The robot will see you now
Mobile machines, remote hookups help Lahey Clinic cope with shortage of specialists
BEVERLY - The robot glides past the beeping heart monitor, past a row of patients supine on their electric beds, past the beehive of the nurses’ station. The sleek, metallic body, dusky blue, stops outside Room 9 and slowly rolls through the doorway.
“Mrs. Morash, Dr. Liesching’s here,’’ says nurse Dawn Deschenes, announcing the arrival of the robot to a gray-haired woman breathing behind an oxygen mask. The face of Timothy Liesching, a pulmonary critical care doctor, gazes at his patient from a computer screen on top of the robot.
“I’m just going to look in your monitor now,’’ says Liesching, his voice flowing from a speaker on the robot even though he is sitting in his office at the Lahey Clinic in Burlington, 22 miles - and one large traffic snarl - away. The computer swivels away from her face. “Your oxygen looks good, your respiratory rate looks pretty good.’’
Even from his distant location, Liesching is able to listen to the beat of his patient’s heart, the heavy sounds of her battered lungs struggling to pull in air. The doctor asks a few more questions before he maneuvers the robot out of the room using a joystick he operates in Burlington.
The machine that Liesching, director of tele medicine at the Lahey Clinic, is guiding down the corridors of Beverly Hospital is the only one like this in New England, say officials at the clinic.
The robots are designed to ease the shortage of some specialized doctors, including critical care physicians like Liesching. Lahey also uses a robot to examine patients at King Edward VII Memorial Hospital in Bermuda. The hospital has three other robots it hopes to place soon in other New England hospitals.
Doctors at Lahey, who have formed a partnership with Beverly Hospital to provide critical care specialists, began using the robot this spring to gather more information about patients when they could not see them in person.
The robots carry stethoscopes that clinicians in the remote hospitals can place over patients’ hearts and lungs, and the doctors, far away, can hear through special headphones. The doctors can see their patients, ask them questions, and study their monitors.
“We recognize that the ideal situation is that every patient has the clinician at their bedside, but because of this shortage that there are in a number of subspecialties and in certain geographical areas, that is impossible,’’ Liesching said.
A few months ago at the Bermuda hospital, a patient scheduled to have his leg amputated was first seen via robot by a Lahey vascular specialist, who recommended a less drastic treatment. Local doctors followed through, and the man’s leg was spared, said Donald C. Thomas III, chief of staff at King Edward.
Doctors and researchers at Lahey and elsewhere see robots as potential money savers that could lower healthcare costs for critically ill patients. Now those patients are sometimes transferred unnecessarily from community hospitals to academic medical centers, where the cost of care is much higher and the distance is inconvenient for families, said Sanford Kurtz, Lahey’s chief operating officer.
Dr. Ronald Dixon, an internist at Massachusetts General Hospital who researches telemedicine, agrees that visiting patients virtually, with robots or computers, can save money.
But he cautions that especially with seriously ill patients, virtual consultations can only augment, not replace, face-to-face medical care.
“If you’re talking about patients who have some risks, the laying of hands and the actual view of the patient in real life is still important,’’ he said.
Lahey officials won’t say how much they pay to lease the robots. InTouch Health, the California company that invented and manufactures the robots Lahey uses, usually leases the machines for $6,000 to $8,000 a month, said Jennifer Neisse, a spokeswoman for the company.
The doctors at Lahey caution that they use the term “robot’’ loosely, because the device doesn’t have artificial intelligence: The doctors control the machine.
Before they can visit their patients virtually, they must first master the skill of driving robots down hospital corridors miles away, manipulating joysticks on their computer monitors to guide the machines. On their laptops, the doctors see the view from a camera mounted on top of the robot; they can swivel the screen to look around. The robots have sensors that keep them from bumping into people and walls.
On the critical care ward at Beverly Hospital, the robot is popular even among patients not scheduled for visits.
A nurse asks Liesching whether he has time to speak to a woman recovering from surgery who has seen him - the robot, actually - glide past her room.
“When I came out of the OR, I said, ‘What is that?’ ’’ the patient says. “When they told me, I thought they were either making up stories or I was still heavily medicated.’’
Marion Morash, the patient Liesching was checking on, has had the robot glide into her room at Beverly Hospital several times. Morash has chronic obstructive pulmonary disease and minor heart problems.
When Liesching examines Morash with the robot one morning this week, she has had a difficult night. The doctor wants to listen to her lungs and see exactly how much difficulty she is having breathing - in more detail that he could glean over the phone.
He wants to know, he says‘ “Is she huffing and puffing? Is she really struggling? How difficult is it to talk?’’ She is struggling, and he orders some changes in her care after a brief exam.
“Do you have any questions for me?’’ the doctor asks his patient when it is time to go. “No? Okay. I’ll see you a little later.’’
The robot turns around, rolls out of the room and down the corridor.
But neither the high-tech machine nor the doctors who control it are omnipotent. As Liesching guides the robot back to the spot in the hallway marked “Robot Parking,’’ the doctor has one plea.
“I’m going to ask you,’’ he tells a visitor, “to plug me in.’’
Kathleen Burge can be reached at kburge@globe.com. 