Can UAVs Lead to Better Healthcare Outcomes?

In Milan, Italy, a group of researchers at IRCCS Ospedale San Raffaele Advanced Technology in Health and Wellbeing, including Sara de Silvestri, Mirco Pagliarani, Filippo Tomasello, Diana Trojaniello, and led by Alberto Sanna, conducted a study to explore the potential for drones to deliver pharmaceuticals.

The study, published by MDPI in March 2022, was part of Flying Forward 2020, “a three-year collaborative research project that will develop a new Urban Air Mobility (UAM) ecosystem aligned with the Digital Government Transformation (DGT) of European countries, which focuses on incorporating Urban Air Mobility within the geospatial data infrastructure of cities.”

The study was prompted by the realization that, under existing standard hospital procedures worldwide, pharmaceuticals rely heavily on people for internal delivery of what is known in other services, such as package delivery, as “last-mile” services. Logistical problems, such as traffic jams en route, may cause inefficiencies in getting critical supplies, including pharmaceuticals, to healthcare professionals and the patients needing them for treatment. The use of drones internally in a hospital may increase efficiencies. There were risks, such as tampering with the delivery container, but those risks could be mitigated, the researchers determined, by using tamper-evident seals or mechatronic locks.

The main users detailed their challenges through a series of semi-structured interviews and visualization materials provided by the researchers. The advancements in urban air mobility underway in the EU, the digital ecosystem being developed by aviation and non-aviation, were then overlaid onto the healthcare systems’ needs. Based on the results of the respondents’ replies, a drone service was designed and validated with the primary users. What emerged was that the biggest benefit of such a service would be increasing hospital logistics efficiency.

The information required by the digital system offering the needed logistics functions was analyzed for future development. Recent conceptual and regulatory advancements in urban air mobility (UAM) in the European Union were elaborated to outline the digital ecosystem allowing aviation and non-aviation operators to exchange information, thus ensuring the operations’ efficiency, safety, and regulatory compliance.

While much of the research in urban and advanced air mobility has focused on external applications – such as personal transportation, infrastructure, agricultural, and military use, little, if any, thought, has been given to the potential for increasing efficiencies in healthcare by improving the efficiencies within a hospital using unmanned aerial vehicles (UAVs).

The design process they authors developed included five key elements to inform their work: the solution would be user-centric; it would include the consumers and relevant stakeholders experience and sentiments to guide the design process; the service would be segmented into critical junctures and sequencing; the use of visualization to help users and consumers better understand how the system might operate; and applying a holistic, end-to-end process to ensure a deep understanding of system as a whole.

Pharmaceuticals on the Fly

The research addressed three subjects: current hospital drug distribution processes, understanding the state of the industry regarding UAV technologies in commercial and medical logistics, and the current EU and international operational and regulatory guidelines under consideration for UAVs to support safety and scalability.

To gain perspective on the “as-is” method for pharmaceutical delivery and to inform the outcome of an “aspirational,” more-efficient pharmaceutical delivery system, the study consulted pharmaceutical staff and members of the operative units where pharmaceuticals are currently delivered. The study also developed a hierarchy of key performance indicators (KPIs). The KPIs would measure responsiveness (on-time delivery), which was divided into preparation time and transport time. A third metric, “resolution time,” was added to measure the time needed to allow the system to respond to the following order having fulfilled any given assignment.

In the current study, ‘responsiveness (on-time delivery)’ was subdivided in ‘preparation time’ and ‘transport time’ to address the specificity of the investigated scenarios. Responsiveness is a measure of the overall time from the start (i.e., intention of submitting an order) to the availability of the ordered products for the OU that made the request. Preparation time is measured from the start to the loading of the cargo. Transport time is the time employed to move the products from the pharmacy to the OU. Resolution time was added by the current study to measure the period needed in order to be able to respond to the next request of the same kind with the same resources after the previous order was fulfilled. This measure has no influence on the single delivery, but it is useful to assess the continuity of the running service.

Two options present themselves for a hospital to implement and operate the drone delivery service: the hospital can contract with a commercial (for-profit) drone operator or it can employ its own staff. Each option has benefits and costs. Using an external drone operator, the legal, regulatory, compliance, and safety responsibilities fall to the contractor. By bringing the service in-house, a hospital would need to add staff: a fleet manager to allocate resources and remote pilots to operate the drones. Delivery routes could be pre-installed or could make use of artificial intelligence (AI) software to make routing decisions and prioritize deliveries. Once the pharmaceuticals have been delivered, the UAVs could be programmed to return to the pharmacy warehouse – ideally, a single vertiport.

Healthcare: Elevated, Automated, and More Efficient

While significant technological and regulatory challenges remain to implement a drone-based pharmaceutical delivery system in hospitals – many of which are not yet fully known – the main benefit such a system would provide is better healthcare outcomes by increasing efficiency.

Pharmaceutical delivery by UAVs, however, pose substantial technological and regulatory challenges which need to be addressed before implementation. By coordinating their research and development efforts, and, by sharing their experience in the U-space, hospitals and UAV operators can more quickly realize the potential benefits and mitigate the risks involved in pharmaceutical delivery to achieve the optimal healthcare outcomes.