THE ROBOT REPORT - DESIGN WORLD - APRIL 2020

A Supplement to Design World - April 2020 www.designworldonline.com

COVID-19

a wake-up call for robotics developers

page 88

INSIDE:

• Robotics industry responds to the COVID-19 pandemic ...........................................................92 • How robotic guidance can improve neurosurgery outcomes .................................98 • Blood-drawing robot shows promising results ...............................................................102 • Diligent Robotics designs Moxi to aid stressed clinicians ............................................................106

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FHA-C Mini Actuator with Integrated Servo Drive

The Servo Drive is in the Actuator!

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• Actuator + Integrated Servo Drive utilizing CANopen communication • 24VDC Nominal +7-28VDC Supply Voltage Range • Single Cable with only 4 wires needed: CANH, CANL, +24VDC, 0VDC • Zero Backlash • Dual Absolute Encoders

• Panel Mount Connectors with 4 exit options • Output Sensing Encoder 14bit (16384 cpr) resolution • Input Sensing Encoder 15bit (32768 cpr) resolution • Control Modes Including Torque, Velocity, and Position Control, CSP, CSV, CST • Harmonic Drive HDL Software

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A Supplement to Design World - April 2020 www.designworldonline.com

COVID-19

a wake-up call for robotics developers

page 88

INSIDE:

• Robotics industry responds to the COVID-19 pandemic ...........................................................92 • How robotic guidance can improve neurosurgery outcomes .................................98 • Blood-drawing robot shows promising results ...............................................................102 • Diligent Robotics designs Moxi to aid stressed clinicians ............................................................106

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The Robot Report

COVID-19:

a wake-up call for robotics developers Robots need to be better than proofs of concept and can no longer depend on on-site support for edge cases. Improvements in these three areas will help accomplish that.

Bastiane Huang • Product Manager • OSARO

Millions of Americans have started to work om home amidst the current COVID-19 pandemic. Retailers have struggled with supply while nervous consumers are hoarding everything om toilet paper to hand soap.

Across the globe, Chinese e-commerce giant JD began testing a level 4 autonomous delivery robot in Wuhan and running its automated warehouses 24 hours a day to cope with a surge in demand.

Suddenly, autonomous machines need to be better than just proof of concepts.

They can no longer depend on on-site engineering support for edge cases. They must be robust enough to work independently across various real-life situations.

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In some ways, the epidemic accelerates an automated future that’s already on its way. It has exposed problems that have long existed in the artificial intelligence (AI) venture scene: buzzwords and hype cloud people’s judgment, making it difficult to see real progress.

The industry needs to take on much-needed reforms towards real-world autonomous systems in the following three areas.

1 Rethink metrics As more autonomous machines are deployed in the real world, conventional metrics such as speed, cycle time, or success rate can no longer represent the full picture. We need to measure the reliability of the system under uncertainties with robustness metrics such as the average number of human interventions.

We need more tools and industry standards to evaluate overall system performance across a wide range of scenarios because real life, unlike a controlled environment, is unpredictable.

If a delivery robot can reach a max speed of 4 MPH but cannot complete a single delivery without human support, the robot is not creating much value for its users.

DevOps emerged a few years ago to shorten the development cycle and continuously deliver high-quality so ware. In comparison with so ware engineering, AI or machine learning (ML) is much less mature.

Eighty-seven percent of ML projects never go into production. However, recently we’ve started to see MLOps or AIOps appearing more and more.

This marks a crucial transition om AI/ML research to actual products that are used and tested every day. It requires a significant change in mindset to focus on quality assurance instead of state-of-the-art ML models. I’m not saying we can’t have both at the same time, but to date, we’ve seen much more emphasis on the latter.

2 Redesign error handling and communication The recent shutdown of Starsky Robotics reminds us that we are still years away om fully autonomous solutions. That doesn’t mean robotics cannot bring immediate value to humans. Even if humans need to handle edge cases 15% of the time, that still means companies can reduce significant labor and integration costs.

However, AI companies currently tend to spend much more resources on building autonomous systems and much less time thinking about error handling and seamless hand-offs between machines and humans.

We need a better way of handling and communicating errors, especially for ML products because ML is more probabilistic and less transparent. Therefore, showing the confidence level of model predictions or aming your predictions as suggestions instead of decisions are ways to gain trust with users.

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The Robot Report We need to categorize errors into different levels, design different protocols accordingly, and prioritize minimizing fatal errors that stop the system and require human intervention.

If fatal errors occur and the system isn’t working anymore, can we respond quickly and troubleshoot remotely?

The most difficult part is to identi the “unknown unknowns,� errors that systems cannot detect. Therefore, it’s also crucial to have two-way communication and allow users to flag errors or choose to activate the previously agreed fallback plan.

3 Redefine human-machine interaction The novel coronavirus forces companies to more rapidly adopt automation and shi to the cloud. As fewer people control a larger number of robots, do we have the right tools and technologies to pass all the relevant information to that decision-maker promptly? Are there

enough sensors on each robot to provide a full picture?

