Robot nurse assistants are joining Texas hospitals amid healthcare worker shortage

·7 min read

SAN ANGELO, Texas — As Texas grapples with a dire nursing shortage, some hospitals are augmenting their workforce with artificially intelligent robots.

In the West Texas city of San Angelo (260 miles southwest of Dallas), Shannon Medical Center's newest assistants are roving the hallways, but not on two legs. They have wheels, oblong faces and blue eyes that light up, literally, into pink hearts.

"We are one of the first hospitals in the country to have this technology," said Lyndy Stone, Shannon's director of marketing.

Austin-based company Diligent Robotics created an artificially intelligent robot it calls "Moxi" to assist healthcare workers. Two such units rolled out for duty in San Angelo on Tuesday, Dec. 14, 2021, to assist with routine tasks, such as fetching medications and delivering lab samples.

Moxi was named one of Time Magazine's 100 Best Inventions in 2019 and has appeared at other hospital facilities, which include Medical City Dallas Hospital and Cedars-Sinai in Los Angeles.

"Moxi," an artificially intelligent robot, arrived in San Angelo at Shannon Medical Center to assist nurses with routine tasks.
"Moxi," an artificially intelligent robot, arrived in San Angelo at Shannon Medical Center to assist nurses with routine tasks.

It took weeks of testing, learning clinical workflows and mapping the hospital environment, but both robots completed their first shifts by helping nurses finish dozens of tasks within the first day, a hospital news release stated.

"It's great," said Michael Smith, a nurse unit manager at Shannon Hospital. "We're able to request (Moxi) for anything that we need — any kind of equipment that may be in different departments or medications from the pharmacy."

Hospital officials say the timing couldn't be better.

As the coronavirus pandemic drags into its second year, the nation is grappling with a critical shortage of nurses.

Robots to the rescue in Texas nursing shortage

In Texas, there were 35,634 advertised job openings for registered nurses — the highest number of unfilled jobs across the state, according to a labor analysis by the Texas Workforce Commission released Thursday, Dec. 16, 2021.

By Sunday, Dec. 20, the number had grown to 38,489 job openings.

Industry leaders worry there aren't enough incoming nurses to fill those positions.

"We remain very concerned about the shortage of nursing professionals in Texas,” said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association. "In addition to too few nurses in the pipeline, COVID has left us with an exhausted workforce that is routinely being asked to do more."

The American Nurses Association in September sent an urgent letter to the Department of Health and Human Services calling the nursing shortage both a "national crisis" and "unsustainable."

"Moxi," an artificially intelligent robot stands to the left of Andrea Thomaz, creator and co-founder of Austin-based tech company Diligent Robotics.
"Moxi," an artificially intelligent robot stands to the left of Andrea Thomaz, creator and co-founder of Austin-based tech company Diligent Robotics.

Texas recruited 2,500 nurses from outside the state, the ANA cited in its six-page letter, while hospitals in Tennessee were operating with 1,000 fewer staff than at the beginning of the pandemic, prompting them to call the National Guard for reinforcements.

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Kroll said the Texas Hospital Association is already looking ahead to see what can be done "to ensure a stable and robust nursing workforce for the future."

That future, as Andrea Thomaz envisions it, will involve robots like Moxi at Shannon Medical Center.

Meet 'Moxi,' an artificially intelligent robot designed to assist nurses

"(Moxi) is designed to work side-by-side with people as a teammate," said Thomaz, co-founder and CEO of Diligent Robotics, who said the healthcare industry was a good fit for robotic helpers.

Before launching her company in 2018 with co-founder Vivian Chu, Thomaz and a team of researchers spent six months following nurses at three different hospitals, watching what nurses were doing and carrying.

"Moxi," an artificially intelligent robot, arrived in San Angelo at Shannon Medical Center to assist nurses with routine tasks. Equipped with drawers to hold PPE and medicine, Moxi's eyes can switch from circles to hearts.
"Moxi," an artificially intelligent robot, arrived in San Angelo at Shannon Medical Center to assist nurses with routine tasks. Equipped with drawers to hold PPE and medicine, Moxi's eyes can switch from circles to hearts.

"Nurses and clinicians are amazing," Thomaz said. "They do anything for their patients. If they need to run to the lab to get something, they do it. If they need to run to the pharmacy, they'll do it without complaint."

During the roughly 150 hours that Thomaz and her team observed nurses in the hospital, they learned healthcare workers spent up to 30% of their time "hunting and gathering" for supplies, in which Thomaz felt could be better spent focusing on what nurses do best — patient care.

