Innovations in the Serbian healthcare with Hololens technology

January 13, 2025
a person taking a selfie in a room
Photo: Google

 

The times we live in are marked by new technologies and innovation seeping into all facets of our lives, health included. Their application helps push efficiency and accessibility of healthcare services, quicker diagnostics of illnesses, customised treatment, and new treatment options. 

We have a good example of using digital tools, helping doctors be more efficient and diagnose more quickly in Serbia as well. 

The Hololens is a head mounted device projecting images in the form of holograms in front of us, placing them within our field of vision. The device has some algorithm-based AI built in, enabling it to map out space, memorise it, respond to our hand gestures, speech, and blinking. Essentially, it is powerful computer worn on the head, by which we can project a virtual reality overlaying what we see through the glasses”, Head of Anaesthesiology and Reanimatology Clinic at the Clinical Hospital Centre “Dr Dragiša Mišović”, prof. dr Predrag Stevanović explains.   

Younger generations are much more familiar with the concepts of virtual and mixed reality. Virtual reality implies a world dislocated into a simulated virtual environment, and mixed reality implies a combination between virtual reality and what we can see and experience. The Hololens device generates this augmented, or mixed, reality. 

When this technology was introduced at the CHC “Dr Dragiša Mišović” during the Covid-19 pandemic, it was a revolutionary change to the everyday workloads of doctors and healthcare professionals, but it was equally groundbreaking for patients placed in the ‘red zone’.

In their daily struggle to save human lives during the Covid pandemic, healthcare professionals were overloaded and at the end of their tether due to the drastic increase in the number of highly contagious patients around. “The Hololens then enables us to not have to enter the Covid zone all at once, but have a single doctor enter with the Hololens and we could all see the patients through this device, including those of us who were in the ‘clean zone.’ The Hololens would project virtual images of the patient’s scans, MRI, X-rays, lab results, based on which we would discuss them live with the doctors in the ‘red zone.’ Covid patients were in a grave situation health-wise, and when you’re inside, dressed in a protective suit, you have to make life-saving, sometimes even fateful decisions very quickly, which is exceedingly stressful. Once we on the outside could see the same things as the person who was in there, then we could work together and make decisions that could save patients’ lives together”, prof. Stevanović highlights.

a man and a woman standing in front of a computer

Photo: CHC “Dr Dragiša Mišović” & UCC of the Republic of Srpska

Once a doctor dons the Hololens device, he/she is in fact using a powerful computer that has certain software installed, just like any other similar device. One of these programs is a simulation of certain diseases, trauma or organs and learning through these simulations. Prof. Stevanović highlights how it is standard practice on Universities around the world for students and doctors to tackle certain issues through learning simulations, so it would not happen they face a certain healthcare issue for the first time in real life. “Thanks to the Hololens, they have an opportunity to practice through emergency situations through simulations so they can tackle them more efficiently once they face them in real life”, he underscores.

During Covid, when Faculty of Medicine students attended classes online, the Hololens was used to show what it looked like working in the Covid zone with the most seriously affected patients, where students were not allowed to enter, and after the pandemic ended the Faculty, supported by the United Nations Development Programme (UNDP), continued using the Hololens to run simulations of patients, healthcare situations, and diseases, within the Medical Faculty Simulations Centre.   

Owing to a Ministry of Science, Technological Development, and Innovation of the Republic of Serbia pilot project run in cooperation with the Ministry of Health and the UNDP, experts from the CHC “Dr Dragiša Mišović” developed training programmes for more than 12 hospitals throughout Serbia to use the Hololens and the Serbian network, so it might serve for them to complement each other in critical situations. CHC “Dr Dragiša Mišović” set up cooperation with the Banja Luka-based University Clinical Centre (UCC) of the Republic of Srpska in May 2024, owing to the Serbian Government support programme for innovative solutions applicable to various developmental challenges of regional countries, implemented by UNDP, enabling this clinical centre to use Hololens technology as well. 

Head of Intensive Care Medicine for Non-Surgical Branches at the UCC of the Republic of Srpska, prof. dr Peđa Kovačević, says that this clinic had opportunities to benefit from telemedicine and teleeducation over the previous decade. 

“We were fortunate to have our own prof. dr Ognjen Gajić working at the USA Mayo Clinic, and he was a great support in setting up this clinic. He patented a checklist for early identification of critically ill and injured patients, and implemented it at our clinic within a pilot project running between 2015 and 2017. During 2016 and 2017, we would present one of our most difficult cases to prof. Gajić and the other experts from the Mayo Clinic in Rochester and the Mayo Clinic in Jacksonville weekly, and they would answer our questions regarding any second thoughts we may have had. Concurrently, this was an important educational process for us”, prof. Kovačević says. He also pointed out how they eagerly accepted prof. Stevanović’s invitation to work together in using the Hololens technology, as a superstructure on their previously gained experience.   

a man holding a laptop

Photo: CHC “Dr Dragiša Mišović” & UCC of the Republic of Srpska

The Intensive Care Unit at the UCC of the Republic of Srpska caters to all patients from the Republic of Srpska and patients whose lives are in danger from other towns and cities in Bosnia and Herzegovina, who are forwarded to Banja Luka according to levels of urgency. Prof. Kovačević and his colleagues support setting up intensive care units in other hospitals as well. Kovačević highlights how the Hololens will be a crucial tool in this process for the purposes of teleeducation and ‘telerounding,’ especially in places where resources in terms of doctors and healthcare professionals are already limited.

Speaking of patients, prof. Stevanović and prof. Kovačević both highlight how the Hololens has a tremendous advantage. “We can use the Hololens to consult another physician who is remote, in another city, country, or even on another continent. Medicine often has these situations when you have a complex case and it is impossible to have experts in every single place, and this is where the Hololens is of utmost importance”, prof. Stevanović says. Additionally, there are more and more programs being installed in the Hololens, and these are intended for patients. Thus, the Hololens can be worn by a patient who can then see what procedure is planned to be conducted. It has shown patients have a much easier time accepting certain interventions when they get full information.

Among the main barriers in using the Hololens and new technologies, professors Stevanović and Kovačević emphasize the technical ones: whether the hospitals have high-quality wireless internet (WiFi) networks and IT professionals who can support the doctors. In addition, there is some scepticism among doctors and healthcare professionals when it comes to accepting new technologies. What seems especially highlighted as a challenge is that there is still no legislation to keep pace with advanced technologies, i.e. the ethical and legal aspects are more slowly regulated. Doctors and healthcare workers are definitely obligated to inform patients, make clarifications, and obtain permissions for each proposed method of treatment, including the use of new technologies. 

As motivation to continue using the Hololens, prof. Stevanović proudly highlights recognitions received: the special award of a jury consisting of professors from the Faculty of Electrical Engineering at the 2024 Belgrade Fair of Technics and Technical Achievements, and being selected among the 10 most important breakthroughs made in the public sector among more than 1000 applicants with last year’s OECD meeting in Dubai, focusing on new technologies and artificial intelligence. 

a group of people standing next to a person

Photo: CHC “Dr Dragiša Mišović” & UCC of the Republic of Srpska

Cooperation between CHC “Dr Dragiša Mišović” and the UCC of the Republic Srpska was established within the Public Call for participating in a challenge on knowledge transfer and application of innovative solutions that can be applied to various developmental challenges of regional countries. The Public Call was supported by the Serbian Government within the scope of official developmental support provided to Northern Macedonia, Albania, Montenegro and Bosnia and Herzegovina, in order to strengthen economic potentials in these countries, and implemented by the United Nations Development Programme (UNDP).