Hospital robotics: When robots work together as a fleet

Robotics in hospitals is about more than mobility; it’s about intelligently connecting processes and significantly reducing the workload on teams. Marco Brizzolara (CEO) and Johannes Drexler (CTO) of Elvio Robotics explain how vendor-neutral orchestration transforms individual robots into integrated solutions for everyday hospital operations.

Marco Brizzolara: A vendor-neutral platform like Elvio OS serves as an additional system and orchestration layer between hardware, hospital infrastructure, and processes. We’ve spoken with many German hospitals, including those that are already testing or using their first robots. However, these are generally isolated solutions that are barely integrated with elevators, doors, or IT systems. When integrations do exist, they are usually complex custom developments that work only for a specific type of robot and are not scalable. Hospitals are often left to handle the integration on their own and can therefore only utilize the potential of robotics to a limited extent.

Robotics becomes particularly interesting from an operational and economic standpoint when larger fleets are deployed. This requires centralized control: operators gain a transparent overview of the systems in use and can manage tasks centrally, rather than switching between different user interfaces.

Another important factor is vendor independence. New hardware can be integrated via our platform without having to set up a new integration project each time. This allows hospitals to select the right robotic system for every task.

Johannes Drexler: Many healthcare experts see the biggest challenges as being technological. However, based on my experience, these challenges are often organizational in nature. The key to success lies in bringing all stakeholders to the table and developing pragmatic solutions for integrating the existing infrastructure.

A prime example is a current project in which we’re integrating a roughly 30-year-old elevator into our platform. To do this, we are working closely with the hospital’s facilities management team, the elevator manufacturer, and the manufacturer of the elevator control system. The situation is similar with hospital IT: The first step here is to build trust and create the conditions necessary for them to provide us with the required interfaces to their systems.

Technically, these integrations can usually be handled well.

Drexler: The key is our orchestration platform. You can think of it as a central control layer through which all relevant systems communicate with one another. Instead of connecting each system directly to every other system, the connections run in a star topology through our platform. This reduces complexity and creates a stable foundation for operations and future scaling.

The platform not only handles data exchange but also coordinates the various robot systems. For example, if two robots encounter each other in a narrow hallway, the platform decides which one should yield or wait. At the same time, it ensures that data is exchanged in a controlled and secure manner between the systems involved. We consistently align our development and security processes with established standards; we are aiming for DIN ISO/IEC 27001 certification in September.

For each robot manufacturer, we develop a connector that standardizes communication between the manufacturer-specific interface and the platform. This allows hospitals to replace individual devices or entire robot fleets without having to interfere with existing processes.

Brizzolara: Robotics is much more than a technical project: it transforms the way a hospital is organized. Interestingly, the use of autonomous robotics is currently most economically viable in the tertiary care sector, where digitization has often been less advanced to date.

Rising cost pressures and staff shortages are forcing facilities to rethink their approaches. Department heads in logistics and housekeeping must become open to digitalization and robotics and collaborate more closely with engineering, IT, and data protection teams. It is equally important to involve all employees early on. Only when change management and communication are successful will robotic solutions be accepted and able to fully realize their potential in everyday clinical practice.

Brizzolara: First, that it’s less about reducing staff and more about reliably maintaining processes despite positions that are difficult to fill. Second, robotics already has a solid business case today: In the jointly developed model for container transport, the break-even point was reached in all nine scenarios during the first year of operation. And third, that it’s not the individual robot that determines success, but rather the interplay of hardware, software, integrations, and organization. That's why we need scalable infrastructure instead of isolated pilot projects.

Drexler: Let’s take the transport of blood samples as an example. In many hospitals today, such ad hoc transports are still handled by staff, often under time pressure and alongside their regular duties. With autonomous small transport robots, these routine trips can be automated, significantly reducing the workload on staff. In the future, many hospitals will operate entire fleets of ten or more robots.

The key difference lies in centralized coordination. Our platform treats the entire robot fleet as a single system. For every new transport request, it calculates in real time which robot can handle the task the fastest, for example, because it is currently near the pickup location or is available. This shortens routes, reduces wait times, and makes more efficient use of available resources.

The intelligence lies not in the individual robot but in the platform. Ultimately, it’s not about deploying as many robots as possible, but about intelligently managing the processes behind the scenes and utilizing available resources as efficiently as possible.

Drexler: From a technical standpoint, hospitals don’t need to build a completely new infrastructure. However, a comprehensive and stable Wi-Fi network is an investment that pays off regardless of the specific robotics project.

The existing infrastructure is also not an obstacle. Elevators, doors, and other building components can be retrofitted with manageable effort and integrated into a central platform. In our experience, therefore, the limiting factor is not so much the existing technology as it is the willingness to connect systems across different manufacturers.

Brizzolara: We see the greatest potential primarily in cleaning and logistics. In floor cleaning, autonomous systems are already providing tangible added value: They take over physically demanding routine tasks and enable shorter cleaning intervals – an important factor for reliable operations, especially when staff resources are limited.

There are also compelling use cases in logistics, such as the transport of medications, samples, small deliveries, and, increasingly, containers. Together with leading manufacturers, we’re also exploring other areas of application, such as autonomous wheelchairs. This allows tasks to be automated, processes to be accelerated, and staff to be relieved of some of their workload.

However, the key lies in the integration of individual applications: When different robotic solutions are coordinated via a central platform and jointly access elevators, doors, and IT systems, hospitals can use resources more efficiently and make processes more resilient. The long-term value therefore lies in the interplay of robotics, infrastructure, and processes. This is precisely how the autonomous hospital is taking shape, step by step.