Robot-Assisted Triage, Treatment in ED Acceptable and Feasible

By Linda Carroll

March 08, 2021

(Reuters Health) - Patients may be open to robots participating in some healthcare interactions, a U.S. survey suggests, and, in an experiment, researchers found that emergency department patients reacted positively to a robot doing some initial triage.

In the online survey, 1,000 respondents were asked about their openness to a robot assisting in performing healthcare tasks such as acquiring vital signs, placing an intravenous catheter, obtaining nasal and oral swabs, and turning a patient over in bed. In the experiment, conducted at the Brigham and Women's Hospital emergency department, 40 patients agreed to have their medical histories recorded by a four-legged dog-like robotic system called Dr. Spot.

Virtually all the patients interviewed called their experience "satisfactory," researchers report in JAMA Network Open. Among participants in the survey conducted in mid-August 2020, most found the idea of robot assistance "useful."

"The key thing here is that robotic systems are feasible for very active settings in emergency departments," said study coauthor Dr. Giovanni Traverso, an assistant professor in the department of medical engineering at MIT in Cambridge, Massachusetts, and a gastroenterologist at Brigham and Women's Hospital in Boston.

"We showed that the hospital staff could operate the robot and patients were accepting of evaluation that is supported by robotic systems," Dr. Traverso said. "The key takeaway is that it can be operated in a busy environment and patients are accepting."

The pandemic helped inspire some of the research, Dr. Traverso said. "Using a robot can protect the healthcare workforce and minimize the use of (PPEs) that still remain in short supply," he added.

The researchers turned to a four-legged robot because it could travel not only inside the hospital on its smooth floors, but also in makeshift outdoor tents with uneven floor surfaces that had been set up for the burgeoning numbers of patients in Boston, Dr. Traverso said.

For the survey, Dr. Traverso and his colleagues partnered with a global market research and data analytics service called YouGov. Survey responses were measured using a five-point Likert scale. Respondents were asked about their perceptions of the usefulness of robotic systems to facilitate specific health tasks. The respondents were asked both in a general context and also in the context of the COVID-19 pandemic. Surveys were completed between August 18 and August 21, 2020.

With regard to the usefulness of a robotic system to perform specific health care tasks, the response of "extremely useful" was selected by 287 participants (28.7%) for facilitating telehealth interviews, 413 participants (41.3%) for acquiring vital signs, 192 participants (19.2%) for obtaining nasal or oral swabs, 159 participants (15.9%) for placing an intravenous catheter, 167 participants (16.7%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed. The numbers increased in the context of the COVID-19 pandemic.

The response of "somewhat useful" was selected by 373 participants (37.3%) for facilitating telehealth interviews, 350 participants (35.0%) for acquiring vital signs, 307 participants (30.7%) for obtaining nasal or oral swabs, 228 participants (22.8%) for placing an intravenous catheter, 249 participants (24.9%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed.

For the emergency department experiment, the researchers sent a dog-like robot, equipped with four cameras and a tablet mounted where the head might be, to interview patients. The robot was operated by a single emergency medicine provider. Of the participants in the experiment 92.5% said they were satisfied with Dr. Spot and 82% said that their experience was on par with an in-person encounter.

Dr. Nicholas Genes called the robot in the ED experiment "cool" and "cute."

As for the survey, Dr. Genes said he suspected that people might have responded less positively if they had been shown a video of the robot, especially when it came to their openness to having Dr. Spot involved in certain tasks, such as obtaining oral and nasal swabs or placing an intravenous catheter. "I'm not sure I'm ready to have a robot poke something up in my nose," said Dr. Genes, associate chief medical information officer at Mount Sinai in New York City.

"They would be fine for simple tasks, like collecting triage information at the beginning of a visit," Dr. Genes said. "I'm not sure you need a quadruped for this, however. You could consider a workstation on wheels, something shaped like R2D2 with an iPad on top, for example. I think the quadruped robot is impressive technology, but I think it's a little overkill when just being used in this way."

SOURCE: https://bit.ly/2PErO0s JAMA Network Open, online March 4, 2021.

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