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，远程远程医疗就诊已占到患者与医生咨询的五分之一，这种远程医疗咨询带来了便利和便利，特别是对于老年人和农村地区。然而，最需要的社区通常仅限于通过智能手机的有限界面进行视频和语音交流。对于早期发现和诊断严重健康问题至关重要的身体检查则被简化为由医生进行。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。护士通过触摸式医疗驾驶舱进行感觉，医生也可以从护士的角度查看检查； ，交互方法和设计，该团队将研究此类远程体检所需的医疗/护理实践和培训，以及医生、护士和患者接受此类检查的程度。技术可能会部署在偏远和农村地区，否则患者可能无法接受医疗检查，特别是在需要专家的情况下。因此，这项研究旨在实现对社会的更广泛影响，特别是对于服务不足的社区，以及在传染病爆发期间。亲自前往集中医疗机构就诊存在风险。该项目旨在改变医生和护士的联合工作环境，同时满足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视为佩戴触觉感应手套的护士/护理人员与患者之间的合作实践。这一框架的关键挑战是触觉感知是主动的（这意味着如果一个人不能直接控制自己的运动，则很难解释触觉模式。手指）、触觉传感和显示技术的缺乏，以及对此类交互设计及其对检查三人组成员（医生、护士和患者）的影响缺乏了解。这些挑战激发了三项研究重点。耳鼻喉检查： 1. 检查驾驶舱和方法的交互动态和设计； 2. 触觉传感和显示/驱动的触摸技术创新；以及 3. 从以下角度理解该方法的影响；所有的重点都涉及工程师、社会/人文科学家和临床/护理研究人员之间的跨学科合作。观察/反思方法。推力 1 将研究交互和测试台配置问题，并开发/维护研究测试台。推力 2 将开发将单独评估并集成到测试台中的技术。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。将参与所有设计和评估阶段，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该技术在农村和偏远社区的可行性调查提供信息。该奖项授予了 NSF 的法定使命，并被认为是值得的。通过评估提供支持基金会的智力价值和更广泛的影响审查标准。