Robotic technology for palliative and supportive care: Strengths, weaknesses, opportunities and threats

Background: Medical robots are increasingly used for a variety of applications in healthcare. Robots have mainly been used to support surgical procedures, and for a variety of assistive uses in dementia and elderly care. To date, there has been limited debate about the potential opportunities and risks of robotics in other areas of palliative, supportive and end-of-life care. Aim: The objective of this article is to examine the possible future impact of medical robotics on palliative, supportive care and end-of-life care. Specifically, we will discuss the strengths, weaknesses, opportunities and threats (SWOT) of this technology. Methods: A SWOT analysis to understand the strengths, weaknesses, opportunities and threats of robotic technology in palliative and supportive care. Results: The opportunities of robotics in palliative, supportive and end-of-life care include a number of assistive, therapeutic, social and educational uses. However, there are a number of technical, societal, economic and ethical factors which need to be considered to ensure meaningful use of this technology in palliative care. Conclusion: Robotics could have a number of potential applications in palliative, supportive and end-of-life care. Future work should evaluate the health-related, economic, societal and ethical implications of using this technology. There is a need for collaborative research to establish use-cases and inform policy, to ensure the appropriate use (or non-use) of robots for people with serious illness.

[1]  R. D. Jackson,et al.  Rehabilitation robotics in Europe , 1995 .

[2]  W. R. Griffin Where are the robots? Good and bad news for automated cleaning. , 2001, Health facilities management.

[3]  Mordechai Ben-Menachem,et al.  Writing effective use cases , 2001, SOEN.

[4]  Russell H. Taylor,et al.  A Perspective on Medical Robotics , 2006, Proceedings of the IEEE.

[5]  Garrett Grindle,et al.  A perspective on intelligent devices and environments in medical rehabilitation. , 2008, Medical engineering & physics.

[6]  Bruce A. MacDonald,et al.  Acceptance of Healthcare Robots for the Older Population: Review and Future Directions , 2009, Int. J. Soc. Robotics.

[7]  T. Shibata,et al.  Robot Therapy: A New Approach for Mental Healthcare of the Elderly – A Mini-Review , 2010, Gerontology.

[8]  N. Sharkey,et al.  Granny and the robots: ethical issues in robot care for the elderly , 2012, Ethics and Information Technology.

[9]  D. Weber,et al.  The role of assistive robotics in the lives of persons with disability. , 2010, American journal of physical medicine & rehabilitation.

[10]  Hugh J. Lavery,et al.  76 NOT A ZERO-SUM GAME: THE ADOPTION OF ROBOTICS HAS INCREASED OVERALL PROSTATECTOMY UTILIZATION IN THE UNITED STATES , 2011 .

[11]  A. Nwosu,et al.  Palliative medicine and smartphones: an opportunity for innovation? , 2011, BMJ Supportive & Palliative Care.

[12]  Marco Ceccarelli,et al.  Problems and Issues for Service Robots in New Applications , 2011, Int. J. Soc. Robotics.

[13]  Ryan A. Beasley Medical Robots: Current Systems and Research Directions , 2012, J. Robotics.

[14]  P. Flandorfer Population Ageing and Socially Assistive Robots for Elderly Persons: The Importance of Sociodemographic Factors for User Acceptance , 2012 .

[15]  Julie Huschilt,et al.  The use of socially assistive robots for dementia care. , 2012, Journal of gerontological nursing.

[16]  M. Karimi Robotic rehabilitation of spinal cord injury individual. , 2013, Ortopedia, traumatologia, rehabilitacja.

[17]  Francisco Martín Rico,et al.  Robots in Therapy for Dementia Patients , 2013 .

[18]  B. O'Neill Pairing new approaches with conventional cleaning to improve hospital infection control. , 2013, Occupational health & safety.

[19]  Sandra Bedaf,et al.  Overview and Categorization of Robots Supporting Independent Living of Elderly People: What Activities Do They Support and How Far Have They Developed , 2015, Assistive technology : the official journal of RESNA.

