Drone use for commercial purposes has gotten much press of late due to Amazon announcing it intends to use drones to deliver packages to customers. This is a very intriguing and transformational idea with many intended and unintended consequences.
The future use of drones in healthcare also is very thought provoking. How can the industry best use this technology to improve safety and care delivery? Well for starters, drones already have been trialed to deliver food aid and medical supplies to areas hit by disaster, such as Haiti, by a startup called Matternet.
The rapid delivery of vaccines, medications and supplies right to the source could quash outbreaks of life-threatening communicable diseases. Communication equipment, mobile technology, portable shelter comprise the vast list of what could be delivered in a rapid fashion to areas where critical infrastructure damage would prevent ground or typical air transport.
Drones help provide more efficient healthcare to patients from a distance or while mobile
In the future, small indoor drones could deliver medicine to the bedside of a patient from the pharmacy, thus eliminating some human steps. This would lead to more rapid and less error prone administration of medications. Nurses and pharmacists can work more efficiently as supplies can be summoned to the bedside instead of the time consuming task of gathering necessary items.
Drones could deliver medications and supplies to patients being cared for in the home instead of a hospital-based setting. The future will see more outpatient care and even home-based care that used to be delivered in the hospital. For many conditions, drone technology may make it easier and safer to provide this home-based care. When a provider rounds on a home patient, blood can be drawn and immediately sent by drone to the lab to be tested. Medications, antibiotics and treatments ordered by the provider may be delivered to the home by drone.
This technology may allow more people in nursing homes to receive care at home for a longer period of time, which would increase the independence of the growing boomer population as they age. A drone could keep tabs on a patient living at home with dementia or deliver a meal to someone who cannot prepare his or her own meals. I can envision drone automated external defibrillators (AED) that would fly to the patient in a public space to provide rapid defibrillation for ventricular fibrillation. No longer would a person have obtain AEDs from a specific location that may be challenging to find in a rapid fashion. Simply summon the AED with the push of a button or smart phone app.
Healthcare organizations already are deploying mobile technology to solve some of the problems in the industry today. Mobile devices, wearable tech, remote monitoring, telemedicine and information sharing platforms all are transforming healthcare. Likely in the foreseeable future, drones, robots and artificial intelligence will assume many tasks in healthcare that are performed by humans, to reduce variability, cost and error.
Jeremy D. Tucker is chair of the emergency department and Physician Champion Patient Safety at MedStar St. Mary's Hospital in Leonardtown, Md. He also serves as regional medical director for Medical Emergency Professionals.
Providing communities with essential health care is no easy task. Medical professionals from emergency responders and third world aid workers to time-stressed staffers in large hospitals face a host of challenges every day—challenges unmanned aircraft systems, or UAS, can help overcome.
Drones make it possible to deliver blood, vaccines, birth control, snake bite serum and other medical supplies to rural areas and have the ability to reach victims who require immediate medical attention within minutes, which in some cases could mean the difference between life and death. They can transport medicine within hospital walls and courier blood between hospital buildings, as well as give elderly patients tools to support them as they age in place. UAS offer a variety of exciting possibilities to the health care industry, possibilities that help save money as well as lives.
“Drones are going to decrease the reliance on human beings that provide care and decrease the cost of assisting people,” said Dr. Jeremy Tucker, vice president patient safety and regional medical director at MEP Health. “Being able to cross long distances at faster speeds to deliver blood products and lab samples also is a huge benefit. Now transporting blood products between hospitals, for example, involves vehicles on the ground that are prone to accidents and delays. Drones can help decrease those incidents.”
The opportunities are there, which is why researchers, manufacturers and nonprofit organizations are starting to look to UAS to provide applications that boost efficiencies and improve medical outcomes.
Transporting Blood and Other Supplies
As drones are incorporated more into the health care industry, Tucker said the first area that will see the most benefit is delivery. Extensive research is already being done in this area with some countries beginning to benefit from this type of UAS application.
