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Drones Show Potential for Delivering Telemedicine, mHealth Services

Drones are being used to ferry mHealth supplies and telemedicine services (as well as beer and pizza) in other parts of the globe. Now federal officials are taking notice of their mobile health value.

Drones – those tiny, unmanned planes that have been buzzing over beaches and playgrounds across the US – are beginning to show up on the radar in healthcare circles, thanks to a handful of successful programs in other parts of the globe. Some see them as the ideal means of transport for emergency telemedicine services, able to drop in on an accident, disaster site or remote location with supplies, digital health tools and a telehealth link to the outside world.

“Drones are going to decrease the reliance on human beings that provide care and decrease the cost of assisting people,” Dr. Jeremy Tucker, vice president of patient safety and regional medical director at MEP Health, told Inside Unmanned Systems in a 2016 interview. “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.”

Because Federal Aviation Authority regulations prohibit GPS-enabled drones from flying out of sight of the operator, their use in the US is limited. But experts say the FAA has made exceptions for healthcare uses and could develop a new policy for medical drones as early as next year.

Among their supporters in President Trump, who launched a program in October to create at least five new drone-based programs.

READ MORE: Red Cross Turns to Telehealth for Emergency Care

Close to a dozen medical drones have been created and tested in the US with the goal of going airborne once the rules are changed. They include the HiRO (Health Integrated Rescue Operations), developed by students at Hinds Community College and the William Carey University College of Osteopathic Medicine, both in Mississippi. Dr. Italo Subbarao, a senior associate dean at the college, came up with the idea after witnessing the devastation caused by a 2013 tornado in Hattiesburg, Miss.

“I remember thinking, 'I can see my grandma’s house,'” he told The Daily Beast. “'But an ambulance can’t get out there.’”

This past October, HiRO was unveiled. Equipped with medical kit capable of treating as many as 100 patients, an audio-visual connection and a pair of smartglasses, it’s designed to connect bystanders and first responders with a remote doctor – wearing a Microsoft HoloLens headset and holographic health record display – who can provide remote care until rescue teams arrive.

The drone is scheduled to participate in disaster training next February with Mississippi’s Emergency Management Agency.

Drones demonstrated their capabilities in healthcare in two separate events in 2015. That summer, the Health Wagon, a mobile health program serving remote communities in southwest Virginia, partnered with the international non-profit Remote Area Medical, NASA and an Australian drone delivery service called Flirtey to use drones to ferry medications from an airport one mile away to the Wise County Fairgrounds, where the Health Wagon was holding its annual three-day RAM clinic for thousands of local residents.

READ MORE: mHealth Heads to the Top of the World

That drone now sits in the Smithsonian’s National Air and Space Museum. The Health Wagon’s executive director, Teresa Gardner Tyson, DNP, FNP-BC, FAANP, hopes to someday be able to use drones again.

“The use of drones for medication delivery provides a great opportunity to address the medical needs of underserved communities,” she wrote in a December 2016 blog. “Living in a rural, mountainous area with frequent heavy snowfalls in the winter presents certain hardships, and patients often run out of much-needed medications. Last winter, southwest Virginia had a record-breaking 42 inches of snow, and the National Guard had to travel into rural areas and deliver life-saving medications such as insulin. The use of a drone to deliver medications to patients in need or to take supplies from our stationary clinics out to our mobile unit would be highly beneficial and meet crucial needs. Embracing this technology would give rural communities such as ours distinct advantages in the delivery of health care.”

Also that year, the Johns Hopkins University School of Medicine and non-profit Field Innovation Team (FIT) teamed with Flirtey in a demonstration, flying drones with medical supplies from a ship off the New Jersey coast to a medical camp at Cape May and back again.

“It would be extremely helpful if we were able to send packages of medicine and vaccines over great distances by drone,” Stan Brock, founder and president of RAM, told Inside Unmanned Systems. “In that part of Virginia (where the Health Wagon event takes place), a large number of under-serviced 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.”

Across the globe, drones have been used for healthcare programs since at least 2012, when they were pressed into action ferrying medical supplies to earthquake-ravaged Haiti. Among their many uses:

  • In Sweden, they were used by the Swedish Transportation Agency to deliver automated external defibrillators (AEDs) to the location of a 911 caller reporting a suspected heart attack (as reported in the June 13, 2017 issue of JAMA). Researchers at the University of Toronto are also testing drones for this use after learning about an ambulance drone program in the Netherlands.

  • In rural Africa, they’re being used by the United Nations Population Fund to deliver contraceptives to women in the most hard-to-reach villages.

  • In Malawi, a California-based company called Matternet is using its drones in a partnership with UNICEF to improve HIV/AIDS testing and care.

  • In Madagascar, the US Agency for International Development (USAID) and Stony Brook’s Global Health Institute are partnering with that country’s government to ferry stool and blood samples from remote villages to Stony Brook University’s Centre ValBio research station for testing.

  • And in Rwanda, a California company called Zipline is using its drones in a partnership with that country’s government to supply 21 hospitals with blood products.

  • In other instances, drones have been used to ferry beer to ice fishermen in Minnesota and to deliver Domino’s pizza in New Zealand.

READ MORE: Telemedicine Robots: Out of Science Fiction and Into the Mainstream

Based on its success in Rwanda, Zipline is working with the FAA to launch a drone delivery service to ferry blood and medicine to remote communities in Maryland, Nevada and Washington, as well as some Native American reservations.

"When you look at rural or isolated communities, particularly Native American populations, populations that live on islands, you have serious health outcome inequalities," Keller Rinaudo, Zipline's founder and CEO, told 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."

The Medical Futurist writes that drones have great potential in healthcare, but they’ve been hazards in other situations, posing a danger to low-flying aircraft and fire and rescue services, skirting privacy rules and being used to smuggle weapons and drugs.

“It is obvious that law-makers have to craft appropriate, drone-related regulations as soon as possible, ideally before the wider spread of drones, especially those delivering lifesaving drugs or medical objects,” the healthcare blogger concludes.

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