Ahead of the wave

December 22, 2007 03:31 pm

Demonstrating Grande Ronde Hospital's new remote-presence robot, new mother Natasha Roba coos to her baby, Leonydis, from one room away. Besides consultations and training, an added benefit of the nearly real-time, two-way broadband connection will be the ability of local families to see those patients who have to be transferred to St. Alphonsus Hospital in Boise. - Observer photos/CHRIS BAXTER
Demonstrating Grande Ronde Hospital's new remote-presence robot, new mother Natasha Roba coos to her baby, Leonydis, from one room away. Besides consultations and training, an added benefit of the nearly real-time, two-way broadband connection will be the ability of local families to see those patients who have to be transferred to St. Alphonsus Hospital in Boise. - Observer photos/CHRIS BAXTER
State of the art robotic technology will be offered to area patients and nursing students as part of a partnership between Grande Ronde Hospital and St. Alphonsus Hospital in Boise.

InTouch Technologies Inc. is the California robotics technology company that designed the remote-presence robot, or RP-7, which has been "on staff" at GRH since last summer.

Yair Lurie, a representative from InTouch who was in La Grande recently to demonstrate the RP-7's capabilities, said, "We knew about the coming shortage of health care providers in rural areas and wanted to see what we could come up with to help with that problem."

Doug Romer, who directs Patient Care Services for GRH, said the robot will give rural doctors and hospitals a greater connection with outside specialists for consultation, but that the possibilities for its usefulness are extensive.

For example, using the new real-time technology to train surgical nurses in La Grande via the robotic link to an offsite instructor is just one of the many ways the new technology will be used to benefit the region.

With the RP-7 unit, a nursing preceptor will virtually beam into the local hospital via what Romer says is a nearly real-time broadband two-way communication connection. The instructor will not only observe, but also listen to and be able to talk back and advise surgical nurses while they are in action.

The instructor will see and be seen through a flat screen computer monitor which is more or less the head of the robot. The screen may be rotated for a 360-degree view, be moved up or down, or zoom in and out.

Observer photos/CHRIS BAXTER
Observer photos/CHRIS BAXTER
The entire robot is controlled via a laptop, joystick and software that connects through the Internet. It comes on rollers and may be moved down the hall, from room to room via the controller.

"The only thing this robot can't do is push the elevator buttons," said Romer.

Although that may come as the technology exists that gives arms to these medical robots. In fact, a successful gall bladder surgery in New York state has already been accomplished utilizing such technology, Romer says.

Dr. Kevin Grayson is a pediatrician at the GRH Children's Clinic. He has already used the RP-7 for consultation with a specialist at St. Alphonsus.

Grayson said he was impressed with the high resolution of the video quality, which is so advanced you can see the flare of a nostril during breathing, assess skin tone and easily monitor vital signs on the equipment in the patient's room.

"It's much better than talking on the telephone for a consultation, because the specialist is looking right at the patient instead of just getting my perspective." says Grayson. "It's like having the consultant right in the room with you to confer with."

Grayson recently had a patient who wasn't doing as well as test numbers coming back from the lab indicated the patient should be doing. Rather than consulting over the phone, or making the call to transfer the baby out to a specialist if it wasn't necessary, Grayson employed RP-7 to consult first.

"The specialist can do a much better job than he could over the phone. With the robot he could watch the breathing, see how much stress the baby was in. It was extremely helpful in this case where we weren't sure what the right thing was to do. We were able to come to a concrete decision with more information," said Grayson.

Although in this case the decision was made to transfer the baby to St. Alphonsus, another plus of the new technology is that other transfers under consideration may be deemed unnecessary with the improved consultation capabilities with specialists in Boise.

"If there is a chance we can keep Grandma in the hospital here, so that her family is around her and nobody has to lose work time and pay for transfers and motel costs and all that — then this technology will have helped us do our job better," said Romer. "Our goal is keep our patients at home."

Observer photos/CHRIS BAXTER
Observer photos/CHRIS BAXTER
Romer said the hospital was approached by St. Alphonsus about the possibility of being a pilot site for the new robot technology. The Boise hospital was awarded several of the robots as part of a U.S. Army Medical Research grant and the benefits of the technology to a rural community range from enhanced patient care to education.

Although the robots are also in place at Oregon Health and Science University in Portland and at St. Elizabeth's Hospital in Baker City, for various reasons they have not yet been fully utilized.

Michael Ward is head of network development at St. Alphonsus and said after talking to Romer he was convinced La Grande was a perfect pilot site for the program.

"It's a big hospital for a community of this size. The people here are outside-the-box thinkers and very innovative in their approach to health care. It's a good partnership for us," Ward said. "It's a pretty big thing for hospitals in rural areas like this to be able to have these remote consultations and teaching opportunities."