When the only physician at West Cancer Center & Research Institute’s Paris, Tenn., clinic was going on a six-week leave, leaders knew that finding someone to fill in for such an extended period of time would be challenging, if not impossible.
Paris is located north of Memphis, near the Kentucky border. To care for patients in rural communities like it, the institute typically relies on telehealth visits, using videoconferencing, or physicians spending long hours traveling to these clinics in these locations. In this situation, though, something innovative was going to be needed.
The organization has 12 clinics, which saw 63,000 unique patient visits in 2024. Headquartered in Germantown, Tenn., just outside Memphis, a great deal of farmland and a number of small communities make up the institute’s service area. Two clinics, in Paris and Corinth, Miss., have populations of fewer than 15,000 people.
To address the immediate concern of the Paris physician’s absence, assigned physicians commuted to the clinic or patients drove to the main clinic two hours away. Several clinical and administrative leaders then met to figure out a long-term solution so cancer patients in those communities could continue to visit with an oncologist near where they live.
The CEO jokingly suggested using a hologram to “send” its best physicians to patients at the institute’s rural locations. Everyone laughed—a nice big chuckle—but the idea stuck. After researching options, the one company that stood out to the organization’s leaders was a hologram manufacturer with an office that just happened to be in Nashville.
Testing and Approving the Hologram
West Cancer Center & Research Institute’s senior leaders traveled across the state to the manufacturer for a demonstration. At first they were skeptical of the technology. Would the physician look real? Would there be a delay in communication, as there is sometimes with videoconferencing calls? Holograms, after all, aren’t intended for use in healthcare.
Despite the demonstration’s $6,000 price tag, leaders gave the thumbs up to proceed. The hologram technology passed the test with flying colors, and senior leaders immediately thought it could make a huge difference for the cancer institute’s patients.
Back in Germantown, the idea to purchase the technology was discussed with additional executive leaders, physicians and the governing board. Everyone agreed using the hologram was worth the investment.
Implementing and Using the Hologram
One year later, West Cancer Center & Research Institute implemented the technology at its Paris and Corinth clinics. The process was relatively simple. At one end, the physician is in a production studio at the Germantown clinic. The physician’s image is beamed over the internet to an exam room at the remote location.
In the exam room, the physician appears as a hologram in what is called a lightbox that’s about 7 feet tall by 4 feet wide. The front of the box has an LCD screen; inside the box, special lighting projects the image in three dimensions versus the flat image of a video call. In many ways, it actually appears as though the physician is really in the room with the patient.
The image is of the entire person, which allows the patient to see the physician’s body language, an important detail in specialties such as oncology. A lot of insight comes from hand gestures or other movements that can get lost in a telehealth visit, which is essentially just talking heads. Patients also sometimes aren’t comfortable using videoconferencing platforms in their homes.
The physician sees and communicates with the patient through a camera. The physician is in the hologram technology studio, where a large monitor shows the patient and family in the exam room. It made more sense for the physician to be projected from the studio to the box rather than having the patient standing in the studio and being projected to the physician. In the studio, the physician can see the patient in the exam room; the camera is on the lightbox that is projecting the physician, and if the physician needs to see something close-up, the patient can move closer to the lightbox.
So far, the hologram technology has fully met the organization’s expectations. Without it, cancer patients in rural communities would have to travel hundreds of miles to visit the nearest oncologist.
This technology, like videoconferencing, does have a downside: The physician is unable to touch the patient. However, a clinician, such as a nurse practitioner, is in the room with the patient during each visit to take a blood pressure reading or more closely examine a rash, for example.
Patients have expressed only appreciation for this new way of seeing their physician. One would think some people might be intimidated by the technology, but that has not been the case. Patients say using a hologram is much better than a regular telehealth visit.
“It was exactly like an in-person visit,” according to one patient. She previously used her cellphone for a virtual visit, but that doesn’t compare to the hologram visit. Another patient said he was able to see everything clearly. “The body language (of the physician) was there, which made it very personal.”
Realizing a Good Investment
The technology’s cost is not prohibitive. Each lightbox costs $35,000 and has been worth the investment. So far, 10 patients use the hologram each week, and many are in palliative care.
Hologram technology is commonly used for marketing and education purposes in healthcare, but this is the first example of it being used for patient visits. It’s an exciting innovation that offers great potential in healthcare. For insurance purposes, the hologram visit is coded the same way as a remote visit; there is no difference.
A hologram visit could be a solution for many rural communities, as in most cases the population numbers are not enough to support a full-time specialized physician. It may be nearly impossible to get a cardiologist, for example, to live in a rural community, but a nurse practitioner is more likely to practice and live there. The cardiologist would be able to see the patient via this technology.
Even after one year, the hologram technology has advanced to where a new lightbox is thinner and more lightweight, and it’s eventually going to be more mobile and less expensive. Another feature that will be coming out soon is language translation. For example, a patient could speak to the physician in Chinese, and the physician would hear the translation in English. The physician would answer in English, and that would be translated into Chinese for the patient.
Senior leaders advised the hologram manufacturer’s engineers as they were developing this language technology to make sure that everything is HIPAA compliant and to load the software with universal medical language. The possibilities with holograms in healthcare are endless, and the institute’s leaders look forward to making them a reality for our patients.
Mitch Graves is CEO and an ACHE Member. Sylvia Richey, MD, is CMO and a medical oncologist. Both are with West Cancer Center & Research Institute, Germantown, Tenn.