Robotics and AI could solve provider shortages (RTS Newsletter #3)

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First, a laugh 🤣 

Community Spotlight: Christopher Gaskins, PhD, OTR/L 🚀

❋ Why are you excited about the Rehab Tech Stack newsletter and community?

Christopher: I am excited to learn about the intersection of rehabilitation and technology and what innovative technological solutions are out there to push the rehabilitation field forward. I also hope to learn more about the balance of technology and the human touch/input and how this coupled approach can enhance patient care.

❋ What innovative technology or approach have you implemented in your practice, and how has it improved patient outcomes or your clinical workflow?

Christopher: Automated home exercise programs with video feedback enhance patient compliance, accelerate functional recovery, and facilitate seamless communication between patients, caregivers, and therapists through real-time progress tracking and remote guidance. It’s been super helpful!

❋ Is there a particular area of rehab therapy where you think technology could make a big impact but hasn't yet?

Christopher: I believe there's enormous untapped potential in AI-supported clinical documentation, remote therapeutic monitoring using wearables, and virtual/augmented reality for community re-integration. AI could revolutionize our documentation process by intelligently analyzing therapy sessions, while wearables could provide data on patients' daily activities. VR and AR could create safe, immersive environments for patients to practice real-world skills, bridging the gap between clinic-based therapy and real-world application.

❋ What advice would you give to other therapists who want to integrate more technology into their practice?

Christopher: To enhance business workflow and the development of patient-facing materials, consider using AI products such as Chat-GPT or CoPilot and automation software such as Power Automate or Zapier. Ensure that the implementation of technology solves the targeted problem.

Consider a lean but practical implementation of technology that reduces your decision workload and automates repetitive tasks, thus allowing you to use more creativity and deep thinking to solve challenging problems in your business and patient care. Also, consider how virtual and augmented reality can bring new worlds to your patients who may have difficulty moving/leaving their homes.

World of Rehab 🌐

• [Speech] A research team led by UCF has developed a simple, affordable vortex whistle that could revolutionize the assessment of voice disorders in speech pathology. The whistle, combined with specialized software, aims to provide a low-cost method for measuring aerodynamics in voice production, addressing a critical gap in current voice disorder evaluations.

• [Occupational] Sarah Lyon, OTR/L, writing for OT Potential, presents a comprehensive list of 11 critical questions that rehab therapists should ask when evaluating AI documentation tools, covering aspects such as technology type, privacy measures, customization capabilities, and impact on patient care.

• [Physical] A recent study found that Japanese physical therapists with McKenzie Method certification demonstrated greater competence and confidence in evidence-based pain management, more biopsychosocial perspectives, better guideline adherence, and more knowledge of modern pain science compared to those without certification.

• [General Rehab] Abridge's whitepaper, "Pioneering the Science of AI Evaluation", outlines their approach to evaluating AI-generated clinical documentation, achieving a 13.7% word error rate on internal benchmarks.

Tech Toolkit 💪

Parkinson’s is the fastest-growing neurodegenerative disease in the world. We need better science on the cause and certainly more effective treatment options.

A study came out earlier this year, and it looks like adding a bit of high-tech fun to physical therapy for Parkinson’s patients could make a big difference! The mix of AI, AR/VR, and possibly robotics as treatment options is exciting to consider.

Here's the Scoop:

• Scientists worked with 60 folks who have mild to moderate Parkinson's

• They tried out different combos of treatments for 12 weeks

• The secret sauce? Virtual Reality (VR) + regular physical therapy

What They Found:

• People who used VR with their usual therapy did way better than the others

• And get this - the improvements stuck around even a month after they finished!

• We're talking better movement, better balance, and more confidence in everyday activities

Why This is a Big Deal:

Imagine being able to improve your Parkinson's symptoms while feeling like you're playing a game. That's basically what this VR therapy does! It's not just effective - it's fun too.

Calling All Rehab Therapists!

If you're a rehabilitation therapist, this study could be a game-changer for your practice. Here's why it matters to you and how you might apply it:

1. Engagement Boost: VR can make therapy sessions more engaging for your patients. Think about how much easier it would be to motivate patients when therapy feels like play!

2. Customizable Challenges: VR allows you to tailor exercises to each patient's needs and abilities. You can easily adjust difficulty levels as your patients progress.

