adaptive automation and mental processes

by L. C. Payne, B.Sc., Ph.D. (Cantab)

Dr. Payne is Joint Managing Director of ELLIOT MEDICAL AUTOMATION t LTD., a member of the ELLIOT AUTOMATION GROUP I)

i Automation is rapidly permeat- onr '^8 every aspect of human endeav- sw Whether its momentous force will

Oract" as^e established traditions and *n soc'a^ upheavals of un-

. nted proportions, or steadily h^p -

ln a new era of prosperity and in for many millions of people

^*5 IS Snm^tViir*rr it u/aiiM to *VCQ' is something it would be rash indyfdict. But, for better or worse, tratim?a* Processes, business adminis- ii<m

--

UUSU1C55 ciuminis-

,Cq the processes of government, itj^nications, building, shipping, avi- 1^3'.Warfare, road traffic control and lf-irf1Clne are only some of the multi- ifl?Us activities already under its Uence.

^'cal automation reach some idea of the extent of

^atkm, consider the field of medi- u illy V a larger extent than is gener-

^own, advances in medicine have 1wt ,?ely determined by improve- \e , applied technology. The

hal?graphs, electrocardiographs, Jiatiaiv?my?graphs, auto-analysers, gas iA blood counters, X-ray '&t$ 1I]es> automatic respirators, dialys- (u ysmographs, isotope equip- ?lher' "^art-lung machines, and much to ecluipment, have enabled medicine %er??ress in ways which would recent ISe have been impossible. In llonB years the computer has also come Sact ? play its part- With dramatic

ln fundamental research, it has ?p Played a vital part in opening V^ular biology, with its exciting ifcog* for unravelling the complex %eas and chemical factors underlying ^r.re

' We can now look forward to ^tion developments in the appli- ^icine?f CornPuters to everyday P^?pHters can be used to analyse

rnical, isotope, cardiological and

physiological data, to calculate radiation treatment plans, to speed up surveys and statistical compilations, to form elec- tronic medical records libraries (which can store vast amounts of data com-

pactly, and be selectively searched or analysed incredibly quickly for even

the most complex relationships), to

alert attention to significant changes in the levels of incidence of abnormalities, cross-infection and morbidity, to store areas of specialised data on the toxicity and doses of drugs, and on bacteria, viruses and tests, to record symptoms, signs and tests, and correlate these with other patient data, and to assist supplies, inventories and administrative pro- cedures.

Besides computers, television, video- tape systems, and continuous microfilm offer new prospects for X-ray storage and retrieval, ultrasonics offer new tools for diagnosis and therapy, patient- monitoring equipment is emerging for intensive care rooms and recovery rooms, semi-automatic sub-pharmacies exist for alleviating the chores of nurses and pharmacists, teaching machines for off-loading lectures, controls for auto- matically monitoring temperatures, hu- midity and sterility in operating theatres, and so on. Technology is the indis-

pensable, and increasingly versatile, servant of medicine.

Mechanisation and automation

Automation is very much more than

a single machine or idea. It embraces

a good deal more than mechanisation or even computers. It is in fact an

applied science, concerned with the

organisation of effective action, depend- ing as much on a critical understanding of the activity with which it is concerned as on the sophisticated techniques in-

volved. It is as comprehensively rele- vant and applicable to human activity

L 139

as the mind itself, though this is far from equating it with all levels of human intelligence.

Before the advent of steam power,

production of commodities relied prin- cipally on manual methods, aided here and there by horse- and water-power. The capital equipment required to

generate steam and the limited, mainly rotary, means by which it could be

applied, involved a dramatic reorganisa- tion in production methods. Following Adam Smith, production processes were broken down into a sequence of simple repetitive operations, so that human

beings mostly lost control and even

awareness of the overall process. They became machine minders. The intro- duction of electric power and the internal combustion engine provided alternatives to steam power, and enabled a wide

variety of power units of all sizes to be built. But the essential organisation of work remained the same, i.e. intense

specialisation, substantially relieved of muscular exertion, but often boring in the extreme, since only the most elemen- tary decisions were necessary.

