The once-futuristic notion of robots helping patients is now a reality in several hospitals and clinics in Saskatchewan.
There are 11 medical robots and portable devices in clinical practice in the province, more than anywhere else in Canada.
Dr. Ivar Mendez, a Saskatoon neurosurgeon, is pioneering the clinical use of remote presence technology. This innovation uses an ordinary cell phone connection to video-link specialists with patients so they can perform real-time diagnosis and monitoring.
Mendez started testing robotic medicine in Nova Scotia as well as Newfoundland and Labrador, prior to expanding the technology's use in Saskatchewan after arriving at the University of Saskatchewan in 2013.
There are currently five robots, roughly 1.5 metres tall, and six portable devices about the size of a briefcase called "doctor in a box."
The implications of this go far beyond traditional telehealth.
Physicians can use smartphones to remotely control a robot and interact via video-link with a patient. But, more importantly, the doctor — with assistance — can connect diagnostic equipment such as stethoscopes, ultrasounds, and electocardiagrams to see, touch and hear the patient.
"This is going to revolutionize the way we deliver health care, not only in Canada but in the rest of the world," Dr. Ivar Mendez told CBC News.
Here are 5 ways it's already happening:
1. Robot on reserve
A robot named Rosie is stationed in the First Nations community of Pelican Narrows, Sask., a six-hour drive northeast of Saskatoon.
CBC News visited the remote medical clinic to capture a virtual appointment on camera. In the above video, watch Saskatoon physician Dr. Tanya Holt take control of Rosie to examine a critically ill toddler on the remote reserve.
If it weren't for this technology, an ambulance or airlift would have taken the 11-month-old boy to a larger centre.
Sick or injured people in Pelican Narrows are forced to make thousands of exhausting and expensive publicly-funded trips out of the community. Last year, there were 750 emergency medical evacuations and another 5,000 patient transfers to cities such as Prince Albert, Sask. or Saskatoon to see specialists, get tests or receive dialysis.
The provincial government is paying for this $250,000 pilot project in partnership with Peter Ballantyne Cree Nation.
In 2010, Dr. Mendez ran a similar pilot project in an Inuit village in Labrador that showed the technology led to a 60-per-cent reduction in medical evacuations.
2. Ambulances using 'doctor in a box'
When a person is seriously injured in a car crash on the highway, emergency room physicians must wait for that patient to arrive at the hospital to perform scans and determine treatment.
Now, a pilot project has trained 12 paramedics and eight emergency room physicians at the Royal University Hospital in Saskatoon how to use the "doctor in a box" while in transport.
The doctor can tele-stream into the ambulance, see the patient, advise the paramedic and conduct an ultrasound before the ambulance arrives at the hospital.
3. Robotic house calls for HIV patients
This is a high-tech version of the traditional country doctor house call.
A nurse in the North Battleford, Sask. area can visit HIV patients at home or set up a mobile clinic that features the portable doctor-in-a-box. This connects those patients with an infectious disease specialist in Regina, Dr. Stuart Skinner, who can speak to the patients and perform diagnostic tests.
"If all is needed is a medication review or check, we can do that remotely rather than have the patient travel three hours each way for what amounts to a 10 to 15-minute visit," Skinner said.
4. Surgical rounds
When Dr. Mendez, the neurosurgeon, goes to a conference in Regina or Toronto, he can still perform his morning rounds or supervise a surgery using a robot stationed at the Royal University Hospital.
Mendez can activate the robot from his smart phone and, with assistance from hospital staff, perform diagnostic tests on patients.
There are two robots in Royal University Hospital and one in Regina General Hospital.
5. Humanitarian work around the world
Dr. Mendez practises humanitarian medical care with a "doctor in a box" in his birth country of Bolivia.
A trained worker in Bolivia carried the portable device to a remote village in the Andes to connect a young boy with pediatric specialists in Canada.
According to Mendez, the boy, Johnny Quispe, was ostracized in his community and unable to attend school because of a rare skin condition that looks similar fish scales.
Using remote presence technology, specialists used microscopes and diagnosed the boy with a condition known as hereditary ichthyosis. The specialists sent a medical skin cream to the remote village and the Quispe's condition has improved.
Mendez also runs a program that gives prenatal exams and ultrasounds on pregnant women in that region.
Barriers in current health care system
These pilot projects are testing everything from cost savings to patient satisfaction.
However, Mendez said expanding the use of remote presence technology will challenge policy-makers to redesign the system. The ability to connect doctors and patients in different regions, and across borders, will require a new system of oversight and physician billing.