You are in the emergency room. As you sit in the waiting room waiting for your turn, kind of mechanical dog with a tablet instead of a head approaches you. The screen lights up and a doctor’s face comes to life and he begins interviewing you. How would you react? The researchers of the Massachusetts institute of technology (Mit) e del Brigham and Women’s Hospital di Boston they decided to answer this question. Because it is true that in the age of social distance, the use of robots in some health interactions a promising way to reduce in-person contact between healthcare workers and sick patients. But not everyone can like it. Especially in situations that are not always pleasant, such as being in the emergency and urgent area of a hospital (and in the Covid era). Well, from a study published on Jama Network Open it emerged that the vast majority of patients consider the interaction with a healthcare professional via a screen mounted on a robot comparable to what happens in traditional ways, that is, in person.
The survey
This study includes two parts: a national survey to examine the acceptability of using robotic systems in carrying out health care activities in a hospital setting, and also a cohort study in one place, on patients’ experiences and their satisfaction in using a mobile robotic system (remotely controlled, ed) to facilitate triage and telemedicine services in the Emergency Department, they explain Peter Chai, associate professor of Emergency Medicine at Brigham and Women’s Hospital, first author of the study, and Professor Giovanni Traverso Mechanical Engineering researcher at MIT and gastroenterologist at Brigham and Women’s, senior author. The investigation involved a thousand individuals US residents who participated in a sample survey via an online analytics platform, between August 18 and August 21, 2020.
Nasal swabs
The questions were about not only the degree of acceptability of a contact with the robot in the triage phase but also other activities such as performing nasal swabs, insertion of a catheter or pronation, that is, the maneuver of turning a patient upside down in bed. On average, respondents said of be open to these kinds of interactions. Surprisingly, people have quite accepted the idea of having a robot perform a nasal swab, which suggests that with some engineering effort one could think about building some of these systems, says Professor Chai. After the outbreak of the pandemic in 202, Traverso and his colleagues turned their attention to new strategies for minimize interactions between potentially ill patients and healthcare professionals. To this end, they worked with Boston Dynamics to create a robot that could interact with patients waiting in the emergency room.
Model
Why a dog-like robot? We have adopted the model developed by Boston Dynamics, a company focused on the development of mobile robotic platforms – Professor Traverso replies to Corriere Salute, Genoese great-grandfather but raised (he great-grandson) between Per, United Kingdom and Canada -. I believe that robots could take many different forms. We are interested in understanding what people prefer. In this study we noted that ipatients are receptive to this form in particular, but we certainly could investigate others in the future. The robot could therefore avoid the risk of exposure to Covid-19 by healthcare professionals and help save personal protective equipment necessary for each visit. However, it is not yet known whether patients are available, and to what extent, for a type of interaction with machines. Often as engineers, we think of different solutions, but sometimes they may not be adopted because people don’t fully accept them, says Traverso. So, in this study we wanted to check if the population was receptive to a solution like this. The cohort study included U.S. resident patients who, between April and August 2020, showed up at Brigham and Women’s Emergency Room, a large urban teaching hospital that provides advanced care in Boston.
Measurement sensors
The robot equipped with sensors that allow you to measure vital signs including temperature, respiratory rate, heart rate and saturation. It also carries a tablet that allows remote video communication with a healthcare professional. Fifty-one patients were approached in the waiting room or in a triage tent e 41 of them agreed to participate in the study. Patients were interviewed about their symptoms via video connection, using the tablet carried by the robot. More than 90% reported being satisfied with the robotic system. With respect to the goal of gathering information on rapid triage, patients found the experience similar to what they would experience talking to a person, Professor Chai reports. But that of the PS robot is only one of the many initiatives carried out by the MIT team. Others involve the development of sensors capable of obtaining vital sign data from patients remotely and integrating them into smaller robots that could operate in a variety of environments, such as field hospitals or ambulances.
But in the meantime it is more useful to create diagnostic systems with Intelligence
A robot dog that lends itself to remote triage in the emergency room? An original and yet impractical idea, according to some experts. The project seems a bit “scenographic” to me, pass me the term. The study consists of two arms: one more of a proposition, in the sense that the authors subject the idea of a robotic solution in certain situations to a very broad survey. So there is nothing concrete and factual he says Alessandro Riccardi, national training manager of the Italian Society of Emergency-Emergency Medicine (Simeu). The very limited part of triage. Talk about triage in that context a bit misleading because it gives the idea of an active process (that of welcoming the patient, identifying the clinical severity and then establishing the priority of intervention, ed), while in reality it is simply a nurse (or a doctor, ed) that command a robot to guide the interview.
Robot outside the operating room
Different robotic systems are beginning to be seen in the hospital. They are peeping out of the operating theaters, where they have been most used so far and they begin to circulate in the corridors of hospitals and retirement homes. They now belong to a family: surgical, modular, service, social, mobile and autonomous. The surgical ones and the cousins dedicated to rehabilitation they have a considerable market value: $ 12.7 billion by 2025 (about 5.9 billion in 2020, with an annual growth rate of 16.5%, according to Market & Market estimates). Too early to ask ourselves if they will feel for humans that empathy of which the philosophers Luisa Damiano and Paul Dumouchel speak in the book Living with robots Essay on artificial empathy (Raffaello Cortina Ed.). Any advantage at all, then? A robotic system could actually facilitate the patient selection process, in certain situations, and staff safety. But all in all, from a real security point of view, I don’t know how innovative it is. It seems like a nice project that involved a lot of money but I don’t think it’s really disruptive in any way.
Rather difficult maneuvers
In the survey in which a thousand US citizens took part, they are asked to comment on the possibility that robots perform tampons, infusions or even pronations on the patient: do you think this is realistic? From a purely technical point of view, robotic management of tamponade rather than intravenous sampling would require machines managed remotely as in operating theaters of robotic surgery. Hence, enormous management costs. Using a million-dollar surgery to perform a vein sampling would seem like a waste to me. Although the risk may be high in the current pandemic situation, we are not talking about Ebola anyway. On the other hand, I believe that to achieve a completely autonomous robot requires an innovation process that could take a very long time.
Promising developments
What, then, could be the most promising developments in technological innovation in the field of emergency-urgency? The use of artificial intelligence diagnostic algorithms, for example, as already happened in Wuhan to assess the progress of Covid-19. Or the insertion of alerts in IT systems, useful to help the doctor to identify, for example, a rare disease such as haemophilia. Or, again, the development of neural networks applied to cynicism and research. Unfortunately talk about all this in Italy still science fiction for the simple fact that we have a backward digitization with an infinite number of computer systems that do not communicate with each other. So at the moment it is impossible to think about it, IT systems should be redesigned hospital so that everyone was networked and compatible.
April 23, 2021 (change April 24, 2021 | 21:18)
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