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Paging R2-D2 to the hospital ICU

10:42 PM, May 23, 2013   |    comments
Dr. Alan Shatzel, left, confers with Dr. Alex Nee in the hall at Mercy San Juan Medical Center in Charmichael, Calif. (Photo: Steve Yeater for USA TODAY)
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(USA Today)-- CARMICHAEL, Calif. - Examining patients, clad in white and sporting a stethoscope, the doctor is in. As always, questions and banter mix. Except this doctor is, well, a robot.

In this suburb outside Sacramento, Mercy San Juan Medical Center is home to a new family of robots. Doctors can make remote visits to patients via PCs or iPads running the robots.

The latest hospital robots, dubbed RP-VITA, come from Roomba vacuum cleaner maker iRobot and InTouch Health. Like R2-D2 in Star Wars, they can roam about on their own, guided by sensors and software that maps locations to avoid collisions. Doctors can also navigate them around ICUs and other facilities.

RP-VITA stands more than 5 feet tall and has what looks like a large tablet computer for a head. Doctors can appear on the screen much like a video chat and use front-facing lenses to zero in on patients.

California hospitals are leading the way at putting them in play in what is shaping up to be a new era of hospital robotics in an increasingly connected digital world.

Doctors and patients are fans of the robots. What's not to like when a specialist can examine and talk with a patient by robot within minutes of arrival at the hospital in an emergency?

Robots are changing the medical industry and hospitals forever, in what many say is a technology overhaul that addresses shortages of staff and improvements to the level of service for patients, especially for hospitals farther away from experts.

"This is changing the landscape of medicine and leveling the playing field of treatment" says Alan Shatzel, a neurologist and the medical director at Mercy Telehealth Network.

Doctors tethered to pagers - yes, they still use them - for 24-hour on-call shifts can now do that entirely on robots. What this means is a doctor can take calls off-site and visit patients within about five minutes from an iPad or PC. Otherwise, doctors might have to commute from home and arrive much later.

Hospitals in the Mercy Telehealth Network have improved treatment of strokes. Strokes are best treated within the first few hours of detection, ideally in the first hour. If done so, doctors may be able to treat some strokes with a clot-busting drug intravenously. Such drugs, known as tissue plasminogen activators, can restore blood flow to speed recovery with less trauma to the brain.

What doctors call the "door-to-needle" time reduction has been a big deal in the profession.

"This has definitely saved lives," says Shatzel, who likes to say, "time is brain."

Brothers Richard Tung, 50, and Garrick Tung, 48, know the effect of a stroke on a loved one. Their mother was admitted to Mercy San Juan Medical Center this month. They were relieved to be seen by a remote specialist right away. "If you know the specialized doctor can see you right now, that makes everyone happy," says Garrick.

The Tung brothers were so caught up in concern for their mother that they didn't even stop to think twice about the doctor's remote visit. "The technology really helped to save my mom's life," Richard says, upon reflection.

Doctors are just one more profession embracing iPads. Some point out that the iPad Mini actually fits the pocket of a doctor's coat. Doctors are quickly adopting smartphones and tablets, says Jan Gurley, a San Francisco-based doctor, because they are capable of delivering medical information, including quick how-to guides for procedures.

She cautions, however, that it's a slow process to bring technology changes to the industry. "Health is a very difficult place to be innovative in - it's highly regulated and the customers are cranky," Gurley says.

RP-VITA's sensors make it possible for it to speed down a hall and stop on a dime should a news reporter step in front, avoiding accidents. Its lenses allow doctors to zoom in close to examine patients and check their vital signs from the monitoring devices. It carriers a stethoscope that can be read remotely as well. Also, it can take a video input to review an exam.

The FDA cleared the RP-VITA in January for use in patient monitoring, including cardiovascular, neurological, prenatal, psychological and critical care assessments and examinations. Hospitals are trying to figure out next how to provide psychological services remotely.

There's an opportunity to disrupt and build businesses in this space, allowing doctors to perform at a distance, says iRobot CEO Colin Angle, noting his first interview via robot. "There's a lot of challenges of doing it right," he says. "This is certainly the most advanced remote presence system."

Lacking mechanical arms, the RP-VITA can't yet open doors. But the iRobot-InTouch Health duo is working to allow the robots to open doors using wireless technology to trigger doors open.

"What's happening in health care and in hospitals is more of the information revolution," says Yulun Wang, CEO of InTouch Health.

ROBOT LABOR

There are other behind-the-scenes roles for hospital robots as well. Aethon is a startup focused on robotic delivery services in hospitals. Certain tasks require a lot of walking and repetition, such as delivering drugs from one point to another. Same goes for moving food carts around to every room. Aethon's TUG robot is designed for those trips and others.

"We want to be like FedEx of indoor delivery so we can track everything and tell where they are," says Aethon CEO Aldo Zini

The robots also handle some grunt work most people wouldn't want to do. Hauling dirty laundry and infectious waste as well as moving up to 500 pounds are just some of the things TUG can do without complaints.

Hospital staff members have grown accustomed to their TUG co-workers, says Zini, adding that these types of robots will be woven into businesses of the future.

So Far, Aethon has about 400 of its robots in roughly 130 hospitals, mostly in the U.S. The private company does not disclose financials but said that it's profitable and revenue doubled last year. The U.S. is about a $4 billion market for such robots, estimates Zini.

"We're looking to expand into other industries as the technology gains traction," says Zini. "I think it will be another transformation in the workplace."

GE's ROBOTS

Some hospital jobs might be performed better by robots. For that reason, General Electric has a small unit focused on work with existing robots to put them into specific hospital applications. One area of concern is sterilization and tracking of surgical instruments.

GE's group figures it can reduce hospital infections and related deaths. A big problem is "improper sterilization of surgical instruments," says John Lizzi, manager of GE's Intelligent Distributed Systems Lab. "It's just a chaotic environment, and they're being asked to do more with less."

The group at GE says there's a simple problem of job turnover in areas like surgical sterilization that can be addressed. For new employees, "there's a very steep learning curve in the sterile processing department," says Lynn DeRose, the principal investigator on the project and an expert on auto-ID technologies. "It will help remove human error."

Ge plans to use RFID chips along with visual-recognition software for robots to identify instruments, sterilize and sort them.

The GE members say they are looking at a system of robots to perform simple tasks such as transporting, cleaning and managing inventory. The difficult task will be baking all the technologies together - software, sensors and robotics - to create these task-oriented workers that could help hospitals cut costs.

Plans are for the work to be demonstrated at Department of Veterans Affairs hospitals that it works with within a year and a half. The next step would be to commercialize it.

DeRose says, "We're developing real cool technology, but we're also saving lives - that's what gets us to come to work every day."

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