The cost-effectiveness of a robot measuring vital signs in a rural medical practice
23 Nov 2015-pp 577-581
TL;DR: The feasibility and cost-effectiveness of a robot measuring routine vital signs in a family medicine clinic in a rural setting and the length of patient consultations were compared showed that consultation lengths were cut by 18% on average.
Abstract: Robots have been proposed to reduce the costs of the provision of healthcare in rural settings, but as yet little research has tested this. This study investigated the feasibility and cost-effectiveness of a robot measuring routine vital signs in a family medicine clinic in a rural setting. The length of patient consultations was compared before (N = 85 patients) and after a robot was deployed in the clinic (N = 48 patients). A Cafero touchscreen robot took the patient's vital signs prior to the consultation and transferred the results to the medical professional's computer. Time-savings were calculated in New Zealand dollar terms and compared to the costs of the robot and its maintenance. Results showed that consultation lengths were cut by 18% on average (3 minutes and 13 seconds). If 20% of the clinics' annual consultations were augmented with the robot this translates to a total annual savings of NZ$19075. The annual cost of the robot was calculated to be NZ$9400 overs 5 years. Present value calculations of Benefit Cost result in a Benefit Cost ratio of 2.3. These results support the cost-effectiveness of the robot in a rural medical clinic. Further research is needed to improve the services provided by the robot and test it in a larger trial.
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TL;DR: Detailed scenarios in the pre-, intra- and postoperative care are outlined, in which the use of robots and artificial intelligence can mitigate infectious contamination and aid patient management in the surgical environment during times of immense patient influx.
Abstract: The COVID-19 pandemic has changed our world and impacted multiple layers of our society. All frontline workers and in particular those in direct contact with patients have been exposed to major risk. To mitigate pathogen spread and protect healthcare workers and patients, medical services have been largely restricted, including cancellation of elective surgeries, which has posed a substantial burden for patients and immense economic loss for various hospitals. The integration of a robot as a shielding layer, physically separating the healthcare worker and patient, is a powerful tool to combat the omnipresent fear of pathogen contamination and maintain surgical volumes. In this Perspective, we outline detailed scenarios in the pre-, intra- and postoperative care, in which the use of robots and artificial intelligence can mitigate infectious contamination and aid patient management in the surgical environment during times of immense patient influx. We also discuss cost-effectiveness and benefits of surgical robotic systems beyond their use in pandemics. The current pandemic creates unprecedented demands for hospitals. Digitization and machine intelligence are gaining significance in healthcare to combat the virus. Their legacy may well outlast the pandemic and revolutionize surgical performance and management. Robots could play an important part in transforming healthcare to cope with the COVID-19 pandemic. This Perspective highlights how robotic technology integrated in a range of tasks in the surgical environment could help to ensure a continuation of medical services while reducing the risk of infection.
101 citations
TL;DR: This pilot study suggests that a homecare robot can improve adherence to medication and increase exercise and further research is needed with a larger sample size to further investigate effects on hospitalizations after improvements are made to the robots.
Abstract: Background: Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD) Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization Objective: This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group Methods: At discharge from hospital for a COPD admission, 60 patients were randomized to receive a robot at home for 4 months or to a control group Number of hospitalization days for respiratory admissions over the 4-month study period was the primary outcome Medication adherence, frequency of rehabilitation exercise, and quality of life were also assessed Implementation interviews as well as benefit-cost analysis were conducted Results: Intention-to-treat and per protocol analyses showed no significant differences in the number of respiratory-related hospitalizations between groups The intervention group was more adherent to their long-acting inhalers (mean number of prescribed puffs taken per day=485%) than the control group (mean 295%, P=03, d=068) assessed via electronic recording Self-reported adherence was also higher in the intervention group after controlling for covariates (P=04) The intervention group increased their rehabilitation exercise frequency compared with the control group (mean difference −453, 95% CI −716 to −192) There were no significant differences in quality of life Of the 25 patients who had the robot, 19 had favorable attitudes Conclusions: This pilot study suggests that a homecare robot can improve adherence to medication and increase exercise Further research is needed with a larger sample size to further investigate effects on hospitalizations after improvements are made to the robots The robots could be especially useful for patients struggling with adherence Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615000259549; http://wwwanzctrorgau (Archived by WebCite at http://wwwwebcitationorg/6whIjptLS)
63 citations
Cites background from "The cost-effectiveness of a robot m..."
...Assistive robots are generally acceptable to people, and there is some evidence that they can improve loneliness and quality of life [13-16] and reduce costs in rural medical practice [17,18]....
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TL;DR: The results show that there are many studies that demonstrate positive effects, but the level of evidence is mostly low and study sizes are often small, and care institutions are reluctant to put innovative technologies into practice.