Drone manufacturer Flirtey recently completed the first ship-to-shore drone delivery in the U.S. The mission, held in conjunction with the John Hopkins University School of Medicine and the nonprofit Field Innovation Team (FIT), demonstrated how UAS can ferry aid such as medical supplies and water during a disaster situation, according to a press release. During the demo the drones carried medical samples for emergency testing, flying them between an onshore medical relief camp at Cape May, N.J., and a test facility on a vessel off the New Jersey coast. The drones also transported medical supplies from the vessel to the onshore medical camp.
This isn’t the first time Flirtey has completed successful missions for the health care field. Last summer, the company was part of the Let’s Fly Wisely event in Wise, Va., where they worked with the Remote Area Medical clinic (RAM), the Mid-Atlantic Aviation Partnership at Virginia Tech (MAAP) and NASA to deliver medical packages to volunteers on the ground, who in turn made sure underserved attendees received the packages—marking the first time a UAS delivered medical supplies and pharmaceuticals in the US.
Stan Brock, founder and president of RAM, a nonprofit organization that provides medical care to remote areas, first became interested in deploying delivery drones a few years ago. At the time, the group had just begun air ambulance operations to bring medicine and vaccines to parts of the upper Amazon rain forest. Manned fixed-wing helicopters fly about every two days to take vaccines, snakebite serum and other medical supplies to remote villages, a more costly and complex operation as compared to using UAS.
“It would be extremely helpful if we were able to send packages of medicine and vaccines over great distances by drone,” Brock said. “In that part of Virginia (where Let’s Fly Wisely took place), a large number of underserviced people can’t get out of the house during the winter, particularly during inclement weather, but are in desperate need of blood pressure medicine or whatever medicine it is. A drone could take that medicine to them where a vehicle wouldn’t be able to do so.”
Beyond last year’s demonstration, the team at RAM also has been working with Dennis Strege, owner of MasterFlight Inc., to build a drone prototype specific for this application. The aircraft he’s modifying, which was originally developed for power line inspections, will be able to fly 150 nautical miles with a 55 pound payload. The UAS will be able to withstand harsh weather conditions that would keep manned aircraft grounded and make multiple deliveries throughout the day. Strege described the vehicle as ideal for a program RAM recently started in the Philippines, where they need to deliver medication across long stretches of water.
The UAS also will be equipped with a defibrillator—something Dr. Mark Head, RAM foreign crisis coordinator, Greece, said is a huge step forward in saving time and lives. Alec Mormot began work on developing the first UAS prototype with a defibrillator as a graduate industrial design student at TU Delft University in Holland. In his version, a smart phone app is used to call the drone during an emergency. Once the drone arrives, a medical professional can walk a friend or bystander through how to use the defibrillator over the phone.
“If you can get a drone to a downed person having a heart attack quicker than an ambulance, you can save lives,” Head said. “The thing about a defibrillator is it doesn’t matter how you use it as long as you can get to the patient quickly. It’s the time after the event that’s critical.”
Delivering Care in Rwanda
The UPS Foundation, Zipline and Gavi, the Vaccine Alliance recently formed a partnership to begin transporting blood and vaccines to rural areas in Rwanda. They’re also working closely with the Rwandan government, whose leadership is actively looking for ways to dispatch vaccines and medicine to its citizens, Gavi spokesperson Frédérique Tissandier said.
During the first phase of the 18-month project, which is expected to begin in mid-August, the UAS will deliver blood to transfusion facilities. The blood will primarily be used to save women experiencing postpartum hemorrhaging, which is a common problem in the country, Gavi Manager of Global Operational Partnerships Mozammil Siddiqui said. After evaluating and determining how well the UAS were operated, how many deliveries were made and how the UAS were perceived, the second phase, which involves delivering rabies vaccine, will begin.
“The global health community is looking for new ways to deliver vaccines, increase coverage and protect children against various diseases,” Tissandier said. “With all the mountains in Rwanda it’s hard to get to remote villages. Some places can only be reached by boat. We’re using this partnership to save kids’ lives and protect them from vaccine-preventable disease.”
