Return of the Guru

Medical Robotics a Thorny Problem for Insurers

Ara Trembly
Insurance Experts' Forum, February 8, 2011

A recent article in ScienceDaily speculates that surgeons of the future might use a system that recognizes hand gestures as commands to control a robotic scrub nurse or tell a computer to display medical images of the patient during an operation.

The article notes that both the hand-gesture recognition and robotic nurse innovations might help to reduce the length of surgeries and the potential for infection. My own sources in the medical community, however, say that efforts to use robot technology in place of humans have not yielded those benefits, at least not yet.

Beyond that, however, I began to wonder about the insurance implications of such technology and its use in situations that will directly impact a person’s health—or his/her life. This is not to downplay the value of robotic aids for medical professionals, but we need to consider just how much we trust a robot that is not supervised by a human. Of course, insurance is a business that is solidly grounded in statistics, and if the statistical evidence for such technology indicates that there is a reduction in cost (not to mention fatalities), we will accept it. But this begs the question: When self-guided technology fouls up and a patient is injured or killed as a result, who is responsible?

According to the ScienceDaily piece, surgeons routinely need to review medical images and records during surgery, but stepping away from the operating table and touching a keyboard and mouse takes extra time and can increase the risk of infection. The new technology uses a camera and specialized algorithms to recognize hand gestures as commands to instruct a computer or nurse/robot.

The problem with this, as with many computer-human interface technologies, is that computers and humans do not always communicate well. It has taken more than a decade for software makers to develop applications that accurately recognize human speech, and even there, the record is still not perfect. In the early days of speech recognition, I can recall a demonstration of the technology at a major press conference in which the application, despite being “trained” previously, completely botched the simple message spoken by the demonstrator. Are we to believe that any device short of a supercomputer will accurately interpret gestures from a wide variety of people who come from different social, ethnic and cultural backgrounds? And what about the casual flip of the hand as a surgeon emotes about some point she is making?

Mistakes will happen with these technologies, and when they do, the finger-pointing will begin. Surgeons will point to the robot makers; the robotics people will point to the programmers; the programmers will point to those who gave them the information to input—and the pointing will go on and on. Is this a health insurance issue or does it fall under the heading of an accident? More importantly, are we ready to put our lives and health in the hands of soulless machines?

Some may argue that computers and the machines they drive do not make mistakes, but we all know that such devices only reflect the skill (or lack thereof) of their makers and programmers.

We may yet reach the point where our confidence in such technologies is high enough to take the risk. For the moment, however, I’d just as soon have my surgeon ask a human being for the right instrument, while someone else makes sure the surgeon is seeing all the information he needs to see.

Ara C. Trembly ( is the founder of Ara Trembly, The Tech Consultant, and a longtime observer of technology in insurance and financial services.

Readers are encouraged to respond to Ara using the “Add Your Comments” box below. He can also be reached at

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