From mechanization to cognitive autonomy: the journey of healthcare evolution from Industry 1.0 to 6.0

The symbiotic relationship between industrial advancement and healthcare delivery has fundamentally shaped modern medicine. This comprehensive review article explores the historical and technological trajectory from the First Industrial Revolution (Industry 1.0) to the rapidly emerging Sixth Industrial Revolution (Industry 6.0), meticulously mapping distinct industrial milestones to their concurrent evolutions in clinical practice.

An exhaustive electronic search was conducted across multiple premier academic and clinical databases, including PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library using specific technological enablers, clinical application domains and reported barriers to implementation.

While Industry 1.0 through 3.0 focused on mechanization, mass production, and rudimentary automation, resulting in the institutionalization and digitization of medicine, the advent of Industry 4.0 introduced cyber-physical systems and the Medical Internet of Things/Internet of Medical Things. Subsequently, Industry 5.0 emerged to address the depersonalization of hyper-automation by reintegrating human-centricity, ethical governance, and mass personalization.

This review posits that the global ecosystem is now transitioning into Industry 6.0, an era characterized by antifragile manufacturing, quantum computing, deep digital twins, and autonomous cognitive systems. By examining specific applications across diagnosis, treatment, screening, monitoring, prevention, and rehabilitation--with a particular focus on hightechnology fields such as orthopaedics--this paper illustrates a paradigm shift from reactive, standardized interventions to proactive, hyper-personalized, and autonomous healthcare delivery models.