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The Robot Will See You Now

2011; Lippincott Williams & Wilkins; Volume: XXXIII; Issue: 3 Linguagem: Inglês

10.1097/01.eem.0000395416.94646.08

1552-3624

Emilia Benton,

Disaster Response and Management

ImageWhen patients imagine a medical robot, it's a sleek, shiny version of C-3PO from Star Wars rather than a souped-up version of the ticket kiosk at the airport. But a kiosk, albeit an extremely smart one that won't mangle your boarding pass, is much closer to reality than a walking, talking human substitute. Researchers in the engineering and emergency medicine departments at Vanderbilt University have dubbed their creation TriageBot, and it is most definitely more machine than human, although it can do much of what a living, breathing ED staffer can do: take a history, measure vital signs, and detect a change in medical status. Instead of waiting for clinical staff to collect information, TriageBot is ready when a patient arrives, asking about chief complaint and ultimately determining in which order patients will be seen. Best of all, Vanderbilt's new robotic technology will triage patients with nonurgent problems, freeing ED staff for clinical care. “In the past, the emergency department has really functioned in isolation,” said Corey Slovis, MD, a professor and the chair of emergency medicine at Vanderbilt. “There was the outpatient ER, and then there was the rest of the hospital.” TriageBot, however, combined the talents of the emergency department's doctors and nurses, the university's robotics engineering group, and the informational technology groups in the hospital. The new technology is outlined in a paper called “Heterogeneous Artificial Agents for Triage Nurse Assistance” presented at the Humanoids 2010 conference last December. (http://bit.ly/TriageBot.) Mitch Wilkes, an associate professor of electrical and computer engineering at Vanderbilt, said the basic idea is that U.S. emergency departments have many nonacute trauma patients who need to be treated right away to avoid risk of death. “We're seeing a lot of staffs comprised of very highly trained nurses and physicians having to spend a lot of time and effort treating and gathering information from nonacute patients,” he said. “A lot of this is routine enough that we can consider offloading it to a team of robots.” A very basic prototype of a robotic registration assistant is currently being developed by undergraduate engineering students at Vanderbilt. Patients directed to these assistants, which look similar to the kiosks at airport check-in lines, would provide information through a touch screen and respond to voice prompts to speed up the registration process. These assistants would measure blood pressure, pulse, respiration, height, and weight before assigning a time to each patient. If a patient were to show abnormal movements such as seizure, sudden standing, or falling, the robotic assistants would be able to alert registration staff, triage staff, and a physician. The monitoring assistants may be mobile robots or be built into waiting room chairs with the ability to check on patients and take vital signs. All would be guided by a cognitive computer supervisor that would interact with the robots and hospital emergency staff to, for example, move a patient from the emergency department to another part of the hospital. Professor Wilkes said his team hopes the TriageBot system, particularly the waiting room component, will ultimately help reduce mortality because of its ability for continuous monitoring. “We believe this to be very important because a patient that has been waiting to be seen for a long time can move from being a nonacute status to being acute. [S]ometimes people actually die in the waiting room as a result,” he said. The system is not yet operational, and is slated to undergo Beta testing within the next few months, although it could take five to 10 years before it is widely available. As with any major change, hospitals are likely to be concerned about patient reactions to this technology, but Professor Wilkes said the team does not foresee much resistance to the idea. Nonetheless, TriageBot's design will take into account that sick and injured patients are unlikely to be in good spirits regardless of who — or what — assists them upon arrival.Dr. Corey SlovisDr. Slovis said robots will assist emergency staff more and more as emergency departments grow busier and as costs increase, forcing EDs to allocate personnel wisely. “Ultimately, we'll look at the robots to assist us even more as they become more functional, more developed, and more sophisticated in monitoring patients,” he said. “But overall, a key advantage is that their upkeep is very minimal. You don't have to pay a robot by the hour or allow it to take lunch breaks.”Prof. Mitch WilkesProfessor Wilkes agreed, noting that “the system will be able to streamline the admissions process and free up highly trained specialists and emergency trained nurses to do more than what they're trained for so that we can free them up to focus on the people who actually need [urgent care].” Comments about this article? Write to EMN at[email protected]. Click and Connect!Access the links in this article by reading it onwww.EM-News.com.