This mode of organisation reached its most extreme form in the mass-produc- tion industries, and went a stage further with the introduction of transfer machin-

ery, which passes units of work from one machine to the next. This works

excellently where the same process or series of processes have to be systematic- ally repeated again and again. It is the

stage of advanced mechanisation which can be called a "fixed-strategy regime. But, as everyone knows, it has its

counterpart in inflexibility. Whenever a change in plan is called for, or an interruption in supplies, time-consuming re-organisation is required to meet it. This is partially met by introducing adjustable machines, that can be set up to operate in one of a number of ways. They can then be re-set, sometimes within quite wide limits, to fit changing patterns of production, as required; this stage corresponds to "multiple strategy mechanisation. Although it offers a

fair degree of flexibility, it still requires manual assessment of all the factors that

go into making the decision, and it still

requires manual intervention to re' '

all the operations involved. jt Unfortunately, in any large P^n^-

needs a good deal of time and inf?r 0{ tion to determine the exact state \

production, inventories and oi"der^e( any given time. It requires fur so time to evaluate the information obtained, to determine what a^J j( ments to various units will bri^ optimally into line with new y When all this has been done, which u

be days or weeks, the decisions are, to a degree, out of date and tltf).^ need revising again. In fact, this P 5: cess is continuous, so that the 11

>

characteristic mode of operation Is

optimal. The answer is to havs j

automatically recorded, transmitted! |.

evaluated, and finally to have a^ ments automatically made to the

A1 jy

of operation. All this, done electro 'i may take minutes instead of hours' J;

hours instead of weeks. The P* aILet a whole is automatically adapting'j! to the optimal mode of operation }

times, consistent with the best in'0 tion available. This is automation ^ How many managers have any ^

like an accurate picture of their cU ^ inventories, exact information ?J? j)i progress of particular jobs, ^ ̂ changing pattern of orders, ol a-

being incurred, of sickness and ^

of machine downtime, of finanClL^ serves ? How often are decisions ^ on "guesstimates"? How ofte^ decisions taken after an event, ^ they might have been anticipated j, trends ? How much are "art," ft and "feel" simply euphemism? jj

making decisions on inadequa^i formation, and how much could

a

rate up-to-date data, autoina ^ processed, refine "intuition" ?

^ often is the right decision taken too )

Routine jobs and decisions c J

performed more efficiently and ously by automation. Moreov

'

actions affect other adjacent pr? so that compensating adjustments ^ to be made elsewhere, this inform^ can be transmitted automatically-^ vyl larly, at the level of clerical sta%c have to count incoming orders an ^ time to time revise production scne

140

^1

[ dec i^e Purchasing staff who have to

dow w^en to revise supplies, and so on

e|e_n the line, all adding their own

p0 ent of delay and inaccuracy, it is

raJfi 6 to have all these book-keeping m'tications worked out automatically.

^?le of computers Automation is thus concerned with

pr asUfing automatically the state of

Pro^reSS a Process> an operation, niare^Ure or Pat'ent> an<i from autc?~ jnflc evaluation and analysis of this

adj rrr*ation, deciding what action or

JUstments should be taken next, to ?n or maintain some desired objective. c?urse, all this can be done by a

'nfo n being, the amount of

ac rrr>ation he can assimilate, and the

aSs-Unicy and speed with which he can as ^late it, is necessarily limited. Just

ijj ae advent of power extended the

gjar capacity of human beings, and fact ? Prom?ted constructional, manu-

and transport methods, so

"gyration, by extending man's PfQ^l-cerebral" faculties, is already Proo management and control

