mHealth Robotics Can Improve Patient Satisfaction, Aid ED Triage

Emergency department triage interviews conducted by mHealth robotic systems lead to high levels of patient satisfaction, according to a new telehealth study published in JAMA Network Open.

The researchers conducted a cohort study and a national survey, ultimately finding that mobile robotic systems have significant potential to facilitate interactions between patients and providers.

The cohort study included 40 participants who were admitted to the emergency department at a large, urban academic health center between April and August 2020. A clinician controlled the robotic system, navigating it through the ED to the participant’s room. Then, clinicians completed a contactless video-based triage interview with the patient through the mobile robotic system.

Researchers collected patient satisfaction data upon completion of the triage interview, finding that the vast majority of participants (92.5 percent) reported satisfaction with the mobile interaction. What’s more, 82.5 percent said that their experience with a mobile robotic system was equivalent in quality compared to the receipt of an interview with a clinician physically present in the room.

The study authors then conducted a survey regarding perceptions of the use of robotic systems in completing healthcare tasks. The results are based on 1,000 nationally representative respondents.

The use of robotic systems to facilitate telehealth interviews was deemed extremely useful among 287 participants (28.7 percent) and somewhat useful among 373 participants (37.3 percent).

When asked about the collection of vital signs, 413 participants (41.3 percent) said that robotic technology would be extremely useful, and 350 respondents (35 percent) said that this technology would be somewhat useful in completing this task.

Additionally, 371 participants (37.1%) said that robotics would be extremely useful for certain caretaking items, like turning a patient in bed. An additional 371 respondents said the technology would be somewhat useful in this capacity.

When asked about obtaining nasal or oral swabs, 307 respondents (30.7 percent) said the use of mHealth robotics would be somewhat useful. However, only 192 participants (19.2 percent) reported that the technology would be extremely useful for this task.

The use of robotics in performing phlebotomies and placing intravenous catheters had the lowest rates of respondent enthusiasm, with 159 people (15.9 percent) and 167 people (16.7 percent) noting that mobile robotic systems would be extremely useful, respectively.

These results show that people are more open to robotic systems providing certain superficial aspects of care, such as interviews and turning a patient in bed, than they are with more intrusive aspects of care like phlebotomy and intravenous catheters. 

However, when the survey asked the same questions in the context of COVID-19, acceptance grew. Respondents said robotic systems were useful for completing telehealth interviews, obtaining nasal and oral swabs, placing an intravenous catheter, and performing phlebotomy went up, highlighting the value mHealth holds amidst a pandemic.

The combination of the cohort study and the national survey show that patients are open to the use of robotic systems in healthcare delivery. The use of contactless triage in particular could be especially useful to reduce in-hospital COVID-19 transmission by minimizing physical contact with individuals who are infected.

In addition to preventing in-hospital spread by keeping at-risk clinicians socially distant from patients infected with COVID-19, tele-triage interviews also have the potential to conserve critical supplies such as personal protective equipment (PPE). In times of PPE shortages or disruption in the PPE supply chain, clinicians can engage in meaningful triage interviews without the need to wear personal protective equipment.

“By designing a robotic platform and triage system that is acceptable to patients, we expect that we can continue to engage patients in the ED during periods, such as pandemics, when in-person visits are less likely to occur,” the study authors wrote.