Health post: Japanese care robots

Last week, I visited Panasonic’s headquarters in Osaka. Back in the US, I knew Panasonic mostly as a television company. But here in the company’s home country, they make all sorts of products including audio-visual equipment, home appliances, IT solutions, smart home and home security technology, and robots – specifically care robots. I was there to meet an engineer, Mr. Ando, who has worked on Panasonic’s hospital delivery robot HOSPI, among others.

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Mr. Ando with the HOSPI robot.

Panasonic is working on care robots that work in pharmacies, hospitals, and personal homes. One splits in half to transform from a bed into a wheelchair (not your typical “robot,” but still an autonomous machine). This eliminates the possibility of injury to the patient during transference as well as injury to the nurse moving them from their bed to a wheelchair.

Panasonic has also built care robots that focus on improving the patient’s happiness. Ando showed me a video of a hair-washing robot: a station where immobile patients can have their hair sink-washed by robot “hands” that massage the scalp and do the washing and rinsing. It looked very relaxing. Ando said that this was in response to patients who were unhappy that they only had showers about twice a week. The nurses were simply too busy to spend more time manually washing patients’ hair, even if more frequent washing does contribute to the patients’ happiness. If a hospital installs a few hair-washing robots, however, patients can get their hair washed more frequently while the nurses focus on more pressing tasks. While this robot may not have a direct impact on their health, I think the impact on their feelings of dignity, independence, and happiness is important.

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One of Panasonic’s numerous buildings in Osaka – when I got here I thought I had arrived at the location for the interview, but I was still 10 minutes away from the right building. Ando told me this area is called “Panasonic Village” since the company’s headquarters comprise so many buildings.

Ando described Panasonic’s robots as contributors to “assisted care” and “assisted independence.” I got the sense that he used these terms to give dignity to the patient and put the user’s needs first rather than focus on the robot’s capabilities. That is, there is a thin line between “assisted care” and “assistive technology,” but the former focuses on the patient while the latter focuses on the technology.

In our talk, Ando and I mostly discussed HOSPI – a waist-high robot that talks, listens, and transports items such as blood samples or medications throughout a hospital. One special version of the robot, the HOSPI Rimo, also has a communication feature that can be used for telemedicine. I asked about how Panasonic came up with all these robots, and Ando told me that when Panasonic develops new products, the most important step in that process, at least for hospitals, is task analysis.

The Panasonic team observes the staff performing various tasks at a hospital to see where the inefficiencies are – gaps that can be hard to notice when you’re in the middle of the workflow, but which become more evident from an outsider’s viewpoint. Based on this task analysis, Ando told me, Panasonic decides what type of product to develop in response to the observed problems.

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HOSPI hangs out in Panasonic’s lobby. She gives tours to guests and shares information about the company’s history.

In most cases, apparently, some type of robot is the best solution. The nurses don’t have enough time to wash patients’ hair? Let’s build a hair washing robot. There are issues associated with transferring a patient from their bed to a wheelchair? Let’s make the process robotic. And, of course, HOSPI, to make transport more efficient. I asked Ando for more details about the design process that led to the HOSPI robot.

He told me that, after Panasonic observed inefficiencies in the hospital, they discussed which solution would be best for the user. (I was glad to hear that – I’ve realized that, since going to Sweden as my first project country, the idea of a user-centered design process being a key factor of success has become really ingrained in my mind). Ando said that Panasonic quickly developed a prototype robot to solve the hospital delivery problem and then showed the prototype to the potential end users, nurses and doctors. The Panasonic team and potential users had a collaborative meeting about once a month, and after each meeting, Panasonic adjusted the robot in response to the users’ feedback.

“So when is that adjusting process finished?” I asked. “When the user says they’ll buy it!” said Ando, laughing.

I asked him if, with this user-focused design process, there are ever negative reactions to new products. His response surprised me: “All people react negatively to new products,” he said. “Especially in Japan.” Ando explained that certain particularities about Japanese ideas towards healthcare complicate the introduction of healthcare technology here.

He told me that the idea of healthcare in Japan is “humans supporting humans;” so robots as helpers for the nurses, then, are not part of the “philosophy” of healthcare. I asked him what he meant by the “philosophy.” Ando gave me the example of the kanji for “nursing care.” (Kanji is the Japanese character-based writing system – one of the language’s three alphabets). Ando reached for a nearby sheet of paper and quickly sketched it out. These characters often incorporate and combine pieces from more basic kanji that represent simpler ideas; so the characters can build on each other, becoming more complicated while representing more and more complex ideas. Ando pointed towards the kanji for “nursing care” and told me that it incorporated the kanji for “human hand” and “human eyes.” Thus the way that “nursing care” is written in Japanese necessarily focuses on the idea of human involvement – excluding the work of any automatic product from being part of the idea of nursing care. I absolutely loved this moment of learning how Japan’s ancient writing system influences reactions to medical devices today. That’s what this project is all about.

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It might be really cheesy that I kept this piece of paper and photographed it, but here you go.

But for the most part, it seems that nurses are grateful for the help that HOSPI offers. Ando stressed that HOSPI has separate tasks from the humans, which is a key factor of its success – it does the grunt, time-consuming work of sorting and delivering medications, allowing the nurses to focus on doing actual nursing work that only humans can do.

“What about the patients?” I asked. “Are they comfortable with the idea of robot care?” Ando said that, based on a survey done by Japan’s National Institute, 85% of people don’t hesitate at all with care robots. Ando said this is mostly due to positive representations of robots in Japanese media such as anime, but that when it comes to care robots, people want robots that are less human-like. He said that people have the impression that anthropomorphic or humanoid robotics are meant to be friends, and when they are in hospitals, they don’t want their friends taking care of them – they want the support and precision of tools. They respond better to simple-looking, machine-esque robots. HOSPI could have been designed to look like a human, but instead she looks like a clean, classic robot – well-suited to the hospital environment. I wonder, too, if patients would have a negative reaction to human-looking robot because of the uncanny valley phenomenon (which, by the way, was first tested by a Japanese roboticist in the 1970s).

Finally, I asked Ando what makes Japan so healthy and what that has to do with technology, if anything. He made a distinction here: the older, super-ageing generation is healthy, while the younger generations are less so. He said that the elderly are healthy simply due to their lifestyle of eating well and exercising enough. But in his opinion, the younger generations eat less healthy food and spend less time exercising – mainly because of the negative effects of technology, especially television and the internet and smartphones.

“So do you think technology helps people be healthy or not?” I asked – after all, Ando does work in the field of healthcare technology. He said that while the prevalence and popularity of technology has a negative effect on peoples’ health and fitness in Japan, it can have a positive effect on peoples’ illnesses. Once people are already sick and in the hospital, said Ando, technology can begin to have a positive effect, such as the effect of robots like HOSPI.

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I really had a blast talking to Ando and meeting HOSPI in person.
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