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Robotics Industry Insights

Robots and Healthcare Saving Lives Together

by Tanya M. Anandan, Contributing Editor
Robotic Industries Association

Physicians, nurses and technicians are the superheroes of healthcare. But even Captain Marvel needs a trusted sidekick. Enter the robots. They augment the surgeon’s potential with superhuman precision and repeatability. They help hospitals save costs, reduce waste, and improve patient care. They offer levels of measurability and traceability that only automated machines can achieve. And they provide medical technology developers with proven platforms for new innovations.

From radiation treatment to eye surgery, rehabilitation to hair transplantation, and robot therapists to robotic pharmacists, and even a robot phlebotomist, healthcare robots are transforming the fields of medicine across the globe.

Teleoperated robot-assisted surgical system for minimally invasive procedures. (Credit: Intuitive Surgical, Inc.)Probably the most widely known medical robot is the da Vinci® Surgical System made by Intuitive Surgical. The teleoperated robot-assisted surgical system has been used successfully on millions of patients since it was cleared by the U.S. Food and Drug Administration (FDA) in 2000. Indications for use include minimally invasive thoracoscopic, cardiac, urological, and gynecologic procedures.

For the squeamish, we stuck to fruit for this demo. Check out this video of a surgeon using the da Vinci robot to peel a grape.

Many believe healthcare robotics is reaching a tipping point. Robots are becoming cheaper and more capable. The sensors and software that heighten their capability continue to drop in price. And as a new age dawns for robots designed to work collaboratively with humans, medical applications will only gain momentum. Reports are projecting tremendous growth for healthcare robotics in the next five years.

“We are at the infancy of the automation spectrum for medical robotics,” says Corey Ryan, Manager of Medical Robotics for KUKA Robotics Corporation in Shelby Township, Michigan. “I say that because the da Vinci has most of the market for surgical robotics, but it is a telemanipulator. The surgeon operates a joystick to perform the procedure. The system doesn’t do the work itself. It’s simply a remote tool the doctor can use.”

This tech paper by Maxon Precision Motors explains how the da Vinci System works. 

Collaborative Robots in the OR
As with many robotic medical applications, the robot merely augments the surgeon’s or technician’s skill. It’s certainly not a replacement for its human operator and most industry insiders agree that we’re a long way off from true autonomy.

Still Ryan sees an influx of research and startups in the medical space, many of them in stealth mode with applications under development. Others are on the cusp of market introduction.

One of those applications soon slated for the operating room is a robot-assisted device for cutting bone with a laser. CARLO (pictured), which stands for Cold Ablation Robot-guided Laser Osteotome, is in advanced-stage development by AOT in Basel, Switzerland. The device uses the KUKA LBR iiwa robot to guide the laser beam to the precise location for the bone ablation procedure.

Robot-guided laser bone-cutting device under development. (Courtesy of AOT AG)Compared to the conventional method of using an oscillating saw to cut through the bone, robot-guided laser osteotomy is reported to provide more precise cutting geometries, thereby minimizing the amount of ablated bone and thermal damage. It also reduces soft tissue damage, promotes faster healing, and allows for complex 3D reconstruction geometries currently only capable with robots. It’s expected to be used in all forms of osteotomies, starting with craniomaxillofacial surgery.

This video takes a peek into the lab at AOT so you can see the laser bone-cutting robot in action.

AOT, a Basel University Hospital spin-off, just completed series B financing and the CARLO device is expected to enter clinical trials soon.

Integral to AOT’s process is KUKA’s collaborative, lightweight robot. The KUKA LBR iiwa (LBR stands for Leichtbauroboter, which is German for lightweight robot) represents a new breed of robots designed to be inherently safe out of the box, without the need for elaborate safety fencing common to many industrial robots. This allows them to work in close proximity with their human operators.

For more information about human-robot collaboration and the robots making news in this domain, check out these articles: Major Robot OEMs Fast-Tracking Cobots and The Realm of Collaborative Robots – Empowering Us in Many Forms.

