Background The distinctive features of the digital reality platforms, namely augmented reality (AR), virtual reality (VR), and mixed reality (MR) have extended to medical education, training, simulation, and patient care. Furthermore, this digital reality technology seamlessly merges with information and communication technology creating an enriched telehealth ecosystem. This review provides a composite overview of the prospects of telehealth delivered using the MR platform in clinical settings. Objective This review identifies various clinical applications of high-fidelity digital display technology, namely AR, VR, and MR, delivered using telehealth capabilities. Next, the review focuses on the technical characteristics, hardware, and software technologies used in the composition of AR, VR, and MR in telehealth. Methods We conducted a scoping review using the methodological framework and reporting design using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Full-length articles in English were obtained from the Embase, PubMed, and Web of Science databases. The search protocol was based on the following keywords and Medical Subject Headings to obtain relevant results: “augmented reality,” “virtual reality,” “mixed-reality,” “telemedicine,” “telehealth,” and “digital health.” A predefined inclusion-exclusion criterion was developed in filtering the obtained results and the final selection of the articles, followed by data extraction and construction of the review. Results We identified 4407 articles, of which 320 were eligible for full-text screening. A total of 134 full-text articles were included in the review. Telerehabilitation, telementoring, teleconsultation, telemonitoring, telepsychiatry, telesurgery, and telediagnosis were the segments of the telehealth division that explored the use of AR, VR, and MR platforms. Telerehabilitation using VR was the most commonly recurring segment in the included studies. AR and MR has been mainly used for telementoring and teleconsultation. The most important technical features of digital reality technology to emerge with telehealth were virtual environment, exergaming, 3D avatars, telepresence, anchoring annotations, and first-person viewpoint. Different arrangements of technology—3D modeling and viewing tools, communication and streaming platforms, file transfer and sharing platforms, sensors, high-fidelity displays, and controllers—formed the basis of most systems. Conclusions This review constitutes a recent overview of the evolving digital AR and VR in various clinical applications using the telehealth setup. This combination of telehealth with AR, VR, and MR allows for remote facilitation of clinical expertise and further development of home-based treatment. This review explores the rapidly growing suite of technologies available to users within the digital health sector and examines the opportunities and challenges they present.
BACKGROUND The distinctive features of the digital reality platform, the augmented, virtual and mixed reality, have extended to medical education, training, simulation, and patient care. Furthermore, this digital reality technology seamlessly merges with the information and communication technology creating for enriched telehealth ecosystem. This review reconstructs a composite overview of the prospects of telehealth delivered using the mixed reality platform in clinical settings. OBJECTIVE This review identifies various clinical applications of high-fidelity digital display technology, viz., augmented, virtual and mixed reality delivered using telehealth capabilities. Next, the review focuses on the technical characteristics, hardware, and software technologies utilized in the composition of AR, VR, and MR in telehealth. Lastly, it highlights the several determinants for adopting or rejecting this technology from both the patient’s and healthcare professional’s perspectives. METHODS A structured literature search was conducted, and full-length articles in English literature were obtained from the Embase, PubMed, and Web of Science databases. The search protocol was based on the following keywords and mesh headings, "augmented reality," "virtual reality," "mixed-reality," "telemedicine," "telehealth," and "digital health" to obtain relevant results. A pre-defined inclusion-exclusion criterion was developed in filtering the obtained results and the final selection of the articles, followed by data extraction and construction of the review. RESULTS We identified 4407 articles, of which 321 were eligible for full-text screening. A total of 134 full-text articles were included in the review. Telerehabilitation, telementoring, teleconsultation, telemonitoring, telepsychiatry, telesurgery, and telediagnosis were the segments of the telehealth division that explored the use of augmented, virtual, and mixed reality platforms. Telerehabilitation using virtual reality was the most commonly recurring segment in the included studies. Augmented and mixed reality has been mainly employed for telementoring and teleconsultation. The most significant technical features of digital reality technology to emerge with telehealth were virtual environment, exergaming, 3D avatars, telepresence, anchoring annotations, and first-person viewpoint. Different arrangements of technology – 3D modeling and viewing tools, communication and streaming platforms, file transfer and sharing platforms, sensors, high fidelity displays, and controllers formed the basis of most systems. Both patients and clinicians indicated a high motivation for using this novel technology but several limitations, including lack of interoperability, unreliable network infrastructure, internet connectivity issues, and upcoming technology that is still evolving, leading to a slower uptake. CONCLUSIONS This review constitutes a recent overview of the evolving digital augmented and virtual reality in various clinical applications using the telehealth setup. This combination of telehealth with AR, VR, and MR allows for remote facilitation of clinical expertise and further development of home-based treatment. This review explores the rapidly growing suite of technologies available to users within the digital health sector and examines the opportunities and challenges they present.
Background: Worldwide, demand for health care services far outpaces the availability of staff. The use of robots in healthcare has advanced in recent years as robots are seen as a viable solution to address the shortage of healthcare staff. We propose the use of a humanoid robot to provide basic nutritional education to patients with diabetes in the waiting room, hence freeing up time for dieticians to address more complex issues. We hypothesize that use of this intervention will be more effective than the current standard of care i.e. A leaflet, in educating and empowering patients with diabetes. Methods: We conducted a single-centre, randomized controlled trial to determine whether a humanoid robot would improve patient’s knowledge of nutrition. The primary outcome of the trial is improvement in patient knowledge score based on 36 items from a validated nutrition questionnaire. Each patient’s prior knowledge of nutrition was assessed by a validated questionnaire prior to the intervention. Patients were randomized to current standard of care i.e. physician-led education plus a leaflet (n=40) or standard of care plus Droid Audio Visual Educator (n=40). Following the trial, both groups had their knowledge of nutrition reassessed using the same validated questionnaire. The performance of patients in each group was compared and effectiveness of the intervention in improving education objectively determined. Results: A total of 90 patients underwent randomization. 10 withdrew before completion. The mean age was 53.7 years. The change in score in the intervention group was 3.2 of 36 points higher than control group on average (95% confidence interval [CI] 0.9 to 5.4; P= 0.006). Conclusions: This trial suggests there is potential for humanoid robots to deliver basic nutritional education Disclosure S.O'connor: None. J.Ong: None. B.Lim: None. S.Coleman: None. H.Worlikar: None. C.Connolly: None. S.E.Mcgarel: None. T.O'brien: None. D.T.O'keeffe: None. Funding Health Services Executive, Intern Network Academic Track
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