Robots have been in use in the healthcare sector for some time, operating largely behind the scenes. Over the last five years, the range of robotic applications in healthcare has expanded rapidly to include assistive applications for doctors, nurses, caregivers and patients in hospitals and care facilities.
In the first of a two-part series, this blog will look at robot applications in drug development and production, drug dispensing in pharmacies and hospital logistics.
Drug development and production
Robots are in use across the whole pharmaceutical supply chain, from basic research to the production of medicines, quality inspection and packaging. Robots support the discovery of vital new treatments; enable faster medical tests for patients; help pharmaceutical manufacturers to meet increasingly strict regulations for the production of medicines and maximise the efficiency of drug production.
Since industrial robots have their origin in manufacturing sectors, it’s no surprise that they are most established in the manufacturing phase of the drug development lifecycle. The technologies needed for performing repetitive tasks with high degrees of precision and accuracy are already mature. The main focus of robots in the manufacturing process is at the filling, assembly and packaging stage, where tasks include filling and labelling containers, assembling finished products such as syringes and packaging assembled products.
For example, industrial robots are used for the assembly of medical syringes (FANUC/Farason) or for filling and closing of vials (Stäubli/Zellwag Pharmatech).
FANUC robots were used by system integrator Farason Corporation in a medical syringe assembly system.
While the applications themselves are well-established, the specifications for robots used in pharmaceutical and medical applications are often much tighter than those for other industries. Working in clean-rooms or sterile environments, for example, requires special filtration and ventilation system to protect against the emission of gases and particles. Clean-room robots often have a stainless-steel finish without paint, to prevent adherence of dust and dirt and allow for proper cleaning and sterilization.
Using robots in laboratories for drug development as well as for testing is less well established but this is changing. Robots in laboratories free scientists and laboratory technicians from tedious, repetitive tasks such as pipetting and vial filling, giving them more time to focus on science, and protecting them from repetitive strain injuries.
Most research laboratories are not automated, and the range and shorter runs of procedures in smaller laboratories means robots have not yet proved cost-effective. This is changing, particularly with the rise of cobots able to work alongside humans as well as dual-armed robots able to perform a variety of tasks – for example, a dual-armed robot performing a variety of tasks in a biomedical cell.
Robots are already more established in hospital laboratories with large throughput of tests. For example, Copenhagen University Hospital (video) was able to maintain a response rate of delivering 90% of all results within the hour despite a 20% increase in blood samples, due to the adoption of collaborative robots. Also traditional industrial robots can be used for the automated sorting of blood samples, as shown by Aalborg University Hospital.
Pharmacy dispensing is a relatively new application for robotics but has a promising future. Robots improve the efficiency and – vitally – the accuracy of drug dispensing in pharmacies. Medication errors, which include dispensing errors, account for cost US$42bn worldwide (IMS Institute for Healthcare Informatics). The British Wirral University Teaching Hospital, for example, reported a 50 percent reduction of dispensing errors in the four months after implementing a pharmacy robot (Journal of mHealth).
Robots are used in both hospital and community pharmacies that deliver medications ordered online. For example, the Shanghai Seventh People’s hospital uses two robots to automate dispensing. One robot locates the medicines in the prescription, which is entered online, while the second assembles the medications in a basket for each order.
ABB pharmacy dispensing robots at the Shanghai Seventh People’s hospital.
Going forward, we can expect to see advances in grippers supporting more applications involving handling of delicate materials in laboratories and packaging. We may also see increasing adoption of robotic vision technologies for quality inspection and tracking. Vision technologies are widely used in the pharmaceutical industry but are typically not mounted onto the robot. While robots in the applications described above are almost exclusively static, we are seeing the start of applications combining a mobile base and robot arm, which allows the robot to perform sequential tasks that involve moving from one machine to another. ABB is prototyping this concept at the Texas Medical Center for example.
Though autonomous mobile robots (AMRs) have been used for some time in hospitals to transport linens, medication and medical equipment, this still is a relatively immature market as many hospitals operate under tight budgetary constraints and have not yet turned to automation. A shortage of healthcare workers in many countries is likely to spur adoption. The boom in AMR manufacturers combined with increasing maturity and cost-effectiveness of the component technologies and assistive tools for installation is likely to reduce the overall cost of installation, further spurring uptake.
In a typical 200-bed hospital, equipment and waste is transported just under 400 miles per week. It is estimated that the use of AMRs reduces the cost per delivery by 50-80% and reduces the average distance of 3-4 miles that a nurse walks each day. These robots reduce back injuries from lifting in hospital personnel and give nurses more time to concentrate on patient care.
To work in hospitals and care facilities, AMRs need to negotiate elevators, and some can issue simple voice commands to alert people to their approach. For example, Zealand University Hospital in Denmark uses an AMR to transport goods from the hospital’s sterilization center. The robot travels more than 10 kilometers per week, improving service, minimizing storage space, reducing walking time for personnel, and preventing equipment shortages.
Going forward, we will need developments in standards for interaction with hardware such as elevators and doors. Communications protocols will reduce overall cost of implementation by enabling faster integration.
In global comparison, some countries are further ahead than others when it comes to the testing and deployment of new technologies in the healthcare sector. There is a discrepancy between companies in the private sector, that usually are driven by competition and the need for high productivity, while publicly-funded undertakings like hospitals are often working on tight budgets and the return on invest for longer-term investments into technology is not yet in the focus.
While in the examples shown so far, the robots mostly are either operating in isolation or interact preferably with trained personnel, AMRs and other types of service robots in healthcare are starting to be used for applications in which the robot has direct contact with patients. Part 2 of this blog will focus on the latter applications.
Teaser picture: ABB pharmacy dispensing robots at the Shanghai Seventh People’s hospital © ABB