SN Computer Science (2024) 5:189

https://doi.org/10.1007/s42979-023-02551-0

SURVEY ARTICLE

Robotics in Healthcare: A Survey

David Silvera‑Tawil1

Received: 26 May 2022 / Accepted: 11 December 2023

© The Author(s) 2024

Abstract
Research and innovation in the area of robotics in healthcare has seen significant growth in recent years. Global trends
indicate that patients are getting older and sicker, while demands in healthcare workers are increasing their chance of injury.
Robotic technology has the potential to enable high levels of patient care, clinical productivity and safety for both patients and
healthcare workers. This paper surveys the state-of-the-art in robotics in healthcare and well-being, with particular attention
to the key barriers and enablers to the implementation of this technology in real-world settings. Desktop research was used
to identify available and emerging robotic technology currently in use (or with potential use) in healthcare settings. Primary
sources of information included: academic publications, international organisations, commercial websites and online news
agencies. In this paper, applications of robots in healthcare were divided into five main areas: service, assistive, socially-
assistive, teleoperated and interventional robots. The maturity and readiness of different products is still an open challenge,
with service and interventional robots leading the way. Wide-spread adoption of robots is likely to happen as the cost of
the technology reduces, and wide evidence of beneficial long-term impact is available. This manuscript identified the main
drivers, challenges, opportunities and considerations for implementing robots in healthcare. We hope this manuscript will
raise awareness about robotics in healthcare among a wider audience to maximise availability, quality, and acceptability
this technology.

Keywords Robotics · Healthcare · Disability · Ageing · Well-being

Introduction the first documented applications of robots in healthcare,

used to define the trajectory of a brain biopsy [3]. Since then,
Robots are physically embodied systems capable of sensing technology has rapidly progressed impacting positively the
and responding to the world through physical interaction. capabilities of robots. Robotic systems today are used in
They can vary in their aesthetic appearance, sensing capa- well-defined tasks such as hospital logistics, productivity,
bilities and degree of autonomy [1]. They can handle materi- and pharmacy automation [4, 5]. Moving forward, we fore-
als that are hazardous to humans, can undertake repetitive see that emerging technology will improve robots’ abilities
activities with great precision, and are immune to psycho- even further, allowing them to be more self-sufficient and
logical wear [1]. work more closely with humans. In fact, the use and demand
With more than 10% of the global gross domestic product of robotics and automation in healthcare is increasing every
(GDP) spent on healthcare [2], digital innovation is increas- day [5, 6].
ingly important to both reduce costs and improve outcomes. Although there has been a significant progress in the field
Robotics is one area of digital innovation that can have wide of robotics [4, 7–13], a general lack of exposure and under-
impact in healthcare. standing of robots in healthcare is a major barrier to devel-
The use of robotic technology in healthcare is not a new oping positive attitudes among stakeholders, including clini-
concept. Technological advances in the 1980s led to one of cians [14, 15]. Society acceptance of robots varies widely
depending on their application. To achieve greater accept-
ance, robots in healthcare should focus on providing sup-
* David Silvera‑Tawil port to patients and clinicians. Tasks that appear to replace
[email protected]
people should be considered with caution [16]. While
1
Australian e-Health Research Centre, CSIRO, Sydney, many experimental studies have demonstrated the potential
Australia

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positive impacts of robots in healthcare, the impacts on long- physical world. While the details of these three components
term adoption are not well known with large-scale studies in vary from robot to robot, most robots constantly repeat this
real-life settings still needed to show economic, societal and sensing-cognition-acting cycle.
health impacts [5, 17]. Robots are often described in terms of two classes: indus-
Using information collected from a range of sources, trial and service robots [20]. Industrial robots are used in
this paper identifies the main stakeholders, settings and manufacturing automation, while service robots are used
applications of robots in healthcare and wellbeing. The for personal, domestic and professional settings. Health-
main objective is to provide a comprehensive review on the care robots are simply the application of service robots to
state-of-the-art, and chart the main opportunities to inform support the provision of healthcare services including (but
future developments, as well as the challenges and necessary not limited to) diagnose and treat conditions, support the
considerations for implementation of robots in healthcare. functioning of impaired individuals, rehabilitation, care and
This manuscript also aims at raising awareness about robotic medical intervention of patients [4, 5, 7]. While industrial
technology in healthcare among a wider audience. robots were developed primarily to automate dirty, dull, and
Since the overall sector of robotics in healthcare is still dangerous tasks without human intervention [21]; service
an emerging area, it is difficult to make a final conclusion and healthcare robots are designed for entirely different
about the future trajectory. Nonetheless, this paper extends environments and tasks, including those that involve direct
previous work [5, 6, 18, 19] to illustrate the major themes interaction with human users in hospitals, rehabilitation clin-
and future directions for this field, and provides examples ics, and the family home [22].
from current and past research and commercial implementa- Today, more than eight million robots are in use around
tions. The identification of drivers, challenges, applications the world [23]. While robots in healthcare are still in the
and key recommendations to the implementation of robots early stages of development and experimentation [24], the
in healthcare presented here can be used as guideline to the field is expected to grow in the face of demographic change,
future development and implementation of robotic solutions shortages of healthcare personnel, and a need to improve
in healthcare. quality of care at reduced costs.
This paper is organised as follows. A brief introduction
to the field of robotics is presented in Sect. 2, followed by
the main drivers for robotics in healthcare (Sect. 3). Then, Global Drivers of Robotics in Healthcare
a review of the landscape grouped into five main areas of
application—service, assistive, socially-assistive, teleop- The application of robotics in healthcare depends heavily
erated and interventional robots—is introduced in Sect. 4. on societal need, acceptance and satisfaction. The primary
A discussion around the future of robotics in healthcare, reasons for implementing robotic technology in healthcare
including the main challenges and recommendations for is normally a robot’s ability to deliver value to the health
their implementation in a health context is presented in system through more effective and affordable healthcare,
Sect. 5 followed by the conclusion in Sect. 6. timely and continuous access to clinicians, and a system
that supplements the efforts of caregivers by optimising care
delivery and reducing human error and workplace injury
What is a Robot? [18, 25]. This section describes the key drivers of robot-
ics in healthcare, focusing on two main areas: societal and
The term robot comes from the Czech word ‘robota’, mean- technological drivers (Fig. 1).
ing slave, servant, or forced labour. The modern use of the
term was first encountered in the 1920s play Rossum Uni- Societal Drivers
versal Robots where Karel Čapek used it to denote an artifi-
cial fictional automaton. The modern perception of robots, Societal drivers lie in three main areas: broadening access
however, leans on developments in artificial intelligence (AI) to healthcare, reducing labour costs, and improving patient
and mechatronics. More specifically, robots are defined as outcomes. Challenges related to these areas are expected to
mechanical (physically embodied) artificially intelligent grow in the face of an ageing population, and increases in
agents with the ability to move in the physical environ- chronically-ill and disabled.
ment to perform complex tasks. This means that devices The world has a rapidly ageing population [26]. Due to
without mechanical action are not generally regarded as the post World War II “baby boom”, the percentage of peo-
robots. Based on this definition, robots can typically do three ple above 65 is growing. Additionally, increased welfare
things either autonomously or semi-autonomously: sense and better medical procedures allow people to live longer.
their environment, carry out computations to make deci- Associated with an ageing population is an increased preva-
sions, and perform coordinated mechatronic actions in the lence of injuries, disorders and diseases [27]. Furthermore,

