El polémico plan de Alabama: usar robots para atención materna en zonas rurales

This is science fiction, but Alabama authorities’ plan to use robots to help embarazada children and their babies in rural areas is real.

During a lengthy stint at the White House in January, while announcing the first funds from the new $50 billion federal rural health program, Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS), called the idea “brilliant.”

That same day, Sen. Bernie Sanders, an independent from Vermont, said there was nothing great about it. Obstetras and other medical professionals have also expressed concern about social media, and one political activist called it “a distópica horror story.”

The reactions encountered reflect the clash between the enthusiasm of technology professionals who are pleading with states for the Rural Health Transformation Agenda and the reality: There are simply not enough health care workers to care for patients in many rural communities. Now that states are beginning to reverse first-year funding, tensions are growing, particularly in Alabama.

Oz discussed the property of the inverter state in the newest robotic ultrasound technology.

“A lot of states in Alabama don’t have obstetric doctors,” Oz said during a meeting with President Donald Trump and other government officials. The question of attention, explained, was what motivated the proposal to use robots to perform ultrasound scans on embarazada women.

Britta Cedergren, director of the Red de Calidad Perinatal de Alabama (Alabama Perinatal Quality Collaborative), made it clear what is happening: “Nadie usa autonomous robots.”

Although robotic ultrasounds are considered “a very interesting technology”, it is explained that they are still not used in the state. In exchange, health professionals are turning to telephone consultations to provide obstetrical attention and, when they have equipment and Internet available, to telemedicine.

The goal, it is said, is “to bring places where there is no medical attention.”

Cedergren participates in various state maternal-fetal health groups, and works daily with physicians, hospitals and emergency personnel. While we recognize the importance of improving technology, we emphasize that it should not replace the need for a well-skilled workforce or a well-coordinated system of attention and data.

In 2024, the most recent year with available data, Alabama’s infant mortality burden was 7.1 deaths per 1,000 people with living deaths. Nationally, the rate was 5.5 for every 1,000 people alive, according to preliminary data from the Centers for Disease Control and Prevention (CDC).

The circle of hospital obstetricians — which involves the loss of providers capable of caring for pregnant women and their babies — is a big data trend in rural areas of the United States. But in Alabama, the losses were particularly severe.

In 1980, 45 of the state’s 55 rural condos operated obstetric and hospital services. By 2025, only 15 will offer this type of attention, according to state data. And the trend is not established: five obstetric units will take place between 2023 and 2024, including the three rural districts: Monroe, Marengo and Clarke.

Katy Backes Kozhimannil, a professor at the University of Minnesota School of Public Health, found that occupations in remote areas are linked to premature births, a leading cause of infant mortality.

“Seguirá habiendo embarazos y partos en nuestra comunidades,” he said. “Necesitamos lugares donde proporcionar atención medica”.

All states include in their requests the Rural Health Transformation Program, the issue of the personal doctor and maternal health as priorities. But only Alabama proposes using robots to cover this need. The rural fund, created by Congress as a last-minute incentive as part of President Trump’s One Big Beautiful Bill Act, has helped states be creators, innovators and showcase technology solutions.

Alabama will be allocated $203 million for the first year of this five-year program. Meanwhile, a doctrine of initiatives to improve rural health, the concern of the state includes strengthening your rural work force and improving maternal and fetal health.

Mike Presley, director of the Alabama Department of Economic and Community Affairs — the agency responsible for the plan — said he was not available to handle telerobotic ultrasounds.

LoRissia Autery, an ob-gyn in a rural area northeast of Birmingham, said robots cannot reduce maternal and infant mortality. Take an ultrasound of your hands, señaló.

Many of our patients have high-risk issues, with conditions such as diabetes, high blood pressure and hepatitis C. Concern about the type of attention these women receive — which is much more important for an hour to see — is replaced by a robot capable specialist.

“We have the type of care we need to give to these women,” said Autery, who co-founded Walker Women’s Specialists. The clinic has three doctors, cares for five patients and needs another doctor to keep up with demand, he added.

“For one of our two years, we have been looking for a social neighborhood,” he said. “It’s difficult for a lot of reasons.”

On social media, Senator Sanders responded to Oz by saying that the lack of healthcare providers in rural areas of the United States was an “international problem.”

“In the richest country in the world, we need more doctors, teachers, dentists and mental health counselors, not more robots,” Sanders wrote on the X platform.

There is less than one country where you use robots with personal abilities to reduce deaths.

In La Loche, a remote village in Canada, Julie Fontaine operates an ultrasound robot in a clinic with two practicing teachers and rotating doctors. Fontaine said patients love the robot because they save time and the cost of traveling or having an hour to a regional medical center.

“When people say, ‘Guau, qué increible the technology today in day,'” commented Fontaine, a member of the Métis Nation of northern Saskatchewan. “It’s something that has never been seen or used.”

When working with patients, Fontaine connects the ultrasound robot to a remote imaging technician located in Saskatoon. This professional manipulates the robotic arm of the machine. Luego, a radiologist — who can be in any part — analyzes the images and sends the report to the family doctor in La Loche, explained Ivar Mendez, neurocirujano and director of the Virtual Health Center of Canada. In this country, most babies are born with the attention of family doctors or partners, not specialists.

“It’s more important to identify a high-level problem with enough anticipation to be able to intervene,” said Mendez, who ensured that robotic ultrasound “is good as presence,” even if it cannot be used in cases where a more invasive vaginal ultrasound is necessary. The burden of maternal and infant mortality in northern Canada, where it is found in La Loche, is 20 to 25 times higher than in the rest of the country, aggregated.

“One of the reasons is that there is no availability of prenatal ultrasounds in these communities, because the embarrassments have to go through the cities and settle in hotels,” explained.

During a 2022 investigation, Mendez and his team at the University of Saskatchewan analyzed 87 telerobotic ultrasound scans and found that, in 70% of cases, there was no need to pass through to receive attention. If all patients plan to use the robot.

This same robotic ultrasound technology was approved for use in the United States in 2017.

Nicolas Lefebvre, president and executive director of AdEchoTech – the company creating and manufacturing the robot – declared that he had “specific projects for maternity in the United States which are in preparation”. According to the company’s business development consultant, the average price of one of these robots is between $250,000 and $350,000.

The use of eco-friendly robots is an integral part of Alabama’s proposed maternal-fetal health initiative, according to the solicitation. Recognizing the body of obstetric units, officials plan to connect smaller providers and rural health centers — which lack quality maternal-fetal health services — with regional centers that can provide these services digitally, including telerobotic eco-friendly services.

For your workforce initiative, the state offers training programs for physicians, emergency responders and obstetric teachers.

The estimated funding needed for the maternal-fetal health initiative is $24 million over five years. For the workforce initiative, Alabama officials provided $309.75 million for the same period.