The introduction of LUCY at Tallaght Hospital

Executive Summary:

Tallaght Hospital has one of the busiest Emergency Departments (ED) in the country.  The Surgical and ICT Departments have developed a novel approach to: 

(1) Assess and treat acutely ill surgical patients; 

(2) Address the increasing numbers of patients seen in ED; and 

(3) Support the growing need for mobile medicine.

The Problem:

Modern medicine requires medical and surgical practitioners to be immediately available to their acute patients at the same time as conducting their ‘normal’ scheduled work. In addition, increased numbers of acutely ill patients are presenting to Emergency Departments across the land, with Tallaght Hospital the busiest in Ireland seeing over 48,000 adult and 33,000 paediatric patients seen each year.

As a way of expediting care, reduce the strain on our ED, reduce patient waiting times while allowing quick access to senior decision makers a novel combination of a new acute assessment unit and telepresence mobile robotics has been successfully piloted over the last nine months at Tallaght Hospital. 

The Solution:

The Acute Surgical Assessment Unit (ASAU) is an urgent care model whereby selected acutely unwell surgical patients presenting to the ED can be diverted to the unit where they are met by the on call service and placed into rapid treatment pathways. The unit enables medical staff to ensure patients are cohorted, seen and assessed quickly so safe and efficient decisions can be made early in their care. 

Through the introduction of LUCY (a remote controlled robot, part iPad, part Segway, approximately five feet tall with a screen for a head) the doctor who is located remotely can been seen and heard by the patient. Lucy combines the flexibility of telepresence with the benefits of personal face time.  Lucy has two wheels at either end of the cylindrical base, with a metal tube extending upwards and at the top a frame for an iPad.  A camera is mounted on the top, which transmits encrypted video and audio via wifi back to the clinician, aiding diagnosis. The remote doctor uses a mobile device to ‘drive’ LUCY from wherever they may be - outpatients, endoscopy suite or even in the operating theatre. The robot not only has the ability to extend to a height of approximately five feet to talk to a standing patient but can also reduce to three feet to be at the eye level of a patient in a bed.

LUCY is also being used for ward rounds in the Hospital and initial study has shown patients like LUCY and have no difficulty in interacting with the doctor through the device.

By using this technology, the efficiency of the unit has increased and makes specialists available around the clock as they can see and speak with the patient from their mobile device via the screen when time is of the essence.

This novel mobile telepresence initiative, embedding LUCY into ASAU represents a major leap forward in the use of technology in Irish healthcare and has only begun use recently after the €5M upgrade of the hospital’s ED.

Next steps

Through the use of LUCY the Department of Surgery will expand the level of service provided through our ASAU, ultimately inviting direct referrals from primary care colleagues in the Tallaght area expanding the hours from 8am-6pm and expand our pilot criteria to accept a broader range of patient conditions. By mobilising and integrating ‘Lucy’ into patient care our consultants will be able to review a greater number of patients in the ASAU and also throughout other areas in the hospital.

Lucy was featured on the 6.00pm and 9.00pm RTE news on Wednesday evening click here to view the report.