The Metaverse Comes to Healthcare: Practical Applications-The HSB Blog 12/07/22

Our Take:

Virtual reality (VR) and augmented reality (AR) have emerged from the Pandemic as practical, digital solutions to help providers and patients solve pressing issues uncovered by COVID including the need to scale the delivery of care, improving care for chronic conditions as patients age-in-place and advancing treatment modalities for the mentally ill. Although virtual reality (VR) technology has been mostly associated with the entertainment industry, its success has become evident in the healthcare industry with promising results for not only diagnosing and treating a variety of illnesses but for ushering in the future of truly transformative techniques in medicine. However, challenges remain around existing infrastructure to support VR, software standardization, rapid technological innovation, and the lack of evidence-based VR programs. Consequently, it would be a disservice for the healthcare industry to overlook the promising results to date in the face of these challenges.

Key Takeaways:

The virtual reality market has a projected compound annual growth rate of over 30% between 2020 and 2025 (PWC)
Some major trends in healthcare VR applications include neurological and developmental therapy, pain reduction through distractions, exposure therapy for phobias, and psychological applications (JMIR Biomedical Engineering)
VR training improved physicians’ surgical performance by 230% compared to traditional training programs (Harvard Business Review)
Barriers to adoption of VR therapy in clinical settings include the lack of evidence-based VR programs, infrastructure to collect and analyze VR data, software standardization, and technological obsolescence.

The Problem:

The rise in chronic illness seen across the developed world, a shortage of care providers, and the need to provide better care at lower cost all necessitate new, more cutting-edge treatments that improve the experience of the patients receiving care, also improve population health and deliver care more efficiently. In this environment, care providers are increasingly turning towards new technologies such as AR and VR to enable new types of training, remote care, and mental health treatments. As a result, the applications of AR and VR in healthcare and healthcare’s overall movement into the metaverse are growing.

The Backdrop:

The “Metaverse is a catch-all term that refers to the entire digital and virtual world and is a convergence of physical, augmented, and virtual reality in a shared online space" according to “Overview: Technology Roadmap of the Future Trend of Metaverse based on IoT, Blockchain, AI Technique, and Medical Domain Metaverse Activity”. As defined in the same article, VR is a technology that substitutes one’s vision of the physical world with a digitally produced scene using software and headgear devices [while] AR is a technology that combines the digital and physical worlds. It uses computer vision techniques such as object recognition, plane detection, facial recognition, and movement tracking to recognize real-world surfaces and objects. The term ‘mixed reality’ refers to a combination of augmented and virtual reality.”

Virtual reality in the healthcare market has a projected compound annual growth rate of approximately 37% between 2022 and 2028 according to a report by GlobeNewswire. A variety of medical professions are beginning to adopt VR technology in a growing number of ways. Some major trends in healthcare VR applications include but are not limited to; neurological and developmental therapy, pain reduction through distractions, exposure therapy for phobias, and psychological applications, according to JMIR Biomedical Engineering. VR therapy has also seen extensive use in the assessment of clinical outcomes for social functioning, cognition, symptomatology, and general mental health research, and is well suited to identify illnesses and offer consistent, low-cost, and accessible care.

While most consumers are familiar with VR in the context of gaming and entertainment, applications like these are increasingly finding their way into the healthcare industry for use by both patients and care providers. For example,”using VR, AR, and MR technology, doctors can create smart digital operation theatres where they can perform virtual live patient operations allowing others to watch and participate for training. In addition, by combining AR and VR technology with artificial intelligence, doctors can face simulated conditions and complications based on their own individual responses. VR has been utilized effectively to increase surgical efficiency and assist in training. As noted in a recent article in the Harvard Business Review, VR training improved participants’ overall surgical performance by 230% compared to traditional training programs. Similarly, the U Conn Health system has been using VR training programs for their orthopedic surgery residents, saving time and money, and partially eliminating the need for comparatively more expensive, one-time use cadavers.

