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Design Thinking Health: Telepresence for Remote Teams with Mobile Augmented Reality

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Part of the Understanding Innovation book series (UNDINNO)


This research examines the capabilities and boundaries of a hands-free mobile augmented reality (AR) system for distributed healthcare. We use a developer version of the Google Glass™ head-mounted display to develop software applications to enable remote connectivity in the healthcare field; characterize system usage, data integration, and data visualization capabilities; and conduct a series of pilot studies involving medical scenarios. This book chapter discusses the need for a AR head-mounted display to improve chronic wound care photography and to facilitate surgical interventions. We provide an overview of the system architecture used in this research, and highlight future applications of AR systems for improved clinical care.

In the broader context of distributed collaboration for improved healthcare delivery, this research provides a foundation for: (i) examining the use of technology for complex distributed problem solving through interdisciplinary collaboration; (ii) gaining an improved understanding of the benefits of human augmentation through enhanced visualization and auditory capabilities, on healthcare team performance; and (iii) exploring an AR system’s ability to influence behavior change in situations requiring acute decision-making through interaction between centralized experts and point-of-impact delivery personnel. Moreover, this chapter provides insight into the need for future IT systems engineering projects aimed at enhancing healthcare connectivity and distributed care.


  • Augmented Reality
  • Pressure Ulcer
  • Inertial Measurement Unit
  • Augmented Reality System
  • Mobile Augmented Reality

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  • DOI: 10.1007/978-3-319-19641-1_5
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Augmented reality


Centers for medicare and medicaid services


Digital single-lens reflex


Electronic medical record


Head-mounted display


Hospital-acquired pressure ulcers


Intensive care unit


Internal measurement unit


Medical record number


Mobile wound analyzer


National pressure ulcer advisory panel




Virtual nurse


  • Ahn C, Salcido RS (2008) Advances in wound photography and assessment methods. Adv Skin Wound Care 21:85–93

    CrossRef  Google Scholar 

  • Albrecht UV, von Jan U, Kübler J, Zoeller C et al (2014) Google glass for documentation of medical findings: evaluation in forensic medicine. J Med Internet Res 16(2), e53

    CrossRef  Google Scholar 

  • Aldaz G, Shluzas LA, Pickham D, Eris O, Sadler J, Joshi S, et al. (2015) Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management. PLoS ONE 10(4):e0121179. doi: 10.1371/journal.pone.0121179

    Google Scholar 

  • Beard HR, Hamid KS (2014) Worth a thousand words: integrating clinical photographs into an electronic medical record. Healthcare 2(1):22–25

    CrossRef  Google Scholar 

  • Bickmore TW, Pfiefer LM, Jack BW (2009) Taking time to care: empowering low health literacy hospital patients with virtual nurse agents. In: Proceedings of the CHI 2009. ACM Press

    Google Scholar 

  • Bizzotto N, Sandri A, Lavini F, Dall’oca C, Regis D (2013) Video in operating room: GoPro HERO3 camera on surgeon’s head to film operations—a test. Surg Innov. doi: 10.1177/1553350613513514

    Google Scholar 

  • Craig AB (2013) Understanding augmented reality: concepts and applications. Elsevier, Boston, MA

    Google Scholar 

  • Dixon BJ, Daly MJ, Chan H, Vescan AD, Witterick IJ, Irish JC (2013) Surgeons blinded by enhanced navigation: the effect of augmented reality on attention. Surg Endosc 27:454–461

    CrossRef  Google Scholar 

  • Doherty A, Williamson W, Hillsdon M, Hodges S, Foster C, Kelly P (2013) Influencing health-related behaviour with wearable cameras: strategies & ethical considerations. In: Proceedings of the 4th International SenseCam & Pervasive imaging conference. ACM, New York, NY, pp 60–67

    Google Scholar 

  • Epic Systems. Accessed 10 Jan 2014

  • Glauser W (2013) Doctors among early adopters of Google Glass. Can Med Assoc J 185:1385

    CrossRef  Google Scholar 

  • Gonzales D, Pickett R (2011) Too much pressure. Stanford Nurse 31(1):12–13

    Google Scholar 

  • Google + Glass Update. Accessed 21 Jan 2014

  • Google Glass. Accessed 5 Aug 2013

  • Goran SF (2010) A second set of eyes: an introduction to Tele-ICU. Crit Care Nurse 30(4):46–55

    CrossRef  Google Scholar 

  • Graves N, Birrell F, Whitby M (2005) Effect of pressure ulcers on length of hospital stay. Infect Control Hosp Epidemiol 26:293–297

