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Challenges and Potential Issues (Philip Barrington)

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Challenges and Potential Issues (Philip Barrington)

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I like the idea of surgeons using the HoloLens to assist them during a surgery. AR technology will help surgeons and nurses in the operation room. This tool can provide additional information that could be critical in life or death situations. Hospital administrators though will often put cost ahead of best practice. Hence, the question to pose to hospital administrators is do we want to save lives or worry more about cost. By lower the AR technology to a price that would be less than 10% of the hospital budget, then hospital administrators would be more inclined to use the AR technology in their hospitals.

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Challenges and Potential Issues (Katie Cowen)

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Challenges and Potential Issues (Katie Cowen)

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It was a very interesting read, however I definitely got the sense that AR has a long road in front of them before hospitals buy and use AR technologies for many reasons. One of the biggest challenges for Medical AR is the cost associated with developing and refining technologies so they run efficiently and have all of their quirks sorted out before they replace current systems. Another challenge is the amount of training required for health care professionals once AR technologies take over, and the future training required to keep up with the new and developing technology. If AR companies are at all rushing the implementation of AR systems, I could see a huge disaster happening for hospitals and health care offices on the horizon. Also, it seems there is already an abundance of AR technologies for surgeries that it would require too much time for professionals to learn ALL of them and then decide which one or two to use in their practice. Lastly, something that concerned me while reading the Harvard Business Review article, is that AR headsets have to be precisely mounted on a surgeons face for the surgery to be accurate and successful. The slightest bump or slip of the surgeons AR headset, could be detrimental to the patient. This is definitely concerning and would require many simulated patients for the surgeons to practice on before performing a real surgery.

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I do wonder if AR will be as revolutionary as we think it will be.  Although the doctor will have all of the information in front of him/her, I wonder if it can also be too much information - and whether the abundance of information can be overwhelming.  I imagine currently, doctors are simply focused on what is in front of them.  Anytime they need to glance of to the corner of their vision to check the status of something else means that they are not giving 100 percent attention to what is in front of them.  Of course, I imagine that doctors will be able to choose what they would like displayed on their AR (if anything at all) so perhaps this is all just a moot point.

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What has technology not changed in hospitals sooner? (Aggie Woodworth)

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What has technology not changed in hospitals sooner? (Aggie Woodworth)

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I think a large problem AR technology in hospitals faces is organizational. The article mentioned that hospitals have been using roughly the same technology since the 1950's and that each system comes with its own monitoring system. I have to wonder why they have been using the same technology for so long. I think that these medical companies have huge investments within hospitals and it would be interesting to see what sort of contracts hospitals (especially in the United States) hold with these companies. A small example, I recall hearing that at one point hospitals were giving away "care packages" to new moms with certain brands of formula etc. This practice sent a message that these products were endorsed by the hospital/ preferred choices.

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It was surprising to know in the article that that this technology was being used since 1950 and giving attention to minute details have let to this stage that we can use this in real scenarios. This is exciting but at the same time I don't feel confident about it completely as the absolute role and indications for AR in surgery are yet to be established. The data so far generated in AR are not substantial. The outcomes discussed in most publications to date include user-friendly features, accuracy of targeting tissues, and costs as end points.  A common underlying error-generating process in AR will always exist because of the tremendous variability in the fundamental elements: definition of accuracy, image acquisition, registration techniques, computers and software interfaces, iterative localization devices and intraoperative use, integration of real-time data, tissue displacement, robotics, and, finally, judgment and clinical experience.

Source:
Shuhaiber JH. Augmented Reality in Surgery. Arch Surg. 2004;139(2):170–174. doi:10.1001/archsurg.139.2.170

Tang  SLKwoh  CKTeo  MYSing  NWLing  KV Augmented reality systems for medical applications.  IEEE Eng Med Biol Mag. 1998;17 ((3)) 49- 58

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Glitches: All tech encounters glitches; AR will be no exception. I worry that during the period of AR growing pains in medicare, the tracking of patients will have trouble remaining stable under all circumstances. To be specific, many AR systems today work off of a trigger system as referenced earlier in this OER. This can be a picture, a symbol, even a human face, but it has to be something. Unless the system is expertly designed to know exactly what someone is looking at, at any given time, and the information is mapped perfectly to the overlaying display, I feel there could be glitches that make using the system difficult or impossible. For example, the HUD displays the incision point 1 inch to the left of where it should be because it is mistakenly tracking something that looks like the correct trigger which is 1 inch to the left of the actual trigger. I hope what I'm trying to say makes sense. Also, the article mentioned operation rooms having many separate systems/displays giving data in the traditional setup, and AR could replace these by combining them into one do-it-all solution. Again, glitches. This idea is great until your one AR system crashes, or there's a glitch, sending the baby out with the bathwater. I hope there are AR techs on-hand for when a high-stakes surgery goes awry because of a technical issue (and yes - I know tech issues happen in traditional settings - but not every system is affected at once).

