With Robotics and AI have we now transitioned from Medtech to Techmed

Have we moved from MedTech to TechMed

Cue strong British northern accent: "When I were a young man we didn't have all these new fangled electronic gizmos. We had proper big steel instruments in surgery. Big retractors for big incisions. You could measure the experience of a surgeon on how big their incisions were. The bigger the incision the bigger the surgeon.”

Ahh the pre 1990’s in any operating room were rows of gleaming stainless steel instruments - simple chromic catgut and silk. A young resident’s job was to to hold that deep pelvic retractor for four hours while occasionally being barked at by the surgeon to “Keep it still you moron !!”

It was the days when as a young rep ,a surgeon would see your new block of metal and ask the head of the operating room “to get a few in I like Steve…”

Ahh how I miss those simpler days… Not.

Where am I going? Well I wanted to say that in the past 35 years I’ve seen some major transitions in the way that medical devices have evolved - and I’ve seen several transitions in the approaches to medical devices. Back then a device was a fairly dumb, fairly single function lump of something. Even the Bovie machines (diathermy or electrosurgery) were pretty basic and dumb. You cranked up to the carbonisation level and burn baby burn. Many surgeons said to me when I watched this lightening show of crackling carbonisation and plumes of smoke “Carbon doesn’t bleed boy.”

Yes I was young and fresh faced in that bygone era.

But in that era we were known as the medical devices business. Because we made and sold medical devices. I still have in my possession here some of the old US Surgical metal staplers that were used at a hospital in Birmingham - big solid metal GIA, TA and EEA. (Go look them up.) And in the early 90’s they transitioned into disposable metal and plastic (but still dumb) single use stapling devices.

We saw at the end to the 90s an electronics revolution where we started to see the miniaturisation of many electronics components, improvements in software, and much consumer tech starting to bleed in to medical devices. We saw Intuitive and Computer Motion bring “robots” to thet operating room. We saw anaesthesia systems move from my day of a chock of wood in the mouth, whiskey and chloroform (joke) to super advanced anaesthesia machines that more or less ran themselves and allowed much more time for the anaesthetist to finish the crossword.

The OR has crept forwards with advances in imaging, and devices became smarter and smarter. Many plugged into the wall, and then with the advent of battery technology we even saw some battery powered devices. (Woooooooo!)

The dumb lumps of metal started to get some technological smarts and slowly but surely we had medical device with more advanced technology. And that brought about a gradual shift where Medical Device started to get the name Medical Technology - or MedTech.

It’s now been a few decades where we have moved through the era of advancing the smarts and functionality of devices. Just look at electrosurgery as we have moved from blast it to advanced energy that aims to minimise tissue damage - where it uses complex algorithms to induce desired tissue effects. Just look at imaging. Take a look at a tower of any medical device company today and see it verses an imaging tower in 1992.

And if you look at the evolution of surgical robotics. We moved from the S to the Si to Xi and now the DV5. Huge leaps forwards in what’s under the skin, attached instruments and imaging. Software and capabilities are a world away from how it started.

We have seen the evolution of stapling devices where now they are self contained computers, drive systems and data analysers. All battery powered.

We could name multiple areas where in healthcare the devices they have leapt towards technology.

But something else has crept in that surrounds those devices. And that is the connected Universe. Devices have started to collect data - and deliver that data back to surgeons and cardiologists, and nurses and hospitals. Entire software ecosystems have emerged that not only drag data from the device - but now start to assemble that data into useful dashboards to begin the deliver insights.

And more than that - we are seeing multiple inputs from multiple devices start to talk to each other and feed that data lake. Imaging, sensors, robots, smart devices. And here I’m talking just about in the OR or the cathlab or other site of care.

But we are now moving beyond that with that data being merged in with pre operative data such as CT, MR scans and more. Electronic health records and data about the patient t being collected and analysed. That is being dragged into the preoperative site of care to give a better understanding of the better personalised treatment for that patient. It’s all assistive.

We are on the cusp of a time where before the patient even gets to the hospital they are given a smart device, a smart button, a smart watch so they are monitored prior to the procedure. Today… we have systems that can look at the walking gate of a persons in the weeks before their knee operation. And feed that data into the navigation system to place the new prosthesis in a way that will give the best corrective outcome… but without changing their waking gate too much.