Ryan says they have research projects at various universities around the world studying the use of KUKA’s lightweight, collaborative robot for various medical procedures. He says the increased adoption of collaborative robots in the industrial sector is driving the medical marketplace as well.

“There’s lots of research and we have four or five OEMs trying to bring products to market using the lightweight robot. It’s a robot built for people in the workspace. That’s where the big change has been in the last three years. The collaborative robot market has exploded.”

One such study involves robotic suturing with the KUKA lightweight robot.

“Kevin Cleary’s group at Children’s National Medical Center did a great project where they developed a system for suturing,” says Ryan. “They built a tool that goes on the end of the robot. It pushes the needle through the skin and the robot pulls it tight just like a surgeon would. The spacing of the sutures was much better than by hand, and even better than the da Vinci System when they tested it. The deformation of the skin was far less when the robot pulled the sutures tight. Overall, the suturing was far superior.”

Researchers are also using KUKA’s lightweight robot for ultrasound scanning.

“The nice thing about the ultrasound scanning is that the robot is force controlled, so the robot will compensate for the patient’s breathing and still keep consistent force,” says Ryan.

He says researchers in Europe are also using the lightweight robot for needle biopsy and minimally invasive surgical procedures.

Out-of-the Box Safety, Flexibility
The KUKA LBR robot boasts unrivaled sensitivity and is in a class of its own with a redundant safe design.

“We have two strain-gauge torque sensors and two position sensors at each axis,” explains Ryan. “We run a position and a torque down to our robot controller and our controller runs two instances of software. So we are fully redundant in our sensing and in our logic, which is what the RIA Standard for safety requires to meet the minimum specification for human-robot collaboration. Because we’re fully redundant, that lends us very well to working out of the box in a safe way.”

The KUKA lightweight robot is a kinematically redundant 7-axis arm. This design gives the robot exceptional flexibility, especially in tight spaces or when working with its human collaborators.

“Because you have a 7th axis, the robot can hold a tool and still move part of the arm,” explains Ryan. “Relatively small it may seem, until you’re right- or left-handed working with the robot and part of the robot is in the way. Now you can move part of the core of the robot to a different configuration while still holding a tool steady. That’s only possible with a 7-axis robot. If you’re right- or left-handed and trying to work around a patient, that can be huge.”

Now imagine the tool, perhaps a needle or a probe of some kind, is actually in the patient. Research conducted by the Karlsruhe Institute of Technology in Germany is developing new methods for robot-assisted surgery using KUKA’s lightweight robot.

In this video, two LBR robots are controlled through haptic interfaces in telemanipulated robotic surgery. At 2:10 into the clip, you see a researcher demonstrate the advantages of kinematic redundancy with hand-guided null space movement.

For more on haptic technology, including the first commercial haptic device to be approved for clinical usage in the OR, see Our Autonomous Future with Service Robots

Shorter Development, Faster to Market
Other features of the KUKA LBR robot also lend themselves to healthcare applications, and provide advantages for medical technology OEMs and startups in particular. Ryan explains.

“We can do gravity compensation, where you put the payload onto the end of the robot and the robot treats it as if it’s part of the robot and only looks for small external forces,” he says. “So you can literally move 14 kilos with your pinky very easily. We have active vibration dampening so when people bump into it, it can mechanically dampen those vibrations. You can set the compliance in X, Y and Z independently, so that X and Y can be very stiff and Z can be very easy to move.”

He says these numerous options and features are the reason technology developers buy the KUKA lightweight robot for medical applications, because it can save significant development time.

“The more you put into the system as options and features, the harder it becomes to initially program and learn,” says Ryan. “But when you do complex applications, those are the things that save you hours or hundreds of hours of development time. If you’re a startup and you’re trying to get a company going, it can save you two years of development. Now all you have to build is the tool at the end of the robot and the interface for the customer. That’s a huge advantage.”