VR data can also be used to create detailed virtual models of a patients’ anatomy, allowing physicians to easily view and manipulate these 3D models from different angles. Additionally, it currently plays a significant role to help diagnose and treat physical trauma and other fractures and has been applied in cardiology and neurology to monitor and assist patients which improve patient health outcomes according to a study from the Journal of Clinical Epidemiology and Global Health. During the Pandemic, VR was used successfully to teach emergency medicine by using 360 degree video. New visualization techniques offered by VR technology can help trainees gain a greater understanding of the human body and the operating procedures they will need to know, increasing confidenceand skills before they enter the operating room with actual patients. VR technology has also been used to help promote clinicians’ empathy for patients. According to an article in the Journal of the Medical Library Association, through VR simulations, certain mental health conditions and age-related health problems can be recreated, helping students better understand the illnesses they are treating and increasing empathy with the people they treat.

In addition to helping train, a variety of clinicians, AR/VR technology is also found to be very effective in the treatment of conditions that impact the mind and mental health. For example, a systematic review from the Journal of Aging Psychiatry found that VR therapy is effective in both diagnosing and treating psychiatric disorders such as anxiety, phobias, and PTSD, as well as illnesses such as dementia, schizophrenia, and autism. The U.S. military has conducted extensive research into treating veterans’ mental health using VR and the results show positive clinical outcomes observed in preventing, identifying, and treating combat-related PTSD as noted in the Journal of Clinical Psychology in Medical Settings. VR’s potential to assist in mental health treatment is well-established in the healthcare industry. For example, VR exposure therapy is shown to reduce patients’ fear of heights by 68% according to an article in The Lancet Psychiatry. The same holds true for PTSD where an early study on VR and PTSD found that of 20 service members who enrolled in and completed the study treatment protocol, 75% had experienced at least a 50% reduction in PTSD symptoms and no longer met DSM-IV criteria for PTSD at post-treatment. In the study average, PTSD scores decreased by approximately 50%, depression scores by 47%, and anxiety scores by 36%.

In the near term, it is clear that AR/VR technology can make complex and often expensive training procedures easier and can also successfully be applied to certain mental health conditions. Longer-term the technology could be utilized for more remote procedures, like using robotic technology to utilize the skills of more experienced clinicians stationed at major medical centers which can act as technology hubs.

Implications:

The technological capabilities of VR are advancing at an astonishing rate and new models of VR headsets are being released so quickly that most consumers may be surprised by their latest capabilities. For example, graphical fidelity has improved to the point that it is able to reproduce real-world settings and phenomena to such an extent that a study in the Journal of Environmental Psychology indicated that both the real and the virtually recreated outdoor exposures led to physiological arousal, showed benefits to mood levels, and had the same restorative impact.

Already, several VR companies have introduced products that are starting to gain a foothold in the industry. In November 2021, AppliedVR received FDA de novo approval for its EaseVRx product to treat chronic lower back pain thus becoming the first VR provider to receive FDA de novo approval for a pain indication. In September 2022, XRHealth, an Israeli-based company, introduced VR-based NeuroRehab designed for individuals who suffer from the consequences of strokes and brain injuries, where patients are guided through activities aimed to help regain functionality.

However, since VR is still a relatively new technology it faces several challenges. These include the lack of commercially available evidence-based VR programs, and rapid innovation in the industry coupled with proprietary issues leading to rapid technology obsolescence. Currently, there are interoperability issues as well as a lack of current infrastructure to support the technology. In addition, many VR programs are still largely therapy-oriented and lack methods to collect and record suitable data for research purposes.

The novelty of VR in healthcare means the resources to support it aren’t quite there yet, and care providers need to make the proper investments to best utilize the data they collect. Given the rapid projected rate of growth of the industry, we expect stakeholders will likely be motivated to solve these issues quickly and efficiently as the demand for VR solutions grows.

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