She said it made perfect sense for a robotic teammate to step in and lighten the load.

"(We saw) the opportunity to help, and that's really what launched the company," Thomaz said.

After years of testing, Diligent Robotics designed Moxi to navigate labyrinthine hospital corridors while transporting medical supplies thanks to drawers at the base of the robot.

Moxi is helping us spend more time with patients, nurses say.

Nurses at Shannon appeared thankful to have Moxi on the team.

"It's a benefit that we don't have to run downstairs to take (supplies) to other departments," Smith said, adding Moxi has allowed him and other nurses more time at their patient's bedside.

Moments earlier, Moxi had whirled up to Smith with a prescription locked inside a compartment, which wouldn't open until Smith scanned his identification badge.

"The (training) process was simple," Smith said, describing how staff learned to work alongside Moxi. "Just a PowerPoint presentation is all it took. ...We just have to request (Moxi) from the kiosk that's at the nurse's station and send it on it's way to pick up whatever equipment we need."

A nurse at Shannon Medical Center scans an ID badge to retrieve medicine from Diligent Robotics robot, Moxi.
A nurse at Shannon Medical Center scans an ID badge to retrieve medicine from Diligent Robotics robot, Moxi.

After Smith collected the prescription, Moxi "chirped," then her eyes lit up, and once again she was back to scooting down the hospital hallways.

Moxi's artificial intelligence make her sensitive to people walking, standing or moving nearby. If Moxi encounters an obstacle, she will navigate around it or pause until the obstacle moves, a company spokesperson said.

At night, Moxi requires about two hours on a charging station before getting back to work.

What nursing groups had to say about Moxie

Most nursing organizations around Texas appeared optimistic by Moxi and what similar innovations could mean for future healthcare.

"There is great opportunity for technology to offload (routine tasks) ...to enable nurses to do more of what they love – being with patients," said Cindy Zolnierek, CEO with the Texas Nurses Association, in an email.

"Much of the work of nursing is cognitive, (such as) interpreting information and using clinical reasoning and judgement to adapt patient care," Zolnierek said. "Physical tasks, like hunting and gathering supplies and endless documentation ... takes away from their ability to be at the bedside assessing their patients."

Kroll sounded pleased by technology that could aid hospital staff in their daily activities.

"We can’t speak to Moxie’s particular capabilities, but we are encouraged by innovations that focus on improving the delivery of hospital-based medical care and allows nurses to continue to provide direct patient care," Kroll said.

Diligent Robotics robot, Moxi, walks along an enclosed pedestrian bridge at Shannon Medical Center to assist healthcare staff. Dec. 15, 2021.
Diligent Robotics robot, Moxi, walks along an enclosed pedestrian bridge at Shannon Medical Center to assist healthcare staff. Dec. 15, 2021.

But not everyone seemed ready to welcome artificially intelligent robots into the hospital.

"I think in this moment, it's extremely insensitive to introduce the idea of a robot that is both untested and unproven in this environment," said Michelle Mahon, registered nurse and Assistant Director of Nursing Practice with National Nurses United, a nursing union boasting 175,000 members.

Mahon said she thought the concept of Moxi "sounded nifty" but believes what hospital administrators should be investing in is the human side of healthcare: nurses, not machines.

"The type of help nurses need right now isn't necessarily a helper robot. Certainly in the era of COVID-19, it should be demonstrating that we value nurses and the human care that they deliver," Mahon said, who advocated nurses receive better staffing and workplace conditions, as well as fair compensation and violence protection for female nurses.

"That investment needs to supersede the priority for various gadgets in the short term," Mahon said. "The application of technology ... is usually at the expense of patient care."

During her interview, Thomaz was quick to point out that Moxi is not a replacement for human healthcare workers, but a means in which they can devote more time to caring for patients.

"In no way is Moxi doing the job of a nurse," Thomaz said. "We're not doing any patient care. We're not able to take on all of the amazing work that a nurse would do."

"What we can do is give back some time that a nurse would otherwise have to be running around the hospital. And so that's really where we see our value is being able to step in and give back that gift of time to focus on patient care," Thomaz said.

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John Tufts covers enterprise and investigative topics in West Texas. Send him a news tip at JTufts@Gannett.com.

This article originally appeared on San Angelo Standard-Times: Nursing shortage 2021: Texas hospitals hiring robot assistants

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