Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

Ong, Triton; Wilczewski, Hattie; Paige, Samantha R.; Soni, Hiral; Welch, Brandon M.; Bunnell, Brian E.

doi:10.2196/26520

Cited by 30 publications

(17 citation statements)

References 219 publications

(243 reference statements)

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“…Clinicians and technologists will mutually benefit from further interaction. Just like clinicians, technologists have been responsive to obstacles presented by the pandemic (Ong et al, 2021 ). One silver lining to the tragedies of the pandemic has been a giant step forward in realizing the potential of technology to enhance the reach of mental health treatment.…”

Section: Discussionmentioning

confidence: 99%

Overcoming Clinician Technophobia: What We Learned from Our Mass Exposure to Telehealth During the COVID-19 Pandemic

Sherrill

Wiese

Abdullah

et al. 2022

J. technol. behav. sci.

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Mental health clinicians have migrated to telehealth during the COVID-19 pandemic and have reported their use of telehealth may be permanent. Understanding how stakeholders overcame hesitancy regarding the use of telehealth can potentially reveal how stakeholders can adopt future clinical technologies. The exposure therapy conceptual framework provides one explanation of how mental health clinicians can face their concerns about technologies that promise to improve clinical outcomes and worker well-being. We review available literature published since the start of the pandemic on the extent to which clinicians migrated to telehealth and their reactions to their transitions. In particular, we review available literature that describes negative attitudes and worries by clinicians as one of many barriers of telehealth implementation. We introduce the perspective that the necessary transition to telehealth at the start of the pandemic functioned as an exposure exercise that changed many clinicians’ cognitive and emotional reactions to the use of telehealth technologies. Next, we provide guidance on how clinicians can continue taking an exposure approach to learning emerging technologies that are safe and can benefit all stakeholders. Clinicians can now reflect on how they overcame hesitancy regarding telehealth during the pandemic and identify how to build on that new learning by applying strategies used in exposure therapy. The future of clinical work will increasingly require mental health clinicians to better serve their patient populations and enhance their own well-being by overcoming technophobia , a broad term for any level of hesitancy, reluctance, skepticism, worry, anxiety, or fear of implementing technology.

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Section: Discussionmentioning

confidence: 99%

Overcoming Clinician Technophobia: What We Learned from Our Mass Exposure to Telehealth During the COVID-19 Pandemic

Sherrill

Wiese

Abdullah

et al. 2022

J. technol. behav. sci.

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“…While technology-enhanced exergames for adults incorporating XR and MoBI are slowly becoming a reality ( Singh et al, 2020 ; Ong et al, 2021 ; Piech and Czernicki, 2021 ; Yen and Chiu, 2021 , see below and in the Supplementary Table ), they provide safe laboratory conditions for training of real-life activities that are investigator-controllable. From the perspective of the participant, XR-MoBI challenges and enhances autonomy, curiosity, motivation and increases adherence ( Gennaro and de Bruin, 2018 ).…”

Section: Technology-driven Exergamesmentioning

confidence: 99%

“…Interestingly, the potential incorporation of adult exergames and XR-MoBI technologies into telehealth, comes at a time that society is having a demand for such exergames due to the COVID-19 pandemic. As it is that under lockdown conditions health care obviously becomes limited due to general measures ( Mantovani et al, 2020 ; Singh et al, 2020 ; Ong et al, 2021 ; Piech and Czernicki, 2021 ; Stasolla et al, 2021 ). Indeed the COVID-19 pandemic actually boosted the number of telehealth trials, with increasing efforts of health care performed remotely via telecommunication technology.…”

Section: Telehealth Architecturementioning

confidence: 99%

“…During the worldwide COVID-19 outbreak of the last 2 years, the implementation of restrictions in health care (lockdowns with travel restrictions and social distancing), overwhelmingly diminished personal contact between care giver and patients ( Mantovani et al, 2020 ; Singh et al, 2020 ; Ong et al, 2021 ). This most severely affected mobility-impaired elderly and sufferers from CNDs due to the stagnation in on-going immediate care.…”

Section: Introductionmentioning

confidence: 99%

“…Trying to overcome the most obvious pandemic restrictions, already authorities retreated to several forms of telecommunication health care ( Mantovani et al, 2020 ; Singh et al, 2020 ; Ong et al, 2021 ). Even though it is not widely implemented nor developed.…”

Section: Introductionmentioning

confidence: 99%

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A Perspective on Implementation of Technology-Driven Exergames for Adults as Telerehabilitation Services

2022

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A major concern of public health authorities is to also encourage adults to be exposed to enriched environments (sensory and cognitive-motor activity) during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality (XR) which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases (CNDs). The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility (due to disability, disease, or age), through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies.

