How 3 Organisations Used Telepresence Robots to Streamline Processes and Minimise Cross-Infection

Technology has made its presence known in every sector. While services and systems meet constant improvement, Singapore has been putting in conscious effort in providing for a specific group set — its ageing population. With digital technology transforming the delivery of healthcare, the Community Care sector has explored using technological innovations to better engage seniors and increase their quality of life. Enter the Telepresence Robots.

The Rise of Robots

The ongoing Covid-19 pandemic and various advisories put in place have placed a strain on the Nursing Homes. Social distancing measures have directly impacted the quality of human interaction and engagement, especially for the elderly. Care staff had to work in split team/zone work arrangements, and caregivers, visitors and volunteers were not allowed into the facilities to minimise the risk of infection.

The restrictions also had an impact on the well-being of residents, who could not interact with their loved ones.

To mitigate these challenges, some of the partners in the Community Care sector decided to try introducing Telepresence Robots in their homes.

Tried and Tested

The Telepresence Robots had undergone a rigorous testing period with three organisations in Singapore, namely Sree Narayana Mission Nursing Home, Vanguard Healthcare and Thye Hwa Kwan group that covers Ang Mo Kio - Thye Hua Kwan Hospital,  Thye Hua Kwan Moral Charities, and Thye Hua Kwan Nursing Home. Each pilot lasted three months for each provider, and these separate trial periods were conducted between August to November 2020, respectively.

Key Success Factor

It was noted that across all the pilots, the success for implementation varied, and those who were more successful in implementation and adoption went through a thorough process review strongly supported by their management.

These Telepresence Robots would fulfil four forms of engagement:

• Family Engagement
• Volunteer Engagement
• Inter-floor/Inter-room Engagement
• Night Sentry Duty

Family Engagement

One of the objectives of Telepresence Robots was to help bridge the gap between residents and their family members. Due to Covid-19 restrictions, residents could not meet their loved ones physically. However, the Telepresence Robots enabled them to stay in touch through video calls, allowing them to not only hear the voices of their loved ones, but also see them on-screen. This visual communication helped manage the general well-being of residents who are prone to bouts of depression and loneliness.

Volunteer Engagement

Thanks to their remote mobility function, the Telepresence Robots were central in allowing volunteers to interact with residents without physically being at the nursing homes. This ensured the human connection of conversing and building friendships were maintained sans the risk and effects of COVID-19.

Inter-Floor and Inter-Room Engagement

Community well-being is also important to the residents, which is why the Telepresence Robots’ ability to roam around on the staff’s behalf promotes both Inter-Floor and Inter-Room Engagement. For example, in Thye Hua Kwan Nursing Home, the Telepresence Robots were used to coordinate cross-ward activities. Two robots were placed in different locations, but controlled by a single user, allowing the user to be simultaneously present at various locations.

This led to an increase in efficiency, as it reduced the need for staff to travel between wards. This ensured greater staff utilisation for the care home and simplified web-based communications via an easy-to-use device.

Furthermore, the introduction of Telepresence Robots also reduced the need for face-to-face interactions between clinicians and residents. This not only minimised the rate of cross-infections while providing clinical care, but also helped identify and treat any symptoms more accurately compared to consultations based on audio alone.

Vanguard Healthcare noted that the Telepresence Robots made for a useful communication tool. The therapy aides use the robots to screen movies and sing-a-long sessions for bed-bound residents.

Night Sentry Duty

The Telepresence Robots also proved to be highly useful when it came to Night Sentry Duty. The use of Telepresence Robots allowed for easy monitoring of the residents, as it provided a good overview of the entire cluster, especially with the robot’s clear night vision capability. With this addition, the Night In-Charge could monitor the ward without physically going to the wards to check on residents.

