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Robots for assisting with care and treatment in nursing homes and hospitals

Robotic systems have great potential in the healthcare sector. For example, intelligent care aids, such as robotic technologies, extended care trolleys and lifters make life easier for nursing home and hospital staff. Mobile robots that assist with transport tasks or guiding people can help patients become more independent. New robots for this field of application have been successfully developed at the Fraunhofer IPA for many years.

Dr.-Ing. Birgit Graf, head of the Household and Assistive Robotics research group at the Fraunhofer Institute for Manufacturing Engineering and Automation IPA in Stuttgart © Fraunhofer IPA

When people hear the words "robot" and "healthcare" in the same sentence, Star Wars-style humanoid robots pushing patients on wheelchairs through hospital corridors or around their homes immediately spring to mind. Dr.-Ing. Birgit Graf, engineer and head of the Household and Assistive Robotics research group at the Fraunhofer Institute for Manufacturing Engineering and Automation IPA in Stuttgart, knows all about the kind of robots used in the healthcare sector, the kind of procedures they are used for and how they will continue to assist staff and patients in the future1. In an investigation carried out on behalf of the Münch Foundation, researchers from the Fraunhofer IPA, in cooperation with the "Assistive Technologies" research group at the Frankfurt University of Applied Sciences, investigated the current state of affairs in the application of robots in the healthcare sector as well as research and future potential2. The researchers are specifically focused on robotic systems in the following fields of application: rehabilitation, assisting staff in nursing homes, hospitals and outpatient care, and systems to help people in their homes.

"The first robotic solutions for inpatient care will probably be in the field of logistics, i.e. robots with no arms whose primary benefit will be their ability to navigate autonomously," explains Birgit Graf. According to statistics from the International Federation of Robotics, more than 20,000 driverless transport systems (FTS) were sold in 2016 for non-production applications, including use in hospitals3. FTS are used in hospitals to independently pick up and transport large containers to wards. The nursing staff then distribute the content to temporary storage facilities and patient rooms. Due to the high demands that they place on hospital infrastructures, FTS are currently only commonplace in large hospitals with over 600 beds.

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Transport robots for smaller hospital facilities as well

The smart care trolley navigates autonomously and saves nurses long and time-consuming walks. © Fraunhofer IPA / Heike Quosdorf

The experts from the Fraunhofer IPA are planning to expand the benefits of existing solutions to specifically assist care staff, whose number is constantly decreasing, in their day-to-day activities. Researchers from the Fraunhofer IPA have developed a care trolley aimed at reducing physical workloads and promoting more use of service robots in smaller hospitals and care homes. The trolley was developed in cooperation with a company called MLR System GmbH as part of a BMBF-funded project called SeRoDi (Service Robotics in Nursing)4. The trolley supports care staff by providing them with the necessary care utensils wherever they are needed. "We are currently assessing three SeRoDi systems in practice. Two of them are being used to transport laundry containers in relatively small nursing homes and the third is being used as dressing cart in a ward at a larger hospital,” says Graf. The care staff use a tablet to direct the trolley to the rooms of patients whose wound dressings need to be changed. For privacy reasons, the trolley then waits outside the room to which it is called. “The trolley comes with an electronic care management system equipped with a touch screen that the nurses use to document which care utensils have been removed. We are currently working on further developing the care trolley in order to replace the touch screen with a sensor that automatically registers an item held underneath it. The staff therefore know at any given moment what is available in the trolley in what quantity. When the quantity of a certain utensil drops to a certain level, the trolley issues a warning. It is then sent back to the storage room where it will autonomously restock itself.

Robots help maintain care quality

SeRoDi is already the second project on “robots in inpatient care” Graf is coordinating. “A few years ago, we were involved in a project called WiMi-Care to find out where care staff see the need for using robots in patient care5,” says Graf. The researchers also found out that the acceptance of robots in patient care was quite high when it was clear that the robotic systems were technical aids for staff rather than systems to replace human beings. “Besides the functional aspects, the systems must be easy to use and reliable.”

Helping patients and nursing home residents to maintain independent lives

It is highly likely that the Care-O-bot 4 will soon be used in hospitals to assist visitors and patients. © Fraunhofer IPA, Photos: Rainer Bez (2015)

In addition to providing assistance to hospital staff in their day-to-day work, robots can also be put to good use in assisting nursing home residents as well as hospital patients and visitors. In 2016, around 1000 robots were sold for these types of applications3. Mojin Robotics GmbH, a Fraunhofer IPA spin-off, which builds such robots is specifically focused on the Care-O-bot 4, a robotic sustem that has for quite some time been guiding customers in Saturn stores. However, Graf is convinced that the robot could also be used in hospitals to transport patients and their relatives, for example to treatment rooms or wards. The company is already in contact with institutions that are interested in trying out Care-O-bot 4. Other applications are already close to practical application. Graf comments: “We are currently focused on a mobile service assistant that will interact closely with nursing home residents to bring them drinks or snacks at the push of a button.” As care staff often lack the time to do this kind of thing, such a function would relieve pressure on staff and give nursing home residents greater independence.

Design of the robots plays an essential role in user acceptance

Using the example of the Care-O-bot6 service assistant, which has been developed and refined over the past 20 years, Graf explains why a robot that is made to look too like a human does not necessarily promote consumer acceptance. “We have tried to keep the robot's appearance fairly abstract, and do not try to make it look like a human being. Our experience shows that robots which look too human tend to frighten people, in the sense that they are scared that robots could easily make human beings superfluous. For this reason, some nursing homes refuse to use robots with a human-like appearance. The decision not to give Care-O-bot too human an appearance was made to avoid raising false expectations about the robot’s capabilities. If a robot looks too human, people would naturally think that it can do everything humans can do. The technology has a long way to go to reach that kind of capability. Under laboratory conditions, robots with arms can go to the kitchen and fetch something to drink. However, under realistic conditions, the complexity of a constantly changing human environment and the safety measures that need to be implemented for direct interaction between robotic arms and human individuals, have so far prevented widespread use of humanoid robots. Graf believes that the use of robots in the healthcare sector is limited as robots that can execute more complex assistive functions are still prohibitively expensive. Covering the costs for currently available robotic solutions is already a challenge for care facilities and hospitals. Graf believes that leasing models might be the solution.

References:

1 Household and Assistive Robotics at the Fraunhofer IPA https://www.ipa.fraunhofer.de/de/Kompetenzen/roboter--und-assistenzsysteme/haushalts--und-assistenzrobotik.html

2 Robotik in der Gesundheitswirtschaft, Einsatzfelder und Potenziale, Stiftung Münch (Ed..), 1. edition, 2018

3 International Federation of Robotics: World Robotics Service Robots. Statistics, Market Analysis, Forecasts, Case Studies, ed. by Martin Hägele. Frankfurt am Main 2017.

4 Project SeRoDi: Service robotics providing support for personal services. http://www.serodi.de/

5 WiMi-Care: Supporting the Knowledge Transfer for a Participative Design of the Care Work Sector through Microelectronics (WiMi-Care) https://www.uni-due.de/wimi-care/index_en.php

6 Robotic assistant Care-O-bot http://www.care-o-bot.de

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