Use of the HoloLens2 Mixed Reality Headset for Protecting Health Care Workers During the COVID-19 Pandemic: Prospective, Observational Evaluation

Abstract

Background The coronavirus disease (COVID-19) pandemic has led to rapid acceleration in the deployment of new digital technologies to improve both accessibility to and quality of care, and to protect staff. Mixed-reality (MR) technology is the latest iteration of telemedicine innovation; it is a logical next step in the move toward the provision of digitally supported clinical care and medical education. This technology has the potential to revolutionize care both during and after the COVID-19 pandemic. Objective This pilot project sought to deploy the HoloLens2 MR device to support the delivery of remote care in COVID-19 hospital environments. Methods A prospective, observational, nested cohort evaluation of the HoloLens2 was undertaken across three distinct clinical clusters in a teaching hospital in the United Kingdom. Data pertaining to staff exposure to high-risk COVID-19 environments and personal protective equipment (PPE) use by clinical staff (N=28) were collected, and assessments of acceptability and feasibility were conducted. Results The deployment of the HoloLens2 led to a 51.5% reduction in time exposed to harm for staff looking after COVID-19 patients (3.32 vs 1.63 hours/day/staff member; P=.002), and an 83.1% reduction in the amount of PPE used (178 vs 30 items/round/day; P=.02). This represents 222.98 hours of reduced staff exposure to COVID-19, and 3100 fewer PPE items used each week across the three clusters evaluated. The majority of staff using the device agreed it was easy to set up and comfortable to wear, improved the quality of care and decision making, and led to better teamwork and communication. In total, 89.3% (25/28) of users felt that their clinical team was safer when using the HoloLens2. Conclusions New technologies have a role in minimizing exposure to nosocomial infection, optimizing the use of PPE, and enhancing aspects of care. Deploying such technologies at pace requires context-specific information security, infection control, user experience, and workflow integration to be addressed at the outset and led by clinical end-users. The deployment of new telemedicine technology must be supported with objective evidence for its safety and effectiveness to ensure maximum impact.

Trends in Use of Telehealth Among Health Centers During the COVID-19 Pandemic — United States, June 26–November 6, 2020

“…Although in-person visits are needed to provide timely routine care and for urgent and emergency situations, maintaining telehealth capacity is critical during the COVID-19 pandemic. Telehealth visits can facilitate patient triage, which can reduce the effect of patient surge on facilities, address limitations to health care access, conserve personal protective equipment, and reduce disease transmission ( 6 ).…”

Telehealth Practice Among Health Centers During the COVID-19 Pandemic — United States, July 11–17, 2020

“…Before the COVID-19 pandemic, lack of uniform coverage policies across insurers and states and obstacles to establishing telehealth in health systems (e.g., high startup costs, workflow reconfiguration, clinician buy-in, and patient interest) led to a slow adoption and use of telehealth services in the United States ( 8 ). Since the pandemic began, telehealth has been used to triage patients and reduce the impact of patient surge on facilities, address decreased access to health care, conserve PPE, and reduce the transmission of SARS-CoV-2 ( 9 ).…”

A Feasibility Trial of HoloLens 2™; Using Mixed Reality Headsets to Deliver Remote Bedside Teaching During COVID-19

“…2). with a decontamination protocol (10). The device and protocols were registered at our local institution with data governance agreed upon.…”

“…The use of HoloLens™ and similar MR devices have already been trialled in medical education speci cally for teaching anatomy (8,9). A recent pilot study at this centre demonstrated the use of HoloLens™ during the COVID-19 pandemic for direct clinical care reduced time exposure of staff caring for COVID-19 patients by 51.5% with an 83.1% reduction in PPE use (10).…”