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Fig. 1  Main drivers for the General Cognition

Labour Performance
implementation of robots in Care shortages Improved outcomes Actuators Autonomy
healthcare Cost Independence Batteries Adaptation
Hazardous work Productivity Processors Machine learning
Sensors Purposeful perception

Societal Technological
Demographic Access/Location Aesthetics Cost
Aging population Urban vs Remote Miniaturisation Affordable
Disability trends Advanced materials
Health trends

across the age spectrum an estimated 90% of the world’s less specialised places, and by less highly educated profes-
population experiences difficulties with physical, cogni- sionals [13, 39].
tive, mental or behavioural health [27]. These experiences Access to healthcare is also related to location. People liv-
may be temporary or permanent, acute or chronic, and may ing in regional and remote locations are especially affected
change throughout one’s lifespan. If left unchecked, trends by a lack of specialised healthcare, with health outcomes
in chronic disease risk factors—combined with a growing consistently below average [40]. Distance and unstructured
and ageing population—indicate a significant increase in the environments are significant obstacles to providing on-site
numbers of people living with life-long conditions including quality care. Autonomous, semi-autonomous, and teleop-
diabetes, obesity, and cancer [27, 28]. erated robots can provide an alternative to health service
Direct challenges of a changing population include work- delivery for people outside populated areas [13, 39, 41, 42].
force shortages and limited availability of informal (fam- Similar obstacles exist as a result of self-isolation restric-
ily) care providers. Projections show that severe shortages tions implemented in response to COVID-19, that can be
should be expected, especially in the nursing professions alleviated with the use robots [7, 43, 44].
[29, 30]. With the expanding demand, healthcare work- Finally, there are several categories of socio-cultural
ers face increasingly hazardous work environments which factors that drive developments in healthcare. The first cat-
exposes them to great risk of debilitating injury and disabil- egory relates to rising expectations about health as a result
ity [30]. Additionally, scarcity of nurses, doctors, and spe- of socio-cultural changes influenced by media and educa-
cialists means that some people will not receive the care they tion. These expectations relate not only to the health services
need, at least not in a timely manner. This is particularly con- themselves but also to the way they are delivered to empower
cerning given the coronavirus (COVID-19) pandemic, which patients. The second category includes safety. With chang-
has been highly demanding on healthcare personnel world- ing practices as a results of social distancing restrictions
wide. Increasing life-long independence from the medical (due to COVID-19), patient and clinician safety are in the
system thus becomes a key societal driver. Enabling elderly forefront. The third and last factor is connectivity. There are
and chronically-ill to stay at home longer and healthier will over 5 billion internet users around the world, with about
reduce the need for specialised healthcare, while improv- half of them accessing the internet over mobile devices. This
ing independence and well-being in caregivers. Enabling connectivity is influencing the way we look after our health.
informal caregivers and people with life-long conditions to Changes in regulation around the world reflect a significant
go into workforce would also offset the expected reduction emergence of patient-centric technologies, including mobile
in available workforce. applications and associated devices to support the provision
Access to effective healthcare is also directly related to of healthcare services [45–47]. These types of regulations
productivity, affordability and scarcity. While the need for are expected to be widen as new technology is developed.
medical procedures and treatments is limitless, the resources
available to supply them are limited [31, 32]. Therefore,
treatment is often restricted to urgent cases. Existing medi- Technological Drivers
cal interventions can be improved through the use of robots
to be less invasive, more cost-effective, and produce less side Technology drivers for robotics in healthcare are similar
effects [13, 33, 34]. More effective methods of training for to those for other technologies: falling prices, increas-
medical practitioners can also be introduced to reduce the ing performance of sensors, faster processors, larger
number of medical errors [35–38]. There is also a constant storage devices, increasing miniaturisation of elec-
drive to make it possible for procedures to be performed in tronic and mechanical devices, advances in batteries and

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communications hardware, advances in machine cognition current applications of robots in healthcare, but will also
(i.e., AI), persistent autonomy and advanced materials. open more areas of opportunity.
Additionally, the use of robots in healthcare involves
physical interaction between caregivers, patients, and tech-
nology. The reciprocal nature of human-robot interactions
Landscape of Robotics in Healthcare
means that a robot needs to be able to perceive and under-
stand its environment to be able to provide useful feedback
The domain of healthcare robotics is diverse. Robots can
to humans, whether that person is a caregiver or a patient.
provide both physical and cognitive support. They can take
Recent developments in sensing and machine learning (i.e.,
part in a range of activities and settings from prevention
deep-learning) have demonstrated that progress in robotic
and assessment to medical intervention, and from short-
perception is evolving in a way that new applications and
term rehabilitation to long-term care support. Within these
real-world tasks can become a reality. Examples include
activities, robots can support clinical staff, administration
object detection, scene understanding, and activity recogni-
and hospital services [56]. In this vein, this manuscript iden-
tion that allow robots to navigate and interact with people in
tifies five major areas of application for robots in health-
safe and effective ways [48, 49]. Data from several sources
care (Fig. 2). This section provides an overview of these
can be combined to create more purposeful perception sys-
areas, including examples of commercial products in use,
tems than those available from a single source of data [50,
areas where significant development is taking place, main
51].
challenges, and potential future applications.
Developments in AI are also improving the abilities of
robots to interact with people in natural and intuitive ways,
providing more personalised, adaptive and long-term sup- Service Robots
port to individuals [52, 53]. Several recent developments
in how people interface with robots have enabled robot Clinicians spend significant amounts of time on tasks that
orthoses and exoskeletons to offer neural integration, and keep them away from patients including dirty, dull, distant,
increasingly more intuitive control of the limb [54]. dangerous or repetitive jobs, such as moving materials or
Additionally, a range of advances in actuation, power, and people from one place to another, and waiting for patients,
control have enabled clinicians to have improved dexterity materials, and medications [19, 57]. The overburden of these
and visualisation inside the body [55]. There is also recent tasks can create a climate for error, frustration and burnout.
progress in the field of micro robots, where miniaturisation Service robots in healthcare can assist clinicians with these
and increasing intelligence have led to new functionalities tasks. These robots have limited requirements to function in
and areas of application [55]. As such, it is expected that close proximity to hospital personnel or patients. As such,
ongoing technological developments will not only improve most systems pose little risk to patients.