KUKA’s LBR also features an open and modular architecture, as opposed to proprietary software common with most industrial robots.

“We use a Java API for the interface, which is very easy for people to learn,” explains Ryan. “There are a lot of Java programmers out there. If you are a development house, the odds are you have somebody that programs Java. We also have build-on modules that add some features and functions, which you can easily turn off and on.”

He says Java also allows for easier integration of external sensors and software packages.

Superhuman Precision
Surgical robots bring superhuman precision to the most exacting procedures. Nowhere is that more apparent than in the precise repeatability of the ARTAS® Robotic Hair Transplant System. This FDA-cleared system turns a once painful, drawn-out process for people suffering from pattern baldness or other kinds of hair loss, into a more precise and comfortable procedure with no scarring and better outcomes.

Robotic hair transplant system eliminates scarring and speeds healing time. (Courtesy of Restoration Robotics, Inc.)One of the integral technologies is an industrial robot arm by Swiss manufacturer Stäubli. In late 2006 the hair transplant system’s developer, Restoration Robotics, contacted Stäubli looking for an industrial arm that could handle the high performance levels of this unique application.

“They had their patents to do hair transplant with a six-axis industrial robotic arm, but they couldn’t find a robot that complied with the safety regulations at the time, nor achieved the sheer performance that the robotic arm needed to maintain,” explains Brian Woods, West Coast Regional Sales Manager for Stäubli Corporation based in Duncan, South Carolina. “It uses stereovision mounted on the end-of-arm tooling to locate a single hair follicle on the back of your head, fire a needle, and auger that hair out. Then the surgeon retrieves it, inspects it, and puts it back in the top of your head.”

He says the old way, called the strip method, was to take a large blade and remove a long strip of scalp from the back of the head, dissect the hair follicles, and implant them.

“You ended up with a big scar on the back of your head,” says Woods. “With the ARTAS, they are just taking a single hair follicle at a time, so you only have very small scabs on the back of your head. There’s no scarring and your recovery time goes from months to days.”

This video shows the ARTAS Hair Transplant System being used in an actual procedure. 

One Hair Follicle at a Time
The Restoration Robotics team worked with Stäubli’s R&D group in Europe to fine tune the system. Woods says Point Grey provides the stereovision camera and Restoration Robotics developed all the algorithms that help determine the best follicles for harvesting.

The ARTAS System uses a standard, off-the-shelf industrial robot, the Stäubli TX60. So what makes it stand out from the pack? Woods says it all goes back to precision.

“It goes back to Stäubli’s DNA,” he explains. “We’re a mechatronics company. We started out in the late 1800s making looms for the weaving industry. Over the years, that mechatronics has been applied to our robotics group. That’s why we get the higher performance and the higher speeds. We make our own gearbox. It’s a patented design that Stäubli owns. It gives us that very smooth motion at slow speed, but when we need it, we can crank these robots up to very high speeds.”

That slow, steady motion comes in handy. With robot-assisted surgery you’re less susceptible to hand tremors and fatigue.

“We move the robot into position and then we send a zero-velocity command, so that freezes the robot right where it is,” says Woods. “It will not move no matter what, even if it gets bumped. That goes back to the design of the Stäubli robot. You can walk up and hit this thing with your fist and it won’t budge. It’s a different kind of robot.”

Robot repeatability can’t be beat. This is crucial when you’re working with submillimeter accuracy, extracting thousands of single hair follicles one after another.

“One of the biggest achievements of the ARTAS was it opened the door to the FDA for industrial robotics to be used as a surgical apparatus,” says Woods. “It got a Stäubli robot approved for use in a surgical application where the robot is making physical contact with the patient.”

The ARTAS System achieved FDA 510(k) clearance in 2011.

