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Vital Signs with Dr. Sanjay Gupta

Emergency Response Software Program Introduced in Tanzania; Utilizing Drones to Transport Medical Samples Examined; Robots Used to Entertain Children in Hospitals. Aired 2:30-3p ET ET

Aired April 23, 2016 - 14:30   ET


[14:30:13] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: When you think of the future of technology, what comes to mind? Maybe robots or flying cars. What about technology's role in medicine? Well, in many ways the future is already here. This is "Vital Signs." I'm Dr. Sanjay Gupta.

Technology and medicine are a powerful combination. Take emergency response systems, for example. Ever since 1968, when there's a medical emergency here in the United States, you call 911. An ambulance arrives equipped with trained first responders and medical supplies to take you to the hospital. On the way there you're already receiving care. Those precious minutes can make all the difference in saving your life.

But in many countries that's not the case. There is no emergency response infrastructure. But a software program called Beacon can ready to change that.

Alongside Lake Victoria in east Africa, this is Mwanza, Tanzania. More than 800,000 people live here making it Tanzania's second largest city, but infrastructure here is unreliable. Bad roads and heavy congestion make traffic accidents the leading cause of trauma in the city, and there's no modern emergency response system in place here or anywhere in Tanzania.


GUPTA: Marko Hingi is a recent medical school graduate here. At just 27 years old he's also the founder and executive director of a Tanzania RURAL Health Movement.

HINGI: We look for a partner who we can work with to start, create a good coordinated personal care. That is where the Trek Medics come in.

GUPTA: Trek Medics International is a nonprofit started by first responder Jason Friesen back in 2009. Using a software system they developed called Beacon, Trek Medics provide the foundation for emergency response systems in places that don't have one like Mwanza.

HINGI: So this office is a control room where we receive calls from community, Emergency calls. And then where we put those information in our software on the laptop. GUPTA: Marko partnered with Trek Medics to bring Beacon here as one

of two pilot programs funded by a Google grant. The other one is in the Dominican Republic. In Tanzania, it's Mwanza's fire station that serves as a dispatch office for Beacon.

HINGI: So right now the system tells me there are 10 active first responders.

GUPTA: Here's how it works. When a med emergency happens, a traffic accident, for example, someone at the accident scene calls the local emergency number. A dispatcher takes all the relevant information and enters it into Beacon. Here's the critical part to understand. In Mwanza and across much of Africa, nearly everyone has a cellphone. So Beacon sends out a text message to first responders in the system. The first responders reply via text, and the ones closest to the scene are dispatched. Along the way, they can text information back to Beacon, like the number of patients, the type of trauma, and estimated time to the hospital.

The Beacon project isn't just about the software. It's also about the training, focusing on a few key areas like major bleeding and airway obstructions. Nothing too advanced, just enough to stabilize a patient before they arrive at the hospital. This program is only a month old, but in that short time Marko says they have saved 11 patients and counting. Nine of the 11 were involved in traffic accidents. The biggest challenge now is raising awareness that the service exists.

HINGI: It's a new system. There are people who have never had this for free before. So they're used to putting a relative in a car.

GUPTA: To raise that awareness and assist in training the first responders, Marko and Trek Medics run simulations. The first responders don't know the simulation scheduled for today. That's part of the training.

They are simulating a severe leg injury after a traffic accident. Don't worry. That's fake blood. Marko places the call to Beacon, starting the simulation.

HINGI: So we expect to have them here responding.

GUPTA: It doesn't take long before a crowd gathers. And that's what Marko was banking on. It's part of the awareness aspect of the simulation. He passes out flyers describing the service, and, most critically, providing the emergency number. In this case it's an ambulance that arrives first on the scene.

[14:35:03] The responders stabilize the patient, applying a tourniquet to the thigh, getting him on a stretcher and into the ambulance. Then it's off to the hospital. During that critical time, care is being provided where it wasn't before.

