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Is the use of a mobile robotic system to evaluate patients in the emergency department acceptable and feasible?
In this survey and cohort study comprising a national survey of 1000 participants across the US and a single-site cohort of 40 patients presenting to the emergency department, 93% of participants reported that their experience of interacting with a mobile robotic system was satisfactory, and most participants believed that using a robotic system for facilitating health care tasks was acceptable. A total of 83% of participants reported that their experience with a robotic system–facilitated triage interview in the emergency department was equivalent in quality to an in-person interview conducted by a clinician.
In this study, the use of a mobile robotic system was perceived as satisfactory and acceptable for the facilitation of health care tasks in a hospital setting.
Before the widespread implementation of robotic systems to provide patient care during the COVID-19 pandemic occurs, it is important to understand the acceptability of these systems among patients and the economic consequences associated with the adoption of robotics in health care settings.
To assess the acceptability and feasibility of using a mobile robotic system to facilitate health care tasks.
Design, Setting, and Participants
This study included 2 components: a national survey to examine the acceptability of using robotic systems to perform health care tasks in a hospital setting and a single-site cohort study of patient experiences and satisfaction with the use of a mobile robotic system to facilitate triage and telehealth tasks in the emergency department (ED). The national survey comprised individuals living in the US who participated in a sampling-based survey via an online analytic platform. Participants completed the national survey between August 18 and August 21, 2020. The single-site cohort study included patients living in the US who presented to the ED of a large urban academic hospital providing quaternary care in Boston, Massachusetts between April and August 2020. All data were analyzed from August to October 2020.
Participants in the national survey completed an online survey to measure the acceptability of using a mobile robotic system to perform health care tasks (facilitating telehealth interviews, acquiring vital signs, obtaining nasal or oral swabs, placing an intravenous catheter, performing phlebotomy, and turning a patient in bed) in a hospital setting in the contexts of general interaction and interaction during the COVID-19 pandemic. Patients in the cohort study were exposed to a mobile robotic system, which was controlled by an ED clinician and used to facilitate a triage interview. After exposure, patients completed an assessment to measure their satisfaction with the robotic system.
Main Outcomes and Measures
Acceptability of the use of a mobile robotic system to facilitate health care tasks in a hospital setting (national survey) and feasibility and patient satisfaction regarding the use of a mobile robotic system in the ED (cohort study).
For the national survey, 1154 participants completed all acceptability questions, representing a participation rate of 35%. After sample matching, a nationally representative sample of 1000 participants (mean [SD] age, 48.7 [17.0] years; 535 women [53.5%]) was included in the analysis. With regard to the usefulness of a robotic system to perform specific health care tasks, the response of “somewhat useful” was selected by 373 participants (37.3%) for facilitating telehealth interviews, 350 participants (35.0%) for acquiring vital signs, 307 participants (30.7%) for obtaining nasal or oral swabs, 228 participants (22.8%) for placing an intravenous catheter, 249 participants (24.9%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed. The response of “extremely useful” was selected by 287 participants (28.7%) for facilitating telehealth interviews, 413 participants (41.3%) for acquiring vital signs, 192 participants (19.2%) for obtaining nasal or oral swabs, 159 participants (15.9%) for placing an intravenous catheter, 167 participants (16.7%) for performing phlebotomy, and 371 participants (37.1%) for turning a patient in bed. In the context of the COVID-19 pandemic, the median number of individuals who perceived the application of robotic systems to be acceptable for completing telehealth interviews, obtaining nasal and oral swabs, placing an intravenous catheter, and performing phlebotomy increased. For the ED cohort study, 51 individuals were invited to participate, and 41 participants (80.4%) enrolled. One participant was unable to complete the study procedures because of a signaling malfunction in the robotic system. Forty patients (mean [SD] age, 45.8 [2.7] years; 29 women [72.5%]) completed the mobile robotic system–facilitated triage interview, and 37 patients (92.5%) reported that the interaction was satisfactory. A total of 33 participants (82.5%) reported that their experience of receiving an interview facilitated by a mobile robotic system was as satisfactory as receiving an in-person interview from a clinician.
