In a beehive, the male drones sit around doing nothing – at least until mating season. Nice work if you can get it. In the delivery sector, though, drones are doing more and more of the work. That includes not just dropping off your pizza on the doorstep, but, increasingly, delivering urgent medical supplies more efficiently than can human-crewed helicopters, fixed-wing aircraft, or ground vehicles. Call them uncrewed aerial vehicles, uncrewed aerial systems, or autonomous/remotely piloted aircraft, the day of the drone is here.
There’s always been something a little sinister about drones, though. From the (then) futuristic Hunter Killers of the Terminator movies to the Predator uncrewed aerial vehicles (UAVs) deployed by US forces in Middle East conflict zones, as well as the drones used by other players such as Yemen’s Houthi rebels, and, of course, most recently by both sides in the war in Ukraine, the ability of a seemingly semi-sentient flyer to strike from afar makes the uncrewed aerial vehicle a potent terror weapon.
As drone technology has developed over just a few decades, drones have come to be perceived not only as state-of-the-art military assets, but on another level as just another cheap and cheerful high-tech toy. Paparazzi photographers have seized on drones to intrude on the private airspace of celebrities. Drones piloted by social media posters flock to the scenes of accidents and natural disasters, sometimes hampering the efforts of first responders. In August, when numerous amateur-piloted drones were flown illegally over active wildfire near Kelowna, British Columbia, the Canadian provinces’s Minister of Forests warned that they were a ‘significant hazard’ to aerial firefighters.
It's important to stress, then, that drones are potent forces for good, too, and perhaps nowhere more so than in the air medical sector.
Even in the world of futuristic fiction, drones aren’t always forces for evil. Back in 1971, science fiction author Fred Saberhagen envisaged a deeply weird post-apocalyptic world in which autonomous military drones called ‘Valkyries’ – relics of a lost technology – patrol the battlefield, picking up wounded warriors to be transferred to field hospitals that no longer exist.
Benefits for operators
In terms of urgent medical deliveries, the future is already here. Motorcycle paramedic couriers have long been employed in this role, moving everything from plasma/blood to organs between medical storage and surgical facilities at speed through traffic-clogged cities. Without the need for air traffic control clearance or a helipad at either end of the mission, an experienced dispatch rider on a big bike can even beat a crewed helicopter door to door in a traffic-clogged conurbation like London or Los Angeles. Now, uncrewed aerial vehicles – tireless, instantly deployable, more flexible and more cost-effective – are beginning to take over that role, with operations that require only minimal infrastructure and which can be set up in a wide range of urban spaces, from rooftops to parking lots and even driveways.
The various uses of uncrewed aerial systems (UAS) are acknowledged by manufacturers, and the adaptability of payloads is incorporated into their design, Jonas Hill, Sales and Marketing Director, UMS Skeldar, stated: “We recognize the potential of our UAS to support resupply operations, which could include medical supplies in both civilian and military domains.”
For operators, the attractions are obvious. It takes around six months and costs around $100,000 to train a commercial helicopter pilot to a basic level. Because uncrewed aerial systems are highly automated, operating a UAV requires less knowledge and skill, so operator training costs a fraction of that and typically takes just one to three months. Hill added: “When compared to something like an Airbus H135/145, our UAS comes in at a fraction of the initial purchase cost. Furthermore, the operational costs are significantly lower, too.”
For search and rescue (SAR) missions, several UAVs can be dispatched for the same cost as one rotorcraft, allowing a greater area to be covered in a given amount of time and at lower cost
In addition, for search and rescue (SAR) missions, several UAVs can be dispatched for the same cost as one rotorcraft, allowing a greater area to be covered in a given amount of time and at lower cost.
The UK’s first national medical drone delivery network, dubbed Project CAELUS, is poised to launch by the end of 2023 across Scotland, following trial flights carried out by drone services provider Skyports. NHS Scotland has said it will bring its ‘Once for Scotland’ approach to the project, the second phase of which will involve live flight trials and removing the remaining barriers to safely using drones at scale within Scotland’s airspace.
In the United Arab Emirates, Abu Dhabi is set to implement a state-of-the-art UAV delivery system – the first of its kind in the Middle East – to serve its emergency healthcare response network, partnering with Abu Dhabi-based tech company SkyGo – the first company to be licensed in the UAE for beyond visual line of sight (BVLOS) drone delivery operations – and California-based Matternet. Drones will deliver medical supplies, medicines and blood units, vaccines and samples between laboratories, pharmacies and blood banks across healthcare facilities around the city. SkyGo and Matternet expect to finalize phase two of trials by the end of this year.
Medical drone use varies by country
Champions of drone delivery in healthcare talk of tremendous opportunities to scale up their operations. More widespread deployment, though, is being slowed by the lack of an overarching, globally recognized framework that regulates airworthiness, operator training, and operations, say some industry insiders.
