The concept of virtual reality (VR) dates back to a 1935 short story by Stanley G. Weinbaum, where goggles placed over the head transport the wearer to a world of simulated sights, sounds, smells, and feels. Modern technology has yet to produce something as rich as what’s described in “Pygmalion’s Spectacles,” but we’re getting a lot closer. 2016 and 2017 will be known as the years where early virtual reality becomes a reality, as a myriad of headsets are set to hit the market over the next few months, each carrying with them the promise to leave classic View-Master-style stereoscopes feeling obsolete – that is, if they aren’t already.
Samsung Gear, Oculus Rift, PlayStation VR, HTC Vive – each of the available headsets is a little different, and the limitations of each varies based on its pricetag and target demographic. Some are being used by programmers to control underwater cameras, allowing the depths of the ocean to be explored without ever getting wet. Others are designed specifically to use with video game consoles, providing an up-close-and-personal way for gamers to frag enemies and explore vast dungeons riddled with glimmering treasures.
To aid in the immersion, sensors can be placed in the room for smoother, more natural-feeling motion and increased spatial awareness. On that note, VR headsets are usually combined with some kind of controller, since moving around your room while your eyes inhabit another location probably isn’t the wisest idea.
The entertainment uses almost write themselves; video gamers have dreamed of virtual reality’s arrival for decades. But, VR tech has applications that go way beyond amusement, including in healthcare. In fact, virtual reality may be coming to a hospital near you – and no, not just because VR-related accidents are likely to spike.
A new (virtual) frontier
Cedars-Sinai Medical Center in Los Angeles has been experimenting with VR tech as a way to improve the patient experience at their facility and beyond. In a YouTube video released in February,1 Cedars-Sinai Director of Health Services Research in Academic Affairs and Clinical Transformation, Brennan Spiegel, M.D., gives an overview of his research on VR as a tool to improve patient mood, happiness, and consequently lower costs by changing the way treatment is conducted.
In the video, patients are seen using the Samsung Gear headset to explore mountains in Iceland, swim with sea creatures, and paint pictures right from their hospital bed. Research into how patients react is still ongoing, and it’s unlikely everyone will have a positive opinion. But, for patients who do respond well to the VR experience, there may be unexpected benefits to be found for them, their provider, and any associated health system.
David Rhew, M.D., Chief Medical Officer and Head of Healthcare and Fitness, Samsung Electronics America, has been a proponent for the use of VR in a medical setting, seeing it as a larger part of a connected-health platform utilized to better understand patient populations, reduce readmissions, and aid seniors with independence.
Admitting frankly that he didn’t consider all of the potential healthcare applications for the Gear VR, Dr. Rhew praises the research Cedars-Sinai and others are doing, saying it’s patients and health-tech innovators who are driving the technology forward.
“(These hospitals) are focusing specifically on how use of the Gear VR can distract individuals during their hospital stay to impact their pain, or their anxiety and stress levels,” he says. “When you put on the VR headset – it’s an immersive experience. You completely feel like you’re in a different place, and even after the headset is removed, patients still feel relief from their pain and anxiety.”
The immersion is real. When you put on a VR headset, it isolates the eyes to only focus on the visual image being projected. Users can move their head in any direction, looking around and moving through an environment as if it were real life. For someone about to get an infusion of cancer meds, being able to explore a beautiful beach may not make the procedure go away, but it could help to calm the nerves more than ambient music and video displays ever could.
At present, the science behind how the brain reacts to VR isn’t completely understood, though research in that area may soon find an answer. Regardless, Dr. Rhew says early studies show that the tech is making a real difference for those who are anxious, stressed, or in pain. And considering the unique stimulation offered by virtual reality in comparison to other visual mediums, it’s easy to understand why.
A virtual prescription
Anyone who has ever been to a doctor’s office has seen the smiley-face charts used to help patients quantify their pain. Ranging from an elated smile to full-on crying (or one to 10) this scale is leveraged by doctors to measure how much medication is needed for proper pain management. According to Dr. Rhew, some of the hospitals experimenting with VR are seeing their patient pain scores reduced by a full point. In turn, this is leading to a reduction in prescriptions for narcotics – which means fewer incidents of addiction.
“If you look at the levels of narcotics that are used for non-surgical patients, about 40 percent of these individuals are receiving narcotics,” Dr. Rhew says. “We’re finding there is a growing epidemic of overuse and abuse – and addiction to narcotics – even post-discharge. What if we have a non-traditional way to impact that upfront, where you could actually reduce your level of dependence on narcotics? That’s where I get really excited.”
Precisely how VR will impact the treatment of chronic pain is still unknown. Research at hospitals and universities is still in its infancy, with many only recently applying for approval to conduct full-scale studies using a scientifically valid random sample. But, Dr. Rhew feels preliminary results are encouraging, and the best practices for pain and anxiety treatment could change dramatically.
