Empowered Mobility Through a Virtual Presence THE ROBOT AS YOUR CHILD’S AVATAR

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BY CHARLES M. SCHWAB, ARCHITECT

Telepresence robots – used today by children’s hospitals, various healthcare providers and individuals alike – can provide virtual mobility by allowing your child to go somewhere and move with freedom when he or she may not be able to physically be there, 100% in person.

003Telemedicine models for healthcare have been growing in recent years. These programs allow specialists to perform consultations between hospitals and remote areas or populations. Telemedicine is especially useful for complex and homebound patients, wherever they live. Robotic telepresence appliances take telemedicine to a higher and more personal level. These combine audio “hearing” and visual screens, which actually represent a person’s face, with traditional telemedicine. Robotic telepresence devices are remote controlled and enable a person to represent themselves in a distant location, giving them the freedom to move around as if they were actually there.

Telepresence robots are being used today by children’s hospitals, various healthcare providers and individuals alike. In this article, I hope to show you how they can provide virtual mobility by allowing your child to go somewhere and move with freedom when he or she may not be able to physically be there in person.

The robot is controlled, in real time, by the person whose face is represented on the screen of the remote controlled robot. The robot can be controlled from thousands of miles away. The person controlling the robot can drive it where he or she wants, look at what they want, and collaborate or communicate with whomever they want, offering freedom for the user. This can be truly mobility empowering for the individual using the robot. The robot can serve as your child or youth’s avatar by being their “eyes and ears” in a remote location.

There are two scenarios that I’d like to explore that are intended to illuminate how a robot can help your child become “mobility empowered” and look at what you can do in your own home to accommodate it. There are currently a limited number of product line brands of telepresence robots available in the USA. In this article I am namely referencing a model product robot named VGo, pronounced “Vee-Go.”

There is another brand device named Giraffe Plus being used in Europe. Its application has heretofore been primarily for the elderly so we won’t explore that model at this time. Since VGo is currently being used in pediatric cases, it makes sense for us to look at this particular model. It also appears (based on significant research) to be the most developed of these robots.

Scenario 1: A robot has the ability to provide virtual mobility to a bedridden child by delivering his or her presence at a specific location or event. The robot can go to school or to a basketball game for example, when the child is ill or cannot be physically present for any given reason. The rolling robot, delivered to the predetermined location and a 6″ LCD screen, becomes the face of your child. In this manner it might be alluded to as his or her virtual avatar.

How to Operate the Robot from Home as an Avatar
• The robot is controlled by a person from a personal computer, laptop or tablet.
• Robot device arrives in a box via mail weighing no more than 30 pounds.
• The family installs VGo client app on their computer. It operates with Windows, Mac, iPad or iPhone
• The installed app provides high quality, two way audio and video at the robot.
• The rolling robot is delivered to the predetermined location where the child cannot be in person, but the robot can.
• A 6″ LCD screen shows the face of the child, as seen through the camera on his laptop or tablet at home. The robot screen “head” shows the child’s face.
• Above the “robots “face” LCD screen is a camera that acts as the child’s “eyes” at the remote location.
• When the user positions their mouse pointer on the screen, driving controls appear.

• The user simply clicks the direction they want to drive, and the VGo moves in that direction.
• Vgo accelerates and mobility begins. It also operates with keyboard arrows, trackpad and adaptive mice.
• The robot is representing your child or youth from a remote location, as your child’s Avatar, and by being there when he or she can’t.
• It might be possible for a community to purchase one and use it in a lending library. Different people can “dial in” to control it, with different codes at different times.

The camera can pan around and look anywhere: up, down and all around. The robot camera “eye,” or robot camera lens, can be turned down to the floor if the person or place being viewed, prefers to not be seen by the robot  controller. This may be necessary for privacy or any number of reasons.

