COVID-19 and beyond: development of a comprehensive telemedical diagnostic framework

Abstract

Purpose During the COVID-19 pandemic, a threatening bottleneck of medical staff arose due to a shortage of trained caregivers, who became infected while working with infectious patients. While telemedicine is rapidly evolving in the fields of teleconsultation and telesurgery, proper telediagnostic systems are not yet available, although the demand for contactless patient–doctor interaction is increasing. Methods In this project, the current limitations were addressed by developing a comprehensive telediagnostic system. Therefore, medical examinations have been assessed in collaboration with medical experts. Subsequently, a framework was developed, satisfying the relevant constraints of medical-, technical-, and hygienic- aspects in order to transform in-person examinations into a contactless procedure. Diagnostic steps were classified into three groups: assisted procedures carried out by the patient, teleoperated examination methods, and adoptions of conventional methods. Results The Telemedical Diagnostic Framework was implemented, resulting in a functional proof of concept, where potentially infectious patients could undergo a full medical examination. The system comprises, e.g., a naso-pharyngeal swab, an inspection of the oral cavity, auscultation, percussion, and palpation, based on robotic end-effectors. The physician is thereby connected using a newly developed user-interface and a lead robot, with force feedback control, that enables precise movements with the follower robot on the patient’s side. Conclusion Our concept proves the feasibility of a fully telediagnostic system, that consolidates available technology and new developments to an efficient solution enabling safe patient-doctor interaction. Besides infectious situations, this solution can also be applied to remote areas.

Mensch-Roboter-Interaktion: vernetzte, lernfähige Maschinen in der Medizin

“…To address this issue, for instance the company Franka Emika in collaboration with university hospital Klinikum rechts der Isar at Munich and our own group, developed a tele-diagnostic station based on the Panda tactile robot arm that comprises a naso-pharyngeal swab, and enough tools to inspect the oral cavity. The physician is connected through a leader robot to control the robot at the diagnostic station [7]. Similar efforts have been done in [8] for ultrasound scanning.…”

“…Sie basiert auf dem taktilen Roboterarm Panda, der einen Nasen-Rachen-Abstrich und notwendige Werkzeuge zur Untersuchung der Mundhöhle enthält. Der Arzt ist über einen Führungsroboter mit der Diagnosestation verbunden und kann so den Roboterarm aus der Ferne steuern [7]. Für Ultraschalluntersuchungen wird an ähnlichen Aufbauten gearbeitet [8].…”

Tactile Robotic Telemedicine for Safe Remote Diagnostics in Times of Corona: System Design, Feasibility and Usability Study

“…Importantly, a customized end-effector conceptualized and implemented by Franka Emika 5 was mounted at the Follower end-effector to help the medical doctor conduct the auscultation, palpation, and ultrasound that are required for medical diagnosis. This was based on the feedback received from medical experts and collaborators collected during the requirement study on telemedicine system [38], [39]. 6 3) Control Loop and Communication: All devices have one common feature that makes their data (signals) and interfaces accessible via Ethernet network using the Robot Operating System (ROS).…”

Telemedical percussion: objectifying a fundamental clinical examination technique for telemedicine

“…In order to expand current possibilities in telemedicine, a comprehensive tele-diagnostic system was developed [9]. The system is integrated into a special cabin as shown in Fig.…”