Saturday, July 14, 2007

BALTIMORE

Has it come to this? Robots standing in for doctors at the hospital patient’s bedside?

Not exactly, but some doctors have found a way to use a videoconferencing robot to check on patients while they’re miles from the hospital.



One is at Baltimore’s Sinai Hospital. Outfitted with cameras, a screen and microphone, the joystick-controlled robot is guided into the rooms of Dr. Alex Gandsas’ patients where he speaks to them as if he were right there.

“The system allows you to be anywhere in the hospital from anywhere in the world,” said the surgeon, who specializes in weight-loss surgery.

Besides his normal morning and afternoon in-person rounds, Dr. Gandsas uses the $150,000 robot to visit patients at night or when problems arise. The robot can circle the bed and adjust the position of its two cameras, giving “the perception from the patient’s standpoint that the doctor is there,” the surgeon said.

“They love it. They’d rather see me through the robot,” he said of his patients’ reaction to the machine.

Dr. Gandsas presented the idea to hospital administrators as a method to more closely monitor patients following weight-loss surgery. Dr. Gandsas, an unpaid member of an advisory board for the robot’s manufacturer who has stock options in the company, added that since its introduction, the length of stay is shorter for patients visited by the robot.

A chart-review study of 376 of the doctor’s patients found that the 92 patients who had additional robotic visits had shorter hospital stays. Dr. Gandsas’ study appears in the July issue of the Journal of the American College of Surgeons.

Nicknamed Bari for the bariatric surgery Dr. Gandsas practices, the RP-7 Remote Presence Robotic System by InTouch Technologies is one of a number of robotic devices finding their way into the medical world. Across town at Johns Hopkins, for example, a similar robot is used to teleconference with a translator for doctors who don’t speak their patient’s language. Robotic devices are also used to guide stroke patients through therapy and help them play rehabilitative video games.

Michael Chan, executive vice president with InTouch Technologies, said his company’s device allows physicians to “be in more than one place at once.”

Speaking with Dr. Gandsas through one of the robots at company headquarters in Santa Barbara, Calif., Mr. Chan said the company envisions the devices’ application in remote locations and for dealing with shortages of health care professionals. About 120 of the robots are used in hospitals worldwide.

Sinai patient David Williams said he appreciated the fact that Dr. Gandsas knew the details of his care.

“If you’re laying flat like this and you see his face, I don’t care what the man’s dressed in. You’re seeing him and you’re talking to him and he’s answering your questions,” said Mr. Williams, a retiree from Falling Waters, W.Va.

Nurse Florence Ford, who has worked with the robot since it was introduced 18 months ago, said patients have reacted well, particularly because “seeing the doctor’s face gives them confidence.”

Dr. Louis Kavoussi, chairman of the urology department at the North Shore-Long Island Jewish Health System, said a study he did on the use of InTouch robots found no decrease in patient satisfaction or increase in complications. Dr. Kavoussi said the field is in its infancy and he expects growth in the use of such devices.

“This is a very rudimentary robot. It doesn’t do a whole lot other than videoconference with patients. But it’s the beginning of this technology,” Dr. Kavoussi said, adding that robots might not be the only form it takes.

“The same monitor you watch your entertainment on you’ll be able to order your lunch menu, instead of having those paper menus, and you may be able to interact with your nurses and doctors right at the bedside.”

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