Comparison of the ArtekMed mixed reality teleconsultation system with a standard video call system in critical care: user acceptance and feasibility analysis

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BACKGROUND: Telementoring and teleconsultation are increasingly employed for collaboration within the healthcare system. The ArtekMed alliance project has developed a mixed reality (MR) teleconsultation system for intensive care units (ICU) using virtual reality (VR) and augmented reality (AR), facilitating real-time interaction between the real world and its reconstructed virtual model, shared by two or more coworkers. OBJECTIVE: We aimed to explore the feasibility and user acceptance of the ArtekMed MR teleconsultation system in a critical care setting and compare it to a standard teleconsultation system using a simulated video call. METHOD: A randomized cross-over study was conducted in a local simulation center: A remote expert (VR user) solved four clinical scenarios, each involving the treatment of an ICU patient with respiratory failure in collaboration with a local practitioner as facilitator (AR user). They used either the MR system (intervention) or a simulated video call (control). A mixed-methods approach was followed to explore structured pre- and post-trial interviews with qualitative and quantitative analyses including standardized usability scores (NASA Task Load Index, System Usability Scale SUS). RESULTS: Twenty-five professionals with intensive care experience completed 100 simulated scenarios. The ArtekMed system achieved an average SUS score of 66, while the simulated video call system was rated almost excellent (SUS score: 84). In three out of four scenarios, the perceived workload using the MR teleconsultation system did not significantly differ from the workload using the standard video call. Most users rated working with both teleconsultation systems positively and anticipated increased efficiency and feasibility with greater familiarity with the MR system. Common issues included visual impairment due to insufficient graphical resolution and unfamiliarity with handling the equipment. 80% of the participants expressed willingness to incorporate the system into their ICU work. CONCLUSION: Collaboration in the ICU using a real-time MR teleconsultation system was rated as a promising technology by the majority of the participants for future use. Technical imperfections seem to prevent further implementation at this stage. Thus, the MR reconstruction needs improvement before clinical implementation.

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