Drones in Health Care—A Flying Potential

Abstract

The application of unmanned aerial vehicles or drone use is increasing in all sectors including the field of health sector. Its use in the health sector can be broadly classified under Public health and Disaster Relief, Medical Transport, and Telemedicine. The advantages of the use of unmanned aerial vehicles or drones in health care are immense as they can reach inaccessible areas, decrease travel time, and are unmanned which makes them appropriate to be used in disasters. As the challenges of payload capacity, flying range, and cost-effectiveness are expected to be met in near future, they could prove to be flying potential for various sectors in health care.

INTRODUCTION

The use of drone technology goes back to World War I where it was used for military operations. Since then the application has undergone revolutionary change and now is widely being used in various sectors like defense, agriculture, and healthcare. The recent allocation by the Indian Government for drone technology marked a 72% increase from the previous year’s allocation and is a milestone toward leveraging drone technology for various sectors. This allocation reflects a commitment to bolstering India’s manufacturing capacity and fostering self-reliance—a key objective of the Atmanirbhar Bharat initiative. Besides, it strengthens the country’s mission of becoming the global drone hub by 2030.[1]

Apart from other sectors, the scope for the use of drone technology in the healthcare sector is immense. The COVID-19 pandemic further accelerated the use of this technology in this sector. During the pandemic, the technology was used for aerial surveillance for tracking gatherings, supply of essentials, spraying of disinfectants, and beyond. The technology has further come to light as it could play a vital role in the supply of medical products in challenging areas.[2] Drones also have the potential to reduce time for transportation and can be a potential innovative technology that can be used during disasters and emergencies.[3,4,5] As per Rosser et al.,[6] the use of drones in healthcare can be broadly categorized as: Public health and Disaster Relief, Medical Transport, and Telemedicine.

USES OF DRONE TECHNOLOGY

In public health and disaster relief

Drones have been used to carry out surveillance of disaster sites, assessing areas of disease outbreaks, and environmental changes. Many countries have adopted the use of drones to conduct assessments for impact after disaster. In Vietnam, UNDP has supported drone technology for disaster assessment.[7] Also, drones were used in rescue and relief operations during the Chamoli glacier burst at Uttarakhand, India, and supported the locust control operation in Rajasthan, India. The application of drones in disasters is vast. As per Moh d Daud et al.,[8] drone applications in disasters have been classified into four major categories; (1) mapping for disaster management, (2) search and rescue, (3) transportation, and (4) training.

Drones could also be used in Public health for epidemiological research. As unmanned aerial vehicles, they have the potential to provide real-time data and can update epidemiological data, especially in outbreaks. Drones have also been seen as a potential tool in control of zoonotic disease transmission. They can be effectively used for accurately conducting vector surveillance, assessing habitat suitability for larval and/or adult mosquitoes, and implementing interventions like dispersing biological control agents, chemical larvicides, Wolbachia-carrying mosquitoes, or sterile males.[9,10]

Medical transport

Drones have immense potential in medical transport as they are fast, can access difficult terrain, and also can bypass traffic. The use of unmanned systems has been tested way back in 2007 for the transport of HIV samples for testing.[11] In recent times, a pioneering initiative was carried out in the hilly terrain of North-East India which delivered about 20000 units of medical supplies (vaccines, tablets, syringes, glass bottles, PPE kits, gloves, etc.) to various hard-to-reach terrains of North-East India.[12]

In a study from Himachal Pradesh, India, which is a hilly terrain, transport of sputum via drone was performed for TB diagnosis and it was found to be more cost-effective compared to transport by motorbike (the per-flight cost was 0.72 dollars higher via motorbike) and played a pivotal role in the diagnosis of drug-resistant TB.[13]

Drones have also been used for delivery of other lab samples, reagents, and automated external defibrillators. The technology is shown to be beneficial for the transport of emergency drugs, vaccines, blood units in a short time period to hard-to-reach, and difficult areas. A study conducted by Amukele et al.[14] has shown that drone transportation systems are a viable option for the transportation of blood products and no adverse impact found on blood products when transported properly. Rwanda was the first country to successfully integrate drone services in health care at the national level. A drone delivery program also known as “Uber for blood” was launched in 2016 by the Rwandan president. Blood was delivered very quickly and efficiently and time was reduced from 4 h to 15–45 min.[15]

Transporting organs and tissues is difficult and requires a sophisticated network, including private charters, commercial aircraft, the green passage, transplant staff, and a network of couriers. The influence of transportation-related parameters, like cold ischemia time, on transplantation outcomes could be significantly reduced if they were made more effective, affordable, and quick.[16] The University of Maryland Medical Centre successfully performed a kidney transplant in April 2019 thanks to the first-ever delivery of a donated kidney by a specially designed drone.[17] Delivering life-saving medical supplies (such as tourniquets, bandages, and analgesics) in a simulated harsh environment where foot or vehicle access is impractical or impossible has been proven to be successful with drones.

It has also been shown that drone transport does not affect the accuracy of routine biochemistry, hematology, and coagulation test results.[18]

Telemedicine

Drones can be equipped with communication devices and cameras and act as a telemedicine communicator particularly for use in emergency, inaccessible areas. Nedelea et al.[19] have shown the Telemedicine System Applicability Using Drones in Pandemic Emergency Medical Situations. Drones are helpful in providing an instant telecommunication infrastructure and could provide communications and a platform for telementoring to remote areas.

Although the uses have been discussed under the three broad categories, the use of this technology is not limited to these, it can further enhance as new innovations are made and challenges are overcome.

Potential and challenges

Drone technology has its own strengths, challenges, and barriers. Drones can reach inaccessible areas, decrease travel time and as they are unmanned they can be used for surveillance in disease outbreaks without posing any risk for transmission to workers. Their immense potential in public health emergencies, surveillance activities, and transport of essential and life-saving drugs, and instruments needs to be harnessed.

Although the technology has many benefits and great potential, there are some drawbacks as well. For example, it requires trained manpower, a valid pilot license to operate it, regulatory and air traffic control clearance, and the assurance of drone safety.

Trade-offs between cargo capacity, performance parameters like speed and maximum range, and costs must be carefully evaluated because drones need to be able to fly to their intended locations in inclement weather (such as wind, rain, snow, or fog). Furthermore, drones are vulnerable to hijacking and are not as safe as many people think. Strong encryption, cautious passphrase changes, rigorous product evaluation, and good air traffic control management are therefore necessary to thwart potential attacks. Drones that malfunction have the potential to be hazardous. There have also been other well-known drone accidents reported worldwide.[20,21]

Many countries have come up with drone regulatory and operational guidelines. Indian Council of Medical Research, India has already come out with an extensive guidance document for the use of drones in the healthcare system in India.[22]

The Document covers the following areas:

1. Taking regulatory approval

2. Selecting the appropriate drone model and suitable area for take-off and landing

3. Highlighting the type of various medical supplies and guidelines on how they can be transported

4. Human resources required and training of the operator

5. Data recording and management

6. Handling of unforeseen events in the field

CONCLUSION

As the cost-effectiveness, payload capacity, and flying range by drone is expected to increase in the future, drone applications will become an indispensable tool in healthcare sector. The technology has to be incorporated after taking into consideration regulatory compliance and needs to be slowly integrated into healthcare systems, without posing risks. As the world continues to invest in innovation and technology, the widespread adoption of drones is poised to bring about profound positive changes and drones could act as a flying potential for medical systems.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.