By Jennifer Chambers
The Detroit News
ANN ARBOR, Mich. ― Jason Corso envisions a rural America where AI-equipped vehicles, driven by medical workers, are deployed to bring specialized health care to patients right where they live.
Corso, a computer scientist and a Toyota professor of artificial intelligence at the University of Michigan, is leading a team on a five-year, $24.6 million federally funded project to create a vehicle platform that can provide advanced medical services outside hospital settings in underserved rural communities, where drives to see health care specialists can be hundreds of miles away.
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The idea would be for patients to meet a medical professional, such as a nurse or physician assistant, in their community — perhaps in a Walmart parking lot — where they enter a customized truck for an appointment.
Inside, they would lie on a medical table for a diagnostic procedure, such as a cardiac ultrasound or X-ray. An AI-guided system would assist the health worker in performing activities beyond their usual training, tasks typically performed by specialists, who are scarce in many rural areas.
An ultrasound tool is connected to AI to guide health care workers in performing the procedure and will generate a health care report after the visit.
“So this project is about bringing health care to rural America at the level and capacity that we see it in urban America these days, which is a challenge,” Corso said. “The AI that we’re building, the technology will guide them through the process and ensure they don’t make any mistakes and can deliver efficient health care.”
The project is one of many being touted as a solution to blunt the impact of hospital closures and workforce shortages across rural America, where residents are at risk of poorer health results because the distance to a health care provider may lead to fewer visits, ultimately resulting in undiagnosed illnesses.
In Michigan, 53 of 83 counties, or 64%, are designated rural. Approximately 2 million of the state’s 10 million people reside there.
The VIGIL platform is being developed by a team of technologists, scientists, doctors and others led by Corso in a University of Michigan robotics lab. The vehicle — the size of a FedEx truck — that will carry the platform is scheduled to arrive this fall at the UM lab. Nine vehicles are expected to launch in December in three states: Michigan, North Carolina and Utah.
This coming week, project organizers are demonstrating to federal, state and university officials several of the tasks the AI-assisted guidance has been trained to do, including performing a deep vein thrombosis scan, a cardiac ultrasound scan and positioning a patient for an X-ray.
For the demo, Corso has created a virtual-reality headset version of ultrasound task guidance, a digital twin version of VIGIL for simulation-based training and a mobile version of the VIGIL to demonstrate portable usage. Corso sees the project as building a human-AI team, focused on building around humans and keeping AI in its lane.
“It’s these physically grounded tasks where the humans are doing something, and they have a goal, and there’s an embodied AI, like a robot, helping them do this,” Corso said. “So that it can guide them and not get in the way.”
The vehicle’s workstation capabilities may be expanded to include 20-week fetal anatomy scans and CT scans. Future tools may include a centrifuge for blood testing, a drug mixing station and the ability to access a chemo port.
Under the program, patients in rural areas would have the option to use the vehicle for their medical needs. Referrals to the AI vehicle would be made for existing patients under a doctor’s care at one of the participating hospital systems in the project. That system has not been determined yet in Michigan.
To equip VIGIL with the ability to perform a range of tasks, the team needs to create a powerful computer, like a workstation on the vehicle, that can do all the processing locally, since it cannot rely on Wi-Fi or 5G in rural areas to operate, Corso said. The car will connect to those systems in other areas when possible.
“All these frontier models and large language models and AI agents, they all run on the cloud on massive compute,” Corso said. “We need to deliver the same level of capability in a single workstation that runs on, like, two to four kilowatts of power instead of hundreds of kilowatts of power. That’s a big technical challenge that we’re solving.”
VIGIL becomes a different kind of ambulance for rural services
The project comes as the Trump administration seeks to address health care shortages in rural America with innovative projects. It’s being funded by the Advanced Research Projects Agency for Health (ARPA-H), an agency established in 2022 within the U.S. Department of Health and Human Services.
The AI vehicle project is part of PARADIGM (Platform Accelerating Rural Access to Distributed and Integrated Medical Care), one of 22 programs that ARPA-H is funding to address challenges in accessing rural health care.
Dr. Bon Ku, a program manager for PARADIGM and a practicing emergency physician in Pennsylvania, told The Detroit News that he and the team are seeking a solution to a major problem in America: Rural hospitals are closing at an unprecedented rate, with one-third at risk of closing at any moment.
“If you’re a patient living in a rural area in America, that is a risk factor for dying earlier from almost every disease. That’s unacceptable in our country,” Ku said. “Patients are having to travel hundreds and hundreds of miles to get advanced-level care.”
Working his entire career inside hospitals, Ku said they contain amazing technology that provides life-saving care. But patients often must seek services at a bricks-and-mortar facility.
“And so I came up with this concept of like, how can we deliver hospital-level care outside the walls of a hospital and developed technical areas that we needed to build a platform to be able to do that right,” he said.
Ku said 80% of what can be done in a hospital, from chemotherapy infusions to minor medical procedures, can be done outside a hospital with the platform technology the team is building.
“This is an R & D effort to prove out that we could develop the technologies to enable that future state,” Ku said.
