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. 2023 Dec:87:479-490.
doi: 10.1016/j.bjps.2022.10.012. Epub 2022 Oct 13.

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

Steven Lo  1 , Spencer Fowers  2 , Kwame Darko  3 , Thiago Spina  2 , Catriona Graham  4 , Andrea Britto  2 , Anna Rose  4 , David Tittsworth  2 , Aileen McIntyre  5 , Chris O'Dowd  2 , Roma Maguire  6 , Wayne Chang  2 , David Young  7 , Amber Hoak  2 , Robin Young  8 , Mark Dunlop  6 , Levi Ankrah  3 , Martina Messow  8 , Opoku Ampomah  3 , Ben Cutler  2 ; 3DTM (3D Telemedicine) Collaborative research group; Roma Armstrong  5 , Ruchi Lalwani  5 , Ruairidh Davison  5 , Sophie Bagnall  5 , Whitney Hudson  2 , Mike Shepperd  2 , Jonny Johnson  2
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Free article

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

Steven Lo et al. J Plast Reconstr Aesthet Surg. 2023 Dec.
Free article

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.

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