Fig. 2  Major areas of application for robots in healthcare

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One of the best tasks for robots in this space is logistics on developing robot-based simulations of a patient’s facial
and transportation (Table 1), where robots can be excep- expressions for medical diagnosis training [37], a patient’s
tionally accurate at given the right conditions. For example, act of gazing or turning away during injections [75], and a
mobile robots can fetch and deliver linen, pathology sam- patient’s oral cavity for dental training [76] or airway man-
ples, medication, and food [58–60]. These systems can auto- agement training [38].
mate the delivery of goods/supplies for pharmacies, nursing The problem of handling an ever increasing number of
stations, kitchens, or laboratories; enabling operation with analyses in pathology is common to all laboratories and
little disturbance to staff and patients. Another task that disciplines. Pathology automation robots aim to optimise
robots can do effectively is moving patients using autono- processes within the laboratory, streamline operations,
mous motorised hospital beds. While autonomous beds are improve efficiency, reduce manual handling and free up
not yet widely available, it is believed that these systems staff for more productive tasks. Laboratory automation has
could improve efficiency and reduce musculoskeletal inju- been commercially available for many years and, similar to
ries in clinicians [61, 62]. There is also potential for aerial industrial robots, it allows for tasks to be completed without
vehicles (i.e., drones) to be used in short- and long-distance user intervention. Total laboratory automation is an effec-
delivery of consumables, medications and pathology sam- tive mean to eliminate batch processing delays and achieve
ples [41, 42]. a consistent and reliable laboratory service [77].
There are some challenges associated with logistic sys- A different type of service robots that has already been
tems. Mobile deliveries need available paths (or hallways) proven to be effective are pharmacy dispensing robots [63,
within the premises that must be taken into consideration 64]. Dispensing machines provide computer-controlled
during the installation or architectural design of new insti- dispensing and tracking of medications. They decrease the
tutions. Aerial vehicles, on the other hand, are exposed to potential for administration errors, and save nursing and
harsh forces of the weather such as wind and rain—not to pharmacists’ time by eliminating the need for manual nar-
mention restrictions from international aviation authorities cotic counts and inventory management. These robots have
[73]. In spite of these challenges, it is expected that robots shown significant increases in pharmacy storage capacity,
will automate many delivery-based services in the near and a decrease in dispensing errors and time required to pick
future, and at a reasonable cost. items for dispensing [59].
There is also increasing interest in the use of robots to Another relevant application of service robots includes
support workforce training and education to improve patient sanitation robots, such as a climbing robot to clean hospi-
safety and quality of care. Robotic patient simulators are life- tal walls using disinfecting liquids [59], and a mobile plat-
sized anthropomorphic robots that can simulate the acts of forms with arrays of ultraviolet (UV) lamps used to disinfect
breathing, bleeding, speaking, expelling fluids, and respond- patient rooms and operating theatres [70, 71]. Sanitation
ing to medications in similar ways to real patients. These robots attracted significant attention during the COVID-19
types of robots allow clinicians to simultaneously prac- pandemic, to kill the COVID-19 virus within hospitals [4].
tice both procedural and communication skills. Examples
of workforce training robots include a system to simulate Assistive Robots
prostate exams [35] and robots that simulate the behaviour
of patients’ limbs [36, 74]. Other researchers have focused Assistive robots support people with a physical disability to
complete necessary activities of daily living (ADL) inde-
pendently including personal hygiene, eating and leisure.
Table 1  Examples of commercially available service robots in logis- The type of support provided by assistive robots includes
tics, pharmacy and productivity manipulation, mobility and rehabilitation.
Robot name Company Application Robots for manipulation support patients with function-
alities of the arm and hand. Robotic arms fitted with grip-
CONSIS.B [63] Willach Drug dispenser
pers are commonly designed to perform specific activities
Robotmat [64] Omnicell Drug dispenser
such as eating, brushing teeth, washing, picking up objects
Moxi [65] Diligent Mobile delivery
and opening doors [78–80]. Handy 1, for example, was one
TUG [66] Aethon Mobile delivery
of the first low-cost robots used for multitask manipulation
RobotT1 [67] Keenon Robotics Mobile delivery
support for activities such as feeding and washing [81].
PathFinder [68] Aim Lab Pathology automation
More recent examples include Obi [82] and the Neater Eater
AutoMate [69] Beckman Coulter Pathology automation
[83]. Both platforms are commercial feeding support robots
Model B/C [70] UVD Robots Sanitation
designed to help people with upper limb disability [78].
Akara [71] Akara Sanitation
Robots for mobility support are intended to help peo-
C-Astra [72] Invento robotics Sanitation
ple with mobility impairments navigate from one place