For example, developing the regulatory framework to enable BVLOS in populated areas has progressed at different rates in different countries. Switzerland has allowed BVLOS flights on a case-by-case basis since 2017, and BVLOS operations are now possible in much of the European Union (EU). Regulatory progress in the EU and the UK continues to open doors to drone services at scale, according to Shannon Nash, Chief Financial Officer at Wing, a subsidiary of Google parent company Alphabet. Wing expects to begin medical drone delivery services to hospitals and other medical care providers in Dublin by late 2023 in partnership with Apian, a healthcare logistics company founded by a team of doctors from the UK’s National Health Service (NHS).
In Rwanda, drone manufacturer Zipline has been using fully autonomous UAVs to deliver blood and medical supplies to regional hospitals nationwide since 2016, and is now responsible for delivering 75 per cent of blood supplies to hospitals beyond Kigali, the nation’s capital. Expanding its network rapidly since 2021, Zipline now serves 4,000 hospitals and other healthcare locations worldwide, including in Ghana, Nigeria, Ivory Coast, Kenya, Japan, and the US states of Utah and Arkansas. Last year, it became the first company to receive Federal Aviation Administration (FAA) Part 135 approval for long-range drone delivery in the USA.
The possibility of providing extended surveillance times is a significant future benefit
In the USA, though, BVLOS flights over populated areas are just beginning to be permitted. Regarding the use of drones in population centers, Hill said: “The possibility of providing extended surveillance times is a significant future benefit. The industry is still some way from presenting a product that will meet current and future requirements, but the possibility is undoubtedly there, and the use case is strong. Other advantages include a lower environmental impact and operating costs for public security forces.”
In September, California-based Matternet, developer of what it claims is the world’s leading urban drone delivery system, received approval by the FAA to operate the Matternet M2 drone BVLOS for package delivery in partnership with UPS Flight Forward (UPSFF), a subsidiary of United Parcel Service (UPS). The approval means its Matternet M2 drones can fly without visual
Certification will be a major hurdle as the process for certifying a passenger-carrying autonomous aircraft hasn’t been finalized yet
observers, using instead ground-based radar. Matternet sees ground-based radar as a scalable approach to true BVLOS operations. Using Matternet Mission Control software, pilots at UPSFF’s remote operations center will be able to control up to three aircraft simultaneously.
“This approval will advance the regulatory framework in a way that encourages wider drone adoption throughout the world,” said Jim O’Sullivan, Vice President of Regulatory Strategy and Special Projects at Matternet, which first partnered with UPSFF in 2019 to deliver medical supplies in North Carolina and Florida. “There is a pressing need for a clear regulatory framework for unmanned flights beyond the visual line of sight of the pilot, but likely helicopter emergency medical services and SAR don’t require a specialized framework.”
O’Sullivan added: “We are at least five years from seeing pilotless aircraft being used in place of crewed aircraft for carrying people. Certification will be a major hurdle as the process for certifying a passenger-carrying autonomous aircraft hasn’t been finalized yet. Another hurdle will be conducting enough analysis and flight testing to convince the customers and regulators that the system has achieved an equivalent level of safety to conventional aircraft.”
The path to widespread adoption
There are signs, though, that the FAA – which often sets the global pace in terms of regulation, with other national bodies following its lead – is on its way to creating a more coherent regulatory policy for drone operations. Under FAA regulations, the operator must obtain Part 135 air carrier certification for flights carrying passengers or cargo, and the regulator must review and approve the safety management system as well as the training curriculum and program. Search missions, which do not involve carrying passengers or cargo, can be conducted under a less rigorous regulatory framework.
In 2021, the FAA chartered the Beyond Visual Line of Sight Aviation Rulemaking Committee to provide safety regulations for BVLOS drone flights, with the stated aim of developing standard rules to make BVLOS operations ‘routine, scalable and economically viable’. The FAA says its long-term goal is ‘to safely integrate drones into the US National Airspace System’ rather than setting aside separate airspace exclusively for UAVs.
The FAA says its long-term goal is ‘to safely integrate drones into the US National Airspace System’
After safely performed BVLOS operations over sparsely operated areas in southern Italy as part of the ECARO campaign, where GPS-based approach procedures were adopted, proving that existing very-high-frequency-based procedures are not the only option for interfacing with air traffic in areas predominantly occupied by manned aircraft, Hill said: “The European Aviation Safety Agency (EASA) is currently developing a set of yet-to-be-released regulatory standards that will ultimately allow UAVs to be deployed over both sparsely populated and, eventually, densely populated areas.”
In many regions, then, UAVs have already made the transition from delivering pizzas to providing new logistical solutions for a variety of medical facilities. It seems unlikely, though, that they will be supplementing or even supplanting crewed EMS aircraft any time soon.