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Computers in the Operating Room: A Patient's View

This article explores the impact of computing technology on the operating room from a patient's perspective. It discusses the evolution of computers, their increasing power and capabilities, and how they are being integrated into medical practices. The article also touches on the concept of telepresence and the potential for computers to become so advanced that they can fool people. Additionally, it explores the idea of everything becoming cyberized and the challenges and opportunities it presents.

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Computers in the Operating Room: A Patient's View

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  1. Computers in the Operating Room: A Patient/Customer and Computer Person’s View The 3rd Congress on Computers & Robotics in the Operating Room 2000 July 14, 1999 Gordon Bell Microsoft Corporation

  2. Outline Computing Technology: Basics Everything “cyberizable” is in Cyberspace Cyber Personal Assistants Electrons replace atoms for “presence”“Telepresence” … being there, while being here and maybe some other time Guardian Angels, an on-body assistant Turing tests ... When will computers be able to fool some of the people some of the time?

  3. Caveat • Discuss where computing is going … and by analogy • Spark your imagination about how computing and other technology will impact life outside (and within) the OR… “no income” • The speaker’s understanding of the OR is from a patient and web-visitor perspective… • “no sight, no blood, no pulse”

  4. The two great inventions • The computer (1946… realised in 1948). Computers supplement and substitute for all other info processors, including humans • The Transistor (1946) and subsequent Integrated Circuit (1957). • Moore’s Law: The integrated circuit evolves at the rate of 60% per year as measured by the number of transistors per chip. • Storage evolves at this rate • Optical transmission lines do too • Phone lines behave Moron’s Law

  5. LINC: Laboratory Instrument Computer c1964

  6. Tera Giga Mega Kilo 1 Storage Backbone Processing Memory ?? Telephone Service17% / year 1947 1957 1967 1977 1987 1997 2007 Extrapolation from 1950s: 20-30% growth per year

  7. Growth of Microprocessor Performance Micros Supers 10000 Cray T90 Cray C90 1000 Cray 2 Cray Y-MP Alpha RS6000/590 Cray X-MP Alpha 100 RS6000/540 Cray 1S 2X transistors/Chip Every 1.5 years “Moore’s Law” Microprocessors have become smaller, denser, and more powerful. i860 Performance in Mflop/s 10 R2000 1 80387 0.1 6881 80287 8087 0.01 1998 1980 1982 1986 1988 1990 1992 1994 1996 Year

  8. Dell Precision610 Workstation 1989 Cray Y-MP8/4128 CPUs 2 Xeon 550MHz 4 166MHz Max RAM 2 GB 1 GB Peak Mflops 1333 1333 Weight < 50 lbs > 5,000 lbs Cost < $15K > $13M Desktop Supercomputing 3/20/89 Electronic News www.dell.com

  9. Bell’s Nine Computer Price Tiers 1$: embeddables e.g. greeting card 10$: wrist watch & wallet computers 100$: pocket/ palm computers 1,000$: portable computers 10,000$: personal computers (desktop) 100,000$: departmental computers (closet) 1,000,000$: site computers (glass house) 10,000,000$: regional computers (glass castle) 100,000,000$: national centers… en route to 1,000,000,000$: Super server: costs more than $100,000“Mainframe”: costs more than $1 million an array of processors, disks, tapes, comm ports

  10. Platform evolution: What do they do that’s useful? How do they communicate?

  11. In a decade we can/will have: • more powerful personal computers • processing 10-100x • 4x resolution (2K x 2K); large displays • storage of one terabyte • adequate networking • ubiquitous access = today’s fast LANs • One chip, networked platforms • more cyberizationThe challenge… interfacing platforms and people.

  12. Outline Computing Technology: Basics Everything “cyberizable” is in Cyberspace Cyber Personal Assistants Electronics replace atoms for “presence”“Telepresence” … being there, while being here and maybe some other time Guardian Angels Turing tests ... When will computers be able to fool some of the people some of the time?