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AR in Conflict Zones, Natural Disasters, Rural Areas

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AR in Conflict Zones, Natural Disasters, Rural Areas

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The article about Purdue's work in helping less-experienced doctors in remote or less-accessible areas interested me the most here. What I liked was the ability for doctors to work with mentees while the mentees are wearing headsets, rather than switching from watching the current telestrator technology to their patient. Developers of this tool are working within a specific set of constraints, not least of which is the access to internet or data required by the mentor and mentee to communicate. I wonder about the language used in the program - are all mentees fluent in English and the terminology used in the program itself in order to act appropriately on the mentor's instructions? What bridges some of that communication barrier is the visual aspect of the program, that mentors and mentees can communicate visually without having to verbalize each precise detail of a process. By offering such a program and using more visuals, this might help to bridge some of the digital divide that exists in healthcare, especially if translation tools - exceptionally good ones! - are incorporated to further assist those mentees who may not be confident communicating in English.

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September 5, 2018 , Purdue University

Purdue University researchers have developed a unique approach using augmented reality tools to help less-experienced doctors in war zones, natural disasters and in rural areas perform complicated procedures. Credit: Edgar Rojas Muñoz/Purdue University

Purdue University researchers have developed a unique approach that allows experienced surgeons and physicians around the world to help less-experienced doctors in war zones, natural disasters and in rural areas perform complicated procedures.

"The most critical challenge is to provide surgical expertise into the battlefield when it is most required," said Juan Wachs, Purdue's James A. and Sharon M. Tompkins Rising Star Associate Professor of Industrial Engineering, who led the project team. "Even without having highly experienced medical leaders physically co-located in the field, with this technology we can help minimize the number of casualties while maximizing treatment at the point of injury."

The team presented the work at the 2018 Military Health System Research Symposium, held Aug. 20-23 in Kissimmee, Florida.

The Purdue technique involves using augmented reality tools to connect health care professionals in remote areas with more experienced surgeons and physicians around the world. The AR headset worn by the mentee in the field is designed to replace current telestrator technology, which uses a separate video screen and freehand sketches to provide feedback.

"There is an unmet need for technology that connects health care mentees in rural areas with experienced mentors," said Edgar Rojas Muñoz, a doctoral student in industrial engineering, who worked on the project. "The current use of a telestrator in these situations is inefficient because they require the mentee to focus on a separate screen, fail to show upcoming steps and give the mentor an incomplete picture of the ongoing procedure."

The Purdue system features a transparent headset screen display that allows the mentee to see the patient in front of them, along with real-time on-screen feedback from the mentor. That mentor is at a separate location using a video monitor to see the AR feed and provide instant feedback to the field surgeon.

Purdue's system uses computer vision algorithms to track and align the virtual notes and marks from the mentor with the surgical region in front of the mentee.

"Our technology allows trainees to remain focused on the surgical procedure and reduces the potential for errors during surgery," Muñoz said.

The U.S. Department of Defense supported the research as it looks to connect its medical professionals out in the field with specialists back at the bases who can provide critical guidance during procedures.

The Purdue technology has gone through a round of clinical evaluation and will soon go through another one. In the next few months, the technology will be tested at a Navy base in Virginia, where mentees and mentors will experiment with a simulated battlefield.

Researchers at Purdue also are working to increase the stabilization ability of the view for the mentees.

Other researchers on the project include Voicu Popescu, an associate professor of computer science at Purdue; Brian Mullis and Ben Zarzaur from the Indiana University School of Medicine; and nurse researchers Kathryn Anderson and Sherri Marley from Eskenazi Health Services in Indianapolis.

The technology aligns with Purdue's "giant leaps" celebrating the university's global advancements made in health, space, artificial intelligence and sustainability highlights as part of Purdue's 150th anniversary. Those are the four themes of the yearlong celebration's Ideas Festival, designed to showcase Purdue as an intellectual center solving real-world issues.

The team is working with the Purdue Office of Technology Commercialization on patents for the technology. The research team also is looking for partners.

Provided by: Purdue University

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'Augmented reality' tools to help health care workers save lives in war zones, natural disasters, rural areas

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September 5, 2018 , Purdue University Purdue University researchers have developed a unique approach that allows experienced surgeons and physicians around the world to help less-experienced doctors in war zones, natural disasters and in rural areas perform complicated procedures.