A Puppet in the Hospital

Curtis Franklin Jr., Executive Editor | 4/2/2012 | 21 comments

Curtis Franklin Jr.
You're lying in a hospital bed when a physician comes through the door. He has the standard white coat and stethoscope, but rather than carrying your chart in his hands he's followed by a small robot.

The slim, wheeled device parks near the foot of your bed and brings your chart up on the screen that tops its body. You notice that the doctor directs comments to the robot, which responds by placing a text block next to the information you can see on your chart. When changes in medication are ordered, a form flashes on the screen, which the doctor checks and approves with radio-buttons and a finger-scrawled signature. When the visit is complete, the robot quietly follows the doctor out of the room.

Congratulations! You've just had a doctor's visit in the future as envisioned by Singapore-based CtrlWorks. The unusual thing about this isn't that we're being shown a future vision, but that the future in the story begins next month. According to an article at Singularity Hub, doctors at Khoo Teck Puat hospital in Singapore will be shadowed by robots, named "Puppets" by CtrlWorks, beginning next month. The really impressive thing, though, is that the company sees the doctor's assistance model as just the beginning of the robots' possible use.

Ultimately, CtrlWorks proposes that a doctor could sit at a single console and send Puppets into hospital rooms all across a city, a region, or even a nation. There's no reason, in this model, that the doctor should ever have to waste time traveling from room to room or facility to facility in order to see patients. It's not hard to imagine the Doctor Puppet going into a hospital room shadowed by a nurse, who could take care of patient manipulation, reading subtle patient cues, and administering medications or treatments on an immediate basis.

Here at Enterprise Efficiency we've covered telemonitoring and home health robots in the past. The difference in the CtrlWorks scheme is that it doesn't intend to replace the doctor in housecalls, or save on time in the hospital. Rather, it is an attempt to maximize the impact of doctors on patients already in hospital.

This is going to be a touchy area for CIOs. On the one hand, most physicians will appreciate technology that lowers travel requirements on their schedules, and that allows them to see more patients while possibly retaining some semblance of a life. On the other hand, patients (and nurses, too, if you catch them off duty) already complain about doctors who have no discernable "people skills." For these "human mechanics," a bedside manner is an archaic relic of a bygone era, like the black leather satchel filled with pills and unguents that accompanied their forebears on housecalls.

Savvy healthcare CIOs will want to call in experts from other fields in a translational, multi-discipline approach to retaining patient confidence and comfort while maximizing the time-value of physicians. Ultimately, we could see a multi-tier system in which generalist physicians make rounds accompanied by specialists who show up by Puppet. No matter how many tiers there are, though, the one certainty is that the CIO will ultimately be responsible for making it work -- and will be the one person for whom no robot replacement is possible.

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View Comments: Threaded | Newest First | Oldest First
batye   A Puppet in the Hospital   4/2/2012 11:56:21 AM
interesting
I think future is now

somehow your article did remind me about movie starring Robin Williams - Patch Adams

as I trust in the Hospital you could not really replace 100% of the Doctor with the robot, human connection is a must



David Wagner   A Puppet in the Hospital   4/2/2012 12:06:15 PM
Re: interesting
I have to say that while the puppets seem cool, they seem an overcomplicated solution to a problem. If you need a nurse or a doctor to be there to manipulate the patient (get them to put their tongue to the camera or put a blood pressure cuff on or something) then way do you need the robot?

Give the nurse the tablet that the puppet holds and just put cameras in the room.
batye   A Puppet in the Hospital   4/2/2012 12:38:15 PM
Re: interesting
could not agree more with Dave really good point... as physical manipulation is really important 
CurtisFranklin   A Puppet in the Hospital   4/3/2012 11:08:37 AM
Re: interesting
@David, I think one of the benefits the robot brings is the ability to record everything that goes on in the visit. This should make record-keeping easier and (in countries where malpractice litigation is big business) will help in those cases, though it does bring up enormous data storage and discovery issues. The other thing it brings is the ability to have a specialist remotely consult with an attending physician during rounds. That could be huge, and could save real time in deciding on a treatment.
David Wagner   A Puppet in the Hospital   4/3/2012 5:26:44 PM
Re: interesting
@Curt- I agree about the record keeping. i just don't see why the cameras have to be in the robot rather than on the wall.

Though this brings up another point. How will patients feel about being recorded during treatment? Some treatment requires disrobing or less than dignified positions. Do people really want video being stored of all that whether it was shot by a robot or a fixed camera?
sohaibmasood   A Puppet in the Hospital   4/4/2012 12:46:33 PM
Re: interesting
@David: People would not want to leave video evidence of their treatment. Ideally people are comfortable with being examined by a human. This comfort is driven by the trust in the doctor and the fact that the details of the diseas/treatment cannot be reproduced especially in a recorded format.