Today, we rely on tactile input like computers or tablets to control robots.

Are these still the best interfaces as the amount of information soars and response time remains short? Should we reconsider human-machine interfaces that go beyond tactile, for example, voice, VR/AR or brain-machine interface?

We also need to decide who should be in control. As machines get smarter, should we always make the final call?

For example, who should be controlling an autonomous robotaxi?

The car itself? The human safety driver?

Someone who monitors a fleet of robotaxis remotely? The passengers?

Under what situation? Or should it be a co-decision with weighted judgment by both humans and machines? What’s the

The Ventilator Project

By Steve Crowe • Editor • The Robot Report

The COVID-19 pandemic has highlighted extreme shortages of medical supplies, including personal protective equipment for healthcare workers and ventilators for COVID-19 patients. The lack of ventilators is most critical for patients hit hardest by COVID-19 – typically people 60-plus years of age and anyone with underlying medical conditions.

To combat this shortage, companies have partnered to ramp up production of ventilators, including two Boston-based robotics startups at MassRobotics. Alex Frost, Founder of FloraBot, and Tyler Mantel, Founder of Watertower Robotics, started The Ventilator Project, a non-profit looking to develop a low-cost ventilator specifically for COVID-19 patients.

One ventilator costs about $40,000, according to estimates. Mantel told The Robot Report his team is rapidly prototyping a ventilator that will cost between $1,000-$2,000. “The best analogy I can come up with is cars,� Mantel said. “RollsRoyce has some amazing cars. You feel like you’re on a cloud when you drive one because you never feel the road. But you can also get a car for far less money that gets you to where you need to go. The ventilators currently on the market are designed for any type of patient. We’re building a ventilator specifically for COVID-19 patients.

Think of it as a stripped-down, bare-bones version of what major companies produce.�

The Ventilator Project is consulting with a group of doctors on the ventilator design. Mantel said the ventilator will be submitted to the Food and Drug Administration under the Emergency Approval Process.

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ethical implication? Can the interface support multi-step co-decision making?

Ultimately, how do we design humancentered AI to make sure autonomous machines make our lives better, not worse? How do we automate the right use cases to augment humans? How do we build a hybrid team that delivers better outcomes and allows humans and machines to learn om each other?

There are still a lot of questions that we need to answer. And the current pandemic is pushing us to answer them more quickly so that would-be autonomous systems can deliver on their promise. If the makers of these systems can focus on the three areas I’ve outlined above, they’ll be better positioned to reach key conclusions more quickly. And that will ensure we’re heading in the right direction. RR

www.therobotreport.com

up and running in 30 days and produce 1,000 ventilators within the first month. “A er that, we’ll ramp up production to help fill the anticipated shortage of 600,000 ventilators worldwide. We’re working on contracts with major manufacturers in the medical device space to use their under-utilized facilities to pump out ventilators.�

MassRobotics donated any unused space in its 40,000-square-foot-facility to The Ventilator Project. Developing hardware requires physical space, of course. This can be tricky due to the physical distancing recommendations currently in place.

Mantel said The Ventilator Project team is following all the recommendations for physical distancing.

As is currently the case for many companies across the world, things have slowed down for Watertower Robotics. Founded in 2017, the company built a robot that inspects water pipes. The goal is to reduce the 20% of water currently lost through deteriorating in astructure. The startup was one of three companies to win the Imagine H2O’s Urban Water Challenge in Stockholm, Sweden. It won funding to deploy its robots in Vietnam. “For me, it’s the same mission I’ve always had,� said Mantel. “I want to affect lives in a positive way using robotics. At Watertower Robotics, we find water for people. I get excited to do these things for the world.�

THE ROBOT REPORT

4/9/20 3:18 PM

FHA-C Mini Actuator with Integrated Servo Drive

The Servo Drive is in the Actuator!

The FHA-C Mini Series is a family of extremely compact actuators that deliver high torque with exceptional accuracy and repeatability. As part of the FHA-C Mini family, an integrated servo drive version utilizing CANopen® communication is now available. This evolutionary product eliminates the need for an external drive and greatly improves wiring while retaining high-positional accuracy and torsional stiffness in a compact housing.

• Actuator + Integrated Servo Drive utilizing CANopen communication • 24VDC Nominal +7-28VDC Supply Voltage Range • Single Cable with only 4 wires needed: CANH, CANL, +24VDC, 0VDC • Zero Backlash • Dual Absolute Encoders

• Panel Mount Connectors with 4 exit options • Output Sensing Encoder 14bit (16384 cpr) resolution • Input Sensing Encoder 15bit (32768 cpr) resolution • Control Modes Including Torque, Velocity, and Position Control, CSP, CSV, CST • Harmonic Drive HDL Software

42 Dunham Ridge, Beverly, MA 01915 | 800.921.3332 | www.HarmonicDrive.net Harmonic Drive is a registered trademark of Harmonic Drive LLC. CANopen is a registered trademark of CAN in Automation.