Time is critical in emergency situations, especially when victims need blood or a rabies vaccine, Siddiqui said. If a child in Rwanda is bitten by a rabid animal, for example, instead of waiting hours to get the necessary vaccine, a UAS can deliver it in about 15 minutes. This type of use is why Gavi has been looking into using drones for vaccine delivery for a few years now. They just needed the right partners to help them move forward, which they found through Zipline and its drone’s capabilities and the UPS Foundation’s logistic expertise.
While drone delivery makes it possible to courier needed vaccines to remote areas in harsh weather, it isn’t without its challenges. Both blood and the vaccines must be kept at a certain temperature during transport, Siddiqui said, or they will be unusable when they arrive. Anyone working with the payloads must be properly trained to ensure the products arrive at the right temperature and that deliveries go smoothly.
Zipline has been developing the UAS, known as Zips, for the last two years, software team lead Ryan Oksenhorn said. The drones have the ability to complete about 150 blood deliveries a day to transfusing facilities in the western half of the country. The development team had to overcome a variety of challenges, such as finding a way to make deliveries without actually landing at the site and creating a UAS designed for this type of long-distance delivery.
“Virtually all emergency medical products are small and lightweight but also high value,” Oksenhorn said, noting clinics that once only received deliveries a few times a year will now receive deliveries a few times a day. “It makes perfect sense to use this technology very cheaply and very quickly to travel long distances. Right now it costs $10,000 to emergency lift someone in a helicopter to go to the hospital if they need blood. For orders of magnitude less money and less time you can deliver the blood with a drone. There’s no need to send several humans in a helicopter. You can send the blood directly to the person who needs it.”
Oksenhorn said the work in Rwanda is just a start and he hopes to see Zips used to deliver blood, vaccines and medication in remote locations all over the world.
In fact, Zipline recently announced it will soon begin flying missions in the U.S., according to the company. Zipline is partnering with Ellumen, ASD Healthcare and Bloodworks Northwest to deliver blood, medicine and medical products to rural/remote communities in Maryland, Nevada and Washington State, including Indian reservations and their surrounding communities. Flights are expected to begin six months after regulatory approval.
Today, much of the research involving health care-related drones centers around delivery to remote areas, but that’s not the only way UAS can benefit this industry. Will Stavanja, founder of consulting company Wilstair, is among those looking into how UAS can be used inside hospitals.
One way is by transporting blood samples and medications from floor to floor or building to building, rather than making such deliveries by foot or through the pneumatic tube systems hospitals typically use, Stavanja said. This can be particularly helpful for growing hospitals making additions. Expanding a pneumatic tube system is a costly endeavor, but using a drone instead gives hospitals the ability to transport specimens and medications from floor to floor at a low cost.
“As the technology continues to advance, a small drone can be scheduled to deliver medicine at 3 in the afternoon to room X,” he said. “As long as each of the waypoints are programmed for the drone’s trajectory, the drone can complete operations a pneumatic tube can’t.”
While Stavanja is excited about the potential uses for drones inside hospitals, like most UAS applications, there are several challenges to making it a reality. The first is communication. Outdoor drones rely on GPS signals and radio frequencies to complete their missions, both of which are limited indoors. Blue tooth technology might offer a solution to that challenge, but researchers also need to figure out a way to fully automate drones so they understand their environment and remember where they are. Then there’s the weight. Typically the smarter the UAS, the larger it is—and the more expensive. To keep costs down, these drones will need to be small. And of course, safety is always a concern, as well as the battery life needed to get from point A to point B.
Many of the people reluctant to use drones inside hospitals are worried it could cost people their jobs, Stavanja said. But he argues it will free them up to spend more time with patients and focus on other tasks. There will also be a need for people to provide flight paths and manage the drones to ensure they’re transporting the right package at the right temperature to the right location.
“With a smart phone app nurses can indicate they need such and such delivered to room X and the drone can be immediately programed to do so,” Stavanja said. “This also gives hospitals the opportunity to use existing staff to do other jobs and support other demands of the hospital. Drones can take on some of the smaller roles such as moving meds from floor to floor. This means patients receive better care.”
