Multisensory Medical Informatics

Peter Jones

Wow – The Wii earns my respect as a serious haptic interface. A University of Arizona team has shown improvements in fine hand motor skill developed from exercises in continuous practice of the Wii for simulated laproscopy.

I’ve interacted with the virtual gall bladder removal and cauterization simulation at Riverside Methodist hospital’s Virtual Care Unit. It tallied a game score just like a Wii game – but the Wii interface may have leveled the playing field by making it possible to learn and tune fine-grained motor skills in the context of purposeful (and cheap) simulations.

The virtual OR lab at the National Center for Collaboration in Medical Modeling and Simulation has been developing alternatives to learning hands-on procedures, primarily based on practice of motor routines in roughly simulated situations. Mark Scerbo, human factors psychologist (and a Cincinnati grad), explains:

“It’s like doing very sophisticated surgery with chopsticks in your hands,” Scerbo said. “It takes a lot of training to look at a two-dimensional display and understand what your instruments are doing. There’s a real need to train doctors, and not on patients.”

Surgeon Leonard Weireiter said: “It turns out you don’t need the high-fidelity haptics. It’s the repetitive practice of the motion that counts.”

Consider the similarity to sports psychology research that shows significant performance improvements from visualization exercises and mental practice. The brain-body system entrains toward the optimal physical movements, timing, and interaction with devices over practice, even when roughly simulated.

Impact on Medical Practice?

Healthcare informatics and e-Learning are rapidly evolving, from several directions –  clinical decisionmaking, patient eMR and personal healthcare records, consumer health information, drug information, resident education, specialist informatics, nursing education, genomics, institutional workflow, finance and insurance integration, and collaborative diagnostics. (I’d link all these to examples, but this was a handful just to type – if I get a reply, I’l do the links!)

Healthcare services and institutions represent a massive information ecology and infoconomy. A significant activity for design research involves understanding these resources and content sources as living, growing players in an ecosystem that cannot be designed, but rather interfaced, linked, connected, and metadatabased. We need ways to visualize the resources, ontologies/taxonomies and information objects available in the overall emerging system – a picture of the stable niches, emerging services, publishers and providers, institutions and their drivers, the relationships among these, and the size/impact of each service in the overall scheme of things. (Let me know if you find one!)