Background:

On 28 November 2022, the Italian magazine DronEzine published an interview with Sara De Silvestri, Researcher and Biomedical Engineer at IRCCS Ospedale San Raffaele (San Raffaele Hospital), one of the thirteen partners comprising the Flying Forward 2020 consortium.

Below, we share the English translation of Sara's interview with Luca Masali, titled 'L’ospedale San Raffaele e i droni sanitari del prossimo futuro', in which she shares details of San Raffaele Hospital's upcoming drone demonstrations for the FF2020 project and how these developments will impact the hospital and society in the near future.

Interview:

The Milanese hospital, through its Centre for Advanced Technologies for Health and Wellbeing, is working on a sophisticated scenario that, in the near future, will see drones integrated into hospital services, from transporting organs to monitoring the hospitals themselves. DronEzine discussed this with Researcher Sara De Silvestri, who is managing the Flying Forward 2020 (FF2020) project, coordinating the activities of the working group and interacting with external partners.

First of all, what is San Raffaele Hospital's Centre for Advanced Technologies for Health and Wellbeing?

It is a Centre at the IRCCS Ospedale San Raffaele in Milan focused on disease prevention and the promotion of wellbeing with healthcare IT applications: eServices for Life and Health.

And how do you use technology to achieve your goals?

Through Information Technology (IT), Automation and Robotics, and in collaboration with leading industries in the medical, pharmaceutical and Information Communications Technology (ICT) markets, scientific research institutes and policymakers, the Research Centre aims to enable and promote healthier, environmentally sustainable and conscious lifestyles. The Centre for Advanced Technologies for Health and Wellbeing works to design the hospital, the city and the life of the future (Smarter & Safer Hospital, Smarter & Healthier City and Smarter & Healthier Life) by analysing, designing, developing and testing safe and reliable hospital processes, promoting innovation in the urban environment, using information technology and telecommunications to help citizens make healthier and more informed choices.

And now these technologies include drones...

Starting in December 2020, the Advanced Technologies for Health and Wellbeing Research Centre is involved in the European research project Flying Forward 2020, funded by the European Union under the Horizon 2020 Research and Innovation programme. The FF2020 project aims to expand the fields of application of Urban Air Mobility (UAM), understood as the derivation of Advanced Air Mobility (AAM) in the urban environment. In the project's vision, UAM is realised in an ecosystem in which various actors, as well as Internet of Things (IoT) objects, communicate by exchanging information to ensure the safety, efficiency and legal compliance of material transport and monitoring operations via drones.

A drone flying above Zaragoza (Spain) during the FF2020 demonstrations in the city

An ambitious project, but the road seems very long given it's under development and constantly changing legislation. How are you organising your activities?

The FF2020 project is intended as a means for the development and implementation of services that will be needed in the future for large-scale commercial applications, i.e., with a high or complete level of automation in populated scenarios. The services and the organisational system proposed within the project are being developed and tested under the coordination of San Raffaele Hospital in five living labs located in five European cities (Milan, Eindhoven, Zaragoza, Tartu and Oulu). Each living lab faces specific challenges: infrastructural and regulatory, but also imposed by natural influences.

And what results have you achieved so far?

The first living lab, High Tech Campus in Eindhoven (The Netherlands), concluded its successful demonstrations this summer, integrating a multiplicity of actors into a single digital ecosystem enabling services for monitoring, surveillance and delivery of goods, also testing them simultaneously in the airspace of High Tech Campus in Eindhoven. Zaragoza City Council also recently completed a flight experience during the Fiesta del Pilar, a huge festival for surveillance and public safety.

Spain and Holland, then. And what about Italy?

San Raffaele Hospital is in the preparation and testing phase of two service demonstrators that will be the forerunners for future, more complex applications. For the design of these services, the Centre for Advanced Technologies for Health and Wellbeing has adopted a methodology of service design – 'co-creation' – that involves all the users and stakeholders of the service in the design of the service itself in order to guarantee the maximum satisfaction of its users. In fact, San Raffaele Hospital is a supporter of the concept that the users of the services and their systems are also part of the digital ecosystem of UAM (think of the hospital's pharmacy inventory, which has to be updated every time an order is dispatched via a drone).

