JMIR Publications

ABSTRACT

Background:

In the last decade, augmented reality (AR) has emerged in healthcare as a tool for visualizing data and enhancing simulation learning. AR, which has largely been explored for communication and collaboration in non-health contexts, could play a role in shaping future remote medical services and training. This review summarizes existing articles implementing AR in real-time (“synchronous”) telemedicine and telementoring to create a foundation for healthcare providers and technology developers to understand future opportunities in remote care and education.

Objective:

This review describes devices and platforms using AR for real-time telemedicine and telementoring, the tasks for which AR has been implemented and the ways these implementations are evaluated in order to identify gaps in research that provide opportunity for further study.

Methods:

We searched PubMed, Scopus, Embase and MEDLINE to identify English-language articles published between January 1, 2012 through October 18, 2022 implementing AR technology in a real-time interaction related to telemedicine or telementoring. The search terms were “augmented reality” OR “AR” AND “remote” OR “telemedicine” OR “telehealth” OR “telementoring.” Systematic reviews, meta-analyses, and discussion-based articles were excluded from analysis.

Results:

A total of 39 articles met inclusion criteria and were categorized within themes of patient evaluation, medical intervention, and education. Twenty devices and platforms using AR were identified, with common features being the ability for remote users to annotate, display graphics and virtually display their hands or tools in the local user’s view. Most studies focus on consultation and procedural education, with surgery, emergency, and hospital medicine being the most represented specialties. Outcomes were most often measured with feedback surveys and interviews. The most common objective measures were time to task completion and performance. Long-term outcome and resource cost measurements were rare. Across the studies, user feedback was consistently positive for perceived efficacy, feasibility, and acceptability. Comparative trials demonstrate that AR-assisted conditions have noninferior reliability and performance and do not consistently extend procedure times compared to in-person controls.

Conclusions:

Studies implementing AR in telemedicine and telementoring have demonstrated the technology’s ability to enhance access to information and facilitate guidance in multiple healthcare settings. However, AR’s role as an alternative to current telecommunication platforms or even in-person interactions remains to be validated, with many disciplines and provider-to-non-provider uses still lacking robust investigation. Additional studies with comparisons to existing methods would offer the most insight to this intersection, but the early stage of technical development and the lack of standardized tools and adoption has hindered the creation of larger longitudinal and randomized controlled trials. Overall, AR has the potential to complement and advance the capabilities of remote medical care and learning, creating a unique opportunity of involvement for innovators, providers, and patients.