Annotated Sources
Chen, Edward T. “Considerations of Telemedicine in the Delivery of Modern Healthcare.” American Journal of Management 17, no. 3 (September 2017): 20–28. Accessed March 1, 2018. https://search.proquest.com/docview/1963800986/abstract/4D17B5D238CE4005PQ/1.
Chen explicates a variety of benefits (access, efficiency, care cost) and potential challenges for telemedicine practice in clinical care (new safety and protocol measures, physician licensures across state borders, provider training on new technology). The article offers mostly surface-level insight into the breadth of advantages and concerns within telemedicine and telehealth technologies. It clearly defines telemedicine and offers a reasonably positive analysis of the potential for telemedicine to reduce physician burnout and increase overall clinical results. Some additional questions for this research motivated by this article include: “What training and certification should providers receive in order to deliver telemedicine effectively?” And “How much should providers be reimbursed from insurance payers for these services?” The first is a wider system-based questions for the ATA and AMA perhaps, and the second question addresses the meta-system issue of our insurance system.
Cheshire, William P. “Telemedicine and the Ethics of Medical Care at a Distance.” Ethics & Medicine 33, no. 2 (Summer 2017): 71–75. Accessed April 10, 2018. http://search.proquest.com/docview/1901674464/abstract/DA07149C8A284136PQ/1.
The article offers a clear lens of deep moral concern for the practice of telemedicine and the potential for losing ethically significant human elements within the context of modern healthcare. While many of the claims are valid and agreeable on the surface, this research really aims to capture the nexus of how to maximize the innovative element of telehealth technologies meets the ethical check on meeting the same human needs by clinical practitioners prior to telemedicine. Often physical presence is not necessary, and may not be preferred for particular patients. A major concluding theme from the article is that of embodiment within medical practice, especially the notion that patient encounters are embodied activities at their core (for both the patient and provider). So, this somewhat negative counterpoint to the opportunities for innovation in telehealth technologies will provide helpful direction in how to frame the overall moral concerns with the technologies while also clarifying that innovation should continue both for the betterment of patients and because it may be unethical to not innovate.
Food and Drug Administration. “InTouch Health 510(k) Submission Remote Presdnce System Summary.” November 2012. Accessed January 25th, 2018. https://www.accessdata.fda.gov/cdrh_docs/pdf12/K123229.pdf.
The Food and Drug Administration granted 510(k) clearance for iRobot Vita in 2014, which approved the Vita for direct patient interactions in hospitals. The submission document clarifies that the Vita creates a real-time link between the patient and the clinical professional. Importantly, in reference to precursor telepresent devices, the Vita does not pose any additional risk to patients and other human actors the Vita device may encounter in a hospital setting. Further, the Vita offers a series of safeguards in response to its signature autodrive feature including slowing down in narrow spaces and whenever it approaches unmapped obstacles (such as a gurney).
Goodman, Kenneth W. “Information technologies and twenty-first-century clinical practice: Ethics and the electronic health record.” In Ethics, Medicine, and Information Technology: Intelligent Machines and The Transformation of Health Care, 1-16. Cambridge, UK: Cambridge University Press, 2015.
This first piece from Goodman’s text offers a glimpse at the convergence of bioethics and medical informatics. Goodman offers a brief historical perspective of ancient medical records to our now integrated approach to patient medical data. One danger that is amplified with the use of electronic medical records is the potential to manipulate those records, to influence the decision-making process for both the patient and provider. Additionally, the electronic health record needs to be improved to optimize reliable decision support, ensure patient privacy protections, and to manifest patient-centered care. The chapter also includes an analysis on justifying patient access to personal health records, and related ethical concerns to any kind of direct access to sensitive clinical data.
Guizzo, Evan Ackerman and Erico. “IRobot Brings Visual Mapping and Navigation to the Roomba 980.” IEEE Spectrum: Technology, Engineering, and Science News, September 16, 2015. https://spectrum.ieee.org/automaton/robotics/home-robots/irobot-brings-visual-mapping-and-navigation-to-the-roomba-980
This website article is a news feature on the new version of iRobot’s roomba, the Roomba 980, that now uses visual SLAM, VSLAM for short. The comparison between the older version of Roomba and the Roomba 980 with additional mapping and navigation capabilities offers a simpler way to understand the benefits of the autonomous navigation technology.
