The IDEAL framework for surgical robotics New framework offers tools for the future of robotics in surgery

Surgical robotics are poised to revolutionize the healthcare industry, as the role of robotics continues to permeate healthcare. But how do you ensure that robotics are of added value to patients, healthcare providers and society? To safeguard this added value, international researchers have developed a new framework with tools and guidelines. Maroeska Rovers and her colleagues at Radboud university medical center also developed an innovation course that is in line with this framework.

The number of robotics in healthcare is expected to increase in the future. They may be able to help with the shortage of staff in healthcare, simplify operations or make healthcare cheaper. This sounds great, but in practice, these robotics are not yet developed, evaluated and implemented in such a way that they actually have added value. This requires a different way of innovating, in which the added value is central in every phase of the development of robotics. Tailor-made analysis and careful evaluation are of great importance.

That is why the international IDEAL Colloquium developed a framework containing guidelines and tools for everyone involved in robotic innovations in healthcare. This framework was recently published in the scientific journal Nature Medicine, led by researchers from the British UCL. The research highlights innovative approaches for the evaluation of surgical robotics at an early stage of their development, which should promote integration into daily clinical practice.

More efficient, sustainable and accessible

The Dutch contribution is by Maroeska Rovers, Janneke Grutters and Mirre Scholte. Maroeska Rovers is Professor of Medical Technology and Innovation at Radboud university medical center and scientific director of the TechMed Centre at the University of Twente. According to Rovers, new medical devices should be assessed for their added value for patients from the very first idea. 'With this framework, we want to encourage every innovator in healthcare to think carefully about robotic innovations in healthcare. Healthcare needs to become more efficient, sustainable and accessible. Innovations such as remote monitoring and robotics can improve care and reduce staff shortages. But careful development and implementation is essential, with attention to the needs of patients and collaboration between all stakeholders. This means taking added value into account upfront.'

The device, the caregiver, the patient, and the system

The researchers call for all stakeholders to be involved in the process in a timely manner. In the article, the researchers describe four perspectives: the device, the caregiver, the patient, and the system. They provide concrete tips and tools for each perspective. When evaluating the device, for example, developers should ask themselves what the addition of artificial intelligence means. Does that change the current evaluation models because the evaluation will be continuous?

When it comes to healthcare providers, the researchers argue that it is important to validate expectations about the ergonomic benefits of robotics for surgeons. The learning curve of surgeons should also be taken into account. From the patient's perspective, robotics introduce new ethical challenges. For example, who is responsible for errors when systems have a certain degree of autonomy?

Rovers and her team looked specifically at the piece on health care costs. Rovers: 'The financial costs of robotic systems are high. An analysis of the economic viability and sustainability of robotics is also important. We have to look at the perspective and needs of the healthcare system, but we also have to consider the impact on the environment.'

Surgical Innovation Course

At the same time as this publication, Maroeska Rovers and her team are launching the Surgical Innovation Course, named ‘Surging Innovation’ which stems from the NWO Vici grant she received in 2018. They developed this course based on their ambition to contribute to the development of effective, affordable and valuable surgical innovations. They researched better methods to evaluate surgical innovations as early as possible, even in the development and testing phase. 'The course is publicly accessible and available to all innovators in healthcare and other interested parties. I encourage everyone to take this course so that we can bring innovations to the market that genuinely add value to patients, healthcare providers and society.'

About the publication

This article appeared in Nature Medicine: The IDEAL framework for surgical robotics: development, comparative evaluation and long-term monitoring – Hani J. Marcus, Pedro T. Ramirez, Danyal Z. Khan, Hugo Layard Horsfall, John G. Hanrahan, Simon C. Williams, David J. Beard, Rani Bhat, Ken Catchpole, Andrew Cook, Katrina Hutchison, Janet Martin, Tom Melvin, Danail Stoyanov, Maroeska Rovers, Nicholas Raison,  Prokar Dasgupta, David Noonan, Deborah Stocken, Georgia Sturt, Anne Vanhoestenberghe, Baptiste Vasey, Peter McCulloch & The IDEAL Robotics Colloquium.

Here you will find Surging Innovation, the Surgical Innovation Course. The course is in English and publicly accessible.

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