Helping the Elderly
Research is also being done to find ways to use drones to benefit the growing senior population. For the last year Naira Hovakimyan, W. Grafton and Lillian B. Wilkins professor of mechanical science and engineering at the University of Illinois at Urbana-Champaign, has been working on a project designed to help the elderly age in place rather than spend their final years in a nursing home. Small drones with manipulator arms can be used to bring them medication, grab a glass of water, clean a chandelier, pick something up from under the table or even sort laundry.
Not only is robotics important to this type of research, so is the psychology, Hovakimyan said. The team must develop flight paths that humans find both safe and acceptable. To that end, the team is working closely with psychology experts.
“We’re immersing people in virtual reality where these drones are flying around them,” Hovakimyan said. “Depending on people’s reaction, including heart rate and head tilt, we can revise the drone design to make sure it’s safe for people.”
The main challenge is developing a robot that is as reliable as your refrigerator or washer, Hovakimyan said. But unlike your refrigerator or washer, these drones must be able to move around all over the home and reliably deliver every time, whether they’re fetching medicine or cleaning. Researchers must also create a drone that elderly from all different backgrounds will consider safe. For it to work, they must feel comfortable interacting with it.
As with every industry interested in implementing UAS, there are challenges to overcome ranging from payload capacity to battery life and, of course, regulations, Tucker said. A lot of the research being done for health-related delivery services is happening in other countries because the restrictions make it too difficult to complete testing in the U.S. And while the new Part 107 regulations the Federal Aviation Administration released earlier this summer remove some of the limitations, some uncertainty remains. But as the barriers start to come down, Tucker sees more people in the industry becoming interested in UAS and reaping the many benefits the technology can provide, starting with delivery services and then moving on to more complicated applications in the next five to 10 years.
“The early adopters are there. I know colleagues who are testing these solutions on their own,” Tucker said. “Early adopters are out there trying to work with these solutions but there are barriers. Some people are just reluctant. They’re reluctant to spend money on new technology because they’re wondering what the cost is going to be and they’re worried about making a business case for it because of the regulations. The FAA has been the biggest barrier, but that is starting to change.
The wait is finally over. After years of wondering exactly what rules commercial drone operators will have to abide by, the industry finally got its answer. Released in June, the Part 107 rule applying to for-profit flights with drones weighing 55 pounds or less, including payload, takes effect in late August.
The rules provide operators of unmanned aircraft systems (UAS) with specific mandates while easing many of the restrictions that have made it difficult to operate UAS businesses in the U.S. Drone pilots won’t need a pilot’s license, they will be able to take a test for the necessary certification. The rules also make it easier to fly. Not only will most operators not need to obtain a Section 333 exemption, there’ll be no need to go through the delay-prone and widely despised process to get a Certificate of Waiver or Authorization (COA) to fly some specific missions.
“We’ve been in limbo for a long time waiting for the rule,” said Rose Mooney, executive director of the Mid-Atlantic Aviation Partnership at Virginia Tech, or MAAP. “The rule gives manufacturers and operators a path toward more extensive use, albeit limited to daylight operations and within visual line of sight. The new rule will open up opportunities in areas such as roof inspections, infrastructure inspections and real estate, allowing for business growth.”
Overall, manufacturers, users and other industry players see the rules, collectively called Part 107, as significant progress.
“With part 107 we’re able to take the infrastructure that we’ve been building of the flight service providers and data providers ad connect those into a network that easily enables data on demand on a much larger scale across the United States,” said John Perry, the founder and CEO of Altavian.
But there are many who would like to see more, especially when it comes to flying beyond the visual line of sight of the pilot. Under Part 107 operators still need to apply for a Section 333 and prove the safety case for permission to perform such flights. Limitations remain as well on night flights and operations over populated areas.
Even with the restraints, there are still opportunities to fly at night or beyond visual line of sight through the waiver process, though it’s unclear exactly how the process will work and how many of these waivers will be granted, said David Proulx, vice president of product and marketing for Aeryon Labs. Regardless, the waivers represent the opportunity for more potential applications and even more growth.
