Just about every job description includes tasks involving repetition, monotony or drudgery. At healthcare organizations, such work often pulls employees away from their main responsibilities and can detract from patient care. One solution: More hospitals are letting robots do more of the chores.
Magee-Women's Hospital in Pitts-burgh is among those that have joined the age of robotics.
"Some (employees) like to push the medical record carts around," says Linda Antonelli, vice president for facilities and support services at Magee-Women's. However, she realizes it's certainly not the most efficient use of their time.
In an effort to keep more hospital workers at the point of care by lessening some of the more mundane tasks, Magee-Women's has started using a robot to transport supplies to various parts of the hospital. These mechanized couriers are just one way that hospital executives say they are using robotics to help improve efficiency and reduce errors at their facilities.
Many pharmaceutical laboratories in hospitals have started automating the labeling and testing of samples, a process that has been called "hands free" because the robots have limited the technicians' handling of the specimens. Other healthcare facilities are using robotic communication devices that allow doctors and patients to interact when they are in different locations.
The robots are being used to increase patient satisfaction, reduce mistakes and relieve some workforce shortages. Through the lab automation alone, hospitals are now spending $30 million per year on the systems, according to Diagnostic Testing & Technology Report, an industry newsletter.
Courier robots are newer, and it's more difficult to pinpoint how much hospitals are investing in them overall.
At least three companies -- Pittsburgh-based Aethon; San Diego-based Pyxis Corp., a subsidiary of Cardinal Health, Dublin, Ohio; and Lake Arrowhead-based California Computer Research -- offer the courier robots. The Aethon robot looks something like R2-D2 of "Star Wars" fame, only with a flat head.
Tireless helpers
The Aethon product, called a Tug, is being used in at least five hospitals including Magee-Women's, which has been a testing site for the robot since 2003. The company charges about $1,250 per month for the Tug, but a cost analysis by Aethon shows that hospitals on average would pay a person $92.50 per shift to do what a Tug can do for about $18.86 per shift.
Robert Brennan, director of materials management at Magee-Women's, says the Tug has been able to help reduce the hospital's overtime costs but said it was too early to come up with a firm figure. The hospital uses two Tugs, one with a locked cabinet for transporting pharmaceuticals and another attached to a cart that transports medical equipment, usually from the supply room to the surgical suite.
"We try to keep them away from the public," Brennan says. "We try to keep it in the service corridors." The hospital tries to limit the robots' running routes to the service hallways because it's easier to keep them clear of obstacles and pedestrians, but that isn't always possible.
Visitors are usually impressed by the Tug and marvel when they do see it, Antonelli says. Aldo Zini, president and chief executive officer of Aethon, calls the Tug "a circuit board on wheels." The Tug is about a foot long and about half a foot high and attaches to the bottom of a specially designed cart.
The machine has a sensor, so if someone or something does get in its way it will stop before a collision occurs. The Tug is also equipped with a camera, which beams images to Aethon's headquarters, where operators monitor the Tugs round the clock. Workers can direct the robots from Aethon's office or the hospital.
A map of the hospital is programmed into the Tug. Usually it works like this: When a request for a delivery is made, a worker in the supply room will load the cart and then select the destination for the Tug through a touch-tone screen.
On the screen, workers can track the Tug's progress. As the machine moves about the hospital, it triggers sensors that open doors and summon elevators. As it approaches an elevator, the Tug will announce, "Calling elevator."
Speakers are located inside the rooms to which the Tug delivers. Once the robot reaches its destination it sends a message -- which is audible through the speakers -- alerting workers to unload the cart. After unloading, the Tug then returns to the supply room, where it can be restocked or insert itself into a charger.
Antonelli is happy with the Tug, but she wishes the device could attach itself to other types of carts. For instance, Antonelli says it would be nice if the Tug could attach itself to a laundry cart and bring it to the laundry room. Zini says the company is working on a Tug that can attach to any cart, a model that could be on the market next year. He also says in about a year the company will be able to roll out a radio frequency identification, or RFID, system through the Tug, which will help locate medical equipment.
He says RFID tags could be attached to hospital equipment and as the Tug passes through the hospital it can locate the items, creating an inventory list of where the equipment is located.
"If I could keep track of wheelchairs alone, that would be great," Antonelli says.
Antonelli doesn't think Magee-Women's will invest in the RFID system right away, but there was also some initial resistance to the Tug.
"I think (workers) were afraid they were going to be replaced" by the Tug, she says.
