Participatory development of a 3D telemedicine system during COVID : the future of remote consultations

Lo, Steven and Fowers, Spencer and Darko, Kwame and Spina, Thiago and Graham, Catriona and Britto, Andrea and Rose, Anna and Tittsworth, David and McIntyre, Aileen and O'Dowd, Chris and Maguire, Roma and Chang, Wayne and Young, David and Hoak, Amber and Young, Robin and Dunlop, Mark and Ankrah, Levi and Messow, Martina and Ampomah, Opoku and Cutler, Ben and Armstrong, Roma and Lalwani, Ruchi and Davison, Ruairidh and Bagnall, Sophie and Hudson, Whitney and Shepperd, Mike and Johnson, Jonny, 3DTM (3D Telemedicine) Collaborative research group (2023) Participatory development of a 3D telemedicine system during COVID : the future of remote consultations. Journal of Plastic, Reconstructive & Aesthetic Surgery, 87. pp. 479-490. ISSN 1878-0539 (

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The COVID pandemic brought the need for more realistic remote consultations into focus. 2D Telemedicine solutions fail to replicate the fluency or authenticity of in-person consultations. This research reports on an international collaboration on the participatory development and first validated clinical use of a novel, real-time 360-degree 3D Telemedicine system worldwide. The development of the system - leveraging Microsoft's Holoportation™ communication technology - commenced at the Canniesburn Plastic Surgery Unit, Glasgow, in March 2020. The research followed the VR CORE guidelines on the development of digital health trials, placing patients at the heart of the development process. This consisted of three separate studies - a clinician feedback study (23 clinicians, Nov-Dec 2020), a patient feedback study (26 patients, Jul-Oct 2021), and a cohort study focusing on safety and reliability (40 patients, Oct 2021-Mar 2022). "Lose, Keep, and Change" feedback prompts were used to engage patients in the development process and guide incremental improvements. Participatory testing demonstrated improved patient metrics with 3D in comparison to 2D Telemedicine, including validated measures of satisfaction (p