Drones could be the next medical emergency workers

Drones have many uses, from movie making to a variety of military capabilities to agriculture. Now, drones are entering a new domain as medical emergency vehicles -- just in time for a global pandemic.

In research presented Monday at the Endocrine Society's virtual ENDO 2020 conference, an international team of researchers showed how an ordinary drone could be used to safely deliver insulin to patients across a 12-mile stretch of ocean off the coast of Ireland. The success of this first-of-its-kind insulin delivery shows how useful drone technology could be during disasters.

"We now have the drone technology and protocols in place to deliver diabetes medications and supplies in an actual disaster if needed," the project's principal investigator and a consultant endocrinologist at the National University of Ireland Galway, Derek O'Keeffe, said in a statement. "This is a milestone in improving patient care."

O'Keeffe tells Inverse that medications are the ideal cargo for drones because of their "low weight and high value."

The authors write that this project was originally conceptualized as a response to a tragedy experienced by Ireland between the fall of 2017 and winter of 2018. During that time, the island was hit first by a category three hurricane and then a devastating blizzard only months later. The authors say that the combined brunt of these natural disasters kept people stuck in their homes and unable to access medications like insulin.

To prevent a repeat of that medical strife, the team began working on a way to ensure medicine could still be delivered to remote parts of the country, such as the Aran Islands, during a disaster. But planning an autonomous voyage across 20 km (roughly 12 miles) of ocean while carrying a sensitive package like insulin is easier said than done, a co-author on the study and assistant professor of internal medicine at the University of Arkansas, Spyridoula Maraka, said in a statement.

"Insulin can be outside the fridge for hours, but it can't be exposed to extreme heat, so we put it in an insulated parcel with temperature monitoring en route," Maraka said. "We also put a security lock on the parcel in case the drone did not arrive at the right place."

The team also spent over a year ironing out regulatory logistics, such as having a pharmacist receive and dispense the insulin, before the drone could finally take flight on September 13th, 2019.

"It was the full circle of care."

"We definitely faced multiple challenges during this project, which we overcame by assembling a multi-disciplinary team of experts," Maraka tells Inverse. "For example, we had to make sure that we comply with the Medication Dispensing Legislation; for this we partnered with AllCare Pharmacy in Ireland (equivalent of Walgreens or CVS in the United States) that ensured that the medications that the drone transferred were actually dispensed by a pharmacist. Another example is that we had to ensure real time connectivity of the Drone with the land. Thus, we worked with Vodafone Ireland who modified their antennas so we can ensure uninterrupted 4G signal up to 130 m on the air."

Another first for this study: on its return journey, the drone was able to bring back a glucose sample for testing.

"We wanted to find a way to monitor glycemic control remotely," said Maraka. "It was the full circle of care, which has not been done by drone before."

This project now joins other successful medical drone projects like the U.S. operated company Zipline which has been delivering vaccines, blood, and medical products in Rwanda and Ghana for several years.

Zipline tells Inverse that the company is already working to accommodate the medical burden imposed by COVID-19, and Maraka tells Inverse that the model in their study could also offer another avenue for delivery of future vaccines, tests, and medical supplies during this time.

"The one thing that is important to remember is that drones could be used when traditional modes of medical care delivery are disrupted," Maraka tells Inverse. "For example, during a state lockdown, drones could be used to deliver medications to quarantined patients or critical supplies to hospitals."

Abstract: Unmanned aerial vehicles (UAVs) or drones have become ubiquitous in modern society, predominantly as recreational tools (e.g. racing, photography). However, their use to transport medical products is still nascent, with the best examples seen in emerging economies with underdeveloped infrastructure due to local terrain such as East African jungles or the South Pacific islands. A case in point is the drone operator Zipline, which has pioneered the delivery of blood products in Rwanda since 2016.1 Therefore UAVs have potential in disaster relief operations where there is often significant disruption of health systems [2]. After Ireland experienced Storm Ophelia (Cat 3 Hurricane) in 2017 and then Storm Emma (Winter Blizzard) in 2018, many of our patients with Diabetes had issues with insulin supplies as they remained housebound due to subsequent flooding/snowdrifts. Diabetes Mellitus is one of the world’s most common chronic diseases with approximately 400 million people affected. Insulin is often needed to achieve and maintain glycemic control and therefore is considered a lifesaving medication for patients with diabetes.3 Consequently, in order to ensure an adequate insulin supply method for patients, after a sentinel weather event, we developed a UAV delivery solution using a vertical take-off and landing (VTOL) Wingcopter 178 drone which we operated under beyond visual line of sight (BVLOS) conditions. After a lengthy planning process, we ensured compliance with all Irish (European) Aviation Aerospace regulations. In addition we complied with regulations surrounding the dispensing of prescribed fridge medications. We had our maiden flight on September 13, 2019 from Galway, Ireland to the Aran Islands (20Km each way) delivering insulin from the pharmacist to the patient’s clinician. This represents the first documented autonomous delivery of insulin for a patient with diabetes.

This article has been updated to include corrected information and comment from Zipline.