“History of Telemedicine | EVisit® Telehealth Solutions.” eVisit® Telemedicine Solution. Accessed April 8, 2018. https://evisit.com/history-of-telemedicine/.
The iRobot VITA is a product of telemedicine, so it was important to establish how this medical field emerged and became established as part of our presentation. This website provided a helpful overview of that whole history, and also pointed out that early telemedicine was designed to be of service to rural and underserved areas. We wound up hammering this home as one of the important advantages of our contemporary invention, the iRobot.
“InTouch Health Vita User Guide.” Santa Barbara, California. 2014. Accessed February 12th, 2018. www.intouchhealth.com.
This manual, designed by InTouch Health, educates users about vita’s features and provides comprehensive instructions on how to use the device. It starts by introducing the recommended guidelines for HIPAA compliance and safety instructions—which clarifies who are the intended users of vita and what specific regulations the users need to adhere during an active session. The next part breaks the technology down into several components—head display, chest display, AutoDrive, and enhancement features—after giving a brief overview to the telehealth system. The manual concludes with the detailed guidelines for cleaning and maintenance as well as the contact information of technical expertise should problems arise during usage. In general, this manual serves to be the go-to guide for the intended audience by deciphering the information about a complicated, professional medical equipment into clear, simplified language and diagrams.
Kaplan, Bonnie, and Sergio Litewka. “Ethical Challenges of Telemedicine and Telehealth.” Cambridge Quarterly of Healthcare Ethics 17, no. 4 (October 2008): 401–16. Accessed April 15th, 2018. https://doi.org/http://dx.doi.org/10.1017/S0963180108080535.
Kaplan and Litewka offer clarifying definitions of telemedicine and telehealth in that the former always involves a clinician as at least one participant, and both involve information communication technologies for healthcare at a distance. Significantly, the authors’ cite that the sociotechnical elements of the design and development of e-health is morally relevant, and that those values (informed consent, autonomy, empowerment…) within must be identified. One major moral concern is that decontextualized data, the voluminous influx of confidential patient information physicians and nurses receive, may widen the opportunity for errors in reassigning clinical tasks to other practitioners. Furthermore, the [human] responsibility for identifying the potential for those errors spawned by the pace of new technologies is currently opaque. As with care unaided by telehealth technologies, interventions should be assessed on technical correctness and ethical appropriateness. In sum, the article offers a focusing lens beginning at the wider angle of broad implications for the healthcare system, and then narrowly at the locus of the patient encounter.
Knight, Will. “With a Roomba Capable of Navigation, IRobot Eyes Advanced Home Robots.” MIT Technology Review. Accessed May 8, 2018. https://www.technologyreview.com/s/541326/the-roomba-now-sees-and-maps-a-home/.
The article reports that the autonomous navigation technology implemented by iRobot uses the SLAM technique. The author underscores a key function called “sensor fusion” that combines all the data from the sensors with the imagery captured by the camera in the robot.
Riisgaard, Søren, and Morten Rufus Blas. “SLAM for Dummies A Tutorial Approach to Simultaneous Localization and Mapping.” Massachusetts Institute of Technology OpenCourseWare, 2005. https://ocw.mit.edu/courses/aeronautics-and-astronautics/16-412j-cognitive-robotics-spring-2005/projects/1aslam_blas_repo.pdf.
Risgaard and Rufus offer an understanding of the SLAM technique in mobile robots in the form of a basic tutorial. There are many ways to compute a SLAM program, and this document displays a rudimentary method of implementing one.
“Unveil the RP VITA Telemedicine Robot.” Accessed April 25, 2018. https://www.intouchhealth.com/about/press-room/2012/InTouch-Health-and-iRobot-to-Unveil-the-RP-VITA-Telemedicine-Robot.html.
