Augmented Reality: supporting sterile processing services?

Every day, hospital staff has to manage complex processes to guarantee quality and patient safety. Yet in some areas, the use of checklists and manuals tends to be more cumbersome and not useful – as is the case in sterile processing. A new project studies how augmented reality can take all the necessary information into the staff's field of view.

In this interview with MEDICA-tradefair.com, Dr. René Reiners explains the potential benefits of augmented reality (AR) in sterile processing and defines what augmented reality glasses should look like in this type of application.

Dr. Reiners, who had the idea of using augmented reality in sterile processing?

Dr. René Reiners: The IT4Process Company, the coordinator of our "Smart Glasses in Sterile Processing" project focuses on the digitization of hospital workflows. This also includes sterile processing solutions. Mistakes can definitely happen in this area – for example, if staff did not receive adequate training, when various processes were not practiced enough or simply due to stress. This prompted questions such as how we can improve the quality of computer-assisted sterile processing. And can we make training information accessible again during work processes? Augmented reality approaches are a great way to pinpoint this information. As part of this project, we now intend to check their feasibility in sterile processing. We study both the use of smart glasses where users have a screen right in front of their eyes, as well as actual AR approaches like Microsoft Hololens, which directly project the information into the environment around you.

What are the actual challenges or unique sources of error in sterile processing where the application of AR is able to offer assistance?

Reiners: At work, staff members in the clean room interact with monitor screens, keyboards, and computer mice. It is crucial that these items can be disinfected to prevent the spread of germs to medical devices. They also take longer to operate.

Having said that, they also have to move around in this area, that being between cleanroom work tables, sterilizers or the storage area, which is also located in the clean room. It is essential for associates to always have the information about the needed components at hand since the information about their location can no longer be accessed in the storage area and must be retrieved from catalogs. There are screens or tablets for this purpose, which would cause the associates to touch them again or turn or crane their necks. This breaks their concentration because they no longer focus on their actual work. It is also time-consuming and can result in incorrect entries. If we were to feed the necessary information into the system at the right time, we could also improve the workflow.

What kind of information could users gather from AR?

Reimers: Right now, we are primarily considering packing lists for surgical trays and the instruments that need to be included. We could also indicate the sequence and offer assembly and disassembly instructions for the surgical instruments. These are special tools that call for in-depth knowledge or instructions for the cleaning process.

We are also focusing on an application scenario to relay added educational videos on the subject. We could also indicate when surgical equipment needs to be replenished and where it can be found in the storage area. The location is frequently specified via complicated article descriptions and number codes. AR could simplify and speed up this entire process.

Do augmented reality glasses have to meet specific hardware or software requirements for this application, which they currently do not fulfill?

Reiners: When it comes to the hardware, none of the currently available glasses feature the right moisture resistance. The glasses must have a certain IP protection rating for disinfection purposes.

On the software side, we would need image recognition to identify instruments or each instrument would need to have a clearly visible code for example. That is already feasible in the case of some instrument sizes. Another option would be to attach tiny NFC tags to the instruments, though they could be damaged by the cleaning solutions. That being said, labels are not the focus of our project at this point. First, we want to determine the scenario where AR glasses would make sense, whether that might be in the packing area or in warehouse logistics. Adapting the hardware would then be the subsequent step.

Generally speaking, what are the potential applications of AR to support hospital processes?

Reiners: I think AR can be applied in all areas of logistics that involve set processes or lists. This could be material transport to or from a storage area, the distribution of medication or meals or even hospital rounds to show physicians scheduled patients and their data.

You could also use AR in the operating room and display imaging data directly on the patient's body for example. In doing so, surgeons would no longer use monitors as much and look away from the operating field.

What are the next steps for your project?

Reiners: We recently conducted kickoff workshops with our project partners to introduce potential users to the subject. We are now in the process of creating feasible interaction concepts and a prototype. That is to say, we take a look at the existing hardware and software and adapt it to the application. At the end of the day, we want to be able to determine the type of operating process where it makes sense to use AR and define the interaction design. Based on this, we want to make a recommendation as to what the hardware would actually need to look like as a finished product and pinpoint the foundation hospitals would still have to lay for its use.