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Virtual reality

How gaming apps are being used in healthcare to improve patient adherence and quality of life
Virtual reality

For many people, the excitement surrounding virtual reality (VR) is pretty firmly embedded in its applications for gaming - allowing players to immerse themselves ever more deeply in their favoured pastime - be it racing cars, shooting zombies or playing sports. In recent years however applications have already started to appear that reveal a swathe of applications outside the gaming sector, including healthcare, and much of the recent activity has resulted from the plummeting costs and rapid improvements in the technology helped by cheaper, faster processors and other components.

In fact, healthcare has emerged as one of the most fertile areas for VR applications. Systems have already been deployed to train doctors and other healthcare workers in a safe, interactive environment, help diagnose diseases and as a tool in robotic surgery, although these tend to be very expensive, sometimes as much as $300,000.

Now, with several cheaper, consumer-oriented headsets due to reach the market in the next few years in the $100 to $1,000 dollar range, the number of applications is expected to grow at a rapid pace.

Comfortably at the head of the pack among these new players is Oculus Rift VR - a company recently acquired by Facebook for $2bn - which has already made its Rift headset available to thousands of developers so they can work on applications for the device.

Facebook chief executive Mark Zuckerberg seems to be enamoured with VR, saying recently he sees it and the related augmented reality (AR) - which layers computer-generated objects into the real-world - as the next major technologies that people will use to interact with each other, potentially supplanting smartphones.

In healthcare and medicine, there are already some fantastic examples of what can be achieved with VR, with much of the activity loosely split between training modules, clinical interventions and consumer-focused applications.

Training and education
Among the medical training applications, surgical simulation specialist ImmersiveTouch has developed a high-end unit that includes 'haptic feedback', recreating the sense of touch via a robotic arm in order to complement the 3D visuals generated by a headset from patients' CT or MRI scans.

The system is already approved for use by the FDA as a training module for both open and minimally-invasive surgeries, with a rapidly expanding library of surgical 'modules' extending its applications.

“Ultimately, surgical simulation should be done fully in virtual reality,” according to Ben Roitberg, professor of surgery at Chicago Pritzker School of Medicine, who has collaborated with ImmersiveTouch on the unit's development.

“That's the way of the future, and that's how training and practice of any procedure can be repeated multiple times, cost-effectively, anywhere in the world.”

That view is backed up by a meta-analysis of 16 trials of VR simulators which concluded that using the technology reduced the time taken to complete a surgical task as well as medical errors, and could distinguish between experienced and novice surgeons.

Other companies working on VR and AR in the training sector include Viscira, Medical Realities and zSpace - with applications ranging from virtual, 3D anatomical atlases to training first responders in emergency situations such as traffic accidents.

Not all these applications require expensive equipment. In Viscira's Mindscape, for example, a Rift headset is used to simulate the effects of schizophrenia so that healthcare workers or carers can gain an understanding of the impact of the disease.

Healthcare has emerged as one of the most fertile areas for VR application

The intent is for the user to develop more empathy for the patient and the challenges they face, and reinforce the need for active, consistent patient support and ongoing medication adherence. It also helps to demonstrate the ability for patients with the disease to still lead active, quality lives with the right plan in place.

Viscira also developed a VR exhibit called EyeMac that enabled physicians to simulate the experience of having neovascular (wet) age-related macular degeneration (AMD).

Treating patients
Using VR as a clinical intervention is still in its infancy, although there have been hundreds of clinical trials looking at its potential.

Many of these focus on the relief of pain and anxiety, but there are also studies focusing on post-traumatic stress disorder (PTSD) and phobias, diseases such as stroke, schizophrenia, multiple sclerosis and attention-deficit hyperactivity disorder (ADHD), as well as rehabilitation of patients undergoing major surgeries such as total knee arthroplasty.

Using Virtually Better's Bravemind - developed by scientists at the University of Southern California's Institute for Creative Technologies (ICT) - soldiers suffering from PTSD can undergo a sophisticated form of graduated exposure therapy - reliving a traumatic event in a controlled way that helps them overcome their fears.

The system uses a headset, a haptic plate to deliver the physical shock of an explosion and even a scent module that mimics smells such as burning plastic, diesel and body odour. A related system called STRIVE aims to helps combatants prevent PTSD in the first place.

Scientists at the University of Washington have deployed VR in SnowWorld, a game that is used to distract burn patients - including veterans - while they undergo excruciating burn treatment and physical therapy. Clinical trials of the approach suggest significant reductions in pain during wound care while in the VR environment compared to simply playing the game in 2D on a console.

Other groups are using VR applications to provide motor and cognitive training to stroke and multiple sclerosis patients, treat headache, correct eye disorders such as strabismus and help people cope with social phobia, among many other examples.

Clinical trials suggest significant reductions in pain during wound care while in the VR environment

Consumer applications
While Oculus' Rift headset has underpinned many of the applications being developed, other tech giants are queuing up to bring rival devices to market.

Sony's project Morpheus is a headset firmly targeted at its PlayStation games console - now renamed PlayStation VR - while HTC and Steam are doing likewise with their Vive device. Both are due to debut next year.

Meanwhile, Microsoft's recently-announced HoloLens device is promising to transform Xbox games and much more - according to their video. Samsung's Gear VR - which turns a Samsung phone into a VR headset - is promising to make the technology available for as little as $99 (not including the phone of course).

Google is also reported to be working on a big VR project called Cardboard that goes well beyond a relatively basic headset prototype, which is an interesting development given the company's evident interest in healthcare.

Increasing competition means that the price point for VR is expected to plummet over the next few years while accuracy and user experience will improve, likely pushing the technology to an ever-wider audience.

Much like wearable devices such as smart watches, VR looks set to find a role in the fitness and wellness category, for example with the development of apps such as a new VR-enabled version of Runtastic that allow users to train in a virtual environment.

A much more sophisticated system called Icaros combines a multigym-like apparatus with software that allows users to fly through virtual landscapes - getting a serious workout in the process. With an anticipated price tag of $5,000 to $10,000, initially the device will be aimed at gyms and other fitness facilities, although the company says it is eventually hoping to develop a home version.

Although some analysts have predicted slow take-up at first - just like PCs and smartphones in the early days - others predict that within as little as three years sales of VR technologies will be worth several billion dollars a year.

Given the level of activity among developers, healthcare looks odds-on to grab a slice of that market. 

Article by
Phil Taylor

is a freelance journalist specialising in the pharmaceutical industry

23rd February 2016

From: Research

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