A vaguely human-like white robot emerges from an elevator and glides down the hallway of a busy Tacoma hospital. Patients and visitors look on, slightly confused, slightly amazed when it stops, its single mechanical arm reaching out deliberately to badge open an automatic door. The robot passes through the threshold, and its digital eyes—formerly bright blue circles—transform into pink hearts.

The sight of Moxi, an AI-powered robot now cruising the hallways of MultiCare facilities including Tacoma General and Deaconess in Spokane, in addition to hospitals across the country, can feel like a vivid dream: the future, coming to rudely remind us that it’s already here. We already have self-driving cars. Why not health care robots, too? 

Diligent Robotics, the company that created Moxi, says on its website that the robot “helps hospitals and clinical staff work smarter, not harder.” Moxi does not care for patients or enter their rooms. Its primary purpose is to make deliveries: running supplies, medicines, even snacks around hospitals in its compartments and, in theory, easing the burden of human hospital workers who might normally have to do that work. The main unit by which MultiCare measures its productivity is “steps saved.” 

The deployment of Moxi in the MultiCare system came in the wake of the Great Resignation, says nursing director June Altaras. Nationwide, about 100,000 nurses left the profession between 2021 and 2023, according to a recent survey by the National Council of State Boards of Nursing. And over half of nurses reported regularly feeling “used up.” 

“For whatever reason, with the unavailability of people to do this work, we’ve had to redesign our work and workflows so the work gets done and yet people are not feeling this burnout of working short-staffed all the time,” Altaras says. “What are the ways we can help people?”

One of those answers is Moxi. At its best, Altaras says, Moxi frees up time to let nurses and techs do what the robot can’t. Ideally, a nurse might assign Moxi a task using an iPad so they can continue caring for a patient. While the nurse works, the unit will go retrieve or deliver a given item using its built-in containers. The specific nature of its tasks will vary from hospital to hospital, depending on layout and need. For example, Tacoma General has a pneumatic tube system for rapid delivery of smaller items, while Deaconess doesn’t. But the net effect is meant to be similar: save time, save steps, and free up overworked hospital staffs. 

But not all hospital workers are necessarily on the same page. After all, it’s a fine line between easing the burden of employees and replacing them altogether. The use of automation to save time and money is not unique to the age of actual robots, nor is it unique to health care. The Washington State Nurses Association, which represents MultiCare nurses, does not oppose Moxi in principle, but did express concern about Moxi’s implementation without the feedback of its membership.

“Not having nurses being part of the decision-making process is akin to Boeing deferring to MBAs on major decisions regarding aircraft,” says WSNA spokesperson Bobbi Nodell.

One MultiCare nurse, who wished to remain anonymous, says that technologies like Moxi emerge from people who see health care as an industry, and not a service. The nurse sees Moxi as “kind of a Band-Aid, rather than actually fixing the root of the problem.” 

“I think there’s a lot of disconnect, and it’s not just MultiCare but health care nationwide, between upper executive leaders and the staff on the floor,” the nurse says. “Health care has become such a business and not actually an industry of helping people. It’s an industry of making money.” 

If hospital systems were really devoted to patient care, work conditions would be better; pay would be better, and the burnout and staffing shortages would not be a problem, the nurse says. After all, even in those ideal situations, a robot as highly functional as Moxi doesn’t work as well as a person would. “The idea is great if it actually worked as designed.” Instead, it moves too slowly, the nurse says: Moxi gets stuck in doorways, and frequently requires the help of a human handler. “She’s kind of a Roomba with a face.” 

Another nurse said she appreciated what Moxi could offer but had not yet gotten to the point where she remembered to use it as part of her normal workflow. Instead, her team only really thought to deploy Moxi as a last resort, in situations when they were super shorthanded.

Diligent Robotics was founded by a pair of engineers: Andrea Thomaz and Vivian Chu. The company grew out of their collaboration at the University of Texas, where Thomaz was a professor studying human-robot interaction and Chu was one of her doctoral students.

Everything about Moxi is designed to make it function effectively in a hospital setting, from its size and shape to the design of its charging station to the disarming “face” with the heart eyes. (Moxi does not have a gender.) When Moxi’s arm is moving to open a door, Thomaz says, its head also moves subtly to look at what it’s doing, so that humans can see what the robot is thinking about. 

“When that arm is moving around, it actually is maintaining this model of a safety bubble,” Thomaz says. “So if anybody comes too close to the robot’s arm during that manipulation, it will stop.”

This differentiates Moxi from other hospital delivery robots. A company called Aethon makes a robot called TUG that looks kind of like a rolling Xerox machine—a far cry from Moxi’s Rosey-from-The Jetsons aesthetic. Another difference is that while Aethon sells its machines to hospitals, Diligent offers Moxi as a subscription service. The human handlers, who appear during emergencies wielding repurposed PlayStation controllers, are part of that service. 

The cost of Moxi is usage-based, and that lower barrier to entry was appealing to MultiCare, according to Altaras. However, she declined to share the cost of the robot. 

“Moxi costs less per hour than any of our people,” says Altaras. “It works in a health system that’s very strapped financially. But I want to be really clear, it is not replacing people. Moxi is helping us fill all these shortages we have in health care.” 

Like any AI-powered device, Moxi is built to learn and improve with time: it will get better at opening doors, faster at navigating crowded hallways. And in its own way, it will help fill some of those shortages in health care. But there will always be things it cannot do. 

“In my job as a direct bedside nurse, it would be very hard to imagine a scenario in which a robot could really help,” says the nurse who wished to remain anonymous. “The whole nursing process is being able to recognize and assess and change based on patient presentation and the reaction to an intervention. It takes a human to have thinking skills and be able to pivot on a moment’s notice.”

That’s something that will never change.