“My biggest excitement is that all of the limitations, except for the weight, are waiverable,” said Matt Scassero, director of the University of Maryland Unmanned Aircraft Systems Test Site and Associate Director for the Maryland Mid-Atlantic Aviation Partnership. “This allows us to push the limits on these rules so we can learn more to create the next set of rules. We can go faster and higher with the right safety case data and analysis. It allows us to do more.”
Good for Business
With the new rule comes a changed mentality, said Mesa County Sheriff’s Office Quartermaster and unmanned aircraft program manager Ben Miller, who often talks with folks already in the UAS industry and those who want to be. Many people were waiting for the rules to come out before investing in this industry, which until now was rife with uncertainty. Because Part 107 takes some of the risk out of moving forward, Miller expects to see even more UAS businesses to start popping up.
“From my perspective what (107) does, at a high level, is it ensures that there’s a commercial UAS industry in the United States,” said Robert Blair, vice president of agriculture at Measure. Among the benefits, he said, is that it is no longer necessary to have a visual observer along during flights. “That reduces costs—that’s huge.”
Existing UAS manufacturers and service providers are expected to see demand climb, with microdrones sales director Chuck Dorgan already hearing from once hesitant customers who are ready to incorporate UAS into their businesses. They’re interested in learning exactly what the new rules mean for them and how they can start using the technology. Dorgan’s firm anticipated and acted on the potential opportunity; the German company merged with Avyon in May, expanding its North American operations in anticipation of the new rules and the potential to fly more in the U.S.
“The entire UAS industry benefits from this rule,” Miller said. “The bottom line is, instead of having to go through a process to get permission to fly, I can look up the rule and I’m good to go. That’s very different. It (the new rule) is disruptive and I don’t think people realize that yet. The psychology of that is huge.”
Industries the Rules Could Benefit Most
Industries that want to deploy small UAS for data collection will benefit most from the Part 107 regulations, said William Janicki, a partner with the law firm Schnader Harrison Segal & Lewis. That includes mining, real estate, some agriculture applications and industries interested in infrastructure inspection such as utilities, wind farms and oil and gas.
Steve Eisenrauch, manager for Transmission Forestry & Line Services for Dominion Virginia Power, said that while most of the larger utility companies already fly UAS for inspection purposes, he sees the rules opening up new possibilities for smaller companies. The biggest reason? They won’t have to find and hire a licensed pilot to fly the drone—a requirement that had proven to be challenging and costly.
Another benefit he sees, in this case for the utilities industry and others that deploy UAS for vertical infrastructure inspection, is the ability to fly around an existing structure above 400 feet if it stays within a 400-foot bubble around the structure. This enables them to fly around structures they wouldn’t have been able to inspect in the past without a special permit, Eisenrauch said.
“One of the surprising provisions the FAA put in the rule was actually targeted at people doing vertical infrastructure inspections, so cell towers and other tall buildings,” said Ian Smith, an account executive for DroneDeploy and an FAA commercial helicopter pilot. “If you have a structure that’s 700 feet tall, you can operate up to 400 feet above the top of it, so 1,100 feet total above ground, as long as you stay within 400 feet of the building.”
The new regulations also allow operations from a moving vehicle as long as the same person isn’t in control of both the drone and the moving vehicle—which is huge for the agriculture industry, Smith said. This enables farmers to fly hundreds of acres without the UAS going beyond visual line of sight.
The Case for Beyond Visual Line of Sight
Because Dominion Virginia Power already has a section 333 exemption, Eisenrauch said Part 107 doesn’t really open up new applications for the company. The rule does get them one step closer to flying beyond visual line of sight, however, which would be a game changer for utilities and a variety of other industries.
Power lines can be located in swamps, mountains or other areas that are difficult to reach, and the ability to fly UAS over extended distances would eliminate the need for crews to travel from structure to structure during inspection—saving time and money while also enhancing safety. Today, there are only two ways to fly between structures, Eisenrauch said. One is to use a daisy chain with an observer on the ground to keep the UAS in sight and the second is to fly a manned aircraft that can see the UAS and report back to the operator if it deviates from its path. Both are fairly expensive and time consuming.