“Back then, no one was thinking about using an industrial robot for this kind of application,” says Woods. “That’s why the da Vinci and the Hansen robots took so long to develop. Those are specialized robots that these companies developed. That adds seven to ten years of development time to the front end of your project. With Restoration Robotics, they at least considered using an industrial robot. Turns out, they got performance and results even better than they needed.”

One Cataract Away
Woods says the hair transplant robot opened the door to Stäubli for other medical applications. One of those is for cataract surgery.

“I’ve seen videos of the best surgeons in the world working inside of the eyeball and then I’ve seen video of our robot going inside a human eyeball, rotating and removing the cataract,” says Woods. “It is shocking the difference in how precise that robot holds its path and how steady it holds the apparatus compared to some of the best surgeons in the world.

“The cataract surgical application needs 5 microns repeatability with a 6-axis robot. That’s unheard of in the industry!” says Woods. “We found that we couldn’t hold that level of precision when we were fully extended at high speed, but if we work in a small envelope when the robot is in a comfortable position, we can hold those kinds of numbers.

“I don’t see robots ever replacing surgeons. But assisting them, I think this is a trend that is only going to continue.”

Large-Scale Robotics in the Hybrid OR
Robotics is transforming our hospital ORs into highly flexible environments where diagnostics, interventional therapies, and surgical procedures can be accommodated in one room, making patient care more efficient. The Accuray CyberKnife® System for non-invasive treatment of tumors and the Artis zeego (pictured) for angiography and vascular surgery both use KUKA robotic technology. Human-robot collaboration is not confined to small, lightweight robots. Large, standard industrial robots have been at work in the medical space for more than a decade.

Robotic angiography system for 3D mapping of blood vessels during vascular surgery. (Courtesy of Siemens AG)“When you look at the CyberKnife and the Artis zeego, those are big robots,” says Ryan. “There’s no inherent safety built into them. Before KUKA (robots), no medical robot manufacturer would let people go in the workspace of any robot that size. Luckily, KUKA had an update in its product and its control system that they said if it’s programmed correctly, it can be made safe. But it does require external sensors like vision systems and other sensors to make sure the robot is running at the speed it’s forecasting and everything is operating correctly.”

This video of the Artis zeego system shows off its robotic flexibility. 

Ryan says if you want to work with people, the robotic system requires a certain level of redundancy. You have to have multiple sensors and systems running checks. He says the customers choose the kind of sensors and systems they want to use.

“Some use vision, some use X-ray detectors,” says Ryan. “For example, the CyberKnife has an external vision camera watching the speed of the robot. If it goes too fast, it slows it down or stops it.”

This video of the CyberKnife System shows the radiosurgery robot and integrated patient positioner in action. 

“With the zeego, they have speed limits and they use KUKA’s safety software (Safe Operation) as a second layer of protection,” says Ryan. “They also have panels that if people lean on the robot, the panels sense the pressure and the robot will stop. So those are mildly collaborative. The person and the robot are in the same workspace, but they are not working together and the robot is really not working on the person. There’s no contact intended.”

The exception is the RoboCouch® System, the patient positioner used with the CyberKnife System. Ryan says KUKA robots used for patient positioning are used in proton centers around the world.

“If you think of a proton treatment center, they have what is called a fixed beam. They have a particle accelerator that is ripping protons off the atoms and pumping that into a patient. But they control the motion of the protons via these large magnets and it comes into the room out of a nozzle. The nozzle is not something they can easily direct, so they need to tilt the patient so they are at the optimal angle from the nozzle. The reason they use this robot is because they have to have a very high rate of repeatability. They have to bring the patient within less than a millimeter away from the planned treatment position. So you have a huge advantage in being able to position the patient exactly where you want them.

“In the case of the C-arm on the zeego, its motion is coordinated with the motion of the table so the C-arm doesn’t hit the table,” he adds.

