The New York Times Magazine featured an article on robots and robotics which I found compelling. Several highlights of the article are featured below, followed by my commentary.
"Bill Gates has said that personal robotics today is at the stage that personal computers were in the mid-1970s. Thirty years ago, few people guessed that the bulky, slow computers being used by a handful of businesses would by 2007 insinuate themselves into our lives via applications like Google, e-mail, YouTube, Skype and MySpace. In much the same way, the robots being built today, still unwieldy and temperamental even in the most capable hands, probably offer only hints of the way we might be using robots in another 30 years."
Comment: I cannot imagine work or personal life without my pc, and recall all too well my first Radio Shack word processor, and how primitive it was relative to todays' offerings. Today's robots are primitive in that sense, but will evolve until they become so embedded in our lives that they become "pc-like."
"Sociable robots come equipped with the very abilities that humans have evolved to ease our interactions with one another: eye contact, gaze direction, turn-taking, shared attention. They are programmed to learn the way humans learn, by starting with a core of basic drives and abilities and adding to them as their physical and social experiences accrue. People respond to the robots’ social cues almost without thinking, and as a result the robots give the impression of being somehow, improbably, alive."
Comment: I believe I'd respond to a robot's social cues without thinking. Pretty eerie, but we're "programmed" to respond to such cues. I am also taken by the observation that you can program robots to learn.
"To qualify as that kind of (sociable) robot, they say, a machine must have at least two characteristics. It must be situated, and it must be embodied. Being situated means being able to sense its environment and be responsive to it; being embodied means having a physical body through which to experience the world. A G.P.S. robot is situated but not embodied, while an assembly-line robot that repeats the same action over and over again is embodied but not situated. Sociable robots must be both, as well as exhibiting an understanding of social beings."
Comment: The definition of a sociable robot-being both situated and embodied- is very helpful. I need to move beyond the term "robot" to "sociable robot," in order to better evaluate the role of robotics in health care.
"Scientists believe that the more a robot looks like a person, the more favorably we tend to view it, but only up to a point. After that, our response slips into what the Japanese roboticist Masahiro Mori has called the “uncanny valley.” We start expecting too much of the robots because they so closely resemble real people, and when they fail to deliver, we recoil in something like disgust."
Comment: There are pretty significant implications for robotic design, flowing from this condition. I wonder how important "person likeness" would be to an acutely ill, short stay patient or to a chronically ill, long term stay patient. Would there be a difference, based on patient condition and stay? And, would we be less demanding of "person likeness" when we are in a passive, patient role?
"The robot (weight-loss) coach, a child-size head and torso holding a small touch screen, is called Autom. It is able, using basic artificial-voice software, to speak approximately 1,000 phrases, things like “It’s great that you’re doing well with your exercise” or “You should congratulate yourself on meeting your calorie goals today.” It is programmed to get a little more informal as time goes on: “Hello, I hope that we can work together” will eventually shift to “Hi, it’s good to see you again.” It is also programmed to refer to things that happened on other days, with statements like “It looks like you’ve had a little more to eat than usual recently.”
Comment: Autom may be useful for my weight loss regimen, but I think I'd shut it down, if it nagged me too much. It does seem to reinforce the assertion that weight loss is aided by peer pressure, even if the "peer" happens to be a robot. However, they are certainly more cost-effective ways to lose weight.
"A few of these uBots are now being developed for use in assisted-living centers in research designed to see how the robots interact with the frail elderly. Each uBot-5 is about three feet tall, with a big head, very long arms (long enough to touch the ground, should the arms be needed for balance) and two oversize wheels. It has big eyes, rubber balls at the ends of its arms and a video screen for a face."
Comment: I wonder how I'd feel if I visited my Mom in a nursing home, and found her being tended by a uBot-5. I wonder how she'd feel. The attitudes of the patient and the family would be critical. Variability in the number and competency of nursing home staff, is an issue, at least in my experience. Would the use of robots diminish such variability?
