By Amber Dance, Special to the Los Angeles Times
The robot, sitting quietly in a corner, suddenly hums to life and rolls down the hospital corridor on three wheels. Perched atop the sleek machine is a monitor showing the smiling face of Dr. Paul Vespa, the physician who's piloting the rover from miles away. He can pull up to a patient's bedside, ask questions, observe symptoms and even use a stethoscope.
"People forget that you're on the robot, and you forget that you're on the robot," says Vespa, a neurocritical care specialist at UCLA who uses the device to consult in other hospitals and check on UCLA patients from home. "You really are there."
Robotic stand-ins are just one emerging technology poised to make a hospital stay safer, shorter, more satisfying and less expensive.
Hospitals can use technology to promote a modern, patient-focused approach to healthcare, says Dr. Rasu Shrestha, vice president of medical information technology at the University of Pittsburgh Medical Center. Hospital beds will become the center of a digital network encompassing information as varied as your heart rate and dietary restrictions to vast stores of data that will help predict how you'll respond to treatments.
Patients need to stay connected to all the doctors, nurses, dietitians and physical therapists managing their care. To keep the team informed, the Pittsburgh medical center is developing "a Twitter for healthcare," as Shrestha calls it. A patient's medical "followers" might receive updates on his blood pressure or temperature, for instance. Helping everyone stay up-to-date can streamline care and prevent errors when new nurses come on duty, Shrestha says.
The medical center is also using modern technology to battle an old scourge: the spread of infections. The best prevention is still simple hand washing; it's getting everyone to stop by the sink that's a challenge.
In Shrestha's hospital, nurses and doctors wear electronic ID tags that are recognized by sinks and hand sanitizer machines. "We actually know if you've washed your hands or not," he says. The hospital goes after clinicians who skip the sink.
Other digital assistants are being designed to give more complex medical advice. IBM, for example, is developing a program called Watson that will be loaded with medical literature. "Watson is your pal who helps you do the reading that you would love to do if you had the time and the memory," says Dr. Martin Kohn, chief medical scientist at IBM's Westchester, N.Y., facility.
Watson is currently being trained at Memorial Sloan-Kettering Cancer Center in New York to understand medical records and treatments. Someday anyone, not just doctors, might be able to query a Watson system and receive personalized advice, Kohn says.
While Watson is still in its version of medical school, robots are already performing tasks ranging from delivering lunch to assisting in surgeries. The type of robot Vespa uses at UCLA, made by InTouch Health of Santa Barbara, roves the halls of nearly 600 hospitals worldwide.
Becky Robelotto says the robot helped her family stay in touch with Vespa last summer when he was caring for her nephew — even during nights and weekends "We were always able to connect with [the doctor], instead of just once a day on rounds," she says.
For their part, doctors call on the InTouch network when they need to make quick decisions, such as when a patient arrives at the emergency room after a stroke. The clot-busting drug called tissue plasminogen activator, or tPA, can help some people, but only if given quickly. In other cases, the medicine may do harm.
Small hospitals may not have the right specialist to judge the situation, and most patients who could benefit from tPA don't get it. On average, just 2% to 4% of the people who could benefit from the medication actually receive it, estimates InTouch CEO Yulun Wang. With an expert on call via robot, that number rises to approximately 25%, he says.
The InTouch robots are just one type of technology that enables telemedicine, in which the doctor and patient are in different locations. Telemedicine can help hospitals keep tabs on patients after they're discharged, making sure they follow instructions and avoid the need to be readmitted.
"In 20 years, telemedicine will be a dominant form of healthcare delivery," Wang says.
But will robots and computers make medicine impersonal? Not at all, says Dr. Ashish Jha of the Harvard School of Public Health in Boston. With a computer assigned to sift through scientific studies or calculate the right dose of medication, Jha will have more time to sit at the foot of a bed, hold someone's hand, and have a real conversation.
"That," Jha says, "is the art of medicine."
