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Medical consultations over synchronous text-based platforms are becoming increasingly popular for virtual care, yet little is known about how physicians translate their training to this healthcare medium. We report the constraints, workarounds, and opportunities highlighted by eight primary care physicians who used such a platform in simulated medical scenarios with standardized patients. We found that due to the perceived inefficiency of communicating over text, the physicians made subconscious use of double-barreled questions and action multiplexing to streamline the conversation. In addition, the physicians overcame the lack of missing verbal and visual cues by adding explicit messages to convey empathy and active listening. We also identify several affordances of text-based platforms, such as the ability for users to reference the conversation history and for patients to feel a sense of privacy during sensitive disclosure. From these findings, we propose design opportunities for how future synchronous text-based platforms can better support medical consultations.
Although Augmented Reality (AR) has been touted as the future of surgery, its contribution to distributed collaboration such as in surgical teleconsulting has not been articulated. We propose AR-Head Mounted Displays (AR-HMD) to tackle two previously-identified challenges: operating surgeons needing to view and interact with imaging systems that reside away from the operative field, and, their lack of gesturing tools to point and annotate on the shared images and physical environment. We report on a controlled lab experiment where 12 expert gynecology surgeons perform a tumor localisation task guided by a remote radiologist (confederate) via an AR-HMD. We find that bringing the shared images to the place of work reduces the need for clarifications and provides opportunistic access to information when required, and, that pointing and annotating provides opportunities to further support verbal instruction in deictic communication. Our results inform the design of intraoperative AR-HMD systems for surgical telecollaboration.
Smart patient rooms are arriving; however, their value has yet to be explored. We interviewed 20 patients in a rehabilitation hospital, which has patient rooms equipped with off-the-shelf smart home technologies, so the entertainment and environment are digitally controllable. This novel implementation supports varying control abilities through touchscreen, voice command, and accessibility controllers. The smart rooms and controls are potentially transformative for patients with reduced motor function, helping them regain lost independence and control of their surroundings. Through semi-structured interviews, we explore how smart home technology deployed in patient rooms: interacts with patients’ needs, presents new challenges, and fits into the hospital context. We identify a range of considerations that inform how hospitals can integrate smart technology into their environment, including technology design considerations and adjustments to how hospital staff supports its use. These results take an important step toward understanding and improving the value of smart patient rooms.
Research has explored head-worn displays (HWD) in various professional contexts. However, evaluations have been limited by short-term use, a focus on the person using the HWD, and on performance variables. In a field study, we evaluated a monocular, opaque HWD for multi-patient monitoring, which supervising anesthesiologists wore for 8-10 days each. We investigated the effect of prolonged HWD use on the experience of the supervising anesthesiologists and their co-workers using interviews and repeated observations. A reflexive thematic analysis showed (1) interaction and mindset changes over time, (2) information on the HWD is more than numbers, (3) the HWD affects co-workers' collaboration with supervisors, and (4) distraction depends on the point of view. Using activity theory, we discuss the fact that HWD use develops and changes over time and that even a single-user HWD influences the collaboration with co-workers. We conclude with implications for HWD design, implementation, and evaluation.
The growing platformization of health has spurred new avenues for healthcare access and reinvigorated telemedicine as a viable pathway to care. Telemedicine adoption during the COVID-19 pandemic has surfaced barriers to patient-centered care that call for attention. Our work extends current Human-Computer Interaction (HCI) research on telemedicine and the challenges to remote care, and investigates the scope for enhancing remote care seeking and provision through telemedicine workflows involving intermediation. Our study, focused on the urban Indian context, involved providing doctors with videos of remote clinical examinations to aid in telemedicine. We present a qualitative evaluation of this modified telemedicine experience, highlighting how workflows involving intermediation could bridge existing gaps in telemedicine, and how their acceptance among doctors could shift interaction dynamics between doctors and patients. We conclude by discussing the implications of such telemedicine workflows on patient-centered care and the future of care work.
The spread of COVID-19 has encouraged the practice of using video conferencing for family doctor appointments. Existing applications and off-the-shelf devices face challenges in dealing with capturing the correct view of patients' bodies and supporting ease of use. We created Dr.’s Eye, a video conferencing prototype to support varying types of body exams in home settings. With our prototype, we conducted a study with participants using mock appointments to understand the simultaneous use of the camera and display and to get insights into the issues that might arise in real doctor appointments. Results show the benefits of providing more flexibility with a decoupled camera and display, and privacy protection by limiting the camera view. Yet, challenges remain in maneuvering two devices, presenting feedback for the camera view, coordinating camera work between the participant and the examiner, and reluctance towards showing private body regions. This inspires future research on how to design a video system for doctor appointments.