And that goes to post operative immediate after care smart monitoring and then longer term. That same smart watch can be used after the intervention to say if the predicted outcome was achieved. If how the patient mobilises - walks or runs… met the expectations.  And then feed all that back into a feedback loop to help the next patients as systems learn.

In the last two years we have seen advances in AI (and I guarantee that many of you who are not living and breathing this every day will not truly grasp where we are, and where we will be in five years.) But the smarts in the smart devices are getting to “better than human” levels - and in everything from imagining, to diagnostics, to automation to autonomy, to predictive outcomes to feedback insights - are accelerating like you would not believe. Much of the medtech industry being dragged along by advances in consumer products that are rapidly spilling into health tech.

Just for one minute think about your 4K stabilised - perfect lighting camera in your iPhone. And  now think that less than twenty tears ago that was the realm of only the most expensive multimillion dollar cinema companies. You now have it in your pocket.

An old VCR (Video cassette recorder) built into a cam corder used to sit on your shoulder and give 35 minutes of battery life to shoot low quality films to be stored on video cassettes. Today that is one small function of your smart phone that can record unimaginable quantities of video that can be stored and then parsed to the cloud on a device that sits in your pocket. Just look at a GoPro….

Those consumer sensors, batteries, printed circuits and more are flooding into health-tech. Nvidia is leading in the chart with systems like Holoscan Bridge to bring entire AI capable systems to a board that fits in a tiny device. It’s insane.

But what is clear is that across our industry it is the tech that is enabling the medical device power ups. It is the tech of cloud based systems, AI, digital ecosystems, data and more that is actually now the front runner of devices. It is tech that is leading this. And more precisely the software side of the tech.

For those doing medical device development - you no longer have an army of metal workers turning lathes. You have an army of software engineers, electronics engineers and technological engineers that build the devices. The metal work is now a forgotten afterthought for the chassis. It is no longer the hero. The tech is the hero.

Advances are happening way way faster than our regulated industry can handle. Our regulatory bodies cannot compute what is coming in. The next few years and they too are tying to make that mental shift. It won’t just be medical people assessing devices - but AI engineers, software teams, ethicists, and technologists that are being brought in the decipher the devices and approve them.  Oh sorry that is happening now.

It is the technology that is thundering ahead and dragging the medical device along with it. And it is going to get faster and faster and faster.

This is why I say we have now moved out of MedTech as an industry… and we have moved across the threshold to TechMed.

So what does that mean for you in the industry

If you are a young technologically savvy engineer, doctor or company professional. This will all seem obvious to you. You are Gen Z or as I like to think for my kids (you’re part of the generation born scrolling—digital natives who speak fluent meme and probably can't recall life before Wi-Fi.)

But for Gen Z this is all just obvious.

But come to a majority of Medical Device leaders in the companies and many of them will be out of Gen X. Still reminiscing (like me) about the Good old days being way simpler before VACs and all this shit that gets in the way of business. Pfffffff.

So if your are of the Gen Z generation - you will be seeing this as a bright future. But don’t be fooled. You are tech savvy for now and can bring a ton to the world of medicine with your current knowledge. But beware. Gen X became obsolete in the past five years. And it took 25 years to get to obsolescence. But they are obsolete in their knowledge.

Gen Z will get to obsolescence in less than 5 years in TechMed. That’s 5X faster than Gen X felt it.

Let me explain. So you’re a young Python programmer and you’re out there now doing systems software for devices X, Y, Z and your ability to build efficient fast code is your differentiator. You are the best coder out there.

Well - this weekend I had a program write me a program in JS that I have no clue about for one of my websites that was able access open AI assistants that I built (with no code). I was able to call that assistant from the “back end” I have no idea what that is, and interact with it in the “front end” - and it is all done in a dev mode (???) And there is a lot of $ sign shit with imports and exports that did stuff...

And it doesn’t matter that I don’t know because a program wrote all that code for me and step by step told me (the idiot as it seemed to be thinking when I duffed it several times with the simple copy and paste) - Yes I had the reasoning thinking of the model on so I could what it thought about me. It was politely thinking I was an idiot.

Anyhow - in a few hours I had built a fully functioning website with an AI agent integrated that then took over and started to tell me how to improve my site and business and all that.

My point is I didn’t need a Gen Z coder to do that for me. 6 months ago I did - on Fiveer. In another 6 months you don’t need coders - you need prompters. So in the arc of just a few years your wonderful coding skills are obsolete. And with AI getting better by the day.. I don’t need design engineers that do industrial design for medical devices - I don’t need systems engineers, I don’t need electrical engineers because the programs can design PCBs way better and faster and cheaper.

