The COVID-19 pandemic has renewed and expanded interest in non-surgical healthcare robots worldwide. A growing number of hospitals and healthcare providers is realizing that robots can offer significant improvements in the delivery of care, laboratory efficiency, and rehabilitation, as seen in the examples below.
The novel coronavirus has highlighted the global shortage of skilled medical staffers. In combination with sometimes laborious and slow laboratory test processes, it can limit access to life-saving treatments.
ABB research hub demonstrates future of care
In response to the talent shortage and laborious processes, biopharmaceutical and testing laboratories are turning to automation to improve productivity, safety, and consistency. In turn, higher-quality, more flexible care can enhance patient outcomes. Major nonsurgical robotics suppliers have recognized this market.
One example is Swiss-Swedish multinational ABB Robotics, which last year opened a global research hub at the Texas Medical Center in Houston. The 5,300-sq.-ft. (500m2) facility includes an automation laboratory and robot training facilities, as well as meeting spaces for co-developing solutions with innovation partners.
ABB views the new unit as the first “global robotics for healthcare research hub,” according to Jose-Manuel Collados, healthcare solutions business line manager at ABB Robotics. A dedicated on-site ABB research team is working alongside medical staffers, scientists, engineers, researchers, and investors from local hospitals, blue-chip technology companies, and start-ups on the TMC campus. They are developing nonsurgical medical robotics systems, including logistics and next-generation automated laboratory technologies.
“All the demos are concepts that ABB will work with the medical community to refine, with the goal to develop robotic systems that are able to carry out repetitive, delicate and mundane processes, leaving highly skilled medical and laboratory staff free to undertake more valuable roles and ultimately treat more patients,” Collados said.
Existing demonstrations include a liquid handling or pipetting station, featuring an IRB 1200 6-axis articulated arm robot, and a centrifuge loading and unloading system, featuring an IRB 14050 single-arm YuMi robot.
A dual-arm mobile YuMi collaborative robot is capable of sensing and navigating its way around human co-workers and learning different routes. It can also be deployed to undertake a wide range of repetitive and time-consuming activities, including preparation of medicines, loading and unloading centrifuges, pipetting and handling liquids, and picking up and sorting test tubes.
The mobile YuMi could also be used in hospitals for a wide variety of logistics roles, including “delivering the medicines it has dispensed, bringing medical supplies to hospital staff and bed linens directly to patients’ bedrooms,” said Collados.
“AGVs [automatic guided vehicles] in warehouse or factory settings typically operate in highly structured environment or simply following fixed routes marked on the floor,” he added. “Hospitals and laboratories are not as structured, so ABB is working to learn how mobile robots can cope with a less structured environment, as well as how and where hospitals and labs can be more structured.”
“The future of laboratories will be different,” Collados said. “There is a move away from hard automation to more flexible or soft automation. As medical science advances, treatment is becoming more personalized, so lab processes will need to adapt, and flexible automation will enable this.”
Andrew+ pipetting robot makes repeat performance
Andrew Alliance SA has created the novel Andrew+ nonsurgical robot to address the need for greater repeatability in life science workflows. In addition to automating liquid-handling processes, the pipetting device is also capable of manipulating the type of labware crucial to sample management in many research workflows.
The robot is managed by state-of-the-art, browser-based software called OneLab, which allows researchers to retain control of their workflow, said Nigel Skinner, global marketing manager at Andrew Alliance. Users can readily adapt the pipetting robot to a wide range of other workflows using a range of Domino accessories, helping to make “optimal use of space, resources, and funding,” he said.
Andrew+ can host eight- and 12-channel pipettes, enabling much larger volumes to be dispensed far more quickly. This capability provides a “significant advantage, for example, in qPCR [quantitative polymerase chain reaction] and NGS [next-generation sequencing] workflows,” said Skinner.