Witu res that would be unthinkable h?ut it. C ̂is context, consider how automa- te tC,?Uld ^ave significantly mitigated obst alidomide tragedy. The busiest

few Ltr^an will not deliver more than a iticj^Hdred babies a year, and with the aro e^Ce of congenital abnormalities

six n he will expect to meet up to

V?TS per year. Suppose he met

s'8nifi year anc* ^ve this; is this

not- nt? The answer is obviously is aj,a few is what he expects, and a few iir^ , .at has occurred. The fact that

arici y'n? this variation is a significant ^systematic increase due to, say,

fr0rn mide, simply cannot be elicited expe ? even the busiest obstetrician's of lence. However, if a carbon copy the

6 ^ata on eac^ birth, recorded for

record-. were sent to a

for ~U,ter centre, and if this were done the^ ^ a quarter of the U.K. births, eacv, 0>000 records would be received

-ji) month. the yf a.m?unt of data is equivalent to ab0ut "i^est obstetrician working for

50 years, and from this wealth of

data, a computer could obviously detect a systematic increase in abnormalities

correspondingly sooner. Even if thalid- omide itself had not been specifically recorded, the computer could quickly select and print out all cases concerned, and a suitable team could start investi-

gating, well before any individual

obstetrician was aware that there was anything significant to investigate. Automation does not necessarily need

large computers. For example, in

anaesthesia, during a lengthy operation, it is the anaesthetist's job to maintain the optimal balance between the mixture of gases at all times. Now it is perfectly feasible to analyse the gases and com- pute the balance automatically. This

does not lessen the human control of an

intensely human situation, but it refines control by indicating accurately and

speedily when adjustments are necessary. The essential role of computers in

automation, therefore, is to assist in the

analysis of measurements supplied by instruments and to calculate the control

adjustments that are necessary. Auto-

mation is an extension of mechanisation, because it not only involves "multiple- strategy" control systems, but also

requires continuous measurements to

be made to assess the current state or

progress of operations, and continuous calculations to evaluate adjustments necessary to maintain optimal working of the control system at all times. It is

therefore automatically adaptive.

Leisure

It will be evident that automation is a

means of instrumenting many adjust- ments and elementary decisions, which

have to date been considered exclusively the province of the human mind.

Moreover, because of its "data-process-

ing" ability, it can often considerably improve on human performance. There-

fore, automation will displace mental

power in many thousands of activities, as well as refine and extend our control

and analysis of situations, such as

nuclear propulsion, industrial processes, government administration, road traffic control, and even medical diagnosis. It

will mean that many types of existing employment will eventually disappear,

and others undergo radical change. Boring tasks will largely disappear, because a human being does them less efficiently and more expensively than

machines. The chores of many pro- fessional activities will also gradually disappear. Much work requiring "judgment" (often the art of making decisions on too little information) will be instrumented so as not to require it.

In all, it is the humbler jobs in modern society that will diminish, but many more requiring personal service will be created (no machine has yet appeared that will satisfactorily perform a haircut). Activity generally will become inten-

sively capitalised, not only in industry, but in almost every field of human

endeavour, and the production of

economic wealth will accelerate rapidly. The problems of how to divide this

between greater leisure, improving social amenities and upgrading economic con- ditions will occupy men's minds for

generations to come. In a sense, they are not essentially new problems, but the scale on which they arise is certainly new. For one thing they are more

international in scope; for another,

they mean developing interest and | bility in large sections of popula11 jj who thus far in history have f?

t

purpose enough in making ends i*1^ and enjoyment enough in football p? and a Saturday night sing-song. (a| <

The enormous social and ^

problems which this entails are a're ^ ,

emergent in the United States, Le (

emerging in the United Kingdom. ^ social sciences are concomitantly g, (

coming more urgent, but it is encoitf ing that bio-statistics aided by c? <j puters are widening our technique understanding. Automation is refl? j5 ing the boredom from work, but

i

increasing the more dangerous bore" which leisure and material affluence ^ inflict on all but a small minority- 0f this minority, during brief epochs ^ leisure in our history, we owe som j. the finest intellectual and artistic (0 umphs of our heritage, and it remain, be seen whether more universal lel will do more to civilise or vU^lC3- At least, awareness of the social, ^ tional, and political problems is grovVOIji< and one can be sanguine, if not c

placent, about the outcome.