# A new reality for telehealth: A simulation-based comparison of wearable mixed reality with videoconferencing for clinician-to-clinician telehealth

## TL;DR

This study compares mixed reality headsets to videoconferencing for telehealth in rural settings, finding mixed results for usability and efficiency.

## Contribution

The paper introduces a simulation-based evaluation of wearable mixed reality for clinician-to-clinician telehealth in rural contexts.

## Key findings

- Advising clinicians found MR headsets more usable and less mentally taxing than videoconferencing.
- Rural clinicians rated MR headsets lower in usability compared to traditional videoconferencing.
- Participants preferred MR headsets despite scenarios taking longer to complete with them.

## Abstract

Telehealth is crucial to the provision of high-quality treatment of critically unwell patients in rural areas. Our aim was to explore the benefits and limitations of a mixed reality (MR) headset for clinician-to-clinician telehealth in a simulated rural context, in which the advising clinician directly views the treating clinician's point-of-view and uses holographic annotations to provide visual guidance in three-dimensional space.

Twenty-five clinicians trialled a MR headset—the Microsoft HoloLens 2—and evaluated it against a trolley-based videoconferencing device used in current practice. Each participant trialled the devices while role-playing one of two perspectives: the Rural Clinician accessing support or the Advising Clinician providing support.

Advising Clinicians had higher ratings of usability and self-efficacy, and lower ratings of mental workload, when providing support via the MR headset compared to the videoconferencing trolley (ps < 0.035). However, Rural Clinicians rated the MR headset lower on usability compared to the videoconferencing trolley (p = 0.020), and rated their self-efficacy and mental workload equally when using both devices (ps > 0.253). Participants generally preferred to use the MR headset over the videoconferencing trolley. On average, scenarios took 1 minute longer to complete when using the MR headset (p < 0.001).

Wearable MR technology has the potential to improve the quality of support provided to rural clinicians; however, it may be more beneficial for those dialling in to the device (advising clinicians) rather than those wearing the device (rural clinicians). Factors that may limit its safety and efficiency are discussed.