Exploring the potential of video technologies for collaboration in emergency medical care

Diane H. Sonnenwald

Goteborg University & University of Borås, SwedenUniversity College Dublin, Ireland

We are investigating the potential of 3D telepresence, or televideo, technology to support collaboration among geographically separated medical personnel in trauma emergency care situations. 3D telepresence technology has the potential to provide richer visual information than current 2D video conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The 3D telepresence technology does not yet exist and there is a need to understand its potential before resources are spent on its development and deployment. This poses a complex challenge. How can we evaluate the potential impact of a technology within complex, dynamic work contexts when the technology does not yet exist?

To address this challenge we conducted an experiment with a post-test, between-subjects design that takes the medical situation and context into account. In the experiment we simulated an emergency medical situation involving practicing paramedics working alone and paramedics working remotely via two conditions: with today’s 2D videoconferencing and a 3D telepresence proxy. We examined task performance, paramedics’ self-efficacy and information sharing between the attending paramedic and collaborating physician to help predict the utility of 3D telepresence. Analysis of paramedics’ task performance shows that paramedics working with a physician via a 3D proxy performed the fewest harmful interventions and showed the least variation in task performance time. Paramedics in the 3D proxy condition also reported the highest levels of self-efficacy. Interview data confirm these statistical results. Overall the results indicate that 3D telepresence technology has potential to improve paramedics’ performance of complex medical tasks and improve emergency trauma health care if designed and implemented appropriately. The information provided by the physician was perceived to be more useful by the paramedic in the 3D proxy condition than the 2D condition.

We conducted a second study to investigate the potential benefits and barriers to the adoption and use of 3D telepresence technology within the U.S. healthcare system. Interviews were conducted with administrators at large and small medical centers, emergency care physicians and nurses at large and small medical centers, paramedics, emergency medical services (EMS) administrators, EMS state-wide policy makers, and hospital and emergency room information technology staff. Results point to both unintended benefits and negative consequences from the technology. Based on these findings suggestions regarding technology design and deployment are discussed. Our research approach and findings may help other emerging technologies understand and respond to challenges in adoption and use before large amounts of resources are spent on R&D and deployment.

This joint work with Hanna M. Söderholm at the University of Borås, and Henry Fuchs, Greg Welch, Jim Manning and Bruce Cairns at the University of North Carolina. It is supported by the National Library of Medicine; contract N01-LM-3-3514, 3D Telepresence for Medical Consultation: Extending Medical Expertise Throughout, Between and Beyond Hospitals.

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