Conclusions and Relevance
In this study, a mobile robotic system was perceived to be acceptable for use in a broad set of health care tasks among survey respondents across the US. The use of a mobile robotic system enabled the facilitation of contactless triage interviews of patients in the ED and was considered acceptable among participants. Most patients in the ED rated the quality of mobile robotic system–facilitated interaction to be equivalent to in-person interaction with a clinician.
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Accepted for Publication: January 14, 2021.
Published: March 4, 2021. doi:10.1001/jamanetworkopen.2021.0667
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Chai PR et al. JAMA Network Open.
Corresponding Author: Giovanni Traverso MB, BChir, PhD, Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, 3-340, Cambridge, MA 02139 (email@example.com).
Author Contributions: Drs Chai and Traverso had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Chai, Dadabhoy, Huang, Chu, da Silva, Raibert, Hur, Boyer, Traverso.
Acquisition, analysis, or interpretation of data: Chai, Dadabhoy, Chu, Feng, Le, Collins, Hur, Boyer, Traverso.
Drafting of the manuscript: Chai, Dadabhoy, Huang, Chu, Feng, Le, Collins, Hur, Boyer, Traverso.
Critical revision of the manuscript for important intellectual content: Chai, Dadabhoy, Chu, da Silva, Raibert, Hur, Boyer, Traverso.
Statistical analysis: Chai, Dadabhoy, Le, Collins, Hur.
Obtained funding: Dadabhoy, da Silva, Boyer, Traverso.
Administrative, technical, or material support: Chai, Dadabhoy, Huang, Chu, da Silva, Raibert, Hur, Boyer, Traverso.
Supervision: Chai, Dadabhoy, Chu, Raibert, Boyer, Traverso.
Conflict of Interest Disclosures: Dr Chai reported receiving grants from E Ink, the Hans and Mavis Lopater Psychosocial Foundation, and the National Institutes of Health (NIH) during the conduct of the study. Dr. Boyer reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Traverso reported receiving grants from Freenome, Novo Nordisk, and Oracle; personal fees from Eagle Pharmaceuticals, Merck, Novo Nordisk, Synlogic Therapeutics, Verily Life Sciences, and Wired Consulting; having a financial interest in Bilayer Therapeutics, Celero Systems, Lyndra Therapeutics, Suono Bio, Teal Bio, and Vivtex; and royalties from Exact Sciences, and Horizon Therapeutics outside the submitted work. Dr Traverso reported receiving nonfinancial support for access to Dr Spot from Boston Dynamics during the conduct of the study. No other disclosures were reported.
Funding/Support: This study was supported by grant NIH K23DA044874 from the Hans and Mavis Lopater Psychosocial Foundation (Dr Chai), grant R44DA051106 and investigator-initiated research grants from e-Link Corporation (Dr Chai), grant T32DK007191-45 from the NIH (Dr Chu); grant R01DA047236 from the NIH (Dr Boyer), and funding from the Karl van Tassel (1925) Career Development Professorship at the Massachusetts Institute of Technology (Dr Traverso), the Department of Mechanical Engineering at the Massachusetts Institute of Technology (Dr Traverso), and the Division of Gastroenterology at Brigham and Women’s Hospital (Dr Traverso).
Role of the Funder/Sponsor: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: Andrew Tsang, MS, Seth Davis, BA, Gene Merewether, MS, Joy Hui, BS, Mike Grygorcewicz, BS, Kim Ang, BS, and Nick Sipes, MS, of Boston Dynamics provided technical support for this study. The team at GT Reel Productions, specifically Giancarlo Traverso, provided assistance with assembly of the supplementary videos.
Additional Information: The SolidWorks plans for health care payloads that were used on the quadruped robotic system are available at https://github.com/boston-dynamics/bosdyn-hospital-bot. Individual data from the public survey and decision analytic model are available in the Supplement. Individual data from the emergency department cohort study are available at https://figshare.com/articles/dataset/_/13476759.
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