Abstract
BackgroundIn many telemedicine applications, the correct use of medical device at the point of need is essential to provide an appropriate service. Some applications may require untrained people to interact with medical devices and patients: care delivery in transportation, military actions, home care and telemedicine training.Appropriate operation of medical device and correct connection with patient’s body are crucial. In these scenarios, tailored applications of Augmented Reality can offer a valid support by guiding untrained people at the point of need. This study aims to explore the feasibility of using Augmented Reality in telemedicine applications, by facilitating an acceptable use of biomedical equipment by any unskilled person. In particular, a prototype system was built in order to estimate how untrained users, with limited or no knowledge, can effectively interact with an ECG device and properly placing ECG electrodes on patient’s chest.MethodsAn Augmented Reality application was built to support untrained users in performing an ECG test. Simple markers attached to the ECG device and onto patient’s thorax allow camera calibration. Once objects and their pose in the space are recognized, the video of the current scene is enriched, in real-time, with additional pointers, text boxes and audio that help the untrained operator to perform the appropriate sequence of operations. All the buttons, switches, ports of the ECG device together with the location of precordial leads were coded and indicated. Some user’s voice commands were also included to improve usability.ResultsTen untrained volunteers, supported by the augmented reality, were able to carry out a complete ECG test first on a mannequin and then on a real patient in a reasonable time (about 8 minutes on average). Average positioning errors of precordial electrodes resulted less than 3 mm for the mannequin and less than 7 mm for the real patient. These preliminary findings suggest the effectiveness of the developed application and the validity of clinical ECG recordings.ConclusionThis application can be adapted to support the use of other medical equipment as well as other telemedicine tasks and it could be performed with a Tablet or a Smartphone.
Highlights
In many telemedicine applications, the correct use of medical device at the point of need is essential to provide an appropriate service
Some examples are telemedicine services on transportation, application during military actions [9], on islands or remote areas [10,11], some emergency applications [12,13], and home care telemedicine supported by family members [14,15,16], elderly care [17,18], operators training and so on
A flow-chart of activities was created to describe all possible sequences of simple tasks necessary to carry out an electrocardiographic test using that particular ECG device
Summary
The correct use of medical device at the point of need is essential to provide an appropriate service. Some examples are telemedicine services on transportation (e.g. aircrafts [4,5,6], boats [7,8], trains, etc.), application during military actions [9], on islands or remote areas [10,11], some emergency applications [12,13], and home care telemedicine supported by family members [14,15,16], elderly care [17,18], operators training and so on In these cases, untrained or improvised (but necessary) actors can, involuntarily, use medical instruments in an inappropriate manner and/or make improper connection between the patient and the medical device seriously invalidating the telemedicine service. In these scenarios, tailored applications of Augmented Reality (AR) can offer a valid support by guiding non-trained people to a correct usage of medical devices at the point of need. The application domains for AR are numerous and extend in different fields such as training and support, design, medicine, entertainment and cultural heritage [19,20,21]
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