A discussion about robotics and digitization in healthcare

Interview Martin Düblin

The industry is on the move and it can be observed every day how new automated solutions are created. Truck deliveries without drivers, robots taking over services, shops without cashiers to name just a few examples. But what does this mean for the life science industry? Is this segment also an area in which automation or robots have a chance or are justifiable at all? An unqualified yes is the answer. Martin Düblin believes that the structures known today and regarded as inviolable will also change significantly in this segment.

Mr. Düblin is a trained machine draughtsman with a degree in mechanical engineering / process engineering and has been working in the life science sector since 1989. He has been globally active in the life science industry for approx. 30 years. With his company One One Eleven GmbH, he currently supports various projects in Europe, North America, Africa and Asia during the planning, conceptual design and strategic implementation. These include laboratories, production facilities, office buildings, training facilities and hospitals. Since the turn of the millennium he shifted his activities more and more to consulting on a mandate basis and focused on integral automation, robotics, AI and digital business areas. He regularly gives lectures worldwide on emerging technologies. With his understanding not only all markets but also social forms will change. We are facing a significant upheaval that challenges us all. Fear of these changes must not paralyze us, but the responsibility of each individual and the joy of design should motivate us to develop and tackle the future together.

Mr. Düblin, you are on the move worldwide as a speaker and project supervisor. How does it live out of a suitcase?

Actually, I’m not really aware that I’m living out of a suitcase. Surely, if I should travel on to the next place after a short stay, this feeling could arise. However, my curious attitude to travelling coupled with my interest in getting to know other regions, peoples and religions in combination with my business activities makes me arrive at all my destinations like at home, regardless of the duration.

From my parents I took in any way that I can, may and should feel at home where I am, quasi temporarily. In the past, people used to joke that I had fallen from the carriage of a gypsy woman. Regardless of what really triggers it, I can say in a relaxed manner that every departure enlivens me, but that I always like to return home. To my family, relatives, friends and my roots.

Do you see any differences in technological progress between the different countries? Where can you mainly be found at the moment?

This is an interesting question. Let’s imagine how the Western world began to develop technologically in the 19th century, taking on a leading role, and how it is still believed today. On the other hand, we have to admit that, for various reasons, countries with previously backward technological levels have caught up and will continue to catch up or may even overtake the Western world.

New technologies such as integral automation, robotics, AI and Data Lakes are placing completely new demands on the developers of technical systems. What used to be dominated by mechanical engineering is now increasingly turning into a system designer who assembles ever more complex assemblies. The mechanical manual skills are lost and are replaced by automated production lines. In the past, for example, when welders and mechanics manufactured an assembly, more and more standardized functional units such as robots were used instead. This change is bringing IT more and more into focus. From this point of view and not limited to the metalworking industry alone, the vision is formed that all manufacturing processes will run completely autonomously in the distant future. If the possibilities for the use of manpower are reduced to the service providing areas in an overall more far-reaching IT world, this offers completely new entry potential for new suppliers and thus also for countries with (even) less reputation on the world market. The result is a more balanced provider base, spread over a larger graphical area.

Let’s take a look at what we have written in the area of AI. There is no question that algorithms today and more complex models in the future can replace work and thinking processes. For example, China is making billions of investments in AI, Israel has long been successful in this domain and others of the same kind. In a few years they will show an enormous potential, which will again trigger a more comprehensive change process in the area of intellectual achievements.

What I have written is based on my personal encounters in the geographical perimeter between Europe, America, Asia and Africa.
To what extent is your everyday life affected by digitization, would it still work without a laptop?

My everyday life is strongly influenced by digitization. All my work is based on digital tools and the exchange of information is also digital. Without a laptop, my business activities as well as a large part of my private activities would no longer be possible. Be it in terms of data required and used, electronic data exchange or digital tools. The consequences would be reduced capacity to act, reduced scope of performance and faded effectiveness. On the other hand, I prefer direct and personal dialogue with others. What is not or not yet possible in digital exchange to convey moods or to get a deeper impression of the other person is made possible by face-to-face conversation.

When I take the liberty of answering the question in the sense of our society, I point out that the answer depends on the attitude of each individual. It is still conceivable that on the same principle as before 1970, everyday life is possible without a laptop. However, the more someone successfully moves in today’s social, commercial and industrial environment, the more difficult or even impossible it becomes.

On the other hand, the question also arises as to why the laptop should be dispensed with. Resisting these social changes robs one of one’s chances of playing an active role and shaping one’s own future.
We are currently in the implementation phase of implementing the electronic patient file. In your opinion, what must happen to make this suitable for the masses?

It does not require too much, only 3 points, and yet again very much, due to the achievable effects.

• First and foremost, the acceptance of the users must be won. This primarily includes the certainty that each individual really has and retains sovereignty over his or her data, today and in the future, which must also be clarified with equal responsibility for the time after his or her death.
• Furthermore, that the use across all medical service providers functions integrally and is guaranteed.
• And beyond that, that a greater benefit is generated for all those involved.

What would be the next step after the EPD?

We have to be aware that the EPD is only a first small tool. It is the first step, which opens the door to major changes on the road to digital health. Health care costs are exploding, and the federal government has to pay huge amounts of premiums every year because the insured are unable to pay them. Medicines are being developed that cost up to half a million a year for treatment therapy and are not affordable for all people. Therapies and treatment strategies are partly questionable and the possibilities of the digital world exceed those of biological humans. Due to a lack of interfaces and inadequate data structures, we are reducing the preventive chances of well-being. The list could be continued.