As the medical device become smarter - so does the technology that makes the technology. I’ve seen it first hand. The window for your skill sets is a few years until technology over takes it.

Until just two days ago I thought that people like me in the Gen X group would have an edge because of our years of knowledge and wisdom and capabilities. And surely that nuanced wisdom cannot be replicated by LLMs or other systems.

As I write this I can tell you. It can. I spent the last 6 months training and LLM on everything I know and insights of the past 35 years of the medical device industry. And trained for myself a custom GPT (which is remaining hidden) knows more about medical devices and medtech than me. It writes better strategies than me - it writes better detailed plans than. Me and it knows more than  I will ever know.  In seconds.This week I have been shocked by the power of the system. For both start ups - and for running strategic medical device businesses. You want to know how to build and run. Start up - just get access to my GPT.

My mind’s now pivoting to stop thinking strategy and start thinking intelligent prompting.

Because it is clear my old currency of knowledge is no longer valuable in TechMed. Instead my ability to ask the systems to deliver me strategies and plans and forward looking visions are what are valuable (today). How do I ask it the right question to get the right answer.

My ability to chain together GPTs, AI assistants, and Agents is what my next three years are about.

So if you are in this industry (even if you think as a sales rep or sales manager you are immune) YOU ARE NOT.

Embrace we are now TechMed - not MedTech and skill up. Because the world is changing fast.

So what does that mean for clinicians?

Again let me start with the Gen Z clinicians coming to the clinical world. The old currency was ability to remember lots of anatomy, surgical techniques, Cath lab techniques and make clinical judgements. Radiologist were about their ability to acquire and then interpret the images. The best radiologists were that ones that could that the best. It was artisanal.

The best clinical skilled people have that certain magic that sets them apart. Skill sets… manually for dexterity, or cognitive for seeing the wider picture and making smarter clinical decisions. “This patient should not be operated on.”

Gen Z have already made a leap from that where knowledge is a Google away. And they are already seeing that TechMed starts to replace the need for dexterous skills. (To some degree.) A Gen Z surgeon in Urology will not know a world without a robot (in some countries let’s talk USA). They will go through their entire career with assistive technologies.Tremor filtration, direct mapping, assisted vision with ICG and soon Hyperspectral imaging. More is coming in the next 12 months.They will train in VR and start to be assessed on their performance by digital analysis systems. Trining will be personalised not see one do one teach one. Their proficiency will be codified, analysed measured and feedback given by a smart digital assistant. It’s here now - it’s just getting going. The heart of the devices and systems will not be metal… it will be code.

This is the norm and will be the norm.

Already I see the old generation of clinicians split into two camps. Those embracing it and driving it and those resisting it and thinking (I’ll retire before it gets me.)

Well not unless you retire in the next five years - because your data is being collected already - those analyses are being run already, and AI systems are starting to single you out. And they will soon be giving your hospitals detailed feedback and you and your abilities.

Not in thirty years - but soon. And honestly,  it should be embraced. It should not be seen a s stick but as a carrot to get you better and improve clinical outcomes. Open your arms and embrace it is my strong advice.

“But it’s all down to the the skill in how I operate… That canner be replicated.”

“I’m the only one that can pass a guide wires across such complex lesions….”

Pfffff. Yesterday.

Automation is taking over today - autonomy very soon. Very very very soon.

With the merging of robotics, data and AI, a robot will soon be able to tie a knot as good as the best surgeon. And soon better and faster and more reproducible. It will be able to dissect with the perfect margin in perfect geometrical arcs based of data that your limited biology can’t compute. It will be able to suggest where to staple, and then then place the stapler and then automations take over to fire it with the perfect staple line. Every time.

Of course you will be running the show (wink wink). But understand you are going to be nothing but a biological switch to get around regulators.

And I know you will be very human about this and say “Of course no machine could ever make better decisions than me…” Glad you think so.

My deepest suggestion is for those comfortable clinicians and hospitals out there cruising in MedTech to understand that TechMed is about to change everything for you as users. In all aspects of healthcare.

Even hospital administration is about to undergo a revolution; as new systems bring in hyper efficiency across the healthcare network. AI systems will not be hanging onto a nostalgic emotion of out of date systems we all know should be changed… but. Well … you know.,.

