TECHNOLOGY AT WORK

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38 Citi GPS: Global Perspectives & Solutions February 2015 obliges individual combatants, and belligerent parties in general, to distinguish between legally legitimate and illegitimate military targets; in other words, it needs to be shown that automated weapons can adequately, and with a high level of certainty, identify the correct target. Morally, robotic weapons are not unethical in themselves, but their development and deployment raises a number of substantive ethical concerns, for example relating to justifications for killing in warfare. While a legal ban and a moral consensus on automated weaponry is unrealistic, policymakers must ensure that the development and deployment of such weapons occurs only within carefully restricted contexts. Opportunity in Healthcare Justin Morris European Med Tech & Services Analyst Atif Malik European Semiconductor Analyst Robots are already being used in surgery, but not without controversy Robots are already being used in a variety of healthcare applications. Robotic surgery will make new forms of minimally invasive surgery possible, which could reduce patient scarring, rehab time, post-surgical complications and deaths. Intuitive Surgical is the leading supplier of robot assisted surgical systems, while Hansen Medical also specialises in robotic surgery. In 2013 there were 523,000 surgeries performed using Intuitive’s da Vinci Surgical System (the majority of procedures being in the areas of gynaecology and urology) on an installed base of >3,000 machines worldwide (>2,000 in the US), compared with only about 1,000 robotic surgeries worldwide in 2000. The use of robotics in surgery has not been without controversy, with some studies cited in the Wall Street Journal actually finding an increase in adverse events with robotic surgery and questioning whether the potential benefits of robotic surgery outweigh the additional costs given that the price of the systems range from $0.9- $2.5 million, with additional consumables of $700-$2,300 needed for each procedure, according to Intuitive. However, a study published in the February 2015 issue of Health Affairs, found that in terms of quality-adjusted life-years gained, the benefits of robotic assisted partial nephrectomy surgery for kidney patients outweighed the healthcare and surgical costs to patients and payers by a ratio of five to one. 64 In the field of medical robots, advances are aimed at creating a seamless connection between humans and robots such that robots can assist in human functions. Japanese company Cyberdyne, with its hybrid assistive limb (HAL) device, uses an exoskeleton with sensors to detect electrical signals from the body and helps transmit these to the brain, helping people suffering from paralysis to walk again. Citi’s Hidemaru Yamaguchi suggests HAL can be used for numerous neural and muscular disorders, including stroke, which affects up to 25 million patients globally, Parkinson’s disease (4 million people) and multiple sclerosis (2.5 million). Brooks Automation’s Life Sciences division provides automated sample management platforms for biologic sample storage in a controlled environment and automates the process of retrieving specifically selected samples from within the storage containers. The automated controlled storage environment ensures that samples are preserved within a narrow temperature band to maintain sample integrity (manual retrieval has an increased rate of degradation due to temperature fluctuations, as more samples than needed are typically removed at one time to find the correct sample) and provide absolutely accuracy in the identification and selection of samples during storage and retrieval (manual retrieval has a 10% error rate). 64 Intuitive Surgical press release. © 2015 Citigroup
February 2015 Citi GPS: Global Perspectives & Solutions 39 As automation increases in the biological sample storage market, the size of the market is also expected to increase Robert Garlick Global Product Head James Ainley European Hotels & Leisure Analyst The Hotel and Entertainment industries are using automation for customer convenience as well as headcount reduction The current market for biologic sample storage is $500 million (33% is automated), with that number estimated to be $1 billion by 2018 (estimated 40% automated). Brooks currently competes in the -20 to -80 degree Celsius market with machines that can house 1 million samples and there are only 3 competitors and 200 customers. Brooks is currently developing -150 degree Celsius automation machines that could house fewer samples, but would attract 15,000 customers. The -150 degree units requires significant R&D and enhanced technology to ensure that the robotics do not freeze (which occurs at -8 degrees Celsius). Currently, the -150 degree market is 100% manual and Brooks is expected to have robotic prototypes available for delivery in 2015 with revenue generation starting in 2016. Robots can also be used to assist patients and the elderly in their own homes, thereby limiting the amount of home healthcare that is required and shortening hospital stays as patients can be monitored remotely. From carrying elderly patients to a bed, a bath or a wheelchair and assisting in food preparation, to lifting food and feeding patients and monitoring vital signs, robots are increasingly being used in the home setting. Examples of devices include 1) Riba by Riken, which can carry elderly patients to a bed, a bath or a wheelchair; 2) Twenty One, which helps disabled people out of bed and helps prepare meals; 3) Secom’s My Spoon, which can lift food to a patients mouth; and 4) Para, which is a therapeutic robot pet shaped as a baby harp seal that is designed to be a companion to the elderly and responds to touch, stroke, light and sound. Robots and Automation in Consumer Markets The last decade has seen the automation of grocery shop check-outs increase and now automation is extending into restaurants. The National Restaurant Association (NRA) suggests there are 13.1 million fast food workers in the US alone. In December 2013 casual dining restaurant chain Applebee's announced that they would have tablets installed at every table by the end of 2014, allowing customers to order and pay the bill at their tables. In October 2014, McDonalds then CEO Donald Thompson told the Wall Street Journal he plans to "make it easier for customers to order and pay for food digitally and give people the ability to customise their orders." McDonalds has started to install touch screens in Europe, eliminating the need for workers to take a customer’s order. A robot manufactured by Momentum Machines can assemble a burger with all the condiments in 10 seconds (i.e. 360 hamburgers an hour) and the company says the device could save fast food outlets $135,000 a year in labour costs according to Digital Trends. This also helps reduce employee turnover issues. In China a new fast food robot called "Chef Cui" slices noodles and costs ¥30,000 to buy ($2,000) vs. $4,700 per year for a human noodle chef, according to Associated Press. Some hotel companies are rolling out mobile check-in and room key access to save on reception staff and improve customer convenience. Marriott is rolling this out to 4,000 hotels starting in 2014. Merlin Entertainment is rolling out virtual queuing in its theme parks to improve customer satisfaction and free up customers to spend money elsewhere in the parks. Virtual queuing allows you to effectively book your slot on a ride using an electronic device or a mobile app. In the meantime, the customer can grab a coffee or go on another ride rather than standing in the queue. Ticket clerks have also been automated at many cinemas and parking lots. In the travel industry, agents have been replaced by digital travel agents such as Kayak. And when travelling abroad many individuals now use automated gates at passport control. © 2015 Citigroup
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