Picture this scenario. You’ve just been admitted to a hospital to determine if you’ve had a stroke. A 5-foot tall robot, operated by remote control, wheels its way into the room and moves to your bedside. On its computer screen “head,” a face comes into view. Meet your neurologist.
It may sound like a lost clip from a retro sci-fi film (robot on wheels!), but the first autonomous telemedicine robot for hospitals just got 510(k) clearance from the U.S. Food and Drug Administration. These robots are being put to work on a wide range of areas from stroke diagnosis and prevention to intensive care units to surgical collaboration. The goal behind them is to significantly improve patient outcomes and reduce healthcare costs to comply with the aims of the Affordable Care Act.
Although the initial models were operated by a joystick, RP-VITA is programmed by a remote physician expert using an iPad who appears on the computer screen. The robot is equipped with sensors to avoid bumping into anything.
Rosalie Wright, a spokeswoman for InTouch, acknowledged that it can take a few seconds for both patients and staff to get over the initial impression the 5 foot tall robot makes. “There is an initial moment of hesitancy, but once they see just how many people can be helped they change their minds.” Once the conversation between the remote expert and patient and healthcare professionals gets underway, the content of the interaction takes center stage and the robot shell fades into the background.
She added, “When people hear “robot,” they think it is something that is taking doctors away or they’re losing the personal touch of healthcare, but in reality we are getting patients the right care from the right place at the right time in the right way.”
Telemedicine robots has been used in hospitals to improve the continuity of care for patients at community and rural hospitals that lack some of the resources of a larger institution. Some health systems have used them for their intensive care units to make up for the shortage of intensivists. Geisinger Health System has used telemedicine to help with overnight shift monitoring of ICU patients with smaller hospitals in and outside its network.
Wright says the telemedicine robot is used in 10 percent of US hospitals. Its primary application is for the area of telestroke and the company works in about 70 telestroke networks. Why? Because strokes are the leading cause of death in the U.S., accounting for 800,000 deaths each year, according to the Centers for Disease Control. There’s a finite window to diagnose and treat them. A medication to break down blood clots, if administered at the right time, can be crucial to extending that window. But a neurologist needs to prescribe it. Many hospitals don’t have specialized neurologists on staff that are available 24 hours a day, seven days a week.
Michigan Stroke Network was one of the first pilot programs for InTouch Health — the company was started in 2002. It uses one hospital that acts as a hub for a network of community and rural hospitals. The hub provides round-the-clock access to stroke expertise, neuroendovascular specialists that diagnose and treat people suspected of having a stroke. Appearing at the patient’s bedside, the expert can read scans and monitors and talk to the patient and on site healthcare professional.
Beyond ICUs and telestroke, telemedicine robots are being used when hospitals lack a specialist and has spanned areas like pediatrics, dermatology and trauma. But there is also plenty of scope for remote experts beyond these areas to bridge communication gaps. Telemedicine robots are also being utilized as interpreters to surmount language barriers.
[Photo courtesy of InTouch Health]
We use them at Palm Drive in Sebastopol, CA. Dr. Gude and his team have a fabulous team approach and the patients love the robot. We use it for stroke communication with CPMC and ICU patients as well. As a critical care RN it was strange at first but I love it now.
What benefit does the robot provide over simple video chat such as Skype or Google Talk? Cool technology, but does offer any value beyond the wow-factor?
In telemedicine image quality and speed of transmission are critical. Surgeons have adopted Da Vinci robot very nicely. Neurology is not an interventional specialty per se. Neurosurgeons might be more facile with robots. However, their liability insurance cost is horrendous.