Session
Round Table - 90 Min
Robotics is pitched for a significant role in the delivery of healthcare services. for the future, from research to actual patient care and hospital maintenance. Already there are a large number of wellness and patient (home) monitoring and support devices in use. This dynamic coalition focuses on the patients or end users interactions with technology. The session will engage the participants to a discussion on the role of robots within healthcare with specific emphasis on the internet.
The session will open with a short presentation of the 2023 DC joint and member papers, on robotics and ehealth related topics, to catalyze the discussion. The basis for the conversation, is to place the "design of processes", by foresight, as well as the human to robot interface, at the center of developments in robotics, MIoT, ehealth and the wellness eco-system, to minimize risks and optimize benefit for the future.
Invited guest speakers will share their work on the development of medical records for out of space and DTN networks, showcasing opportunities for rural engagement and connectivity for ehealth and robotics. Speakers will also look at the spaces for marginalized communities to gain full access to new developments.
Examples of questions that could be discussed, but not limited to, are: What are the issues, including ethical issues that must be discussed now, to enable a safe relationship between the technology and humans for the future? Can robots work offline where internet connectivity is not available and achieve the same expected outcomes compared to urban areas? How can we trust the robots in the medical space? How can we ensure quality data feeds for robots? What are the energy and back-up requirements for MIoT? How will the public user be educated on the interaction with robots? Are there exceptional data privacy issues that should be addressed specific to robots? How can we minimize the impact on the climate with ehealth. MIoT and robotics?
Members of the IGF Dynamic Coalition on Data Driven Health Technologies: Amali De Silva-Mitchell, June Parris, Dr Amado Espinosa, Frederic Cohen, Yao Amevi Amessinou Sossou, Dr. João Rocha Gomes, Jorn Erbguth, Dr Galia Kondova et al.
Link: Dynamic Coalition on Data Driven Health Technologies (DC-DDHT) | Internet Governance Forum (intgovforum.org) and book Health Matters, Technologies Driving Change in Ehealthcare. A Community of Thought.
Oscar Garcia - Board Member & Project Works Lead IPNSIG, Interplanetory Networking Special Interest Group. He is the chief software architect of Unified Medical Records System (UMPS), which currently serves thousands of patients and doctors. He received the Award of the World Summit on the Information Society in Digital Health in 2005 for Argentina. He publicly presented the first Medical Record System for Space Exploration in 2020. This development got the interest of the Space Agencies for serving astronauts, space tourists, researchers and doctors in Space medicine. He is currently working to test UMR for Space Exploration for a mission to the Moon. Mr. Garcia also started the Global DTN Network for testing the bundle protocol (BP) in scale to be used in the Interplanetary Network.
Dr Samo Grasic - Since 2016, has led design and development for the Nomatrack LoRa-DTN platform at Dálvvadis economical association in Jokkmokk. Tailored for Arctic reindeer herding, this technology reflects his expertise from his PhD in Human Work Science from Luleå University of Technology (2014). There, he specialized in ICT infrastructure for the Arctic's sparse populations. A member of The Inter Planetary Networking Special Interest Group, Samo co-authored the PRoPHET routing protocol (RFC 6693). His passions span from routing in networks, energy harvesting, and system development to the socio-economic implications of ICTs. Prior to academia, Samo spent six years in industry, crafting hardware and software for meteorological and radiological systems.
Jutta Croll – She is with the IGF Dynamic Coalitions of Child Online Safety and Access in Libraries and is a leader of the Dynamic Coalition of IGF DCs. She is member of a number of steering committees and advisory boards at the national, European level and with the United Nations such as UNESCO and IGF and transitional bodies. She was Managing Director (2002 -2014) of the German Digital Opportunities Foundation. She is a researcher at the University of Bremen, Telecommunications Research Group in the Department of Applied Informatics since 1992.
Judith Hellerstein – Is a member of the IGF Dynamic Coalition of Accessibility and Disability DCAD. She is founder and CEO of Hellerstein & Associates. She has 30 years of extensive experience developing policy, regulations and laws for the ICT sector, nationally, internationally and for the UN institutions. She was ICANN ALAC NomCom Representative 2021-2023, amongst other extensive achievements.