Trying to fly beyond visual line of sight with these restrictions is cumbersome and not very practical, said Grant Leaverton, vice president and general manager for AAIR, a company that provides inspection services for a variety of industries using the Falcon 8 and the SteadiDrone Mavrik drones. But the regulations the FAA put in place are a start, he said. He would like to see the FAA continue to evaluate the regulations and learn more about how operators can safely fly beyond visual line of sight to effectively assess transmission lines, gas pipelines and other similar assets.
The beyond visual line of sight limitation also could hold the health care industry back, said Dr. Jeremy Tucker, Vice President Patient Safety and Regional Medical Director at MEP Health. Many health-related applications involve delivering blood, medication or other specimens, which typically happens beyond visual line of sight. So while there’s plenty of opportunity in the health care industry, the current regulations still leave some uncertainty when it comes to flying these mission in the U.S. And while operators can apply for waivers to ask for permission to fly beyond visual line of sight, many in the industry are interested to see just what that process will look like and how many waivers will be granted.
“I think that’s one of the most intriguing parts of the rule,” Proulx said. “It remains to be seen how the process will be carried out in practice and what level of risk mitigation operators will be required to present to satisfy the FAA. It’s a really interesting concept and certainly opens the door to a lot of interesting things, but how operators take advantage of it and how the FAA responds will determine how impactful it really is.”
Pilot License Requirement
Dropping the pilot license requirement is huge, Mooney said, and will open the door for wider adoption of UAS in a variety of industries, creating business opportunities for service providers and manufacturers.
Dorgan said the pilot license requirement has been holding up the entire industry and is the biggest, most positive impact the rules provide. Pretty much anybody can take the certification test now, and once they pass they can legally fly a UAS for commercial purposes, as long as they follow the rules.
Leaverton agrees, and said it’s going to make it easier for companies like his to find and train qualified team members without having to search for licensed pilots.
“We can find talented people who have experience flying these types of aircraft. We can incorporate these folks into the team without worrying if they have a pilot’s license or spending $10,000 to get one. They can get the certification and then we can train them up on our platforms,” Leaverton said. “It opens up labor markets and gives flexibility to a larger pool of talent, leading to lower costs. Industrial and infrastructure inspection operations will see a benefit from both cost and safety aspects, which are huge drivers on the OEM side.”
While Part 107 represents an important step in the UAS industry, there’s still challenges to overcome and a long way yet to go before drones truly reach their full potential.
One challenge Eisenrauch sees is the increased demand the new regulations will bring. As more companies want to use drones, the already established manufacturers and service providers might struggle to maintain the same level of service and quality they’re able to offer today. New companies will enter the market, but while they get up to speed current businesses will need to meet the demand—which could become overwhelming.
Thomas Bartlett, who owns Image in Flight, a company that primarily flies UAS for the construction industry, sees safety as another challenge. While most are excited about the FAA dropping the pilot license requirement, he’s concerned if everyone with a drone can get a certificate to fly, it could lead to safety issues.
“It’s so easy to fly now there’s going to be a flood of people,” Bartlett said. “Someone else’s accident could put us all out of business. With this new freedom comes responsibility for every one of these operators.”
Andy Von Stauffenberg, founder of VStar Systems, a company focused on developing UAS for military applications which also has interest in the commercial market, said it won’t be long before insurance companies become more involved, adding another layer of complexity. Insurance companies will likely develop their own requirements, even stricter than the FAA’s, that could hold some operators back. This might include requiring a specific amount of flight hours to perform certain tasks. “Once we see more and more UAS come out and operate, the insurance companies are going to take a critical look and that will drive a lot more of the requirements,” he said. “The insurance companies will have a big say on the minimums they want to see before they’ll insure someone for a UAS. There’s no way around it.”