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to another. The wheelchair is one of the most important In rehabilitation, robots are normally intended to help
mobility support tools. However, many people are not with functional restoration to both the lower and upper body.
able to use a traditional wheelchairs due to, for example, The main objective is to increase training intensity and
blindness, limited muscle power in the arms, or limited assessment of progress compared to using a human thera-
eye-hand coordination. Smart wheeled platforms (includ- pist. Common conditions that are treated with rehabilita-
ing smart wheelchairs) provide needed opportunities to tion robots include spinal cord injury, sports injury, stroke,
those individuals. A smart wheeled platform is a powered musculoskeletal pain syndromes, fibromyalgia and traumatic
mobile device to which computers, sensors, and assistive brain injury [25]. Rehabilitation robots can also be used to
technology are attached to. A good example is the iBOT support muscle sustaining therapies. Examples of commer-
wheelchair from DEKA (now in partnership with Toyota). cial robots for upper-limb rehabilitation include MIT-Manus,
Unlike most wheelchairs, iBOT can go up and down stairs ArmeoSpring and ReoGo [92], while Lokomat is the most
and allows the user to rise from a sitting to a standing posi- well-known lower-limb rehabilitation system [33, 92, 96].
tion [84, 85]. Alternative approaches focus on wheelchairs Additional examples of mobility support and rehabilitation
with automated navigation support for those users with robots are available in [5].
difficulties manoeuvering powered wheelchairs [84, 86]. Advances are also being made towards robots that assist
Similar to wheelchairs are smart walkers, which can in lifting patients in a semi-automated way. Robear [97] and
support individuals with limited standing, walking or RIBA [98], for example, are specifically designed to help lift
balancing ability, or who suffer from additional limita- and move a bedridden patient from a bed to a wheelchair and
tions (e.g., blindness). The Lean Empowering Assistant back. Other types of assistive robots that support staff and
by Robot Care Systems [87], for example, is a roboticised patients include the RobotBathtub, which is used to bathe
walker with active guidance, navigation and motion. Other a person while they lie down; and the Quirubot, a robotic
example includes the Smart-Cane and Smart-Walker, scrub nurse [80].
which can detect obstacles and build a map of their sur-
roundings in order to localize the user inside the map, and Socially‑Assistive Robots
subsequently guide them to different waypoints [88].
In some cases, both mobility and manipulation support Socially-assistive robots (SARs) provide assistance to
are needed. Wheelchair-mounted robot arms can pro- humans through social interaction, rather than physical inter-
vide improved means of manipulating objects. Examples vention. To be effective, SARs must understand and inter-
include PerMMA [89, 90] and JACO [91]. In these sys- act with their environment, exhibit social behaviour, sus-
tems, the user’s motion intention is commonly extracted tain engagement and achieve specific assistive goals. They
through either manual manipulation (e.g., joysticks and should do this in a way that is safe, ethical and effective.
buttons) or sensors implanted in the user’s body [92]. The robot’s physical embodiment and behaviour are at the
Another technology that provides both mobility and heart of SARs’ effectiveness, as they leverage the inherently
manipulation support is wearable robots such as prosthe- human tendency to engage with life-like (but not necessarily
ses, orthoses, and exoskeletons [9, 93–95]. A prosthesis is human-like) social behaviour. Based on their appearance,
a device that supplants a person’s missing limb. Robotic SARs can be divided into three main categories: anthropo-
prosthetics aim to fully emulate a missing limb through morphic, zoomorphic and non-biomimetic robots (Fig. 3).
replication of its joints and limb segments, and seamless Anthropomorphic robots are those designed with a human-
integration that provides intuitive control of the limb as like resemblance, such as a head, eyes, torso, arms or legs.
well as touch feedback to the wearer [93, 94]. These robots can provide complex behaviour patterns, such
Orthoses and exoskeletons, on the other hand, help as those available in interpersonal interactions, and evoke
people with intact limbs with limited movement or con- social behaviours and perceptions in the people they interact
trol. Orthoses protect, support, or improve the function of with, while appearing less intimidating and more predict-
body parts such as ankles, knees and the spine. Robotic able than humans. Zoomorphic robots are non-threatening
orthoses are typically designed in the form of an exoskele- animal-like robots that allow for the expression of limited
ton which envelopes the body part in question. They allow social cues that are appropriate to their physical form. The
free motion of limbs while providing the required support. interactive behaviour of these robots are often simpler to
Most recent robotic exoskeletons are still expensive and those available in anthropomorphic robots. Finally, non-
have limited battery (power) to be used as orthoses, and biomimetic robots are those designed without considering
are only used within rehabilitation clinics. Comprehensive their resemblance to any biological species. Non-biomimetic
reviews of upper and lower limb rehabilitation exoskel- robots are commonly used to engage children in free-play
etons are available in [9, 95]. [99], or as catalysts for interaction with adults or children
[100].

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Fig. 3  Socially-assistive robots

divided into three appearance-
based categories: anthropo-
morphic robots NAO and QT,
zoomorphic robots Probo and
Paro, and non-biomimetic robot
Sphero

(a) NAO (b) QT (c) Probo (d) Paro (e) Sphero

SARs have the potential to enhance the quality of life incorporated to improve participation and performance. In
for large populations of users, including the elderly [101], this vein, SARs have successfully served as motivators with
individuals with cognitive impairments [102], and children weight management and self-monitoring strategies [120], as
with socio-developmental disorders [17, 103]. A popular tools to motivate physical exercise in older adults [121], and
application is the use of robots to provide comfort or com- as support tool to physical therapy intervention for children
panionship, with some solutions breaking out of academia with cerebral palsy [122]. It has been observed that the moti-
into the market as commercially available products. Paro vation generated by the interaction with a SAR facilitates the
the robotic seal (Fig. 3d), for example, was the first long- persistence in exercise (e.g., walking) and the fulfilment of
standing SAR certified by the U.S. Food and Drug Admin- objectives [122–124].
istration (FDA) as a neurological therapeutic device shown SARs are also entering patients’ homes to assist with eve-
to decrease stress, anxiety, and medication in elderly patients ryday needs and nursing support (e.g., medication reminders
[101, 104]. More recently, the Mabu robot was deployed as and health monitoring) to people with chronic conditions,
an in-home personal companion for patients with chronic the elderly and individuals with cognitive impairments [11,
health issues [105]. Companion robots like Mabu (by Catalia 108, 125, 126]. Fischinger et al. [127], for example, pre-
Health [106]), Paro, and My Special Aflac Duck (by Aflac sented the development and evaluation of ‘Hobbit’ a care
and Sproutel [107]) can assist with emotional support, medi- robot to promote ageing in place and postpone the need to
cation adherence, health monitoring and to encourage exer- move to a care facility. Hobbit is designed especially for
cise [11, 108]. fall detection and prevention. While most personal assis-
SARs are also used to support psychosocial interventions tance robots are only available as research platforms, there
(e.g., social, cognitive and behavioural therapy). One of the is growing interest to build-up on the momentum of AI
most common applications in this area is the diagnosis and assistants and develop SARs to assist within the home envi-
treatment of autism spectrum disorder (ASD) and cogni- ronment. Commercial examples include Zenbo, Buddy and
tive impairments; see [8, 109] and [110] for comprehensive Care-O-bot 4 (Fig. 4).
reviews. SARs hold great potential in this area, with many While these robots have the ability to support people with
recent studies reporting that autonomous and remotely- a range of relatively simple activities, a stand-alone plat-
operated robots can promote, among other skills, facial form that can successfully support people with most ADL
expression recognition [111], joint attention [112], imitative is a long way from reaching the consumer market, particu-
free-form play [113], verbalisation [103], and turn taking larly due to the high degree of manual dexterity, sensing
[114]. The advantage of robots in support of therapy and and learning capabilities required. An overview of personal
education lies in their controllable behaviour and ability to home robots is available in [131].
repeat actions. Other examples of SARs used in psychoso-
cial interventions include ageing, where robots can reduce
anxiety and increase social interaction with peers [11, 115,
116], and cognitive rehabilitation intervention for adults
with intellectual disability [102].
SARs have shown to increase engagement and moti-
vation. They have been used to coach young children on
nutrition and healthy food choices [117], to help children
with type 1 diabetes learn about their illness [118], and to
reduced paediatric distress in oncology patients by teaching (a) Zenbo [128] (b) Buddy [129] (c) Care-O-bot 4 [130]
children about their condition and providing them with tech-
niques to manage their distress [119]. New strategies that Fig. 4  Commercial socially-assistive robots in domestic environments
provide interesting and motivating interventions are often [128–130]