Prof. Rajendra Pratap Gupta - Founder & Chairman. Health Parliament – Digital Health Associates – India (private sector) Representative for the Dynamic Coalition on Digital Health
DC members: Amali De Silva - Mitchell (DC Coordinator); Dr Joao Rochas Gomes (Ada Health / University of Porto); Yao Amevi Amessinou Soussou; Frederic Cohen; Dr Amado Espinosa (IGA-SA Executive Committee Member); June Parris; Houda Chihi (Tunisia Telecom), Jorn Erbguth (University of Geneva +).
Dr Amado Espinosa / Judith Hellerstein
Amali De Silva - Mitchell / Dr Joao Rochas Gomes
1. No Poverty, 2. Zero Hunger, 3. Good Health and Well-Being, 4. Quality Education, 5. Gender Equality, 6. Clean Water and Sanitation, 7. Affordable and Clean Energy, 8. Decent Work and Economic Growth, 9. Industry, Innovation and Infrastructure, 10. Reduced Inequalities, 11. Sustainable Cities and Communities, 12. Responsible Production and Consumption, 13. Climate Action, 14. Life Below Water, 15. Life on Land, 16. Peace, Justice and Strong Institutions, 17. Partnerships for the Goals
Targets: Directly links to UN SDG # 3 Health & Wellbeing For All. Impacts and associates with all other UN SDGs.
Report
UN SDG 3 mandates Health & Wellness For All. Meaningful Medical IoT access must explore technologies, such as DTN, to enable equitable access to medical services and record keeping.
Muttiskateholder discussions on the way forward with human robotic interaction interfaces (acessibility. privacy, security +). Internet HCI interfaces are a good startiing point for discussion.
IGF 2023 Dynamic Coalition on Data Driven Health Technologies (DC DDHT)
IGF Kyoto 2023 Session Report on Robotics and the Medical Internet of Things
October 9, 2023
Reported by Amali De Silva-Mitchell (Coordinator DC DDHT) and Dr Joao Rochas Gomes
Onsite moderators: Dr Amado Espinosa (Mexico) and Judith Hellerstein (US). Online Moderators Amali De Silva-Mitchell (UK/Sri Lanka) and Dr Joao Rochas Gomes (Portugal).
Robotics is pitched for a significant role in the delivery of healthcare services for the future, from research to actual patient care to hospital maintenance etc.. Already there are a large number of wellness and patient (home) monitoring and support devices in use through the internet, but access and accessibility issues are limiting access to All, UN SDG #3, Health and Wellbeing for All. This dynamic coalition focuses on the patient or end user interactions, with technology. The DC is due to publish a paper on this same subject in 2023. The session engaged the guest speakers and participants to a discussion on the role of robots within healthcare, with a specific emphasis on the internet.
Oscar Garcia
Outlined the need to have good standardized medical records systems set up, for meaningful, systematic data exchanges. Robots and AI need well organized data records to function optimally. He emphasized that the communications regarding record’s content can be facilitated to remote areas such as the moon with Delay Tolerant Networks DTN. This technology can be developed for rural and remote parts of the planet at a fraction of the cost of the set-up of satellites, which will speed the development of e-health to all much faster.
Dr Samo Grasic
Showcased the technology behind DTN. DTN works by storing data at an intermediate point for data transmission. His work with tagging roaming reindeer in northern Sweden has been effective using this technology in remote locations of the arctic. This highlighted that there are solutions that can be further developed to bring peoples living in very remote areas, access to ehealth and emergency health care support, far sooner than could be expected. These solutions will help with critical, disaster and emergency relief and help bring the goal of the United Nations Sustainable Development Goal number 3, Health and Wellness for All within operational range.
Jutta Croll, DC on Children, Co-Coordinator DC of DCs
Referred to the UN Convention on the Rights of the Child, Art. 24 and called on States Parties to recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. She outlined what the UN-Committee on the Rights of the Child had laid down in general Comment #25 on children’s rights in the digital environment in relation to digital technologies. A child’s health, she said, start with its birth, therefore without identification, registration and acknowledgment of child / person, access to healthcare may be limited, delayed or denied. With regard to the medical Internet of Things she referred to Teddy the Guardian, a health monitoring device for children and pointed out there are issues of privacy, transparency and ethics in to the sensitive data of children
Judith Hellerstein, DCAD Co Coordinator
Persons with Disabilities are very fearful of robots in the medical profession since it will mean they are not able to communicate with their doctor, nurse etc., and will be disenfranchised. Persons who are hard of hearing cannot read lips as the robot has no lips and no facial expressions. They also need either sign language or human captioning. AI captioning is not very good or reliable. Also need to be face to face and without a mask. However, if these robots were telepresence ones, machines with a computer on top where they can communicate face to face with a person on a screen and have access to captioning, face 2 face or have access to sign language, that could be a big help. So, if they are connected and can have this in with the doctor that would be helpful. Facial expressions are critical for lip reading and hand gestures for sign language. Hence it will be essential to have text displays for adults and the robot needs to conduct sign language.
