Collaborative Research: FW-HTF-RL: Collaborative Remote Physical Examination: Transforming Medical and Nursing Practice

协作研究：FW-HTF-RL：协作远程体检：改变医疗和护理实践

• 批准号: 2326454
• 负责人: Brooke Feeney
• 金额: $ 25万
• 依托单位: Carnegie-Mellon University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2326454&HistoricalAwards=false
• 关键词: Collaborative; Research; FW; HTF; RL

Since the FDA lifted restrictions on telemedicine during and after the COVID-19 pandemic, remote tele-health visits have grown to account for one of every five patient-physician consultations. Such telemedicine consultation has brought convenience and access, especially for the elderly and rural communities that are in the greatest need. Telemedicine consultations, however, are typically limited to video and voice exchanges, often through the constrained interface of a smartphone. Physical examinations, critical to early detection and diagnosis of serious health concerns, are reduced to the physician asking the patient to do a self-examination. The project will investigate technologies and practices that enable remote physicians to collaborate with nurses at local sites to perform medical physical examinations. The nurse wears touch sensing gloves to do the examination. The physician experiences what the nurse feels through a touch-enabled medical cockpit at which physician also sees the examination from the nurse’s perspective. Clinical physician and nursing researchers; mechanical, industrial, and computer engineers; and psychologists will collaborate on this research to develop the touch sensing and display technologies, the interaction methodologies and designs, and the medical/nursing practices and training needed for such remote physical examinations. The team will study the effectiveness of the technology and practices, and the degree to which physicians, nurses, and patients will accept such examinations. The team will also investigate how this technology may be deployed in remote and rural settings where patients may not otherwise have access to medical examinations, especially if a specialist is required. Hence, this research aims at realizing broader impacts on society, especially for underserved communities, and during infectious disease outbreaks when physical visits to centralized medical facilities carry risks.The project seeks to transform the allied work contexts of physicians and nurses while addressing the societal need of providing inclusive access to healthcare through telemedicine. The research efforts frame remote physical examination as a cooperative practice between a nurse/caregiver wearing tactile sensing gloves proximal to the patient with a distal physician at a multimodal interactive cockpit. Critical challenges to this framing are that tactile perception is active (meaning that it is difficult to interpret tactile patterns if one is not in direct control of the movement of one’s fingers), the paucity in haptic sensing and display technologies, and the lack of understanding of such interaction designs and their impacts on the members of the examination triad: the physician, nurse, and patient. These challenges motivate three research thrusts in the context of ear, nose, and throat examinations: 1. The interaction dynamics and design of examination cockpits and methodologies; 2. Touch technology innovations for haptic sensing and display/actuation; and 3. Understanding the impacts of the approach from the stand-points of perceptual and social understanding, cognitive load, technology acceptance, and medical/nursing practice and training. All thrusts involve interdisciplinary collaboration among engineers, social/humanities scientists, and clinical/nursing researchers. The research will take an iterative Design-Build-Test-Observe/Reflect approach. Thrust 1 will investigate interactive and testbed configuration issues and develop/maintain a research testbed. Thrust 2 will develop technologies that will be evaluated separately and integrated in the testbed. Thrust 3 will evaluate the iterative designs and technologies and develop new workflows and training for medical professionals. Clinical physician and nursing researchers will participate in all design and evaluation phases to ground the research, motivate design trajectories, and formulate new practice and training approaches for doctors and nurses. These methods will, in turn, be tested in conjunction with the technology and testbeds. An advisory team will guide the research and inform investigation of feasibility of the technology in rural and remote communities.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.

由于FDA在19日期大流行期间和之后取消了对远程医疗的限制，因此远程远程医疗访问已增加，以占五次患者 - 医学咨询中的一次。这种远程医疗咨询带来了便利和访问，尤其是对于最需要的老年人和艰难的社区。但是，远程医疗咨询通常仅限于视频和语音交换，通常是通过智能手机的约束界面。身体检查，对早期发现和严重健康问题的诊断至关重要，将减少为身体检查，要求患者进行自我检查。该项目将调查技术和实践，使远程医生能够与当地现场的护士合作进行医学检查。护士戴着触摸感的手套进行检查。通过一个触摸的医疗驾驶舱，护士的身体经历从护士的角度看考试。临床身体和护士研究人员；机械，工业和计算机工程师；心理学家将在这项研究上进行合作，以发展触摸敏感性和展示技术，互动方法和设计以及此类远程体格检查所需的医学/护理实践和培训。团队将研究技术和实践的有效性，团队的学位还将调查如何将这种技术部署在远程和粗糙的环境中，在这些环境中，患者可能无法接受体检，尤其是在需要专家的情况下。因此，这项研究旨在实现对社会的广泛影响，尤其是对服务不足的社区，在传染病爆发期间，当对集中医疗设施进行实际访问时，该项目旨在改变医生和护士的盟军工作环境，同时解决通过远程医疗提供包容性医疗服务的社会需求。研究工作将远程体格检查作为护士/照顾者之间的教练实践，戴着触觉敏感性在多模式互动驾驶舱上靠近患者的患者靠近患者。这款框架的关键挑战是触觉感知是有效的（这意味着如果一个人直接控制着手指的运动，很难解释触觉模式），触觉感应和展示技术的匮乏，以及对这种相互作用设计及其对检查成员的影响及其对互动设计的理解：身体，身体，培训，培训和患者。这些挑战激发了在耳朵，鼻子和喉咙检查的背景下的三项研究推力：1。检查驾驶舱和方法的相互作用动态和设计； 2。触摸技术创新，用于触觉感测和驱动； 3。从感知和社会理解，认知负荷，技术接受以及医疗/护理实践和培训中了解方法的影响。所有推力都涉及工程师，社会/人文科学家和临床/护理研究人员之间的跨学科合作。这项研究将采用迭代设计建造测试效果/反思方法。推力1将研究互动和测试的配置问题，并开发/维护经过测试的研究。推力2将开发将分别评估并集成在测试中的技术。推力3将评估迭代设计和技术，并为医疗专业人员开发新的工作流程和培训。临床物理学和护士研究人员将参加所有设计和评估阶段，以基础研究，动机设计轨迹，并为医生和护士制定新的实践和培训方法。这些方法又将与技术和测试床一起测试。咨询团队将指导研究并告知该技术对粗糙和偏远社区的可行性的投资。该奖项反映了NSF的法定任务，并使用基金会的知识分子优点和更广泛的影响审查标准，认为通过评估被认为是宝贵的支持。