Doctor Who. Robots do patient support.
Part of being at the forefront of patient support programs is being aware of new technology and how this can facilitate adherence.
More and more, we are seeing a movement away from massed information delivery to tailored individualised programs, with research showing improved outcomes accompanying this shift. Our clients are also recognising the need to embrace technology, with more programs having a web-based component, and increased use of text messaging, emails and smart technologies to measure adherence.
Often the use of technology is limited to the population that is targeted. Younger generations tend to embrace technology readily, but there is an increasing trend in the older populations to also do so. Understanding the use of technology in the older population is crucial if we are to cater appropriately for this group and combat the misperception that the elderly do not use health-related technology. I recently had this misconception corrected by an 82-year-old woman I sat next to on a flight who was texting her grandchild prior to take off, and who reported that she now used the internet to gather information about her medication and disease state.
There is little debate that we live in an ageing population, with the proportion of 60+-year-olds worldwide being predicted to double between 2000 and 2050. This means that our current limited healthcare services would be further stretched by having to manage the increasing numbers of people with chronic health conditions. This would exacerbate the difficulties around the shortage of medical professionals even further, and increase the need for good patient support programs and the implementation of newer technologies.
An advancing field that may assist with these deficits is the use of health robots. Healthcare robots can be broadly categorised into those that provide physical assistance, those that provide companionship, and those that monitor health and safety. Robots have been built and used in surgery, rehabilitation therapy, facilitating independence for the disabled and cognitively impaired, increasing motivation to exercise and lose weight, and for telemedicine, meal delivery, medication delivery and hospital laundry.
Dr Elizabeth Broadbent of The University of Auckland is a leading researcher in the field of health robotics. At present, Dr Broadbent is involved in a three-year project to develop a health robot to assist the elderly. She states that, “[health robots] are the way of the future” and indicates that the current project aims to develop helpful technology for the ageing population. At present, the project is working with elderly residents at a rest home to identify which tools would make a robot most useful for them. Again challenging the perception that the elderly do not embrace technology, residents have indicated that they would like a robot to assist with detecting falls and calling for help, switching appliances on and off, cleaning, contacting doctors or nurses, and reminding them to take medications. Staff at the home also indicated that robotic assistants would be useful with tasks such as measuring vital signs, general reminders for patients, and locking the house at night.
There is increasing media attention around the development of health robots. Carnegie Melon University has developed a robot call Pearl to provide assistance in rest-homes. Pearl can guide older people around, and give reminders about medical appointments and medications. In Japan and Europe, researchers are developing devices to enable older people to remain in their homes for longer. Wakamaru, a robot produced by Mitsubishi for the home, can distinguish people by face recognition and can provide daily schedule and medication reminders, monitor the home for burglars, send emails if someone has fallen over or is not responding, or if usual activities are missed. Similarly, the French AILISA French project includes a smart-shirt that monitors physiological signs, detects falls and assists with walking. Health-smart homes can help provide measures of health on a daily basis.
Social robots, with the aim of decreasing loneliness and isolation, have also been found useful and accepted by older people. The Hug is a large cushion-like robot that you can hug and electronically send to another Hug in another location so that someone there can receive it. For those elderly people who can no longer care for a pet, the AIBO, a robot toy dog has been created. Loneliness has been reduced in patients in long-term facilities who have used AIBO and communication improved in dementia patients. Similar robots that have also been produced have been found to be well-liked by older people in rest-homes and hospitals, at the same time increasing social communication, mental stimulation and providing comfort.
The future of robotics in healthcare is promising, with researchers needing to carefully design the robots to be functional as well as acceptable to the target population. Dr Broadbent states that whilst the current project has generated interest and has appeared acceptable to their research participants in the current study, it is likely that the demand for such technology will increase and be more readily accepted as younger generations age. She further emphasises that robots are designed to supplement care, and not to replace it.
The use of robots in healthcare currently creates a number of interesting possibilities and opportunities to utilise cutting-edge technology. It is likely that as robots become more advanced and researched, we will see more of them in areas where there is a great demand, including rest homes and teaching hospitals. In terms of supporting patients to be more adherent to their medication regimens, there appears to be a niche for robotics, particularly in terms of primary non-adherence (failing to take medication as a result of forgetting). Other advantages potentially include measuring physiological reactivity and adjusting medication in response to this and communicating with caregivers and HCPs about health status.
Robotics is likely to have a significant impact on healthcare and adherence in the future and will be an area that we will be monitoring with interest here at Atlantis Healthcare.
Liesje Donkin
Health Psychologist
Atlantis Healthcare Australia
