“Orthobot, to your station!” The application of the remote presence robotic system in orthopaedic surgery in Ireland: a pilot study on patient and nursing staff satisfaction

Higher education personnel's perceptions about telepresence robots

The interest towards using telepresence robots in a variety of educational contexts is growing, as they have a great potential to enhance the educational experience of remote learners and provide support for teachers. This paper describes a study, examining the perception of Georgian university personnel about the use of telepresence robots in education. This exploratory research aimed to obtain evidence-based information on how the personnel (16 persons) from eight Georgian universities perceived the telepresence robots' role in enhancing learning and teaching, and what challenges, benefits, opportunities, weaknesses and threats would characterise these robots. The results of the study revealed that the university personnel perceived telepresence robots to have a great potential to enhance educational activities. In addition, the participants indicated the major challenges, benefits, opportunities, weaknesses and threats, regarding integrating telepresence robotics into the teaching and learning in Georgia. Recommendations for future research are also presented.

Telehealth for Upper Extremity Conditions: Perceptions of the Patient and Provider

The recent coronavirus pandemic has prompted providers to adopt telehealth as a way to maintain contact with their patients on an unprecedented scale. The purpose of this study was to evaluate the perception of care for both patients and physicians using telehealth visits for the management of upper extremity orthopaedic conditions. This study consisted of the analysis of surveys sent to both physicians and patients immediately after the completion of a telehealth visit for an upper extremity condition. Eighty percent of patients responded as “very satisfied” with their encounter. Satisfaction scores were similar for patients seen for a new issue or an existing issue. The use of a video platform was preferable to patients compared with a telephone call. Physicians would have requested a radiograph or offered a steroid injection during a new patient evaluation in 77% of cases. Physicians were less satisfied with the use of telemedicine, particularly when evaluating a new patient. A large majority of patients and physicians alike felt telehealth visits have a role in patient management, acknowledging they would both choose to incorporate “some” of their visits as telehealth evaluations for any particular issue.

Telerounding Offers High Patient Satisfaction After Total Joint Arthroplasty

BACKGROUND

Research in surgical fields other than orthopedics has demonstrated high patient satisfaction with non-traditional telerounding modalities.

QUESTIONS/PURPOSES

We sought to determine patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores of patients who experienced telerounding in the post-operative period after undergoing total joint arthroplasty (TJA).

METHODS

Fifty consecutive TJA patients were prospectively enrolled to receive telerounding. The patients were divided into two groups based on their satisfaction with telerounding. The HCAHPS scores of the patients who received telerounding were compared with 50 control patients.

RESULTS

Overall, the telerounding cohort had a positive reaction to telerounding. Comparing patients who were highly satisfied to those who were dissatisfied with telerounding, younger patients were found to be more frequently satisfied with telerounding. Compared with patients who did not receive telerounding, patients who experienced telerounding rated the hospital higher on a 10-point scale were more likely to recommend the hospital to others, more frequently believed their physicians treated them with courtesy and respect, and more often believed their physicians always listened to them carefully.

CONCLUSION

An overwhelming majority of our patients found telerounding using FaceTime enhanced their care while recovering post-operatively from TJA. Those patients were typically younger and had significantly higher HCAHPS scores, which potentially can enhance the physician-patient relationship.

Robot Assisted Surgical Ward Rounds: Virtually Always There

BACKGROUND

 While an explosion in technological sophistication has revolutionized surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation.  Use of telepresence allowing off-site clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive, static devices.  We designed a prospective study to ascertain feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients.  This device is, uniquely, lightweight, freely mobile and emulates 'human' interaction by swiveling and adjusting height to patients' eye-level.   METHODS: Robot-assisted ward rounds(RASWR) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRoboticstm, California USA).  Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs.  The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as control group. Data were paired, and non-parametric analysis performed.  RESULTS: RASWRs are feasible (>90% completed without technical difficulty). The RASWR(n=52 observations) demonstrated face validity with strong correlations (r>0.7; Spearman, p-value <0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n=25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/NCHD cohort (100% (n=11) willing to regularly partake in RASWR).  CONCLUSION: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be physically present.

The application of telemedicine in orthopedic surgery in singapore: a pilot study on a secure, mobile telehealth application and messaging platform

Background

The application of telemedicine has been described for its use in medical training and education, management of stroke patients, urologic surgeries, pediatric laparoscopic surgeries, clinical outreach, and the field of orthopedics. However, the usefulness of a secure, mobile telehealth application, and messaging platform has not been well described.

Objective

A pilot study was conducted to implement a health insurance portability and accountability act (HIPAA) compliant form of communication between doctors in an orthopedic clinical setting and determine their reactions to MyDoc, a secure, mobile telehealth application, and messaging platform.

Methods

By replacing current methods of communication through various mobile applications and text messaging services with MyDoc over a six week period, we gained feedback and determined user satisfaction with this innovative system from questionnaires handed to the program director, program coordinator, one trauma consultant, all orthopedic residents, and six non-orthopedic residents at the National University Hospital in Singapore.

Results

Almost everyone who completed the questionnaire strongly agreed that MyDoc should replace current systems of peer to peer communication in the hospital. The majority also felt that the quality of images, videos, and sound were excellent. Almost everyone agreed that they could communicate easily with each other and would feel comfortable doing so routinely. The majority felt that virtual consults through MyDoc should be made available to inpatients as well as outpatients to potentially lessen clinic loads and provide a secure manner in which patients can communicate with their primary teams any time convenient to both. It was also agreed by most that the potential of telerounding had advantages, especially on weekends as a supplement to normal rounds.

Conclusions

Potential uses of MyDoc in an orthopedic clinical setting include HIPAA-compliant peer to peer communication, clinical outreach in the setting of trauma, supervision in the operating room or watching procedures being performed remotely, providing both patient and parent reassurance in pediatric orthopedic patients, and finally in the setting of outpatient clinics. With our pilot study having excellent results in terms of acceptance and satisfaction, the integration of a secure, mobile telehealth application, and messaging platform, not only in the orthopedic department but also the hospital in general, has an exciting and limitless potential. More so in this era where downsizing hospital costs is beneficial, doing so may also be mandatory in order to comply with the soon to be introduced personal data protection act.

A Review of Mobile Robotic Telepresence

Mobile robotic telepresence (MRP) systems incorporate video conferencing equipment onto mobile robot devices which can be steered from remote locations. These systems, which are primarily used in the context of promoting social interaction between people, are becoming increasingly popular within certain application domains such as health care environments, independent living for the elderly, and office environments. In this paper, an overview of the various systems, application areas, and challenges found in the literature concerning mobile robotic telepresence is provided. The survey also proposes a set terminology for the field as there is currently a lack of standard terms for the different concepts related to MRP systems. Further, this paper provides an outlook on the various research directions for developing and enhancing mobile robotic telepresence systems per se, as well as evaluating the interaction in laboratory and field settings. Finally, the survey outlines a number of design implications for the future of mobile robotic telepresence systems for social interaction.