September 28, 2023

Michigan Medicine learners using augmented reality to improve care for patients with diabetes

Dr. Alton Johnson, Jr. is developing Mi-VEST, a wearable teaching tool that uses augmented reality

Alton R. Johnson Jr., D.P.M.

In his practice as a podiatrist, surgeon, and wound care specialist, Alton R. Johnson Jr., D.P.M., sees a high percentage of patients with diabetes who seek care for things such as neuropathy, vascular complications, or chronic wounds associated with the diabetic foot.

Johnson, a clinical assistant professor in the Department of Orthopaedic Surgery, is also an educator who works with learners across Michigan Medicine. Due to the high population of patients with diabetes that he treats, his rotation often hosts medical students, residents and fellows from areas such as Internal Medicine, Family Medicine and Endocrinology who are learning to perform diabetic foot examinations.

Johnson is hoping that his health education innovation, Michigan Virtual Examination for Skills Training or Mi-VEST, will help learners develop the skills to treat this population through the use of an interactive, augmented reality (AR) device.

“I want to incorporate Mi-VEST so I can teach people who are not podiatrists, or who are medical students or residents, how to perform a diabetic foot exam,” said Johnson. “It’s kind of hard to get someone who’s already practicing to learn something new, but you can get someone who’s specifically coming to your rotation to learn a new skill set.”

The Initial Idea

Through one of his mentors, Johnson learned about a wearable device that incorporates AR to connect physicians to experts, typically in a telehealth setting. He realized that this device, known as the Head Mounted Tablet or HMT-1, could have applications to training and education and eagerly worked to acquire one to use in his clinic.

His initial idea involved creating a curriculum of first person videos that learners could watch to review procedures and surgeries. “I started bringing the device to clinic and recording videos of myself using it. Everyone was looking at me and calling me a Marvel superhero,” shared Johnson.

The makers of the device, Hippo Virtual Care, then introduced him to the virtual checklist feature. This feature allowed Johnson to build a customized checklist within the device’s software that could walk a physician wearing the device through each step of the exam. As they progress, a visual checklist appears via the viewfinder connected to the head-mounted computer, allowing the user to see both the virtual checklist in real time as well as the surrounding environment, ensuring no steps are skipped. 

Johnson was thinking about piloting the device and what his next steps might look like when a University of Michigan medical student on her rotation suggested that he look into RISE. Johnson was unfamiliar with RISE, but his interest was piqued. He spent the next few hours exploring the RISE website, learning all he could about the resources available, the Innovation Development Program and past participants. He recognized the name of a former RISE Innovator and reached out to learn more about her experience before deciding to apply.