By Dr. Stephen Schimpff, author of The Future of Medicine – Mega Trends in Healthcare
Sometimes the doctor patient interaction is far from adequate, but new mobile robotic technologies can help resolve the problem. I have a colleague who developed a cardiac arrhythmia called paroxysmal atrial tachycardia or PAT. The treatment was to thread a small catheter via the femoral artery in his groin up to his heart, find the site where the arrhythmia was originating and cauterize it. The procedure went well on a Friday afternoon and my friend was kept in the hospital overnight for observation. On Saturday, the cardiologist never appeared to check him or to discuss the results. From the doctor’s perspective, the patient was fine and he didn’t need to travel into the hospital. But my friend wanted to have a discussion about the procedure. To him, it was a big deal if not to the cardiologist. So, in frustration, he checked out “AMA.” He spent the weekend annoyed and did not get to talk to the doctor until Monday. This could have been solved with a technology that is essentially a computer mounted on a mobile cart. It can be controlled from a computer at home or work to move to the patient’s room where, with two way visual and voice communication much like you may have used with Skype, the doctor can see and communicate with the patient and vice versa. It is simple, relatively inexpensive and effective. I first learned of it at Hackensack Hospital in New Jersey where they named it “Mr. Rounder” and put a white coat on it with a stethoscope to make it look interesting.
I saw a similar device used at Sinai Hospital in Baltimore. We watched on a monitor at an offsite meeting location while a surgeon in a distant city directed the robot from its “parking place” in the hall to a patient’s room. There, he had a conversation with the patient, looked on as the nurse took the dressing off the incision site and told the patient he would communicate with him again later that evening once he got home from his trip. The patient was pleased to have his surgeon, albeit far away, still involved with his care and communicate with him and the physician felt comfortable that his patient was doing well. Good communication and good medicine - all done wirelessly.
On another occasion I watched a video of an encounter between a neonatologist and the parents of a just delivered premature infant. The delivery took place in a rural hospital and it was clear that the baby needed to be transported to the ICU in the big city many miles away. But before transport, the neonatologist was able to examine the baby utilizing the electronic stethoscope and watching as the local pediatrician did other elements of the exam. Then the specialist was able to have an interactive conversation with the parents. All of this allowed the specialist to have advance information – much better than just a written report – and the parents were able to get to know the doctor from afar. It improved communication, transferred key information and began the process of establishing a doctor-patient relationship, so important at that moment of great anxiety for the parents.
Another problem in the hospital is that medications are sometimes late in being delivered from the pharmacy to the nurses’ stations by the pharmacy technicians. Here is another example of how mobile robots can make an improvement using wireless technology. I was walking down the hall of the University of Maryland Medical Center and here came a robot, self guided, delivering medications. Basically, the pharmacist checks the incoming electronic orders, the technician prepares the meds, the pharmacist gives them a second check, the technician loads up the robot, programs in which units it should go to and off it goes, calling the elevator via wireless commands. It moves along the hallways, circumvents obstacles such as a dietary cart or “beeps” to lets its presence be known. When it reaches its first destination, it calls out to the nurses’ station “I have meds for you” and the nurse unlocks with a password the drawer for her floor and removes the medications. The robot then moves on to its next destination. At first it sounds very impersonal but in actuality it improves productivity by freeing up the pharmacy technicians to do the more critical work of dispensing medications and meanwhile speeds up delivery to the floors. Everyone is pleased.
These are but a few of the new robotic approaches that use mobile technology to advance productivity while improving quality and adding to safety. Expect to see more.
Dr. Schimpff is a retired CEO of the University of Maryland Medical Center and author of “The Future of Medicine – Megatrends in Healthcare.” More information at www.medicalmegatrends.com or http://medicalmegatrends.blogspot.com