MEDdesign

Augmented Reality: Helping Healthcare Professionals Observe What Nobody Else Can See

By Gautam Goswami
August 27, 2020


• Categories: 03-Manufacturing Execution, MEDdesign

Back in 2016, augmented reality (AR) went mainstream with the viral smartphone game Pokémon Go, where players hunt for Pokémon by using their phone’s camera to capture virtual creatures in real-world environments.

The uses of AR technology have gone far beyond recreational and gaming platforms, into many practical applications with notable benefits. While being applied in a variety of industrial settings, AR has also brought an unparalleled depth of vision into the healthcare field.

With AR technology, users see the real world overlaid with computer-generated images for an enhanced composite view in real time. Objects can be overlaid on live camera views of screens ranging from smartphones, tablets, to smart glasses, as well as high end helmets outfitted to provide users with a fully hands-free enhanced engagement and control interface into systems and applications.

By 2019, according to a review in the Journal of Med Internet Research (JMIR), the field of AR had already been well-researched with trends pointing toward its applications in healthcare. However, the article noted, its use in the field of medicine is in its early stages and it had not, even as of last year, been widely adopted into mainstream clinical practice.
However, there are a growing number of instances where AR is being applied by early adopters in the healthcare industry to perform very specialized lines of work. One of the earliest to set many precedents was neurosurgery, which has been at the forefront of image-guided surgery and continues to push the frontiers of AR technology in the operating room.¹

Precursors to AR

In 1998, the use of AR was demonstrated in endovascular applications. Four years later, the first augmented neurosurgical endoscope was developed. By 2016 most publications, including the Canadian Journal of Neurosciences, discussed AR in neurosurgery relative to tumor resection, while others described open neurovascular surgery, spinal procedures, localization of catheters or probes, and cortical resection in epilepsy. The technology also offered surgeons an enhanced visualization of superficial and deep venous structures.

AR guidance was especially useful for aneurysms involving unusual trajectories or hidden branches. And in scull base tumor surgery, AR overlays of volumetric data reduced patient use of both intensive care units and length of hospital stays by 40–50% compared to non-AR cases.¹

There are other clinical applications of AR as well. And with the onset of COVID-19, its use in telemedicine—particularly in providing expert detection, analysis, and instruction from remote locations—has helped to extend the reach of specialized physicians to every part of the world, enabling a doctor in one geography to treat a patient in another location. It has also been used to electronically triage disaster patients, guide orthopedic residents to perform arthroscopic shoulder surgery, and train novices on point-of-care ultrasound.

A 2019 article in the JMIR describes an instance where physicians in Birmingham, Alabama, using an iPad outfitted with both virtual and augmented reality-software, assisted local doctors in Saigon, now Ho Chi Minh City, Vietnam, with neurosurgical procedures.²

And elsewhere around the world, paramedics and other healthcare workers who have been stretched thin by the demands of the coronavirus pandemic sought remote solutions to help when it was too dangerous for them to travel.
AR is well-positioned to be part of that solution by enabling real-time knowledge transfer between physicians.

Outside hospital walls, AR apps are showing users the exact locations of nearby automated external defibrillators (AEDs). Others provide patients with animated models of medications to show how they work inside the body.

In hospitals and other clinical settings, AR has become instrumental for remote support, enabling technicians and on-site personnel to get the required expert help for the installation, setup, maintenance, troubleshooting, and repair of highly specialized, sensitive hospital equipment.

Teaching Medicine

As a medical teaching tool, AR is remarkably valuable. Medical learning is highly complex, with instruction involving all sorts of possible variations. Much of that learning is workplace learning. And as such, learning by doing—integrating new experiences with existing knowledge—is an ongoing requirement.

AR can help to create a learning environment very similar to the professional work environment. It is highly interactive, providing immediate learner feedback. And its augmentations can visualize the invisible, simulating relevant dimensional, tactile, and other aspects of the real-world task.

Several AR systems have been developed specifically for anatomy education, including ones for use in undergraduate classes.³ They involve relatively inexpensive hardware, provide a more meaningful context than textbooks, and base their visualizations on real-life material. Teaching topics have included lung dynamics, laparoscopic skills, surgical planning, electrocardiograms, ultrasound, arthroscopic surgery, and many other specialties.

“Learning supported with AR technology enables ubiquitous, collaborative, and situated learning,” the authors of a journal article on the topic observed.⁴ “It delivers a sense of presence, immediacy, and immersion,” they add suggesting a benefit to the medical learning process.

Even so, AR technology is still relatively new. And its medical applications—although promising—have yet to become established as indispensable tools in healthcare. But, as innovative uses of augmented reality prove their value in a growing number of life-saving procedures, AR technology appears to be on the verge of widespread acceptance within the medical community.

References

1. Guha, D., et al. (2017). “Augmented Reality in Neurosurgery: A Review of Current Concepts and Emerging Applications”. The Canadian Journal of Neurological Sciences, Inc.
2. Munzer, W.M., et al. (April 2019). “Augmented Reality in Emergency Medicine: A Scoping Review.” J Med Internet Res. U
3. Kamphuis, C., et al. (September 2014). “Augmented reality in medical education?” Perspect Med Educ.
4. Wu, H., et al. “Current status, opportunities and challenges of augmented reality in education”. Comput Educ.