3. Safe Environment: VR provides a controlled, safe space for patients to practice challenging movements without the risk of real-world falls.

4. Objective Tracking: Many VR systems come with built-in tracking, giving you precise data on your patient's movements and progress.

5. Home Exercise Programs: Consider recommending VR-based exercises for home practice. It could improve compliance with home programs.

6. Multitasking Training: VR environments can simulate real-world scenarios, allowing patients to practice motor skills while managing cognitive tasks - crucial for daily living.

7. Expanding Your Toolkit: Even if you don't have access to VR yet, think about how you can make therapy more immersive and engaging. Can you incorporate visual feedback or gamification elements into your current treatments?

Remember, while this study focused on Parkinson's, the principles could potentially apply to other neurological conditions too.

What's Next?

Of course, there's still more to learn:

• Will this work for people with more advanced Parkinson's?

• How much would it cost to get this tech in every clinic?

But hey, this is a pretty exciting start!

Indie Insights 💡

While I'm no robotics expert, I'm genuinely intrigued by how this field could transform healthcare, especially in addressing provider shortages. The idea that combining data and robotics might allow our top healthcare professionals to focus on more complex aspects of care is fascinating.

And it's not just speculation anymore. Jensen Huang, CEO of Nvidia, recently made some eye-opening statements about the current state of robotics: "Robotics is here. Physical AI is here. This is not science fiction, and it's being used all over Taiwan. It's just really, really exciting," he said.

Nvidia backs this up with impressive numbers. Over five million preprogrammed robots worldwide are being tested and validated using advanced techniques like digital twin simulations in their Omniverse platform. While these robots are primarily aimed at factory work, the potential implications for healthcare are significant.

The Economics of Robotics

The economics of robotics have shifted dramatically since the 1980s. According to Construction Physics, robot prices have dropped significantly, and improvements in cost-efficiency and performance have made robots more accessible across various applications, including healthcare.

A robot with a 1-meter reach and 10 kg payload would cost less than half as much today as in 1984, while also performing better.

In the '80s, robot prices were oddly disconnected from size - a tiny robot might cost nearly as much as a large one. Today, pricing is more logical, with size and capability more closely tied to cost. This shift has made robots accessible and affordable across different sizes and applications, including healthcare.

A Potential Breakthrough on the Horizon?

Josh Wolfe, investor at Lux Capital, predicts a ChatGPT-like moment for robotics in the coming years. I'm cautiously optimistic, but you know how it goes with tech predictions - they're always "just around the corner" until suddenly you're living in a sci-fi movie.

The challenge robotics has encountered regarding healthcare is primarily related to the real-world interaction data required to train the robot. Unlike language models (e.g. OpenAI and ChatGPT) that can learn from text data, robotics requires context from motion, movement, sound, and other environmental factors.

However, new approaches to capturing this data are emerging, potentially unlocking applications in areas like rehabilitation therapy.

Robotics has already shown promise for lower and upper extremity rehabilitation. For example, in lower extremity rehabilitation, robots significantly increase the efficiency and effectiveness of gait recovery by providing consistent, high-dose movement training while reducing the physical burden on therapists, allowing them to focus on supervision and personalized treatment planning.

The possibilities in rehab are exciting… and a bit nerve-wracking

As we look to the future, I have a lot to wrap my head around, but some intriguing applications come to mind:

• Home-based rehab with remote monitoring: Robotic devices could be used in patients' homes to guide exercises and collect data while therapists monitor progress remotely.

• AI-driven adaptive therapy: Robots equipped with AI could adjust therapy difficulty in real-time based on patient performance and fatigue levels.

• More efficient caseload management: Robotic systems could automate routine tasks, allowing therapists to oversee more patients simultaneously.

• Data-driven personalization of treatment plans: Robots could collect precise, consistent data on patient movements and progress, helping therapists tailor treatment plans more effectively.

• Assistance with diverse daily living tasks: Robotic assistive devices could help patients practice a variety of functional tasks in a controlled, repeatable manner.

As we navigate this evolving landscape, we must remain open-minded, curious, and focused on how these technologies can best serve patient needs and support healthcare providers.

“The future is here. It’s just not evenly distributed.”

See you in two weeks,

Eddie

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