Robotic surgery

• Robotic surgery systems capable of performing cardiac bypass operations were being installed several years ago in Columbus and have been installed in more than 100 cities nationwide. Cincinnati's first system was installed this year - and that was possible only through a charitable gift. Doctors predict using robots to handle tedious parts of long operations will reduce complications.

3-D software

• Fewer than half the 23 linear accelerators in Greater Cincinnati are equipped with 3-D computer software and other special equipment that can more precisely target radiation beams on a lung cancer or breast cancer tumor, thus reducing harmful side effects and allowing higher doses of radiation. Building upgrades

• Hospitals have delayed numerous projects not visible to the general public, including spending millions to upgrade older intensive care units and operating rooms that are too small to meet modern standards.

Special equipment

• Some doctors in Cincinnati find themselves paying for special equipment that hospitals say they cannot afford, including orthopedic surgeon Dr. Paul Favorito who has spent more than $10,000 in the past two years on specialty tools to perform minimally invasive surgery to repair rotator cuff injuries.

Tech advances

• In other Ohio cities, hospitals are winning praise for technological advances. Ohio State University Health System, along with Akron General Medical Center and Toledo's ProMedica Health System, were listed by the American Hospital Association among America's 100 "Most Wired" hospitals and health systems. No Cincinnati-area hospitals made the list.

Convenience

• Efforts to expand high-tech health services to the suburbs have been slowed. This issue is about more than simple convenience. In cancer care, some people wind up relying on less-sophisticated equipment simply because they can't stand driving to better services in the central city.