Holo-Stroke-ii: Stroke care through stroke hologram teleportation- inpatient immersion.

BACKGROUND

Telestroke allows care irrespective of distance but has limitations in degree of immersive interaction. Augmented Reality (AR) holds promise, enabling providers and patients to interact as if in the same physical space. Prior investigations have shown immersive satisfaction for Holo-Stroke allowing 3D hologram providers to be transmitted to distant sites, and allowing for hologram assessments of Large Vessel Occlusions (LVOs).

METHODS

We presented 2 evaluation techniques (both telestroke and Holo-Stroke) to a group of stroke service inpatients. Three optical cameras with depth sensing capability were placed around the stroke provider, with imaging streams transmitted in real-time via intranet to a HoloLens 2 Head-Mounted-Display (HMD) worn by patient at a distant site. The provider was visualized in the patient's room as a hologram. Sample MRI, CTA, NIHSS picture card, and animation video were also visible to the patient through the HMD. Satisfaction questions were assessed via Likert scale. Wilcoxon Signed Rank, and Exact Binomial Test were used.

RESULTS

Twenty inpatients with deficits consistent with acute stroke participated. Median age was 68 years, 45 % were female, 55 % white, and 20 % Hispanic. Median Likert scores favored Holo-Stroke over telestroke overall (47(93 %) vs 25.5(48 %);p < 0.001), and for immersion (10(92 %) vs 4(37 %);p < 0.001), beneficial technique (10(95 %) vs 5.5(55 %);p < 0.001), and seeing images (10(97 %) vs 5(45 %);p < 0.001). Clinical observations were overwhelmingly favorable.

DISCUSSION: This Holo-Stroke telestroke, assessing acute stroke patients in the inpatient setting using wireless 3D hologram technique, resulted in robust immersion and significant increase in patient satisfaction. Although future evaluations of Holo-Stroke in acute telestroke are still warranted, Holo-Stroke has now clearly been shown to improve inpatient immersion and satisfaction.