At the beginning of the pandemic, it was announced that Microsoft HoloLens Mixed Reality headsets were to be used by frontline medical staff in the fight against COVID-19. The technology offered the possibility of remote care in the midst of a highly contagious and deadly virus and enabled clinicians at Imperial College Healthcare NHS trust to visit patients in high-risk wards in full PPE and a HoloLens. This system then enabled clinicians to feed live footage to colleagues in a low-risk area through the Dynamics 365 Remote Assist app.

A year later, the headset technology is still showing considerable value by reducing the amount of time staff are spending in high-risk areas and significantly reducing personal protective equipment (PPE) usage, as only the doctor wearing the headset is required to dress in PPE. Imperial College Healthcare NHS trust has said that using HoloLens has led to a fall in the amount of time staff are spending in high-risk areas of up to 83%. It has also been shown that using HoloLens is saving up to 700 items of PPE per ward, per week.

The technology has since been adopted by other hospital trusts across the country, such as University College London Hospitals and The Leeds Teaching Hospitals. Amongst these, is also University Hospitals of Morecambe, which initially rolled out the technology as a project on emergency respiratory services in Morecambe Bay and then later in the Respiratory Ward 37 Project at Lancaster.

"Our initial consideration was to support ED and the ward bedside and connect patients to remote Respiratory Consultants in real-time, for urgent support and decision making." 

-Dr Colin Brown, CCIO and consultant gastroenterologist, Morecambe Bay

Morecambe adopts HaloLens2

During the #HIMSS21Europe 2 Conference, Dr Colin Brown, chief clinical information officer and consultant gastroenterologist from Morecambe Bay, England shared their experience of using HoloLens2 Headsets and remote digital connections to support clinical care during the COVID-19 pandemic. The trust was involved in building a national collaborative, which included partners from Imperial College London, Alder Hey Hospital Merseyside, Leeds Hospitals, Health Education England and others.

"Our initial consideration was to support ED and the ward bedside and connect patients to remote Respiratory Consultants in real-time, for urgent support and decision making," said Brown.

"This intention changed to use on the Respiratory Ward 37 at Lancaster, England to reduce staff COVID contacts and reduce PPE use. Then a quality improvement project was developed to support Care Home Residents at Kendal Care Home and connect them in real-time with their General Practitioner, who could talk with a member of staff wearing the headset and directly see the patient. These are members of society, rendered especially vulnerable during the recent and ongoing COVID pandemic."

Key outcomes

Brown also shared some outcomes and benefits of the project for patients, relatives and healthcare staff. The team then developed thoughts as to potential future use for the technology in health and care and noted the key enablers and constraints.

The project is currently being deployed for care home residents and general practitioners (GPs). One of the care homes was Kendal Care Home, where Hololens2 was trialled on 102 patients from October 2020 to April 2021.

The key outcomes and benefits from this trial were:

• Supported remote care in the care sector during the COVID-19 pandemic.
• Provides insights and "early evidence" for future Care Pathways.
• Avoids non-essential travel and infection contacts for patients and GPs.
• Supports remote visual assessment of patient, including comfort, agitation and distress.
• Supports remote clinical assessment of leg swelling, rashes etc
• Supports compassionate care for End of Life / "Gold Standards Framework"
• Promotes confidence and reassurance for families: my relative was "seen"
• GP can visually assess remotely, whilst also accessing EPR Records in office.

HoloLens expands

Alder Hey Children’s Hospital and NHS FT previously rolled-out HoloLens mixed reality headsets to support its operational theatre. The partnership’s goal was to build an app for the headset that will overlay ultrasounds, CT scans, angiograms, or other notes and records in the surgeon’s field of view. 

In a study published in European Radiology Experimental, surgeons at St. Mary’s Hospital in London used Microsoft HoloLens to overlay images of CT scans onto patients' legs during reconstructive lower limb surgery. 

During the conference, Dr Brown presented the Morecambe Bay experience of using mixed reality headset technology in supporting GPs and nursing staff, in providing safe, remote, clinical services, during the pandemic. He outlined the project aims, the outcomes, benefits and future potential applications of this technology in health and care.

Watch the 'Telehealth Workshop II: From Evidence to Practice' session 'On Demand' here.