Now, many in the hospital would like to have a Tug in their departments -- indeed, a hospital lawyer jokes that she wants a paralegal Tug -- but Antonelli says departments can add them only if their purchase is budget-neutral.
Zini cites some of Aethon's cost-analysis studies and says one Tug equals one-half of a full-time equivalent employee. Magee-Women's rents its Tugs for $1,250 per month.
Cardinal Health purchased HelpMate Robotics, which developed a courier robot in 1999. The HelpMate, which stands 4 feet 6 inches tall, can weigh up to 600 pounds and has a 24-inch-by-26-inch storage capacity.
The company has deployed 108 robots at 78 healthcare facilities, and like the Tug they're used to make deliveries of various supplies and equipment. It differs from the Tug because the entire robot is one unit, while the Tug attaches itself to a cart. Including installation, the HelpMate goes for about $150,000 -- it can also be rented -- and the company says a hospital can see a return on investment in 18 to 24 months.
Unlike the Tug or Cardinal's HelpMate, California Computer Research's RoboCart runs along a fixed path.
The RoboCart is mostly used to transport specimens from one end of a clinical laboratory to the other. The RoboCart is being used in about 10 hospitals in the U.S. and in 15 hospitals abroad, according to its manufacturer. At a RoboStation, robotic arms attached to a table load and unload the RoboCart.
The RoboCart travels along a path marked by special tape, and technicians can operate it with a handheld device, says Don Nagy, president of California Computer Research. The RoboCart costs about $1,375 per month to rent or about $25,000 for purchase and installation, according to the company.
Denise Geiger, laboratory director at John T. Mather Memorial Hospital in Port Jefferson, N.Y., thought about adding a courier robot to address some of the workforce shortage problems at her hospital, but instead decided to purchase a lab automation system. Largely because of an aging and growing population in its market, the hospital has witnessed a 100% increase in emergency room visits since 1996 and now receives about 40,000 visits per year. Despite the accompanying increase in lab workload, the hospital hasn't had to add staff, in part thanks to increased automation. "We have the same number of FTEs and double the volume," Geiger says.
About four years ago, the hospital purchased a lab automation system from Beckman Coulter. These systems, which move blood samples like bottles through a brewery, are currently in about 200 hospitals, but that number is expected to reach about 300 hospitals by year-end, according to Diagnostic Testing & Technology Report.
"It's a hands-free process," Geiger says, "completely computerized."
At Geiger's hospital, about 60 tests can be performed through the system, and it takes about 45 to 60 minutes for completion. "Before it was unpredictable" when a test might be completed, she says.
The results have improved patient flow, which leads to fewer unnecessary admissions and savings of close to $2 million per year, according to the hospital.
The process usually starts in the emergency room. Staff members in the ER label a lab specimen with a bar code that indicates which patient the sample is from and what tests need to be performed. The samples are then put on a conveyor belt that leads into the laboratory. From there, the sample can be tested and placed into a refrigerated storage bin, all without a lab technician handling it. This process eliminated about 14 steps for technicians, and it's helped the hospital realize a 20% decrease in possible errors, Geiger says.
InTouch Health, Goleta, Calif., has developed a 5-foot-6-inch mobile robot that might stir up images of Number 5 from the 1986 movie "Short Circuit." Unlike Number 5, this robot needs to be operated by a user.
The robot is designed for doctors to communicate with patients, even when doctors are not in the same building, a process that's been dubbed "telerounding." The University of California-Davis Medical Center is taking part in a study, which started in August, that's examining whether telerounding is as safe as performing traditional rounds.
"It's basically a remote teleconferencing system," says Charles Casey, a hospital spokesman. Hospitals need a wireless Internet connection to use the robot.
Lars Ellison, a UC-Davis urologist, has been using the robot, which the hospital has nicknamed Rudy. Ellison can sit in his office, located about three blocks from the hospital, and check on patients via Rudy. A camera pointed at the doctor portrays his image on the screen that serves as Rudy's head. Ellison speaks into a microphone and steers Rudy with a joystick.
The hospital is leasing the robot for about $3,000 per month, and the study should be concluded in about six months. The hospital hasn't identified how Rudy can save money, but Casey says the benefits will be in improved patient satisfaction. UC-Davis will also use Rudy as a teaching tool.
The robot is good for doctors, such as Ellison, who work at more than one hospital. It's often more reassuring for patients to speak with a doctor who has been treating them, and the camera on Rudy lets him zoom in close, enabling the doctor to examine an incision.
"There's a chuckle factor involved," Casey says. He adds: "On its surface it's strange, but everyone has liked it."
