Beyond Robotics: The Next Evolution of Image-Guided Therapy

When I began my career as an interventional radiologist more than two decades ago, my world revolved around the patient in front of me. On a busy day, I might help seven or eight people through minimally invasive procedures. Every one of those patients mattered.

That hasn't changed. I became a doctor because nothing replaces the privilege of helping someone through one of the most difficult moments of their life.

What has changed is the scale at which I can help. Today, I have the opportunity to help shape the future of diagnosis and treatment. So while I still think about the patient in front of me, I also ask a much bigger question: how can we help millions – perhaps even billions – including people in places where access to care is needed most?

I have already had the privilege of witnessing one remarkable transformation in medicine.

When image-guided therapy first emerged, it fundamentally changed what was possible. Instead of opening the body through large surgical incisions, we learned to navigate spaghetti-sized catheters through blood vessels using medical imaging. Procedures that once required major surgery could increasingly be performed through an opening little larger than the tip of a pencil.

Today, we can restore blood flow after certain strokes, repair damaged heart valves, treat tumors and stop internal bleeding using minimally invasive techniques that can mean less trauma and faster recovery for patients.

I often say that surgery isn't disappearing. Being cut open is.

That was the first revolution of image-guided therapy. I believe the next is about something different: making increasingly sophisticated diagnosis and treatment available to many more people.

Wherever I travel, I hear remarkably similar concerns. Populations are aging. Cardiovascular disease, stroke and cancer continue to place enormous pressure on health systems. Diagnostic and therapeutic procedures are becoming more sophisticated, while shortages of physicians, nurses and technologists continue to grow.

We cannot simply recruit our way out of that challenge. We have to find ways to extend the capabilities of the healthcare professionals we already have.

The challenge, therefore, is no longer simply whether we can perform remarkable procedures at the world's leading hospitals. It is whether we can democratize that expertise so more patients can receive high-quality care, no matter where they live.

And this is not only a challenge for lower-resource countries.

In Indonesia, I have seen how nationwide investment in image-guided therapy can extend advanced cardiac, stroke and cancer care across a country of thousands of islands. In Japan, healthcare teams are confronting the demands of one of the world's oldest populations. Across Europe and the United States, geography, workforce shortages and uneven distribution of specialists can also determine how quickly patients reach expert care. Access looks different from one health system to another, but the underlying question is remarkably similar.

I was reminded of that question during conversations at NASA's Johnson Space Center with Maj. Gen. Dr. Josef Schmid, a NASA flight surgeon involved in human space exploration. When you consider healthcare on future missions to the Moon and eventually Mars, the constraints become extreme: few specialists, limited resources, enormous distances and a need for intelligent clinical decision support.

But the underlying problem is not so different from the one healthcare systems face here on Earth.

A patient may be thousands of miles from a specialist. A radiologist may be responsible for an overwhelming volume of imaging. A hospital may have the technology required for a complex intervention but not enough experienced physicians to meet demand.

This is why I believe AI and robotics are becoming so important across both precision diagnosis and image-guided therapy.

AI can help clinicians make sense of rapidly growing amounts of clinical information, automate repetitive work and support more consistent decision-making. Robotics can assist physicians in navigating instruments with greater precision and reproducibility. Advanced imaging gives us increasingly detailed information about anatomy and disease.

Combined with intelligent clinical workflows, they can help less experienced physicians perform more sophisticated tasks with greater confidence, while giving highly experienced clinicians capabilities that can feel almost superhuman: seeing more clearly, navigating more precisely and managing complexity more effectively.

The goal is not to remove the physician. It is to increase the reach of the physician.That could mean improving the efficiency of clinical teams, helping reduce variation, and ultimately enabling scarce expertise to serve many more patients. In other words, technology can become a way to democratize healthcare.

For Philips, that is why robotics is not a standalone destination. It is one capability within a much broader vision that brings together imaging, AI, intelligent software, connected devices, robotics and clinical workflow into an increasingly intelligent environment for diagnosis and therapy.

We are already building important parts of that future.

And the scale we have already reached is significant. Philips' image-guided therapy technologies are used across more than 80 countries, treating millions of patients each year.

That is an extraordinary achievement. But I find myself increasingly asking another question:What if we could help twice as many patients — particularly in places where access to expert care is most constrained?

Not by asking already overstretched physicians to work twice as hard, but by enabling more clinicians to deliver sophisticated care and by allowing expertise to travel farther than it can today.

Early research around remote robot-assisted intervention gives us a glimpse of why this matters. These are research milestones, not routine clinical practice, and many technical, clinical and regulatory questions remain. But they point toward an important possibility: expertise may not always have to be physically located next to the patient.

Imagine what that could eventually mean for someone having a stroke hundreds of miles from a neurointerventional specialist. Or for a regional hospital struggling to recruit highly specialized physicians. Or for a health system trying to make advanced treatment available across a vast geography. That is why this ARPA-H-supported program matters. The goal is not simply to develop another robot. It is to explore how advanced imaging, AI, robotics and connected clinical workflows might work together to help clinicians deliver expert stroke care to more patients.

When I began my career, my ambition was to help every patient who entered my procedure room. That ambition has never changed.

What is changing is our ability to extend what one clinician knows and can do far beyond the walls of a single procedure room.

Image-guided therapy transformed how we treat disease. Intelligent diagnosis and intervention may now help transform how far human expertise can reach.