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Can Robots Put the Sexy Back in Primary Health Care?

How would you feel about seeking medical care from your local community health robot?Two articles in Sunday’s New York Times got me thinking. First Louise Aronson’s op-ed, The Future of Robot Caregivers, asked me to consider a whole new group of health care providers: robots.Aronson does not pose some way-out futurist idea; she lists specific probabilities of our imminent future when robots will be taking our temperatures and bringing us our meds. In Japan, robots are already employed to support the needs of aging adults. We see robotics used in surgery, but we don’t often think of robots as part of a team of health workers or as partners in providing community outreach.As professionals who study health systems, my colleagues and I at IntraHealth International are continuously seeking better ways to meet the growing health demands of our expanding populations and aging communities with the limited human and financial resources available. We advocate for a stronger health workforce that is present, ready, connected, and safe to maximize access and ensure the highest quality of care. We are exploring how physicians and nurses can team up with less highly-skilled cadres and community health workers to improve care and expand high-quality services.Also on Sunday, in Bottlenecks to Training Doctors, the New York Times Editorial Board pointed out why our work is so important—and so challenging. But money doesn’t flow so easily to the nuts and bolts of primary health care, even though primary health care systems and primary care providers are what make it all work.Primary Health Care Isn’t SexyVenture capital toward new medications may bring miracle cures and large financial returns. Government investments in a shiny new tertiary hospital demonstrate to constituents the great achievements of their ministry or department of health.But investing in health workers who work on the front lines puts resources into that unseen backend of the system. That backend has to be strong for the whole system to work, but it receives little recognition and even less support, because longer-term investments can’t promise immediate gratification. It’s like saving for a beautiful, new swimming pool only to have your plumbing system burst. You don’t forge ahead with digging your new pool. Now you will spend those savings underneath the house with nothing seemingly to show for it, and certainly not a pool party!Or think about putting aside just enough money to fix the dents and scratches on your 10-year-old car, only to find out it needs new timing belts and brake pads.That’s what it is like to work in my field. I am always advocating for plumbing and brake pads, but competing with swimming pools and new paint. My work is definitely not sexy. But now I’ve got robots. That changes the playing field.At IntraHealth, we have a very innovative informatics team. We developed the mSakhi mobile phone application for community health workers to bring better primary health care into homes and neighborhoods.We created an interactive voice response program that helps nurses and midwives use basic mobile phones to update their training in family planning, and we help governments and health facilities take control of their personnel data with our iHRIS suite of human resource information systems.I don’t think we’ve begun on robots yet. But it won’t be long.Maybe robots will become part of the health workforce, standing side-by-side with nurses and community health workers. Maybe they’ll be the new face of that backbone of primary health care.This week, IntraHealth International participated in a meeting in Toronto, hosted by the World Bank and the International Council of Nurses. Our goal was to explore policies that will open those bottlenecks to better primary health care and to see how nurses can help move that policy agenda forward.  Maybe we can get the robots involved, too. If it takes robots to turn attention to nurses, community health workers, and other primary care providers, I say bring them on!