If the next physician you see has a robotic bedside manner, it could be for good reason: That doctor might actually be a robot. Surgical robots that help perform delicate, minimally invasive procedures have been around for more than 15 years. Now, telemedicine robots are roving through emergency rooms, allowing remote specialists to rapidly assess and diagnose patients experiencing strokes when every second counts. Here’s a glimpse at how robotic devices add another dimension to health care.
Tele-stroke networks allow patients at satellite facilities, for instance an isolated rural hospital, to receive immediate consultations from specialists based at major medical centers, says Gerry Popolow, vice president for international client services with InTouch Health, which implements and manages a global tele-stroke network and makes a range of health-care robotic devices.
One such network hub is Thomas Jefferson University Hospital in Philadelphia, with 37 member hospitals. “There’s a specialty neurologist – a tele-stroke neurologist – on call at the big hospital,” Popolow says. “And their response time is amazing, which is vitally important because in stroke treatment, physicians say, ‘Time is brain.’” This network covers the three-state area of New Jersey, Pennsylvania and Delaware.
Robot-assisted care can start at home, as paramedics respond to an emergency call. A portable device, the Xpress, allows first responders to quickly connect a patient with a physician in the emergency department. That physician uses patient-provider access software – installed on a laptop, iPad or iPhone – to get an instant read on the patient’s condition.
From the patient’s perspective, Popolow says, this portable device looks like a computer screen showing the doctor’s face, but it’s much more sophisticated. “It is robotic in that the physician is able to have the opportunity to monitor the patient’s vital signs,” she says. “The EMT attaches diagnostic devices in the ambulance to the robot. It is robotic in that the physician in the emergency room is able to move the high-resolution camera in the device to zoom, pan and tilt to assess the patient – just as if they were in the ambulance. The patient experiences the doctor’s face and voice in a very natural way so the patient feels as if they are talking to a real person. And very importantly, the connectivity is very reliable.”
Through that connection, the doctor asks patients how they feel and what symptoms they’re having while viewing the patient – learning enough to make a diagnosis. That way, the right treatment can be started as soon as possible.
At the hospital, the ER team might include the life-size, 5-foot-6-inch “Vita” robot. “It’s moving around, controlled by the physician or automatically programmed to move about the emergency room to specific bedsides,” Popolow says. “That’s when the patient is seeing something that really looks like a robot to them.”
With navigation enabled by scanning systems, similar to operating a self-driving car, and sophisticated cameras, the robot allows the operator to zoom in and examine key stroke signs like pupil reactions. The robot transmits data from the ER, as well as images and other test results available in the tele-stroke data cloud. This allows instant access to the patient’s electronic medical record, real-time vital signs and other health monitors to enable the on-call, off-site specialist to give a diagnostic and treatment opinion from his or her remote location.
Growing Networks
Tele-stroke capabilities exist at Cleveland Clinic, Mayo Clinic and more than 1,500 other large and small hospitals throughout the world, Popolow says. Cost-efficiency, as always, is an issue. “In the U.S., we lease our solutions to hospital systems, and depending on the complexity of the requirement, these [costs] range from hundreds of dollars per month to thousands,” Popolow says. Compared to the expense of hiring a full-time specialist for individual hospitals, she says, that’s “a fraction of the cost.”