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The Robot Report

Robotics industry

responds to the

COVID-19 pandemic From disinfection to delivery and telepresence, robots extend healthcare capabilities.

Eugene Demaitre • Senior Editor • The Robot Report

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Disinfection robots can help with staffing shortages and in multiple environments. | UVD Robots

No technology or industry has escaped the effects of the COVID-19 pandemic.

With hundreds of thousands of confirmed cases and tens of thousands of fatalities worldwide in 2020 so far, governments have closed borders, businesses have shuttered, and millions — even billions — of people have stayed in their homes in the hopes of controlling the spread of infection.

At the same time, robotics developers and suppliers have risen to the challenge. They are offering systems to civil authorities and healthcare providers now keenly aware of staffing shortages, the need to limit human contact, and the ability of robots and drones to efficiently handle certain tasks.

“Reducing the risk of person-to-person transmission is of the highest priority for government and health officials,” said Rocos Global Ltd. The Auckland, New Zealand-based company’s Rocos Robot Operations Platform is designed to enable developers and users to connect, monitor, and control fleets of robots.

Rocos pointed out that “robots are no stranger in the healthcare system,” now being used in surgical procedures, dispensing medication, and transporting items within hospitals. While no one robot can do it all, there are robots that can help with informing the public, moving patients, and cleaning and disinfecting areas.

Some of the challenges facing robotics startups that want to serve the healthcare market include central management of growing robotic fleets, providing the right levels of support, and improving collaboration among robots and with human staffers and patients, said Rocos.

“China is becoming the largest testing ground to demonstrate how emerging technologies can be harnessed to improve epidemic management and minimize the economic impact of the coronavirus outbreak,” stated Venkata Naveen, a disruptive tech analyst at GlobalData.

Some companies serving manufacturing and logistics have claimed that their robots are helping to deal with the novel coronavirus, but that’s indirect aid. Still, the crisis could expand public and industry awareness and acceptance of robotics.

Here are some examples of robots that are attracting interest around the COVID-19 crisis.

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The Robot Report For instance, Hamilton Co. is offering its MagEEx STARlet and PCR Prep STARlet assay-ready workstations. It said it is prioritizing orders for testing products at its manufacturing sites in Reno, Nev., and Bonaduz, Switzerland.

SRI Biosciences in Menlo Park, Calf., is using robots and AI in developing antiviral agents.

The European Commission is offering small businesses €164 million ($178.16 million U.S.) in fast-track funding to develop treatment, testing, monitoring, and other technologies to help fight the COVID-19 pandemic.

The R80 ground robot sprays | XAG disinfectant in China.

Disinfection robots ride to the rescue UVD Robots ApS is among the first providers of mobile robots that use ultraviolet light to disinfect hospital rooms. The Odense, Denmark-based company was already scaling up last year to meet global demand, said Per Juul Nielsen, CEO of UVD Robots. The subsidiary of Blue Ocean Robotics has received numerous orders for its disinfection robots from China and Brazil, among other countries.

Los Angeles-based Dimer UVC’s GermFalcon is a cart that uses UV radiation to disinfect aircraft cabins.

Shanghai-based TMiRob has deployed 30 disinfection robots across hospitals in Wuhan, China, the epicenter of the COVID-19 outbreak.

Wilmington, Mass.-based Xenon Corp. provides UV-C lamps to Xenex Disinfection Systems. San Antonio, Texasbased Xenex’s robots are designed to reduce healthcare-associated infections in hospitals. It claimed that its LightStrike UV robot is already in use in 500 facilities in the U.S. More recently, Xenex has sent robots to Italy, which has been hit hard by the illness.

In Taiyuan, China, local authorities have used a remote-controlled vehicle

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to spray disinfectant in residential areas in an attempt to limit the spread of the coronavirus. XAG has scaled up its use of ground robots with aerial drones, converting agricultural units into disinfectant sprayers. The company has deployed more than 2,600 drones in China, which is reportedly starting to recover.

MTR Corp., the Hong Kong subway system, is using vaporized hydrogen peroxide (VHP) robots developed with Avalon Biomedical (Management) Ltd. to disinfect rail cars.

“We plan to deploy a total of 20 VHP robots for train cleaning in depots and hope this helps to ensure the comfort of passengers’ journeys by providing ever greater health protection for our colleagues and our customers alike,” said Dr. Tony Lee, operations director at MTR. Autonomous vehicles have also been pressed into service. Idriverplus, which makes a street-sweeping robot, is also contributing to COVID-19 disinfection efforts.

Automated testing scales up Testing hundreds of thousands of people for infection, as well as potential vaccines, is a monumental task aided by automated systems. www.therobotreport.com

Drones, robots search for symptoms, scofflaws Shenzhen MicroMultiCopter (MMC) has launched drones to remind people to wear masks, spray disinfectant, and manage traffic. Chinese officials are using aerial drones to keep residents indoors, according to social media posts.

