Starting in November, 25 Dallas-area veterans will be the first to try cutting-edge rehabilitation technology designed to transmit sensations of physical touch over the Internet, according to researchers at the University of Texas at Dallas who are leading the initial six-month trials.
The project, dubbed the Multi-modal 3D Tele-immersion Research Project, seeks to provide enhanced access to physical therapy for disabled veterans who cannot commute to the doctor’s office by combining recent advances in 3-D cameras, high-speed Internet connections, video game engines and the rapidly evolving field of “haptic,” or sense-of-touch, technology.
“We’re bringing the sense of touch to telemedicine,” said Dr. Balakrishnan Prabhakaran, computer science professor at UT-Dallas and the project’s principal investigator.
Patients would go to the Dallas Veterans Affairs Medical Center and perform upper-arm exercises with a haptic device, which will transmit the location and force of the patient’s motions over the Internet to an identical device used by a therapist at the UT-Dallas campus, about 20 miles away in Richardson.
The research received $2.4 million from the National Science Foundation in 2010 and an additional $300,000 last year from U.S. Ignite, a partnership between the White House Office of Science and Technology Policy and the foundation.
Haptic technology uses a variety of vibrations, tactile sensors and the application of force to the user to re-create the sensation of physical touch. Some of the most common forms of haptic technology include a cellphone’s vibrate mode and the “rumble” effect on a videogame controller. But more advanced forms of this technology are changing the way people interact with the Internet and could affect the booming telemedicine industry, which uses communication technology to provide medical services at a distance.
The UT-Dallas project’s initial trials will measure the technology’s effectiveness in evaluating upper-arm injuries and conditions, but it is not yet ready to be used for treatments, according to Dr. Thiru Annaswamy, an associate professor at UT Southwestern Medical Center and physician at the Dallas VA Medical Center who is involved in the project.
The new technology comes with some concerns, however.
Cybersecurity threats range from eavesdropping to data breaches on the doctor’s or patient’s end.
“With all of this new functionality comes new security risks,” said Chris Prosise, vice president at Praetorian, an Austin-based cybersecurity consulting firm. “Usually it’s during the early adoption period that we find security vulnerabilities.”
In January, hackers broke into insurance carrier Anthem’s computer systems, compromising the names, birthdays, Social Security numbers and other confidential information of nearly 80 million people.
The UT-Dallas project was slated to begin over the summer but was postponed to implement additional cybersecurity measures. The researchers are confident the participants’ privacy is safe.
How it works
At their respective locations, the patient and the therapist will stand before a 60-inch television monitor that displays a shared virtual environment much like a multiplayer videogame while 3-D cameras beam a live feed of the patient and therapist onto each other’s screen.
In front of each screen is a haptic device, a 10.5-inch tall, 12-inch wide, clam-shaped machine with a protruding arm that the user can move.
As the patient moves the device, the force and position of the movements are converted into a digital signal and are transmitted via the Internet to an identical device on the other end, which re-creates the movements in real time and allows one user to feel the force of the other’s movements.
The therapist will guide the patients through exercises based on their disabilities. Many of the exercises come in the form of games, including one that requires the patient to saw through a virtual log using the haptic device. The log appears on the television monitor along with a live video feed of the patient. The haptic device re-creates the resistance of the log, and after 20 sawing motions the log is cut in two.
The haptic device, called Omega.3 by the Swiss firm Force Dimension, is commercially available and costs $27,000.
Even if the UT-Dallas project is successful, the haptic device’s price tag and sluggish Internet speeds in many places could impede the technology from being widely adopted.
Prabhakaran said an Internet connection speed of at least 100 megabits per second is ideal to use the technology — more than 8 times faster than the average U.S. Internet speed of 11.9 mbps, according to the tech firm Akamai in its “State of the Internet” report for the first quarter of 2015.
The UT-Dallas team is currently developing algorithms to allow for slower Internet speeds. Last week, Prabhakaran’s team successfully tested the technology at 50 Mbps.
Prabhakaran said the project has civilian and military applications — including for active-duty soldiers deployed in places where they may not have access to physical therapists.
Early next year, the UT-Dallas team will begin discussing the project with the Army’s Telemedicine and Advanced Technology Research Center headquartered at Fort Detrick in Maryland.
Telemedicine in Texas
Telemedicine uses communication technology to provide certain medical services at a distance for patients who cannot commute to the doctor’s office or don’t have access to the services they need where they live. Currently, telemedicine technology is limited to video and phone conferencing.
The telemedicine industry is a large part of the burgeoning U.S. telehealth industry, which saw $240 million in revenue in 2013 that is expected to mushroom to $1.9 billion by 2018, according to a report last year by business consulting firm Ernst and Young.
Despite the industry’s growth, it has been the subject of controversy in Texas. In May, a federal judge blocked the state from enforcing a rule approved by the Texas Medical Board that required patients to have a “face-to-face or in-person evaluation” before being prescribed medication.
“Not all patients are appropriate (for telehealth), especially if they suffer from depression or social isolation,” said Dr. Alan Lee, associate professor at Mount Saint Mary’s University in Los Angeles who has used telehealth with patients.