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: 2326455
• 负责人: Ericka Greene
• 金额: $ 24.83万
• 依托单位: The Methodist Hospital Research Institute
• 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=2326455&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.

自从FDA在COVID-19大流行期间和之后取消了对远程医疗的限制以来，远程医疗访问已经增长到每五个病人-医生咨询中就有一个。这种远程医疗咨询带来了便利和可及性，特别是对最需要的老年人和农村社区。然而，远程医疗咨询通常仅限于视频和语音交换，通常通过智能手机的受限界面进行。体检对于早期发现和诊断严重的健康问题至关重要，但医生要求患者进行自我检查。该项目将研究使远程医生能够与当地护士合作进行医疗体检的技术和实践。护士戴着触摸感应手套进行检查。医生通过触摸式医疗驾驶舱体验护士的感受，医生也从护士的角度看到检查。临床医生和护理研究人员;机械，工业和计算机工程师;和心理学家将在这项研究中合作开发触摸传感和显示技术，交互方法和设计，以及这种远程体检所需的医疗/护理实践和培训。该小组将研究技术和实践的有效性，以及医生、护士和患者接受此类检查的程度。该团队还将研究如何将这项技术部署在偏远和农村地区，在这些地区，患者可能无法获得医疗检查，特别是在需要专家的情况下。因此，本研究旨在实现对社会的更广泛影响，特别是对服务不足的社区，以及在传染病爆发期间，当身体访问集中医疗设施时会带来风险。该项目旨在改变医生和护士的联合工作环境，同时解决通过远程医疗提供包容性医疗保健的社会需求。研究工作将远程体检框架为佩戴触觉传感手套的护士/护理人员与患者近端的远端医生在多模式交互式驾驶舱之间的合作实践。这一框架的关键挑战是，触觉感知是主动的（这意味着它是难以解释的触觉模式，如果一个人不是在一个人的手指的运动的直接控制），在触觉传感和显示技术的缺乏，以及缺乏了解这样的交互设计和他们的影响上的检查三位一体的成员：医生，护士和病人。这些挑战激发了耳、鼻、喉检查的三个研究方向：1.互动动力学和考试驾驶舱和方法的设计; 2。用于触觉感测和显示/致动的触摸技术创新;以及3.从知觉和社会理解、认知负荷、技术接受以及医疗/护理实践和培训的角度理解该方法的影响。所有的推力涉及工程师，社会/人文科学家和临床/护理研究人员之间的跨学科合作。该研究将采用迭代设计-构建-测试-观察/反映方法。第一目标将调查交互和测试平台配置问题并开发/维护研究测试平台。Thrust 2将开发将单独评估并集成到测试平台中的技术。Thrust 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。临床医生和护理研究人员将参与所有的设计和评估阶段，为研究奠定基础，激励设计轨迹，并为医生和护士制定新的实践和培训方法。反过来，这些方法将与技术和测试平台一起进行测试。一个顾问团队将指导研究，并为农村和偏远社区的技术可行性调查提供信息。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。