TECHNOLOGY MATRIX
Comparative information: ASUIR Service (a service generator) versus ASUIR (a generator of ultra-efficient production facilities).
As with ASUIR, hospitals, laboratories and hotels can be viewed as production facilities that generate services, such as procedures, tests or X-rays, rather than goods. In this sense, the principles of ASUIR and ASUIR Service are similar: staff salaries are at US levels or higher, while the cost of the service (in a hospital, this is a procedure) is comparable to that in Bangladesh — one of the cheapest countries in the world, where staff salaries are similar to those in the US (here, $10,000).
At the same time, the ASUIR service's increased productivity is not achieved by increasing the workload of service personnel, but by automating production through the use of robotic systems.
Automation Step by Step: From Manual Service Production to Production Largely Carried Out by Robotic Devices.
The effectiveness of a given option is assessed in the same way as for an automated control system in a power plant. The hospital's equipment, building and employees' salaries, including the doctor's, are considered direct costs and are factored into the service's cost. The cost of medication is included in the service cost and is the same for all options.
Industry catalog
The outpatient treatment unit at a large hospital in Los Angeles (IV therapy, with around 80 chairs spread across two rooms).
The main point: moving from manual work to robotic systems raises the number of procedures in the unit from to per year, while the hospital's direct costs per procedure (equipment, staff pay, rent) fall from to . Nobody's pay is cut.
1. Why automation goes in stages
Healthcare is a conservative industry, with new equipment only being introduced after it has been tested and approved. The automation of healthcare services therefore proceeds in three stages:
- Stage 1 — today. All work is done by people, the staff.
- Stage 2 — partial automation. Ready-made devices are added that are already sold and used in hospitals.
- Stage 3 — almost full automation (as seen from today). Service staff are being replaced by robotic devices. However, a certain number of doctors and nurses will still be needed. This will become possible once robotic systems are approved for use with patients, which is expected to happen in 2031.
2. What is purchased at each stage
Stage 2 — purchase of devices along the lines of the list below:
- an electronic queue with a display board to call patients;
- self-check machines ( units) for blood pressure, pulse, oxygen and temperature;
- IV pumps, one per chair, for automated drug dosing;
- Each ward has a single central control panel that displays the status of all IV drips in one place, helping to reduce the number of nurses needed.
Stage 3 — In addition to the Stage 2 devices, robotic systems have been purchased. It is assumed that one robotic system will serve up to four chairs.
3. Productivity growth
Higher productivity enables us to provide more services.:
| 1. Today: people | 2. People + devices | 3. Future: robotic systems | |
|---|---|---|---|
| Hospital costs per year | |||
| Medical staff (nurses, support staff, doctors) | |||
| Depreciation of devices and robotic systems per year | |||
| Rent of premises and chairs | |||
| Direct costs per year | |||
| Cost of one procedure | |||
| Number of procedures per year | |||
| Direct costs per procedure | |||
| Drug cost per procedure | |||
| Total full cost of one procedure | |||
| Hospital profit | |||
| Payment for procedures per year (excluding the drug) | |||
| Direct costs per year | |||
| Profit from the unit per year | |||
Appendix: calculation with supporting data
| There has been a shift from manual service provision to service provision carried out primarily by robotic devices. | 1. Today: people | 2. People + devices | 3. Future: robots |
|---|---|---|---|
| Operating schedule | |||
| Working hours of staff and robotic systems per day | |||
| The number of hours worked per day by staff and robotic devices. | |||
| Preparing a chair between patients, hours | |||
| Number of staff per shift (two-shift operation) | |||
| Care staff — nurses Today, one nurse looks after three to four patients. In option two (partial automation), one nurse looks after up to six patients. In option three (full automation), one nurse and robots look after ten to twelve patients. | |||