Drones could use thermal imaging to detect people with fevers, said Cameron Chell, CEO of Draganfly Inc. In fact, Guangzhou Gosuncn Robot Co. is providing police with patrol robots remotely controlled via 5G to detect people with fevers.

Similarly, the California-based CaliBurger restaurant chain is using technologies including thermal imaging and facial recognition to screen entrants.

Although sensors are not yet sensitive enough to detect viruses at a distance, artificial intelligence is being applied to analyze how the coronavirus is spreading to detect patterns, begin formulating vaccines, and draw lessons for future epidemics.

Mobile robots help protect hospital personnel Hong Kong University of Science and Technology is testing a variety of mobile robots for infection control in collaboration with the government and local hospitals. It noted that the current pandemic requires truly global cooperation for innovative responses.

Several hospitals in China are using robots to deliver food and medical supplies internally to limit people’s potential exposure to the new coronavirus, said Rocos.

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Drones can monitor traffic and quarantines. | MMC

For example, Pudu Technology Inc.’s robots are autonomously delivering meals, and Qianxi Robotic Catering has donated robots to prepare food for medical workers in Wuhan.

A hospital in Hangzhou, China, is using 16 “Little Peanut” robots from Keenon Robotics Co. to deliver food.

Mobile robots can also remove trash.

Some of China’s biggest tech companies have also gotten involved.

Siasun Robot and Automation Co. has donated robots for collecting throat cultures, as well as adjustable beds, to hospitals in Shenyang. JD.com Inc. has also tested delivery robots in Wuhan.

Although most social robots are designed to provide information than care, a new field hospital in Wuhan, China, uses a variety of systems, including CloudMinds’ 5G-enabled humanoid robots.

Shenzhen, China-based Ubtech Robotics Inc. has modified its AIMBOT, ATRIS, and Cruzr service robots to measure people’s temperature.

Orbbec, which makes 3D cameras, said its partners have joined efforts to slow COVID-19’s spread and to treat patients. They include delivery robot maker Keenon Robotics Co., disinfection provider EVA Robot, and guide robot supplier OrionStar.

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Mobile manipulation and coronavirus Austin, Texas-based Diligent Robotics Inc. recently raised $10 million in Series A funding for its Moxi service robot. The mobile manipulator is more mature than other platforms, and we have yet to see the full market for robots to aid nurses and doctors.

Zheng Gangtie, a professor at Tsinghua University in Beijing, built mobile manipulators to protect medical personnel in Beijing while attending to patients, but each one cost $73,000 to make.

Hooman Somani has also placed a robot arm on a mobile base for its Ambulance Robot or AmbuBot. As with humanoid designs, these robots are still catching up to other material-handling systems.

Robot, drone deliveries help people avoid pandemic Baidu Inc. has partnered with Neolix to deliver food and supplies to Beijing Haidan Hospital with the Apollo autonomous vehicle. Baidu’s AI algorithms are also being used to track the spread of infection.

Grocers, pharmacies, and restaurants have limited resources for fast and accurate order fulfillment, so robots are increasingly important in getting goods from warehouses and stores to trucks and customers. JD.com has used Level 4 autonomous vehicles for deliveries in Wuhan.

Drone deliveries of medication aren’t yet commonplace, but companies such as Drone Delivery Canada Corp. (DDC) anticipate that they will be.

“The company is in dialogue with governments at various ministries and levels emphasizing that the current situation is an ideal use case for our proven drone logistics solution to limit person-to-person contact; bring needed medical and pharmaceutical supplies to remote, rural, and suburban communities; transport blood samples to laboratories for testing; and deliver other relevant supplies needed for Canada to effectively manage the current situation,” stated Michael Zahra, president and CEO of DDC.

Service robots can provide information and check for fever. | Ubtech

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The Robot Report Aerial drones transport medicine and other supplies. | DDC

“With a global pandemic quickly on the rise, government officials will need to act quickly in search of a scalable solution that will help slow down the spread of coronavirus,” said Matthew Sweeny, founder and CEO of Flirtey. “Flirtey is uniquely positioned to provide drone delivery technology for pandemic management, because our technology can be utilized as a scalable, effective and low-risk means to significantly mitigating the virus’s threat.”

Antwork Ltd., a Terra Drone group company, is already transporting medical supplies and laboratory samples between a hospital, a disease-control center, and a branch of Xinighang County People’s Hospital.

Telepresence robots join the coronavirus fight Most telepresence robots were not designed with the coronavirus pandemic in mind, but wider use could help drop their prices. To keep patients from overwhelming hospitals, more physicians could turn to telemedicine.

Alexandra Hospital in Singapore, which just started testing a BeamPro robot, plans to use it to see isolated patients suspected of being infected with the new coronavirus.