"At their core, robots are not so very different from living things. “It’s all mechanistic,” Brooks said. “Humans are made up of biomolecules that interact according to the laws of physics and chemistry. We like to think we’re in control, but we’re not.” We are all, human and humanoid alike, whether made of flesh or of metal, basically just sociable machines."
Comment: Perhaps it is true that we are all "sociable machines" and that the distinction between human and humanoid is less evident than we think. Intellectually, I can get my arms around this observation. Emotionally, I'm not there yet.
Monday, July 30, 2007
Wednesday, July 25, 2007
IBM and the University of Florida
Excerpts from a recent article in PC World merit your attention, I believe. The key players are IBM, the University of Florida's Department of Computer and Information Science and Engineering, a spin off company called Pervasa and the Eclipse Foundation, an open source development tool sponsor. Dr Sumi Helal leads the initiative at the University. During the past several years, Dr Helal and his colleagues developed smart devices for the elderly in a model home known as the Gator Tech Smart House in Gainesville.
I recently had a brief chat with Bob Sutor, Vice President for Standards and Open Source at IBM. He noted that the collection of patient information from smart devices could help build an electronic medical record, a perspective I can now appreciate. Security issues seemed of import, and in his view, IBM was involved in this venture for both commercial and social purposes.
Be sure and view the multi-purpose video referenced below. It is well done!
IBM Corp. and the University of Florida believe they've come up with middleware that will allow doctors to remotely monitor the health of their patients. The technology makes it possible for standard wired or wireless devices like blood-pressure and glucose monitors to be reconfigured so that when used by patients at home the devices can automatically send the collected readings to health-care professionals.
IBM and the university have been working on the smart device project for the past 12 to 15 months and have produced a short video to illustrate its possible use. In the video, an elderly man called Charley requires twice weekly visits to his doctor to check his blood pressure. He's able to cut down on the number of those visits by taking his readings at home using a monitor that's been reconfigured with the middleware.
The value of the technology is what could be achieved with it by any device manufacturer, said Sumi Helal, professor of computer and information science and engineering at the University of Florida, who headed up the project. The technology is a combination of middleware software and sensor hardware called Atlas from University of Florida spin-off Pervasa Inc. Should the technology be adopted, Helal would expect to see smart devices on the market within the next one to two years. It would then be possible to buy a device off the shelf and by dialing a 1-800 phone number establish a connection between the device and one's doctor. "The device itself becomes a service," he said.
Much of the work on developing Web services around a SOA (service-oriented architecture) has been looking at how to exchange information between people when neither party is familiar with how the other's IT system was built. There's been plenty of SOA work to Web-enable legacy mainframe systems. "What's the ultimate legacy system for us? The human body," said Bob Sutor, vice president of standards and open source at IBM.
The security governing the devices would be the same as that used in online banking, Helal said. It's possible to make that security very finely grained, Sutor added, to encrypt particularly sensitive fields. It will be up to device manufacturers to ensure that their products are tamper-proof to avoid the possibility of false readings, Helal said.
As a way to start building momentum behind the technology, IBM has contributed components of the project to the Open Healthcare Framework of the open-source development tools Eclipse Foundation community.
"You could look at this as something very nice for IBM," Sutor said, in terms of the vendor being a provider of all the necessary back-end technologies including middleware, databases, servers and storage. "But because it's standards-based, anyone can play," he added. "There's nothing we're doing here that gives us a product advantage."
I recently had a brief chat with Bob Sutor, Vice President for Standards and Open Source at IBM. He noted that the collection of patient information from smart devices could help build an electronic medical record, a perspective I can now appreciate. Security issues seemed of import, and in his view, IBM was involved in this venture for both commercial and social purposes.
Be sure and view the multi-purpose video referenced below. It is well done!
IBM Corp. and the University of Florida believe they've come up with middleware that will allow doctors to remotely monitor the health of their patients. The technology makes it possible for standard wired or wireless devices like blood-pressure and glucose monitors to be reconfigured so that when used by patients at home the devices can automatically send the collected readings to health-care professionals.