“These C-arms have been around for ages and 90-plus percent of them are manual,” says Ryan. “Somebody with a set of joysticks moves the C-arm up and rotates it themselves. The zeego is the apex of automation for that, so they can image from here to here and they don’t have to align it to the table or figure out the reach. It just happens automatically.”

Healthcare professionals are not robot programmers, so medical technology manufacturers like Siemens provide the intuitive interface that makes the robotic technology easy to use.

Medical Research to Robotics
Ryan says most of the ground-breaking applications that KUKA is involved in originate in universities and research institutions.

“They come to us,” he says, describing the impetus behind the “hirob” rehabilitation robot. “That was a researcher studying how horse riding is an excellent therapy for stroke victims. The constant motion and having to reorient yourself while you’re in the saddle helps your brain sort of rebuild itself. In large cities there is no place to put horses, so it came down to can I put a person at the end of a robot and simulate that motion? The answer is yes.”

Using a KUKA industrial robot, the “hirob” provides movement therapy for the improvement of trunk control and stability in patients with neurological deficits. This video shows the “hirob” in action

“In medical, it’s generally someone on the research side that has discovered that some procedure would be beneficial to a patient or they want to test a theory. The robot is really a motion control platform. If you want to move people, tools or whatever, this is a simple platform for you to do it in an off-the-shelf kind of way. You don’t have to spend years trying to figure out how to build and control the system. You just have to build the tool on the end, whether it’s a saddle or a surgical tool, and the interface for the user.”

Rehab Robots with Measurable Results
From equine-inspired robotic therapists to robot arms for physical therapy and neuroscience research, rehabilitation robotics is growing rapidly. In March, Automate 2015 showgoers were treated to a live demo of the ReWalk™ robotic exoskeleton, just one of the latest advancements in robotic rehabilitation and personal-assist devices. 

ReWalkers rejoice at their new-found mobility in this video montage. Both the personal and rehabilitation versions of the exoskeleton have FDA clearance. 

Researchers at SRI International in Silicon Valley are working on the softer side of wearable robotics with hopes that someday children with muscular dystrophy may walk taller and stronger with the aid of Superflex, a soft robotics bodysuit. 

Robotic arms provide rehabilitation therapy for patients recovering from stroke and other neurological disorders. (Courtesy of Barrett Technology, Inc.)This video demo shows how the Proficio™ force-modulated robot arm by Barrett Technology provides intensive therapy for victims of stroke and other neurological disorders. Coupled with an immersive 3D video gaming experience, the robotic arms take rehabilitation to a new, engaging experience. 

Barrett was recently awarded $300,000 in grants to help develop the Proficio arm and other Barrett robots for commercialization. 

KUKA’s Ryan says robots are perfect for rehab.

“You can measure the amount of force generated, the range of motion, and so on. You can adjust it based on how hard the patient is pushing. We have a partner in Germany that just developed a system for doing knees, where the patient can push on the robot with their leg and the robot will adjust the angle of applied force to minimize the forces on the injured area. It allows athletes and patients to maintain their muscle tone after knee surgery or a knee injury. It’s a standard industrial robot with force feedback devices on it.”

With robotics, the rate of rehabilitation progress is very measurable. Traceability is also a major consideration. Ryan thinks it could reduce the number of frivolous lawsuits against medical providers.

“With traceability, they can absolutely prove that an injury did not occur from treatment in the hospital,” he says. “When they can prove that the treatment was delivered as planned and within these parameters, it’s very much a record of what happened. I can tell you that I didn’t touch you there or push you there. This is proof that no motion happened in that area. When some of these facilities can protect themselves through use of a robotic system, that’s going to be a huge selling point.”

Mobile Robots on Call
Mobile robotics is another booming area not only on the industrial side, but now it’s also accelerating in healthcare. Adept Technology with its Lynx® Autonomous Intelligent Vehicle, Amazon Robotics with its fleet of 30,000 Kiva robots, and startups such as Fetch Robotics are reorganizing the logistics space.

