This presentation - given at the inaugural Arts Health Network Queensland 'Create, Connect, Collaborate' forum on 6 Oct 2018 - explores the promise and pitfalls of three technologies (apps, avatars and robots) posed to transform healthcare. It reflects on key ethical, cultural, social and political implications of the virtual information age for consumers, and healthcare educators, researchers and practitioners. It is built on this paper: Miller, E. & Polson D. (2019). Apps, avatars and robots: The future of mental healthcare. Issues in Mental Health Nursing. https://doi.org/10.1080/01612840.2018.1524535

1. Apps, Avatars & Robots –
THE FUTURE OF HEALTHCARE
Associate Professor Evonne Miller, Director QUT Design Lab
@evonnephd
Miller, E & Polson, D (2018) Apps, avatars and robots: The future of mental
healthcare. Issues in Mental Health Nursing, in press.

2. Image Source: Debut Art
What will cities, communities, homes, and hospitals
of the future look like?
the future…. ?
IMAGINE THE FUTURE – 2028?

3. Will robots be nurses, doctors or psychologists?
Credit: Fraunhofer
Institute for
Manufacturing
Engineering and
AutomationThe Care-
O-bot
Would you go to a robot to get a vaccination, or to diagnosis the flu –
or treat your broken arm or broken heart?

4. Will robots care for
older people or babies?
Is one more ‘acceptable’?
Source: goo.gl/vFDMPc; goo.gl/fG3Hk8

5. Image: Robots Exhibition – London Science Museum, 2017 - Evonne Miller
Will robots read the news?
(Kodomoroid, Japanese newsreader )

6. Will robots be our romantic partners?

7. The Future is NOW
We are living through the 4th Industrial Revolution
http://cutitronics.com/2018/02/22/dr-david-heath-the-fourth-industrial-revolution/

8. Example 1 - APPS
2 billion people use apps to collect, measure, track, display
& share data – most commonly health & fitness, the
QUANTFIED SELF movement

9. Apps Recommended by PainAustralia

10. 260,000+ mHealth apps (free & paid)
“your charming robot friend, here to help 24/7”.

11. Woebot

13. The rapid growth in apps, combined with no
regulation and limited evidence-based
research, means there is a
“chaotic mix of apps of varying degrees of
usefulness, quality, effectiveness and danger”
Hilty, D.M., Chan, S., Hwang, T., Wong, A. & Bauer, A. (2017). Advances in mobile mental health: opportunities
and implications for the spectrum of e-menatl health services. mHealth, 3, 34.

14. UNREGUATED MARKET PLACE

15. Our Care Journal
Co-Designed with
Brisbane Carers

16. @evonnephd

17. Example 2 - Avatars, augmented & virtual reality
Artificial intelligence: a task when performed by a program or a machine - we would say a
human doing the same task would have applied some aspect of intelligence (planning,
learning, reasoning, problem solving, social intelligence).
Narrow forms of AI: part of daily life - machines pre-programmed to perform a specific task
(eg voice recognition system on Siri)
VR - the use of 3D simulation technology (graphics, animation, speech recognition) to create
an immersive and engaging environment, accessed through headsets and goggles
Augmented Reality - a technology that superimposes a computer-generated image on a
user's view of the real world, creating a composite view.

18. Launched in October
2013, Dementia
Australia’s Virtual
Dementia
Experience™ is an
immersive, interactive
virtual reality
experience that
“invades the senses
and takes people into
the world of a person
living with dementia,
simulating thoughts,
fears and challenges”.
VR: immersive experience of what it might be
like to live with dementia

19. https://www.youtube.co
m/watch?v=PGYUqTvE6J
o
Programmed to respond
reassuring statements such
as: “if you want to tell me
more about it, I think I can
help you and your family” and
“Of course, we can meet again
. . . you see, I will always be
here to guide you to the help
you need, whenever you’re
ready”
SIM COACH –FOR US VETERANS
Helps tackle stigma of mental health help seeking. And limited resources

20. “What in the damn fucking shit is this? How much time,
energy, and money was waisted on this mutherfucking
shit? Veterans don't want a goddamn computer
program, we have problems that we need help with,
telling us to talk to a computer is dehumanizing and
humiliating” (Hoaggie Sammich, 2012).
not all supportive – annoyonmous online feedback

21. Example 3 – Social Robots

22. The Rise of the Robot Nurse - Sept 2018, IMT Newsletter - https://bit.ly/2P4sZ40

23. The Rise of the Robot Nurse - Sept 2018, IMT Newsletter - https://bit.ly/2P4sZ40

24. The robotic movement: What does ‘cyber-care’ look like?
CompanionshipChores /
Compliance
Care / Cuddles
How will technology will change care?
Would you trust a robot to look after you? Why / why not – & what tasks?

