BELFAST, Northern Ireland — In Rwanda’s Kanyinya COVID-19 treatment facility, white humanoid robots glide from patient to patient, taking temperatures, monitoring their vitals, and feeding information back to health professionals. Donated by the United Nations Development Programme, the robots are cutting the amount of time that doctors and nurses spend in direct contact with patients — reducing the risk of contracting COVID-19 and freeing them up for other tasks.
While the use of robotics in health care is not new, the need to limit the spread of the coronavirus and plug gaps in the health workforce — there is a global shortage of 5.9 million nurses worldwide — has brought such technology to the fore.
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Allowing robots to perform time-consuming tasks — such as registering data — means health workers can focus their efforts where they are needed most, said Elizabeth Mutamba, head of exploration at the Accelerator Lab for UNDP Rwanda.
Already, the potential of this technology is visible in some places — but there are limits, and there is work to be done before “robo-health workers” can take off in many lower-income settings.
Positives and pitfalls
For Dr. Gabin Mbanjumucyo, lead of the emergency medicine faculty at the University Teaching Hospital of Kigali in Rwanda, one of the key benefits of using robots is additional safety for staff members.
“Many health care professionals have lost lives by getting infected through direct contact with patients,” he noted in an email. Robots can also act as an additional workforce in places where there is a shortage, he said.
Dr. Kate Tulenko, CEO of global health services company Corvus Health, went further, arguing that robotics can help improve health care by overcoming the human challenges of fatigue, inattention, and bias that often impact the quality of care. They can also eliminate human error, boost productivity, reduce burnout, operate in different languages, and provide access to health care in locations where none has previously existed, she said.
“You cannot have a robot coming in and taking care of granny. These capabilities don’t exist.”— Bernd Stahl, director, De Montfort University Centre for Computing and Social Responsibility
So far, robots have been used to perform microsurgery, dispense drugs, detect tumors, assist patients with mobility issues, and clean facilities. Drones have also been critical in transporting blood across Rwanda, Mutamba said.
Yet robots are not a substitute for human contact and there are still safety issues, said Bernd Stahl, director of the Centre for Computing and Social Responsibility at De Montfort University. “If we had a robot in the house, what’s the likelihood of this working as it should and how likely is it that it trips up the person it’s supposed to be looking after?” he asked.
There are also major challenges around accountability and liability, Tulenko added. While health care personnel often have medical malpractice insurance to cover any mistakes, there are few mechanisms in place — if any — for when a robot makes an error and no clear accountability.
Then there is the mistrust among health workers, who may fear that robots will eventually lead to their replacement. “There will be loss of jobs to robots,” Mbanjumucyo predicted.
But Tulenko disagrees. “If there’s one industry where there’s going to be [a need for] the warm human heart after all other industries have gone completely robotic, it’s going to be health care,” she said, adding that trust can be built by involving health workers in the design and rollout of robotics and integrating a technology element into medical training. “If health workers feel threatened by technology ... they’ll be resistant to using it,” she explained.
A trend on the rise
Rather than staff replacement, the bigger issue is that there are not enough people in care jobs in the first place, Stahl argued.
Attitudes toward robots will be determined by how their use is framed, he said. The narrative should not be “human versus machines”; instead, it should highlight technology as a tool to help people do their jobs. “You cannot have a robot coming in and taking care of granny. These capabilities don’t exist,” he said.
“The more likely scenario — rather than technology taking over jobs — is that technology will change jobs,” Stahl said, adding that certain aspects of health work could be allocated to robots as workers become upskilled in technology.
Medical personnel who are training to work with UNDP robots in Rwanda are already developing and improving their skills in computer literacy, software development, and programming, Mutamba said. “In this era when everything is going digital … you have given him or her other skills,” she added.
Driven by the shortage of health care workers worldwide, Stahl said it is likely that the use of such technologies will continue to grow in health care settings.
He noted that their use in lower-income contexts might be limited, however, because “they tend to be expensive … and rely on a particular type of infrastructure,” typically including a steady supply of electricity and Wi-Fi.
“That may mean there may have to be modifications — different types of innovations that may adapt technologies for other environments than they were initially developed for,” Stahl suggested.
Local production of robotics, which Tulenko said is on the rise, could play a role in this. Countries such as India, Pakistan, and Kenya are producing technology that will be better tailored to their contexts, as well as more affordable, she said. The UNDP Renewed Strategic Offer in Africa also focuses on helping African countries keep up with the digital revolution and ensure such technological advances are available on the continent.
“I think the fact we are seeing AI and robotics development in LMICs will make a difference because these will be products … solving very unique problems,” Tulenko said.
Update, June 16: This story was amended to clarify a comment.
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