Other mobile health unit vehicles exist in the U.S. , but focus on delivering primary care or prevention services. Ku said the VIGIL vehicle will be a tenfold improvement.
The vehicle could not be as large as an 18-wheeler, which would require a commercial driver’s license, so the team focused on an ambulance-sized truck.
“How can we take what we do in a hospital, put it in the same form factor as an ambulance, and deliver care outside of a hospital? So it’s, you know, ambulances are going this way, and this service is going the opposite way, because a patient can’t travel hundreds of miles each time to get chemotherapy care.”
ARPA-H is modeled after DARPA (the Defense Advanced Research Projects Agency ) inside the U.S. Department of Defense, Ku said. The project looks at how the U.S. can invest in technologies that will redefine the future of the country’s health care.
“There’s probably no greater need than rural America right now, where geography determines how long you will live in the U.S.,” Ku said. “And so we’re trying to help out rural communities by building a technology platform to be able to deliver a hospital-level service and those communities that have lost their lifeline to do medical care.”
UM demonstrates how to do an ultrasound with AI
During a visit to the lab at UM’s College of Engineering and the Ford Motor Co. robotics building, nurse and VIGIL team member Heather Stickle demonstrated how to perform an ultrasound using the AI tool in a mock-up area of the lab.
Stickle first aligns the test patient, who is a team member, on a medical table in the lab. Colored lights projected on his body fall across his head, shoulders and chest. They act as a guide for the healthcare worker on where to begin the cardiac ultrasound. After the ultrasound probe is prepared and ready for use, the next step is to begin the procedure.
Once the ultrasound tool is positioned on the patient’s heart, a video screen projects a four-colored breakdown of the human heart ― right ventricular, left ventricular, right aorta and left aorta. The screen shows where the ultrasound is making contact and, using coordinated colors, guides the health care worker to turn the probe in a different direction ― left, right, up or down ― to cover the intended area.
Stickle, who has experience working with rural patients, specifically in the Pacific Northwest and on mobile vans in New York City, wants to know how the project will grow and adapt to meet the needs of the rural populations.
“Like, what’s the human experience going to look like?” Stickle said as she worked in the lab. “And I think that’s what I’m interested in: How is that going to evolve? And we’re learning as we go. We want to move the guidance to the (patient) table, instead of having a provider look at a screen.”
Asked how patients might feel about climbing into a vehicle for a medical test, Corso said developers are using a projection-based interface rather than forcing the generalist to look only at the screens. An earpiece will be used to prevent the AI’s audio from filling the room, he said.
The VIGIL team has had 18 months of discussions with the communities where the vehicles will be going, Ku said.
“To understand what patients want and getting their input, and co-designing this service with them,” Ku said. “Because we don’t want this misperception that they’re going to be getting a lesser or an inferior level of care than they would going to a brick and mortar facility.”
MSU expert: Make sure to understand needs of different rural areas
Innovative AI-based tools are entering the health care field through multiple entry points.
Earlier this year, Michigan’s McLaren Health Care launched a new tool that uses artificial intelligence to identify patients’ risk of cardiovascular disease, allowing them to receive care before the disease worsens. The tool will be available at all 12 of McLaren’s hospitals in Michigan and uses CT scans to detect heart disease. McLaren officials said their system is the first in the state to use this particular platform.
About a third of adults nationally said they have turned to artificial intelligence (AI) chatbots in the past year for health information, according to a new tracking poll on health information and trust by KFF, a nonprofit health policy research, polling and news group. The poll in English and Spanish surveyed 1,343 adults with a margin of error of plus-minus 3 percentage points.
The poll found that most who turned to AI for health information said they were seeking quick, immediate advice. As with AI use generally, younger adults are more likely than older adults to rely on AI for health information, particularly for mental health, the survey found.
Mobile health care units already operate in rural areas of the state, said Dr. Andrea Wendling, director of rural medicine at Michigan State University’s College of Human Medicine and a practicing physician in northern Michigan. But they are not working with existing health systems or with the physicians in the area, she said.
“If you’re able to identify the services that are not available, and you’re able to provide those services in a way that people, through their primary care providers and through their health systems, could access those services without having to travel,” Wendling said, “I can see a model that would be really positive for a community. “
“If what you’re doing, though, is sending mobile units into a community to compete against local services, then you’re not going to help that rural community,” she said. “You’re going to end up competing against the health system that’s existing already.”
Wendling hopes an effort will be made to understand the needs of Michigan’s rural communities to do the most good for patients.
“What Alpena needs might be really different than what Traverse City needs or what Charlevoix needs,” she said.
At MSU, Wendling developed the Leadership in Rural Medicine Program in 2012, designed to address the shortage of physicians in rural communities. High-tech care is not always the highest need in rural communities, she said. It’s people.
“It’s interesting, because the care that I see people needing is less technology-based care, OK, and it’s more ‘We need rheumatologists. We need neurologists,’” Wendling said. “If you have a rheumatologist, and then that rheumatologist retires, I mean, it could be years before you can recruit somebody else into that community.”
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