Telediagnostic solutions: expert exams with no physical contact

Applications of telemedicine surged in popularity in efforts to reduce the COVID-19 infection risk for both medical professionals and patients. Unfortunately, the services typically lack a proper diagnostic option.

To facilitate exams of potentially infected individuals, the interdisciplinary team of the federally funded ProteCT project came up with a solution. The result is a robot-supported telediagnostic system that is currently in practical application at the University Hospital Klinikum rechts der Isar of the Technical University of Munich. Dr. Maximilian Wolfgang Berlet, resident physician at the University Hospital, and MSc Jonas Fuchtmann are members of the research group and explain how the solution works.

Dr. Berlet, what makes the robotic-assisted ProteCT system so unique?

Dr. Maximilian Wolfgang Berlet: For the first time, the ProteCT system enables a complete robotic-assisted clinical examination of patients who might be at risk of spreading infection to others. It means the physician and the patient never have direct physical contact with each other, yet the heart, lungs, abdomen, and vital signs are monitored as if both parties were in the same room. The concept combines a high-quality exam with a maximum level of safety as it pertains to infection prevention. Thanks to modern video and audio technology, the patient feels as if the examining physician is physically present.

The system is already being assessed in the emergency department setting. How do staff and patients respond to it and what feedback are you getting - also as it relates to possible improvements?

Dr. Berlet: The patients responded very well to the system. The participants even pointed out that the ambience and the way information about their illness was communicated was much better in the cabin as the setting was quieter and calmer, allowing them to understand the physician more clearly. Since there was no need to wear masks inside the cabin, one deaf patient could also read the physician’s lips. All told, participants felt the robot-powered examination was just as pleasant as a traditional physical examination. We only had a few improvement suggestions pertaining to the look and design of the cabin, which some perceived as somewhat "bare and stark". The specialists were able to perform all intended examinations as scheduled and received excellent feedback.

Mr. Fuchtmann, we have not yet seen a widespread acceptance of telemedicine by the general public. Has the pandemic changed people’s mindsets? After all, ProteCT was initiated in response to the contagious virus.

Jonas Fuchtmann: There was a noticeable drop in office-based visits amid the pandemic. At the same time, we also saw a marked increase in demand for telehealth services. The assumption is that many will continue to utilize these technology options in the future. However, current services primarily emphasize teleconsultation, with only a few diagnostic options in the offing. It means telemedicine adoption strongly depends on the implementation. The ProteCT project bridges the existing technological gaps to facilitate telemedicine that is equivalent to an in-person examination.

According to the BMBF (Federal Ministry of Education and Research), the project has ended. What are the next steps for the system after the federal funding has expired?

Jonas Fuchtmann: We will continue our project research beyond the grant period. There are many ideas to expand the system. More specifically, we are part of the "6G-life" joint project, which is likewise funded by the BMBF. It means, we are working on integrating the system into a future 6G network infrastructure. As the successor to the 5G technology currently under development, 6G enables us to optimize the system as it pertains to data transfer, while considering factors such as latency and security. It’s an important step that will drastically improve robotic control. The positive feedback encourages us to pursue our long-term goal of transforming the concept into routine clinical practice.