TOLEDO, Ohio (AP) — There is a new physician's assistant in the emergency room at Mercy St. Vincent Medical Center, but this one is not human. A robot named Vincent by the hospital staff, or Vinnie for short, is breaking ground in medical treatment in northwest Ohio.
The remote-presence robot, RP7, can be controlled by a doctor from his office, home, or car through any computer device, even a smartphone, and commanded to roll on its own into any room in the emergency department.
The doctor's face appears on a large flat-screen monitor attached to the robot and he or she can talk directly to a patient or another medical professional in the room with the patient. The robot comes equipped with medical instruments such as stethoscopes that can be placed on the patient's body and the doctor can remotely hear the patient's heartbeat and assess other vital signs from miles away.
Telemedicine, as it is called, has arrived in Toledo and it is changing the way medicine is practiced nationally and globally, said Dr. John Whapham, medical director of endovascular, neurosurgery, and stroke program for Mercy.
Whapham is a telemedicine pioneer, having been instrumental in building a program at St. Joseph Mercy hospital in the Detroit area called the Michigan Stroke Network. He helped create a similar program in Chicago that focused primarily on getting faster medical care to patients who were showing signs of having a stroke.
He said Vinnie has been "live" in the emergency room at St. Vincent for about two weeks and most patients have been accepting of the technology. They are also glad to know that a specialist such as Whapham is available to be a part of their care because the robot makes him accessible any time of the day or night.
Whapham has been in Toledo for about a year and a half, and is developing a regional telemedicine program for Mercy that experts say will break ground. Mercy officials said the program won't focus only on connecting doctors remotely to stroke victims. They plan to train doctors who specialize in cardiac, critical care, and trauma to use Vinnie in the hospital's emergency room and in other critical-care units, said Julie Georgoff, Mercy administrator of orthopedics and neuroscience.
Most telemedicine robots that you can't drive cost about $50,000, Georgoff said. Units like Vinnie can cost more than $100,000 because they can be driven remotely by a doctor. There is an even more advanced model, RPVITA, that can drive itself, memorize a hospital's layout, and navigate its way on to elevators, Whapham said.
Mercy's plans for Vinnie extend beyond St. Vincent, Georgoff said. The health system is setting up a regional network in which robots like Vinnie will be placed in other emergency rooms. Mercy Tiffin Hospital will be next, followed by other regional referral centers, including the Fulton County Health Center. This will make time-sensitive illness more of a priority, Georgoff said.
Whapham said the technology enables doctors to be in their offices and think of medicine not in terms of patients in the building, but patients in the entire network. Mercy plans to encompass all of Ohio's northern half and portions of Michigan and Indiana.
"It's neat for me because I'm a relatively younger physician and my specialty literally didn't exist when I was a resident," he said.
Whapham said many of the major medical centers in the country such the Mayo Clinic, the Cleveland Clinic, and Johns Hopkins have used this technology for years. But here in Toledo, his plans will take the use of the robots a step further than what's in use in other health systems.
He is pioneering the use of a smaller robot unit that can be placed in a Life Flight medical helicopter so doctors can start diagnosing and treating patients at the scene of accidents or during the flight from the accident to the hospital.
Whapham said he made history in his office in St. Vincent Medical Center on Jan. 20.
The small portable robot unit lifted from the teleport at St. Vincent in a Life Flight helicopter. The unit was being carried on the lap of the co-pilot for the flight from Toledo, through Chicago to Wisconsin, where it will be fitted with a special bracket so it can be put into service in the helicopter.
During the test flight, Whapham connected with the pilot and co-pilot through the robot for the entire trip, and received data, pictures, and information from the portable unit, giving him a glimpse of how the unit will perform when patients are in the helicopter.
At one point during the test, Whapham marveled at the quality of the pictures being sent back to his laptop. "Oh, wow, you have to see this, guys. Look at this from the air — how I can zoom. I can see individual cars and farms and stuff," he said.
"This was an overwhelming success and this is now the longest recorded telemedical flight in U.S. history. This is a very positive technological first step. The video is actually phenomenal. It's better than we thought we would get actually," he said.
He said the next step is to dissect the results and make some tweaks, but Mercy plans to put the unit in service right away. The unit will be operating as soon as the doctors finish the training.
About 50 doctors and residents will be trained to use the remote-presence units, Ms. Georgoff said. Some of the residents will be trained to do so on the medical helicopter, which also will be groundbreaking, Dr. Whapham said.
At the scene
"They can unhook it and take it directly to the scene of the accident or where the victim is," Whapham said. They also will have the capability of streaming live ultrasound and EKG imagery back to the hospital during the flight.
"I have not heard of anyone else using remote presence in helicopters in the country," said Rob Fisher, an executive with InTouch Technologies, Inc., the company that created the robots. He was the architect of the Michigan Stroke Network in 2006, in which Dr. Whapham trained in the telemedicine field.
"The Michigan Stroke Network was really the catalyst for this taking off nationwide in some of the larger hospitals like Mayo and Cleveland Clinic," Fisher said.
He grew up in Bryan and has many connections to Toledo. He graduated from the University of Toledo and has family in Perrysburg.
He said Whapham is one of the top experts in the country on the use of remote presence and telemedicine robotics and that he will put Toledo in the forefront of the field.
"Medicine is evolving," and the investment in this medical infrastructure is really changing the game, Whapham said.
"I've gone from having to drive into the hospital long distance to even understand what's going on with the patient before I could make a decision about treating them, to seeing them live on the way, checking in with them remotely and to have that kind of connectivity from your pocket, it's been a huge evolution in medicine and it's only going to continue."
Fisher said he already has seen how this technology can improve care for patients and save lives. About two years after the Michigan Stroke Network began, the state did an assessment. "They said your program has completely changed the approach to stroke in the state. It had elevated the level of stroke care in the state through the robot," he said.
Vinnie, the emergency room robot, and the smaller remote-presence unit that will be used in the medical helicopter were developed by InTouch, which does business under the name InTouch Health. This company has also assisted the U.S. military with technology used in the drone program, Georgoff said.
Whapham said what we are seeing is the use of the same technology in the drone program, turned around to help save lives.
"The country as a whole is trying to figure out how to give higher-quality health care at a lower cost, said Yulun Wang, InTouch's chief executive officer and founder.
As more and more doctors move into specialized fields, small and rural hospitals can't afford to employ all the varied specialists on staff. Wang believes telemedicine levels the playing field for those who don't live near major research hospitals.
"Imagine in the outskirts of Toledo, a person has a stroke. They go to a small hospital and the ER doctor is not trained in stroke and they don't know what to do. If they have an inkling it's a stroke, they can call Dr. Whapham and he can show up on the robot." Wang said.
Information from: The Blade, http://www.toledoblade.com/