The other two websites spoke broadly about the development of telemedicine, but this site touched upon important components of the birth of the iRobot VITA in particular. These include the marriage of inTouch Health and iRobot, the certificate of approval from the FDA, and its launching onto the market in 2013. All of these were important events for us to convey to our audiences when describing how the iRobot VITA made its way into a good number of hospitals nationwide.
“What Is Telemedicine?” Chiron Health. Accessed April 22, 2018. https://chironhealth.com/telemedicine/what-is-telemedicine/.
This website offered another useful chronology of telemedicine, emphasizing certain technological advancements– the rise of radio technology in the 1950’s, the dawn of the Internet age in the late 20th century– which were especially catalytic for this field of medicine. We underlined the same instances in our panel presentation.
ADDITIONAL SOURCES
Akin, D. L. Minsky. “Space Applications of Automation, Robotics and Machine Intelligence Systems (ARAMIS), Phase 2. Volume 1: Telepresence Technology Base Development,” October 1, 1983. https://ntrs.nasa.gov/search.jsp?R=19840002515.
Aronson, Louise. “Opinion | The Future of Robot Caregivers.” The New York Times, July 19, 2014, sec. Opinion. https://www.nytimes.com/2014/07/20/opinion/sunday/the-future-of-robot-caregivers.html.
“Ava500_ITAdminGuide_v_1-0.Pdf.” Accessed January 29, 2018. http://www.irobot.com/~/media/Files/Robots/Commercial%20Applications/Ava%20500/Ava500_ITAdminGuide_v_1-0.pdf.
“Ava500_ITAdminGuide_v_1-0.Pdf.” Accessed January 28, 2018. http://www.irobot.com/~/media/Files/Robots/Commercial%20Applications/Ava%20500/Ava500_ITAdminGuide_v_1-0.pdf.
“Borensteinrobot_caregivers.Pdf.” Accessed January 29, 2018. http://www.cs.cmu.edu/~illah/CLASSDOCS/Borensteinrobot_caregivers.pdf.
Chaet, Danielle, Ron Clearfield, James E. Sabin, Kathryn Skimming, and on behalf of the Council on Ethical and Judicial Affairs American Medical Association. “Ethical Practice in Telehealth and Telemedicine.” Journal of General Internal Medicine 32, no. 10 (October 1, 2017): 1136–40. Accessed January 22, 2018. https://doi.org/10.1007/s11606-017-4082-2.
Chen, Edward T. “Considerations of Telemedicine in the Delivery of Modern Healthcare.” American Journal of Management; West Palm Beach 17, no. 3 (September 2017): 20–28. https://search-proquest-com.proxy.library.georgetown.edu/docview/1963800986/abstract/7D0C7AB7A584B14PQ/1.
Chung, Kevin K., Kurt W. Grathwohl, Ron K. Poropatich, Steven E. Wolf, and John B. Holcomb. “Robotic Telepresence: Past, Present, and Future.” Journal of Cardiothoracic and Vascular Anesthesia21, no. 4 (August 1, 2007): 593–96. https://doi.org/10.1053/j.jvca.2007.04.013.
Deli, Karen. “The Essential Elements of a Just In Time Virtual Organization: A Transformation in the Delivery of Healthcare Services – A Case Study: Specialists on Call.” Masters paper presented by Karen M. Deli. Executive Masters in Leadership Degree, McDonough School of Business, Georgetown University. (February 14, 2012). Accessed February 26, 2018.
“Connecting Devices to the Internet of Things with Wi-Fi.” Accessed February 12, 2018. http://www.embedded-computing.com/embedded-computing-design/connecting-devices-to-the-internet-of-things-with-wi-fi.
Herring, Susan C. “Telepresence Robots for Academics.” Proceedings of the American Society for Information Science and Technology50, no. 1 (January 1, 2013): 1–4. https://doi.org/10.1002/meet.14505001156.
