Tuesday, May 18, 2010

Robot Doctors?

Gienna Shaw, for HealthLeaders Media, May 18, 2010

Telehealth and remote medicine are hot topics these days, widely regarded as fields that are about to explode—from remote radiology readings to ICU monitoring by off-site intensivists, to e-visits during which the patient and physician consult via video. But perhaps the most futuristic use of these technologies is the doctor robot: a device that allows the doctor to "walk" (or, perhaps more accurately, roll) into a room and examine his or her patient.

One such device is the five-foot tall RP-7® Robot, manufactured by InTouch Health® in Santa Barbara, CA. A physician, using a control station and a joystick, can maneuver through the hospital halls, interacting with patients, family members, other clinicians, and staff via a live video feed. The doctor's face is visible on a monitor that serves as the robot's "head." A camera, speaker, and microphone allow real-time, two-way audio and video communication.

Clinicians use the remote presence devices in a variety of different applications, from time-sensitive stroke treatment, emergency room call, critical care coverage, hospital capacity management, and specialty training and collaboration.

Early adopters include California's UCLA Medical Center, St. Joseph Mercy Oakland in Pontiac, MI, and the North Shore LIJ Health System in New York.

In addition to improved efficiency for doctors, who can conduct night and weekend rounds from their home, clinic, or office, the robots can also improve patient and family satisfaction. In a study led by Louis Kavoussi, MD, chairman of urology at North Shore-LIJ, and the nation's first user of the remote rounding robot, half the patients preferred a "tele-rounding" visit by their own doctor to a "real" visit by another physician. More than 80% of the patients felt that the robot increased physician accessibility.

"Patients have been extraordinarily receptive and enthusiastic about the robot," Kavoussi, who is using one of the three robots at LIJ to check on his patients after hours and on weekends, said in a release. LIJ is also using two robots in its ICU. The hospital's intensivists use the robots from their homes and offices to provide additional patient monitoring.

Although there are benefits—especially in rural and other areas where access to specialists is limited and as a Band-Aid for the physician shortage in general—there are some critics who say some robotic-controlled procedures are gimmicks, that the price of the technology is to steep for many hospitals, and it could limit the human contact that's important to the patient-physician relationship, notes an article in the Ventura County Star in Camarillo, CA ("Robots' place in diagnostics, surgeries debated").

An anecdote I heard recently suggests the latter argument is not always true, however. An elderly woman had been seeing her physician via robot over the course of several visits. At the time of one scheduled visit the physician was in the area and decided to meet with her in person. "What are you doing here?" she asked when he walked in the exam room. "And where is my robot?"


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