An experiment that, we imagine, will also involve ENAC...

The use cases were developed according to the so-called 'CONUSE' selected by ENAC (Italian Civil Aviation Authority) and reported in the National Strategic Plan for the development of UAM. The FF2020 project, and in particular the work of San Raffaele Hospital within it, shares its objectives and promises to contribute to the advancement of Urban Air Mobility.

And what will be the first part of this strategy?

The first demonstrator ('Autonomous monitoring and predictive intervention of critical infrastructures in a hospital') aims to develop the prototype of a service for the maintenance and security of hospital infrastructures. Within this demonstrator, there are inspection scenarios, such as the thermography of buildings in order to monitor their thermal efficiency, as well as surveillance scenarios, in which the service via drones would be available to security personnel for regular patrols of the hospital perimeter or to obtain timely information on a scene in which intervention is required (accidents, assaults, theft or tampering). This would allow both maintenance and security personnel to reach the places that need to be inspected in less time and with less risk.

A drone flying above High Tech Campus Eindhoven (The Netherlands) during the FF2020 demonstrations in Eindhoven

But you also plan to use drones to transport medical supplies, right?

Yes. The second demonstrator ('Precision logistics services for aerial transport of biomedical material') concerns last-mile transport of emergency medical material. In this case, Ospedale San Raffaele designed the service to maximise the logistical efficiency of intra-hospital transport of pharmaceuticals (from the pharmacy to the operating units (OUs) that request them) and diagnostic samples (from OUs to laboratories). In this way, even areas that are not served by pneumatic post-delivery, such as PallaRia, the intensive care unit inaugurated in 2020 to cope with the COVID-19 pandemic, can be reached without the mobilisation of personnel, saving time in the logistical process.

And how will these drones fly?

At this stage, the commissioned drone operator (ABZero), supported by the advice of EuroUSC Italy, also a partner of FF2020, is carrying out Beyond Visual Line of Sight (BVLOS) flights over unpopulated areas in preparation for the deployment of drones in hospital airspace, in order to demonstrate to the authorities the maturity of the skills and full compliance with all the safety measures required to bring drones to densely populated areas such as the San Raffaele Hospital, which is located just outside the border of the Milan metropolitan area, on the take-off route of Linate airport and next to the helipad for emergency flights.

How will you capitalise on the experience gained in the project?

These activities allow researchers to measure themselves against the practical and regulatory limitations that have to be overcome to enable drone-designed services. In the future, the goal could be to use drones not only to transport pharmaceuticals and diagnostic samples within the hospital area but also between a network of clinics, warehouses and laboratories.

A project that requires considerable investment. How do you see economic sustainability? 

It is clear that these services will only be able to sustain themselves in the future, i.e. without public funding, if they offer enough benefits to justify the costs. However, for many scenarios, such as material transport, this budget remains an open question at the moment. It is still not quite clear what operational costs an organisation will face, ranging from authorisation, insurance, specialised personnel, maintenance of technology and infrastructure, concessions and licences, use of airspace and related U-Space services. This is why we want to focus on services, such as hospital services, which also have a high societal impact, in order to acquire data and experience to support subsequent evaluations. Consolidating experience and having technology subjected to design verification by EASA for drone operators will also mean being able to handle complex scenarios such as the transport of dangerous goods in densely populated areas. At the moment, this service is only feasible in the presence of highly impacting constraints, such as that of keeping a very large area around the drone's path 'controlled', which makes it too expensive and operationally difficult to implement in an area such as the San Raffaele Hospital. Moreover, as mentioned, there is a lack of shared standards for the safety of third parties and for the quality from the clinical point of view of the product transported, as well as from the logistical point of view. From this point of view, European projects such as Flying Forward 2020 can give a boost to the sector, which, in the not-too-distant future, will be in a position to offer more and cheaper technologies and services, as well as to develop the necessary experience and skills.

Opening image: San Raffaele Hospital, post-produced image, for illustrative purposes only.