Beijing Orion Star Technology Co. has partnered with Cheetah Mobile to provide robots for fixed-point delivery of medical supplies and remote consultation at Peking University Shougang Hospital, Beijing Haidian Hospital, Wuhan Vulcan Mountain Hospital, and Zhengzhou’s Xiaotangshan Hospital. Cheetah Mobile is an investor in the service robot company.

“Since the outbreak of COVID-19, we have launched the anti-epidemic products in hospitals in the hope that they can alleviate the tension resulted

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from insufficient medical personnel as well as cross-infections,” stated Fu Sheng, CEO and chairman of Cheetah Mobile.

OrionStar’s robots can also follow human instructions to collect, store, and transmit photos, video, and data, including body temperature measured by a no-contact infrared thermometer.

The hospitals can disinfect the robots as needed, and informational models are being programmed with general epidemiological data, said a company spokeswoman.

In addition, China Mobile and CloudMinds have donated 5G-enabled robots to a Shanghai medical facility to aid medical staffers. The hospitality industry is also using telepresence robots in response to health concerns.

In Everett, Wash., doctors used an InTouch Health robot to remotely communicate with a patient.

Zorabots is offering its telepresence robots to Belgian nursing homes, where vulnerable populations are limiting contact with family members in response to COVID-19.

Israel-based Robotemi is also offering its Temi personal robot in South Korea to help reduce exposure to COVID-19.

Although robotics competitions have been canceled or postponed, robotics can be helpful for telepresence and distance learning. For instance, children in New Rochelle, N.Y., another community hard hit by the virus, have also been using the Temi robot. www.therobotreport.com

Dallas-based RoboKind, which makes the Milo humanoid robot, is offering its robots4STEM Avatar Version software for free to students whose elementary and middle schools are closed. The virtual coding class follows computer science standards set by the International Society of Technology.

Even if the pandemic eases soon, it’s likely that healthcare providers, consumers, and businesses will be more comfortable with robots of all kinds and more interested in using them.

“The IMF has predicted global declines in the next two quarters, but we see the market for robotics picking up again,” Nikhil Kaitwade, senior research manager at Future Market Insights, told The Robot Report. RR

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The Robot Report

How robotic guidance

can improve neurosurgery outcomes Cranial robotic guidance platform provides real-time visualization, feedback and robotically-assisted movement to allow surgeons to accurately align with surgical plans.

Keith Shaw • Senior Editor • The Robot Report

Phoenix Children’s Hospital recently became the first health system in the U.S. to deploy Medtronic’s Stealth Autoguide platform, which robotically assists neurosurgeons for more accurate positioning of instruments during procedures.

Medtronic’s Stealth Autoguide platform robotically assists neurosurgeons for more accurate positioning of instruments.

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The cranial robotic guidance platform provides realtime visualization, feedback and robotically-assisted movement to allow surgeons to accurately align with surgical plans. The system integrates with Medtronic’s StealthStation surgical navigation system and Midas Rex surgical drill technology to improve workflow efficiency in an operating room. The system can assist surgeons with placement of biopsy needles, the placement of stereo electroencephalography (stereo EEG or sEEG) anchor bolts to enable placement of depth electrodes, and support for laser ablation.

At Phoenix Children’s, P. David Adelson, division chief of neurosurgery and director of the Barrow Neurological Institute (BNI), has performed at least two procedures (an sEEG procedure and laser ablation) with the new system on patients with epilepsy. The Robot Report spoke with Dr. Adelson about the hospital’s interest in the system and the benefits for surgeons using the robotic guidance system.

www.therobotreport.com

THE ROBOT REPORT

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The Robot Report

Besides improving instrument position during procedures, Phoenix Children’s Hospital said surgical robots help decrease length of stay in the hospital, time in the operating room, and exposure to anesthesia. Credit: Medtronic

Q How did you first get interested in the possibility of robots being used in neurosurgery?

Dr. Adelson: Over the last few years, there’s been a number of new entries into neurosurgical robots. Throughout the U.S., we’ve seen increasing robotic technology for a lot of different aspects of healthcare and surgery. But with regards to neurosurgical robots, particularly cranial, there were a number of excellent technologies that were very interesting.

The big issue for me was how easy would it be to integrate these into our present workflow. If you have to add new software for guidance, or new software that changes what you do or how you do it, then obviously there’s an extensive relearning and a high learning curve.

Q How did you narrow it down to selecting the Medtronic system?

Dr. Adelson: Number one was the size, because it married into the technology that we already were employing – the Stealth Navigation System, as well as some other technologies in which we would be using the new robotic device. We had worked with Medtronic in the past on a number of different technologies, including the image guidance system and the laser ablation technology. This seemed to marry very well with that. The robot is also

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markedly smaller than its competitors, and so much easier to integrate into the operating room as an assistive device.