HINGI: At the hospital, where it is the end of the simulation, and it was a very good job done by first responders as they responded on the call. Just within ten minutes they already arrived at the hospital. GUPTA: So far Beacon covers roughly 100,000 people in Mwanza, but

Marko plans to expand to the city's full 800,000-plus population within the next six months.

HINGI: My dream for this program is to make it successful, to have access to this free hospital care.

GUPTA: Infrastructure is key here, but what happens when roads just aren't an option? That's the case in a lot of places around the world, and for timely responses like medical specimen testing it's time to look to the sky. Is there a future in health care for drones?


GUPTA: You might not realize it, but non-communicable diseases are now responsible for more deaths than infectious diseases. According to the World Health Organization, non-communicable diseases kill 38 million people worldwide every year.

[14:40:00] We're talking about heart disease, cancer, diabetes, diseases that are not passed from person to person. These chronic diseases also require continued testing, often over the lifetime of a patient. That means access to labs for things like blood and urine samples.

Again, it's a matter of infrastructure, and, again, technology could provide the solution. This time, however, we're not looking to the roads, but to the sky.

In the core laboratory at Johns Hopkins hospital in Baltimore, lab technicians are busy testing everything from hair to blood samples. Some 10,000 samples come through here every day. Dr. Timothy Amukele is a pathologist here. After visiting labs around the world and particularly in sub Saharan Africa, Tim had an idea. If transporting samples from medical testing was one of the biggest hurdles because of traffic, poor roads, lack of accessibility, why not remove those factors altogether? Why not fly them in a drone?

TIMOTHY AMUKELE, ASSISTANT PROFESSOR OF PATHOLOGY, JOHNS HOPKINS MEDICINE: The idea for using drones first came from the problems of moving samples internationally. There's a lot of places in the world where there's no roads. There's trouble getting specimens to places that can actually do the testing. However, the advantage of drones is that they don't require -- they don't need roads.

GUPTA: When you get your blood drawn or give a urine sample at the doctor's office, testing is rarely done at that location. There are roughly 200,000 registered labs in the United States, but Tim says most of them are primarily collection sites that can perform a few key tests but not the full range, and that requires the samples to be moved.

How important is speed when it comes to testing these samples?

AMUKELE: Speed is everything for biological reasons because it's not like moving a shoe or book. If it's there for a day, it's OK. If it sits there a long time, at some point the specimen starts deteriorating and is not so useful anymore.

GUPTA: A lack of obstructions would speed up the process, and that's where the drones come in.

AMUKELE: So a drone is a transport mechanism, and I think in five or 10 years they'll be just like having a motorcycle or something, where it doesn't matter what you put on it. As long as you package it safely and transport it according to the regulations it will be just fine.

GUPTA: The first of its kind, Tim ran a proof of concept study to see if blood samples in this case could be successfully transported via drone. Tim took six blood samples each from 56 volunteers. Half the samples were taken to the Hopkins lab. The other half were loaded on a drone and flown around for varying time periods between six and 38 minutes.

AMUKELE: My biggest concern, and this is why we addressed it first, is that the drone transport itself would deteriorate the samples. The pressure of the air destroys some of the blood samples. They're really that sensitive. So my initial fear was that transporting the drone because of the engine, and the way it's launched, it's launched by hand, and the shaking and all that would deteriorate the blood specimen.

GUPTA: What do you find?

AMUKELE: We found that they didn't. They worked just fine. It was great.

GUPTA: I wanted to see the drone in action. So we drove an hour from Johns Hopkins to an FAA approved drone field where Tim performed the original study. Waiting for us with a couple of drones is Jeff Street, an engineer who helped him with the study.

So this is it? Huh? This is the drone?


GUPTA: I guess I'm not exactly sure what I expected, but here -- this is Styrofoam and rubber bands that are sort of holding the wings of the overall drone itself. And you've got the compartment here for the battery and -- I guess the specimens. That's pretty much it.