[20]  Reuven Katz Tele-care robot for assisting independent senior citizens who live at home , 2015, AAATE Conf..

[21]  Franz Werner,et al.  Assessing User Needs and Requirements for Assistive Robots at Home , 2015, AAATE Conf..

[22]  J. Gould,et al.  Current state of virtual reality simulation in robotic surgery training: a review , 2016, Surgical Endoscopy.

[23]  Norman Hendrich,et al.  Architecture and Software Design for a Service Robot in an Elderly-Care Scenario , 2015 .

[24]  Zhenhai Zhang,et al.  Development of a Biomedical Micro/Nano Robot for Drug Delivery. , 2015, Journal of nanoscience and nanotechnology.

[25]  M. Birks,et al.  Robotic Seals as Therapeutic Tools in an Aged Care Facility: A Qualitative Study , 2016, Journal of aging research.

[26]  Yukie Majima,et al.  Utilization of Communication Robot in Patient Education , 2016, Nursing Informatics.

[27]  Eduard Clotet,et al.  Assistant Personal Robot (APR): Conception and Application of a Tele-Operated Assisted Living Robot , 2016, Sensors.

[28]  Alexander Hörbst,et al.  Robotic Assistance in Medication Management: Development and Evaluation of a Prototype , 2016, Nursing Informatics.

[29]  T. Körtner,et al.  Ethical challenges in the use of social service robots for elderly people , 2016, Zeitschrift für Gerontologie und Geriatrie.

[30]  M. Hanheide,et al.  Robot deployment in long-term care , 2016, Zeitschrift für Gerontologie und Geriatrie.

[31]  Julia Adler-Milstein,et al.  Making IT work - harnessing the power of health information technology ti improve care in England , 2016 .

[32]  J. Torsner,et al.  Internet of Things in the 5G Era: Enablers, Architecture, and Business Models , 2016, IEEE Journal on Selected Areas in Communications.

[33]  L. Billeci,et al.  Autism and social robotics: A systematic review , 2016, Autism research : official journal of the International Society for Autism Research.

[34]  Maria Rita Palattella,et al.  Internet of Things in the 5G Era: Enablers, Architecture, and Business Models , 2016, IEEE Journal on Selected Areas in Communications.

[35]  P. Shaw,et al.  High-fidelity simulation: Teaching end-of-life care. , 2017, Nurse education today.

[36]  Sandra Petersen,et al.  The Utilization of Robotic Pets in Dementia Care , 2016, Journal of Alzheimer's disease : JAD.

[37]  A. Nwosu,et al.  O-7 Robotic technology and palliative care education: the development of a ‘nao robot’ computer program , 2017, BMJ Supportive & Palliative Care.

[38]  D. Smink,et al.  An appraisal of the learning curve in robotic general surgery , 2017, Surgical Endoscopy.

[39]  H. Abdullah,et al.  Robotic assistants in personal care: A scoping review. , 2017, Medical engineering & physics.

[40]  E. Morya,et al.  Robotic assisted gait as a tool for rehabilitation of individuals with spinal cord injury: a systematic review , 2017, Journal of NeuroEngineering and Rehabilitation.

[41]  E. Swinnen,et al.  The immediate effects of robot-assistance on energy consumption and cardiorespiratory load during walking compared to walking without robot-assistance: a systematic review , 2017, Disability and rehabilitation. Assistive technology.

[42]  S. Tobis,et al.  Occupational Therapy Students' Perceptions of the Role of Robots in the Care for Older People Living in the Community , 2017, Occupational therapy international.

[43]  Wendy A. Rogers,et al.  Understanding the potential of PARO for healthy older adults , 2017, Int. J. Hum. Comput. Stud..

[44]  B. MacDonald,et al.  Homecare Robots to Improve Health and Well-Being in Mild Cognitive Impairment and Early Stage Dementia: Results From a Scoping Study. , 2017, Journal of the American Medical Directors Association.

[45]  Khaled Goher,et al.  Ethical framework of assistive devices: review and reflection , 2017, Robotics and biomimetics.

