ABSTRACT
Rural areas face a lack of medical facilities in many countries, with a significant crisis in the deployment and retention of medical professionals. Also, in the present scenario of the COVID-19 pandemic, social distancing is the critical factor in breaking the chain of transmission of the deadly virus. This has restricted the in-person visits in medical practices. The advancement in research and development of newer technology has paved the way for telemedicine via augmented/virtual reality (AR/VR). Telemedicine is a technique to remotely treat and monitor the patient and is also utilized to give procedural training to eligible medical professionals. While it was earlier publicized as a medium for the extension of healthcare services to rural people, it has become a safer way of treatment during novel coronavirus outbreaks. This approach has unprecedented benefits, including saving upon travel time and cost of the patient, proving to be environmentally, economically feasible, and a safer treatment method for both the patient and the medical officer. In this chapter, we review the various telepresence technologies developed using AR/VR platforms for remote procedural training. This is compared with the conventional methods available. The chapter covers the brief history of telecare, challenges in medical treatments, medical visualization, and diagnosis, basic requirements for telehealth such as management of patients records, real-time monitoring of patients with 3D representations and other telepresence technologies, and AR/VR technology in telemedicine. © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has acted as a catalyst for the development and adoption of a broad range of remote monitoring technologies (RMTs) in health care delivery. It is important to demonstrate how these technologies were implemented during the early stages of this pandemic to identify their application and barriers to adoption, particularly among vulnerable populations. OBJECTIVE: The purpose of this knowledge synthesis was to present the range of RMTs used in delivering care to patients with COVID-19 and to identify perceived benefits of and barriers to their use. The review placed a special emphasis on health equity considerations. METHODS: A rapid review of published research was conducted using Embase, MEDLINE, and QxMD for records published from the inception of COVID-19 (December 2019) to July 6, 2020. Synthesis involved content analysis of reported benefits of and barriers to the use of RMTs when delivering health care to patients with COVID-19, in addition to health equity considerations. RESULTS: Of 491 records identified, 48 publications that described 35 distinct RMTs were included in this review. RMTs included use of existing technologies (eg, videoconferencing) and development of new ones that have COVID-19-specific applications. Content analysis of perceived benefits generated 34 distinct codes describing advantages of RMTs, mapped to 10 themes overall. Further, 52 distinct codes describing barriers to use of RMTs were mapped to 18 themes. Prominent themes associated with perceived benefits included a lower burden of care (eg, for hospitals, health care practitioners; 28 records), reduced infection risk (n=33), and support for vulnerable populations (n=14). Prominent themes reflecting barriers to use of RMTs included equity-related barriers (eg, affordability of technology for users, poor internet connectivity, poor health literacy; n=16), the need for quality "best practice" guidelines for use of RMTs in clinical care (n=12), and the need for additional resources to develop and support new technologies (n=11). Overall, 23 of 48 records commented on equity characteristics that stratify health opportunities and outcomes, including general characteristics that vary over time (eg, age, comorbidities; n=17), place of residence (n=11), and socioeconomic status (n=7). CONCLUSIONS: Results of this rapid review highlight the breadth of RMTs being used to monitor and inform treatment of COVID-19, the potential benefits of using these technologies, and existing barriers to their use. Results can be used to prioritize further efforts in the implementation of RMTs (eg, developing "best practice" guidelines for use of RMTs and generating strategies to improve equitable access for marginalized populations).