“It is a complete redesign [of the earlier Andrew robot], with the ‘plus’ referring to the fact that it is a fully connected device,” he added. “It is able to communicate withOneLab by Ethernet or Wi-Fi, from which is receives step-by-step guidance of each step of a given protocol and with the electronic pipettes themselves, by Bluetooth.”
“This communication is two-way, with instructions being passed from OneLab to Andrew+, which ensures the remote programming of the pipettes, and back from the pipettes to OneLab, meaning that each step if being fully recorded,” said Skinner.
The nonsurgical system is designed to increase the repeatability and traceability of experiments, he said. Two-way communication with Bluetooth pipettes means that each step in the execution of protocols is recorded, along with the calibration data of the pipette itself.
“This ensures full traceability, as well as a high degree of quality control, which is especially important if you want to automate costly and complex liquid handling steps associated with qPCR or NGS,” Skinner said. “In a simple qPCR experiment, typical pipetting errors with a standard, routinely calibrated pipette, can result in DNA copy numbers varying by as much as 3%. Imagine the impact of that on the results of an important translation biology experiment, or in a regulated diagnostic laboratory.”
Andrew Alliance, which has offices in Geneva, Boston, and Paris, was acquired by Waters Corp. in January. The company is offering qualified customers a 20% discount on all its products for the development of therapeutic and diagnostic responses to COVID-19.
Stroke rehabilitation another nonsurgical application on the rise
Another increasingly common nonsurgical robotics application in healthcare settings is the use of robotic exoskeletons in stroke rehabilitation. One of the early frontrunners in this field is California-based outfit Esko Bionics, which last year released the EksoNR, the next generation of the EksoGT wearable device.
The company’s products are designed to be intuitive to help patients recovering from stroke or other conditions to learn to walk again with a more natural gait.
“EksoNR is the only exoskeleton available for the rehabilitation setting that can provide adaptive amounts of power to either side of a patient’s body, challenging the patient as they progress through their continuum of care.” said Jack Peurach, president and CEO of the company. “We developed it specifically for neuro-rehabilitation to help physical therapists and patients to maximize the benefit of each rehabilitation session.”
The EskoNR features integrated actuators at the hips and knees, which are used to regulate joint flexion and extension, as well as sensors positioned throughout the device to provide feedback. The latest generation of the nonsurgical device now has EksoView, a touchscreen controller that provides visualizations. It allows therapists to adapt assistance to challenge patients using real-time feedback and to measure performance outcomes during use.
“EksoNR is beneficial for both patients and therapists and provides patients with the ability to mobilize earlier, more frequently, and with a greater number of high intensity steps,” said Peurach. “As an advanced rehabilitation tool, the device gives therapists the ability to strategically target gait deficiencies with real-time feedback and track patient progress with cloud-based analytics. Patients are able to get more out of each rehabilitation session and ultimately have better outcomes.”
“As adoption of EksoNR continues to expand, we see the potential for its use in other healthcare settings beyond inpatient and outpatient rehabilitation, such as skilled nursing and long-term care facilities,” he added. “The goal is to make it widely accessible to all patients who can benefit from it.”
Another device, the EksoUE, is a wearable upper-body exoskeleton that assists patients with a broad range of upper-extremity impairments. It can assist them with a wider range of motion and reduce fatigue. The device, which is worn like a jacket, provides lift assistance via passive mechanisms located on the arms that do not require any battery power.
Ekso Bionics created the EksoUE with the aim of engaging patients in more diverse and complex motor movements. The nonsurgical device can improve the wearer’s endurance and ability to complete tasks during therapy sessions.
Although the EksoUE was tested primarily with stroke patients at the development stage, Peurach said the device could also be applied to a variety of upper-extremity impairments.
“EksoUE is currently being placed with select existing customers, primarily focused on early stroke recovery,” said Peurach. “As we continue to roll it out and educate the rehabilitation market about it, we believe occupational therapists will also find the device to be a beneficial tool for various causes of upper-extremity weakness.”