How robots could deliver urgent triage in our hospitals

As the urgency of maintaining population health becomes a pressing reality, governments and regions seek innovative solutions to the impending crisis in the health system. Australia has a world-class health system but there is little spare capacity in our hospital emergency departments to admit large numbers of seriously ill citizens. We must think and work smarter to optimise our health system before it is inundated by a tsunami of acutely unwell patients.

We are all in this together

In Australia, a mobile platform could be used to quickly reach and engage large populations to undertake quick surveys, capture accurate clinical and mobile data then understand the health status of individuals at risk using COVID-19 assessment protocols.

If hundreds of thousands or even millions used a mobile app linked to a control centre console, COVID-19 clinical and operational teams could review real-time information and send notifications to state and federal health services and quarantine centres to activate specific pathways such as self-isolation or quarantine. Mobile geolocation features combined with large-scale functionality in the platform could be used to notify users, activate quarantine management, and provide home monitoring and care coordination.

For this to work effectively individuals would need to consent to share their health status in the app — for their own good and for the good of the wider community. My Health Record might be a good digital place to capture that consent given that 90% (22.7m) of Australians have one. This would allow government public health services to better coordinate the national response by delivering local health care that meets the needs of local communities and citizens.

Real-time digital data beats a gut feeling

Most Australian hospitals are now digital. This means that they have electronic systems of records that can communicate with other systems to improve patient health in real time. If we work smarter, frontline clinicians can do their job in a safer, faster and more effective way.

Sharing individual and aggregated data from patient administration systems and electronic medical record systems for health surveillance and monitoring will be critical if we are to understand when our quarantine centres and hospitals are nearing capacity and new patients must be redirected elsewhere. The system will need to work across public and private hospitals and quarantine centres so they can communicate in real time. This includes contact tracing and family relationship mapping so the right care can be delivered at the right place at the right time. This is not the time to be stuck in an ambulance going to the wrong hospital.

For this to work on a massive scale, it requires coordination at a health system, state and federal level so that real-time data can be shared quickly and dynamically between systems. We have the technology — but we have never had to use it before.

The robot will see you now

Most hospital emergency departments are already close to capacity, which means we need a dedicated process to receive and triage acutely unwell, ambulatory patients without distracting busy staff. In China, sick patients are now greeted by a robot that quickly takes their temperature, triages them and issues verbal instructions to go to the COVID-19 waiting area for testing and treatment. The robot is critical in minimising infection risk to patients and clinicians. These robots would work well in Australia once people understand they are there to keep us healthy and support our already overloaded medical staff. Critically unwell patients arriving by ambulance would bypass the robotic checkpoint.

It is likely that hospital beds and life support systems will be set up at short notice, and we need our skilled clinicians to be looking after our sickest patients while we leave the robots to do the important but higher volume, lower complexity tasks.

So what are the recommendations?

We need to quickly identify a crisis response platform that can be used to reach out to every Australian for public health surveillance and individual health status monitoring in real time so we can plan capacity for quarantine centres and hospitals.

We need to urgently procure and configure sufficient emergency department robots to triage large numbers of patients for COVID-19 treatment.

Government and private sector need to work together quickly and productively without overly onerous delays caused by probity and value for money concerns. We need to spend our limited health resources wisely — but remember that every delay will mean more lives in the balance.

As a society and as a nation we must overcome the barriers and obstacles that hold us back so that we can look back on this time with the satisfaction that we did everything we could. Now is the time for Australians to demonstrate that we are stronger when we act together.