FW-HTF-P: Toward Collaborative Remote Physical Examination: Transforming Medical and Nursing Practice

FW-HTF-P：迈向协作远程体检：改变医疗和护理实践

• 批准号: 2222918
• 负责人: Francis Quek
• 金额: $ 15万
• 依托单位: Texas A&M University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2222918&HistoricalAwards=false
• 关键词: FW; HTF; Toward; Collaborative; Remote

Since the early in in the COVID-19 pandemic, telemedicine has seen tremendous growth in the U.S, providing people in under-resourced areas with broader access to healthcare through remote telemedicine visits with health professionals and experts to whom they may not otherwise have access. However, these visits are currently restricted to video teleconference-style exchanges and lack the capacity for physical examinations, which contribute significantly to diagnoses and the identification of health concerns that may not otherwise surface during a medical visit. This project investigates the possibility of supporting physical examination as a paired practice between a caregiver local to the patient and a remote physician, using touch-based and augmented-reality technologies. Caregivers will perform examinations while wearing touch-sensitive gloves, guided by remote physicians using a physical examination cockpit that lets them see and feel the patient using the outputs from the caregiver’s gloves and a video feed. The technology and practice will potentially transform the work of physicians and local caregivers, opening the door to more effective and more accessible telemedicine visits.The foregoing discussion uncovers a number of questions that the project is designed to address. First, tactile interpretation is active, meaning that one has to typically be in control of the sensing process to be able to interpret the sensory output. The proposal will explore conditions under which one can meaningfully interpret passively received tactile information, such as what the remote physician would feel when a local (to the patient) caregiver is now in control of the sensing motions. One method to be tested for returning agency to the physician is the psychological phenomenon known as the ‘rubber hand’ or body transfer illusion, where one psychologically associates an appropriately-placed rubber hand as one’s own, and an impact on the rubber hand is viscerally felt by the subject. Even if the rubber hand illusion does not fully activate, joint expertise between the local touch explorer and the distant interpreter may facilitate the needed tactile understanding, and this understanding may be enhanced through practice. The project team will explore configurations (e.g., relative positions of the distal toucher’s hands to the subject’s hidden hands, degree of and type of movement/tactile exploration, visual/augmented reality presentation) that allow body transfer illusions or joint expertise to enable interpretation. The team will also conduct a series of video-based grounded theory explorations of physicians performing physical examinations to gain a better understanding of the process and to categorize specific actions that may serve as the basis of communication between the local caregiver and the distal physician, and to inform the technology developments necessary to enable this collaborative examination. Finally, the project team, comprising physicians and nurses, mechanical engineers, human-computer interaction researchers, and perceptual psychologists, will collaborate on the research described, engaging in team development exercises to gain a stronger shared understanding of the joint physical examination process and support future research and development of these practices and technologies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

自从在199日大流行中的早期以来，远程医疗在美国已经巨大的增长，为资源不足的地区提供了通过远程远程医疗的访问，可以与卫生专业人员和专家访问更广泛的医疗保健服务，以否则他们可能无法与他们接触。但是，这些访问目前仅限于视频电信风格的交流，并且缺乏进行体格检查的能力，这对诊断和医疗访问期间可能不会浮出水面的健康问题产生了重大贡献。该项目研究了使用基于触摸和增强现实的技术来支持体格检查的可能性，作为患者本地护理人员与远程物理的配对实践。护理人员将在戴触摸敏感手套的同时进行检查，并在远程医生的指导下使用体格检查驾驶舱，使他们可以使用护理人员手套和视频供稿的输出来看到并感觉到患者。该技术和实践将有可能改变医生和当地护理人员的工作，为更有效，更容易获得的远程医疗访问打开大门。上述讨论发现该项目旨在解决的许多问题。首先，触觉解释是活跃的，这意味着通常必须控制灵敏度过程才能解释感觉输出。该提案将探讨可以有意义地解释被动收到的触觉信息的条件，例如，当当地（对患者）护理人员控制敏感性动作时，远程物理学会感觉到。一种要测试的归还机构到身体的方法是一种被称为“橡胶手”或身体转移幻觉的心理现象，在该心理上，一个人将适当放置的橡胶手作为一个人自己的手，对橡胶手的影响是由主题的内在感觉到的。即使橡胶手的幻觉没有完全激活，本地触摸探险家和遥远的口译员之间的共同专家也可以促进所需的触觉理解，并且可以通过实践来增强这种理解。项目团队将探索配置（例如，远端触摸者手的相对位置与受试者的隐藏手，运动/触觉探索的程度和类型的类型，视觉/增强现实表现），以允许身体转移幻觉或共同的专业知识来启用解释。该团队还将对医师进行体格检查的医师进行一系列基于视频的基础理论探索，以更好地了解该过程，并对可能作为当地护理人员与独特的身体之间进行交流的特定行动进行分类，并为启动这项协作审查所必需的技术发展提供信息。最后，项目团队，合规的医师和护士，机械工程师，人力计算人的互动研究人员和知觉心理学家将在所描述的研究上进行合作，参与团队发展练习，以获得对共同的物理检查过程的更深入的共同理解，并支持未来的研究和发展这些实践和技术的发展。影响审查标准。