MEDICINE MEETS VIRTUAL REALITY 14 Studies in Health Technology and Informatics This book series was started in 1990 to promote research conducted under the auspices of the EC programmes’ Advanced Informatics in Medicine (AIM) and Biomedical and Health Research (BHR) bioengineering branch. A driving aspect of international health informatics is that telecommunication technology, rehabilitative technology, intelligent home technology and many other components are moving together and form one integrated world of information and communication media. The complete series has been accepted in Medline. Volumes from 2005 onwards are available online. Series Editors: Dr. J.P. Christensen, Prof. G. de Moor, Prof. A. Famili, Prof. A. Hasman, Prof. L. Hunter, Dr. I. Iakovidis, Dr. Z. Kolitsi, Mr. O. Le Dour, Dr. A. Lymberis, Prof. P.F. Niederer, Prof. A. Pedotti, Prof. O. Rienhoff, Prof. F.H. Roger France, Dr. N. Rossing, Prof. N. Saranummi, Dr. E.R. Siegel, Dr. P. Wilson, Prof. E.J.S. Hovenga, Prof. M.A. Musen and Prof. J. Mantas Volume 119 Recently published in this series Vol. 118. R.G. Bushko (Ed.), Future of Intelligent and Extelligent Health Environment Vol. 117. C.D. Nugent, P.J. McCullagh, E.T. McAdams and A. Lymberis (Eds.), Personalised Health Management Systems – The Integration of Innovative Sensing, Textile, Information and Communication Technologies Vol. 116. R. Engelbrecht, A. Geissbuhler, C. Lovis and G. Mihalas (Eds.), Connecting Medical Informatics and Bio-Informatics – Proceedings of MIE2005 Vol. 115. N. Saranummi, D. Piggott, D.G. Katehakis, M. Tsiknakis and K. Bernstein (Eds.), Regional Health Economies and ICT Services Vol. 114. L. Bos, S. Laxminarayan and A. Marsh (Eds.), Medical and Care Compunetics 2 Vol. 113. J.S. Suri, C. Yuan, D.L. Wilson and S. Laxminarayan (Eds.), Plaque Imaging: Pixel to Molecular Level Vol. 112. T. Solomonides, R. McClatchey, V. Breton, Y. Legré and S. Nørager (Eds.), From Grid to Healthgrid Vol. 111. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips, R.A. Robb and K.G. Vosburgh (Eds.), Medicine Meets Virtual Reality 13 Vol. 110. F.H. Roger France, E. De Clercq, G. De Moor and J. van der Lei (Eds.), Health Continuum and Data Exchange in Belgium and in the Netherlands – Proceedings of Medical Informatics Congress (MIC 2004) & 5th Belgian e-Health Conference Vol. 109. E.J.S. Hovenga and J. Mantas (Eds.), Global Health Informatics Education Vol. 108. A. Lymberis and D. de Rossi (Eds.), Wearable eHealth Systems for Personalised Health Management – State of the Art and Future Challenges ISSN 0926-9630 Medicine Meets Virtual Reality 14 Accelerating Change in Healthcare: Next Medical Toolkit Edited by James D. Westwood Randy S. Haluck MD FACS Helene M. Hoffman PhD Greg T. Mogel MD Roger Phillips PhD CEng FBCS CIPT Richard A. Robb PhD and Kirby G. Vosburgh PhD Amsterdam • Berlin • Oxford • Tokyo • Washington, DC © 2006 The authors. All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without prior written permission from the publisher. ISBN 1-58603-583-5 Library of Congress Control Number: 2005937901 Publisher IOS Press Nieuwe Hemweg 6B 1013 BG Amsterdam Netherlands fax: +31 20 687 0019 e-mail: [email protected] Distributor in the UK and Ireland Distributor in the USA and Canada Gazelle Books IOS Press, Inc. Falcon House 4502 Rachael Manor Drive Queen Square Fairfax, VA 22032 Lancaster LA1 1RN USA United Kingdom fax: +1 703 323 3668 fax: +44 1524 63232 e-mail: [email protected] LEGAL NOTICE The publisher is not responsible for the use which might be made of the following information. PRINTED IN THE NETHERLANDS Medicine Meets Virtual Reality 14 v J.D. Westwood et al. (Eds.) IOS Press, 2006 © 2006 The authors. All rights reserved. Preface Accelerating Change in Healthcare: Next Medical Toolkit James D. WESTWOOD and Karen S. MORGAN Aligned Management Associates, Inc. Machine intelligence will eclipse human intelligence within the next few decades – ex- trapolating from Moore’s Law – and our world will enjoy limitless computational power and ubiquitous data networks. Today’s iPod® devices portend an era when biology and in- formation technology will fuse to create a human experience radically different from our own. Between that future and the present, we will live with accelerating technological change. Whether predictable or disruptive, guided or uncontrollable, scientific innovation is carrying us forward at unprecedented speed. What does accelerating change entail for medicine? Already, our healthcare system now appears on the verge of crisis; accelerating change is part of the problem. Each technological upgrade demands an investment of education and money, and a costly infrastructure more quickly becomes obsolete. Practitioners can be overloaded with complexity: therapeutic options, outcomes data, procedural coding, drug names… Furthermore, an aging global population with a growing sense of entitlement demands that each medical breakthrough be immediately available for its benefit: what appears in the morning paper is expected simultaneously in the doctor’s office. Meanwhile, a third-party payer