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 COVID-19 大流行初期以来，远程医疗在美国取得了巨大的发展，通过与原本无法接触到的卫生专业人员和专家进行远程医疗访问，为资源贫乏地区的人们提供了更广泛的医疗保健服务。然而，这些访问目前仅限于视频电话会议式的交流，并且缺乏体检的能力，而体检对于诊断和识别健康问题有很大帮助，而这些健康问题在医疗访问期间可能不会出现。该项目调查了支持体检的可能性。护理人员将在远程医生的指导下，戴上敏感手套进行检查，使用体检驾驶舱，让他们使用护理人员手套的输出和视频来查看和感觉患者。这项技术和实践可能会改变护理人员的工作。医生和当地护理人员，为更有效、更方便的远程医疗就诊打开了大门。上述讨论揭示了一些问题该项目旨在解决的第一个问题是，触觉解释是主动的，这意味着人们通常必须控制感知过程才能解释感官输出，该提案将探索人们可以有意义地解释被动接收的条件。触觉信息，例如当本地（患者）护理人员现在控制感知运动时远程医生会感觉到什么，用于测试将代理权返回给医生的一种方法是称为“橡胶手”的心理现象。 '或身体转移幻觉，其中人们在心理上将适当放置的橡胶手视为自己的，并且受试者本能地感受到对橡胶手的影响即使橡胶手错觉没有完全激活，本地触摸探索者和远程翻译之间的联合专业知识也可能会出现。促进所需的触觉理解，并且可以通过实践来增强这种理解（例如，远端触摸者的手与受试者隐藏的手的相对位置、触摸的程度和类型）。该团队还将对进行体检的医生进行一系列基于视频的扎根理论探索，以更好地了解该过程。对可作为本地护理人员和远端医生之间沟通基础的具体行动进行分类，并告知实现这种协作检查所需的技术发展。最后，由医生和护士、机械工程师、人类组成的项目团队。 -计算机交互研究人员，以及感知心理学家将就所描述的研究进行合作，参与团队发展练习，反映了对联合体检过程获得更强有力的共同理解，并支持这些实践和技术的未来研究和开发。该奖项是 NSF 的法定使命，并被认为是值得的通过使用基金会的智力优势和更广泛的影响审查标准进行评估来获得支持。