Evaluation of a tactile display around the waist for physiological monitoring under different clinical workload conditions

Augmenting Critical Care Patient Monitoring Using Wearable Technology: Review of Usability and Human Factors

Background

Continuous monitoring of the vital signs of critical care patients is an essential component of critical care medicine. For this task, clinicians use a patient monitor (PM), which conveys patient vital sign data through a screen and an auditory alarm system. Some limitations with PMs have been identified in the literature, such as the need for visual contact with the PM screen, which could result in reduced focus on the patient in specific scenarios, and the amount of noise generated by the PM alarm system. With the advancement of material science and electronic technology, wearable devices have emerged as a potential solution for these problems. This review presents the findings of several studies that focused on the usability and human factors of wearable devices designed for use in critical care patient monitoring.

Objective

The aim of this study is to review the current state of the art in wearable devices intended for use by clinicians to monitor vital signs of critical care patients in hospital settings, with a focus on the usability and human factors of the devices.

Methods

A comprehensive literature search of relevant databases was conducted, and 20 studies were identified and critically reviewed by the authors.

Results

We identified 3 types of wearable devices: tactile, head-mounted, and smartwatch displays. In most cases, these devices were intended for use by anesthesiologists, but nurses and surgeons were also identified as potentially important users of wearable technology in critical care medicine. Although the studies investigating tactile displays revealed their potential to improve clinical monitoring, usability problems related to comfort need to be overcome before they can be considered suitable for use in clinical practice. Only a few studies investigated the usability and human factors of tactile displays by conducting user testing involving critical care professionals. The studies of head-mounted displays (HMDs) revealed that these devices could be useful in critical care medicine, particularly from an ergonomics point of view. By reducing the amount of time the user spends averting their gaze from the patient to a separate screen, HMDs enable clinicians to improve their patient focus and reduce the potential of repetitive strain injury.

Conclusions

Researchers and designers of new wearable devices for use in critical care medicine should strive to achieve not only enhanced performance but also enhanced user experience for their users, especially in terms of comfort and ease of use. These aspects of wearable displays must be extensively tested with the intended end users in a setting that properly reflects the intended context of use before their adoption can be considered in clinical settings.

The Evaluation of Tactile Parameters and Display Prototype to Support Physiological Monitoring and Multitasking for Anesthesia Providers in the Operating Room

Communicating physiological information via the tactile modality is shown as a promising means to address data overload faced by anesthesia providers. However, it is important to ensure that the tactile parameters which represent information are intuitive. There is currently no consensus on which tactile parameters should be used to present information within anesthesia. The two studies presented here evaluate: (a) a set of 24 tactile cues manipulating intensity, temporal, and spatial tactile parameters in a usability study and (b) a prototype tactile display based on the usability study's findings in a single and dual-task scenario. Findings of the usability study show intensity and temporal were rated most urgent and had the most potential to represent changes in physiological measures. This was confirmed in the follow up study as increases/decreases in intensity were shown to represent increases/decreases in a physiological measure and using different spatial locations to represent physiological measures resulted in greater than 95% response accuracy. Response times and accuracy were not adversely affected while performing a secondary task. The findings contribute to a better understanding of how to map tactile parameters to physiological information and demonstrate the effectiveness of end-user feedback in tactile display design to develop intuitive alerts.

Vibrotactile guidance for trajectory following in computer aided surgery

Most conventional computer-aided navigation systems assist the surgeon visually by tracking the position of an ancillary and by superposing this position into the 3D preoperative imaging exam. This paper aims at adding to such navigation systems a device that will guide the surgeon towards the target, following a complex preplanned ancillary trajectory. We propose to use tactile stimuli for such guidance, with the design of a vibrating belt. An experiment using a virtual surgery simulator in the case of skull base surgery is conducted with 9 naïve subjects, assessing the vibrotactile guidance effectiveness for complex trajectories. Comparisons between a visual guidance and a visual+tactile guidance are encouraging, supporting the relevance of such tactile guidance paradigm.