Robots in Healthcare

Dr Keith Nelson

Since the dawn of the industrial revolution, mankind has been dreaming of creating a machine replica of a human in the quest for both loyal assistance with a variety of activities and for companionship. Reflections of this pursuit in popular culture have flooded movie and TV screens over the years in a myriad of forms including Robby the Robot (Twilight Zone), the Lost in Space Robot (Danger, Will Robinson!), Data (Star Trek), C-3PO, the Terminator and the titillating Alicia Vikander in Ex Machina. Meanwhile, in the real world, non-humanoid machines, like the Roomba vacuum and delivery drones, have been steadily developed, mostly to perform singular functions, and have created a category distinction between human-like androids and robots assuming an alternate, nonanthropomorphic form.

A robot is defined as a type of automated machine that can execute specific tasks with little or no human intervention and with speed and precision. To wit, robots can be guided by an external control device, or be completely autonomous. It is the latter which is the stuff of dreams (and nightmares) and is the canvas upon which to develop a functional evolution from simplistic Boolean and AI program routines to the holy grail of sentience and the ability to learn and to evolve.

Robots have a multitude of potential applications that transcend nearly every business vertical. Most, as defined above, are programmed to perform specific tasks with great precision – case in point, the industrial robots seen in factory production lines. Hence, there are many different types of robots and, based on the task(s) that a robot is designed to perform, Gartner segments them into four (4) categories: Personal, Smart, Logistic and Industrial. I have taken the liberty of adding a sometimes-overlapping 5th category, Humanoid, to the mix. Let’s review these.

Types of Robots

Personal Robots

A personal robot is a robot that has been designed and created to be used by an individual. It will assist the user in their daily life and tasks, help in family life, do some repetitive tasks around the house or, in some cases, become a daily companion. Personal robots perform tasks autonomously based on given rules or algorithms.  Examples of vendors and products in this category are: Moxie from Embodied, Robo Temi, and Pepper by SoftBank Robotics.

Smart Robots

A smart robot is a robot that works autonomously in the physical world, learning in short-term intervals from human-supervised training and demonstrations or by their supervised experiences on the job. They sense environmental conditions, recognize and solve problems and can work alongside people (for example, in workspaces, as hospital/surgical robots, or in retail or warehouses). Hence, they are sometimes called “cobots” (collaborative robots). Smart robots don’t require complex and precise programming. Instead, smart robots can be trained by showing them the movements required to complete a task.  Examples of vendors and products in this category are: SoftBank Robotics’ Whiz or the aforementioned Pepper, LG’s CLOi line up (including PorterBot for the airport, ServeBot for hotels, and GuideBot and CartBots for the store and market).

Logistic Robots

A logistic robot is a smart robot designed for work in a warehouse or logistics facilities, often alongside people.  Examples of vendors and products in this category are: Geek+, Locus Robotics, XYZ Robotics.

Industrial Robots

An industrial robot is a robot used for manufacturing and requires complex and precise programming. They are often used to perform repetitive or dangerous tasks and sometimes placed in cages (as they don’t have enough sensory capabilities to work along with humans). For the purpose of this discussion, industrial robots also include agriculture robots.  Examples of vendors and products in this category are: FANUC, Motoman Robotics, Kawasaki.

Humanoid and Anthropomorphic Robots

Humanoid and anthropomorphic robots are those with a body shape built to resemble the human or particular animal body in form and/or function. This represents a crossover category of the above listed segments. Great examples are the Boston Dynamics (Dancing) Atlas and Spot, Honda’s Asimo and the UBTECH Walker-X.

There are seemingly limitless potential applications for robot technology within the boundaries of current technology, which is driving a burgeoning business sector and frenetic research and development activity. That said, one of the biggest obstacles to the wholesale adoption of robotics today is cost.

Some Examples of Diverse Robot Types and Uses

  • Autonomous Vehicles and Drones (civilian and military)
  • Bots (virtual)
  • Surgical Robots (e.g. DaVinci, Medtronic Hugo)
  • Manufacturing/Assembly
  • Warehouse Inventory Management (pick and pack; replace human-piloted forklift transport and conveyor belts)
  • Delivery (FedEx/UPS, Walmart, Amazon, Domino’s)
  • Lab Research
  • Bomb Defusing
  • Fire Fighting

Robots for the Healthcare Theater

Given the considerable breadth, diversity and expanding potential of the robotic technology landscape, I thought it would be worthwhile to highlight a few current use cases specific to the healthcare sector.

