AstraZeneca
Helping Doctors Have a Change of Heart
Pod person. Strapped into a pneumatic vest with his feet on the pedals, a physician prepares to experience congestive heart failure inside one of five Heart FXPod stations. The Mac mini runs the show in each station from a compartment under the seat.
Chest tightness. Fatigue. Shortness of breath. For anyone suffering from congestive heart failure (CHF), it can be challenging to communicate to doctors just how severe the symptoms feel. As a result, physicians sometimes misdiagnose this disease or underestimate its debilitating effects.
But a Mac-based simulator, developed by the pharmaceutical company AstraZeneca in collaboration with teams from the RJO Group and Corsair Studio, now makes it possible for physicians to experience — firsthand — what CHF patients feel at various stages of this chronic disease.
Have Simulator, Will Travel
Currently making calls on physicians in medical centers throughout the United States is the Heart FXPod, a 53-foot-long mobile van outfitted with five virtual reality stations that offer a complex multimedia demonstration involving custom devices and interactive feedback. Each of the five simulator stations runs on a single Mac mini computer.
“It’s an interesting physiological experience. After going through the simulation, many doctors said, ‘Wow, I had no idea it was this intense this early on.’”
In mid-2005, Peter Raymond of New York’s Corsair Studio was approached by the RJO Group, a marketing firm that represents AstraZeneca. Impressed with a large-scale multimedia show Raymond had created for the Baseball Hall of Fame, the company hired him to develop the multi-sensory CHF simulator.
Raymond immediately got to work. “There were a lot of human factors to study,” he says. “A big piece of it was designing the simulation so that doctors could tell the difference between the classes of heart failure.” After conferring with physician advisors from AstraZeneca, Raymond and his team of designers and programmers devised a system that included custom devices including a special chair, a pneumatic vest, and a set of foot pedals.
Inside the completed Heart FXPod, seated physicians watch an interactive video featuring Hank, a CHF patient, as he tries to take a walk in the park. As Hank’s condition worsens, he has a harder time walking, and consequently, the physicians have a harder time pedaling. When Hank tires even more, the physicians start feeling the effects of CHF as their pneumatic vests tighten, constricting their breathing. They even experience Hank’s elevated heart rate by way of an audio system built into the chair that is so effective it feels as if their own hearts are racing. “It’s an interesting physiological experience,” says Raymond. “After going through the simulation, many doctors said, ‘Wow, I had no idea it was this intense this early on.’”
Putting Macs in Control
One of the key challenges in developing a complex simulator like the Heart FXPod is in controlling the devices to trigger events at appropriate times during the video and responding to user input from external devices, such as foot pedals, in real time.
Raymond initially considered using a projector with an HD video server as part of the technology solution — a setup often used in large-scale multimedia shows and presentations. But for that configuration, the hardware alone would have cost several hundred thousand dollars per station. Instead, he discovered he could do everything he wanted — including serving HD video, controlling binaural audio playback, LED lighting effects, triggering chest compression and delivering real-time hapatic feedback through the pedals — using a single, inexpensive, off-the-shelf Mac mini.
“The form factor was great, and so was the quality control, just knowing the Mac OS and the Mac mini hardware are locked together,” Raymond says. “I also wanted to tap into a lot of the Mac OS X core technologies, the graphics subsystem,” he adds. “I really wanted to create real-time composites. It’s important that the graphics are superimposed over the video in real time to create the composite.” For instance, he explains, if he had a background video track and wanted to drop in a new audio track in a different language, he could do that dynamically without having to change the core video track. This modular approach would save hours of production time and provide flexibility in the event they needed to make changes later.
Raymond’s programmer, Chuck Bueche, had extensive experience developing interactive games, which rely heavily on event and device control. Bueche wrote the code for the Heart FXPod in C++, compiling it on the Mac mini. Although he hadn’t developed for the Mac in a decade, Bueche had a working prototype ready for Raymond in just a week. “As far as Mac OS X goes, it was a fairly easy transition,” says Bueche. “With the developer resources out there, there’s a lot of sample code. The forums were very useful. And so it was easy to get up and running.”
1 2 Next Page >
At a Glance
Peter Raymond of Corsair Studio was hired by marketing firm RJO Group to design and develop a mobile multi-sensory congestive heart failure simulator for its client, AstraZeneca.
The requirements were stiff: multiple simulator stations had to fit inside a mobile tractor-trailer, with a separate simulator needed for trade show exhibits. It had to run on the standard kind of power available in mobile and trade show environments. It had to be easy for participants to prepare to go through the simulation. And the physical equipment had to accommodate a wide range of body shapes and sizes. It also needed to be simple to run, without requiring a highly technical staff.
Raymond needed a system powerful and sophisticated enough to seamlessly control all the different hardware devices and multimedia components of a highly complex virtual reality simulation, and make sure everything happened at the appropriate times. He needed a system robust enough so that it would not crash during the simulation or need regular rebooting. And in the rare case that a problem did arise, he needed an off-the-shelf system that would be easy and fast to get up and running again.
Most important, Raymond had to create a simulation realistic enough that physicians would immerse themselves in the experience, feeling as if they were actually suffering from congestive heart failure for the brief period they were in the simulator.
On top of everything else, Raymond had just a few months to complete the project, and he needed do it all within a tight budget.
Apple Solution
Peter Raymond hired programmer Chuck Bueche of Craniac, Inc. to build the scripting language and write the playback engine on the Mac OS X platform. Bueche had decades of experience in interactive game development and an electrical engineering degree, but he hadn’t developed anything for the Mac in ten years.
He developed a prototype in one week. And just a couple weeks later, the final program was almost done.
Raymond chose the Mac mini as the CPU hardware for the simulator, primarily because of the form factor but also because it had the power to run the show, which includes HD video and binaural audio in a QuickTime environment using the Pixlet codec.
Raymond credits the tight integration between the Mac OS and the Mac mini hardware as an important factor in evaluating the system’s quality control. “In the end, Apple’s responsible for it,” he says.
Once finished, both men were pleased with the performance. “It was pretty robust,” says Bueche. “There weren’t any of these terrible nagging problems that were always biting you in the tail end as the project goes ahead.”
