iRobot
and InTouch Health have partnered to create the Remote Presence Virtual+Independent Telemedicine Assistant (RP-VITA) through which a doctor in a remote location can conduct patient care as if he or she is in the room.
"The RP-VITA raises the bar for overseeing patient care remotely and allows me to proactively control a situation as if I were there," said Dr. Jason Knight, director of the Children's Hospital of Orange County California Transport Program and assistant clinical professor at the University of California, Irvine, in an interview. Knight has tested the device and led RP-VITA's clinical validation process at CHOC. The robot -- the most sophisticated of its kind, according to Timothy Wright, InTouch Health's vice president of corporate and market strategy -- was born out of a development collaboration between the two companies in July 2011.
A nurse examines a patient under the watchful eye of a doctor via the RP-VITA, a robot co-developed by iRobot and InTouch Health that can autonomously travel around a hospital and allow a physician to administer care as if he or she is in the room with a patient. (Source: InTouch Health)
iRobot -- known for its development of consumer robotic devices like a robotic vacuum called the Roomba that cleans the floor on its own -- provided navigation capabilities that allow the robot to move autonomously based on its Ava mobile robotic platform. InTouch Health provided RP-VITA's remote presence technologies and video-based user interface that allows doctors to feel as if they are actually present in the room with patients. The company, which works on a range of telemedicine solutions, also integrated hospital diagnostic implements such as electronic stethoscopes, otoscopes, and ultrasound equipment into the robot to allow for remote examination.
While robots have been used in hospital telemedicine programs before, Wright told us that RP-VITA was designed to take ease of use and sophistication to a new level to help doctors provide better patient care under increased demand for their time and attention. “There are no other robots like this on the market,” he said. "It supports is a growing trend in telemedicine to help extend a physician's reach."
To date, devices that allow doctors to remotely interact with patients have been operated by a joystick, Wright said. However, "we believe that in order to expand physician adoption, we need to make our robots easy for them to use," he said. To facilitate this, InTouch promoted the use of an iPad to navigate RP-VITA, which makes it relatively simple for someone even without technical skills or manual dexterity to use, Wright said. Via this navigation, RP-VITA can travel on wheels around a hospital at a maximum forward speed of 3.36 mph, rolling through corridors and into patient rooms.
One of its key features -- advanced obstacle detection avoidance sensors that include laser range finders -- allow the robot to keep out of the way of obstacles in its path and maneuver around them, allowing for a safe journey through busy hospital hallways. The robot also creates a digital map of an environment that it can access for future use, labeling rooms, controlling navigation speeds for certain areas, and marking zones where the robot should not travel, Wright said.
This is a great development. Given the number of patients doctors have to see in a day, this could help make better use of their time. Proper triage procedures would obviously be essential, however. This type of technology makes most sense for patients who aren't in any kind of immediate danger or who aren't critical vs. those with more pressing issues where an in-person examination is preferrable.
Love the integration with the iPad. That's bound to make the technology far more accessible to tech-adverse docs.
This is a very timely idea, given the way medical treatment is changing. More and more often, I'm seeing that many doctors have a physician's assistant who visits the patient and does a basic interview minutes before the doctor arrives. This concept seems to be a twist on the physician's assistant trend.
They put a similar thing into one of the area ICU's (I think) in the Milwaukee area. While it wasn't anywhere close to being as advanced as the system described here, I thought it was a good start. The primary advantage is that the more experienced doctor could keep an eye on patients in other locations rather than having to transfer everybody to the "mother ship".
I can see this medical technology being used in a limited way for the emergency room. Less critical cases can be addressed by a telepresence robot, thereby alleviating the long wait time in emergency room. Great article Beth!
Actually, Elizabeth has to take credit for this one, Mrdon, but I agree it was a real interesting post.
I like Chuck's parallel to the trend of Physician Assistants doing more of the early interviewing and upfront examination work. I am seeing that with the doctors we see as a family. Although from a personal standpoint, I can't help but think I'd feel the doctor was somewhat detached if I wasn't interacting with them directly and doing so via remote telepresence technology. Maybe not for a routine examination, but certainly for something with more serious ramifications.
Beth, You bring up a good point regarding doctor-patience relationship and beside manner. Today's doctors in residence are being scrutinized for their beside manner. Being impersonal with a patient makes it difficult to address their medical needs. Not quite sure how telespresence technology will address this since the doctor will not physically be in the room with the patient. Body lanaguage plays an important role in treating patience.
Poor Beth. She's been indoctrinated in Obama care already. I remember old doctors that visited your house when you were sick but wouldn't clean it for you.
I thought that medical care was going to be like a visit to the post office or DMV. Instead now the "doctor" can vacuum your floor when you're not sick.
I remember our family doctor visiting our home when one of us kids was sick. Talk about bedside manner. But I like this robot idea. This has got to be more efficient than our current system. At a time of ever escalating medical costs, it's nice to see some efficiency introduced.
@Robatnorcross: You're going to have to explain what you mean by the house cleaning comments. Is that because we're talking about a robot?
The reality is, the days of doctors doing house calls are far in the past. I'm 50 and my dad was a doctor in a semi-rural town and I can tell you that was never part of the lexicon even back then, whether for good or bad. Unfortunately, it's just not realistic in today's society. That said, I guess I'm for any kind of video/robotics/information technology that can streamline the process just a little bit for routine tasks and consultations, freeing up the docs so they can spend quality time with patients whose cases are more acute.
I was refering to the Roomba "robots" that clean/vacuum (not sure which) your floors by wandering around the house when they feel like it. My Vietnamese friends named theirs Stanley. Stanley has ALOT of free time when he/she/it is not cleaning and if you could teach him/her/it to do other things like "go get me a beer Stanley" he would be much more productive in terms of usefull work per day.
With a software upgrade Stanley could remember to provide your medicine when you were sick or bring you the thermometer if you had a fever. The sky's the limit.
Stanley currently doesn't speak or recognize voice commands but could be equipped with an automatic weapon in case your house is burglarized.
Several robots for providing at-home medical care are in the works, based on a somewhat similar design platform as this one. That platform is iRobot's Ava mobile robot design: http://www.irobot.com/ava/
Ok - I'm fine with technology and think robots are cool - but so much of good medicine is about the ability to "read" a patient and establish trust as a physician. When the face on the screen says "take your medicine" it's just another commercial. Doctors should be walking the halls, popping in on patients and sharing chance encounters with nurses who can give the Dr. a quick 30 second update on the patient in 203. Human interaction is healing, too.
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