December 6-8, 2021
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The Leaflet Article

Featured Article:

Augmented Rx

Paul Ryzar - Inventor & Founder

One of the great ironies of modern medicine is that at the same time hospitals and medical facilities are leveraging new technologies and innovative solutions to achieve extraordinary breakthroughs in patient care–they are also struggling to overcome a host of seemingly intractable problems. From medical device liability to hospital-acquired infections, the challenges are significant. Those challenges highlight the need to combine medical innovation and modern-day healthcare practices with innovative problem solving.

Surgeons and specialists are using new tools and techniques to diagnose and treat patients. Designers and engineers are bringing inspired new ideas and devices with life-changing and lifesaving potential to the marketplace. But heightened regulatory pressures and new medical and operational challenges with respect to patient care and modern-day medical facility operation complicate that rosy picture. Large-scale changes in the healthcare industry are changing the way patient care is provided while simultaneously introducing new competitive and financial factors into the healthcare equation. On the medical device manufacturing side, regulatory and legislative pressure to reduce or eliminate manufacturing/production errors is also on the rise.

Across the medical landscape, the demand for quality, consistency, efficiency and profitability (priorities that can sometimes seem incompatible) has never been greater. The financial stakes are high. The stakes for patients and medical professionals are even higher. In many cases, these issues are quite literally a matter of life and death.

In this context, the emergence of a category of powerful new tools quite unlike anything else the industry has seen before is a development that many individuals both inside and outside the medical profession are tracking with growing interest.

Augmented reality

These new tools occupy a space known as “augmented reality”: specialized technologies designed to make complex processes simple by guiding users through individual steps with a combination of audio and visual cues to standardize manual processes. While crude versions of augmented reality have been around for decades, a new generation of powerful, flexible and customizable tools has emerged and begun to gain real traction. Some hospitals and medical device manufacturers have already begun to embrace these tools–which have had a dramatic impact in other industries, most notably the automotive manufacturing sector.

Augmented reality tools allow users to follow the correct steps in the correct order, effectively eliminating many of the most common human errors, procedural sticking points and quality, health and safety concerns in environments ranging from a surgical suite to the floor of a manufacturing facility. The technology streamlines processes, improves productivity and eliminates errors for any number of assembly and manufacturing applications for medical devices, along with in-hospital use cases such as personnel training, ensuring catheters and endoscopes are sterilized and cleaned properly, culture preparation, or guiding technicians through finely-tuned microscope and lab work. The idea behind augmented reality is simple, but the virtually unlimited range of applications makes augmented reality ideally suited for the unique constellation of challenges presented by the healthcare industry.

Basically any manual process or established procedure can benefit from augmented reality guidance. Augmented reality provides the right information, at the right place and at the right time. In clear contrast with written or monitor-based instruction, the most effective new augmented reality solutions provide real-time guidance that is dynamic, interactive and adaptive. The best of these tools integrate several different technologies into a single solution. Users are “walked” through a process that can be as simple as washing hands for a specified length of time or as complex as training for a surgical procedure or assembling a complex piece of delicate medical hardware. No-faults-forward practices ensure that the right parts and equipment are used and that steps have been completed correctly before allowing the user to move ahead with the next step. This confirmation and sequencing control is critical both in a medical manufacturing context, and in a hospital or other healthcare facility.

Some of the most innovative and effective augmented reality systems integrate heads-up displays and sophisticated projection systems to create a “digital canvas” that can be overlaid directly into the workspace or onto a work surface. This new virtual dimension facilitates direct and highly precise color-coded visual guidance that can be coordinated with audio cues, prompts, pacing, sequencing and direction.

Augmented care

In a healthcare context, the benefits of an intuitive guidance system that can standardize processes and virtually eliminate errors are extraordinary. Whether you are counting pills or assembling a medical device, the ability to dramatically reduce or eliminate human errors impacts everything from the health and well-being of patients to the financial outcomes of institutions and healthcare organizations.

For medical device manufacturers, augmented reality technology can streamline processes, boost efficiencies, reduce production errors, and increase productivity. For doctors, nurses and other healthcare providers, augmented reality solutions can improve hygiene, reduce costly and dangerous medical errors, enhance patient care and improve outcomes. These are issues that don’t just save time and money – they save lives.

