Participatory development of a 3D telemedicine system during COVID: The future of remote consultations

Steven Lo; Spencer Fowers; Kwame Darko; Thiago Spina; Catriona Graham; Andrea Britto; Anna Rose; David Tittsworth; Aileen McIntyre; Chris O'Dowd; Roma Maguire; Wayne Chang; David Young; Amber Hoak; Robin Young; Mark Dunlop; Levi Ankrah; Martina Messow; Opoku Ampomah; Ben Cutler; 3DTM (3D Telemedicine) Collaborative research group; Roma Armstrong; Ruchi Lalwani; Ruairidh Davison; Sophie Bagnall; Whitney Hudson; Mike Shepperd; Jonny Johnson

doi:10.1016/j.bjps.2022.10.012

Participatory development of a 3D telemedicine system during COVID: The future of remote consultations

J Plast Reconstr Aesthet Surg. 2023 Dec:87:479-490. doi: 10.1016/j.bjps.2022.10.012. Epub 2022 Oct 13.

Authors

Steven Lo¹, Spencer Fowers², Kwame Darko³, Thiago Spina², Catriona Graham⁴, Andrea Britto², Anna Rose⁴, David Tittsworth², Aileen McIntyre⁵, Chris O'Dowd², Roma Maguire⁶, Wayne Chang², David Young⁷, Amber Hoak², Robin Young⁸, Mark Dunlop⁶, Levi Ankrah³, Martina Messow⁸, Opoku Ampomah³, Ben Cutler²; 3DTM (3D Telemedicine) Collaborative research group; Roma Armstrong⁵, Ruchi Lalwani⁵, Ruairidh Davison⁵, Sophie Bagnall⁵, Whitney Hudson², Mike Shepperd², Jonny Johnson²

Affiliations

¹ School of Medicine, Dentistry and Nursing, University of Glasgow, UK; Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK. Electronic address: Steven.lo@ggc.scot.nhs.uk.
² Microsoft Corporation, Redmond, WA, USA.
³ National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana.
⁴ Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK.
⁵ West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK.
⁶ Computer and Information Sciences, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK.
⁷ Mathematics and Statistics, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK.
⁸ Robertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, G12 8QQ, UK.

PMID: 36890078
DOI: 10.1016/j.bjps.2022.10.012

Abstract

Background: The COVID pandemic brought the need for more realistic remote consultations into focus. 2D Telemedicine solutions fail to replicate the fluency or authenticity of in-person consultations. This research reports on an international collaboration on the participatory development and first validated clinical use of a novel, real-time 360-degree 3D Telemedicine system worldwide. The development of the system - leveraging Microsoft's Holoportation™ communication technology - commenced at the Canniesburn Plastic Surgery Unit, Glasgow, in March 2020.

Methods: The research followed the VR CORE guidelines on the development of digital health trials, placing patients at the heart of the development process. This consisted of three separate studies - a clinician feedback study (23 clinicians, Nov-Dec 2020), a patient feedback study (26 patients, Jul-Oct 2021), and a cohort study focusing on safety and reliability (40 patients, Oct 2021-Mar 2022). "Lose, Keep, and Change" feedback prompts were used to engage patients in the development process and guide incremental improvements.

Results: Participatory testing demonstrated improved patient metrics with 3D in comparison to 2D Telemedicine, including validated measures of satisfaction (p<0.0001), realism or 'presence' (Single Item Presence scale, p<0.0001), and quality (Telehealth Usability Questionnaire, p = 0.0002). The safety and clinical concordance (95%) of 3D Telemedicine with a face-to-face consultation were equivalent or exceeded estimates for 2D Telemedicine.

Conclusions: One of the ultimate goals of telemedicine is for the quality of remote consultations to get closer to the experience of face-to-face consultations. These data provide the first evidence that Holoportation™ communication technology brings 3D Telemedicine closer to this goal than a 2D equivalent.

Trial registration: ClinicalTrials.gov NCT05267197 NCT04444323.

Keywords: 3 Dimensional; COVID-19; Plastic Surgery; Realism; Remote Consultation; Telemedicine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Cohort Studies
Humans
Remote Consultation*
Reproducibility of Results
Telemedicine*

Associated data

ClinicalTrials.gov/NCT05267197
ClinicalTrials.gov/NCT04444323