So, yes privacy will be a major concern for patients. 
LuFu   A Puppet in the Hospital   4/2/2012 1:30:59 PM
Robotic Bedside Manners
Like illegible handwriting, poor bedside manners are a cliche for doctors. While this may be true in some cases, it's not necessarily the rule. A puppet-robot may have a role as a roving medication deliverer but I believe it an unwanted intrusion if it tries to replace the human touch from a nurse or even a doctor with a robotic personality.
CurtisFranklin   A Puppet in the Hospital   4/3/2012 11:17:10 AM
Re: Robotic Bedside Manners
You know, @LuFu, my wife and I saw Dr. Oz on a television show recently, and we realized that he's unusual in that he's a surgeon with a friendly user interface. Most surgeons aren't comfortable dealing with conscious patients, and since they're the "rock stars" of the medical profession their attitude tends to spread. I'm old enough to remember the "country doctor" who treated everything and was a trusted partner in both healthcare and the community: It's a shame that's far less common now than it once was.
LuFu   A Puppet in the Hospital   4/3/2012 1:09:28 PM
Re: Robotic Bedside Manners
@Curtis - I agree, Dr. Oz is very user friendly for a doctor but he's not alone. My own doctor reminds me of him actually and doesn't put up that doctor-patient firewall that some rock star doctors throw up. Anecdotally I have encountered a couple of rock star surgeons/specialists who were attending a family member and close friend who were terminal. These doctors were sympathetic and supportive throughout and were extremely helpful - counter to what people usually complain about.

On the other hand, I had a college friend who became a doctor who just looked at patients as subjects or challenges rather than as people. I would trust him as a doctor but I wouldn't expect him to hold my hand.
kstaron   A Puppet in the Hospital   4/2/2012 2:15:48 PM
Programming in a bedside manner
Interesting idea. as a patient I think I might like it because the conversation you have with the 'puppet' could be recorded, so if you have further issues, he can review past visits to look for patterns.  A robot may bottom out the whole bedside manner cliche.  hmm, maybe we could program the puppet with a bedside manner especially for doctor's that don't have one?
David Wagner   A Puppet in the Hospital   4/2/2012 3:16:01 PM
Re: Programming in a bedside manner
Maybe we could hire actors to do the talking for the puppet so the bedside manner improves. The doctor can ask the boring medical questions and the actor can turn them into warm and friendly questions. Kinda like a high tech Cyrano de Bergerac.
Hammad Masood   A Puppet in the Hospital   4/2/2012 4:25:53 PM
Re:
Will the patients be satisfied with this approach ? A doctor visiting the patient or a robot visting the patient, will they be equal ?
Broadway   A Puppet in the Hospital   4/2/2012 9:26:29 PM
Re:
One of the common complaint of the current US system is that you barely see your doctor. Maybe he or she stops in at your checkout for like 5 minutes at most if you're lucky, otherwise you're dealing with nurses and physician assistants. A robot would be further down the list toward inadequate medical attention.
David Wagner   A Puppet in the Hospital   4/3/2012 5:25:07 PM
Re:
A robot would be further down the list toward inadequate medical attention.

Personally, I'd consider a robot higher up the chain. No offense to nurses and PAs. They're awesome. But we're talking about robots here! :)

vnewman   A Puppet in the Hospital   4/4/2012 11:16:32 AM
Re:
And they could be programmed to be on time!  Bonus!  
Gigi   A Puppet in the Hospital   4/3/2012 12:06:05 AM
Gigi
Doctor Vs Robot
Hammad, I don't know up to what level this technology is acceptable. In future it may replace Doctors and Nursing assistances. But whatever may the technological developments, NO device can judge or analyze the datas like a human brain. Analyzing the patient condition, interpreting it in right way and prescribing the most suitable medicines are more important in treatment. I strongly believe that only doctors can perform well in such situations.
CurtisFranklin   A Puppet in the Hospital   4/3/2012 11:48:16 AM
Re: Doctor Vs Robot
@Gigi, there's a reason that the phrase "Medical Arts" is still inscribed over the door to many hospitals and medical schools. The human body presents so many variables that human judgment is still important. We can inform that judgment with lots of computer-assisted information, but I agree that the human element will be critical for a long time to come.
Pedro Gonzales   A Puppet in the Hospital   4/2/2012 10:11:02 PM
cool puppet
for me it is very interested how asian countries are more willing and interested in introducing robots into healthcare than specially, here, in the United States.  I would really like to know how are these puppets improving doctor efficiency in singapore, I wouldn't mind seeing little puppets running around hospitals halls, if they are helping physician with their goal of helping people.  I heard than in japan too, they are trying to introduce robots to help the elderly.
CurtisFranklin   A Puppet in the Hospital   4/3/2012 1:34:52 PM
Re: cool puppet
@Pedro, I agree that it's very interesting to compare the societal response to these devices. I suspect it has to do with the very different relationship between patients, doctors and the concept of healthcare in the different regions of the globe. It will be most fascinating to see whether the lead taken by one region is followed by those who live elsewhere!
freespiritny25   A Puppet in the Hospital   4/4/2012 4:50:41 PM
Re: A Puppet in the Hospital
Granted, sometimes when your being checked by your doctor you feel like your with a robot, but seriously a puppet doctor just seems creepy. We need a real live human being doctor, is that too much to ask for? I realize the healthcare system is going down the drain, but a puppet cannot stand in for a physician, no matter how "smart" it is.
syedzunair   A Puppet in the Hospital   4/5/2012 11:35:36 AM
Re: A Puppet in the Hospital
i am with you on this one, freespirit...

A puppet robot tailing behind a doctor will be too much for some people who prefer privacy and are only comfortable with an actual human doctor around. One on one doctor-patient relationship is also very important.


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