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Effect of Mixed Reality on Delivery of Emergency Medical Care in a Simulated Environment

Lawson,

Martin,

Guha

et al. 2023

JAMA Netw Open

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ImportanceMixed-reality (MR) technology has the potential to enhance care delivery, but there remains a paucity of evidence for its efficacy and feasibility.ObjectiveTo assess the efficacy and feasibility of MR technology to enhance emergency care delivery in a simulated environment.Design, Setting, and ParticipantsThis pilot randomized crossover trial was conducted from September to November 2021 at a single center in a high-fidelity simulated environment with participants block randomized to standard care (SC) or MR-supported care (MR-SC) groups. Participants were 22 resident-grade physicians working in acute medical and surgical specialties prospectively recruited from a single UK Academic Health Sciences Centre. Data were analyzed from September to December 2022.InterventionParticipants resuscitated a simulated patient who was acutely unwell, including undertaking invasive procedures. Participants completed 2 scenarios and were randomly assigned to SC or MR-SC for the first scenario prior to crossover. The HoloLens 2 MR device provided interactive holographic content and bidirectional audiovisual communication with senior physicians in the MR-SC group.Main Outcomes and MeasuresThe primary outcome was error rate assessed via the Imperial College Error Capture (ICECAP) multidimensional error-capture tool. Secondary outcomes included teamwork (Observational Teamwork Assessment for Surgery [OTAS]; range, 0-6 and Teamwork Skills Assessment for Ward Care [T-SAW-C]; range, 1-5), scenario completion, stress and cognitive load (NASA Task Load Index [NASA-TLX; range 0-100]), and MR device user acceptability.ResultsA total of 22 physicians (15 males [68.2%]; median [range] age, 28 [25-34] years) were recruited. MR technology significantly reduced the mean (SD) number of errors per scenario compared with SC (5.16 [3.34] vs 8.30 [3.09] errors; P = .003), with substantial reductions in procedural (0.79 [0.75] vs 1.52 [1.20] errors; P = .02), technical (1.95 [1.40] vs 3.65 [2.03] errors; P = .01), and safety (0.37 [0.96] vs 0.96 [0.85] errors; P = .04) domains. MR resulted in significantly greater scenario completion rates vs SC (22 scenarios [100%] vs 14 scenarios [63.6%]; P = .003). It also led to significant improvements in the overall quality of teamwork and interactions vs SC as measured by mean (SD) OTAS (25.41 [6.30] vs 16.33 [5.49]; P &lt; .001) and T-SAW-C (27.35 [6.89] vs 18.37 [6.09]; P &lt; .001) scores. As reported via mean (range) NASA-TLX score, there were significant reductions for MR-SC vs SC in participant temporal demands (38 [20-50] vs 46 [30-70]; P = .03) and significant improvements in self-reported task performance (50 [30-60] vs 39 [10-70]; P = .01). Overall, 19 participants (86.4%) reported that they were more confident in making clinical decisions and undertaking clinical procedures with MR support.Conclusions and RelevanceThis study found that the use of MR technology reduced error, improved teamwork, and enhanced practitioner confidence when used to support the delivery of simulated emergency medical care.Trial RegistrationClinicalTrials.gov Identifier: NCT05870137

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Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

Cited by 30 publications

References 219 publications

Overcoming Clinician Technophobia: What We Learned from Our Mass Exposure to Telehealth During the COVID-19 Pandemic

Overcoming Clinician Technophobia: What We Learned from Our Mass Exposure to Telehealth During the COVID-19 Pandemic

A Perspective on Implementation of Technology-Driven Exergames for Adults as Telerehabilitation Services

Effect of Mixed Reality on Delivery of Emergency Medical Care in a Simulated Environment

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