Robots do ward rounds in pandemic

Robot helps Tygerberg specialists on ward rounds.

Intensive-care specialists at Tygerberg Hospital have a new infection-resistant “colleague” helping them do ward rounds on Covid-19 patients.

“Quintin” – as “he” is affectionately called – is a Double Robotic robot that has been employed to help specialists do virtual ward rounds – even from home – if they are unable to be physically present.

Coenie Koegelenberg, professor of pulmonology at Stellenbosch University’s Faculty of Medicine and Health Sciences (FMHS), started experimenting with options to perform virtual ward rounds in the intensive care unit (ICU) of Tygerberg Hospital shortly before South Africa’s lockdown, and is assured that ICU specialists can, indeed, run ward rounds remotely, using robots as tireless helpers that can’t get infected.

Tygerberg Hospital has a limited number of specialists in its general medical ICU at present.

“Between the specialists, we will share the workload of Covid-19 patients who end up in ICU. The odds of at least one or all of us falling ill are quite high, so we need to realistically plan for what could happen.

“If any of the specialists gets the virus and is unable to physically go to work, we will be able to function remotely using the robot, from a phone or a laptop,” said Professor Koegelenberg.

“Using this device will enable us to provide a service if our skills sets are in short supply.”

The idea of using robots came about through “a combination of thoughts of many people,” Professor Koegelenberg said.

“We started wondering how we could help more people if we ourselves were to fall ill.”

His wife, Dr Suretha Kannenberg, a dermatologist, had told him about this device.

“In mid-March, on my way home after many meetings, I wondered whether ‘virtual’ ward rounds in many ICUs could be feasible. I phoned my wife and shared my thoughts. I had thought of using a fancy ‘nanny cam’ she bought a few years ago.

“She suggested using the Sunskill laboratory’s Double Robotic robot instead. (Sunskill is a state of the art clinical training facility at the FMHS).

“I was not familiar with this device. The next day I met with Professor Ian Vlok from the FMHS’ Division of Neurosurgery, and the Sunskill facilities manager, Bronwyn Stockenstrom who gave me a crash course on how to use the Double Robotic robot,” said Professor Koegelenberg.

The Sunskill lab without any hesitation agreed to have the robots be used in the ICU until the pandemic is over.

“On the next Friday, Dr Usha Lalla (Tygerberg Hospital’s head of ICU) and I tested the device. We performed a full ICU ward round without entering the ICU.

“It was truly an eye opener and a potential game changer in this and future similar pandemics. It was a remarkable success.

“We both concluded (with more than 30 years of combined experience in ICU) that our physical presence was not required, and that the technology has great potential to be rolled out.

“This is, of course, anecdotal and not ‘true evidence’, but desperate times calls for desperate measures.

“Moreover, should one of us be under self-quarantine, we would be able to work from home, added Professor Koegelenberg.”

The robot looks like an computer tablet and has two wheels, uses gyroscope and accelerometer sensors in its base and can be controlled from a desktop, tablet or smartphone.

It enables communication between patient and doctor through a microphone and a zoom function and can relay vital signs of highly infectious patients.

Robots have also been used in Italy, where the pandemic has claimed many lives, including those of doctors.

The use of the robot at Tygerberg Hospital is yet another example of how the pandemic has brought ingenuity and collaboration to the fore.

“This has been a team effort – and such a bonding experience,” said Professor Koegelenberg.

Professor Vlok, who oversees activity at the Sunskill lab, said: “The Sunskill clinical training facility uses world class technology to further the skills training of our postgraduate students at Stellenbosch University.

“The robots have given us access to international and national experts in their fields for training with their virtual presence guiding the teaching and training,” added Professor Vlok.

“Now the same technology can allow us to carefully navigate and manage patients in a high-risk environment and reduce risk to our staff.

“I sincerely hope this initiative will not only have a positive effect during this pandemic but open the door for further innovation and collaboration.”

Sue Segar is a freelance writer for Stellenbosch University.