Wars have forced immense advances in medical care. Mobile x-ray machines and sanitary napkins were a result of World War I.^[i]Metal plates to help heal fractures were a result of World War II. The use of frozen blood products came with the Vietnam War.^[ii] Advances in physics, mathematics, computer sciences, radar, infrared, prosthetics, and organ replacement have been propelled by wars.^[iii] The COVID-19 pandemic – a war being waged by nations across the world – is going to accelerate advances in innumerable medical technologies. 

History has already witnessed this truth as far back as the 14^th Century. The Bubonic Plague, which took away the lives of 50 million people^[iv], showed us how a pandemic can become the crucible of great technological advances. With epidemics claiming millions of lives, cities adopted new environmental “engineering” approaches that focused on buildings with improved ventilation and drainage, street cleaning, and waste disposal. COVID-19 is going to hyper-advance the technology of intelligent robotics and applications in health care—bringing safety, precision, and speed of treatment to the forefront. 

Safer, tireless, precise

Innovators are already entrusting hard robots – physical entities, some in the form of exoskeletons – with the task of waging war against COVID-19. Self-deploying intelligent robots are disinfecting hospitals using UV, handling samples and lab work, delivering food using touchless processes, and remotely monitoring isolation wards without the threat of infecting health workers.^[v] They can be used to handle and dispose highly contagious hospital waste^[vi] and deliver medication and bed supplies to patients, and equipment to doctors in operating theaters without the need for humans.^[vii] 

Even more sophisticated robots in health care environments ensure doctors can work faster with greater precision and considerably reduced mental stress and physical exhaustion. Today, open heart surgery, once an extremely invasive procedure, is completed with a few incisions that allow doctors to insert surgical equipment and endoscopes into the body, magnified images on a screen, and long-handle robotic arms with haptic feedback.^[viii]

The arrival of intelligent life savers

Many of today’s robots in healthcare are motorized and automatic. They use a sequence of processes. With COVID-19, we are about to see an infusion of intelligence into these robots, turning them into autonomous, fast-moving, fast-thinking, life savers in health care. COVID-19 has accentuated the necessity of autonomous, intelligent robots. The demand for them was always there from hospitals that have wanted to minimize the number of times humans need to move in and out of OTs and ICUs (to examine patients, wheel in equipment, conduct procedures, and provide food and medication). But these tasks, at best, have low-levels of intelligence embedded in them. Pandemics like COVID-19 will ensure that robots have a new level of sophisticated abilities, such as image recognition, autonomous navigation, analytics, and natural language processing (NLP). 

Four key areas where robotics and related cyber-physical systems are expected to be applied include:

• Training and diagnostics where skills can be imparted, developed, and certified safely without fear of infection and sometimes without the need for human cadavers; in addition, medical interventions can be improved with the help of robotic diagnostics.
• Treatment where surgery has the potential to introduce a revolution, especially with the advent of 5G networks, in practices like orthopedics by delivering absolute precision and control.
• Patient care and rehabilitation that can be provided 24×7 at lowered costs and improve recovery time from weeks to days; in addition, nano robots can be used for targeted drug delivery with precise dosages that reduce side effects.
• Hospital management, especially for situations that involve emergencies and hazardous care.

Our Robotics practice is collaborating with startups and Wipro Enterprises to develop a hospital management solution that will deliver contactless delivery solutions to wards and ICUs. This will also enable medical practitioners to interact remotely with patients in the wards.

From cyber-physical systems to bionics

The good news is that technology has already begun to transform cyber-physical systems into bionics—a form of robotics that employs, among other things, prosthetics, computational photography, machine learning, laser powered depth scanning, analytics, Artificial Intelligence (AI), and medical science to overcome conditions that have so far eluded healing. These are in the form of bionic eyes, regrown bones, portable pancreas, smart knees, and wearable kidneys.^[ix]

The key to these dramatic advancements lies in the availability of enabling technologies (computer vision, 5G, AI, analytics) and human machine interfaces (foot pedals, voice commands, haptic feedback), energy systems that can power prosthetics and embedded cameras, and biocompatible materials (photopolymers, alginates) for tissue engineering and regenerative medicine.

Exoskeletons for next level care

Equally, extreme innovations are occurring in the area of exoskeletons. Exoskeletons have been used in military, construction, manufacturing, and industrial environments to enable labor-intensive activities like lifting and moving heavy loads without injury or using heavy tools without feeling their weight. As an example, Boeing has used exoskeletons for repetitive tasks as a means to accelerate the manufacture of its Dreamliner.^[x]However, exoskeletons are increasingly finding their way into medicine and changing the way people live. Exoskeletons in medicine can improve mobility in the aged and assist in stroke and spinal cord injury rehab by promoting correct movement patterns. Exoskeleton technology has a long way to go, and questions surround its safety, cost, and clinical efficacy. However, the technology improves with every passing day, holding the potential to overcome handicaps and provide independence to the infirm in shopping malls, restaurants, parks, etc.

Addressing the new normal

Robotics, with an infusion of intelligence, presents one of the most interesting opportunities in health care—especially given that hazardous environments are going to be part of the new normal in which patients, doctors, and medical care teams will have to operate. 

Admittedly, we are decades away from mimicking the eyes, brains, and nervous systems of humans, but COVID-19 has shown the urgency with which we need to combine AI with robotics to provide doctors a better chance to fight the odds they are up against. Last year, a report by the Policy Department for Economic, Scientific, and Quality of Life Policies in the European Union estimated that the market for AI in health care will reach around US$6.6 billion by 2021 (about EUR 5.8 billion) and result in major cost savings for health care systems.^[xi] With the arrival of COVID-19, those budgets are likely to increase several fold, making robotics the new area of interest in health care.

References

^[i] https://www.mentalfloss.com/article/31882/12-technological-advancements-world-war-i

^[ii] https://www.fpri.org/article/2018/02/advances-in-medicine-during-wars/

^[iii]https://www.researchgate.net/post/Do_enormous_advancements_in_the_states_of_science_and_technology_depend_on_war_or_the_threat_of_war

^[iv] https://www.historytoday.com/archive/black-death-greatest-catastrophe-ever

^[v] https://www.dezeen.com/2020/02/20/drones-robots-coronavirus-china-technology/

^[vi] https://bodegasbegastri.com/robotic-medicine-may-be-the-weapon-needed-to-combat-the-coronavirus/

^[vii] http://www.hoomansamani.com/coronavirus

^[viii] https://www.davincisurgery.com/procedures/cardiac-surgery

^[ix] https://www.livescience.com/12954-bionic-humans-artificial-limbs-technologies.html

^[x] https://www.reuters.com/article/us-boeing-787-dreamliner/boeing-goes-bionic-to-roll-out-more-dreamliners-idUSKCN1PQ4X7?il=0

^[xi] https://www.europarl.europa.eu/RegData/etudes/IDAN/2019/638391/IPOL_IDA(2019)638391_EN.pdf

Hemachandra Bhat

Hemachandra Bhat is the Senior Delivery Manager, CTO Office, Wipro.

With more than 30 years of experience in product development, he has led the development and deployment of many products, including personal computers; servers; System on Chip (SoCs) for automotive/ consumer applications; and embedded systems for consumer applications. He has led the development of AI solutions for banking, manufacturing, and FMCG customers as part of CTO’s office. Currently, he heads the Robotics practice in Wipro that develops robotics solutions for manufacturing operations. He holds a Master’s Degree in Software Systems. To his credit, he has one patent granted and two pending.