Hospital Robot Helps to Save Lives Off Battlefield

By Fred W. Baker III
American Forces Press Service

Dec. 5, 2008 - Once confined solely to the pages of science fiction, remotely controlled robots are now commonplace on today's battlefield, extending the reach of bomb experts and being used extensively to search for and destroy booby traps intent on killing U.S. troops. Remotely piloted aircraft also have proven their worth in combat, and now are in high demand, allowing the U.S. military to project its firepower and reconnaissance capabilities beyond its troops' reach.

And behind the scenes in a handful of military hospitals, the use of remotely controlled robots is being explored as a means of projecting doctors' expertise beyond the walls of their own medical facilities and into places where troops need their specialty care.

"It takes a little bit of an imagination. It's hard for some people to grasp everything that you can do with this thing," said Dr. Kevin Chung, the medical director for the burn intensive care unit at the Army's burn center at Brooke Army Medical Center in San Antonio. "The potential is limitless."

Chung is one of the military's pioneers in robotic telepresence, and he regularly pilots a robot around the halls of the intensive care unit at BAMC. His RP-7 robot, made by InTouch Health, a robotics technology company based in Santa Barbara, Calif., is a wireless, mobile, robot that allows Chung to be in many places at once.

A laptop computer connected to a wireless signal serves as the control station for the robot, which brings to mind a souped-up, four-foot tall version of Disney's animated robot "WALL-E."

A computer screen serves as its head, with a camera that can pan, tilt and zoom. Two-way audio and video allows for interaction between doctor and patient or staff. Using the robot, Chung can interact with patients, check vital-sign monitors, examine X-rays and zoom in to read charts or examine a patient's wound. The system also can capture and share digital images and videos.

The RP-7 can move freely, guided remotely by Chung. Chung recently returned from a six-month deployment as a critical care doctor at a combat support hospital in Baghdad. While he was there, he said, he was able to log in via satellite to the robot at BAMC and make his rounds seeing patients there. Twice, Chung was able to see and direct treatment for patients he had seen first in Baghdad to follow up on their care after they were flown to BAMC.

Doctors long have used the telephone to call in and check on patients, but that limits them to information passed to them with no way to visually assess the patient. Teleconferencing has been used as well, but it often is static and isn't mobile.

Using the robot, Chung said, he is able to see wounds for himself, read body language, watch facial expressions and examine a patient. He can talk to the patient and staff, and even meet the family.

"It doesn't beat real presence, obviously," he said. "Being there is the best thing. But let's say you can't be there. Which would you rather have? A telephone or this?"
Also, using such a robot would allow specialists from other hospitals to project their expertise even though they cannot be there physically, Chung said. This could be helpful in areas within the military where there is a shortage of medical care providers, especially those with specific skills.

The program still is in its pilot stage, but the goal is to have robots stationed at all military treatment facilities so that the experts can project their presence anywhere, Chung said.

The robots do have some limitations, Chung said. It doesn't have arms, so it can't open doors, and it is designed to stay in only one area. Also, "dead spots" in wireless connectivity can cause the robot to lose its signal momentarily. It then needs a gentle push by a staff member to move it out of the dead spot.

Chung acknowledged it also takes some time for the staff and doctors to get used to using and interacting with the robots. The patients, however, seem to like the robot, he added.

"It's not embraced by everyone," he said. "Ultimately, one of the things I see happening as technology improves and as wireless is available globally, ... [is that] connection issues that we have now are not going to exist, and it's going to be something that is embraced."

The Army's Medical Research and Materiel Command leased four robots in the pilot program. The robots cost about $250,000 each, or lease for about $80,000 a year, Chung said. BAMC is in the process of buying the robot Chung uses for about $100,000, he said.

Chung said he can see eventually deploying such robots into mass casualty situations, such as a biochemical attack, allowing experts from around the world to project their skills to the site quickly and safely.

Applications could expand into teaching as well, Chung said, with auditoriums full of medical students following along as a robot and doctor make their rounds.

"If you look at this simply, it is a video teleconference on wheels," Chung said. "As the technology improves, I think this is going to become a very useful tool."

Already, though, the robot has proved its worth in Chung's eyes, as a tool that can be used to save lives. Since he has been using the robot, he said, a handful of his patients were dying, and he was able to direct their resuscitation from a different state.

Chung was at his wife's bedside after giving birth to their third child, Chung said, when he got a call from a surgeon who asked that he look at a soldier who was dying. Chung stepped out of the room, logged remotely into the robot, and examined the patient.

"It was like I was there," he recalled. "I was able to process the information very quickly. Look at the patient. Look at the monitor. Look at the vitals." He even met the wife of the injured soldier for the first time via the robot.

The patient lived, Chung said.

"That patient's alive. He was dying," Chung said. "The robot itself isn't going to save lives. It's just another tool you can use to help make your life more efficient and extend your capabilities as a physician."