Remote medicine: drones deliver healthcare to developing countries
Nigel Whittle, Head of Medical & Healthcare at Plextek, explores how disruptive technologies have the potential to transform the lives of millions in areas where access to health care is limited.
Much has been talked about with regards to the use of drones, or Unmanned Autonomous Vehicles (UAVs), for the delivery of commercial products. Back in 2013, Amazon’s Jeff Bezos claimed that drones would soon become ‘as normal as seeing mail trucks on the road’. However, this is yet to come to fruition and in reality, still seems to be a long way off.
In the meantime, the use of drones has quietly moved forward in another very significant sector. So, is the sky the limit when it comes to healthcare?
Earth versus sky
One of the biggest challenges facing the provision of affordable healthcare in the developing world is the patchy distribution of facilities and expertise. In particular, remote rural areas, as well as presenting environmental demands, often lack trained healthcare workers due to the difficulty in attracting practitioners. Many of the better educated and skilled locals migrate to the cities.
This problem is then compounded by the poor infrastructure of roads and other transport networks. As a result, it is not uncommon for patients, irrespective of age and physical health, to walk many miles over harsh terrain to see a healthcare practitioner, who themselves may have limited resources at hand. That walk may have to be repeated several times for further diagnosis and treatment. Recent examples of extreme weather events can render land transportation in any form hugely demanding.
But a paradox of developing countries is that they are actually often capable of leap frogging more advanced economies through infrastructure developments in the same way mobile networks have rapidly supplanted fixed line networks in numerous countries.
In the same way, disruptive technologies have the potential to transform the lives of millions of people living in countries where access to any form of healthcare is limited.
The main reason for this is that many novel diagnostic technologies are being designed for use at the actual point of care where the need is most acute, rather than for centralised hospital and laboratory facilities found commonly in the developed world. An example is the rapid and affordable DNA-based tests for infectious diseases, which not only provide sensitive indications of exposure to pathogens, but can also indicate the correct course of treatment for a particular problem.
Drones come into the equation by being able to bypass tough terrain and cover large distances without the restrictions and logistical risks associated with the reliance on transportation on the ground. They are able to deliver appropriate diagnostic tests and medicines to the patient faster and more safely while reducing the need for arduous treks.
The future is flying high
A number of developing countries are already deploying the use of drones to transport drugs, vaccines or medical aids and even blood. Perhaps one of the most impressive examples is Zipline International, a Silicon Valley start-up which uses the technology to support medical clinics in Rwanda. This system of delivering life-saving medicines and other health treatments has been so successful since its inception in 2016 that it is now also being rolled out in Tanzania.
It works simply by health workers based at remote clinics and hospitals texting orders for necessary medical products to Zipline. Within minutes they are loaded from distribution centres onto the drones, arriving by parachute just 15 minutes later for a journey which would previously have taken four hours. This agile supply chain can make a massive difference in the provision of critical healthcare to patients and at the same time empowers the doctors themselves.
This tried and tested success means it is likely that using drones for the distribution of high-value and diagnostic items in remote and adverse environments will only grow in demand and expand going forward. This in turn will lead to an increasing need for enhanced control and navigation systems.
Technology companies will need to design their drones specifically for this work and create the associated required solutions to take advantage of the potential demand. This could mean miniaturised systems with minimal size and weight but with the right power factors for successful and safe deployment and delivery.
Unmanned drones give us a remarkable example of how technology used in one part of the planet for one particular ‘first world’ industry can be used in a totally different geographical region for the provision of life saving care in another one. Their use in medical care can be for both routine requirements or in crucial scenarios where time is of the essence, such as during natural disasters or in medical emergencies.
Overall, we can expect to see an overhaul of quite significant proportions in the delivery of vital health care in many parts of the globe, which have for so long been restricted by physical and topographical constraints.
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.