Robot leads ICU reopening

by Rollie Atkinson - Sonoma West Staff Writer

ROBOTICS — Director of Nursing Lori Austin shows off the ICU’s new robot, Herb. - Rollie Atkinson
The newest member of Palm Drive Hospital's medical team is just over five feet tall, weighs 220 pounds, glows in the dark and works for 1/8th the usual payscale of a trained specialist.

His name is “Herb” and he's a robot. He's part of the medical team for the modernized Intensive Care Unit (ICU) set to re-open next week, following a public Grand Opening and Tour on July 5.

“I love him,” said Lori Austin, director of nursing. “He's going to help local doctors keep their practices here and our nurses are looking forward to this new ICU experience.”

Hospital leaders are also hopeful the new ICU will bring new patients and revenues to the cash-strapped public hospital.

Palm Drive filed Chapter 9 bankruptcy papers in April and continues to post daily operating losses.

New interim CEO Jim Sato and a newly reorganized board are rushing to complete a 23-point “turnaround” plan before summer's end.

Herb and his human partner, Dr. James K. Gude, will link Palm Drive's five-bed ICU to a multi-hospital ICU network of specialist physicians spread across Northern California. Patients will have “live time” monitoring, diagnosis and consultation on a 24/7 basis.

Palm Drive patients and their primary care physicians will now have access to scarce specialists including heart, kidney, neurology, infectious control and pediatric critical care.

Members of Dr. Gude's specialist team can “visit” a patient through the monitoring software, eyes and ears of Herb from a central office or any remote office with an Internet connection. When necessary, the specialists will make actual visits to Palm Drive, with Dr. Gude on sight daily.

“This is doable, affordable and medically and legally acceptable,” Dr. Gude told members of the hospital's board of directors last week on an ICU tour. “This will save lives by bringing access to specialists a small hospital could never support in the past.”

Dr. Gude, a highly respected respiratory specialist and university professor, has secured a $4 million Sutter Medical Foundation grant to link as many as 10 small rural hospitals with his assembled team of doctors and specialists.

Robots like Herb will be placed at each hospital and the grant provides a full year of operating costs. A robot was installed at the Willits hospital last month and Healdsburg's hospital will re-open its ICU next month with a robot named Sid.

Beginning next week, Dr. Gude is moving his base of operations called Off Site Care to Palm Drive, moving here from Sutter Medical Center in Santa Rosa.

“You will be getting a blend of me and the robotic tele-medicine,” Dr. Gude told the directors. “I think we can help the hospital financially and we can keep patients closer to home when it's appropriate.”

He calls his medical model the opposite of centralized behemoths like Kaiser Permanante.

“It's time for a change and I think this will empower our smaller, rural hospitals,” Dr. Gude said.

In a closely related strategy, Palm Drive is helping to create a Joint Powers Authority (JPA) with Healdsburg, Sonoma Valley and other small health care districts in Northern California. The JPA will share costs, services and insurance and regulatory negotiations and oversight.

Herb and his robot brethren were invented just five years ago in Santa Barbara by InTouch Health and were first used last year at the UCLA hospital in Los Angeles.

Dr. Gude's Off Site Care is also working to establish networks in New Zealand, Japan and India.

It's not just ICU nurses who like robots like Herb. Studies and surveys show “favorable” acceptance by patients. Robotic medicine is faster, more accessible and “technically reassuring” to patients, a Johns Hopkins University study concluded.

An ICU patient at Palm Drive would have all their vital signs and charts monitored by their primary care doctor, assisted by two RNs and therapists.

Trauma cases from the Emergency Room next door, higher-risk surgery patients and other acute cases will be treated in the new ICU, which recently underwent a $250,000 renovation.

Not all ICU patients will need the services of Herb, Austin said. “We've always had excellent ICU-trained nurses. This is the patient care nurses really love to do.” The new ICU is well-lighted and has windows overlookng the trees and landscape of the Laguna Uplands. “I think our doctors are going to really appreciate what we have here,” Austin said.

Dr. Gude or his specialists will offer remote consultation and review of all the vital sign data and medical records. With the aid of Herb the robot, they will talk, listen to and examine a patient. One specialist could actually monitor and diagnose several patients in different hospitals at the same time.

Dr. Gude's network brings instant access to Oakland's Children Hospital for critical care pediatrics that now requires a long helicopter ride.

Other network specialists are from California Pacific Medical Center and UCSF in San Francisco, an infectious disease specialist from Harvard University and several physicians from the Sutter Medical alliance throughout Northern California.

“We will have rapid response, diagnosis and treatment that even Memorial, Sutter and Kaiser don't have,” said Dr. Gude. “This is the very top degree of service with most of our specialists being multiple-board certified.”

The robots are being leased for $4,400 per month and cost $400 each month to service.

The July 5 Open House is from 5:30 to 7:30 p.m. Refreshments will be provided and demonstrations of the new technology will be given. For more information, call 823-8312.

ROBO-TALK - Dr. James Gude explains the workings of the robotic tele-medicine system that he will oversee at Palm Drive Hospital.