The new rules for flying UAS commercially help UAS manufacturers as well as drone-centric service firms like AAIR, Image in Flight and Altavian, which is building a data-on-demand network based, initially, on the drone operators using its hardware platform and its Fetch data software.
Many potential customers interested in UAS are no longer in wait-and-see mode, and those who are still hesitant aren’t being cautious because of restrictive regulations or a lack of clarity about what they can and cannot do. As more professionals see and understand the benefits UAS can provide, more of them will start looking to drones for safer, more cost effective operations, which will drive further innovation and help spur the industry forward.
As more innovations are made and users continue to become more proficient, a whole other world of opportunity and potential applications will open up. The industry is eager to fly beyond visual line of sight, and many hope that is addressed more specifically in the next set of rules. For now most seem happy with the guidance they finally have from the FAA and are looking forward to seeing this industry continue to grow.
“To make things a little broader and more robust we need to get to a point where we can fly heavier aircraft with bigger payloads. Imagination is the limit,” Janicki said. “We’re all expecting a round with more robust rules for heavier aircraft and different types of applications. The first round is a nice step but we still need further rulemaking to expand this industry.”
They exist, if you know where to look
FAA approved drone fields are dotted around the United States -- open fields where you can legally indulge your drone hobby.
Drive north of Baltimore, on the East Coast of the United States, for an hour or so and you'll find one. Every now and then, you'll see a team there, wearing gloves and lab coats, flying a small white drone.
This special white drone is made of Styrofoam, weighs just four pounds, and costs less than $100. This hobby-grade drone could represent the future of medical delivery.
The diseases killing 38 million people a year
Back down in Baltimore, the Core Laboratory at Johns Hopkins Hospital is busy.
Medical samples are tested here -- everything from hair to urine to blood. Some 10,000 samples come through here every day and the need for testing is on the rise.
Non-communicable diseases, such as heart disease or diabetes, are now responsible for more deaths than infectious diseases. According to the World Health Organization (WHO), non-communicable diseases kill 38 million people worldwide each year.
These diseases are not passed from person to person, but develop over time and require continued testing, often over the lifetime of a patient. This needs access to labs for biological samples and tests.
Going off road
Dr. Timothy Amukele is a pathologist at Johns Hopkins. After visiting labs around the world, particularly in sub-Saharan Africa, Amukele had an idea.
If access to labs and transporting samples for medical testing were some of the biggest hurdles -- because of traffic, poor roads and lack of accessibility -- why not remove those factors altogether?
Why not fly the samples in a drone?
"The idea for using drones first came from the problems of moving samples internationally," Amukele said.
"There's a need in places that are really poor that don't have roads. And then in places like here in the United States, we have issues with traffic."
The need for speed
When you get your blood drawn, or give a urine sample at the doctor's office, testing is rarely done at the same location. According to Amukele, most clinics are primarily collection sites that can perform a few key tests, but not the full range. The latter requires samples to be moved.
"Speed is everything," Amukele said. "If it sits there for a long time, at some point the specimen starts deteriorating. It's not so useful anymore."
A lack of obstructions would speed up the process -- that's where the drones come in.
"A drone is a transport mechanism," Amukele said. "I think in 5-10 years it will be just like having a motorcycle, where it doesn't matter what you put on it, as long as you package it safely."
The first of its kind, Amukele ran a proof-of-concept study to see if blood samples could be successfully transported via drone. Six blood samples were taken from 56 volunteers. Half of the samples were taken to the Hopkins lab and the other half were loaded on a drone and flown around for varying time periods between six to 38 minutes.
Initial questions focused on the samples themselves, and if the drone flight would deteriorate them. Changes in air pressure and the shaking of the drone in the wind and during the take-off and landing were all concerns.
But the drone test worked -- and Amukele was on to something.
Using drones to save lives
Amukele acknowledged this success is the first in a long line of steps. The regulations for drones differ in every country, and in many cases, are still being worked out. There are other questions too, like who would fly it? And how do they make it secure?
The samples are packed in a special foam with a sponge that would fully absorb the specimens in case the drone were to crash.