Second, it increased our efficiency of doing these procedures. When we were researching the different technologies, I was being sold on the fact that we could do an operative plan in eight to 12 minutes. I was already doing these in eight to 12 minutes, so I didn’t see what was going to be the added benefit with this significant investment. But the Medtronic one clearly led to increased efficiency – for us it has actually cut the time in half.

Lastly is the accuracy – I felt very comfortable using their present technology getting 0.2 to 0.5 millimeters of accuracy. With a frame-based system you could get to 0 to 0.2mm. So this robotic device gives us that type of accuracy without having to use a frame.

A frameless approach saves time, saves anesthesia for the patient, and ultimately gives us the same accuracy.

Q How important is accuracy in terms of some of these procedures? From a layman’s perspective, is there really that big a difference between 0.3 and 0.5 millimeters?

Dr. Adelson: That’s a great question. I guess if it’s your brain, you’d want it as close as it can be, but it’s not as simple as that. In many situations it’s not as www.therobotreport.com

important, but in certain situations it’s very important. If we have only a three-millimeter lesion that’s deep in the brain that we have to navigate across segments, then accuracy is very important to avoid blood vessels, to avoid particular tracks in the brain, and to try to get to deep locations in a safe way. In that case, the accuracy is quite useful.

Q For pediatric patients, is accuracy a bigger deal, because of the body type of a child versus an adult?

Dr. Adelson: We always make a joke that children are not small adults, and I think that’s very true. Some of the lesions and types of problems that we’re using this robot for are quite different.

For example, for epilepsy if they have a hypothalamic hamartoma, sometimes these lesions are only three millimeters in diameter. The accuracy and targeting for these are very important – we don’t see these types of lesions in adults. So robotic technology is useful in certain pathologies that are unique for children.

I’m sure there will be unique pathologies that the robot will be used in adults as well.

It was really a privilege and truly enjoyable to work with Medtronic to roll this out for children, because children often don’t get first out-of-box technologies. Often it’s done in adults, and then OK, the kids get kind of the layover – so I think this was wonderful for Medtronic to work with us to roll it out with us.

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Q What reaction do you get om either patients or parents when you tell them about the robotic system?

Dr. Adelson: A question came up with a family that asked, “Is the robot going to do the surgery?” and I said, “No, that’s not how it works.” The two patient families were on board, very interested in the technology as I explained how we were going to be using it.

Q What were your thoughts om the two procedures you’ve done?

Dr. Adelson: The first one was a stereo EEG where we placed 10 electrodes, and that’s how I knew we could cut the time.

As I said earlier, I was a little skeptical because I could already do this in eight to 12 minutes. We were doing them in four to five minutes [with the robot]. So that decreased anesthesia time for that child, and decreased operating room time.

When you’ve got that many operative plans, the robot increasing your efficiency that way clearly saved us at least a half hour.

[In the second case], we were marrying the image guidance system with the robotic technology and laser ablation in order to treat a young woman with intractable epilepsy. We used it with two probes, and all of them have gone where we needed them to go, which has been fantastic.

Q Does the extra time now allow you to do additional procedures, or is it more of a scheduling factor where you can schedule procedures faster than what you could have done before?

Dr. Adelson: The hospital would like to know that I’m scheduling more surgeries – that would be fantastic (laughs). But for us, it’s about cutting down the time that patients are exposed to anesthesia, especially young children. They wake up easier if they’re not under anesthesia as long. Overall, we like to think that decreased length of stay in the hospital and decreased time in the operating room is better for health care, economics, and those kinds of things. RR

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The Robot Report

Blood-drawing robot shows promising results

A team led by Rutgers University researchers developed a robot that draws and tests blood more efficiently than humans.

Steve Crowe • Editor • The Robot Report

The first human clinical trials of a blood sampling and testing robot showed promising results for both patients and healthcare workers, reported Rutgers University. The trials found that an automated blood-drawing device developed over the past six years by a Rutgers-led team performed as well or better than human clinicians.

The device provides quick results and would allow healthcare professionals to spend more time treating patients in hospitals and other settings, said the researchers.

The results were comparable to or exceeded clinical standards, with an overall success rate of 87% for the 31 participants whose blood was drawn. For the 25 people whose veins were easy to access, the success rate was 97%.

The device combines high precision robotics with 2D ultrasound imaging to automatically guide an attached needle. Credit: Rutgers University

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Solving a costly problem Venipuncture, which involves inserting a needle into a vein to get a blood sample or perform intravenous (IV) therapy, is the world’s most common clinical procedure, with more than 1.4 billion performed yearly in the U.S. But clinicians fail in 27% of patients without visible veins, 40% of patients without palpable veins, and 60% of emaciated patients, according to previous studies.