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Robots are normally limited by their onboard functional- (and telehealth) has become particularly pertinent since
ity and hardware. However, they have the ability to leverage the COVID-19 pandemic began, primarily due to the rising
information from other technologies in their environment to demand for contactless healthcare. Telerobotics allows for
perform more complex tasks and requests [108]. For exam- procedures such as surgeries, treatments, and diagnoses to
ple, a smart environment can be used to locate a patient be conducted remotely.
when the robot is called for support, enhancing navigation In a teleoperated robot (or telerobot), a human opera-
skills [132]. A similar approach can be used to find mis- tor controls the movements of robots remotely, via wired
placed items for the elderly [133]. and/or wireless communication networks. Most teleoper-
SARs are also being trialled for use as concierges or ated robots are semi-autonomous, task-oriented and have
receptionists answering questions, checking appointments, a limited range of functions. While the physical separation
assigning patients to medical staff and delivering informa- may be very small (e.g., within the same room), telerobotic
tion and public health education [134–136]. Research is also systems are—at least conceptually—split into two different
available in which SARs are used as guides (multilingual sites. In this manuscript, the term telerobotics is used to
way finders) greeting and helping people navigate from one describe the provision of remote services where there is a
spot to another within a hospital [137], and as entertainers or significant distance between the two sites (i.e., they are not
distractors to reduce stress during hospital stays [138–141]. within the same building).
SARs are also being developed to follow doctors or nurses In telerobotics, the local site encompasses the human
during medical rounds, carry armamentarium, and record operator (typically a clinician) and all elements needed to
electronic health data [142]. control the system, while the remote site contains the robot
Finally, SARs played an important role to prevent the and the environment to be manipulated (Fig. 5). The local
spread of coronavirus during the COVID-19 pandemic and remote systems are called “master” and “slave” respec-
[143]. In this vein, SARs performed three main activities: tively. The slave robot is commonly programmed to follow
(1) liaison, where robots acted as a links between humans to the motions of the master.
minimize human-human contact (e.g., patient registration, Teleoperated robots can provide access to treatment for
book appointments, and print prescriptions); (2) safeguard, people outside populated areas and in disaster scenarios.
including all functions related to ensuring risk-free environ- Remote surgery (or telesurgery), for example, is the ability
ments (e.g., safety advice and enforce protective measure- for a doctor to perform surgery on a patient from a remote
ments); and (3) well-being support, where robots acted as site [146]. The promise of telesurgery is to allow the exper-
coaches to preserve physical and psychological well-being tise of specialised surgeons to be available for patients
(e.g., companionship and entertainment). A comprehensive worldwide, without the need for either of them to travel
review of the implementation of SARs during the COVID- beyond their local hospital.
19 pandemic is available in [143]. The first successful telesurgery, named “Operation Lind-
Despite showing great promise, there has been skepticism bergh”, took place in 2000 using a dedicated multiservice
against the use of SARs in healthcare. It has been hypothe- transmission network provided by France Telecom, and a
sised that clinicians perceive robots as expensive and limited surgery robot called Zeus [147]. In Operation Lindbergh, a
tools which provide no real advancement to current proto- laparoscopic intervention was performed on a patient located
cols [144]. A significant reason behind this is that the ben- in Strasbourg, France while the operating surgeon was
efits of SARs have been demonstrated particularly in short- located in New York, USA. Since then, different systems
term studies with small groups of participants, with very have been successfully trialled around the world. Recent
few following clinically-valid randomised controlled trials examples include the RAVEN robot for laparoscopic sur-
(RCTs) to evaluate their efficacy [109, 139, 145]. While cur- gery research and the RIME robot for transpedicular fixation
rent clinical evidence is insufficient, research suggests that
SARs constitute a promising opportunity to support health
management needs particularly in children, elderly and indi-
viduals with cognitive impairment.

Teleoperated Robots

Teleoperated robotics, or telerobotics, is considered to be

a part of telehealth. The ultimate goal is to provide spe-
cialised healthcare services over long distances. Telerobot-
ics can virtually bring specialists to areas where medical Fig. 5  Overview of a telerobotic system. Adapted from Niemeyer
facilities and experts are not available [13]. Telerobotics et al. [39]

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SN Computer Science (2024) 5:189 Page 9 of 19 189