"It doesn't answer all the other questions," Amukele said. "But the key question was does the blood arrive ok, because if it doesn't arrive ok, then none of it matters."
Perhaps the biggest hurdle now might be the word 'drone' itself.
"When we say the word 'drones, people think of things that fly over their heads and kill their children," Amukele said.
That's not what we're talking about here. We're talking about small, unmanned flying systems. We're talking about a different way to transport goods."
The use of drones for healthcare delivery is also being trialed elsewhere. Teams at Delft Technical University are testing them to deliver emergency equipment, such a defibrillators, to quickly care for patients after a heart attack. If successful, they could be used by ambulance services.
Reports have also been made of "drone-ports" being piloted in Rwanda later this year where drones will be trialed to deliver blood and other emergency supplies.
The next step for Amukele's team, however, is more testing. Further trials are estimated to be up and running in the United States, and abroad, within the next six months.
"People are starting to realize that drones can be used for good," Amukele said. "Already, in the United States, they are being used for agriculture and film making, but what they haven't been used for is healthcare. Healthcare is the industry where we need this capacity."
San Francisco-based Zipline, which launched its autonomous drone medical supply delivery program in Rwanda, is bringing its live-saving robots to the U.S. as regulations ease.
Zipline, a San Francisco-based robotics company, is expanding its medical supply and blood delivery drone program it started last month in Rwanda to rural, hard-to-reach communities in Maryland, Nevada and Washington state, the company announced this week.
Zipline, which was founded in 2011 by Keller Rinaudo, Will Hetzler and Keenan Wyrobek, is currently delivering life-saving supplies via its 25-pound drone all over Rwanda. The electric drones can carry 3 pounds of blood or medicine and can fly 75 miles before recharging. The company's U.S.-based program should be in the air in a year.
"When you look at rural or isolated communities, particularly Native American populations, populations that live on islands, you have serious health outcome inequalities," Rinaudo, Zipline's founder and CEO, tells The Verge. "There's a linear relationship between how far away you live from a city and your expected lifespan. So our hope is that this type of technology can solve those kinds of inequalities."
To launch the U.S. program, Zipline partnered with health care companies Ellumen, Bloodworks Northwest, and ASD Healthcare. As of right now, the areas it plans to serve include Smith Island in Maryland and San Juan Islands of Washington.
Ordering Zipline's service is almost as easy as hailing an Uber. When a patient needs a blood transfusion, antibiotics, vaccines, or antivenom, a doctor, nurse, or health center technician sends Zipline a text message and a drone airdrops the needed supplies within 30 minutes. The drone will send a message to the health center when it is two minutes away and the package, equipped with a parachute, will fall to the ground. The craft will then return to the launch site on its own.
Zipline, which has raised $18 million in funding from investors including Sequoia Capital, Google Ventures, and Microsoft co-founder Paul Allen, is staffed by former aerospace employees from NASA, SpaceX, and Boeing. The company partnered with the National Center of Blood Transfusion and signed a deal with Rwanda's ministry of health to provide medical delivery services. After launching in Africa, the White House asked Rinaudo about starting the same program in the U.S. to serve remote communities, including those in Native American reservations.
If you follow drone regulations, you know exactly why Zipline launched abroad. Commercial drone use in the U.S. has been held back by regulations. Drones are considered aircraft and pilots must adhere to strict line-of-sight rules, caps on altitude, and other restrictions. But in June, the Federal Aviation Administration (FAA) released new rules that will hopefully help commercial drone pilots be authorized to take to the skies for commercial purposes. Strict rules will still remain: pilots must be able to see the drone at all times and drones can only undertake one mission at a time. Rinaudo says Zipline is applying for an FAA waiver so it can start operating and let its autonomous drones fly without a pilot following beneath the aircraft in the air.
Back in April, Rinaudo said he believes Zipline's drones, which are called "Zips," will be able to help revolutionize the way emergency medicine is delivered to people in remote locations.
"Patients frequently die because of lack of access to a basic medical product that exists in a central warehouse 75 kilometers away but can't make it out that final mile to the person who needs it," said Rinaudo.