These are not that expensive, and that's exactly the point. Jeff says this hobby-grade drone costs less than $100. That's important, because if you're supplying these to developing areas you don't want something incredibly expensive to replace or repair.

UNIDENTIFIED MALE: All right, so now we're ready to fly.

GUPTA: The drone launches by hand into the wind.

GUPTA: Imagine that and just seeing those all across these remote areas of the world.

AMUKELE: Carrying specimens, with medicines.

GUPTA: Exactly. That changes the game.

AMUKELE: Absolutely.

GUPTA: Tim acknowledges this is just the first in a long line of steps. The regulations for drones differ in every country, and in many cases are still being worked out. There are other questions as well, like, who would fly it? And how do they make it secure? The samples are packed in this foam with a special sponge so that if it does crash or a tube breaks, the specimen is fully absorbed.

[14:45:06] AMUKELE: It doesn't answer all the other questions, but the key question was, does the blood arrive OK? Because if it doesn't arrive OK, then none of it matters.

GUPTA: The other hurdle, and perhaps the largest one, is the drone itself, or, rather, the word "drone."

AMUKELE: When we say the word "drones," people think of things that fly over their heads and kill their children. That's not what we're talking about here. We're talking about small, unmanned flying systems. So we're talking about essentially a different way to transport goods.

GUPTA: That's a perception issue.

AMUKELE: It's a perception issue.

GUPTA: The next step is more testing. Tim estimates he will have trials up and running in the United States and abroad within the next six months.

That represents a future to you. Doesn't it?

AMUKELE: Yes, absolutely. Absolutely.

GUPTA: That's pretty neat.

In many ways the future is already here. That's the case for some kids at Children's Hospital in St. Louis, Missouri.

UNIDENTIFIED FEMALE: Hello, human companion.

GUPTA: Where a visit from Dr. Robot means a much-needed virtual escape beyond the hospital walls.


GUPTA: Past the dinosaurs, across the room, even on to the elevator, Celia the robot is becoming a familiar sight here at the St. Louis Science Center in Missouri.


UNIDENTIFIED FEMALE: It's a robot. [14:50:00] GUPTA: But perhaps what makes Celia so interesting is not

the fact that she's here. It is a science museum, after all.

UNIDENTIFIED FEMALE: It re-inflates. Isn't that cool?

GUPTA: It's why she's here. And to understand that, you need to meet Robert.

DEE EVANS, ROBERT'S MOTHER: He is a very easygoing kid. I mean, nothing bothers him. He just kind of goes with the flow. You know?

RANDALL EVANS, ROBERT'S FATHER: He liked outdoor stuff. Fishing and stuff. Me and him go fishing. Of course, his mom, too. And he liked to play ball. He loved playing ball.

GUPTA: Robert was a curious kid who loved being outside. So when he suddenly wasn't interested in doing that anymore, his mother knew something was wrong.

DEE EVANS: He just wasn't Robert. You know? He didn't go outside and play like he normally does. He'd kind of sat on the couch and watched TV. And -- just -- you know -- and he was kind of pale. He mentioned he had a little bit a headache. We said, well, OK, we better take you to the doctor.

GUPTA: Right after their doctor noticed Robert's spleen was enlarged, and a test revealed he had a white blood cell counter of 200,000. That's 20 times higher than normal. Robert was diagnosed with leukemia.

Robert was flown by helicopter to St. Louis Children's Hospital while he parents made the three-hour drive to meet him there. Robert started chemotherapy, and in the past three years, he's already had two bone marrow transplants. His little brother was the donor for both, and in just a few days Robert is having his third transplant. He's only 14 years old.

RANDALL EVANS: I think if he lives through this, it will change him in the future. He may not know it now, but he will when he grows up.

