Three stories of AR applications in medicine

Mark Underbrush MD, lead physician in the Department of Internal Medicine at St. Philippine’s Medical Center, Austin TX. Typically, my day consists of seeing new patients, observing hospital patients, and performing selected manipulations. I work on a twenty-four hour duty schedule, so I have to have contact with a lot of patients and clinic staff during my shift. So, on a typical day, I have about 8 or 10 examinations and consultations when new patients come in.

We use the Cerner EHR system, where we enter records of research and medical appointments, as well as patient history, previous visits, diagnoses, and prescription medications. The benefits of the augmented reality helmet became clear in the first days.

First, I don’t have to waste time entering data from the keyboard. I examine the patient, immediately enter the results into his history, say the text, and the clever software fills in the fields of the form. At the same time, I see and control the process and can make corrections. I do all this without touching the controls with unsterile hands. Before, everything was longer and more complicated. Especially with some patients, taking notes and examining at the same time was simply impossible.

Secondly, I don’t distract from the patient’s story, I don’t turn away from the patient, and in doing so, I already review previous appointments and laboratory tests. Immediately during the examination, I make the first appointments and referrals for tests. Without a doubt, the speed of my work has at least doubled, there is less stress and more attention to the patient.

Third, my caseload has periodically increased many times since the beginning of the pandemic COVID-19. I observe up to 30 or more patients during a shift. Now 10 minutes is enough for me to assess changes in dynamics and adjust therapy. I already walk down the hall to the patient and have time to review all the updates. I come in and talk, even though all the new records have already been entered into the system, the administrators and nurses have already accepted the changes. I won’t speak for them, but I’m sure that this technology also helps them a lot in their work.

As for the disadvantages, I think the main thing is to get used to the weight of the helmet. Exactly to get used to it, because I don’t normally wear headwear in my life, nothing but medical clothes. A medical cap is weightless and you don’t have to get used to it.

Breathing through a helmet-integrated respirator is much easier than with other respirators. There’s an undeniable advantage. Eyes and goggles don’t sweat. I love the direction that science and technology is taking.

Petra Angelis MD, Medical Resident in the Department of Emergency Medicine at St. Philippine’s Medical Center, Austin TX. This is my third year with the center. I don’t need to explain that the speed of the staff in our department determines life and the prognosis of further treatment. The main difference from planned hospitalization is the emergency nature of the diagnosis and the stress of the patient. Of course, we are used to interaction no worse than a Formula One team, nevertheless people change in shifts and when you are used to work with some people, then with others you can’t understand half a word at once anymore.

What the new helmet with AR technology allows me to do faster is to quickly digitize appointments and referrals, like typing on a tape recorder. Already you go to the next exam room and know that the previous patient has been admitted and will be conducted according to my notes without distracting me, and I have time during the break to review the journal updates and see the results of the examinations. The schedule is constantly updated before my eyes. I see urgent calls promptly; we haven’t used the speakerphone in the department in a long time.

It all, you know, lowers cortisol and adrenaline hormone levels. I think there is a future for this kind of technology, because it is natively convenient, like a tablet. You don’t need instructions, the interface is intuitive and concise. It’s especially nice that you do your work and take notes at the same time, you don’t have to remember.

Other than that, I also want to point out the comfort during medical manipulation. You’re in a dirty uniform with unsterile hands that are busy, there’s just no alternative to holding a patient and looking at their history, and sometimes, I’m not embarrassed to say it, even looking at the medical knowledge base and literature. You know, there are still cases that you encounter for the first time and time goes by, minutes to minutes. It’s a great technology.

Spenser Gaudi MD, cardiac surgeon at Interventional Cardiology at St. Philipp’s Medical Center, Austin TX. I will say unequivocally, I support innovation in medicine, including surgery. I don’t know how easily I can switch to remote surgery in the near future and work with manipulators and joysticks on a surgery robot, when I am used to working with my hands and to a certain brand of instrument.

The clinic management meets me halfway. But in this case, I can say that augmented reality technology is convenient. Especially for complicated cases, when tomography images are not enough, you are waiting for a non-trivial location and developmental features. When such episodes occur, it is better to invite another expert for a remote consultation and discuss the strategy in a few minutes. Still, the experience of two surgeons is more than your own, but twice as long.

Keeping the scans in front of your eyes and using them to revise before resection and suturing is a simple but effective idea. Auto-logging of procedures and manipulations is another great idea. This detailed automatic report is a good defense against unwarranted claims from insurance companies and their lawyers.

Image quality is also high, with binoculars is less convenient, the field of view is smaller and you often need to refocus the pupils, when it is impossible to work without touching them. I would not call it a revolutionary technology, but it is more progressive and convenient for surgeons. There are more options. After all, this is a digital device.

The names and titles have been changed. Any similarity is coincidental.

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