IBM and the university have been working on the smart device project for the past 12 to 15 months and have produced a short video to illustrate its possible use. In the video, an elderly man called Charley requires twice weekly visits to his doctor to check his blood pressure. He's able to cut down on the number of those visits by taking his readings at home using a monitor that's been reconfigured with the middleware.
The value of the technology is what could be achieved with it by any device manufacturer, said Sumi Helal, professor of computer and information science and engineering at the University of Florida, who headed up the project. The technology is a combination of middleware software and sensor hardware called Atlas from University of Florida spin-off Pervasa Inc. Should the technology be adopted, Helal would expect to see smart devices on the market within the next one to two years. It would then be possible to buy a device off the shelf and by dialing a 1-800 phone number establish a connection between the device and one's doctor. "The device itself becomes a service," he said.
Much of the work on developing Web services around a SOA (service-oriented architecture) has been looking at how to exchange information between people when neither party is familiar with how the other's IT system was built. There's been plenty of SOA work to Web-enable legacy mainframe systems. "What's the ultimate legacy system for us? The human body," said Bob Sutor, vice president of standards and open source at IBM.
The security governing the devices would be the same as that used in online banking, Helal said. It's possible to make that security very finely grained, Sutor added, to encrypt particularly sensitive fields. It will be up to device manufacturers to ensure that their products are tamper-proof to avoid the possibility of false readings, Helal said.
As a way to start building momentum behind the technology, IBM has contributed components of the project to the Open Healthcare Framework of the open-source development tools Eclipse Foundation community.
"You could look at this as something very nice for IBM," Sutor said, in terms of the vendor being a provider of all the necessary back-end technologies including middleware, databases, servers and storage. "But because it's standards-based, anyone can play," he added. "There's nothing we're doing here that gives us a product advantage."
Thursday, July 19, 2007
International Conference on Aging, Disability, and Independence (ICADI)
I want to draw your attention to the 4th annual ICADI conference which will be held in St Petersburg, FL on February 20-23, 2008. Early registration ends by November 30th, and details can be found at the ICADI website. A conference summary follows.
"The International Conference on Aging, Disability and Independence (ICADI) will focus on approaches to support people as they age in maintaining independence in daily living at home, at work and in the community.
As people age, independence can be maintained by use of assistive technology, by modifying homes, workplaces and environments and by selecting products that follow universal design principles. As people remain in the workforce into advanced years or return to work, knowledge and technologies are developing to adapt workplaces to meet their needs. Aging in the workplace is a new and significant area of focus for ICADI this year. Livable communities is another new focus, representing a broadening of the concepts of home modification and universal design to address design of communities so they are livable for all people. Mobility is another important component of independence as it relates to walking and wheeling, to driving and to using other methods of transportation. Prevention of injuries is essential to maintaining independence in advanced years. Current and future development in robotics will help and support individuals in everyday tasks; and, advances in telehealth approaches hold promise in monitoring and serving health and independence-related needs.
Each of these is important to aging well and will be addressed in eight ICADI tracks by an international cadre of presenters representing research and development, policy, practice and services, business, and consumer perspectives."
"The International Conference on Aging, Disability and Independence (ICADI) will focus on approaches to support people as they age in maintaining independence in daily living at home, at work and in the community.
As people age, independence can be maintained by use of assistive technology, by modifying homes, workplaces and environments and by selecting products that follow universal design principles. As people remain in the workforce into advanced years or return to work, knowledge and technologies are developing to adapt workplaces to meet their needs. Aging in the workplace is a new and significant area of focus for ICADI this year. Livable communities is another new focus, representing a broadening of the concepts of home modification and universal design to address design of communities so they are livable for all people. Mobility is another important component of independence as it relates to walking and wheeling, to driving and to using other methods of transportation. Prevention of injuries is essential to maintaining independence in advanced years. Current and future development in robotics will help and support individuals in everyday tasks; and, advances in telehealth approaches hold promise in monitoring and serving health and independence-related needs.
