July ‘Madra’ the robot and drones deliver emergency medicine on Mayo island in successful remote health project

The project on Clare Island, Co Mayo aims to become a template for telemedicine in other rural parts of the country

This article was originally published by Áine Ryan in the Irish Times on Tue Jun 27 - read it here

An island off Co Mayo has proven to be the perfect laboratory for rolling out a €1 million remote health project which aims to become a template for telemedicine in other rural parts of the country.

Academics, healthcare professionals and some politicians braved rough seas on Tuesday morning to be treated to drone and robotic demonstrations at a conference marking the success so far of the Clare Island Home Health Project.

The Robot called ‘Madra’ proved particularly popular as it delivered emergency medicines whilst a drone demonstration showed how efficiently an epipen could be delivered to the island.

The medical simulation on Tuesday was the delivery of an epipen from the island’s medical centre to an emergency anaphylaxis situation. Madra brought a first aid kit up through mountains terrain at Capnagower to a patient.

Over 80 islanders, aged from 18 to 90, have already signed up to the project, which began in September 2022.

The brainchild of Professor Derek O’Keefe, a physicianeer (physician and engineer), who is attached to the University of Galway, the project is funded through a public-private partnership led by global technology company Cisco and CÚRAM, the Science Foundation of Ireland Research Centre for Medical Devices at the University of Galway, in partnership with the HSE.

“Through our Health Innovation via Engineering (HIVE) laboratory in the university we have produced a patient-centred solution towards democratising clinical access and care. One of the major challenges for patients here in the West and beyond is the long distances people have to travel to access care, so new ways of delivering healthcare are necessary. The engagement of the islanders with the project has been key to the project’s success so far, “ Prof O’Keeffe says.

The HIVE lab delivered insulin from Galway to Inis Mór by drone in 2019, confirms Prof O’Keeffe.

For islander and project manager, Dr Ian McCabe, his experience of remote working from the island during the pandemic for the School of Physics at the University of Galway proved an invaluable experience, informing the practical and strategic approach for the everyday development of the project. Coincidentally, his late grandmother moved to the island from Co Galway’s Inishbofin in 1939 to oversee communications with the outside world through morse code skills – the remote form of communication with the outside world at the time.

“Cisco wanted to test the bounds of what was possible for healthcare in a remote location and through proactive engagement with the former development coordinator here on the island, we were chosen,” McCabe explains.

Welcoming both visitors and locals to the island’s community centre, McCabe praised the excellent service already provided by the two resident island nurses, Margaret O’Grady and Mary Murray, as well as GP, Dr Noreen Lineen- Curtis. She travels by sea from Achill each week for clinics, as her father did too for many decades.

Addressing the gathering, Dr Lineen-Curtis observed: “This is the next dimension of remote GP care. You could say that we were already successfully providing remote care as I live on Achill Island and have a weekly clinic here. However, I would have often have made a diagnosis over the phone, to one of the two marvellous resident nurses on Clare, based on a photo of an ECG or a wound. The next step might have been requesting a Coastguard helicopter or the lifeboat.”

The platform for the technologies available at the health hub is delivered through Irish company MyPatientSpace software. It includes the facilitation of clinical consultations with dual screen videos, remote patient monitoring and an Artificial Intelligence algorithm which actively triages the level of urgency for an outpatient appointment.

Project participants wear Withings Pulse HR watches which allows them monitor aspects of their daily activities and heart-health. This information is downloaded to tablets they have been given for further analysis.

Dr Lineen-Curtis cited a typical example of a possible cardiac arrhythmia event picked up through the monitoring process but which easily could be overlooked if a patient just presented at A & E.

Islander, Jack Pinder (23) graduated with a social science degree from the University of Galway in 2022 and is delighted to be in a position to live at home and work on the project.

“I can already see such a change in people’s attitude to health on the island,” Islander Jack Pinder who works on the project told The Irish Times.

“I even came out of Mass the last day and some of the older farmers were standing chatting at the wall, as they always do, but they were chatting about their step-counts.”

He started engaging with islanders last year thorough the community newsletter, the WhatsApp group and house visits.

“There has been such a positive reaction to it. I can already see such a change in people’s attitude to health on the island,” Pinder told The Irish Times.

“I even came out of Mass the last day and some of the older farmers were standing chatting at the wall, as they always do, but they were chatting about their step-counts. One of them was saying: ‘Well, I haven’t gone out after the sheep yet and that will bring it up for the day’.”

Unsurprisingly, island representatives from along the coast attended the conference.

John Walsh, of Co Cork’s Bere Island said: “It is really good to see that this service augments, and isn’t replacing, the existing service offered by nurses and doctors. Islanders would not just want technology alone. However, the drone technology will really provide a vital addition.”

Brian Jordan, Cisco’s lead for Ireland’s Country Digital Acceleration programme, said: “Meeting people here on the island today really shows how their journey, as patients, has been fundamentally changed for the better.” He praised the HSE’s innovative approach and the Western Development Commission for the key roles they played.