Clinical Use Cases

  • Patient Rounds (Telemedicine) – Examples: InTouch Health (Vita), AVA Robotics, Double Robotics, VGo. Patients respond enthusiastically to the robot interactive experience, and the technology gives providers workflow flexibility, and allows for both more frequent check-ins with the patient and the mitigation of travel stress.
  • Robotic Surgery – Examples: The aforementioned Intuitive Surgical DaVinci Robot, Medtronic Hugo. One can envision a future where surgeries are performed by a remote expert surgeon working in conjunction with a local surgical support team.
  • Restricted Zone Coverage (e.g. area with infection, toxic agent or radiation exposure). This is particularly compelling in an epidemic or pandemic situation.

Operational/Administrative Use Cases

  • Room Sanitization (disinfecting and cleaning) – Examples: CIRQ+, Ava Robotics, Xenex. There are three types of cleaning robots:
    • UVC – Sterilizing with UV light. Must avoid human skin and eye exposure. Only sterilizes what it can see (projected line of sight).
    • Fogging – Creates a wet mist in the air. Must wait 30 minutes before people are allowed into the treated space to avoid inhalation of the disinfectant. Uneven surface coverage (cleaning agent stays where it lands). Used extensively by airlines.
    • Electrostatic Spraying – Uses an electrode that introduces a positive electric charge to the disinfectant solution, yielding extensive and creeping surface coverage, especially in hard-to-reach areas. Recommended by the CDC. Low moisture. Disinfectant agnostic. Treatment area almost immediately available to occupants.
  • Visitor Assistance (delivering information, wayfinding)
  • Supplies/Food/Beverage/Medication/Linens Delivery (hospitals) – Example TUG Robot

Affordability Factor

The cost of purchasing a robot depends upon the type of machine and the level of sophistication of the technology that is needed to perform a desired function. On the higher end, a fully autonomous robot that performs patient rounds can be purchased in the range of $32,000 to $80,000, but there are leasing programs that start at around $1,000/month.  On the low end, the Double Robotics self-driving, semi-autonomous robot with object avoidance technology sells for $4,000, making it affordable for nearly any telepresence scenario including patient rounding, hospital visitor assistance, and student proxy presence in a medical school classroom.

At the end of the day, robots clearly represent an extremely promising supportive technology to enhance the delivery of healthcare.  From an aggregate category perspective, robotics most certainly addresses the widely adopted healthcare Quadruple Aim of improving the patient experience, improving the provider experience, lowering costs and improving patient outcomes. As with most technologies, new use cases will emerge over time, driving greater innovation to meet those challenges. I would argue that the biggest bang for the buck and the majority adoption trigger will be the development of multifunctional robots that allow for the maximization of their use, thereby lowering the investment threshold. But then again, how can you put a price on Ah-nold?

Dr. Keith Nelson is the Director of Healthcare Strategy at Connection and is responsible for formulating and implementing Connection’s go-to-market strategy for the healthcare industry. His responsibilities include identifying and developing differentiated use case driven technology solutions for Connection’s healthcare clients, promoting Connection’s healthcare practice, and driving strategic client and partner engagement. Before joining Connection, Keith led the healthcare vertical at Ingram Micro. Prior to that, he was a consultant to the healthcare industry, providing guidance to hospitals, large physician groups and vendors in the areas of business development, marketing, finance and improving operational efficiency. Concomitantly, Keith worked with various private equity firms focusing on roll-ups in the healthcare sector. He has held senior management positions at MDNY Healthcare, HealthAllies (now a subsidiary of United Healthcare), and was the founder of the Renoir Cosmetic Physician Network. Prior to that, Keith spent ten years in private medical practice focusing on surgical reconstruction of the foot and ankle and chronic wound care. He has an MBA in Finance, as well as a Doctorate in Podiatric Medicine, and is Board Certified by the ABPM.