In healthcare, robots make the biggest difference

The Netherlands must invest at least 100 million in robotics by 2025. It is not yet clear what part of that amount should be invested in robots for the healthcare sector. It is certain that the expected impact of robotics on the healthcare sector is the greatest of all sectors in the Netherlands, but the required investments are also the highest in the healthcare sector.

These are the main conclusions of the report ‘Opportunities for Dutch robotics – Investing together in application-oriented R&D’, drawn up by 18 leading industrial players and science institutes such as Philips, Demcon, TNO and six Dutch universities. The parties, plus a number of cluster organisations such as RoboValley and High Tech NL, work together under the umbrella of Holland Robotics.

Prosthetics

“That this impact on the healthcare sector is so great is due to the fact that the Dutch healthcare sector is not very far advanced in the field of robotics”, says Willem Endhoven, director of High Tech NL. Some functions now use robotics. Medical robots are used for minimally invasive treatments, endoscopies and micromanipulation, for example. Holland Robotics also mentions exo-skeletons, robots that you can ‘put on’, as a revolutionary new generation of prosthetics. The report predicts that the number of applications will increase significantly in the coming years, especially in the field of hospital logistics and rehabilitation care.

Human tasks

Holland Robotics refers to the report ‘Deployment of the care robot essential for future care of the elderly’, published by KPMG in August 2017. It calculates that care can no longer be provided without robotics. Willem Endhoven: “We have to deal with less and less available personnel for care. At the same time we are getting older and the group of needy people is growing. So we need to look at what tasks people actually still have to perform. Think about putting on compression stockings. A robot can do that very well, giving a nurse time to talk to a patient.” Moreover, this does not exclude the need to develop sociobots, which contribute to the social inclusion of the elderly, the disabled and other homebound people.

Smart beds

The first trials with smart beds are being carried out in hospitals. A number of nursing tasks are taken over by the beds and patients need to be disturbed less for example for weighing and turning in bed to prevent bedsores. Robots are also used to change the beds. Now that’s time consuming and hard work for the nurses. By using robots a lot of downtime is prevented and nurses can spend their time on nursing tasks. Nurses can therefore greatly appreciate the use of the robots (3). The robots that change the beds not only gently lift the sheets, but also directly disinfect the mattresses by means of UV light. Patients can’t appreciate the robots changing their beds. At first they even have a lot of resistance (-3). Once they see that this is happening safely, the resistance decreases slightly (-2), but they prefer to have the attention of the nurses. However, due to the large shortage of personnel, the deployment of the robots seems to be an irreversible road.

Future

“The scope of our report is: what happens in five to ten years?” says Endhoven. “What happens in the next two years is important but less interesting. Those projects are up and running.” Holland Robotics wants to investigate the wishes and possibilities in the future. Willem Endhoven: “As industry and science we have kicked off with this report. Now we want to get in touch with users – for example doctors and nurses from hospitals and nursing homes – to see what areas we need to develop”. To this end, the report identifies six technological issues that differ in nature, namely: system development, human/robot interaction, mechatronics, perception, navigation and cognition, and learning. In health care, which involves a lot of working with people, themes in the field of human/robot interaction are particularly relevant, but also cognition; for example, recognising facial expressions or responding to wishes and habits. Endhoven also points to the surgical robots, where precision and controllability are important. There are questions in the field of mechatronics.

Operation robots in front of your eyes

For example, there are already robots that help ophthalmologists with the precise surgical work or take over the entire operation themselves. Robots can take over the surgeon’s hand movements, but with a much firmer ‘hand’ and much smaller movements. This is highly desirable from an ophthalmologist’s point of view, because older ophthalmologists are often unable to perform more operations, while they, as the best, know what needs to be done. In common operations, such as laser eye surgery and lens replacement, the robot can take over the operation as a whole if the type of operation has been specified beforehand. Sensors then determine exactly what needs to be done. Because the results are better than those of the ophthalmologist himself, patients are reasonably satisfied (2). At first, ophthalmologists and hospital operating assistants are reasonably satisfied (2), but notice when they work with the robots for a longer period of time that part of their work disappears (-2). Employees of private clinics, on the other hand, remain enthusiastic (1).

SWOT analysis

In the report, Holland Robotics provides a SWOT analysis for the success of robotic systems in the Netherlands. Its strengths are: systems thinking, chain cooperation and application-oriented innovation. For the healthcare sector, this is reflected in the good cooperation between academic hospitals and industry. The report also mentions the strong domain knowledge in healthcare technology of a company like Philips. This offers the Netherlands opportunities to distinguish itself through application-specific robots with cognitive algorithms.

Furthermore, Willem Endhoven is not tempted to make a SWOT analysis of the robotics focused on care. “This report is intended to put robotics on the agenda. I just don’t want to take an advance on the filling in. I like to hear it from the field. I invite anyone with ideas to contact me.”

We don’t know yet what robotization will bring. Conversations with the employees indicate that they find it exciting, but are open to robots that take over certain routine care tasks. There’s no fear of the work disappearing. It would even be very nice if certain work disappears, leaving more time and space for other work that cannot be robotized. Employees react a little more negatively when it comes to robotisation that affects their professional identity and pride more, i.e. robotisation that takes over professional tasks. Patients initially reacted very hesitantly when it comes to taking over tasks at the bedside, but are positive when it comes to robotising parts of the care that they do not have a direct view of. Think of doctors working with surgical robots, more technology there gives confidence.