Telemedicine Spaces: Lighting Design with Communication in Mind

| August 13, 2019

Accuracy in telemedicine is dependent on clear visual communication, both parties must be able to clearly and comfortably see each other. Therefore, providing proper lighting is a critical factor to accurately assess and treat patients while utilizing telemedicine.

The lighting must enable medical examination and facial expression recognition of the patient, as well as patient comfort and visibility of the remote healthcare provider. The goal is to illuminate the environment in a way that reduces glare and shadows, provides adequate illumination of the patient, prevents color distortion, and allows for productive conversation between the healthcare provider and the patient.

Patient Visibility

Remote assessment requires that the patient’s environment have clear, bright light levels and be free of glares, tints, and shadows. This is dependent on three factors: color temperature, lumen output, and fixture placement.

The color temperature of the lighting, along with the color rendering index (CRI), will affect the appearance of a patient, which in turn affects their diagnosis. For instance, if a patient is in a room with very cool lighting, they may appear blue. To a healthcare provider, this could indicate health problems the patient is not actually experiencing. Likewise, it could overshadow other symptoms that the patient is experiencing. Both outcomes impede the healthcare providers ability to quickly and efficiently reach a diagnosis. Full spectrum or warm white light temperatures, 3200K or 4000K per the FGI guidelines, will offer more accurate results without being too orange or too blue.  It is also important the patient’s environment be painted a neutral color, or the patient be provided with a background that is a neutral color or pattern.

Similarly, the healthcare providers need enough light to not just see the patient, but to ascertain clinical details and recognize facial expressions. An illumination level around 150 footcandles is recommended by the FGI to provide adequate light to the remote healthcare provider. However, light levels this high may cause some glare, so diffused lenses are recommended.

The lighting layout in patient exam rooms must allow visibility for both the remote healthcare professional and the patient viewing the display screen. While we can count on downlights to be the main source of light in any patient area, having only downlights may cause shadows which can obscure the patient or the patient’s features from view. The display screen should already be slightly above the patient and at a slight downward angle for optimal viewing, so it will be beneficial to place lights above the camera and facing the patient at a downward 45-degree angle. This can dispel any shadows caused by the vertical lighting.

Circadian Lighting for Telemedicine Centers

The remote aspect of telemedicine allows healthcare providers to treat patients without having to worry about locations or even time zones. However, as with any remote technology center, the large screens and odd hours increase the risk of fatigue. In fact, the very nature of providing healthcare runs the risk of decision fatigue.

Fortunately, circadian lighting can decrease both risks by increasing alertness and mood. Circadian light, or human-based lighting, does this by simulating a healthy outdoor environment. People who work under circadian lights have been shown to start their work days with more vigilance than those with traditional lighting, and to maintain more of that awareness well into the afternoon. When assessing patients, being alert is crucial to the decision-making process.

Just as it is important for patients to be seen clearly by the healthcare providers, it is also important that the healthcare providers are seen clearly by patients. The healthcare providers should be fostering an environment of clear and comfortable communication. The temperature should also be full spectrum to warm white. To enhance the patient’s viewing experience, the healthcare provider’s station should be equipped with a monitor mounted lights, angled 45 degrees downward, and should have a calm, neutral colored background.

As healthcare continues to grow and develop, telemedicine will continue to be an important tool in connecting patients to healthcare providers. Providing appropriate lighting for both the patient and the provider will increase the quality of care and the accuracy of diagnosis.

 

Savannah Dalton
About

As Electrical Design Engineer, Savannah coordinates systems from concept through construction, attending site visits and conducting systems evaluations, cost estimates and specifications. She has provided these services for a multitude of project types for various types of clients from academic to healthcare to municipal to science and technology.

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