Surgical Multidisciplinary Team Meetings Are Enhanced by Collaboration in the Metaverse.

Abstract

Multidisciplinary team meetings (MDT-Ms) are utilized as a tool for clinical decision-making. Currently, these are in-person or remotely attended via screen-sharing of patients' electronic health records, including clinical findings, numerical data, and two-dimensional and three-dimensional imaging. Immersive virtual reality (IVR) is an emerging technology that allows multiple care-providers to remotely interact with each other and with patient data in a metaverse-an immersive and collaborative digital environment. An MDT-M held in the metaverse could enhance surgical decision-making. To develop an IVR metaverse for MDT-M and to test its feasibility and efficacy to visualize data and make clinical decisions in the orthopedic trauma setting. Interviews of users attending existing orthopedic trauma MDT-Ms at a regional major trauma center identified strengths, weaknesses, opportunities, and threats for a novel metaverse platform. This was iteratively tested for feature development, and 24 simulated cases were curated from previous admissions. Pilot MDT-Ms were conducted, and user experience was measured using the NASA Task Load Index (NASA-TLX) and System Usability Scale. An IVR metaverse platform was developed to conduct MDT-Ms with multiple remote participants. Four MDT-Ms were successfully conducted with health care professionals (n = 13). Participants found that "data visualization" and "clinical decision-making" were effective in IVR: median 5 (interquartile range [IQR], 4-5) and 5 (IQR, 4-5), respectively. Ratings on "ease of communication" in the metaverse varied with a median of 3 (IQR, 2-4.5). Qualitative analysis highlighted the strength of IVR to interrogate 3D anatomy and injury patterns collaboratively and quickly. The NASA-TLX domain "task performance" was rated consistently highly, indicating the ability to use presented data to advance patient management. Health care professionals can feasibly conduct complex MDT-Ms using a novel metaverse platform on commercially available IVR headsets. Participants were able to collaboratively interrogate clinical data, facilitating enhanced discussion, decision-making, and perceived task performance. Future iterations will focus on improving the designation of roles to improve communication in the metaverse meeting.