Repeated failures to start an IV line boost the likelihood of phlebitis, thrombosis, and infections, and they may require targeting large veins in the body or arteries – at much www.therobotreport.com

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The Robot Report To improve the system, researchers intend to add a third degree of freedom to auto-align the needle trajectory path and analyze how machine learning models can make rapid needle position corrections. Credit: Rutgers University

for patients, but it can also be modified to draw blood in rodents, a procedure which is extremely important for drug testing in animals in the pharmaceutical and biotech industries.”

greater cost and risk. As a result, venipuncture is among the leading causes of injury to patients and clinicians, said the New Jersey-based university.

Moreover, problems with accessing veins can increase procedure time by up to an hour, requires more staff, and costs more than $4 billion a year in the U.S, according to estimates.

System breakdown The device combines high-precision robotics with 2D ultrasound imaging to automatically guide an attached needle. The device is composed of three main components: • A 2-DOF robotic manipulator containing an electromagnetic needle loader and needle tip force sensor • A 2D short-axis view ultrasound probe • A host processor An integrated module that handles samples and a centrifuge-based blood analyzer could be used at bedsides and in ambulances, emergency rooms, clinics, doctors’ offices, and hospitals.

The researchers previously developed a venipuncture device for point-of-care blood analysis that featured a 9-degree-of-freedom (DOF) robotic system that used NIR imaging and computer vision processing to identify suitable vessels for cannulation and ultrasound imaging to guide the robotic needle insertion. However, its large size, lack of mobility, and large number of DOF make it difficult to implement in a number of clinical scenarios requiring rapid venous access.

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How the system works Once a suitable blood vessel is identified by the attending physician, the device is manually positioned over the chosen venipuncture site for ultrasound imaging.

The device is then positioned over the arm so that the ultrasound probe is perpendicular with the imaged vessel.

The blood vessel coordinates, retrieved from the ultrasound images, are then used by the device to compute the necessary kinematics for needle insertion so that the needle tip reaches the lumen center at the intersection of the ultrasound imaging plane. After successful insertion, the needle tip can be seen in the center of the vessel lumen.

A yellow dashed ellipse highlights the vessel wall in the ultrasound image, where red and blue lines represent the vessel ellipse major and minor axes, respectively.

Once successfully inserted, 5 mL of blood is drawn into a collection tube, after which the needle is retracted and dispensed.

“Using volunteers, models and animals, our team showed that the device can accurately pinpoint blood vessels, improving success rates and procedure times compared with expert health care professionals, especially with difficultto-access blood vessels,” said Martin Yarmush, a researcher involved in the study. “Not only can the device be used www.therobotreport.com

Avoiding future complications In the future, the device could be used in procedures such as IV catheterization, central venous access, dialysis, and placing arterial lines. Next steps include refining the device to improve success rates in patients with difficult veins to access.

For example, before the device can perform the needle insertion, the needle trajectory must be manually aligned and centered with the underlying blood vessel. This can become timeconsuming, prone to mistakes, and require the device to be fixed and steadied once it is aligned and centered with the vessel. To improve this, the researchers intend to add a third DOF to the device that will auto-align the needle trajectory path with the underlying vessel.

The team will also investigate combining predictive machine learning models with the device kinematics to make rapid needle position corrections that would maximize the likelihood of a successful venipuncture.

“A device like ours could help clinicians get blood samples quickly, safely and reliably, preventing unnecessary complications and pain in patients from multiple needle insertion attempts,” said lead author Josh Leipheimer, a biomedical engineering doctoral student in the Yarmush lab in the biomedical engineering department in the School of Engineering at Rutgers University–New Brunswick. RR THE ROBOT REPORT

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Diligent robotics designs to aid stressed moxi clinicians The startup was working on a mobile manipulator before the COVID-19 crisis and has seen interest continue to rise.

Eugene Demaitre • Senior Editor • The Robot Report The COVID-19 pandemic has brought attention to the challenges that healthcare providers face every day, such as staffing shortages, physical strain, and the need to securely manage medications and laboratory samples. Robotics developers and suppliers have addressed some of these challenges, but a flexible and useful humanoid or service robot has been elusive.

Diligent Robotics Inc. has launched Moxi, a mobile manipulator designed to aid hospital personnel. Andrea Thomaz and Vivian Chu co-founded the Austin, Texas-based company in 2017. They began testing the robot, which also has social intelligence capabilities, in four hospitals in 2018.

“Our vision is to improve the way people think about their work by giving them more time to utilize their unique human skills and let iendly robot assistants efficiently take care of their chores,” stated

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The Moxi mobile service robot is designed to help hospital workers. | Diligent Robotics THE ROBOT REPORT

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| Raytheon

The Robot Report Thomaz, CEO of Diligent Robotics.

The company raised $2.1 million in seed funding in 2018 and $10 million in Series A funding last month. It has also received Small Business Innovation Research grants om the National Science Foundation worth $725,000.

Moxi can relieve nurses and other clinical workers of some tedious tasks. | Diligent Robotics

Moxi is not designed for patient-facing tasks, but it can help with retrieving and bringing supplies to hospital rooms and nursing stations or delivering samples to laboratories.

