Trends in virtual reality technologies for the learning patient

NextMed convened the Medicine Meets Virtual Reality 22 (MMVR 22) conference in 2016. Since 1992, the conference has brought together a diverse group of researchers to share creative solutions for the evolving challenge of integrating virtual reality tools into medical education. Virtual reality (VR) and its enabling technologies utilize hardware and software to simulate environments and encounters where users can interact and learn. The MMVR 22 symposium proceedings contain projects that support a variety of learners: medical students, practitioners, soldiers, and patients. This report will contemplate the trends in virtual reality technologies for patients navigating their medical and healthcare learning. The learning patient seeks more than intervention; they seek prevention. From virtual humans and environments to motion sensors and haptic devices, patients are surrounded by increasingly rich and transformative data-driven tools. Applied data enables VR applications to simulate experience, predict health outcomes, and motivate new behavior. The MMVR 22 presents investigations into the usability of wearable devices, the efficacy of avatar inclusion, and the viability of multi-player gaming. With increasing need for individualized and scalable programming, only committed open source efforts will align instructional designers, technology integrators, trainers, and clinicians. Curriculum and InstructionCurriculum and Instructio

Flexible and Mindful Self-Tracking: Design Implications from Paper Bullet Journals

Digital self-tracking technologies offer many potential benefits over self-tracking with paper notebooks. However, they are often too rigid to support people’s practical and emotional needs in everyday settings. To inform the design of more flexible self-tracking tools, we examine bullet journaling: an analogue and customisable approach for logging and reflecting on everyday life. Analysing a corpus of paper bullet journal photos and related conversations on Instagram, we found that individuals extended and adapted bullet journaling systems to their changing practical and emotional needs through: (1) creating and combining personally meaningful visualisations of different types of trackers, such as habit, mood, and symptom trackers; (2) engaging in mindful reflective thinking through design practices and self-reflective strategies; and (3) posting photos of paper journals online to become part of a selftracking culture of sharing and learning. We outline two interrelated design directions for flexible and mindful selftracking: digitally extending analogue self-tracking and supporting digital self-tracking as a mindful design practice

Primer for Image Informatics in Personalized Medicine

AbstractImage informatics encompasses the concept of extracting and quantifying information contained in image data. Scenes, what an image contains, come from many imager devices such as consumer electronics, medical imaging systems, 3D laser scanners, microscopes, or satellites. There is a marked increase in image informatics applications as there have been simultaneous advances in imaging platforms, data availability due to social media, and big data analytics. An area ready to take advantage of these developments is personalized medicine, the concept where the goal is tailor healthcare to the individual. Patient health data is computationally profiled against a large of pool of feature-rich data from other patients to ideally optimize how a physician chooses care. One of the daunting challenges is how to effectively utilize medical image data in personalized medicine. Reliable data analytics products require as much automation as possible, which is a difficulty for data like histopathology and radiology images because we require highly trained expert physicians to interpret the information. This review targets biomedical scientists interested in getting started on tackling image analytics. We present high level discussions of sample preparation and image acquisition; data formats; storage and databases; image processing; computer vision and machine learning; and visualization and interactive programming. Examples will be covered using existing open-source software tools such as ImageJ, CellProfiler, and IPython Notebook. We discuss how difficult real-world challenges faced by image informatics and personalized medicine are being tackled with open-source biomedical data and software

Occupational therapists’ views of using a virtual reality interior design application within the pre-discharge home visit process

This article has been made available through the Brunel Open Access Publishing Fund.Background: A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment, to enable patients to function independently after hospital-home discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualise changes prior to implementing them. Customised VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration if developed effectively and integrated into the PHV process. Objective: To explore the perceptions of occupational therapists with regards to using VRIDAs as an assistive tool within the PHV process. Methods: Task-oriented interactive usability sessions, utilising the think-aloud protocol and subsequent semi-structured interviews were carried out with seven Occupational Therapists who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centring around the parameters that impact upon the acceptance, adoption and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). Results: OTs’ perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich communications and patient involvement, and improved patient/practitioner shared understanding. However, it was unlikely that VRIDAs would be suitable for use with cognitively impaired patients. For PEoU, all OTs were able to use the software and complete the tasks successfully, however, participants noted numerous specialist equipment items that could be added to the furniture library. AU perceptions were positive regarding use of the application across a range of clinical settings including children/young adults, long-term conditions, neurology, older adults, and social services. However, some “fine tuning” may be necessary if the application is to be optimally used in practice. Conclusions: Participants perceived the use of VRIDAs in practice would enhance levels of patient/practitioner collaboration and provide a much needed mechanism via which patients are empowered to become more equal partners in decisions made about their care. Further research is needed to explore patient perceptions of VRIDAs, to make necessary customisations accordingly, and to explore deployment of the application in a collaborative patient/practitioner-based context

Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults

Background Mobile health technology can improve medication safety for older adults, for instance, by educating patients about the risks associated with anticholinergic medication use. Objective This study's objective was to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Methods Twenty-three primary care patients aged ≥60 years and using anticholinergic medications participated in summative, task-based usability testing of Brain Buddy. Self-report usability was assessed by the System Usability Scale and performance-based usability data were collected for each task through observation. A subset of 17 participants contributed data on feasibility, assessed by self-reported attitudes (feeling informed) and behaviors (speaking to a physician), with confirmation following a physician visit. Results Overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task and a mean System Usability Scale score of 78.8, corresponding to “Good” to “Excellent” usability. Observed usability issues included higher rates of errors, hesitations, and need for assistance on three tasks, particularly those requiring data entry. Among participants contributing to feasibility data, 100% felt better informed after using Brain Buddy and 94% planned to speak to their physician about their anticholinergic related risk. On follow-up, 82% reported having spoken to their physician, a rate independently confirmed by physicians. Conclusion Consumer-facing technology can be a low-cost, scalable intervention to improve older adults’ medication safety, by informing and empowering patients. User-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change

Consumer e-health education in HIV/AIDS: a pilot study of a web-based video workshop

BACKGROUND: Members of the HIV/AIDS community are known to use web-based tools to support learning about treatment issues. Initial research indicated components such as message forums or web-based documentation were effectively used by persons with HIV/AIDS. Video has also shown promise as a technology to aid consumer health education. However, no research has been published thus far investigating the impact of web-based environments combining these components in an educational workshop format. METHODS: In this qualitative study HIV/AIDS community members provided feedback on an integrated web-based consumer health education environment. Participants were recruited through organizations that serve the HIV/AIDS community located in Toronto, Canada. Demographics, data on Internet use, including messages exchanged in the study environment were collected. A group interview provided feedback on usability of the study environment, preferences for information formats, use of the message forum, and other sources for learning about treatment information. RESULTS: In this pilot study analysis of the posted messages did not demonstrate use for learning of the workshop content. Participants did not generally find the environment of value for learning about treatment information. However, participants did share how they were meeting these needs. It was indicated that a combination of resources are being used to find and discuss treatment information, including in-person sources. CONCLUSION: More research on the ways in which treatment information needs are being met by HIV/AIDS community members and how technology fits in this process is necessary before investing large amounts of money into web-based interventions. Although this study had a limited number of participants, the findings were unexpected and, therefore, of interest to those who intend to implement online consumer health education initiatives or interventions

The role and impact of digital and traditional information and communication pathways in health service access and equity

This review of the literature was conducted by Flinders University (SA Community Health Research Unit and Southgate Institute for Health Society & Equity) to provide an overview of changing communications in health promotion to inform the Falls Prevention Project of Country Health SA’s Local Health Network. The context is that falls health literacy information is being increasingly made available via digital formats, including the Internet. This is in line with healthcare around the world increasingly moving to e-health (the delivery or enhancement of health services through the Internet and related technologies). There are particular expectations that for rural Australians making health services and information available through digital formats will overcome existing problems with access and availability. Despite a large amount of activity in the area of e-health, there is a scarce evidence base on the equity impacts of e-health promotion

The use of Natural Language Processing techniques to support Health Literacy: an evidence-based review

Background and objectives: To conduct a literature search and analysis of the existing research using natural language processing for improving or helping health literacy, as well as to discuss the importance and potentials of addressing both fields in a joint manner. This review targets researchers who are unfamiliar with natural language processing in the field of health literacy, and in general, any researcher, regardless of his or her background, interested in multi-disciplinary research involving technology and health care. Methods: We introduce the concepts of health literacy and natural language processing. Then, a thorough search is performed using relevant databases and well-defined criteria. We review the existing literature addressing these topics, both in an independent and joint manner, and provide an overview of the state of the art using natural language processing in health literacy. We additionally discuss how the different issues in health literacy that are related to the comprehension of specialised health texts can be improved using natural language processing techniques, and the challenges involved in these processes. Results: The search process yielded 235 potential relevant references, 49 of which fully fulfilled the established search criteria, and therefore they were later analysed in more detail. These articles were clustered into groups with respect to their purpose, and most of them were focused on the development of specific natural language processing modules, such as question answering, information retrieval, text simplification or natural language generation in order to facilitate the understanding of health information.This research work has been partially funded by the University of Alicante, Generalitat Valenciana, Spanish Government and the European Commission through the projects, "Tratamiento inteligente de la informacion para la ayuda a la toma de decisiones" (GRE12-44), "Explotacion y tratamiento de la informacion disponible en Internet para la anotacion y generacion de textos adaptados al usuario" (GRE13-15), DIIM2.0 (PROMETEOII/2014/001), ATTOS (TIN2012-38536-C03-03), LEGOLANG-UAGE (TIN2012-31224), SAM (FP7-611312), and FIRST (FP7-287607)

Problematising upstream technology through speculative design: the case of quantified cats and dogs

There is growing interest in technology that quantifies aspects of our lives. This paper draws on critical practice and speculative design to explore, question and problematise the ultimate consequences of such technology using the quantification of companion animals (pets) as a case study. We apply the concept of ‘moving upstream’ to study such technology and use a qualitative research approach in which both pet owners, and animal behavioural experts, were presented with, and asked to discuss, speculative designs for pet quantification applications, the design of which were extrapolated from contemporary trends. Our findings indicate a strong desire among pet owners for technology that has little scientific justification, whilst our experts caution that the use of technology to augment human-animal communication has the potential to disimprove animal welfare, undermine human-animal bonds, and create human-human conflicts. Our discussion informs wider debates regarding quantification technology