| Support staff for auxiliary tasks: front desk, port access, registration, measuring blood pressure and temperature, preparing chairs; today 35–40 people, including nurses, work on procedures | |||
| Robotic systems (option 3 only — possible number, price, etc.) | |||
| Robotic systems, units20 at the chairs (one per 4 chairs) + 8 in maintenance rotation | — | — | |
| Purchase price of one robotic system, $preliminary estimate: specialized medical robotic systems will cost more than today's general-purpose robotic devices, which cost $15,000–$100,000 | — | — | |
| Expected service life of a robot, years | — | — | |
| Repair and maintenance of a robot per year, % of its purchase price | — | — | |
| Reference data common to all three options | |||
| Total number of chairs | |||
| Average length of a procedure, hours from 2 to 5 hours | |||
| Rent of premises and procedure chairs, $ per year | |||
| Cost of drugs and supplies per procedure, $for an exact cost calculation, enter the cost of the drug used in the procedure | |||
| Pay of care staff (nurses), $ per month | |||
| Pay of one doctor, $ per month | |||
| Doctors in the unitat least 5; | |||
| Payment for a procedure by the insurance company, excluding the drug, $ | |||
| Projected figures | |||
| 1. Possible number of procedures | |||
| Expected number of procedures per day | |||
| Possible number of procedures per year | |||
| 2. Required number of staff | |||
| Expected number of medical staff working 8 hours a day, 250 days a year in total | |||
| Total staff time spent per patient | |||
| Expected number of doctors in each option | |||
| 3. Total cost of medical staff per year | |||
| Cost of medical staff and support services per yearfull-time positions (8 hours a day, 250 days a year) × monthly pay × 12 months | |||
| Cost of doctors per yeardoctors × doctor's monthly pay × 12 months | |||
| Cost of medical staff, doctors and support services per year | |||
| 4. Direct costs | |||
| Purchase of devices and robotic systems | |||
| Depreciation of devices and robotic systems per year | |||
| Rent of premises and chairs per year | |||
| Total direct costs per year(pay, robotic systems, rent) | |||
| 5. Costs per procedure | |||
| Direct costs per procedure, excluding drugs | |||
| Full cost of one procedure, including drugs | |||
| 6. Hospital income and profit | |||
| Payment the hospital receives for procedures per year, excluding drugs | |||
| Hospital profit from the unit per month | |||
| Hospital profit from the unit per year | |||
| Payback period of the purchased robotic systems and other equipment | |||
| 7. Safety margin | |||
| Hospital direct costs per day (equipment, building, pay of staff and doctors) | |||
| Procedures per day needed to cover direct costs | |||
| Capacity marginhow far the number of procedures can drop before the hospital starts losing money | |||
Devices to be purchased
| Device | Replaces | Approved? | Qty | Purchase price per unit, $ | Total |
|---|---|---|---|---|---|
| Electronic queue with patient call and waiting-time tracking | front desk | no approval needed | |||
| Machine where the patient measures their own blood pressure, pulse, oxygen and temperaturethe seller gives the purchase price on request — this is an estimate | measurement by a nurse | freely sold | |||
| Alaris IV pump, refurbished | nurse watches the IV drip by hand | used in US hospitals | |||
| Central console Alaris Infusion Central: the nurse sees all IV drips at oncepurchase price — estimate | nurse walking from chair to chair | used in hospitals | |||
| Total devices (service life 7 years, repairs 10% of purchase price per year) | |||||
| Robotic system — benchmark: Unitree H1 / H2 Plus ($90,000–100,000) | nurse at the chairs, support staff | future, approval needed | |||
For the engineer: how it is calculated
Procedures per year = chairs × hours per day ÷ (procedure + chair preparation) × days per year.
Medical staff = people per shift × (hours per day ÷ 8) × (days per year ÷ 250).
Doctors work during the day (usually until 5 pm), so their number does not change when the unit works longer hours.
Direct costs per year = pay of staff and doctors per year + purchase price of devices and robotic systems ÷ service life + their repair and maintenance + rent of premises.
Required productivity = direct costs per year ÷ working days per year ÷ payment for one procedure.
Full cost of one procedure = drug + direct costs per year ÷ procedures per year.
Break-even purchase price of a robotic system — the price at which the hospital's cost per procedure in option 3 equals option 2.