A team of researchers from Johns Hopkins discussed how the COVID-19 crisis has accelerated new advances in automation, while also unveiling bottlenecks in the rollout of robotic systems in health care settings.
They argue that advances in human-robot interactions — like enhancing robots' capabilities for touch, feeling, and decision-making — will decide whether tomorrow's robots will help hospitals keep their lead on the encroaching pressure of the next global pandemic, according to an article shared on Nature Machine Intelligence.
Health care robots can do much more than 'just deliver supplies'
The research team observed three ways robots have significantly advanced both patient care and provider safety amid the COVID-19 crisis. Robotic technology minimized contact between patients who had contracted the virus and health care workers, while also reducing the need for PPE, and also freed up time for health care workers to devote more attention to other crucial tasks. But the team of researchers looked forward, anticipating how advances could be leveraged to further adapt and enhance the reliability of robots for similar health calamities of the future.
Involved in the discussion were commentary authors Russel Taylor and Axel Krieger of the Whiting School of Engineering, along with Director Brian Garibaldi of the Johns Hopkins Biocontainment Unit.
"You go into a pandemic with the robots you have, not the robots you wish you had," explained Taylor, in the Nature Machine Intelligence article. "We can't build a fleet of robots for an emergency and put them in a warehouse. Not only is that not economically viable, but by the time you need them, they could be obsolete." This means advances in robotics and automated services surrounding health care require new "core capabilities into deployed systems that can be easily adapted for the challenges of the moment."
When the pandemic hit hospitals, there were already robots capable of delivering meals and taking a patient's temperature, explained Taylor. "Now we are talking about much more sophisticated systems — that can do serious cleaning, that can perform nursing tasks, that can do many things beyond just delivering supplies." But these new capabilities create serious engineering challenges.
Robots don't need fresh PPE every time they approach a patient
One of the major challenges revolves around deployability and how rapidly non-expert users can adapt and customize the robot for specialized scenarios. "For example, our ICU ventilator robot was designed for one kind of ventilator that pushes buttons," said Taylor. "But some ventilators have knobs, so we need to be able to add a modality so that the robot can also manipulate knobs."
"Say you want one robot that can service multiple ventilators; then you'd need a mobile robot with an arm attachment, and that robot could also do plenty of other useful jobs on the hospital floor," Taylor said.
"The pandemic has shown some of the current limitations of robotic systems to robustly work and adapt in difficult, changing environments at large scales," said Krieger, to Nature Machine Intelligence. The greater degree of uncertainty and chaos surrounding the unexpected in hospitals is taxing on any system, robotic or not. One strategy for overcoming this is implementing health care robots with shared autonomy, "which combines the knowledge of medical experts with the capabilities of robots."
Unlike human health care workers, robots don't need to wear fresh PPE every time they move close to an infectious patient — and this "frees up valuable supplies and time for human providers," said Garibaldi, in the Nature Machine Intelligence article.
Robots could execute fine motor tasks, like surgery
However, a major point of potential improvement for robots lies in advancing their ability to execute fine motor tasks, so they can offer more comprehensive health care service, like "placing an IV, intubating the trachea, or inserting central lines," explained Garibaldi. "Other potential tasks could include basic room cleaning, phlebotomy, and ventilator and monitor management and manipulation."
However, there are some tasks for which patients will prefer human health providers for the foreseeable future. In addition to the moral support and empathy offered by a living, breathing human, there are instances when caregivers will still say "I'm not sure I can trust a robot to do that," said Taylor. "Engineers need feedback on how these systems really work in the wild."
The research team is exploring ways of enhancing ICU robots — with an emphasis on "higher accuracy and higher fidelity operation of ventilators," said Krieger. Future health care robots might also carry out lung ultrasound imaging via 3D cameras and force sensors — in addition to advanced autonomous surgical robotic procedures (like suturing). With a more efficient feedback loop between deployment, implementation, and development of robot and automated systems, the next generation of health care robots could eventually prove a match to the logistical chaos of pandemics, move for move.