Robots in the Healthcare Sector Care Robots Rethought, Free from Hype

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Robots and artificial intelligence in the care sector are an often-touted future scenario, but often fail in practice. Which technologies are actually useful and desirable for care? Researchers from Vienna and Linz are working with care staff and care home residents to find answers and develop practical prototypes.

'Robear' was one and a half meters tall, weighed 309 pounds and had a cute bear face. The care robot developed in 2015 was intended to lift care home residents, but never made it past the prototype phase. The more compact lifting robot 'Hug' also failed tests in Japanese care homes. Both products were time-consuming, awkward to move and the lifting process was uncomfortable for many residents.

Questioning the Role of Technology

Robear and Hug are representative of the disappointed expectations placed in robots and artificial intelligence (AI) in view of the ageing population and the shortage of nursing staff. "The fact that they have not yet become established in practice is largely due to the fact that the complexity of care is massively underestimated when designing the technology," says Laura Vogel, PhD student at the Department of Ergonomics and Organization at TU Wien. "The idea of simply setting up a device that then solves problems falls short of the mark."

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Vogel's colleague Reinhard Kletter, a doctoral student at the Institute of Management Sciences at Vienna University of Technology, is a robotics expert and has seen care robot prototypes come and go: "Technology often looks great on paper. But if it doesn't meet the day-to-day requirements and values of care, it's a waste of effort. With many solutions, the cost of implementation and maintenance is currently underestimated. The result is frequent software updates that shift costs and work to the IT area instead of saving them," emphasizes Vogel.

User-oriented research, on the other hand, attempts to place the needs of the care facility at the center of product development. This is often based on a specific technology with the aim of applying it to the care context.

Participation And Dialog

In the transdisciplinary project 'Caring robots // Robots in care', Laura Vogel, Reinhard Kletter and other researchers from the fields of computer science, robotics and social sciences are taking a step back: "Together with carers and people receiving care, we asked what roles are desirable and useful for robots and artificial intelligence in the care context," says Kletter.

In order to understand the needs and challenges in the care sector, Vogel and other social scientists interviewed care staff and systematically observed their day-to-day work. In addition, the project team organized a series of workshops with care staff and residents in Caritas care homes. "The aim was to learn from each other: first, we presented the technical background to AI and robotics: how do robots 'see', how can you talk to machines using language models, and what possibilities does this open up?" explains Kletter.

Finally, together with the workshop participants, the researchers collected wishes and ideas for application in the care context. Building on this, Kletter and his colleagues from the fields of computer science, electrical engineering and robotics are currently developing several prototypes.

Language Models Instead of Robots?

"For many desired applications, it turns out that a robot with a body is not necessary at all," concludes Kletter. Nursing staff are hoping for support with documentation in particular. The scientist has therefore developed AI assistance software that is currently being tested and continuously improved. The idea: care staff wear a small clip-on microphone that records conversations during care activities. "This is important because even small talk can contain care-relevant information," says the researcher. With the help of speech recognition and large language models, care-relevant information is subsequently extracted and a structured report is created that can be used for care documentation. In addition, the researchers are using another prototype ('Calls of Care', see graphic) to test how language models can be used for conversational animation and biography work in a meaningful way, especially for people with dementia.

Value-Oriented Technology

It is not enough for care technology to be functional. It must also be in harmony with ethical care values. In his doctoral thesis, Reinhard Kletter specialized in the issue of privacy, which is particularly important to residents and caregivers: "Privacy must be considered in the design right from the start. It's not just about data protection, but also about ensuring that an aid does not change the interaction between the caregiver and the resident." In the case of the AI documentation aid, only the transcript with the care-relevant information is retained, while the audio file is deleted directly. The mere possibility that the technology can also be used for monitoring is a problem and requires clear communication and transparency.

Care Quality First, Hype Second

The aspect of privacy shows how new technology can change the social structure in the work context, says Laura Vogel. She is currently particularly concerned with the effects on the professional self-image of care staff: "Technology should create added value, i.e. make work easier or strengthen skills, instead of degrading care staff—for example, if they have to clean up after a machine and ultimately spend less time on care." The autonomy and participation of nurses must be maintained in all care processes, adds Kletter, who therefore wants to incorporate 'human in the loop' steps into AI-supported care documentation.

Many of the wishes expressed in the discussions—such as for a robot that cooks together with residents—reflect a fundamental tension, according to Vogel: "Care should be time-efficient, but ideally holistic and person-centered at the same time. I don't think this conflict of objectives will be resolved if machines divide the work into many small automated steps." When it comes to the question of what the care of the future should look like, we as a society should critically scrutinize the advantages and disadvantages of AI and robotics—free from hype and blind faith in technology.

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