HeartTeam 4.0: HeartTeam-Based Decision Making in Real Time and Over the Distance via an Interactive Tele-Presence System following A User-Centered Approach

Objectives: Due to specialization of medicine, the availability of personalized therapy options and the increasing multimorbidity of our aging society, individual therapy decisions have become more and more complex. Hence, in cardiovascular medicine complex therapy decisions are undertaken following an interdisciplinary “HeartTeam” (HT) approach. However, although there is a high demand on cardiac surgical expertise, due to the concentration of cardiac surgery in few large centers the majority of patients seen in cardiology units cannot profit from cardiac surgical expertise on site. Although video communication could be an option to discuss patients online, commercially available systems do not fulfill the requirements to replace real HT-decision making. Here, we introduce a patient-centered, interactive telepresence-system for remote HT-based decision making between cardiologists and cardiac surgeons allowing for real-time, joined therapy discussions and patient involvement.

Methods: First, we analyzed the regulatory, technical and non-technical requirements of all stakeholders and defined specifications of the system, including following crucial characteristics: patient-centered, interactive bi-directional immersive presence, secure and light-weight. Then, we designed and developed a custom-made, flexible and mobile prototype by a user-centered approach.

Result: Based on the specified requirements we developed a mobile telepresence system (HeartTeam 4.0) as a light-weight, mobile, immersive video communication solution for large touch-screens. The fully-working prototype system (current screen size: 55″) allows for real-time, life-size bedside communication and interactive clinical data discussion. Following a split-screen approach on one half a constant video stream of the respective other side is displayed, on the other half, there are two windows for sharing and annotating clinical data directly from the local CIS and PACS systems by means of end-to-end encrypted multi-screen sharing. The shared data can be annotated with a stylus or by touch via lettering, scribble, or predefined geometric figures.

Conclusion: The introduced system may help to close the gap between available and needed cardiac surgical expertise by allowing implementation of online HT-Team decision making in real time and over distance following a user-centered approach. Following clinical studies are warranted to evaluate implementation, usability and benefit of the developed system into clinical routine.

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Artikel online veröffentlicht:
19. Februar 2021