GUPTA: Remembering to enjoy life can sometimes be tough when you're stuck in the hospital for a long time. Robert's parents say he spent more time here in the last three years than at home, but today there's a special treat in store for him.

UNIDENTIFIED FEMALE: Hello, human companion. I am GNGKS. Please tell me your name.


GUPTA: This is Meccano.

UNIDENTIFIED FEMALE: It is customary to shake upon meeting a new acquaintance.

GUPTA: And this is Keith Miller, a professor at the University of Missouri, St. Louis. Here at the hospital, he's affectionately known at Dr. Robot. Celia, the robot cruising around the science center, was his idea.

KEITH MILLER, PROFESSOR, UNIVERSITY OF MISSOURI, ST. LOUIS: Robots have the kind of potential computers always had, but robots have this physical dimension. They can also go, they can move, they can have an effect in the world that computers, your PC just sitting there, can't have.

It's slotted here. So we -- pull it down.

I had never met Robert, and everyone I talked to said, Robert's a great guy. He's really smart, really quick, but he's real quiet. Don't take it personal. When that Meccano got going, he wanted to know how that robot worked. He lit up, and I love to see that.

GUPTA: Meccano is just a warm-up. The real aim for this visit is to get Robert out of this hospital room. He can't physically do that, but Keith found a way to do so virtually.

MILLER: We had just ordered these robots, and the robots, one of their selling points if a child is sick, the child can attend school using one of these robots. And I thought, whoa, there are a lot of sick kids in that children's hospital. Maybe we can get them hooked up for a virtual visit to the science center.

GUPTA: Keith's assistant Trey helps Robert set up a laptop.

UNIDENTIFIED MALE: Hello. Can you say hi?



UNIDENTIFIED MALE: Can you hear us all right?

GUPTA: In no time at all, Robert is virtually controlling the robot in the St. Louis museum center down the road.

UNIDENTIFIED MALE: So these guys over here are making parachutes.

GUPTA: He is driving it from the laptop. He can see what it sees through the camera. He can have conversations with people on the museum side, including his tour guide for today, Christian.

UNIDENTIFIED MALE: Let's head our way to the paleo-lab and see if we can find some dinosaurs.

UNIDENTIFIED FEMALE: Sodium chloride, lithium and copper, which one's your favorite? Which color?


UNIDENTIFIED FEMALE: The green. Yes. Yes. This copper is one of my favorites. MILLER: Even though we're just a few miles from where has robot is,

you could do this from here to Tokyo and it would have pretty much the same kind of effect. In fact, we're looking into that, is getting robots all over the place to talk to kids in lots of different hospitals.

GUPTA: On the museum end, kids at the Science Center noticed the robot, and come over to say hi.

UNIDENTIFIED MALE: Hi, Robert. My name is James.

[14:55:00] MILLER: They're making a connection. They're getting tied together. What a great use of technology, to get a kid who has to be at the hospital and a kid who's at the science center and they make a connection via the robot. How cool is that?

GUPTA: Robert via his robot travels through the Science Center, from the maker's lab --

UNIDENTIFIED MALE: Get this guy in there --

GUPTA: -- to the dinosaur exhibit and everywhere in between.

UNIDENTIFIED FEMALE: This is one of his brow horns. So this would have been right above his eye.

GUPTA: The entire time a smile, ear to ear, on Robert's face.

RANDALL EVANS: I noticed my son has lost his shyness.

UNIDENTIFIED FEMALE: This is one of the few opportunities I have found to have the kids be out of this place emotionally. Like, he's not here right now. He's not in that bed, not in the school room, one on one with an adult. He is out with those kids in the Science Center, being the coolest thing in the room, not the sick kid they feel sorry for.

GUPTA: Less than a week after we met Robert he had his third bone marrow transplant, and we're happy to report it's been a success so far.

From a patient's medical care to morale, it's clear that technology has a big role to play in the future of medicine. For "Vital Signs," I'm Dr. Sanjay Gupta.