3D Telemedicine During COVID-19: Cohort Study

1. Background:

Telemedicine is critical during Covid pandemic. A seismic shift in clinical practice has occurred in the UK, with nearly all medical clinics cancelled or converted to telephone or telemedicine clinics (Attend Anywhere or Zoom). These fail to adequately substitute for a face-to-face consultation, with the National Health Service (NHS) needing higher quality, more clinically effective methods of remote patient interaction. This project will be the world's first evaluation of a novel, potentially transformative form of 3D telemedicine, facilitating telepresence as if the patient were in the room. This state-of-the-art system has been developed by an industrial partner, specifically to help with remote patient communication during Covid pandemic. This uses an array of 3D cameras connected to fusion and render servers, allowing reconstruction of a 3D image in real time. This may give more information about a patient's condition, particularly in more visual specialties such as Plastic Surgery

The research will fulfil criteria for the European Commission's Model for Assessment of Telemedicine applications (MAST, Kidholm 2012). This will include participatory design, and evaluation with a preliminary cohort study, to shape the follow on research. This will assess clinicians' and patients' perception of system usability, delivery of therapies, clinical accuracy and interaction. On project completion, fulfilment of MAST criteria will enable upscaling and lead onto a randomized trial. The study design will be informed by participatory design prior to the start of the clinical study. This will include clinical stakeholders (specialist nurses, doctors and physiotherapists), the digital research team, and patient groups. The focus groups will collate user groups opinions about the 3D system, functionality, risks, and applicability.

The clinical study will be a feasibility study involving clinician and patient feedback on 3D telemedicine, and will additionally collect safety, reliability and fidelity data. The study will be a mixed methods analysis assessing measures of usability, satisfaction, presence, task load index, and accuracy. Clinicians and patients will complete questionnaires and undergo a short interview on the use of both forms of telemedicine. There are no data regarding the use of 3D telemedicine, but this will leverage study design and validated questionnaires from other similar studies (Buvik 2016). The study will continue as post covid services are being established. 2. Aims

This study will refine and pilot the feasibility of introducing 3D telemedicine into plastic surgery clinics and gain pilot data on the comparative efficacy and acceptability compared to face-to-face clinics, from both a patient and clinician perspective. The feasibility study will then inform the design and size of larger randomised study to compare 2D and 3D telemedicine. 3. Research Questions Primary