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A doctors holds male patinets hand while wearing a HoloLens headset

HoloLens and house calls: Telehealth technology delivers virtual consultations

General practitioner Dr. Cheng Chao-hsin was making a house call for an older patient who had constant pain radiating through his right hand. The man’s condition was puzzling. A few weeks earlier, another physician had diagnosed it as a case of rheumatoid arthritis and prescribed medication. But this treatment didn’t seem to be working.

Cheng listened intently to the patient and soon developed doubts. He wanted a rheumatology specialist to take a second look. Normally that might mean waiting days or weeks for an appointment and transporting the patient, who is a person with limited mobility, to a hospital many kilometers away.

But this time, Cheng simply reached into his bag and put on a HoloLens 2 mixed-reality headset. Within minutes he was collaborating with the specialist at the hospital in a real-time patient examination.

Linked via the Microsoft Dynamics 365 Remote Assist app and Microsoft Teams, the specialist was able to talk with the patient, examine his hand and see what Cheng was seeing. It soon became clear the original diagnosis had been wrong. Instead of rheumatoid arthritis the patient was actually suffering from a degenerative form of arthritis and needed different medication.

Community doctors in Taiwan often make house calls to serve the needs of older people and people with disabilities. And Cheng is among a growing number of physicians using Microsoft HoloLens to take this medical service to a new level.

The practice known as “telehealth” is finding momentum in Taiwan thanks in no small part to the country’s leadership in IT and its progressive healthcare system.

Wearing the mixed-reality headset with a patient at home, Cheng can access medical records and bring a specialist for a real-time virtual consultation via its audio and video feeds. With Azure Spatial Anchor, HoloLens gives doctors, nurses, and hospital volunteers a new set of eyes and ears on house calls.

Previously, a doctor on a house call might consult a specialist by phone, text message or via video recordings or simply refer patients to them.

Nurses can also use the HoloLens for house calls. Doctors at a hospital kilometers away can guide a nurse through a patient examination and help diagnose what is wrong. In a virtual sense, this upgrades a nurse’s visit to a doctor-level visit. In the meantime, more doctors are freed up to focus on urgent cases at the hospital.

Telehealth is finding new urgency during the COVID-19 pandemic because it enables medical professionals to treat more patients remotely and avoid unnecessary exposure to the virus.

Dr. Vincent Tsai, the superintendent of the Ten-Chan General Hospital in Taoyuan, Taiwan, where Cheng also works, speaks enthusiastically about the possibilities of telehealth.

“Patients can get feedback on their condition in real time and avoid risking contact with COVID-19 in a hospital,” says Tsai, a urologist. “With the HoloLens, I can access patient medical records, blood test results, X-rays, and other data when I’m with a patient at their home, so I don’t need to travel with these documents in-hand.”

Using the HoloLens, he notes, significantly speeds up treatment time compared to setting up in-person appointments with specialists.

“After the pandemic, we plan to continue a push for further telehealth adoption,” says Tsai. The Ten-Chan General Hospital is now using telehealth for three main applications: check-ups and medical record access, long-term care, and training and research and development.

A woman operates a HoloLens while a man looks on

Norman Hsu, Ten-Chan General Hospital’s chairman, has been an early evangelist for telehealth. He sees the benefits of helping hospitals conserve resources by allowing doctors to treat patients remotely. And he hopes the practice will be adopted nationwide.

“Taiwan has an aging population and doctors are being stretched thin,” says Hsu. “There just aren’t enough doctors and specialists to go around. But with telemedicine and HoloLens, we can give more patients quality consultations with doctors and specialists in real time.”

More than 10,000 families in Taiwan subscribe to senior care services for their older relatives. As a COVID-19 high-risk group, the residents at Ten-Chan General Hospital’s nursing homes benefit from telehealth by getting personalized treatment without risking exposure to the virus at a hospital.

Cheng, Tsai and other frontline workers at the hospital are finding a new sense of confidence in their work by providing better, faster, cheaper and smarter healthcare from the comfort of a patient’s home.

With COVID-19 infections rising globally, Taiwan’s telehealth movement is at the cusp of a wider rollout across the Asia Pacific region. Hsu is optimistic: “I truly believe this is the future of healthcare and the pandemic is just accelerating what we already knew was coming.”