AnatOnMe: An interactive look inside the body
Written by Gabriella Blake
At this year’s ACM CHI Conference on Human Factors in Computing Systemsa team of Microsoft researchers from Washington’s Redmond campus showcased a prototype projection-based handheld device designed for use in physical therapy consultations.
The device, which the team has christened AnatOnMe, features a projector, a digital camera, an infrared camera and a laser pointer.
Six stock images are stored on the device and are used to depict the state of the patient’s injury beneath the surface. The projector displays the relevant image on one of a choice of three presentation surfaces: the wall of the consultation room, the injured part of the patient’s body, or the corresponding body part of a model. The images detail bone structure, muscle tissue, tendons and nerves.
Amy Karlson led the team of researchers alongside Tao Ni and Daniel Wigdor.
“AnatOnMe comes pre-loaded with ‘teaching scripts’ for six common injuries for which people seek physical therapy,” Karlson told Heathcare Global. “Each script consists of a series of anatomy images that a therapist would use to teach a patient about an injury, including underlying anatomical structures, the anatomical manifestation of the injury, and the anatomical goals of the recovery process.”
The digital camera on the device can be used to take images and videos of the patient’s injury. These can be used to monitor how effectively the patient is performing their therapy exercises.
The infrared camera and the laser pointer, meanwhile, can be used in conjunction to allow the doctor to ‘draw’ on the image of the injury, in the form of labels or annotations. Photographs can then be printed for the patient to take home.
The device was designed to combat the issue of reluctance on the part of patients to complete care plans advised by their doctors. Studies suggest that 30 to 50 percent of patients with chronic conditions are likely to give up treatments early.
“One of the biggest challenges the healthcare industry faces is inspiring patients to comply with care plans—for example taking medications, eating right, exercising, and so on,” Karlson explained.
“In physical therapy, successful recovery often requires that patients perform exercises on their own time—exercises that are often boring and uncomfortable.”
“One popular strategy for encouraging patient compliance with an exercise regimen in physical therapy is to gain patient ‘buy-in’ by educating patients in detail about their injury and the goals of recovery,” she continued.
Doctors report having limited time to educate patients during a consultation. The device would aid and speed up this process so that patients are more likely to comply with the care plan.
“By teaching patients about an injury directly on their bodies, AnatOnMe provides a personalised and engaging educational experience that helps bridge the knowledge gap between therapists and their patients,” Karlson stated.
Tests showed that the device provoked a more engaging and informative consultation. Many patients reacted with expressions of awe such as “ooh”, “wow” and “cool”. One patient even remarked: “I feel like I am looking directly through my skin… and thinking about what is going on inside.”
“Our study concluded that there appears to be something quite unique about viewing medical imagery on one’s own body,” Karlson said.
“The body-based projection was considered highly engaging and helped participants understand the precise location of anatomy structures with respect to their own bodies.”
A questionnaire with Likert-scale questions was used to compare patients’ experiences with each of the three presentation surfaces tested. Patients assessed the use of the device on each surface in terms of how engaging, disturbing, fun or enjoyable they found the process. Using the device to display an image on the patient’s own body constantly came top or joint top.
Doctors were also enthusiastic about the device. A doctor praising the use of the patient’s body as a surface stated: “There is a definite value of having an individual’s picture as an exercise model, as opposed to a preprint. It is more personal.”
The team was pleased with the success of the study and is considering how the device can be developed for use on a wider scale.
“Refinements to the system would be necessary to ensure that AnatOnMe meets the needs of any target discipline,” Karlson noted.
“For example, in the physical therapy domain, six teaching scripts would not provide sufficient coverage of the injuries for which patients typically seek a physical therapist and so would require additional scripts to be developed.
“Furthermore, the system we built and explored was a rapid prototype designed to learn about the potential utility of such a device, but additional investigation would certainly be required to hone its industrial design for day to day use.”
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.