Abstract: Background The field of digital technologies being developed or applied to support nursing care is extensive. The aim of this scoping review is to provide an overview on technologies for which results on positive or negative effects on persons in need of care, caregivers or care institutions are available and to appraise the reliability of these results. Methods A scoping review design has been used to identify studies focussing on the effectiveness of digital technologies in nursing care for persons in need of care, caregivers or care institutions. The screening process included 19,510 scientific publications from 9 databases. Results A total of 123 single studies and 31 reviews were subjected to the analysis. The included technologies comprise nursing and health information technologies, such as assistive devices, information and communication technologies, sensors and robotics. The results show that there are many studies that demonstrate positive effects, but the level of evidence is mostly low and study sizes are often small. Hardly any technology has been researched intensively enough to produce conclusive results. Studies on a high level of evidence (RCTs) lack for most technological areas. Heterogeneous results in some areas indicate that effects may depend strongly on the mode and specific context into which the technologies are introduced. Conclusion Due to the limited evidence on effectiveness of digital technologies in nursing care, it is not surprising that care institutions are reluctant to put innovative technologies into practice. The scoping review indicates technology areas that should be subject to future research with higher quality studies. Research on outpatient, informal and cross-sectoral care should be intensified to further exploit the potential of digital technologies with a view to improving independence of care-recipients and unburdening formal and informal carers.
24 citations
TL;DR: An outcome framework is developed for DNT to indicate which outcome areas have been most frequently evaluated in previous studies and how this has been done and to recommend the development of outcome areas for the macro level of effectiveness assessment.
Abstract: Digital nursing technologies (DNT) comprise an expanding, highly diverse field of research, explored using a wide variety of methods and tools. Study results are therefore difficult to compare, which raises the question how effectiveness of DNT can be adequately measured. Methods currently used might not be sufficient for certain specific nursing contexts. A comprehensive outcome framework that shows the multitude of possible outcome areas could be useful to generate more comparable results. The aim of the present study is to develop an outcome framework for DNT and to indicate which outcome areas have been most frequently evaluated in previous studies and how this has been done. We combined an inductive and deductive approach to develop the framework. The numerical analysis is based on a scoping review focussing on the effectiveness of DNT for persons in need of care, formal or informal caregivers or care institutions. Nine databases were included in the screening: Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. Additional literature searches and expert interviews were included. The developed framework comprises four outcome target groups and 47 outcome areas. There are considerable differences in the researched outcome areas for the individual outcome target groups. Persons in need of care were by far the most frequently surveyed, particularly with respect to their psychological health. There are much fewer studies on formal and informal caregivers, and it is particularly noticeable that the quality of life of both groups has rarely been investigated. Care process quality was most frequently researched for organisations. We were able to provide a comprehensive DNT outcome framework, thereby identifying the outcome tools used and the less researched outcome areas. We recommend a detailed investigation of all areas and tools in future research projects with a view to initiating a discussion on the differing importance of existing outcome areas and on a standardisation of outcome tools. We also recommend the development of outcome areas for the macro level of effectiveness assessment.
18 citations
Cites background from "The cost-effectiveness of a robot m..."
...robot that measures vital signs prior to consultation) [22]; or iv) to support the training or education of nurses (e....
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TL;DR: This literature review aimed to inform healthcare robotics research by highlighting communication behaviours that are important within the context of healthcare by highlighting research in human clinical interactions, followed by a review of similar factors in social robotics research.
Abstract: A growing shortfall exists between the number of older individuals who require healthcare support and the number of qualified healthcare professionals who can provide this. Robots offer the potential to provide healthcare support to patients both at home and in healthcare settings. However, in order for robots to be successfully implemented in these environments, they need to behave in ways that are appropriate and acceptable to human users. One way to identify appropriate social behaviours for healthcare robots is to model their behaviour on interactions between healthcare professionals and patients. This literature review aimed to inform healthcare robotics research by highlighting communication behaviours that are important within the context of healthcare. The review focussed on relevant research in human clinical interactions, followed by a review of similar factors in social robotics research. Three databases were searched for terms relating to healthcare professional communication behaviours associated with patient outcomes. The results identified key communication behaviours that can convey clinical empathy, including humour, self-disclosure, facial expressions, eye gaze, body posture, and gestures. A further search was conducted to identify research examining these key behaviours within the context of social and healthcare robotics. Research into these factors in human–robot interaction in healthcare is limited to date, and this review provides a useful guide for future research.
18 citations
References
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TL;DR: The literature about human responses to healthcare robots is reviewed and the variables that have been found to influence responses are summarised.
Abstract: The rapidly ageing population is placing increasing strain on healthcare services. Robots have been proposed as a way to assist people to stay healthy and safe in their own homes. However, despite the need for such assistive devices and the success of some healthcare robots, other robots have had a poor response. This article reviews the literature about human responses to healthcare robots and summarises the variables that have been found to influence responses. It may be possible to increase acceptance of healthcare robots by properly assessing the needs of the human user and then matching the robot’s role, appearance and behaviour to these needs. Because robots have limitations in their abilities, another way to increase acceptance may be to modify the expectations of users to better match robots’ abilities. More research needs to investigate potential users’ needs and expectations in specific situations and whether interventions to increase the match between robot and human can increase acceptance.
