Publication

Background: Access to echocardiography in remote and rural areas is limited due to a shortage of trained sonographers and the difficulties of accessing isolated regions. A Haptically-Enabled Robot for Teleoperated Echocardiography (HERTEC) was developed to address these disparities, enabling experienced echocardiographers to perform cardiac ultrasound examinations remotely using a robotic platform with integrated haptic feedback.

Objectives: This pilot study evaluated the feasibility of the HERTEC system under varying network latency conditions and feedback settings and assessed ergonomic modifications to the haptic control device.

Methods: Five experienced echocardiographers conducted remote examinations on a healthy volunteer, acquiring five standard cardiac views under three network latency conditions (50 ms, 150 ms, and 250 ms) with haptic feedback enabled or disabled. The haptic device, modified with a dummy probe designed to replicate the feel and orientation of an actual ultrasound probe for improved ergonomics, was tested with and without these changes for analysis. Quantitative metrics, including task completion times, were combined with Likert-scale and open-ended feedback.

Results: Enabling haptic feedback reduced acquisition times for some and improved confidence in probe positioning, though its utility varied among users. Network latency above 200 ms noticeably impeded teleoperation performance but did not prevent the acquisition of diagnostic-quality images. The ergonomic modifications received a median comfort rating of 7/10 and an ease of use rating of 8/10, though some noted arm strain requiring further refinements.

Conclusion: The HERTEC system demonstrates the potential for enabling reliable and efficient remote echocardiography, even under moderate network latency conditions. Haptic feedback and ergonomic enhancements play critical roles in improving usability and operator performance. Future research will focus on refining the system’s force-feedback calibration, enhancing ergonomics, and validating clinical efficacy with a larger participant cohort.