AI will come with ruthless efficiency within hospitals, companies, and every aspect of your life. Those big bold ego centric personalities that get what they want when they want… it’s over.

Some people will say that they will not be part of the tech creep. They will resist. But honestly most people have not understood that YOU ARE ALREADY A CYBORG!

I know this sound mad but I guarantee that everyone reading this blog has a smart phone that rules their lives. Sets agendas, runs some tasks, runs an assistant now an again. We wake up and we check the phone. We need something done - we use the phone. We are just about to go to sleep… we use the phone. Your phone is part of you. You are part of your phone. You are a cyborg… it’s just not fully implanted yet.

To that end, as TechMed starts to dominate… that fusion of human and tech into healthcare provision will accelerate and will start to become indistinguishable between you and the tech. Be it a data system, a physical stapler, a robot, an imaging system. The way we interact will become a fusion. And symbiotic interdependency. And the tech will start to take more and more control and authority. It will be a slow creep - but the tech will become the master in every aspect of our lives. Don’t believe me - as a teenager to get off TikTok.

Embrace it.

Where will it all go with technology in healthcare?

I am a futurist. And I will preface this with - not every health care system across the world will get to this in the next decades. But many developing healthcare systems will jump across the analogue healthcare and jump straight to the modern digital - efficient, techmed led healthcare. It will actually be cheaper and better.

Much like many developing countries were well ahead of the USA and Europe on 5G because they skipped cables and went from no telecoms infrastructure to wireless in a single leap. Cutting all that insane cost of burying cables or putting them on telegraph poles. All that cost of infrastructure was avoided became it was useless. All those countries left ahead of the historic countries because of tech.

They will do the same in healthcare - they will leap ahead. If you have not been to a Chinese congress lately and seen the floor of the exhibitors. Wake up !!!!

But for the majority of developed health systems around the world these advances are here and now, and will come into mainstream faster than you can think. Autonomous systems are operating clinically today. Lupin Dental, Andromeda Surgical, Vitestro and more and more are landing by the day.

Medical device became Medical Technology and we have now crossed over into Technological Medical or TechMed. (Update your linked in for this)

We are in the TechMed era and things are about to change fast: so strap in. And when I mean fast I mean fast - because many of the new devices and systems are pretty self sufficient. And what I mean by that is that change management in medical device is very different to change management in TechMed - because of smarts. And the reason things changed slowly was always the sludge in the system that made chamgemansgement hard and slow.

In the 1990s if you wanted to change from one dumb device to a new dumb device - it was on the company to train and deploy training resources. It was on the clinicians to adapt and change and learn and interpret. Paper work took forever. Data needed five years ti prove it. Proof will be again by real world AI models and testing before the device ever touches a human. Go watch GTC from Nvidia. TechMed devices will have been tested for thousands of years in billions of patients before they ever touch a human. Ai will have tweaked them and tested them. Just Google King Fu robot to see where we have come singe Boston Dynamics.

In the world of TechMed smart devices they need you to simply to say something or push a button. They come with built in VR or AR training. In many cases they will not need you to be trained because you are just an input device or a biological switch. You won’t actually be doing it. They come deployed and self trined,  where they will learn about the environment they are now in and the users they have been deployed to (with all your nuances). They train themselves to work along side you.

I know you are sat there and many of you are saying - “Steve’s gone a bit mad…”But others of you that are already at the cutting edge of this are saying “Steve’s being a bit conservative here…”

Which ever camp you are in, I will leave you with this. Because we are already in TechMed.

You need to open you minds and look around you. Chat GPT and DeepSeek and so many other things have changed the world in the last 12 months. And they are on an exponential development curve. And that change is rushing at TechMed. My strong advice is to set aside a few days and do a deep dive into what I’m saying and prepare yourselves.

If nothing else - in the next few weeks learn to prompt. Learn how to tell a simple chat GPT to do something for you. NO not a simple “Give me a list of X”. That is a Google request not a prompt. Learn to prompt. And then when you get that - dive into one of the LLMs and prompt it to educate you on this stuff. You will be shocked.

I for one am thrilled that I’m alive and still active in TechMed as we go through this revolution. I’m embracing it and putting all my old knowledge on the shelf. I’m getting hip with the tech bro.Or as GPT told me in Gen Z - Bro, I'm lowkey vibin' with the tech rn, no cap.

These are future looking views of the author for education purposes onlky and to provoke you a bit.