Each of these is important to aging well and will be addressed in eight ICADI tracks by an international cadre of presenters representing research and development, policy, practice and services, business, and consumer perspectives."
Monday, July 16, 2007
Remote Presence Robotic System
Today, we look to Yahoo News for an interesting story on robot use for hospital patients recovering from bariatric or weight loss surgery.
"Has it come to this? Robots standing in for doctors at the hospital patients' bedside?
Not exactly, but some doctors have found a way to use a videoconferencing robot to check on patients while they're miles from the hospital. One is at Baltimore's Sinai Hospital. Outfitted with cameras, a screen and microphone, the joystick-controlled robot is guided into the rooms of Dr. Alex Gandsas' patients where he speaks to them as if he were right there. "The system allows you to be anywhere in the hospital from anywhere in the world," said the surgeon, who specializes in weight-loss surgery.
Besides his normal morning and afternoon in-person rounds, Gandsas uses the $150,000 robot to visit patients at night or when problems arise. The robot can circle the bed and adjust the position of its two cameras, giving "the perception from the patient's standpoint that the doctor is there," the surgeon said. "They love it. They'd rather see me through the robot," he said of his patients' reaction to the machine.
Gandsas presented the idea to hospital administrators as a method to more closely monitor patients following weight-loss surgery. Gandsas, an unpaid member of an advisory board for the robot's manufacturer who has stock options in the company, added that since its introduction, the length of stay has been shorter for the patients visited by the robot. A chart-review study of 376 of the doctor's patients found that the 92 patients who had additional robotic visits had shorter hospital stays. Gandsas' study appears in the July issue of the Journal of the American College of Surgeons.
Nicknamed Bari for the bariatric surgery Gandsas practices, the RP-7 Remote Presence Robotic System by InTouch Technologies is one of a number of robotic devices finding their way into the medical world. Across town at Johns Hopkins, for example, a similar robot is used to teleconference with a translator for doctors who don't speak their patient's language. Robotic devices have also been used to guide stroke patients through therapy and help them play video games."
Let's try to get behind the information presented in the article. Our aim is to better understand such issues as patient privacy, consumer acceptance of "virtual services", and cost versus benefit assessments.
1. According to a January 2007 report published by the Agency for Healthcare Research and Quality, the total number of bariatric surgeries in the US increased nine-fold from 1998 to 2004. Across all age groups, the fastest growth in bariatric surgery occurred among adults aged 55-64. And, in 2004, 78% of these surgeries were covered by private insurance, with Medicare and Medicaid covering roughly 7% and 5% respectively.
2. The robot stands 5 1/2 feet tall and has a computer screen where a person's head would be. The screen broadcasts the face of a physician, who controls the device remotely. In addition to a screen, the device includes cameras and a microphone. According to the article, the device cost $150,000. About 120 of the robots are being used in hospitals worldwide.
3. The device was purchased by the Sinai Hospital in Baltimore. Patients using the device were discharged sooner than patients who didn't, yielding the hospital more than $200,000 in new admissions and saving some $14,000 in room and board costs, according to an article in the July 16, 2007 edition of Modern Healthcare.
4. The patients were hospital based, and not home based, and bore no added cost for the service. Apparently, they had positive reactions to the device, and there was no indication that privacy infringement was an issue. I'd like to see further studies of in-patient reactions, and also, am curious whether nursing home or home bound patients would have the same positive reactions.
5. The attending physician made normal morning and afternoon rounds, and used the device at night, or when problems arose and he was not immediately available. Thus, there was a mix of high touch and high tech.
6. The attending physician indicated that he was an unpaid advisory board member of the manufacturer and had stock options in the company.
7. A study by the attending physician in a peer reviewed journal cited a decrease in patient stay for patients who experienced robotic visits. If the results are replicated elsewhere, significant system cost savings could be achieved.
8. The robot was being used at Johns Hopkins Hospital to overcome language barriers with patients and for guiding stroke patients through therapy. It's hard to imagine there couldn't be a more cost effective way to deal with the former use, and the latter use would suggest a broader application to other patients with chronic conditions.
