Appropriate data representation schemes. How can patient-specific data best be combined with generic models of humans in a computationally efficient manner?
Reduction in wide-area network delays. Delays must be significantly reduced to provide for coordinated long distance work.
There are several social issues that will also need to be addressed if VE technology is to achieve wide acceptance in medicine:
Acceptability to care providers. Physicians generally practice from a perspective of conservatism, refraining from the use of techniques that may be unproven, such as the opportunities for surgical training and performance offered by VE technology. Accepted practice, to be encoded in the future as practice guidelines, is widely regarded as a way to ensure that the well-being of patients is not placed at undue risk.
Public opinion. For understandable reasons, the public may feel uncomfortable with the perception that a robot is undertaking surgical operations. Negative public reactions to the recently tested robot used in hip replacement surgery are a case in point. A cultural shift that acknowledges that automation can help care providers do their jobs more effectively will be necessary. Moreover, the necessary shift is bidirectional: patients will have to change the way they regard their care providers, and care providers will have to change the way they present themselves to patients.
To gain physician and public acceptance, convincing demonstrations will be necessary. These systems will have to demonstrate that their use will result in better outcomes, fewer complications, and ultimately even less invasive, less debilitating procedures.
In the current health care environment, a third social consideration must be addressed: cost. Explicit cost-benefit analyses for various technologies are likely to become increasingly common, and VE will be no exception.
Any activity that involves performing tasks in environments that are unsafe for humans, or in which safety is too costly, is a potential application of a teleoperated system. Chapter 9 provides a review of the technology underlying teleoperation; in this section we discuss ways in which this technology has been applied in hazardous environments.