JMIR Publications

ABSTRACT

Background:

The distinctive features of the digital reality platform, the augmented, virtual and mixed reality, have extended to medical education, training, simulation, and patient care. Furthermore, this digital reality technology seamlessly merges with the information and communication technology creating for enriched telehealth ecosystem. This review reconstructs a composite overview of the prospects of telehealth delivered using the mixed reality platform in clinical settings.

Objective:

This review identifies various clinical applications of high-fidelity digital display technology, viz., augmented, virtual and mixed reality delivered using telehealth capabilities. Next, the review focuses on the technical characteristics, hardware, and software technologies utilized in the composition of AR, VR, and MR in telehealth. Lastly, it highlights the several determinants for adopting or rejecting this technology from both the patient’s and healthcare professional’s perspectives.

Methods:

A structured literature search was conducted, and full-length articles in English literature were obtained from the Embase, PubMed, and Web of Science databases. The search protocol was based on the following keywords and mesh headings, "augmented reality," "virtual reality," "mixed-reality," "telemedicine," "telehealth," and "digital health" to obtain relevant results. A pre-defined inclusion-exclusion criterion was developed in filtering the obtained results and the final selection of the articles, followed by data extraction and construction of the review.

Results:

We identified 4407 articles, of which 321 were eligible for full-text screening. A total of 134 full-text articles were included in the review. Telerehabilitation, telementoring, teleconsultation, telemonitoring, telepsychiatry, telesurgery, and telediagnosis were the segments of the telehealth division that explored the use of augmented, virtual, and mixed reality platforms. Telerehabilitation using virtual reality was the most commonly recurring segment in the included studies. Augmented and mixed reality has been mainly employed for telementoring and teleconsultation. The most significant technical features of digital reality technology to emerge with telehealth were virtual environment, exergaming, 3D avatars, telepresence, anchoring annotations, and first-person viewpoint. Different arrangements of technology – 3D modeling and viewing tools, communication and streaming platforms, file transfer and sharing platforms, sensors, high fidelity displays, and controllers formed the basis of most systems. Both patients and clinicians indicated a high motivation for using this novel technology but several limitations, including lack of interoperability, unreliable network infrastructure, internet connectivity issues, and upcoming technology that is still evolving, leading to a slower uptake.

Conclusions:

This review constitutes a recent overview of the evolving digital augmented and virtual reality in various clinical applications using the telehealth setup. This combination of telehealth with AR, VR, and MR allows for remote facilitation of clinical expertise and further development of home-based treatment. This review explores the rapidly growing suite of technologies available to users within the digital health sector and examines the opportunities and challenges they present.