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Robots’ Role in Telemedicine
April 30, 2008
At several rural Kentucky hospitals, Kerri Remmel, M.D., is sometimes referred to as the “robot lady.” Remmel, however, didn’t earn the nickname as a result of a rigid bedside manner. Instead, some patients coined the term of endearment because she has used a robot to help treat them.
Last November, University of Louisville (Ky.) Health Care purchased 15 robots and a management system from InTouch Health, Santa Barbara, Calif., to help better deliver care at some of its referring facilities. And Remmel, interim chair of the department of radiology at the University of Louisville and director of the delivery system’s stroke center, is the first physician to use the technology.
The vendor’s Remote Presence System is designed to enable a physician at one location to treat patients at another by using a robot to see and talk with them. It uses wireless technologies to create a video network between the physician’s PC and the remote robot.
Digital video cameras and microphones on the robot transmit images over the network to the physician’s computer, which enables them to see where the robot is going. The physician’s computer also has video cameras and microphones that send an image of the doctor that’s displayed on the robot when they are conducting a telemedicine session.
Clinicians at the remote locations also use the robot to receive care instructions for their patients from physicians on the other end. And after a telemedicine consultation has been completed, their only maintenance responsibilities are to ensure the devices are charged and cleaned, Remmel says.
So far, UofL Health Care has deployed robots at 10 referring facilities that don’t have a stroke neurologist on staff, Remmel says. One other physician is using the technology to offer telemedicine services in the neonatology and infant ICU departments at those facilities.
The organization plans to evaluate whether the technology could be used for other specialties at up to 20 more hospitals, Remmel says.
“We have credentials in these other facilities so they already were calling me for care advice with stroke patients. Back then I’d have to make a decision over the phone about whether the patient needed to be brought to UofL Health Care for more specialized care or could stay at their own hospital,” she says. “Now I can use the robot to literally go in the patient’s room to determine that.”
Fast Deployment
Remmel and a neonatologist colleague both pushed UofL Health Care to invest in the robotic technology after seeing demonstrations of it last year while attending conferences for their respective fields of care.
“It is time-consuming and takes a lot of expertise to offer our services to places that don’t have stroke care,” Remmel says. “But one of the other advantages I thought the technology would offer was that if I could use it to look at patients, I might be able to keep them at their own hospitals near their families and save a bed here for someone who needs care here. I tended to be more conservative when I was evaluating them over the phone.”
It didn’t take long for the physicians to get delivery system executives and referring facilities to view the robotic system as an extension of services that already exist.
For example, when UofL Health Care announced it had purchased the technology, executives at one of its referring facilities, Owensboro (Ky.) Medical Health System, asked that it be deployed in their emergency department the next day.
The other seven hospitals signed on soon after Remmel and UofL Health Care executives demonstrated the technology at their facilities, she says.
“The administrators and I talked about the technology to ER directors at the other hospitals, then scheduled on-site demonstrations of it,” Remmel says.
Once a hospital agrees to host the robotic technology, the vendor helps set it up. UofL Health Care is paying all expenses for the initiative, but its executives declined to reveal the cost of each robot and how much they’ve spent so far.
The delivery system hasn’t yet measured its return on investment for the project, but executives never anticipated it would yield a profit, says Lucha Ramey, spokesperson for UofL Health Care.
Payer reimbursements for consultations, however, have been the same whether they are conducted face-to-face or via the robots, she adds.
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