25. Wheel-I –Am
Virtual Art Gallery Visit –
NSW Feros Village
trip to Tweed Regional Museum
http://www.abc.net.au/news/2017-04-02/dementia-patients-look-to-new-technology-to-communicate/8406260
technology changing and enhancing aged care experience

26. http://www.dailytelegraph.com.au/newslocal/wentworth-courier/welcome-to-the-future--sydney-aged-care-and-retirement-village-first-in-australia-to-use-robots-for-rehabilitation/news-story/5d16194ebc8660be48326a65699ed447
https://theconversation.com/dancing-toward-better-physical-rehabilitation-79539?sa=pg1&sq=robotics&sr=2
robots for rehabilitation – yoga, exercises, dance

27. Participants interacting with
social robot during the trials -
- Rajiv Khosla; Khanh Nguyen;
Mei-Tai Chu; International
Journal of Human–Computer
Interaction. 2017, 33, 510-522

28. Matilda - designed to facilitate engagement and acceptability
Rajiv Khosla; Khanh Nguyen; Mei-Tai Chu; International Journal of Human–Computer Interaction. 2017, 33, 510-522
• 115 residents with
dementia, 2010-2013
• Only 2% concerned
• Detects mood … sends
email to relatives to
please come visit
La Trobe, Prof Rajiv Kholsa
‘dance, play, call out Bingo cards’
La Trobe, Prof Rajiv Kholsa
-

29. In 2013, ~$5000. Can respond to touch,
light, voice and temperature
Prof Wendy Moyle, Griffithhttps://zestdementiacare.com.au/shop/therapeutic-robots-paro/
Robo Pets – Paro (the seal)

30. http://www.boredpanda.com/retirement-home-shelter-cats/
Compare: live Animals (feeding foster kittens) to Paro
“live animals could get
tired or stressed and
were not necessarily
always liked by
residents” –
Paro popular for
people with dementia

31. Robots as Companions?
Images - insideagedcareproject.wordpress.com
One older participant felt a
“robot could be like a friend.
The person wouldn't have the
impression of being
completely alone…24 hours,
it's a long time when you're
alone” (Pino et al., 2015).
Interactions with a pet-like robot (Paro the seal)
reduced loneliness, systolic and diastolic blood
pressure for older aged care & hospital residents

32. Broadbent et al., 2011. Attitudes towards health-care robots in a retirement village. Australasian Journal on Ageing, 31(2)
Acceptability of Health-Care Robots – RV Residents, Staff, Family (NZ)
People see potential
for robots to be useful
• Detecting falls and calling for
help rated most useful robot task.
• Robot appearance must match
task performed.
• Concerned robots will take
away jobs and replace human care

33. 1. Objectification of older people as 'problems' to be
solved by technology
2. Potential for 'carebots' to enhance or restrict
capability, freedom, autonomy of older people being
cared for
3. Potential for 'carebots' to enhance or restrict
privacy of 'cared-for'
4. Quality of physical & psychological care ‘carebots’
can be expected to provide
5. Potential for ‘carebots’ to reduce levels of human
contact, be infantilizing or deceptive
Vallor, S. (2011). Carebots and caregivers: sustaining the ethical ideal of care in the 21st
century. Philosophy & Technology, 24, 254.
Tom Sorell & Heather Draper (2016). Robot carers, ethics and older people. Ethics &
information Technology, 16, 183-195.
‘CARE-BOTS’ - ETHICAL DEBATES AND CONSIDERATIONS FOR POPULATION AGEING

34. Context: Workforce – not always positive
UK – Daily Mail, Friday 7 July 2017

35. Context: Workforce
AU – ABC News. Family Hidden Camera Shows Staff Member Abusing Resident
http://www.abc.net.au/news/2016-07-25/secret-camera-captures-nursing-home-attempted-suffocation/7624770

36. Image Source: Debut Art
Cities, communities, homes, and hospitals
of the future.. Sparrow’s futurist nursing home?
the future…. ?
IMAGINE THE FUTURE – 2028?

37. Associate Professor
Evonne Miller
Director,
QUT Design Lab
@evonnephd