TapTrak

TapTrak is a modular 3D Spinal Tap Training system that aims to improve the current lumbar puncture training procedures by helping future and current physicians construct a mental model of the human anatomy with the help of real-time feedback based on needle tracking.

It also allows physicians to work and practice on different kinds of scoliotic spines so that it can eventually help trainees transition from the simulated environment to a clinical setting more comfortably and effectively.

Overview

ABOUT

Timeline – 6 Months (in progress - Summer 2017)

Collaborators – Neethi Bathula, Janet Johnson.

Advisors - Dr. Nadir Weibel, UC San Diego
                    Dr. Preetham Suresh Clinical Professor, UC San Diego School of Medicine

Challenge

Epidural procedures such as lumbar puncture are always difficult for early physicians and Anesthesiologists to learn and perform. Along with the complexity, It is noticed that the training phase is really time consuming and complex and involves a lot of cost. 
Our core challenge was

How might we improve and train physicians more effectively to perform epidural procedures in a clinical setting ?

Solution 

Our solution TapTrak aims to improve the current training procedures with a modular mannequin training system that help future and current physicians construct a mental model of human anatomy using real-time 3D feedback based on needle tracking.

In bringing the modular approach and added feedback to the training environment, we hope to help physicians transition from the simulated environment to a clinical setting more comfortably.

My Role

My role as a User Researcher and Prototyper involved formulating insights from

  • Observational Research
  • Contextual interviews and Focus Group discussions.
  • Journey Mapping of a trainee surgeon
  • Personas Development, Ideation and
  • Hardware Prototyping (in progress as of Summer 2017)

Research

Contextual Interviews and Observations

We conducted a lot of interviews with professors, medical students, resident surgeons to understand the core problems that these physicians notice while performing epidural procedures.
One of the most common theme that was uncovered through our initial research was that physicians had difficulty understanding the 3D structure of human anatomy and hence epidural procedures required a lot of practice before moving into clinical settings. 

We interviewed doctors, medical students and professors in the UC San Diego School of Medicine, Simulation Training Center and VA Hospital to understand problems faced by trainees learning epidural procedures. (Snippets of interviews in the video)

We interviewed doctors, medical students and professors in the UC San Diego School of Medicine, Simulation Training Center and VA Hospital to understand problems faced by trainees learning epidural procedures.

(Snippets of interviews in the video)

Journey Mapping And Focus Group Discussions

We designed our journey map through our initial research to understand the learning process of an anesthesiologist and how they transferred their knowledge and practice of epidural procedures into clinical setting. 

Journey Maps helped us understand our target user.

Journey Maps helped us understand our target user.

We performed observational studies to look into the current training phases. (including hospitals and training centers)

We performed observational studies to look into the current training phases.

(including hospitals and training centers)

With thorough observation study and focus group discussions with doctors and professors in the field, we realized that targeting the initial training phase would be a great point of intervention for having maximum impact on making physicians understand the human anatomy.

I along with my teammates then went to the Simulation Training Center at UC San Diego School of Medicine and did observational studies on current manikin (medical mannequins) based training systems and found out that current methods though quite realistic did lack visual cues that could help trainees understand the 3D anatomy of humans for perfect epidurals. 

IDEATION

We discussed different ideas along with medical researchers and engineers and with the help of affinity diagrams we discovered various pain points in the current mannequins systems that also guided our persona process. 

After cumulating all our research findings, we brainstormed along with medical researchers, professor and engineers for possible modifications to the training methods and decided to make the current system more interactive with 3D needle tracking and fault detection, customizable spinal inserts, added procedural feedback and a gamified skill-based training modules. 

We believe that having an interactive training program with the features we envisioned, will help physicians transition from the simulated environment to a clinical setting more comfortably.

Note: For our solution, we decided to focus on the most common epidural procedure i.e. the lumbar puncture (also known as 'spinal tap'). 

Design

 
 

We designed TapTrak - A spinal tap training assistant that helps construct a mental model using real-time feedback based on needle tracking, and allows physicians to choose the kind of spine they want to work with.

FEATURES OF TAPTRAK

Needle Tracking and Fault Detection

The needle trajectory would be tracked by the cameras and the light

The needle trajectory would be tracked by the cameras and the light

Different views for trainees to detect faults

Different views for trainees to detect faults

For tracking, the current needle was painted black, with bright spots placed along its length. In the dark, the light source helps the camera identify the position of these spots, that can be used to display the needle trajectory, overlayed on the digital reconstruction of the spinal insert. The system will alert the physician when a fault is encountered. This could include an optional audio alert.

Multiple Inserts

Trainee can monitor trajectory in 3D space on a screen.

Trainee can monitor trajectory in 3D space on a screen.

We also aim to incorporate modular spinal configurations through array pf inserts 

We also aim to incorporate modular spinal configurations through array pf inserts 

Our design also incorporates a modular approach with a diverse array of inserts  to accommodate abnormal anatomies of the spine. These inserts would have a 3D-printed bone structure embedded in a transparent gel block. Each insert would have a corresponding digital persona that would be used to provide visual feedback to the physician.

Customizable and Added Feedback

Physicians will be provided with feedback both during the training and after.

Physicians can choose to learn from a variety of constructive feedback of training such as -

  • Video replay of the procedure.
  • Statistics indicating speed, direction, and number of failures.
  • Visualizations based on their training trends.

 

Trainees can get post and pre training data

Trainees can get post and pre training data

Different modules will have different aids based on skill-level of the physician.

Different modules will have different aids based on skill-level of the physician.

We also thought of having different training modules that would provide varying levels of educational training aid based on the skill-level of the physician. This allows for a gamified experience. For example, a beginner will be provided with audio prompts and detailed statistics as they deviate from the correct path while an expert would only get the same after multiple failed attempts.

    It is our expectation that these features and constant feedback will help engage the physicians and make the learning process a more effective one.

    How It Works

    about_systemdiagram.png

    Hardware

    Along with our hardware engineer, we look into the existing mannequin setup of the spinal tap simulation and made changes that would help us achieve our goal. 

    Two cameras(Top and Right) and a light source surrounding the spinal insert will be mounted on the current manikin that would help in tracking.

    The back mesh would be embedded with piezoelectric sensors that would help us to map out the position of the needle. 

    Current Phase (Summer 2017)

    We are currently in the phase of implementing our prototype. We hope to develop the same within the next 2 months and test its efficiency with medical students at UC San Diego School of Medicine and the Simulation Training Center at UC San Diego.

    We also hope to implement an Augmented Reality add-on to the manikin system that would mimic patient movement and live feedback for a more realistic and immersive training experience.

    Bonus Video Proposal

    I also created this 6 minute video along with my teammate that explains our project proposal and future goals for the system.

                                                                                                      Project Solution Proposal

    Reflections

    Working on TapTrak gave me exposure to the complex product development cycle in the medical device industry. Working on products related to healthcare requires a lot of additional tasks such as IRB approvals, specialized trainings for Healthcare research, Sensitive Observational Research and much more. Though extremely challenging, It was a great learning experience to work directly with hospitals and School of Medicine for this project.