, from https://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/