Scenario 2: A doctor or primary health care provider makes a virtual house call. Robots are also used by doctors making house calls without having to actually go to the home in person. The travel time required by both the doctor traveling to a patient at home, or the child patient having to travel to a hospital or rehabilitation clinic, can be eliminated. In-Home Post-Op Care the telepresence robot is also being used to provide medical services in patient homes, initially for post-operative pediatric patients. When the child patient returns home to their family after surgery, a VGo is included with the care package provided to the home.
The following information was obtained from VGo product literature:

How Primary Health Care Providers Use the Robot
A variety of clinical specialists, including the surgeon, can use VGo to make very efficient house calls both on a scheduled basis, and on-demand if problems or questions arise after surgery for example.
• While it is anticipated that this use could improve patient outcomes, the most important economic driver is to reduce readmission by addressing issues in the home.
• The doctor or other user can move delicately around the confines of a child’s home bed room, move close in to get the best viewpoint for the doctor’s visual examination.
• The doctor’s face is shown on the screen and the virtual doctor can then “step back” to observe the patient or to address family members or colleagues.
• With control from the remote, the doctor can slowly pan around the room or join a colleague walking down the hall.
• In a large hospital for example, a VGo could roam the premises all the while the doctor remains in one location.

Home Design for Mobility and Robots too!

You might be wondering what you need to do in your own home environment to accommodate the benefits of robot use. There are steps you can take to prepare your own home when the virtual doctor comes to visit. The following are some key considerations:
• The robot can drive itself up a 1 inch rise by 12 inch run slope ramp. This ramp is the steepest allowed by the ADA. It can drive from a drop off point into the building.
• The VGo robot moves similar to a center drive wheelchair, it has a minimal 15 inch turn diameter. Size at the base is 13 x 15 inches.
• It can roll over a 1″ threshold. Its ability to negotiate minimum floor variations accommodates varying floor surfaces.
• A non-slip solid surface floor or low pile closed loop carpet no deeper than ¼” is best.
• Good lighting with no or low glare will make it easier to see the 6 inch LCD screen.
• Because VGo “hears,” like any other conversation, the less background “noise” there is, the easier it will be for the distant user/controller to hear a private conversation.
• VGo recognizes large objects, and therefore will not run into walls and furniture. It will be easier (and safer) for the user to operate when clutter is removed.
• Keep the area in front of the charging station free and clear of clutter or other objects. The VGo can locate and then roll to, and find its home docking and charging system all by itself, so a clear, clutter free access route needs to be provided so it can get to its dock.
• It weighs only 22 pounds with a 12 hour battery and 18 pounds with a 6 hour operating battery. There are no floor load concerns because it is so light.
• Consider what is at your back when a robot is viewing you. Think of it as filming a video: many of the same procedures apply when communicating through the virtual avatar.
• A home internet router can be used but if not available, VGo has an embedded Verizon 4G LTE sim card so it can connect to a cellular network.

Users say that the single, most empowering part of using VGo is that they are autonomous and independent in the remote location. Bern Terry, a spokesperson for VGo communications says he has heard children exclaim: “Look Mommy I’m walking, I can walk.”
That surely sounds like real virtual mobility to me. •

ABOUT THE AUTHOR:
Charles M. Schwab is an Architect specializing in fully accessible and universal design homes for over 20 years. It was after his grandfather suffered a series of strokes in 1992 that he realized that most American homes do not meet the needs of those with mobility needs. In 2005 he completing his first accessible home plan book, Universal Design Smart Homes for the 21st Century, 102 plans you can order and build. He designs accessible and universal design home remodels, additions and new homes throughout the USA and Canada. He contributes to many access magazines and has started a new design blog. His new book Child Access Bed and Bath is written and designed to be easy to read, cost and time friendly and jargon free, It will be useful to families after injury or disease resulting in the need to use mobility aids at home. It will be helpful to therapists, architects and designers alike. For further info. contact CharlesSchwab@UniversalDesignOnline.com


References
1. Health Attitude: Unraveling and solving the complexities of Healthcare, 2015 John Patrick
2. Interview & literature, Bern Terry, www.vgocom.com Home-bound education