“Once technology is proven in industry, the medical side of things usually picks up pretty quickly,” says KUKA’s Ryan. “There are already systems moving medical charts and medications around hospitals. Our LBR robot is portable. We definitely have people that are interested in the ability to move it. And the next question is always can I automate the motion? Can I just have them push a button and it will move to OR 4? That will come. Customers are already looking into it.”

The mobile transport robots Ryan referred to have been racking up the miles in hospitals for over a decade. Consider these statistics. In a typical week, a 200-bed hospital has to move 10,000 medication orders, 4,500 meals, 83,000 pounds of linens, and 70,000 pounds of trash. That’s healthcare workers clocking 370 miles a week moving this stuff around the hospital.

Autonomous mobile robot travels miles of hospital hallways transporting medications, patient meals, medical supplies, linens and trash. (Courtesy of Aethon Inc.)Now substitute a robot into that scenario. You will find that one mobile robot maker has a lot of miles on it. Not an acronym but more in the spirit of a tugboat, the TUG made by Aethon Inc. is an autonomous mobile robot designed to transport the tons of goods and supplies that keep a hospital running.

“Hospitals are starting to realize that they’ve done a lot to manage the logistics from outside of their building to their dock, but they’ve done very little to manage the logistics inside of their organization,” says Tony Melanson, Vice President of Marketing for Aethon. “That’s what we call intralogistics.

“So when a nurse is waiting for something, or they’re trying to get a room turned over, or a patient is waiting for a meal, or they’re trying to get medication to a patient, you’re in this indoor city and you’re trying to move all this stuff around. Nurses are waiting and patients are waiting. All of those things come into play when you look at the big picture.”

Established in 2001, Aethon deployed its first TUG in 2004. Now TUGs are operating in 125 hospitals with the largest fleet of 25 robots traversing the halls of the UCSF Medical Center.

See the Bay Area TUGs in action

It may sound simple, but beyond its 1,000-pound payload capacity, the TUG houses some sophisticated technology under the hood. Multiple sensors, including sonar, infrared and a SICK laser scanner, help it navigate autonomously and safely among its biped coworkers and hospital visitors.

TUGs travel the same hallways you would use when visiting your loved one in the hospital. Unlike AGVs (automated guided vehicles), the TUG is fully autonomous. It freely navigates hospital corridors and service areas without needing to follow magnets or painted stripes on the floor, or requiring any special infrastructure.

From Ward to Command Center
Melanson says other onboard and remote technologies make the TUG unique in this space.

“Because we’ve been in the hospital space for so long, we’ve developed a lot of enabling technology,” explains Melanson. “It’s one thing to have a robot go down the hallway from point A to point B. It’s entirely another thing for the robot to be able to control elevator systems, or to respond to alarm conditions, or to be able to have two-way communication with the users. Or to have a fleet of robots that are interchangeable among departments, sharing duties and managing when those robots are dispatched, what their next job is, and whether they are dedicated to a certain department at certain times of the day.”

One of those primary enabling technologies is a 24-hour remote command center at Aethon’s headquarters in Pittsburgh, Pennsylvania.

“We have over 450 robots installed in the field,” says Melanson. “One of the things that has allowed us to manage that type of customer base and to be successful is our cloud command center, which allows us to stay connected to all the robots that are installed in the customer base. So if a robot encounters a problem, an algorithm detects the problem and our support technicians here can respond to that condition. The result being that over 97 percent of all alerts that the robots make to the command center can be resolved remotely without any involvement by the customer on site.”

Aethon’s command center operates 24 hours a day, 365 days a year. The remote support comes with every TUG, whether it’s purchased outright or leased.

“Let’s say a bed is across a hallway and the robot can’t get around it,” explains Melanson. “We get a signal and we’re able to either address the problem remotely or in the three percent of situations where we can’t deal with it remotely, we can dispatch one of the customer employees to move the bed or move the robot.”

