Growing research into telehealth drones

It seems rural USA has drunk the Kool Aid in as far as investing in telehealth drones is concerned.

And it is a good thing for rural citizens the world over, most of whom live considerable distances away from the nearest doctor.

Of course, medical delivery drones have ensured that ensured that rural dwellers in Africa – at least those in Botswana, Ghana, Madagascar, Malawi, Mozambique, Nigeria and Rwanda – can at least breathe easily when it comes to delivery of basic healthcare implements to the nearest health centres.

And we can all appreciate how the same specially made tin birds were instrumental in making timely distributions of vaccines in some countries.

But when it comes to specialist healthcare – the kind that had a drone playing a part in saving a Swedish man’s life recently, there seems to be some explorations that need to be made.

Getting vital healthcare services and supplies is a challenge for rural patients worldwide because of the long distances involved and because smaller communities lack doctors, nurses and clinics.

That is what led to doctors and other smart people at the University of Cincinnati develop their own special kind of unmanned aerial vehicle that could fly indoors to administer health care – just like what a human doctor would do.

And that is what the College of Nursing at the University of Alabama in Huntsville (UAH), is now looking into too.

A part of the University of Alabama System, the nursing college along with the UAH Rotorcraft Systems Engineering and Simulation Center (RSESC) Unmanned Aircraft Systems (UAS) Program, have started research into whether the drones might be a good answer to the shortage of doctors in rural areas in the USA.

“We have been working on several projects in utilizing drones in telehealth,” says Dr. Azita Amiri, an associate professor of nursing, who is leading the research with Casey Calamaio, an RSESC research engineer.

“In addition, citizens in rural areas are more likely to experience health disparities. People have to travel 30 to 40 miles to reach a clinic or a health center in many rural areas.”

About 2 years ago, her committee connected with the RSESC and “we noticed the strong capacity and capabilities of the Unmanned Aircraft Systems Programs at UAH.”

“We’re trying to connect nursing, aerospace, and Unmanned Aircraft Systems and use it in the systems in healthcare to improve nursing care and patient outcome.”

Current FAA regulations and rules limit drone package delivery functions in the USA. Walmart has successfully tested drone delivery of COVID-19 testing kits, but it provided the service only to patients who lived within a one-mile radius of the designated supercenters to adhere to FAA regulations that the drone must be visible while flying.

“Significant coordination with the FAA to safely implement a rural UAS delivery system is required,” Calamaio says. “Challenges in assured operational safety and regulatory compliance need addressing before UAS are used as delivery mechanisms on the scale to tilt the medical supply chain in a significant way.”

The limitations of regulations notwithstanding, the research has shown so far that drone delivery could be ideal, as it keeps patients at home and avoids any constraints in rural transport infrastructure along the way.

Drones provide a unique platform for short-range delivery of time-sensitive payloads and their use for delivery of healthcare services is well documented in humanitarian relief efforts or during significant natural disaster events in rural locations across the globe, the researchers further say.

The UAH collaborators recently tested drone delivery technologies and approaches for nursing education on campus, with an eye to refining the system for use in rural USA.

UAH Nursing and Aerospace Committee, UAH Rotorcraft Systems Engineering and Simulation Center team and representatives of the Skyfire Company. Picture: Michael Mercier/UAH.

“Led by clinical associate professor Dr. Darlene Showalter, the simulation involves a pregnant woman at risk for preterm labor who arrives at a rural hospital,” says a report by the university publication.

“Reflecting real life, the hospital has encountered supply-chain issues associated with the global COVID-19 pandemic and has limited capabilities and staff.

“Nurses perform a focused preterm labor assessment and receive a prescription for fetal fibronectin (fFN) and betamethasone, but neither is available in the rural agency. Using a drone, an urban clinic sends the medicine and a fetal fibronectin (fFN) testing kit. fFN is a protein produced during pregnancy that’s used to predict risk for preterm delivery and betamethasone is vital for maturing fetal lungs in the event of preterm birth.”

Upon receipt, the nursing staff at the rural hospital immediately unloads the supplies, performs the fFN test and sends the specimen back to the urban clinic via drone.

This situation is verisimilar to the one health authorities in Benin – a country with one of the highest maternal mortality rates in Africa, because new mothers in its rural areas have no access to much needed blood and medical supplies – have been trying to solve recently.

“This simulation was designed to promote creative and viable decision-making by nurses,” Dr. Showalter says. “We are equipping our students to collaborate and think through real-life issues that serve as obstacles to healthcare equity. I am grateful for the faculty of the maternity course, who quickly embraced this innovative learning opportunity for their students.”

Says Dr Amiri; “This simulation model can also be used as a pilot for medical services delivery in our hospital systems in Huntsville. Our team is now working on a simulation where we have a case of an overdose in a rural area, and a drone is used to deliver the life-saving medication naloxone to reverse the effects of opioids.”

Both the obstetric and overdose simulations are designed to bring nursing students to the table in the planning and implementation of solutions to make an impact in the health of the community.

Other experts involved with the research include Helping nursing professor Dr. Pamela O’Neal, clinical associate professor Dr. Kim Budisalich, and nursing instructor Jarmel Poole.

A local industry partner with expertise in public safety UAS, Skyfire Consulting, provided an aircraft and medical payload to the team for the demonstration.

“This demonstration provided a simple scenario to test unmanned aerial delivery solutions in a campus environment,” Calamaio says. “We also had a chance to identify areas with radio frequency interference in urban environments, considerations for UAS traffic management, and to discuss effective ways to introduce UAS in the local medical community.”

A custom payload bay made of Kydex, a thermoplastic acrylic-polyvinyl chloride material, and standard ruggedized cases that are widely used by emergency services were tested on the UAS.

“This prototype payload for medical supply delivery paves the way for more rigorous testing to see how transportation on a UAS affect different medicine containers, samples, and in particular, liquids with specific temperature or vibration sensitivity,” Calamaio explains. “The demonstration builds off the UAS Research Program’s expertise in disaster response and emergency services research with the Federal Aviation Administration (FAA).”

There are 57.2 million people living in rural areas, based on the 2020 U.S. Census. That’s 17.3 percent of the population.

“Limitations in healthcare services in disadvantaged communities lead to delay in diagnosis, as well as inconvenient patient and physician experiences,” Dr. Amiri says. “They also lead to reduced medication adherence, poor diagnostics for treatment and universal healthcare issues, such as antibiotic resistance.”

In Alabama, which covers 50,744 square miles with a 2020 estimated population of 5,024,279, there are 1,146,765 people living in rural areas, or 23 percent of the population, according to the U.S. Department of Agriculture’s Economic Research Service.


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