surgery [13]. None of these systems are available for com- disability in exploring a public exhibit. Their study revealed
mercial use. positive trends toward the use of mobile telepresence robots
The two main factors impacting progress in telerobotic to improve wellbeing, physical and social self-efficacy. Simi-
surgery are data transmission speed and communication lar studies were conducted to improve the hospital experi-
latency. Effective stable connections that offer minimum ence of paediatric patients [162] and people with motor dis-
latency delays are expensive, and their availability is limited abilities [163]. Telepresence was one of the most widespread
particularly in remote and rural areas. With previous studies functions of robots during the COVID-19 crisis [143].
indicating that latency delays are associated with more errors Telerobotics remains an exciting area of robotics. In many
[148], additional trials to improve data transmission and ways, it forms a platform which can use the advances in
evaluate the efficacy and safety of this systems are needed. technology while leveraging the skills and capabilities of
Making a diagnosis usually requires the attendance of clinicians. Teleoperated robots can serve as a pathway for a
a doctor. New developments in telerobotics make remote gradual introduction of autonomous robots into healthcare.
assessment of patients possible. The MELODY system
(by AdEchoTech), for example, is a tele-echography robot Interventional Robots
that facilitates ultrasonography over a distance [149]. The
doctor who is performing the examination is assisted by a The main goal of interventional robots is to assist medical
paramedic at the patient’s site who positions the robot over practitioners in executing efficient and safe diagnostic or
the patient, but is the expert who remotely manipulates the therapeutic procedures. The usual motivation is to increase
ultrasound probe. Telerobots can also support clinicians with precision rather than efficiency. As such, a range of advances
other tasks, such as the remote evaluation and rehabilitation have been made that enable clinicians to have improved
of upper-limb function [150, 151]. dexterity and visualisation inside the body, and reduce the
A subfield of telerobotics is “telepresence”, which refers degree of movement during operations [33].
to systems that include immersive interfaces that help the Technological advances in the 1980s led minimally inva-
operator feel present in the remote site using feedback from sive procedures to become an established approach across
vision, audio, touch and even smell and taste. There is also several surgical techniques. Minimally invasive surgery
potential to increase the level of interaction between tel- (MIS) uses smaller incisions or openings than conventional
epresence robots and the patients/environment via sensors surgery. While this provides several advantages over tradi-
and manipulators. Examples of telepresence robots used tional open surgery (e.g., quicker recovery times), the sur-
in healthcare include the RP-VITA robot (by iRobot and geon is limited by a lack of sensory feedback and a very
InTouch Health), an FDA-approved telepresence robot to restricted range of motion [92]. Surgical robots for MIS were
allow clinicians to check in patients remotely [152, 153]; developed to address these challenges with the first surgical
ROBIN, a telepresence robot integrated into a sensor-rich robot introduced in 1985, a Puma 560 industrial robot modi-
environment to support independent living [154]; and Rob- fied to be used to define the trajectory of a brain biopsy [3].
oConsultant, a telepresence robot to facilitate intraopera- The introduction of surgical robots gave rise to new inno-
tive consultation by expert surgeons located in remote sites vation to support MIS, including the laparoscopic assistant
[155]. robotic system (LARS) created at the IBM Watson Research
Most telepresence robots to date are essentially a video Center [164] and the robot assisted microsurgery (RAMS)
chat session on a mobile platform. The physicality and inter- workstation developed at the NASA’s Jet Propulsion Labora-
active abilities of robots, however, can yield a stronger feel- tory [165]. Among the most significant innovation of these
ing of presence for both patient and caregiver. A number of robots was the introduction of a workstation to allow the sur-
studies have shown that mobile telepresence robots can help geon to control a robotic arm using a small joystick. Eventu-
reduce the length of stay after minor invasive surgery [156] ally, the idea of controlling robotic arms to perform laparo-
and at intensive care units [157], as well as reduce response scopic surgery from a teleoperated workstation resulted in
times in emergency situations [157, 158]. In other studies, the Computer Motion’s Zeus robot [166]. Zeus was with-
patients agreed that mobile telepresence robots should be drawn from the market in 2003 and replaced by the da Vinci
part of regular hospital care, and stated that they would robot from Intuitive Surgical Inc [167].
rather be seen remotely by their own physician than by a The da Vinci system consists of a surgeon’s console and
different physician [159, 160]. a patient-side cart (Fig. 6a) with three to four robotic arms
Telepresence robots can also provide unique opportuni- teleoperated by the surgeon to allow him to manipulate a
ties to people who are homebound or hospitalised due to full range of instruments (e.g., clamping, dissecting, sutur-
either a medical condition or a disability. Friedman and ing, etc.). Da Vinci is used in a wide variety of surgical
Cabral [161], for example, evaluated the use of a mobile procedures, including urological and cardiac procedures
telepresence robot operated by people with developmental with more than 4500 systems sold worldwide [34]. Since

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189 Page 10 of 19 SN Computer Science (2024) 5:189

robots have not delivered on its early promise, with studies

divided on their overall benefits [180, 181].
From one generation to the next surgical robots improve
dexterity and precision, reduce invasiveness and tissue dam-
age [34]. The concept of minimal invasiveness has resulted
in the evolution of new types of flexible and steerable robots
(a) da Vinci (b) Mako (c) Navio that require only one opening (single-port surgery) or no
artificial opening of the skin (e.g., umbilical incision) [182,
Fig. 6  Examples of commercial surgical robots 183]. Recent advances in miniaturisation methodologies
have also contributed to the use of robots in ear, nose, and
throat microsurgical procedures, which typically require sub-
Table 2  Examples of commercial surgical robots millimetric accuracy [34].
Robot name Company Application
Although flexible robots are promising, new advances in
miniaturised robotics are paving the way toward the next
Magellan [168] Auris Health Vascular surgery generation of interventional robots. In this vein, wireless
Monarch [169] Auris Health Laparoscopy capsule endoscopes were introduced for gastrointestinal
Zeus [166] Computer Motion Inc Laparoscopy diagnosis. Once swallowed, capsule endoscopes move
Viky [170] Endocontrol Medical Laparoscopy through the gastrointestinal tract to perform diagnosis using
da Vinci [167] Intuitive Surgical Inc Laparoscopy visual and biopsy information [184]. These devices are only
Mazor X [171] Mazor robotics Spine surgery a few centimetres in size.
ROSA [172] Zimmer Biomet Spine/brain surgery In recent years, micro- and nano-robots have been devel-
Hugo RAS [173] Medtronic Laparoscopy oped for diagnostic and therapeutic purposes. Micro- and
Neuromate [174] Renishaw Neurosurgery nano-robots have the potential to crash kidney stones with
BlueBelt Navio [175] Smith & Nephew Orthopedics little harm and side effects [185], detect a cancer cell and
Niobe [176] Stereotaxis Vascular surgery deliver targeted medication [185, 186], destroy microbio-
Acrobot [177] Stryker Orthopedics logical pathogens, or even reverse the effect of genetic dis-
Mako [178] Stryker Orthopedics eases by replacing entire chromosomes [187, 188]. Although
there are many studies investigating the use of micro- and
nano-robots for different biomedical applications, there are
its introduction, a number of commercial surgical robots still many significant challenges for implementing this tech-
have been developed, examples are summarised in Table 2. nology in real-life applications [188].
Additionally, a summary of clinical, experimental and com- Needle placement for percutaneous procedures have also
mercial systems is available in [13, 34]. become common in interventional robotics. The process
Most robots for MIS are teleoperated over a short dis- involves the use of patients’ images to plan needle trajecto-
tance. However, semi-autonomous systems also exist. The ries [189]. Robot-assisted needle placement procedures are
Mako robot (Fig. 6b), for example, is a semi-autonomous used for drainage, tumour destruction, aspirations, local drug
orthopaedic surgery robot used for knee replacement [178]. delivery, biopsies and automated suturing [13, 189–191].
Mako uses preoperative CT scans to build a model of the Other applications of interventional robotics include oral
patient’s knee to plan the surgery. The system generates vir- surgery [192], ophthalmologic interventions [193], radiation
tual constraints to guide the surgeon in the milling opera- therapy [191] and catheterisation [194]. Furthermore, dur-
tions and avoid burring the bone outside the predefined areas ing the COVID-19 pandemic, autonomous and teleoperated
[179]. A different example of a semi-autonomous robot oropharyngeal swab robots were introduced to help medical
used in orthopaedic surgery is Navio [175], from Smith & staff to perform COVID-19 swab sampling without close
Nephew (Fig. 6c). Navio is a telerobot designed to assist contact with patients [195, 196]. Additional information on
surgeons with knee replacement surgery without requiring interventional robotics is available in the many available
a CT scan to plan the surgery. Instead, during the procedure, reviews [13, 34, 92, 184, 189, 191, 194, 197].
Navio builds a 3D model of the patient’s knee. This informa- Despite a number of achievements demonstrated by inter-
tion helps the surgeon determine the correct size and posi- ventional robots, only a handful of them have reached a com-
tion of the implant. mercialisation stage, and even fewer have been adopted in
The successful introduction of robots in orthopaedic sur- practice. For a device to be commercially feasible, it must
gery is possible thanks to the rigid nature of bones and con- be accepted by third-party payers including the public and
sistent imaging registration. However, this success does not private health systems. An issue that limits the adoption of
translate into MIS involving soft tissue manipulation, where interventional robots is the high cost associated with the