He says all of the communication is through Wi-Fi and there’s also a secure VPN channel that connects to the remote command center over the Internet.

“It’s really a very important part of our technology platform, because to make an autonomous robot commercially viable, meaning it is affordable enough to purchase because it has return on investment, you can’t necessarily build every single recovery mode into the robot that would be necessary in the field. It would just become too expensive and too complicated. We use our own people internally to address those edge cases.”

At initial deployment, Aethon creates a shared, common map of the hospital and a route definition for all the robots in the hospital’s fleet. Down the road if a route changes, someone in the support center can make the adjustment.

“We can very quickly and very flexibly change, update, and improve the routes and the stops for the robot fleet. The customer doesn’t have to make any infrastructure changes or re-mapping themselves,” says Melanson. “We can do it from here (Pittsburgh command center) and all the robots will know about it.

Autonomous mobile robot securely delivers medications and IV preparations to healthcare professionals throughout the hospital. (Courtesy of Aethon Inc.)“The same TUG can deliver clean linen and then turn around and deliver food, but most customers separate the TUGs among departments,” explains Melanson. “The exception to this is the TUG that has our integrated carts with the biometrics. Those TUGs are dedicated to delivering laboratory specimens or pharmaceuticals.”

Robot Rx
President and CEO Aldo Zini, who joined Aethon shortly after it was established, has roots at Automated Healthcare, which developed the first robotic medication dispensing system for hospitals, ROBOT-Rx. It was later acquired by multibillion-dollar pharmaceutical distributor McKesson Corporation. Building on his experience, Zini was one of the catalysts behind MedEx™, Aethon’s software solution for securing and tracking medication deliveries in real time.

Melanson says there’s a black hole between when a medication is ordered and when it’s delivered to the designated patient.

“That is the preparation, who got the medication when it left the pharmacy, who received it when it got to the nursing unit, and where it went from there. None of that is tracked today.

“One of the number one sources of medication errors are interruptions and distractions,” explains Melanson. “And one of the number one sources of interruptions and distractions, for the pharmacy in particular, are phone calls.

“That’s the nurse calling the pharmacy asking, where’s my medication? So we inserted hardware and software in that black hole, so that every single step along the way the medication has a chain of custody. Now everything is visible. They don’t have to make the phone calls, because all they have to do is look at a screen and it will tell them the status of exactly where the medication is and who received it.

“We have helped hospitals that receive 200 missing medication requests a day,” adds Melanson. “Now they’re down to 10 a day. When you can reduce the amount of calls, you can really improve the safety of medication preparation and ordering.”

Combatting Rising Healthcare Costs
Safety and efficiency accompany the TUG wherever it goes. In a beleaguered healthcare industry, administrators are looking around every corner for ways to cut costs.

“We tend to see ROI in the 18-month range,” says Melanson. “That’s plenty short enough for a hospital to get their benefit.”

He says ROI is largely measured in labor savings. When constructing new buildings, hospitals can deploy TUGs in lieu of hiring labor. But it also has a lot to do with the kinds of tasks healthcare staff can do when they’re not burdened with moving supplies around the hospital.

“So in the case of the pharmacy, the people that deliver things by hand can now be in the pharmacy working on preparing medications for the patients,” explains Melanson. “There’s value there when you have people doing work at the top of their pay grade.”

Another area of savings is in worker’s comp costs and safety issues. This draws an interesting parallel with the industrial sector where there’s a strong motivation to robotize the dull, dirty and dangerous jobs.

“Compared to industry, hospitals have four times the rate of days lost due to illness and injury,” says Melanson. “Part of this is due to running around the hospital with these very large carts pulling very large loads, and sometimes pulling two of them at a time. You have back and wrist injuries, and repetitive stress injuries. There are real cost savings related to reducing those types of injuries.”

Melanson also cites the cost of turnover, noting that these kinds of undesirable service jobs have 30 percent turnover. “If you can reduce the churn of replacing people, those are very real costs that can be avoided.”

