Robotics telepresence in acute care facilities during influenza AH1N1 outbreak in Mexico

Introduction

The main objective of this study is to show the experience of using telepresence with robots in acute care facilities (ACFs) at community hospitals (CHs) during an influenza AH1N1 outbreak in Mexico.

Methods

Three CHs with 60 beds each were equipped with a telepresence system that includes: high-speed connectivity, wireless Internet access, a RP-7i robot (InTouch Health, Santa Barbara, CA, USA) and a central computer based at a high-care hospital. The CHs give medical care to people without social security and are far away from the capital city at not less than 63 km (Atlacomulco 63 km, Valle de Bravo 85 km and Tejupilco 90 km). The program was designated to assist physicians in ACFs, which include emergency rooms (ERs) and ICUs during the second wave of an influenza AH1N1 outbreak in Mexico. The program includes: rounds at the ACF and isolation area for patients with influenza-like syndrome (ILS) every day from 9 am to 15 pm from Monday to Friday given by the MPH specialist team (intensivist), mechanical ventilation supervision (MV), transfer from CHs to high-care hospitals, length of stay (LOS) and mortality. Additionally, interventions in critically ill patients were recorded.

Results

From 3 October to 30 November, 56 patients with ILS were assisted by the MPH team: three patients in Atlacomulco CH, six in Valle de Bravo CH and 47 in Tejupilco CH. The mean age was 45.3 years old (from 19 years to 84 years), 32 were female (57%). A confirmatory test for AH1N1 was documented in 10 patients (17.8%). Patients assisted in the ER, three; in the ICU, nine; in the isolation area for influenza, 44 patients. The mean LOS for all patients was 3.6 days, 3.4 days for patients in the isolation area, 6.5 days in the ICU and 1 day in the ER. There were five patients on mechanical ventilation (8.9%) and two patients were pregnant (3.5%). Mortality was observed in five patients (8.9%) and the mortality rate in the ICU was 50%. Additionally, two patients were transferred to a high-care hospital (one died). All patients who went on ventilatory support died during the first day on MV.

Conclusions

This preliminary report shows that the practice of telepresence using robots at acute care facilities during an influenza outbreak is feasible at CHs in Mexico.