With the electronic patient file, registered users are provided with a tool that helps to optimise personal care. The basis of the own stored values, supplemented with anonymized data of other persons of very similar profile as well as of the own family tree, of course confirmed by the affected persons, leads over the artificial intelligence to medical insights, which cannot be reached by an individual physician or not with the same hit rate. Thus the user receives first recommendations without the intervention of a physician, also preventively, and this at any time and regardless of his whereabouts.

If the initial situation is critical, this digital doctor recommends as the next step the trusted doctor, which may and should also be an e-doctor, with all the advantages in terms of costs, time and location. A personal visit to a biological doctor may be necessary from a distance in order to check the situation. Or the remotely recommended therapy, for which drugs can be digitally released and obtained at any location, is sufficient.

Invoices and health insurances are in turn purely digital service vessels with which we reach medical facilities such as hospitals and homes. The lack of personnel resources in dealing with patients can be relieved thanks to the platform of the electronic patient file, while at the same time improving care. In addition, the digital options offer added business value for these providers, including completely new business areas.

At the end of this analysis, personalized medicine. Thanks to new procedural facilities, it will become more and more socially acceptable and, on the one hand, further improve the treatment of patients and, on the other hand, trigger a transition in the pharmaceutical industry and lead to new business configurations. All in all, an end-to-end digital and automated landscape in which processes increasingly dissolve into fully automated and digital service units and digital healthcare becomes a reality. The fact that lower cost structures are possible with significantly higher quality is evident in the overall design.

Let’s move over to another area you’re moving in, robotics. Where is Switzerland?

Interestingly enough, as already known from many other areas, in the first place. We are a country of developers and have some unique opportunities in a global comparison, which we should and must cultivate. With regard to the question, the answer is not only limited to the manufacture of robots, but also extended to their implementation and use in different areas. For example, for a plant where robots are to be installed and used. For the overall concept, i.e. the combination of the various modules with the robot, a so-called integrator is required. This integrator is capable of realizing the task of an application with the use of robot technology. And in Switzerland we have about 50 (!) companies that are active as integrators.

In addition, our universities have been researching robotics for many years, from which solutions have emerged and are emerging that are used in the industries. These are not only the actual robots, as they are generally known from the production of cars, but also autonomous and self-acting units of different design. The time has come for robots to leave the factory and enter everyday life. I formulate this consciously of the consequences that we are very much challenged to place these disruptive solutions in harmony with the changing society.
Do we have any chance at all to innovate competitively in this area? Keywords are costs and specialists.

In a global comparison, Switzerland has a unique mix of specialists such as highly qualified professionals, engineers, academics and complementary experts who operate in an environment of agile and financially strong companies. In addition, the country offers political stability, a strong global network and an entrepreneurial quality that guarantees trust, credibility and reliability. This is associated with our Swiss cross, which at the same time triggers high expectations. This mix offers a huge potential for intellectual, commercial and industrial development which is not present in any other country, and I stress, in any other country. Higher costs are therefore not relevant at all, because the result and the constant and trend-setting developments pulverize this assertion and it is obsolete to speak of too high costs in a successful and still real model. Of course, an entrepreneurial cost-consciousness is always necessary to prevent counterproductive developments.
Where are the opportunities in the pharmaceutical industry? What are potential dangers?

The opportunities lie in competition. Every company has opportunities and possibilities to change and pursue new strategies. However, since the pharmaceutical industry always reacts somewhat belatedly to technological developments and acts surprisingly cautiously, especially with robotics, there is a danger that it will miss the entry completely and thus leave the competition to others. This statement is not only limited to the topic of robotics, but aims at the entirety of industry 4.0. This is referred to as the umbrella term of the digital revolution as industry 4.0, or better declared as industry X.Y taking into account the ever faster development.

With the new technologies, the quality in the pharmaceutical industry can be increased, investments can be made more economically optimized, competitiveness can be increased, other operating models can be tackled, integrated product control can be achieved and completely new flexibility can be achieved. In the worst case, missing entry means losing access to a certain market or being confronted with major competitive disadvantages. The new technologies also lead to a critical examination of which activities a pharmaceutical company should carry out. Developing pharmaceuticals and marketing the products is not necessarily the core business of pharmaceuticals, logistics and manufacturing. A world of integral digital conception leads us to the idea of manufacturing centres which are also operated independently of pharmaceutical companies, thus opening up various interests. To go into this subject further would go beyond the scope of this advertisement. I am currently on an Asian tour where such visions are discussed. I am happy to accept enquiries in order to elaborate further on what has been addressed.

Last question, if you would have the chance again today to start again and would stand shortly before the conclusion of the upper school. Which direction would you choose, where would you invest more time?

First of all, I would choose exactly the same course of studies and supplement it with business administration and IT. This tri-national commit meets the language requirements immediately. If possible, add a humanities science to it and my basic package is named. That international relations and or political science are an interesting addition, some history and psychology to it, the potpourri becomes stunning. Physics couldn’t hurt either, but let’s leave it at the first stage in the form of the tri-national basic package.

I would invest more time in getting closer to industry as early as possible. It was a pity that at that time we acquired our title largely without reference to the real economy. Therefore, it is my personal concern today to give the student groups I support an unfiltered impression in direct contacts with industry when opportunities arise. The young people appreciate this very much and react with an enormously high motivation in their work.

Finally, I would like to thank you for this interview and the opportunity to express my personal opinion on these challenging topics. There are groundbreaking changes ahead and we need to prepare for the future, our future, which is a wonderful opportunity that should not go unused.