634 citations
"The cost-effectiveness of a robot m..." refers background in this paper
...Robots are increasingly being used in healthcare for applications such as surgery, pharmacy, telemedicine, dementia care, teaching autistic children, and transportation [4-6]....
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...The design of the robot is an important issue that can affect ease of use and acceptance [6]....
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14 Oct 2008
TL;DR: This study is studying long-term interaction in natural user environments and describes the implementation of a robot designed to help individuals effect behavior change while dieting, the first where a sociable robot interacts with a user to achieve behavior change.
Abstract: Human-robot interaction (HRI) is now well enough understood to allow us to build useful systems that can function outside of the laboratory. We are studying long-term interaction in natural user environments and describe the implementation of a robot designed to help individuals effect behavior change while dieting. Our robotic weight loss coach is compared to a standalone computer and a paper log in a controlled study. We describe the software model used to create successful long-term HRI. We summarize the experimental design, analysis, and results of our study, the first where a sociable robot interacts with a user to achieve behavior change. Results show that participants track their calorie consumption and exercise for nearly twice as long when using the robot than with the other methods and develop a closer relationship with the robot. Both are indicators of longer-term success at weight loss and maintenance and show the effectiveness of sociable robots for long-term HRI.
299 citations
"The cost-effectiveness of a robot m..." refers background in this paper
...Other research has shown people form a closer therapeutic alliance with robot diet coach than a computer diet coach [9]....
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TL;DR: Investigating the perceptions and emotions toward the utilization of healthcare robots among individuals over 40 years of age, investigate factors contributing to acceptance, and evaluate differences in blood pressure checks taken by a robot and a medical student finds individual attitudes and emotions regarding robots in general are likely to influence future acceptance.
Abstract: Fifty-seven (n = 57) adults aged over 40 years and recruited from local general practitioner or gerontology group lists participated in two cross-sectional studies. The first was an open-ended questionnaire assessing perceptions of robots. In the second study, participants had their blood pressure taken by a medical student and by a robot. Patient comfort with each encounter, perceived accuracy of each measurement, and the quality of the patient interaction were studied in each case. Readings were compared by independent t-tests and regression analyses were conducted to predict quality ratings. Participants' perceptions about robots were influenced by their prior exposure to robots in literature or entertainment media; however, they saw many benefits and applications for healthcare robots. Many expressed some concerns about reliability, safety, and the loss of personal care.
111 citations
"The cost-effectiveness of a robot m..." refers methods in this paper
...Furthermore, the blood pressure measurements taken by a robot have been shown to be similar to the blood pressure measurements taken by a human [12], indicating they are accurate....
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TL;DR: Results showed participants had more positive interactions with the robot compared to the computer tablet, including increased speech and positive emotion (smiling), and participation in the relaxation exercise, which suggests that robots may offer benefits over and above computer tablets in delivering healthcare.
107 citations
"The cost-effectiveness of a robot m..." refers background in this paper
...For example, people were more trusting of a robotic exercise coach, attributed more positive personality characteristics to it, were more adherent to its instructions, and wanted to interact with again more than they did a similar coach on a computer tablet [8]....
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11 Oct 2010
TL;DR: Both pre-interaction emotions and attitudes towards robots, as well as experience with the robot, are important areas to monitor and address in influencing acceptance of healthcare robots in retirement village residents and staff.
Abstract: This study investigated whether attitudes and emotions towards robots predicted acceptance of a healthcare robot in a retirement village population. Residents (n = 32) and staff (n = 21) at a retirement village interacted with a robot for approximately 30 minutes. Prior to meeting the robot, participants had their heart rate and blood pressure measured. The robot greeted the participants, assisted them in taking their vital signs, performed a hydration reminder, told a joke, played a music video, and asked some questions about falls and medication management. Participants were given two questionnaires; one before and one after interacting with the robot. Measures included in both questionnaires were the Robot Attitude Scale (RAS) and the Positive and Negative Affect Schedule (PANAS). After using the robot, participants rated the overall quality of the robot interaction. Both residents and staff reported more favourable attitudes (p < .05) and decreases in negative affect (p < .05) towards the robot after meeting it, compared with before meeting it. Pre-interaction emotions and robot attitudes, combined with post-interaction changes in emotions and robot attitudes, were highly predictive of participants' robot evaluations (R = .88, p < .05). The results suggest both pre-interaction emotions and attitudes towards robots, as well as experience with the robot, are important areas to monitor and address in influencing acceptance of healthcare robots in retirement village residents and staff. The results support an active cognition model that incorporates a feedback loop based on re-evaluation after experience.
72 citations
"The cost-effectiveness of a robot m..." refers methods in this paper
...Previously the robot Cafero has been deployed in a retirement village to provide healthcare services for residents, including entertainment, memory training, and taking vital signs [10]....
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...The doctors and nurses were trained in the use of RoboGen and could cut and paste the vital signs data (which were text-based codes) to Medtech32....
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...The vital signs data were sent by the robot to a secure medical server, RoboGen [10]....
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...Access to RoboGen was installed on the medical staff’ computers before recruitment began....
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