[46]  C. Abdelnour,et al.  Challenges for Service Robots—Requirements of Elderly Adults with Cognitive Impairments , 2017, Front. Neurol..

[47]  E. O. Polat,et al.  Energy‐Autonomous, Flexible, and Transparent Tactile Skin , 2017 .

[48]  C. Lockwood,et al.  Effectiveness of robotic assisted rehabilitation for mobility and functional ability in adult stroke patients: a systematic review , 2017, JBI database of systematic reviews and implementation reports.

[49]  M. Haghi,et al.  Wearable Devices in Medical Internet of Things: Scientific Research and Commercially Available Devices , 2017, Healthcare informatics research.

[50]  An In-home Advanced Robotic System to Manage Elderly Home-care Patients' Medications: A Pilot Safety and Usability Study. , 2017, Clinical therapeutics.

[51]  B. Draper,et al.  Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial. , 2017, Journal of the American Medical Directors Association.

[52]  J. Hindmarsh,et al.  A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making , 2017 .

[53]  B. Collins,et al.  Big Data analysis to improve care for people living with serious illness: The potential to use new emerging technology in palliative care , 2017, Palliative medicine.

[54]  I. Higginson,et al.  What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death , 2017, Palliative medicine.

[55]  B. Draper,et al.  Does Cognitive Impairment and Agitation in Dementia Influence Intervention Effectiveness? Findings From a Cluster-Randomized-Controlled Trial With the Therapeutic Robot, PARO. , 2018, Journal of the American Medical Directors Association.

[56]  Ayanna M. Howard,et al.  The Ugly Truth About Ourselves and Our Robot Creations: The Problem of Bias and Social Inequity , 2017, Science and Engineering Ethics.

[57]  Mary Brown,et al.  Infection prevention and control challenges of using a therapeutic robot. , 2018, Nursing older people.

[58]  D. Jayne,et al.  The role of robotics in colorectal surgery , 2018, Annals of the Royal College of Surgeons of England.

[59]  A. Sheikh,et al.  Health Care Robotics: Qualitative Exploration of Key Challenges and Future Directions , 2018, Journal of medical Internet research.

[60]  Hyunsuk Frank Roh,et al.  Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery in randomized controlled trials: A systematic review and meta-analysis , 2018, PloS one.

[61]  Benjamin R. Lee,et al.  Recent advancements of robotic surgery for kidney cancer , 2018, Asian journal of endoscopic surgery.

[62]  C. Gastmans,et al.  The use of care robots in aged care: A systematic review of argument-based ethics literature. , 2018, Archives of gerontology and geriatrics.

[63]  S. Tobis,et al.  Could Robots Help Older People with Age-Related Nutritional Problems? Opinions of Potential Users , 2018, International journal of environmental research and public health.

[64]  P. T. Jensen,et al.  A systematic review about costing methodology in robotic surgery: evidence for low quality in most of the studies , 2018, Health Economics Review.

[65]  N. Vasdev,et al.  The future of robotic surgery , 2018, Annals of the Royal College of Surgeons of England.

[66]  Corinne Cath Governing artificial intelligence: ethical, legal and technical opportunities and challenges , 2018, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[67]  E D Oña,et al.  A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb , 2018, Journal of healthcare engineering.

[68]  J. Sosa,et al.  Thyroid surgery for differentiated thyroid cancer — recent advances and future directions , 2018, Nature Reviews Endocrinology.

[69]  Vicente Julián,et al.  PHAROS—PHysical Assistant RObot System , 2018, Sensors.

[70]  Amanda K. Hall,et al.  Acceptance and perceived usefulness of robots to assist with activities of daily living and healthcare tasks , 2019, Assistive technology : the official journal of RESNA.

[71]  C. Rodriguez-Gonzalez,et al.  Robotic dispensing improves patient safety, inventory management, and staff satisfaction in an outpatient hospital pharmacy , 2018, Journal of evaluation in clinical practice.