example, in surgical procedures, robots may provide clinicians with the
ability to perform less invasive procedures to areas of the body inaccessible
with existing instrumentation due to
issue or distance constraints. These
can include types of neurological, gastric, and fetal surgical procedures.
Direct robot users. When designing
robots for DRUs, there is great value
in designing straightforward solutions
to problems. At a recent workshop discussing healthcare robotics, people
with Amyotrophic Lateral Sclerosis
(ALS) and other conditions reported
that most of all they just wanted “a robot to change the oil.”
30 In other words:
help is most needed with basic, physical ADL tasks, such as dressing, eating,
ambulating, toileting, and housework.
Robots that can help people avoid falling could also be incredibly beneficial,
as falls cause thousands of fatal and
debilitating injuries per year.
Currently, standalone robots that
can successfully perform the majority
of these key physical ADL tasks are a
long way from reaching the consumer market. There are several reasons
for this. First, the majority of these
tasks remain challenging for today’s
robots, as they require a high degree
of manual dexterity, sensing capability, prior task knowledge, and learning capability. Furthermore, most
autonomous, proximate robots move
extremely slowly due to safety and
computational purposes, which will
undoubtedly be frustrating for end
users. Finally, even if robots could
perform some of these more complex
ADL tasks, their power budgets may
make them impractical for deployment in most care settings.
However, there have been substantial gains in recent years for other
tasks. For example, robots that provide DRUs with additional physical
reach (for example, smart on-body
prostheses, wheelchair mounted robot arms) and robots which provide
multi-setting mobility capability (for
example, exoskeletons, accessible
personal transportation devices).
These are likely to continue to be the
types of systems that reach end users
first for the foreseeable future.
Cognitive tasks. Clinicians. Any
technology that can effectively reduce
clinical workload is likely to be warm-
This article will focus on primary
beneficiaries; however, it is impor-
tant to note that all other stakeholder
groups are critical to the successful
end-deployment of robotics in health-
care, and should be included when
possible in decision-making.
Care settings. Another critical dimension to contextualizing the use of
robotics in healthcare is to consider the
location of use. This can significantly impact on how suitable different
technologies are for a given setting,
and can affect the design of a robot
and its required capabilities. For example, while a 400-lb, 5’ 4” dual-arm
mobile manipulator may work well in
a lab, it is ill-suited to an 80-sq. ft. room
in an assisted living facility. While it
is understandable robot makers may
immediately be more concerned with
achieving platform functionality than
the particulars of care settings, to successfully deploy healthcare robots, setting must be considered.
The accompanying table defines
different kinds of care settings, and
includes longer-term care facilities in
the community, as well as shorter-term
care facilities, such as hospitals. For
longer-term care in the U.S., the Fair
Housing Act, and Americans with Disabilities Act set some general guidelines for living space accessibility; however, the majority of space guidelines is
state-dependent, and can have a large
degree of variation. For example, an
assisted living facility in Florida must
provide 35-sq. ft. per resident for living and dining, whereas in Utah it is
100-sq. ft. An in-patient psychiatric facility in Kentucky must provide 30-sq.
ft. per patient in social common areas,
Oregon requires 120-sq. ft. in total and
40-sq. ft. per patient.
Robots in healthcare can also affect
the well-being, health, and safety of
both direct robot users and clinicians.
The field of evidence based health-
care design40 has produced hundreds
of studies showing a relationship
between the built environment and
health and wellness, in areas including
patient safety, patient outcomes, and
staff outcomes. When new technology
such as a robot becomes part of a care
setting, it is now a possible disruptor to
health. HAs must balance the risks and
benefits for adopting new technology,
and robot makers should be aware of
these tradeoffs in how they design and
test their systems.
Care tasks. Robots may be helpful
for many health tasks. Robots can provide both physical and cognitive task
support for both DRUs and clinicians/
caregivers, and may be effective and
helping reduce cognitive load. Task
assistance is particularly critical as
the demand for healthcare services
is far outpacing available resources,
which places great strain on clinicians
Physical tasks. Clinicians. Tasks involving the “3Ds” of robotics—dirty,
dangerous, and dull—can be of particular value for clinical staff. Clinicians
spend an inordinate amount of time
on “non-value added” tasks, for example, time away from treating patients.
The overburden of these tasks creates a
climate for error; so robots, which can
help clinicians effectively, surmount
these challenges would be a boon.
Some of these non-value added tasks
include: Transportation, such as moving materials or people from one place
to another, Inventory, such as patients
waiting to be discharged, Search Time,
such as looking for equipment or paperwork, Waiting, for patients, materials, staff, medications, and Overburdening of Staff and Equipment, such as
during peak surge times in hospitals.
Two of the best tasks for robots in
this task space are material transportation and scheduling, which robots can
be exceptionally skilled at given the
right parameters. For example, robots
that can fetch supplies, remove waste,
and clean rooms. Another task robots
can do that will help greatly improve
the workplace for clinicians is moving patients. This is a very hazardous
task—hospital workers, home health
workers, and ambulance workers experience musculoskeletal injuries between three and five times the national
average when moving patients according to NIOSH.
Robots can also help clinicians with
other dangerous tasks, such as helping
treat patients with highly infectious
diseases. Robot mediated treatment
has become particularly pertinent after
the recent Ebola outbreak, where clinicians and caregivers can perform treatment tasks via telepresence robots.
Finally, robots may help extend the
physical capabilities of clinicians. For