Welcome to the future of telemedicine!

 Microsoft Teams is a cloud-based component of Microsoft Office 365 that allows chat, video meetings, file storage, and applications integration (similarities to Zoom and Slack). Video meetings can be between 2 people or an entire organization. Teams works on Windows 10 devices, iPhones/iPads, and Android devices. Since March 5, 2020, during the COVID19 pandemic, Microsoft is making Teams available to everyone for free from individuals to enterprises. Security-wise Teams is HIPAA compliant .

Although traditional diagnostic ultrasound equipment is mounted on large carts, advancements in technology have led to the development of transducers that can be carried in one’s pocket and plugged into a smartphone or tablet at the bedside. Hence, they are called “point of care” or POCUS.  By connecting a remote expert to a POCUS augmented device, Microsoft Teams allows the remote expert to see the POCUS study unfold in real time. The Society of Point of Care Ultrasound  has a lot of links to resources including COVID-19 and a number of POCUS vendors (e.g. Butterfly IQ, Philips Lumify, Sonosite, et al).

In the digital spatial computing world, hologram has come to mean the superimposition of a digital image on top of the real world. The most sophisticated systems have transparent head-mounted displays such as Microsoft HoloLens 2 or Magic Leap 1. This digital enhancement of the real world is called Augmented Reality or AR. Microsoft HoloLens 1 and 2 work with Microsoft Teams in conjunction with Dynamics 365 Remote Assist software. With Remote Assist, a remote expert can see exactly what the HoloLens-wearing healthcare worker is seeing in a patient’s room, and conversely the healthcare worker in the patient’s room sees a Teams video screen floating in mid-air in front of them with the remote expert’s video displayed. If the screen of the tablet which is connected to the POCUS probe is brought in as a third “participant” in the meeting, the tablet screen can be shared with the participants. The Healthcare worker in the patient’s room can see the POCUS video displayed in real time as a floating screen in front of them, and the remote expert can see it too on their monitor. This is the essence of Holographic Onsite Care Under Supervision with Point Of Care UltraSound...or HOCUS POCUS™ for short.

Remote telepresence, or in this case having the remote doctor appear as a hologram in the room with you with the aid of an AR headset  is not science fiction. Admittedly, it does conjure up visions of Princess Leia saying, “Help me Obi Wan Kenobi…” and the holographic Jedi Council meeting straight out of the Star Wars movies! Solutions put out by Spatial, Valorem Reply’s Holobeam, and Mimesys are a few examples of working telepresence applications. Spatial’s product is avatar-based, while Valorem Reply’s Holobeam uses volumetric video. Both work on HoloLens 1 and 2, but Spatial is cross-platform to include Oculus Quest VR headsets, Magic Leap, and nReal AR glasses. Recently, Microsoft announced their Microsoft Mesh platform which will enable similar capabilities to Spatial, but Mesh will be integrated into Microsoft Teams. This would allow HOCUS POCUS to be integrated into a single application! Currently, it utilizes avatars, but their vision includes volumetric video holoportation.