NSF Award
2326455
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.<br/><br/>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.<br/><br/>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.