There is tremendous opportunity for robotic devices to be developed to assist with accessibility. For persons with cognitive disabilities, a quiet place to assist these would be helpful. We just have to remember that robots that take blood, or assist doctors we cannot forget the human touch or robots that are telepresence ones.
Prof. Dr Rajendra Pratap Gupta, DC- Digital Health
Spoke of the imminent presence of robots in the healthcare space and pointed to the fact that the capability of robots exceeds the human capability. Robots will find use in two main areas; handling 1) Routine tasks like cleaning & disinfecting wards, serving patients, and drug dispensing and diagnostic sample delivery. This will lead to cost savings and floor efficiency and in 2) Medicine: like doing clinical procedures, the role of the exoskeleton in paralyzed patients, social interactions with seniors and other specialized roles in clinical settings which will lead to better clinical outcomes and cost savings for care providers. He further added that he envisioned a future of specialized robotics like cardiology robotics, urology robotics, and oncology robotics. Also, clinical robots are expensive so while the effectiveness is proven, democratization will take years to happen, given that we need to bring down the cost.
Dr Houda Chihi, DC DDHT
Spoke of the numerous security issues that must be overcome to secure communication between robots and the humans. These protections are essential for the expected function of robots and for the outcomes. The security design process for robot function in the environment at large must be well thought out and stress tested. Updates with security patches to software are critical, to maintain protections.
Jörn Erbguth, DC DDHT
Privacy concerns arise with the use of robots due to their extensive data collection capabilities through numerous sensors including cameras, microphones, temperature sensors, sound, touch, and proximity sensors among others. Additionally, robots might be able to access patient files and other monitoring devices resulting in the accumulation of vast amounts of data exceeding that of traditional surveillance systems. Patient data is typically highly sensitive health data that is afforded the highest protection under EU GDPR and other data protection laws. What part of the data is stored and for how long? It is important to determine who has access to this data within the hospital; is it solely restricted to the treating doctor, or is it accessible to all personnel? Additionally, does the robot manufacturer have access to the data, e.g., for the purpose of detecting malfunctions and improving the functionality of the robots? Further, in the event of the patient's demise, do the relatives have access to this data? Does law enforcement have access to this data? What is the legal basis for that processing of highly sensible personal data? If based on consent, data protection regulation might require to be able to give granular consent, meaning limiting the consent to some of the data processing only.
Dr Joao Rochas Gomes, DC DDHT
Provided points from the DC DDHT draft paper on Robotics in Miot and Healthcare, due to be published in December 2023 at https://intgovforum.org/en/content/dynamic-coalition-on-data-driven-health-technologies-dc-ddht
During his intervention, he discussed the integration of robotics in healthcare. He emphasized data privacy, accountability, seamless hardware-software integration, and reliable connectivity as key aspects. João further noted the importance of scalability, user-friendly design, and education. He concluded by highlighting the potential and challenges of robotics in healthcare, inviting further discussions.
DC DDHT Annual Work 2023 Announcement
The authors for the 2023 edition of the Dynamic Coalition on Data Driven Health Technologies book “Health Matters, Technologies Driving Change in Healthcare, A Community of Thought” were: Frederic Cohen, Dr Joao Gomes and Yao Amevi Amessinou Soussou. The book is found at: https://intgovforum.org/en/content/dynamic-coalition-on-data-driven-health-technologies-dc-ddht
Highlights from their articles are as follows: Emphasis on international collaboration for research and development, noting the rapidly changing landscape for medical technologies and the need for designing “Greening” into health technologies.
We thank the 35+ participants for their interest in the session and encourage them to join our DC for extended conversations!