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Over the last two years, we built, evaluated, and published a volumetric communication system for volumetric-based training and assistantship of medical personnel. Technical aspects of the system have been published at HICCS conference. In this paper, we discuss a follow-up work: the design and evaluation of a mixed reality real-time communication system for remote assistance during CPR emergencies. Our system allows an expert to guide a first responder, remotely, on how to give first aid. RGBD cameras capture a volumetric view of the local scene including the patient, the first responder, and the environment. The volumetric capture is augmented onto the remote expert's view to spatially guide the first responder using visual and verbal instructions. We evaluate the mixed reality communication system in a research study in which participants face a simulated emergency. The first responder moves the patient to the recovery position and performs chest compressions as well as mouth-to-mask ventilation. Our study compares mixed reality against videoconferencing-based assistance using CPR performance measures, cognitive workload surveys, and semi-structured interviews. We find that more visual communication including gestures and objects is used by the remote expert when assisting in mixed reality compared to videoconferencing. Moreover, the performance and the workload of the first responder during simulation do not differ significantly between the two technologies. 

We present the design of a mixed reality (MR) telehealth training system that aims to close the gap between in-person and distance training and re-training for medical procedures. Our system uses real-time volumetric capture as a means for communicating and relating spatial information between the non-colocated trainee and instructor. The system's design is based on a requirements elicitation study performed in situ, at a medical school simulation training center. The focus is on the lightweight real-time transmission of volumetric data - meaning the use of consumer hardware, easy and quick deployment, and low-demand computations. We evaluate the MR system design by analyzing the workload for the users during medical training. We compare in-person, video, and MR training workloads. The results indicate that the overall workload for central line placement training with MR does not increase significantly compared to video communication. Our work shows that, when designed strategically together with domain experts, an MR communication system can be used effectively for complex medical procedural training without increasing the overall workload for users significantly. Moreover, MR systems offer new opportunities for teaching due to spatial information, hand tracking, and augmented communication. 

We design a volumetric communication system for remote assistance of procedural medical tasks. The system allows a remote expert to spatially guide a local operator using a real-time volumetric representation of the patient. Guidance is provided by voice, virtual hand metaphor, and annotations performed in situ. We include the feedback we received from the medical professionals and early NASA TLX [5] data on the cognitive load of the system.