THE ROLE OF “ROBOTIC ASSISTED INTENSIVIST” AS SOLUTION OF RESOURCES MANAGEMENT IN COVID-19 PANDEMIC ERA

Providing expertise in the care of critically ill patients is one of the main needs of critical care medicine, especially in the COVID-19 pandemic era. This goal is particularly challenging, given the acknowledged shortage of intensive care specialists. We need the bedside nurse to have real-time access to get continuous reporting monitoring. The intensivist also has access to bed site examination at some time when they are not possible for coming to the intensive care unit (ICU). The big problems during COVID-19 are the limited personal protective equipment, the limited number of intensivist doctors, and the nature of the disease was very contagious and deadly. It is necessary to find a solution so as not to cause new problems, namely the death of medical staff and nurses due to frequent contact with Covid-19 patients. In this article, the author wants to open a view to getting solutions to problems in the field by presenting human replacement technology.


INTRODUCTION
One of the strategies in modern critical care is using information technology (IT).IT applications offer promise to improve patient care, clinician efficiency, and patient outcomes.Technology applications and initiatives are multiplying to stop the spread of disease, treat patients, and reduce pressure from overworked health care workers, as well as develop new effective vaccines, as the coronavirus disease 19 (COVID-19) pandemic develops.Digital information and technology surveillance has been launched in an unprecedented way to gather reliable data and evidence to support public health decision-making at a time when everyone needs better information, such as epidemic disease modelers, state authorities, international organizations, and people who were quarantined or maintaining social distancing.Artificial intelligence, robots, and drones are being deployed to help track disease and enforce restrictive measures; while scientists apply gene editing, synthetic biology, and nanotechnology in preparing and testing future vaccines, treatments and, diagnostics (1).
One of the COVID-19 managements in China that we have to learn is robot using to provide services and care for those quarantined or practicing social distancing.Robotics developers are responding quickly to public health concerns and needs and the pandemic has fast-tracked the 'testing' of robots and drones in public, with all stakeholders seeking the most expedient and safest way to grapple with the outbreak and limit its further spread.
Thinking about the use of robots in developing countries becomes a separate homework.Developing countries, for example, Indonesia needs to make innovation to save existing resources, one of which is human resources.The number of health professionals is not balanced by the number of cases in a pandemic situation.Therefore, this article tries to review some of the introductory literature that has discussed the use of medical assistant robots.

LITERATURE REVIEW COVID-19 and The Risk of Medical Staff
COVID-19 which started in China in December 2019 has spread rapidly to all parts of the world.This is because this disease is easily transmitted from human to human.Physical distancing is a major concern that must be done to prevent further transmission.This is of course very difficult for medical personnel to treat the patient because they must always be close together (2).
Some reports support that COVID-19 is also transmitted by humans to humans are reports that inform COVID-19 occurs in the family cluster (Wu et al., 2020).This disease can be transmitted through touch, droplets spread by coughing, sneezing, or talking face to face.In a small study conducted on women in their third trimester who were confirmed to be infected with the coronavirus disease, there was no evidence that there is the transmission from mother to child (3).
Highly sensitive laser beam scattering observations have revealed that loud noises can emit thousands of drops of oral liquid per second.In a closed and stagnant air environment, they disappear from the window of view with time constants in the range of 8 to 14 min, which corresponds to droplet nuclei of ca, with 4 μm diameter, or 12to 21-μm droplets before dehydration.So that normal speaking causes airborne virus transmission in confined environments (4).The research result by Stadnytskyi (2020) gives the information that the risk of transmission between patients and health care workers is a problem that must be prevented and overcome.The use of roboticassisted health workers is one alternative to prevent the risk of being infected.The other reason is to maintain existing human resources.The multidisciplinary collaboration was instrumental in the creation of robotic-assisted health workers.The role of education centers, companies, funders, and health workers is needed for the creation of appropriate robots.At the Institute of Technology Surabaya, 10 November has succeeded in creating several assisted health worker robots.This is stimulation for beginning to put technology in human activity.2007) reported that RP-7 decreased LOS and significantly decreased costs on a bariatric surgery service (7).Earlier discharge of patients enabled their institution to refill 60% of beds within 3 hours of discharge.The net financial benefit to their hospital was $370K per year per physician user.Petelin et al. (2007) reported that the earlier generation RP-6 robot was associated with decreased LOS and increased patient satisfaction in a community hospital setting.Hackensack University Medical Centre has embarked on a protocol to use the RP-7 in decreasing LOS with initial success, whereas the Ryder Trauma Centre in Miami has used the RP-7 to enhance both care and training in their trauma ICU (8).
If in a difficult situation attending presence is not available, the importance of time rounds is critical becomes even more essential.Communication between attending physicians and staff is enhanced when in this pandemic era.The previous article said that communication between attending physicians and staff is enhanced by RPT with the RP-7 robot was efficient (9).This data may be implicated in this pandemic that we stand in a difficult situation.The minimal amounts of professional staff face to huge amount of critical and infectious patients.

The Chance in Developing Country
One example of the use of robot technology in infectious disease services is robot-controlled non-contact ultraviolet (UV) surface disinfection.This robot is very helpful for disinfecting the surface area of tools in the COVID-19 treatment room because droplets that stick to the surface of objects can be a medium of transmission.Corona-viruses can persist on inanimate surfaces-including metal, glass, or plastic-for days, and UV light devices (such as PX-UV) are effective in reducing contamination on high-touch surfaces in hospitals (10).But, the safest UV length must be considered to protect the environment.
Another example of the use of robotic technology in health care is telepresence robots.This robot is useful for monitoring the patient's vital signs, triage, evaluate, monitor, and treat patients from a safe distance between health workers and patients.Besides, it can assist the health care system, maintain public health, and provide health services that are more effective and safer.This of course will reduce the burden on hospitals to pay for human labor and the risk of contracting infectious diseases (11)(12) (13) (14).Some of the obstacles to using robot technology for emergency health services and ICUs are the expensive price of robots, the use of robots is useful and the infrastructure capability of using robots is not yet scientifically proven.This is because it involves the shape of the building floor, doors, and others (15).
Available at https://e-journal.unair.ac.id/IJAR | DOI: 10.20473/ijar.V3I12021.34-38This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION Volume 3 (1), January 2021 : 34-38 Available at https://e-journal.unair.ac.id/IJAR | DOI: 10.20473/ijar.V3I12021.34-38This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License INDONESIAN JOURNAL OF ANESTHESIOLOGY AND REANIMATION Volume 3 (1), January 2021 : 34-38 Robotic Telepresence The use of remote presence has previously been described in the medical literature by multiple authors.Zhang et al. (2019) had made the telepresence Robot with a virtual reality head-mounted display (VR HMD) (5).Zhang, Hansen, and Minakata (2019) made a Comparison between gaze-and hand-controlled telepresence robots with a head-mounted display.The gaze interactive interface can serve a range of telerobots, including a modified wheelchair, a build yourself model (Parallax Arlo), and a thirdparty model (Padbot) (6).Vespa et al. credited RP-7 rounding for a more rapid response to critical situations in a neuro ICU.They also reported a 0.63-day decrease in LOS and an estimated $1.1 mol/L reduction in ICU cost through enhanced efficiency, coordination of care, and throughput.Gandsas et al. (