Recognizing needs even before the coronavirus crisis Even before the current global health crisis, many nurses were forced to spend time on non-nursing activities, according to a study by the Institute of Medicine. More than 30% of hospitals reported that they could not find enough candidates to fill open clinical positions, and clinician turnover was almost 20%.

Nursing burnout costs $9 billion for hospitals annually and $14 billion for the healthcare system overall, said the report.

“There will be a shortage of 1.1 million registered nurses in the U.S. in 2022, and 9 million in 2030,” Thomaz said at an MIT event. “We wanted to solve the interesting problem of having service robots help people in semi-structured environments like hospitals.”

“During our beta trials, we were focused on learning as much as we could about clinical workflows and opportunities for automation to make the biggest impact,” she told The Robot

Report. “We learned so much om all of the 125 nurses that Moxi had the privilege to work alongside during the trials. We’re now very excited to act on those learnings and roll out Moxi as a full-time hospital teammate that makes a real impact on workflows.”

“As the current pandemic and circumstance [have] shown, the real heroes are our healthcare providers,” said Q Motiwala, partner at DNX Ventures and newly named board member for Diligent Robotics. “Diligent Robotics has built a hospital robot assistant, Moxi, to help solve one of healthcare provider’s biggest challenges — nursing shortages.”

“Now more than ever, hospitals are under enormous stress, and the people bearing the most risk in this pandemic are the nurses and clinicians at the ontlines of patient care,” added Thomaz, who is an engineering professor at the University of Texas at Austin. “Our mission with Moxi has always been focused on relieving tasks om nurses, giving them more time to focus on patients, and today that mission has a newfound meaning and purpose.”

Designing a clinician’s aid Moxi was built on a mobile base and navigation so ware based on the Robot Operating System om Fetch Robotics.

Moxi combines standard robotics components for mobile manipulation. | Diligent Robotics

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The Robot Report gather and deliver supplies such as linens or medication can also help limit nurses’ exposure to pathogens such as the novel coronavirus.

Vivian Chu (left) and Andrea Thomaz co-founded Diligent Robotics in 2017. | Diligent Robotics

It also includes a lidar sensor from Velodyne, a camera from Intel, an arm from Kinova, and a gripper from Robotiq.

“Because of ramps and other technologies, hospitals are already robot-accessible,” explained Thomaz.

“Doors proved to be the biggest architectural challenge. We work with hospital IT to enable Moxi to integrate with various software systems in the hospital.”

Moxi’s torso and head can change in height, and it has a humanoid face for interacting with people. The goal was to have a form that is non-threatening but still useful for picking up dropped items, for example. Moxi is not designed for patient-facing tasks, but it can help with retrieving and bringing supplies to hospital rooms and nursing stations or delivering samples to laboratories.

“Another hugely pleasant surprise during our beta trials was the overwhelmingly positive reaction to Moxi by patients and their families, along with the front-line staff working with Moxi,” said Thomaz, who spoke at the inaugural Healthcare Robotics Engineering Forum last year. “We are humbled to get the

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opportunity to focus on building a product designed to positively impact nursing and healthcare, and we felt very proud seeing such an immediately positive reception of Moxi across the board.”

Diligent focuses on AI Diligent Robotics has 18 staffers and describes itself as an artificial intelligence company, with the goal of applying AI so that people can attend to high-value tasks such as caring for patients. The fifth version of Moxi uses machine learning for object recognition, grasping, and learning tasks in real time. Time named the robot one of the best inventions of 2019.

“We build artificial intelligence that enables service robots to collaborate with people and adapt to dynamic human environments,” said Chu, cofounder and chief technology officer of Diligent Robotics. “Diligent Robotics is delivering a new class of hospital service robots by building a solution that can autonomously navigate a hospital to perform collaborative tasks with nursing staff.”

The robot’s ability to autonomously

www.therobotreport.com

Moxi is available now The company plans to use its latest funding to continue developing both its hardware and software and for the product launch.

“We fully expect that our product will continue to evolve as we roll out with our first set of strategic partner customers this year and gain further insights into ways to drive value for them,” said Thomaz. “Our focus initially is on delivery-support tasks that take nurses away from the patient floor, and we are continually honing Moxi’s dexterity to handle an even a wider variety of objects for materials-management tasks.”

Moxi is available in a robotics-asa-service (RaaS) model, and Diligent is in talks with two of the top hospital networks in the U.S. “Cost is based on the customized utilization of each Moxi robot for every hospital’s particular needs,” noted Thomaz.

Diligent Robotics said the latest funding will help it scale its system to a wider customer base as well as invest in product strategy and development in both hardware and software. Humanoid and service robots have faced both technical and marketing challenges.

“We envision a future powered by robots that work seamlessly with human teams,” said Thomaz. “We are enabling our hospital customers to redesign workflows for their frontline teams, letting nurses make full use of their specialized skills and letting robots handle tedious fetching tasks and other routine work.” RR

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