Hills, J. W., and J. F. Jensen. “Telepresence Technology in Medicine: Principles and Applications.” Proceedings of the IEEE 86, no. 3 (March 1998): 569–80. https://doi.org/10.1109/5.662880.
“History | IRobot.” Accessed January 30, 2018. http://www.irobot.com/About-iRobot/Company-Information/History.aspx.
Hockstein, N. G., C. G. Gourin, R. A. Faust, and D. J. Terris. “A History of Robots: From Science Fiction to Surgical Robotics.” Journal of Robotic Surgery 1, no. 2 (2007): 113–18. https://doi.org/10.1007/s11701-007-0021-2.
“How 802.11 Wireless Works: Wireless.” Accessed February 13, 2018. https://technet.microsoft.com/en-us/library/cc757419(v=ws.10).aspx.
“How Does RADIUS Work?” Cisco. Accessed February 13, 2018. https://www.cisco.com/c/en/us/support/docs/security-vpn/remote-authentication-dial-user-service-radius/12433-32.html.
“IRobot-Ava-500-Data-Sheet.Pdf.” Accessed January 29, 2018. https://www.irobot.com/~/media/Files/Robots/Commercial%20Applications/Ava%20500/iRobot-Ava-500-Data-Sheet.pdf.
“K123229.Pdf.” Accessed January 28, 2018. https://www.accessdata.fda.gov/cdrh_docs/pdf12/K123229.pdf.
Kristoffersson, Annica, Silvia Coradeschi, and Amy Loutfi. “A Review of Mobile Robotic Telepresence.” Research article. Advances in Human-Computer Interaction, 2013. https://doi.org/10.1155/2013/902316.
Li, Jamy. “The Benefit of Being Physically Present: A Survey of Experimental Works Comparing Copresent Robots, Telepresent Robots and Virtual Agents.” International Journal of Human-Computer Studies 77 (May 1, 2015): 23–37. https://doi.org/10.1016/j.ijhcs.2015.01.001.
“Nursing Grandma with a Robot | Robohub.” Accessed January 28, 2018. http://robohub.org/nursing-grandma-with-a-robot/.
“Robot Platform | Knowledge | Holonomic vs. Non-Holonomic.” Accessed January 29, 2018. http://www.robotplatform.com/knowledge/Classification_of_Robots/Holonomic_and_Non-Holonomic_drive.html.
Rudolph, Alexandra, Jacqueline Vaughn, Nancy Crego, Remi Hueckel, Michele Kuszajewski, Margory Molloy, Raymond Brisson, and Ryan J. Shaw. “Integrating Telepresence Robots Into Nursing Simulation.” Nurse Educator 42, no. 2 (March 1, 2017). https://doi.org/10.1097/NNE.0000000000000329.
Sabin, James E., and Kathryn Skimming. “A Framework of Ethics for Telepsychiatry Practice.” International Review of Psychiatry 27, no. 6 (December 2015): 490–95. Accessed April 16th, 2018. https://doi.org/10.3109/09540261.2015.1094034.
“School of Nursing Pilots New Interactive Telepresence Robot | School of Nursing | University of California, Irvine.” Accessed January 28, 2018. http://www.nursing.uci.edu/news-son-pilots-new-interactive-telepresence-robot-technology.asp.
“Telepresence and Trust: A Speech-Act Theory of Mediated Communication | SpringerLink.” Accessed January 28, 2018. https://link-springer-com.proxy.library.georgetown.edu/article/10.1007%2Fs13347-016-0233-3.
“Telepresence and Trust: A Speech-Act Theory of Mediated Communication | SpringerLink.” Accessed January 28, 2018. https://link-springer-com.proxy.library.georgetown.edu/article/10.1007%2Fs13347-016-0233-3.
Tipton, Stephen J., Sara Forkey, and Young B. Choi. “Toward Proper Authentication Methods in Electronic Medical Record Access Compliant to HIPAA and C.I.A. Triangle.” Journal of Medical Systems 40, no. 4 (April 2016): 1–8. Accessed April 16, 2018. https://doi.org/http://dx.doi.org/10.1007/s10916-016-0465-x.
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