Sally robot aids in continuity of care for children with neurodevelopmental disorders

The Health Services Authority's (HSA’s) state-of-the-art medical robot is already transforming the way the Authority’s clinical experts deliver care. An HSA psychiatrist utilizes the robot to provide continuity of care for her patients while she pursues a subspecialisation in neuropsychiatry overseas.

Dr Toni-Ann Heron, who began a one-year subspecialty training programme in Clinical Neuropsychiatry (MSc) at King’s College London in September, is using the next generation InTouch Health RP-Lite 4 telemedicine robot, nicknamed 'Sally', to continue providing care to some of her regular patients here in the Cayman Islands.

Dr Heron, who sees mainly children & adolescents, prepared the selected patients for the transition by discussing what the new teleconsultation format with the Sally robot would be like. “I explained that not a lot would have changed – our consultations would still be interactive and confidential, but I would be communicating with them remotely through a screen on the robot.”

She added that many of her patients and their families appreciated the convenience of this option. “Continuity of care is valuable and important to doctors and patients. When you have patients with whom you have built a therapeutic relationship it can be hard for them to have to switch to another doctor.

Dr Heron started her weekly clinics through Sally robot on 1 October. She described the experience for her and her patients as a fairly seamless transition and one that fascinated many of her younger, more tech-savvy visitors. “Children are now born into a very digital world, so the transition to a telemedicine platform has largely been intuitive for them.”

“Psychiatry is being able to foster that connection with the patient in which they feel they are in a private setting and are being listened to,” said Dr Heron. “This was very easy to replicate over Sally robot, even for the adolescents and older patients who experience anxiety and depression. It is comparable to our in-person meetings in my office. Patients and their families have given feedback that they feel comfortable and I have observed that they disclose as much as they usually would.”

Another benefit of using Sally robot is the ability to consult with physicians at the HSA, including a locum who is providing care to some of her patients, and engage in case conferences. “Multidisciplinary collaboration is at the core of paediatric psychiatry, and reflects the principle of holistic patient care through the application of biopsychosocial principles to management,” Dr Heron stated. “Multidisciplinary team meetings involve consultations with other professionals involved with the child’s care including other physicians, clinical/educational psychologists, therapists (eg ABA/occupational), school SENCOs (special education needs co-ordinators), teachers/other school staff and social workers.”

Dr Heron is expected to complete her training in September 2020 and return to the HSA as its first neuropsychiatrist.

“Neuropsychiatry is an interdisciplinary field of medicine, at the intersection of neurology and psychiatry which is critical the treatment of many persons in our modern society due to mental complications of head trauma, such as a motor vehicle accident. Neuropsychiatrists may be involved in the management of patients with a range of conditions including neurodevelopmental disorders, traumatic brain injury, epilepsy, autoimmune diseases with neuropsychiatric manifestations, functional neurological disorders, obsessive-compulsive disorder and neurodegenerative disorders e.g. Parkinson’s Disease and Alzheimer’s Disease.,” said Dr. Arline McGill, Head of Psychiatry & Behavioural Health Services at HSA. “I am elated that Dr Heron has taken the step to further her education is an area that will widen the spectrum of patients she sees, as well as significantly enhance the quality of care she provides to her patients.”