  13. Everything cyberizable will be in Cyberspace! Body Continent Car Region/ Intranet Home Campus, including SANs World Fractal Cyberspace: a network of … networks of … platforms

  14. “Everything will be in Cyberspace” • Is this a challenge? goal? quest? fate?… or • Cyberization enables new computing platforms thatrequire new networks to connect them • Infrastructure supports the content • Three evolutionary dimensions

  15. Cyberization: interface to all bits and process information • Coupling to all information and information processors • Pure bits e.g. paper, newspapers, video • Bit tokens e.g. money, stock • State of: • places like the OR, • things e.g. robots, instrumentation, especially people…

  16. OR 2000: Implications when everything is in cyberspace • IP on everything • Delivered by some standard wire or fiber e.g. Ethernet or Firewire or USB • HTML accessible… • Even the robots have to be connected so they can feedback!

  17. Atoms a.k.a. massy vs. massless bits Atoms (mass)Electrons, etc. (massless) people know computers also know bricks & mortar anywhere (personnel/clients) office hours anytime radio nets => anwhere reports & databases web access for all documents! letter & fax email & web access phone email, voice & video mail personal visits videophone / videomail signature authenticated images envelopes digital envelopes / store

  18. New or old money… it’s just bits Credit ATM / Prepaid Check Cash Prepaid

  19. Put those checks & statements in Cyberspace or eliminate them!

  20. Paperless transactions: put them all in Cyberspace

  21. Http://wwww.medicalogic.com • Internet-based service for keeping medical records electronically …EMR • No on site or in office equipment except a browser • Facilities • rapid input and record retrieval • accessible anywhere at anytime • patient accessible • prescription drug interaction, advice, etc.

  22. Especially cyber-ready images

  23. Sensors, actuators/emitters, sensor-actuators, and wireless • Medical: P, T (body), blood gas, ECG, etc. • Mobile: location (GPS, compass), ambient (P,T), acceleration, • Personal: A/V (and eyes) including IR, body & head position (6 degrees), • Speech and glasses • Radar, sonar, beacons, • Spectrum, chemical, etc. analyzers • Connected without cables

  24. Outline Computing Technology: Basics Everything “cyberizable” is in Cyberspace Cyber Personal Assistants Electronics replace atoms for “presence”“Telepresence” … being there, while being here and maybe some other time Guardian Angels Turing tests ... When will computers be able to fool some of the people some of the time?

  25. The Cyber Admin or the prosthetic memory…When we can store everything we’ve: read/written, heard/said, seen/acted, plusphysical parameters.

  26. Captures the creation of all personal/professional information Everything that happens in the OR Stores and organizes Retrieval is the challenge recalling readings, conversations, presentations, images helps the “guardian angel” What are the apps? when we can do this? What does Cyber Admin do?

  27. My project … putting my legacy and future bits in Cyberspacehttp://www.research.microsoft/ • Personal paper documents • Books (encoded by CMU), papers, articles, memos, notes, email, notebooks, drawings • Encode video and audio lectures • Current electronic media • email, files, papers, photos (now digital) • voice notes and records • Would like to capture photos and slides

  28. Capture and encoding

  29. HP Digital Sender… color document scanner

  30. Sony voice notes recorder…

  31. Evolving cameras to capture images and voice notes

  32. A word about storage… CDs hold 6 “near VHS quality” videos (300 Kbps)

  33. Book page

  34. Now how do you find or use the rich information The system must: locate, retrieve, visualize, order, up load the organization’s IP assets (text, proposals, images, videos, presentations, experiments, procedures, etc.) … with appropriate controls.

  35. Thumbnails to aid retrieval

  36. Virage Video Cataloger

  37. Outline Computing Technology: Basics Everything “cyberizable” is in Cyberspace Cyber Personal Assistants Electronics replace atoms for “presence”“Telepresence” … being there, while being here and maybe some other time Guardian Angels Turing tests ... When will computers be able to fool some of the people some of the time?

  38. Telepresence… being there while being here, at another time, and with time scaling • Telepresentations • Telemeetings and telecollaboration • The “work”

  39. TelepresentationElements • Slides • Audio • Video • Script, text comments, hyperlinks,etc.

  40. Telepresentations:The Essentials • Slide and audio a must • Add some video (low quality) to make us feel good • Storage and transmission costs low

  41. What about telecollaboration?… working together at a distance

  42. Conference Rooms with Teleconferencing

  43. Telework: it’s the sound, screens, and bandwidth, stupid http://research.microsoft.com/barc/GBell/

  44. CMU wearable computers

  45. Future OR

  46. Current OR

  47. Telepresence: Reflection terminal

  48. Mobile videophone

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