The Telepresence Robots also boast other features:

• The controls for the robot can be managed on a mobile phone, tablet or laptop, making it easy for the nursing homes to incorporate, regardless of the type of device they’re working with. The robots are also compatible with all device platforms (i.e. Windows, Mac OS, Android and iOS).
• The robot is very intuitive, making it easily adaptable by experienced and inexperienced users alike.
• Clear audio quality and screen resolution add to the ease and comfort of engaging with the robot.
• Added security and convenience with custom link for each family conference session. Upon set-up, family members would receive a custom link, allowing for users to stay in touch with loved ones easily.
• The robot is able to reach a speed of 2km/h and tow up to 2kg worth of items, although users have noted that using it as its maximum capacity would shorten battery life.
• Despite their abilities to perform many functions, these robots are not meant to be autonomous. Operation and management should be controlled by care staff, MSW, etc.
• Good WiFi coverage is an ideal setting for the robots to perform at their optimum capabilities.

Challenges

Although the benefits of the Telepresence Robots prove to be a great addition both socially and professionally, one of the trial’s unintended benefits was the identification of weakness in WiFi infrastructure within the establishments. Through this pilot, two of the establishments have made upgrading their WiFi infrastructure a priority, as they  recognised that having good connectivity within the establishment itself was key to leveraging on the Internet of Things and smart devices such as the Telepresence Robots.

Ang Mo Kio - Thye Hua Kwan Hospital found the battery life of the Telepresence Robots to be short. However, they foresee themselves using the robots in isolation rooms so that no physical or close interaction is required by the users to the isolated patients. They might also consider using the robots to deliver documents or other non-perishable items as another option to use the robots, but doesn’t rank that as a priority.

Vanguard Healthcare noted that some of the challenges faced by their staff were the low speaker volume and delayed voice recognition, which led to slight delays in response from the residents.

Testimonies

Sree Narayana Mission Nursing Home

The team noted that while residents were able to connect with loved ones through telepresence during the pandemic, the added advantage of using the Telepresence Robots was the personal space it afforded the residents. As it was not necessary for a care staff to be present during the video calls, residents could enjoy privacy with their loved ones throughout the call.

Vanguard Healthcare

The staff rostered for the night shift utilises the Telepresence Robots to monitor the residents. The robots are deployed to make rounds in the ward and check on restless residents who are not asleep. The Night In-charge can also communicate with residents remotely via the Telepresence robots without having to physically check on the residents.

Thye Hua Kwan Moral Charities

For those undergoing rehabilitation care, the robots were able to facilitate tele-rehabilitation sessions, thus eliminating the need for travel time (saving up to 60 minutes per session) and transport fees for the client and therapist alike. Thye Hua Kwan Moral Charities chose to utilise Telepresence Robots specifically for home therapy sessions with their clients. The robots were placed in the client’s home for home therapy sessions to train the client to strengthen their core muscle and upper/lower limb strength, as well as functional mobility. Caregivers were able to conduct home therapy effectively and confidently, thanks to the Telepresence Robots.

Another use of a Telepresence Robot was allowing the supervisor of Occupational Therapists (OTs) to observe them during therapy sessions with their clients, and provide feedback via the robot. Both the supervisor and OT who were part of the pilot attested that it was as good as having an in-person session.

Overall feedback

The teams had positive feedback on the features of the robots, namely for their good video quality and clear speakers/microphone, which made video calls with caregivers easy and seamless.

Some of the additional feedback from the clinical teams touched on the aspect that the robots were able to deliver medication and small items on their behalf to patients who require attention to these matters on a daily basis while being easy to operate across the teams.

The robots have also become a welcome addition amongst the residents during their recreational time as the robots allowed them to communicate/play games with one another while being socially distanced.

Summary

While it is safe to say that Telepresence Robots are not here to replace people and their jobs entirely, they have proven to be a handy little helper much needed during the time of physical limitations. In a time like COVID-19 where face-to-face engagements were prone to risk and infection, Telepresence Robots were able to step into the gap, ensuring the safe and effective needs of human connection.