Robotic Triage

Long time readers know of my intense obsession dislike of equivocating nurses/nursing with robots, and here is a classic example. Somewhere, somehow, some engineer is just not getting what triage nurses do:

If a group of computer engineers gets their way, we will no longer hear stories of patients dying in the ER after excruciatingly long waits. A solution for overburdened triage staff and long emergency room wait times appears to be in sight.

If you’re willing to wait five years, robots could help speed the ER triage process, according to Mitch Wilkes, associate director of the Center for Intelligent Systems and associate professor of electrical and computer engineering at Vanderbilt University. He is the lead author of a paper presented yesterday at the Humanoids 2010 conference held in Nashville.

The paper describes an ER that would feature electronic kiosks (like those at the airport) at the registration desk and smart chairs. A mobile robot or two might monitor patients in the waiting room.

After I finished laughing a little too gleefully at the thought of patients screaming at a triage robot, it seemed to me there is some, um, misunderstanding about a nurse’s role at triage, which decidedly is not about taking the patient’s temperature and sending her out to the waiting room. And if patients are demanding more face time with a health care professional, installing robots seems, well, a little counter-intuitive.

Here’s a thought on how to relieve “overburdened triage staff”: instead of spending a gazillion dollars developing and setting up the technology, then a gazillion more for ongoing upgrades and maintenance (for you know these things will break down when someone looks at them cross-wise), why not just adequately staff emergency departments with real, live nurses?

Naw. Too simple.

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  1. #1 by Sean on Wednesday 22 December 2010 - 1044

    I think this simple ‘concept’ reverberates throughout the health care profession and nursing community doesn’t it. It seems that staffing is always last on the list. *sigh*

  2. #2 by Not Nurse Ratched on Wednesday 22 December 2010 - 1251

    They won’t get far with this idea. A robot would be foiled instantly, with “enter your pain level from 0 to 10,” because patients would be unable to poke a key. “Well, earlier it was a 4, but then I did something stupid and it became an 8, and if I sit totally still it’s a 6. What? RIGHT NOW it’s…8.375, ballpark.”

    Game over, robot.

  3. #3 by Jenn Jilks on Wednesday 22 December 2010 - 1317

    OMG. The sheer joy of visiting the ER, finding a human who will listen to your symptoms, insists you put on a mask (as you are coughing your guts up), takes your temperature, blood pressure, with caring, and understanding, with the assurance that ‘the doctor will be right with you’, and me not paying a dime up front for this medicare program, since we all pay a little through taxes, and then getting home within the hour with a Rx written for your whooping cough…

    Triage is a science best benefitted from not only facts, but experience, compassion, eye contact, ethics, and an understanding of what can and cannot wait.

    God bless our triage nurses.

  4. #4 by Boris on Wednesday 22 December 2010 - 1415

    This is far too close the hospital triage scene in “Idiocracy”…

    • #5 by Susan Hughes on Saturday 15 January 2011 - 0925

      Can I get a position as a triage nurse in your ED if you have time to do all that at triage? I also love the part about getting seen and home within an hour.
      Today I would have welcomed a triage robot or a short row of computerised cubicles to deal with everyone who came into ED instead of taking their Category 5 complaints to a gp …….. and then complaining about the 2 – 3 hour wait to see the doctor (that was the definition of “the doctor will see you shortly” for today).

  5. #6 by Erin Blakley on Monday 18 June 2012 - 1552

    Triage robots — like most robots in general — aren’t meant to replace triage nurses, just assist with the job. They can gather more information while you all do something else vitally important to health care. (No sarcasm intended.) And the money invested in this kind of technology will pay itself off over the years, especially as it’s generalized to other industries.

    And actually, the engineers developing this kind of tech probably do know — and are still learning — A LOT about triage, or they wouldn’t be able to develop the kind of complex “architecture… designed to allow robots to integrate quick decision-making with the more common deliberate decision-making process in flexible ways” like humans do. They are aware that human mental processing is complicated and unique, and they’re working hard to account for everything possible.

    This article is far more balanced than the one you cite: http://news.vanderbilt.edu/2010/12/developing-robots-for-the-hospital-emergency-room/. Note that their paper, “Heterogeneous Artificial Agents for Triage Nurse Assistance” emphasizes that the “agents” are for “nurse ASSISTANCE.” It’s not the engineers “not getting what triage nurses do”; it’s the journalists!

    I think your job is awesome, I could never in a million years do what you do, and I appreciate the effort you put into it. :)

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