The medical world has grown accustomed to surgical and nursing robots

Like for many other technologies related to the health sector, COVID-19 has had a major effect on the use of robots and robotics in medical care. The use of droids surged during the pandemic, and this has changed many ways of doing things.

While robotic arms have been used in surgery since the 1980s, the technology has matured and is now employed for increasingly complex tasks, a trend which accelerated during and after COVID. Robotic arms are regularly used to assist minimally invasive surgeries which are performed through very small incisions. Working manually through a button-sized incision is difficult, even for an experienced surgeon. Surgical robots help to make these procedures easy and accurate, with a goal to reduce infections and other complications. Surgeons control the robotic arms using a computer. This enables them to have a high-definition, 3D view of the surgical site.

The IEC is leading the way when it comes to safety and performance of medical equipment standards. IEC Technical Committee 62 prepares standards for medical equipment, software and systems, including for surgery. It publishes IEC 80601-2-77, which specifies particular requirements for the basic safety and essential performance of robotically assisted surgical equipment.

Moreover IECEE, the IEC System of Conformity Assessment Schemes for Electrotechnical Equipment and Components, offers testing and certification for the safety, quality, efficiency and overall performance of electrical equipment for medical use, to IEC International Standards.

Cleansing robots

Much written about was the use of robots for disinfection during the pandemic: in Chinese, Italian and many other hospitals around the world, these were employed for cleansing patient rooms and operating theatres. The benefits of employing droids for this sort of thankless and tiring work have outlived the pandemic and robots are now used in many medical facilities as a matter of course. The cleansing devices use a mobile array of powerful short wavelength UV-C lights that emit enough energy to literally shred the DNA of any dangerous micro-organisms.

The cleansing process itself is far from new: UV-C germicidal irradiation has been used in medical sanitation since the middle of the 20th century. At wavelengths of 200-280 nanometres (nm), UV-C light breaks molecular bonds in the DNA of microorganisms and viruses, stopping them from reproducing.

Despite it being a well-established way of destroying germs, using UV-C devices is not without risk. UV-C irradiation can cause injury to the skin and eyes if people are in the vicinity of the device for a too long period of time. The pandemic prompted both the IEC and the Global Lighting Association (GLA) to act together quickly to limit the risks of using such equipment. A publicly available specification, IEC PAS 63313, was issued as a result of their joint efforts.

“The IEC has established a new working group, TC 34/WG 23 which looks at UV-C irradiation for germicidal purposes. We are considering the proposal of a new work item, based on the PAS. The idea would be to develop a new IEC Standard, which will initially deal with the safety aspects related to UV-C radiation used for disinfection. The new work item must still be approved by the members of TC 34,” explains John Gielen, who is one of the convenors of the new working group.

The use of autonomous devices for cleansing hospital rooms relieved exhausted staff and stopped them from entering in contact with the virus. Very much like any autonomous vehicle, the portable droids require sensors and sometimes light detection and ranging (LIDAR), which is a remote sensing method that uses light in the form of a pulsed laser, to measure variable distances between objects.

IEC Standards help to specify the safety and performance benchmarks for many of these devices. IEC TC 47, which produces some of the key standards relating to sensors, publishes IEC 62969, which deals with the general requirements of power interfaces for automotive vehicle sensors. IEC TC 100 publishes standards for audio, video and multimedia systems and has established Technical Area 17 focused on multimedia systems and equipment for vehicles.

Hospital bots everywhere

While robots were initially used for cleansing, they rapidly carried out other tasks, for instance delivering food trays to patients. A field hospital staffed by robots opened in the Hongshan Sports Center in Wuhan, China, during the pandemic. All medical services in the facility were carried out by robots and other Internet of Things (IoT) devices. Patients entering were screened by connected 5G thermometers to alert staff to anyone who had a temperature.

Robots are even used in pharmacy. The Children’s Specialty Hospital, Al Jalila, one of Dubai’s best paediatric hospitals, uses robotics in its outpatient pharmacy. Robotic arms can pick the right capsules, medicinal packets or collect and label the medicine. The joint technical committee formed between IEC and ISO, JTC 1, prepares standards for information technology (IT). It comprises many subcommittees, including ISO/IEC SC 41, which prepares standards for the IoT and Digital Twin.

IEC TC 62 has published a standard for robots used in medical care, IEC 80601-2-78. The standard specifies safety and performance requirements for medical robots that physically interact with an impaired patient. These robots are expected to support and help with the rehabilitation, assessment, compensation or alleviation of patients who have difficulties to move.

Droids in care homes

Home became our refuge during the pandemic. We became used to consulting doctors online and getting prescriptions electronically. Many elderly people who lived in care homes found their lives drastically changed for the worse, when they were forbidden visitors and told to stay in their rooms for hours on end. Medical staff had to be extra careful when looking after them as they were most susceptible to catch the virus. Some initiatives during and just after COVID helped to improve their daily lives.

Robots able to hold simple conversations and learn about people’s interests were deployed in some UK care homes after an international trial found they boosted mental health and reduced loneliness. Called “Pepper”, the robots were capable of moving independently and making gestures with robotic arms and hands. After some initial programming they learned about the interests and backgrounds of care home residents. Deep learning algorithms allowed them to initiate rudimentary conversations, play residents’ favourite music, and offer practical help including medicine reminders.

ISO/IEC SC 42 prepares standards relating to artificial intelligence. It publishes a technical report, ISO/IEC TR 24372, which aims to help users understand algorithms by categorizing them according to the purpose of the AI system. The TR provides an overview of the state of the art of computational approaches for AI systems. It describes not only the main computational characteristics of AI systems, but also the principal algorithms and methodology used in AI systems, referencing use cases contained in ISO/IEC TR 24030.

Helping people to stay at home longer

The pandemic highlighted problems health professionals and governments were already aware of. Unless it can’t be avoided, it is better for elderly people to live in their own homes as long as possible with the assistance of specific technologies and services, called active assisted living tools. It is less costly for the healthcare system and is better for the psychological well-being of this growing demographic.

To standardize Active Assisted Living (AAL) technologies, the IEC has established the Systems Committee IEC SyC AAL. This SyC has the role of promoting safety, security, privacy and cross-vendor interoperability in the use of AAL systems and services, and of fostering standardization, which boosts their usability and accessibility. Its role and scope are constantly being expanded.

“IEC SyC AAL brings together many stakeholders, including developers, manufacturers and suppliers, medical device and pharma companies and more recently technology companies, as well as regulators and policy makers, so as to ensure the products and systems developed for AAL users and health service providers are safe and follow regulations,” explains the current Chair of SyC AAL, Ulrike Haltrich. “AAL publications in the pipeline”, Haltrich adds, “include a standard which considers the functional performance criteria for robots used in AAL connected home environments.”

Robots are here to stay and, contrary to popular belief, are not going to replace us. They are helping with difficult and tiresome work that humans are increasingly reluctant to do but also with precision surgery that requires computer-aided visualization.

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