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SN Computer Science (2024) 5:189 Page 11 of 19 189

acquisition and maintenance of such systems. This is largely allowing clinicians to use higher-level commands during the
attributed to the high development costs related to strict teleoperation. Similarly, advances in sensing and navigation
safety and reliability requirements. Future developments in will enable mobility aids and smart mobility beds. These
the field will require addressing both clinical and technologi- systems might allow the operator to issue only high-level
cal challenges, at an accessible cost. commands for complex navigation tasks.
Within the next 5–10 years, robots will be able to extract
significant data from wearable and distributed sensors (e.g.,
Discussion heart rate, movement, sleep, etc.) within a controlled envi-
ronment (e.g., clinics, ageing facilities), to complement the
Over the last two decades we have seen a wide range of data collected by the robots themselves. Integration of the
robotic technology and platforms developed to support multi-modal data will be essential for modelling user behav-
healthcare and wellbeing. Robots can be used in rehabilita- iour and intent. Algorithms developed in that time will allow
tion, psychosocial interventions, physical therapy, conva- robots to learn and adapt dynamically to changing environ-
lescence and in support of those with impaired function- ments and users. At the same time, autonomous SARs will
ing. They have a role in augmenting virtual consultations be able to maintain longer, repeated interactions in a broader
and workplace training, and can be used to acquire medical set of domains, including companionship, coaching, social
and behavioural data to gain quantitative insights into both and cognitive support. They will adapt their behaviours to
physical and social behaviour. changes over time, including small fluctuations in mood,
An important aspect for robots in healthcare is the con- slow decline or improvement, and sudden unexpected
nection between technology and people. When robots are changes in a patient’s health or behaviour.
deployed within the healthcare system, they need to com- During this time, robotic dexterous manipulation for eve-
plement or enhance service provision. To achieve this, it ryday objects should be expanded to handle more general
is important that end-users of robots are involved in the objects and tasks. Manipulation capabilities will enable
research, development and deployment of systems. the next level of socially-assistive and telepresence robots
required to assess and treat patients. General purpose auton-
The Future of Robotics in Healthcare omous physical support is not foreseen within the next 10
years, due to the cost and complexity of the technology.
In this paper applications of robots in healthcare were In surgery, more intuitive interfaces that better estimate
divided into five main areas: service, assistive, socially assis- the surgeons intent, rather than simply executing the user’s
tive, teleoperated and interventional robots. It is expected commands should be expected in about 10 years. We should
that new products and services related to these areas will also see significant developments in algorithms to provide
continue to enter healthcare, and create new opportuni- appropriate feedback to allow surgeons to feel forces, tex-
ties. Within the next five years, we should expect robots tures, and other physical properties of a patient. At the same
to increase their capabilities to autonomously support the time, wearable robotic systems should be able to provide
clinical workforce in well-defined tasks that require little physical feedback to a human operator.
human intervention/interaction including logistics, phar- Finally in the next 10–15 years, we should expect sig-
macy administration/dispersion and productivity. We should nificant developments in micro- and nano-robots, allowing
also expect new implementations in aerial delivery of con- this technology to assist in microsurgeries or the localised
sumables, medications and pathology samples. delivery of medications.
Interaction with humans will be more intuitive and enjoy- Introducing new technologies in healthcare is disruptive.
able. SARs will autonomously maintain short-term interac- For robots to be successful, management and hospital staff
tions with staff and patients in well-defined tasks, including must understand not only how the new technology is going
workforce training, entertainment and distraction. Ongoing to benefit the organisation, but also how it’s going to benefit
developments in AI will also allow robots in front-of-house them and the patients they care for. The following section
and in-home support roles, providing health education, describes some of the main challenges to be expected when
reminders, coaching, helping patients navigate from one implementing a robots in healthcare.
spot to another or serving as data collection devices (i.e.,
interviews). Key Barriers to the Implementation of Robots
As a response to COVID-19, teleoperated systems are in Healthcare
also expected to attract more attention with mobile telep-
resence taking a significant role in clinical consultations. Negative attitudes and concerns from the public, patients
Mobile telepresence robots will acquire semi-autonomous and healthcare staff can be a significant barrier to imple-
functions in navigation and patient-robot interaction, mentation. Specifically, healthcare staff might be opposed

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189 Page 12 of 19 SN Computer Science (2024) 5:189

