Robot-Assisted Bedside Visits Reduced Hospital Stays

Featured Article
Main Category: Medical Devices / Diagnostics
Also Included In: Obesity / Weight Loss / Fitness;  IT / Internet / E-mail
Article Date: 16 Jul 2007 - 12:00 PDT

email to a friend   printer friendly   view / write opinions

A US study has shown that using a "robot" to help remotely visit patients who have had noncomplicated surgery helps surgeons to be in two places at one time and this results in shorter hospital stays.

The study is published in the Journal of the American College of Surgeons and is the work of Dr Alex Gandsas of the Division of Bariatric and Minimally Invasive Surgery, Sinai Hospital of Baltimore, in Maryland, and colleagues.

The reason for the study was primarily a financial one; as healthcare costs continue to rise, the need to reduce length of hospital stay, without impacting quality of care, grows too.

Gandsas and colleagues retrospectively reviewed the records for 376 patients who had a laparoscopic gastric bypass to treat morbid obesity between the start of 2004 to the middle of 2006.

The patients comprised two groups. In the first group, the non-assisted group, 284 patients received the regular post-op, morning and afternoon visits from the surgeon.

In the second group, the robot-assisted group, 92 patients also received extra visits from a "robotic telepresence". This was a remotely controlled mobile computer mounted on a wheeled frame,with a screen, microphone and cameras that the surgeon could control from anywhere via a link, using a joystick and a normal computer terminal.

The patient can see and hear the doctor and the doctor can see and hear the patient.

11 patients were not included in the study because they had complications following their surgery. The study points out that they only dealt with patients who had noncomplicated operations.

The results showed that:

• 77 per cent of the patients from the robot-assisted group were discharged on the first day after their operation.
• No patients from the non-assisted group were discharged on the first day after their operation, and 77 per cent were discharged on the second day.
• The mean length of stay for the robot-assisted patients was 1.26 days compared with 2.33 days for the non-assisted group.
• Early discharge released a capacity of 71 patient-days.
• Although only 76 per cent of the early released beds were reoccupied, the financial gain was still over 219,500 dollars.
• Additional savings included over 14,000 dollars for room and board.
• Other benefits include a lower readmission rate for the robot-assisted group: this was 1 per cent compared to 2 per cent for the non-assisted group.

The study concluded that:

"Robotic telerounding substantially reduces length of stay of patients undergoing noncomplicated laparoscopic gastric bypass operation. Telepresence technology applied in these settings had a substantial financial impact by reducing variable cost and creating capacity for growth and income."

Commenting on the findings, Gandsas said that the patients "loved" the robot and were able to relate very well to it. Using the robot allows him to visit patients at times of the day outside of the normal rounds as and when patients need him.

A nurse who has worked with the robot for 18 months said to the Associated Press that seeing the doctor's face gave patients confidence.

The robot is called RP7 and its annual cost is estimated to be around 60,000 dollars a year. It is made by InTouch Health and there are about 120 of them in use around the world. Gandsas is reported to have a financial interest in the company.

Known as "Remote Presence", the techonology is really a type of advanced teleconferencing that combines mobile robotic technology with telecommunications. The robot is about 6 feet tall with a 15 inch flat screen for a "head" (showing the doctor's face) joined by a metal neck to a grey "body" and it moves on wheels.

"Robotic Telepresence: Profit Analysis in Reducing Length of Stay after Laparoscopic Gastric Bypass."
Gandsas A, Parekh M, Bleech MM, Tong DA.
Journal of the American College of Surgeons, Volume 205, Issue 1, Pages 72-77 (July 2007).

Click here for Abstract.

Written by: Catharine Paddock
Writer: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today