So what’s ahead for the TUG? Melanson says Aethon is looking to grow internationally in both the healthcare and non-healthcare sectors. TUGs also roam the aisleways of the industrial and logistics space.

“We have TUGs in Denmark, Australia and Germany,” says Melanson. “And soon to be in Singapore and China.”

Aethon is also working on new technology. Currently, the TUG gets its locomotion from two wheels on a rotating head located at the front of the vehicle. Those two wheels pull the entire load. Aethon is testing an additional platform with an omnidirectional base with four independently motored wheels that will allow it to pivot on its own axis and move sideways and diagonally, providing for more maneuverability when needed.

Mobile telepresence robot remotely connects physicians with their patients. (Credit: InTouch Health)The TUG is not alone in the medical space. The Swisslog RoboCourier and the Lamson RoboCourier, which both incorporate the Lynx autonomous mobile platform by Adept, is at work in hospitals right now. Check out this video from down under. 

There’s also the QC Bot from Vecna Technologies, which recently acquired VGo Communications, a developer of mobile telepresence robots. All eyes are waiting to see what’s next on the horizon for these free-ranging medical workhorses.

Transport vehicles aren’t the only mobile robots making rounds in hospitals. The InTouch Vita telemedicine robot (pictured), developed by iRobot and InTouch Health, connects physicians with their patients no matter where they are, thanks to mobile telepresence technology.

From mobile patient care and robotic surgical suites, to rehab arms and blood-drawing bots, healthcare robots come in many forms and form factors.

Robot Phlebotomist
Stäubli’s TX40 robot, a smaller version of the TX60 used for hair transplant, is the primary component in the Veebot automated venipuncture system. This robotic phlebotomist uses infrared sensors to locate an appropriate vein in a patient’s arm, then ultrasound to detect blood flow, and the smooth precision of the robot arm to insert the needle in the right location.

This video shows an early prototype of the Veebot device using a different robot. Although it is still under development, the system using the Stäubli robot has reportedly drawn blood with repeated success. 

Blood-drawing robot under development. (Courtesy of Veebot LLC)Woods says the company is currently evaluating its options for undergoing clinical trials. With billions of blood draws performed every year, a robotic solution could help reduce human errors that can lead to patient discomfort, significant time and cost inefficiencies from re-draws, and even the spread of infection.

Here’s video of another concept for a robotic phlebotomist that has recently come on the scene and has the backing of the National Science Foundation. 

Digital Hospital of the Future
Stäubli’s TX60 robot is also the central workhorse in the RIVA automated compounding system from Intelligent Hospital Systems.

“It dispenses IV bags, prescriptions … all the medicine internal to the hospital,” says Woods. “It takes the human error out of the equation on medical dispensing.”

Humber River Hospital in Toronto, Canada, touted as North America’s first “fully digital” hospital, has a mobile robot fleet transporting supplies through its corridors, a Stäubli robot dispensing chemotherapy drugs, and a suite of radiology robots. Check out this news coverage as the medical center prepared for its grand opening in October. 

UCSF Medical Center has also robotized its pharmacy. Watch these robots in action

Woods is excited for the prospects in healthcare robotics. He stresses how important these technologies are to the greater good.

“We’re doing something out here that’s going to improve the quality of life for a lot of people,” says Woods. “Some of the things I’m seeing these robots do are just unbelievable. I can’t believe this technology is part of something that is changing so many people’s lives.”

The future of healthcare technology is truly awe-inspiring. Industry insiders know more than they can say, and they’ve seen amazing things. For a glimpse into the crystal ball, watch this internationally renowned surgeon and researcher discuss the future of surgery, where advanced imaging, simulation, robotics, and artificial intelligence will revolutionize the art and science of medicine for better patient care. 

For that’s what technology is all about, improving our quality of life.

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Originally published by RIA via www.robotics.org on 11/23/2015

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