to the introduction of robots due to lack of familiarity with uptake, particularly if significant technical support is needed
technology, perceived threats to professional roles (e.g., job during or after implementation.
losses), absence of an apparent personal benefit, or lack of
trust in the technology [5, 15]. Key Recommendations to the Implementation
Moreover, there is the question of acceptability by of Robots in Healthcare
patients, families and informal caregivers. A trusting rela-
tionship between the healthcare staff and patients is often The application of robots in healthcare has large potential
perceived to require human input [15]. Robotic applications benefits. The main recommendation is therefore to further
designed to work in specific settings with limited interaction develop this area through evidence-based research and
with people (e.g., service robots) are often received posi- implementation programmes. More specifically, the key
tively, and are perceived as being less difficult to implement areas of consideration when implementing robots in health-
than those that were designed to operate in human-dense care are:
surroundings [15]. Robotic applications designed to support
healthcare staff and do not replace them receive higher levels Innovation
of acceptance [16].
The next barriers are related to cost. Commercially avail- The field of robotics in healthcare is still in its infancy,
able robots are few and expensive, limiting their usability to with only a few products commercially available. Future
organisation with significant purchasing power. As the tech- innovation should incorporate not only basic research, but
nology matures, it is expected that an increase in demand also practical applications that ensure effective translation
may cause a decline in direct costs. Financial challenges, of research into practice. Comprehensive analysis of needs
however, should also include considerations beyond capital and user acceptance should be explored as part of new pro-
expenditure, including ongoing costs, potential risks asso- jects. Ideally, projects that investigate short-term practical
ciated with the new technology, and potential impacts in applications as well as long-term opportunities should be
associated areas within the organisation. considered.
For robots to reach their full potential they must be inte-
grated into an organisation’s current workflow, systems and Usability
physical spaces. Ageing infrastructure, as well as space limi-
tation in wards, theatres, corridors, and laboratories can sig- Robots that are difficult to use have a high likelihood of
nificantly increase the cost and time involved in retrofitting being abandoned. There are two main ways to address this
new robots. issue. One approach is to reduce robot complexity and cre-
The absence of adequate regulation and the difficulty of ate robots that are easier to use and maintain. The other is
the legal system keeping up with the rapid pace of tech- to improve user interfaces through inclusive design princi-
nological developments presents significant implementa- ples (e.g., co-design) that allow for user-friendly interfaces.
tion challenges. Without responsible corporate policies and Either way, all new systems should undergo user testing
protocols, many robot capabilities can become a threat to evaluations before their implementation.
both healthcare staff and patients. However, as noted by Dr
Kathrin Cresswell [15], “while regulation is important, it Acceptability
should be designed in a way that promotes routine use with-
out stifling innovation.” The appearance, behavior, and functionality of robots plays
The next barrier is related to the longitudinal use of a major role in their adoption and sustained use. Roboticists
robots. While real-world applications require repeated inter- are usually concerned about a robot’s functional capabilities.
actions over extended periods of time, many of the current However, there is great value in also considering a robot’s
studies in human-robot interaction (HRI) in healthcare con- appearance and behavior to improve technology adoption.
texts are focused on short-term interactions between humans While humanoid robots are often preferred in order to pro-
and robots. Additional research in the longitudinal impact of vide a similar interactive experience to that currently avail-
robots in healthcare are required to improve efficacy, trust able through clinicians, human-like robots often fall short
and acceptability by the different stakeholders. of human expectations, resulting in disappointment and
Technical challenges are not to be ignored. Advances in mistrust [18].
battery performance, sensing capabilities, processing power, Acceptance and trust towards robots in healthcare will
learning capabilities (i.e., AI), and data communication are improve through exposure, communication, education and
key for ongoing innovation. In addition, strong digital foun- appropriate management of expectations. As success stories
dations are required to manage advanced robotic innovation. of robots become more visible, robots are likely to become
Limited technical skills in hospital staff might be an issue to more acceptable in healthcare. Acceptance from both

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SN Computer Science (2024) 5:189 Page 13 of 19 189

hospital staff and patients in needed for widespread adop- Cost

tion. At the moment, acceptability of robots in healthcare
varies widely. The prospect that robots may take over health- When a robot is being acquired, it is important to consider
care jobs is of particular concern [16, 198]. Augmenting its costs beyond the purchase and maintenance, including the
human capabilities and empowering professionals instead impacts in infrastructure, clinical workflow and other unin-
of replacing them is generally more accepted. Nevertheless, tended consequences. That is, we should ensure the selected
greater reliance on robots is likely to have impacts in the robot can be installed in available spaces, meets clinical needs
short, medium, and long term and that must be managed without increasing workflow, appropriate plans for implemen-
responsibly. tation and ongoing support are in place, and the safety, reliabil-
ity and efficacy of the robot are properly evaluated. We should
also make sure the organisation and relevant stakeholders are
Privacy, Reliability and Safety ready for the new technology, with training put in place to min-
imise the impacts in staff. Finally, we need to ensure the new
Robots in healthcare work in close proximity to people who system is compatible with other products and technologies,
may be vulnerable to harm due to disability, injury, or ill- and adaptable to ongoing changes within the organisation.
ness. When robots and people are proximately located, safety
and reliability are incredibly important. While there is sig- Change Management
nificant work looking at safe physical human-robot interac-
tion (e.g., collision avoidance), there is little work available There are risks in introducing a new system before it is fully
in cognitive or emotional safety. That is, ensuring that the functional, as resistance to an innovation often grows out of
appearance of the robot is well-aligned with its functions mistakes or overlooked issues in an implementation plan.
to avoid deception, or considerations around how the robot Integration of new technology requires planning, testing,
manages users’ data to maintain privacy and dignity. guidance and appropriate change management practices.
Ideally, the least disruptive application should be the first
Training and Education one to be implemented.

End-users (either staff or patients) need to be brought Deployment

onboard with the technology, how it works and what are its
limitations. If users do not know how to use these robots, or Integration of robots with existing practices is challenging.
what their limitations are, then the implementation will not This process requires clear objectives, detailed plans, and
be effective. Interdisciplinary programs that bridge medi- an adequate management of expectations. Success metrics
cal and engineering training at the university level might should be determined in advance and evaluated continually.
be beneficial. Quality improvement should be supported on an ongoing
basis. More importantly, deployment of robots should be
considered only after the clinical effectiveness is demon-
Clinical Efficacy strated. This process will reduce potential risks for mistrust,
frustration and disappointment.
For robots to be clinically effective they should ben- Additionally, key stakeholders should be included and
efit patients, clinicians or both. This question should be engaged from the onset. In most cases, a clinical champion
answered thorough evidence-based studies. These studies is recommended to manage expectations. Public engagement
should evaluate technology reliability, reproducibility of campaigns and public dissemination of successful case stud-
experiments, safety, usability, acceptability and generalisa- ies of robots in healthcare could help promote a positive
tion of outcomes. As systems become increasingly intel- attitude towards robots among staff and patients.
ligent and autonomous, it might be necessary to develop Finally, given that internet connectivity is vital to many of
methods for measuring and evaluating adaptive technologies these devices, the provision of a fast and functional internet
that change along with robots. Longitudinal evaluations of service is of significant importance.
implementation (translation from research to practice), adop-
tion, and optimisation should be considered.
Depending on the application, robots might need to Conclusions
undergo regulatory approvals (e.g., FDA). Particular atten-
tion needs to be given to an organisation’s current work- The application of robotics in healthcare is a relatively
flow, and how robots will be integrated without significant new and exciting area driven by the expectation that robots
disruption. will be able to help address key challenges and introduce

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 189 Page 14 of 19 SN Computer Science (2024) 5:189

efficiencies over the next decades. To date, only a few robots included in the article’s Creative Commons licence, unless indicated
are commercially available and used in large-scale. The most otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not
prominent healthcare robots currently in use are service and permitted by statutory regulation or exceeds the permitted use, you will
surgery robots, with many other applications under develop- need to obtain permission directly from the copyright holder. To view a
ment. How these robots will be integrated into the healthcare copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
system remains unknown, but there is no doubt that robots
will be a major enabler to the delivery of healthcare.
Integrating new robotic systems into healthcare is com- References
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