One of the most important characteristics of this new generation of augmented reality tools is their flexibility. The best examples of the genre are designed to seamlessly connect with existing systems and tools to simplify the complex manual tasks that are a part of modern healthcare. The visualization and intuitive utility of these systems makes them ideally suited to improving assembly, quality control and training for any number of medical processes. In addition to streamlining medical device manufacturing processes, augmented reality solutions are a good fit for applications such as surgical instrument sterilization and part kitting, physical therapy and rehab, clinical simulation training, patient education, and pathology and wet lab sample preparation in addition to ensuring that medications are mixed and dispensed correctly.

In a hospital setting, augmented reality provides an enhanced version of the standardized processes and checklist-style procedural structure that has become the best-practices standard. While checklists can standardize a process across personnel and time, the reliance on hard copies is inefficient, inconvenient, unwieldy and potentially even unsanitary in a hospital or medical office environment. For hospitals with rooms or wings where paper is not permitted due to concerns about particulate matter, augmented reality is an obvious solution. Even traditional monitor-based guidance typically requires the manipulation of a keyboard or mouse, which is another potential contamination or hygiene issue. The fewer physical touchpoints in a setting, the better in order to protect against the transfer of communicable material while reducing the likelihood of infection. The bottom line is that while checklists have the right information, augmented reality has the right information delivered in the right way, at the right place and at the right time.

Going from a paper or screen-based checklist to an augmented reality system is similar to going from a classic handheld paper map to a modern-day GPS system. While a map can certainly help you get to where you need to go, GPS guidance provides visual and verbal guidance and navigation that adapts to real-time realities, provides confirmation that you are making the correct turns as you proceed to your destination, and allows you to do so all without taking your hands off the wheel or your eyes off the road.

Another asset included in the best new augmented reality solutions is a fully integrated and highly detailed track-and-trace monitoring setup. Detailed process data is gathered for every individual process or build cycle. In a medical manufacturing environment, this allows for the creation of digital “birth certificates.” In any context, metrics like cycle time are monitored and can be made available for analysis in addition to stored web cam pictures of each completed step. This traceability, specific feedback and reporting can be used to pinpoint bottlenecks or other safety issues, identify training opportunities, improve compliance, resolve challenges, and facilitate procedural refinements and strategic improvements.

Perhaps most importantly of all, projection-based AR can deliver higher results when compared to wearable AR and other comparable technologies. The last thing most doctors and nurses want is responsibility for another device–something else to keep track off, have in your pocket, keep the batteries charged, etc. Projection-based augmented reality solutions are typically station specific. Users can be guided through their work at each station with the right information at the right time and place, and then simply move on.

Augmented potential

While projection-based augmented reality technology solutions represent the cutting edge of today’s augmented reality tools, the reality is that this is a field that is evolving as rapidly as healthcare and medical devices themselves. Powerful new augmented reality devices are already integrating features such as voice recognition technology and automated program generation that increases customization for individual processes, synchronized information at multiple workstation for increased user flexibility, new webcam vision options, and the ability to coordinate and connect with a wide range of complementary tools and integrated features like machine vision systems, barcode scanners, label printers, torque guns, and even smartphone apps. Integrated personal tech devices like computers, touchscreen monitors and touch mats can be introduced into some systems to make augmented reality solutions easier and more intuitive to program and control.

Today, healthcare decision-makers looking to switch to digital and interactive work instructions from paper- and monitor-based work instructions are heartened to discover that the best augmented reality solutions are designed to be able to easily connect with existing systems and tools. And relatively modest space and electrical requirements for implementing most examples of augmented reality technology mean that medical facility planners, designers and architects can incorporate these technologies into their facilities with minimal disruption while delivering a fast Return on Investment.

Typically, such systems come in two broad categories: permanent or semi-permanent tools that can be installed in place (such as a hand-washing monitor above a sink), or a more mobile platform that is integrated into a computer workstation and can be moved easily from place to place.

While costs can be reduced and any minor design issues easily navigated when planning ahead for a new facility, the biggest advantage when designing augmented reality technologies directly into a new building is enhanced customization. Some solutions can be engineered to be not just task specific, but facility-specific: with modular designs that can be customized with different types of hardware to match aesthetic preferences, optimize functionality, and satisfy any space constraints. At a time when the healthcare industry is becoming increasingly hemmed in with fewer options, greater pressures and more regulatory limitations, the ability to “augment” existing capabilities and access such a flexible and powerful new tool in a manner that precisely meets the demands of your facility and process demands is a powerful value proposition.

Engineer, inventor and entrepreneur Paul Ryznar created Light Guide Systems and is the founder, president and CEO of Novi, Mich.-based OPS Solutions.

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