“If they are successful in these trials, I think it’s going to revolutionize the way we think about how we can manage pain – and anxiety and stress,” he says. “Not only in the hospital, but even outside of the hospital. It’s going to change how we manage, on a day-to-day basis, things we typically assume need to be treated through standard treatments and standard medications.”
More satisfied patients
If you’ve ever been stuck in a hospital bed for an hour – let alone a week – you know how markedly boring it can be, with only a tiny TV to satisfy the need for an escape from your coughing roommate and the looming med cart manned by an overworked nurse. For most, there’s a limit to the power Food Network has to help time pass swiftly. But with a VR headset, a hospital bed can feel a little less like a jail cell.
“We talked to some children’s hospitals, and they said, ‘A lot of our kids are in here for weeks on end and they’re bored.’ We talked to senior care centers, senior living, and they say boredom is a major issue,” says Dr. Rhew. “Imagine now being able to put these headsets on and they can lift you away to go to Disneyland, where you can ride rides. Or maybe a Rihanna concert just happened – well, you’re now in the front row, watching it even though you couldn’t go because you had surgery that week.”
The 360-degree visual element is supported by high-quality sound to create a sophisticated illusion. In some cases, chambers are being developed to isolate a person from all the noises of the outside world, allowing them to become immersed in the virtual reality with minimal distraction.
That sure beats watching sitcoms on cable. And for hospitals, this could translate to higher online user ratings and patient satisfaction scores. In the value-based era, this, in turn, could lead to higher reimbursement rates.
Filling the social gap
For seniors who have trouble traveling, VR provides them a chance to escape and explore parts of the world they’ve never traveled to. And the good news is, some simpler VR headsets are little more than a smartphone attached to a piece of cardboard. In those cases, content is stored locally on the device; so the user can customize their own experience based on available smartphone apps – and there are already countless applications available.
“Boredom and loneliness actually have huge implications,” Dr. Rhew says. “I spend a lot of time thinking about the senior markets, and researchers identified that loneliness is one of the major issues for seniors – and it is actually associated with smoking 15 cigarettes a day.
“[Loneliness] reduces your mortality, your life expectancy. When you don’t feel like you have a purpose and you’re lonely, it’s not only something that we don’t appreciate, it’s also something that’s detrimental to one’s health.”
VR may not solve the problem of a need for socialization, but it can provide new experiences and ways to connect with loved ones that go beyond a Skype call or picture message.
In some experiments, VR is already being combined with cameras and other communication technology to allow the wearer to interact with people live, in real time. If you’re too sick to make it to a family vacation, you can still enjoy some time with loved ones, thanks to new technological advancements that are constantly improving. In the near future, it isn’t hard to imagine add-ons that complement the sights and sounds, allowing a virtual visit to include the simulated touch of loved ones. It may never be as good as the real thing, but it could be just enough to stave off a serious depression.
A new way to educate
Those who stopped by the Samsung booth at this year’s HIMSS conference at the Sands Expo in Las Vegas may have tried the Gear VR headset for themselves. The demo included an ER application where attendees took the role of spectator during an emergency surgery. For medical students, this could be done live via a camera feed, allowing them to virtually shadow any physician and watch procedures as they happen.
For patients scheduled for an upcoming surgery, virtual reality opens a door for insights that go beyond an explanation from their doctor. Imagine a patient watching a realistic re-creation of the actual procedure they will be getting, understanding precisely how their knee replacement surgery will go, step by step. For those who are about to undertake any new medical procedure, the normal fear and anxiety may be reduced by a virtual-reality education.
Education empowers patients; fewer questions left unanswered makes for a less-scary hospital waiting room. Even if no one is having a procedure done, VR could provide improved, interactive information about a diagnosis and the steps a patient and their family need to take to manage it properly. For those who learn by doing, VR is going to be far more helpful than a conversation with a nurse, a take-home pamphlet, or an educational video featuring the poorly animated human anatomy.
For patients, this means a healthier life, and for providers a virtual-reality education may very well improve adherence and further reduce readmission rates.
Reality check
The fact is, researchers, software developers, physicians, and video gamers alike have just begun to scratch the surface of what VR can do. As time goes on and new, innovative thinkers begin to combine the tech with the myriad of other connective devices on the market, there’s no telling what the future holds.
For those seeking thrills, that may mean the ability to literally smell, taste, and feel a strange world from the comfort of your bed. For healthcare, virtual reality may open the door to telemedicine advancements and new treatment options that we have yet to consider.
After all, headsets like the Oculus Rift, Samsung Gear, and Sony PlayStation VR are just now hitting the market. This influx of VR is but the first iteration of what could be an evergreen asset. One thing is for sure, major players in all areas of IT – from healthcare giants to Facebook – are investing big dollars into VR advancements, which may very well mean big things are coming on the virtual horizon.
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