9. For the time being, the device would appear to be available for hospital inpatients only, less available to nursing home residents, and not a financially feasible alternative for the home bound.
"Has it come to this? Robots standing in for doctors at the hospital patients' bedside?
Not exactly, but some doctors have found a way to use a videoconferencing robot to check on patients while they're miles from the hospital. One is at Baltimore's Sinai Hospital. Outfitted with cameras, a screen and microphone, the joystick-controlled robot is guided into the rooms of Dr. Alex Gandsas' patients where he speaks to them as if he were right there. "The system allows you to be anywhere in the hospital from anywhere in the world," said the surgeon, who specializes in weight-loss surgery.
Besides his normal morning and afternoon in-person rounds, Gandsas uses the $150,000 robot to visit patients at night or when problems arise. The robot can circle the bed and adjust the position of its two cameras, giving "the perception from the patient's standpoint that the doctor is there," the surgeon said. "They love it. They'd rather see me through the robot," he said of his patients' reaction to the machine.
Gandsas presented the idea to hospital administrators as a method to more closely monitor patients following weight-loss surgery. Gandsas, an unpaid member of an advisory board for the robot's manufacturer who has stock options in the company, added that since its introduction, the length of stay has been shorter for the patients visited by the robot. A chart-review study of 376 of the doctor's patients found that the 92 patients who had additional robotic visits had shorter hospital stays. Gandsas' study appears in the July issue of the Journal of the American College of Surgeons.
Nicknamed Bari for the bariatric surgery Gandsas practices, the RP-7 Remote Presence Robotic System by InTouch Technologies is one of a number of robotic devices finding their way into the medical world. Across town at Johns Hopkins, for example, a similar robot is used to teleconference with a translator for doctors who don't speak their patient's language. Robotic devices have also been used to guide stroke patients through therapy and help them play video games."
Let's try to get behind the information presented in the article. Our aim is to better understand such issues as patient privacy, consumer acceptance of "virtual services", and cost versus benefit assessments.
1. According to a January 2007 report published by the Agency for Healthcare Research and Quality, the total number of bariatric surgeries in the US increased nine-fold from 1998 to 2004. Across all age groups, the fastest growth in bariatric surgery occurred among adults aged 55-64. And, in 2004, 78% of these surgeries were covered by private insurance, with Medicare and Medicaid covering roughly 7% and 5% respectively.
2. The robot stands 5 1/2 feet tall and has a computer screen where a person's head would be. The screen broadcasts the face of a physician, who controls the device remotely. In addition to a screen, the device includes cameras and a microphone. According to the article, the device cost $150,000. About 120 of the robots are being used in hospitals worldwide.
3. The device was purchased by the Sinai Hospital in Baltimore. Patients using the device were discharged sooner than patients who didn't, yielding the hospital more than $200,000 in new admissions and saving some $14,000 in room and board costs, according to an article in the July 16, 2007 edition of Modern Healthcare.
4. The patients were hospital based, and not home based, and bore no added cost for the service. Apparently, they had positive reactions to the device, and there was no indication that privacy infringement was an issue. I'd like to see further studies of in-patient reactions, and also, am curious whether nursing home or home bound patients would have the same positive reactions.
5. The attending physician made normal morning and afternoon rounds, and used the device at night, or when problems arose and he was not immediately available. Thus, there was a mix of high touch and high tech.
6. The attending physician indicated that he was an unpaid advisory board member of the manufacturer and had stock options in the company.
7. A study by the attending physician in a peer reviewed journal cited a decrease in patient stay for patients who experienced robotic visits. If the results are replicated elsewhere, significant system cost savings could be achieved.
8. The robot was being used at Johns Hopkins Hospital to overcome language barriers with patients and for guiding stroke patients through therapy. It's hard to imagine there couldn't be a more cost effective way to deal with the former use, and the latter use would suggest a broader application to other patients with chronic conditions.
9. For the time being, the device would appear to be available for hospital inpatients only, less available to nursing home residents, and not a financially feasible alternative for the home bound.
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