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Do Robots Have Value in Clinical Settings?

A telemedicine pilot in Dubai is placing robots in two critical-care facilities to connect doctors with specialists in emergencies.

- Telemedicine robots are being deployed in two hospitals in the United Arab Emirates in a nationwide effort to link emergency care centers to needed specialists.

The robots, designed by Santa Barbara, Calif.-based InTouch Health, will be stationed at Hatta Hospital and the Nad Al Hammar Primary healthcare center, and will link with specialists at high-profile health systems like Rashid Hospital and Dubai Hospital. The pilot program, called RoboDoc, is being launched by the Dubai Health Authority.

"Telehealth is a boon, especially in emergency cases, where time plays in critical role in saving a patient's life,” Amani Al Jassmi, the DHA’s director of information technology, told the Thomson Reuters Zawya online news service. “Telehealth provides immediate access to consultation with specialists. In fact, through the robot, doctors can consult with two or more specialists in different health facilities at the same time to get immediate specialized consultation.”

Future phase of this telemedicine project will put robots in ICUs and NICUs, as well as other healthcare sites, DGHA officials said.

Led by the likes of InTouch Health and iRobot, robots and robotic technology have piqued the interests of healthcare providers since about 2009 (the first reported telesurgery, a complete laparoscopic cholecystectomy performed by two New York doctors on a patient in Strasbourg, France, was done in 2001). Just last year, InTouch Health’s robots were adopted by Hawaii’s Kona Community Hospital to connect patients with mainland-based psychiatrists for video consults within 20 minutes. And two years ago, California’s Mercy San Juan Medical Center started using RP-VITA robots to enable their remote or office-bound physicians to visit patients in their rooms.

In 2014, New York’s Mount Sinai Health System Icahn School of Medicine conducted two separate studies on the feasibility of telerobotics, with a doctor in one location controlling a robotic instrument in a surgical procedure at another site – ultrasounds in one study, echocardiogram exams in the other.

“These studies lift the robotic imaging and telemedicine to the next level,” said Sherif F. Nagueh, MD, medical director of the Echocardiography Laboratory at Houston's Methodist DeBakey Heart and Vascular Center, in an editorial accompanying the studies.

Last year, the Florida Hospital Nicholson Center in Celebration launched a series of studies to determine if clinicians could conduct surgery via telemedicine.

"The networks that exist today in well-equipped hospitals are more than capable of supporting telesurgery," Roger Smith, PhD, the Nicholson Centers chief technology officer, told mHealth News. "But we've got a long way to go before that will happen."

While using robots to perform surgeries might be a little more distant, robots are now used for room service and deliveries and for remote consults. They can be stationed in hard-to-reach health clinics or community centers, or – as in Dubai – used to connect doctors in ERs and other urgent care facilities to specialists.

"The challenge today for all healthcare organizations worldwide is how to deliver consistent high quality care at lower costs,” Yulun Wang, InTouch Health’s chairman and CEO, told Zawya.  “Telehealth is the answer because it can leverage physicians such that physicians can be available anytime and anywhere and they can provide quality care to anyone at reduced costs. There have been many studies, which highlight that with the right technology telemedicine consultations are just as effective as in-person meetings. In fact, telemedicine consultations can be better than in-patient consultations as well because the computer helps the physician in real time. The computer analyses the images of the patient in real time and helps improve the diagnostic capabilities.”

"For example: If telehealth is used in dermatology, while the dermatologist is looking at a patient's lesion or rash, the computer can be looking at the rash at the same time and it can give the dermatologist suggestions on what the rash might be,” added the former president of the American Telemedicine Association. “A physician is limited by his eyesight but the computer can see and magnify the images. Therefore moving forward, telehealth will not only become a vital tool to provide medical care at any time and place but also a tool to improve diagnosis."

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