    CrossRef  Google Scholar 

  • Hayes S, Dodds S (2003) Digital photography in wound care. Nurs Times 99(42):1–3

    Google Scholar 

  • Ishimaru S, Weppner J, Kunze K, Kise K, Dengel A, Lukowicz P, Bulling A (2014) In the blink of an eye: combining head motion and eye blink frequency for activity recognition with Google Glass. In: Proceedings of the 5th augmented human international conference. pp 150–153

    Google Scholar 

  • Krouskop TA, Baker R, Wilson MS (2002) A noncontact wound measurement system. J Rehabil Res Dev 39:337–345

    Google Scholar 

  • Lutz BJ, Kwan N (2014) Chicago surgeon to use Google Glass in operating room. Accessed 2 Feb 2014

  • Lyder CH, Wang Y, Metersky ML et al (2012) Hospital-acquired pressure ulcers: results from the national medicare patient safety monitoring system study. J Am Geriatr Soc 60:1603–1608

    CrossRef  Google Scholar 

  • Magnusson L, Hanson E, Borg M (2004) A literature review study of information and communication technology as a support for frail older people living at home and their family carers. Technol Disabil 16:223–235

    Google Scholar 

  • Mattke S, Klautzer L, Mengistu T, Garnett J, Hu J, Wu H (2010) Health and well-being in the home: a global analysis of needs, expectations, and priorities for home health care technology. RAND Corporation, Santa Monica, CA

    Google Scholar 

  • MAVIS III. Accessed 7 Apr 2014

  • Medical Xpress. First US surgery transmitted live via Google Glass (with video Accessed 13 Oct 2013

  • Mobile Wound Analyzer. Accessed 6 Apr 2014

  • Muensterer OJ, Lacher M, Zoeller C, Bronstein M, Kübler J (2014) Google Glass in pediatric surgery: an exploratory study. Int J Surg 12:281–289

    CrossRef  Google Scholar 

  • National Pressure Ulcer Advisory Council (2014) FAQ: photography for pressure ulcer documentation. Accessed 16 Mar 2014

  • NPUAP Pressure Ulcer Stages/Categories (2007) Accessed 11 Nov 2014

  • Sen CK et al (2009) Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen 17:763–771

    CrossRef  Google Scholar 

  • Shluzas LA, Aldaz G, Sadler J, Joshi SS, Leifer L (2014a) Mobile augmented reality for distributed healthcare: point-of-view sharing during surgery. In: Proceedings of the fourth international conference on ambient computing, applications, services and technology (Ambient 2014), IARIA, pp 34–38

    Google Scholar 

  • Shluzas LA et al (2014b) A wearable computer with a head mounted display for hands-free image capture and bi-directional communication with external sensors. US Provisional Patent No. 61968857, Mar 2014

    Google Scholar 

  • Starner T, Mann S, Rhodes B, Levine J, Healey J, Kirsch D, Picard R, Pentland A (1997) Augmented reality through wearable computing. Presence 6(4):386–398

    Google Scholar 

  • van Krevelan DWF, Poelman R (2010) A survey of augmented reality technologies, applications, and limitations. Int J Virtual Real 9(2):1–20

    Google Scholar 

  • Wagner P, Bartl K, Gunthner W, Schneider E, Brandt T, Ulbrich H (2006) A pivotal head mounted camera that is aligned by three dimensional eye movements. In: Proceedings of the 2006 symposium on eye tracking research & applications. ACM, New York, NY, pp 117–124

    Google Scholar 

  • Wu L, Cirimele J, Card S, Klemmer S, Chu L, Harrison K (2011) Interactive cognitive aids: maintaining shared mental models in anesthesia crisis care with nurse tablet input and large-screen displays. UIST’11, ACM

    Google Scholar 

  • ZBar barcode reader. Accessed 12 Feb 2014

  • Zhou F, Duh HBL, Billinghurst M (2008) Trends in augmented reality tracking, interaction and display: a review of ten years of ISMAR. In: Proceedings of the 7th IEEE/ACM international symposium on mixed and augmented reality. ISMAR, pp 193–202

    Google Scholar 

  • Zhu E, Hadadgar A, Masiello I, Zary N (2014) Augmented reality in healthcare education: an integrative review. doi:10.7287/peerj.preprints.335v1

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Correspondence to Lauren Aquino Shluzas .

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Shluzas, L.A., Aldaz, G., Leifer, L. (2016). Design Thinking Health: Telepresence for Remote Teams with Mobile Augmented Reality. In: Plattner, H., Meinel, C., Leifer, L. (eds) Design Thinking Research. Understanding Innovation. Springer, Cham.

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