system generates conflicting priorities for patient care and stockholder returns. The result is a healthcare system stressed by scientific promise, public expectation, economic and regulatory constraints, and human limitations. Change is also proving beneficial, of course. Practitioners are empowered by better im- aging methods, more precise robotic tools, greater realism in training simulators, and more powerful intelligence networks. The remarkable accomplishments of the IT industry and the Internet are trickling steadily into healthcare. MMVR participants can readily see the progress of the past fourteen years: more effective healthcare at a lower overall cost, driven by cheaper and better computers. We are pleased that this year’s conference has an increased emphasis on medical educa- tion. In many ways, education is the next medical toolkit: a means to cope with, and take advantage of, accelerating change. Through interaction with novice students, medical edu- cators are uniquely equipped to critique existing methods, encourage fresh thinking, and support emerging tools. Each new class of aspiring physicians stimulates flexibility in prob- vi lem solving and adaptation within technological evolution. As an earlier generation of phy- sicians trains its successors, experience can guide innovation so that change accelerates for the better. As always, we wish to thank all the participants who make MMVR possible each year. It is our privilege to work with you. vii MMVR14 Proceedings Editors James D. Westwood MMVR Program Coordinator Aligned Management Associates, Inc. Randy S. Haluck MD FACS Director of Minimally Invasive Surgery Director of Surgical Simulation Associate Professor of Surgery Penn State, Hershey Medical Center Helene M. Hoffman PhD Assistant Dean, Educational Computing Adjunct Professor of Medicine Division of Medical Education School of Medicine University of California, San Diego Greg T. Mogel MD Assistant Professor of Radiology and Biomedical Engineering University of Southern California; Deputy Director, TATRC U.S. Army Medical Research & Materiel Command Roger Phillips PhD CEng FBCS CIPT Research Professor, Simulation & Visualization Group Director, Hull Immersive Visualization Environment (HIVE) Department of Computer Science University of Hull (UK) Richard A. Robb PhD Scheller Professor in Medical Research Professor of Biophysics & Computer Science Director, Mayo Biomedical Imaging Resource Mayo Clinic College of Medicine Kirby G. Vosburgh PhD Associate Director, Center for Integration of Medicine and Innovative Technology (CIMIT) Massachusetts General Hospital Harvard Medical School viii MMVR14 Organizing Committee Michael J. Ackerman PhD Office of High Performance Computing & Communications, National Library of Medicine Ian Alger MD New York Presbyterian Hospital; Weill Medical College of Cornell University David C. Balch MA DCB Consulting LLC Steve Charles MD MicroDexterity Systems; University of Tennessee Patrick C. Cregan FRACS Nepean Hospital, Wentworth Area Health Service Henry Fuchs PhD Dept of Computer Science, University of North Carolina Walter J. Greenleaf PhD Greenleaf Medical Systems Randy S. Haluck MD FACS Dept of Surgery, Penn State College of Medicine David M. Hananel Surgical Programs, Medical Education Technologies Inc. Wm. LeRoy Heinrichs MD PhD Medical Media & Information Technologies / Gynecology & Obstetrics, Stanford University School of Medicine Helene M. Hoffman PhD School of Medicine, University of California, San Diego Heinz U. Lemke PhD Institute for Technical Informatics, Technical University Berlin ix Alan Liu PhD National Capital Area Medical Simulation Center, Uniformed Services University Greg T. Mogel MD Dept of Radiology, University of Southern California; TATRC/USAMRMC Kevin N. Montgomery PhD National Biocomputation Center, Stanford University Makoto Nonaka MD PhD Foundation for International Scientific Advancement Roger Phillips PhD CEng FBCS CIPT Dept of Computer Science, University of Hull (UK) Carla M. Pugh MD PhD Center for Advanced Surgical Education, Northwestern University Richard A. Robb PhD Mayo Biomedical Imaging Resource, Mayo Clinic College of Medicine Jannick P. Rolland PhD ODA Lab at School of Optics / CREOL, University of Central Florida Ajit K. Sachdeva MD FRCSC FACS Division of Education, American College of Surgeons Richard M. Satava MD FACS Dept of Surgery, University of Washington; DARPA; TATRC/USAMRMC Steven Senger PhD Dept of Computer Science, University of Wisconsin – La Crosse Ramin Shahidi PhD Image Guidance Laboratories, Stanford University School of Medicine Don Stredney Interface Laboratory, OSC x Julie A. Swain MD Cardiovascular and Respiratory Devices, U.S. Food and Drug Administration Robert M. Sweet MD Dept of Urology, University of Minnesota Kirby G. Vosburgh PhD CIMIT/Brigham & Women’s Hospital / Harvard Medical School Dave Warner MD PhD MindTel LLC; Institute for Interventional Informatics Suzanne J. Weghorst MA MS Human Interface Technology Lab, University of Washington Mark D. Wiederhold MD PhD FACP The Virtual Reality Medical Center