For those who ordered early, the long-awaited Oculus Rift starts shipping today, the HTC Vive is expected to officially ship April 5, and Sony’s Playstation VR is slated to arrive in October. Virtual reality headsets aimed at the consumer/gamer market are finally becoming a reality.
But health care organizations have been taking a healthy dose of virtual reality for quite some time. Most of the health care VR projects are in the experimental stage, but virtual and augmented reality are a natural fit for medical training simulations. And it’s not hard to imagine practical uses of VR for students, doctors and even patients that could transform the medical field.
With recent improvements in virtual and augmented technology, simulations will get more realistic, more compelling, and more customized. “Virtual reality will change the way we both train and practice medicine,” predicts Nick van Terheyden, chief medical officer at Dell Healthcare.
In fact, some simulations made possible by virtual reality were not really feasible before.
For example, medical students need to practice deciding when to give rapid tranquilization to patients in a mental health ward.
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“It’s something they couldn’t do legally in real life with real patients,” said Fee Berry, project manager at Mediverse. “And it’s quite hard to set up a real-life simulation of that kind of thing — it’s quite expensive to get actors to play the patients. In the virtual world, it’s quite an easy thing to do.”
Berry is currently working with the UK’s National Health Service on the project. Currently, one trainee plays the virtual patient, while other trainees play the doctor or nurse. “It’s one of the things that people don’t expect from virtual reality — that you identify pretty strongly with your avatar and you see things from their perspective,” she says. “If you are a doctor, it is a useful thing to have seen the simulation from the patient’s perspective and the nurse’s perspective.”
In addition, avatar behaviors can be recorded and automated, in the form of bots, where the computer controls the other characters. Bots are already being used to populate the virtual setting with other patients and staff, she says.
Ferry’s simulations currently look like video games, with animated characters. But virtual reality can be extremely realistic, as well.
For example, neurobiologist Eric Greenbaum, founder of the New York Virtual Reality Meetup and a patent attorney in Great Neck, N.Y., is working on a virtual reality medical education application where students can watch surgical procedures in a virtual reality environment from the point of the view of the surgeons themselves.
“Instead of watching it from across the room, you really get to watch it from the point of the practitioner,” he says. “When you’re in a 3D space, your focus isn’t distracted by anything else around you. You can really see what’s happening, exactly what you would see as a practitioner doing it.”
According to Greenbaum, medical virtual reality is reaching its “day one” moment. “Everything before has been experiments, prototypes, developer kits,” he said. “Everything’s been a little buggy, a little kludgy.”
Today, commercially-available devices such as the Samsung Gear VR, which costs $99, offer an excellent experience and can be used by anyone. But the Oculus Rift and the HTC Vive will make the biggest impact because of their higher processing power and graphics. “I’ve tried both and they’re both amazing,” he says.
The doctor goes virtual
In December, doctors at Nicklaus Children’s Hospital in Miami created a virtual model of the heart of a 4-month-old infant suffering from what had been previously deemed to be an inoperable condition.
The doctors then used an iPhone and a Google Cardboard headset to plan the surgery, which saved the baby’s life. The particular headset was an actual cardboard version of Google Cardboard, available for $5 and up from online retailers. More durable versions of Google Cardboard are available from more than 100 manufacturers, and typically cost between $20 and $100.
But these headsets only allow users to look around inside a virtual environment, with very limited interactivity. That will soon change, since vendors and researchers are rapidly working on developing technology that would allow users to actually touch virtual objects.
“Haptics are getting a lot better and so you’re going to be able to actually grab things and release things,” says Howie Leibach, senior research and insights analyst at research firm Greenlight VR. “Haptics and peripheral technologies are improving drastically and are allowing for more realistic human interaction in a simulated world.”
This would lead to not just better training simulations, but real-time surgeries performed in a virtual environment. Doctors would be able to get a much closer view, and from any angle, and work on a much smaller scale than previously possible.
Rehab, pain and phobias, oh my
The next time you find yourself suffering from agonizing pain, debilitating phobias or PTSD, or need physical therapy to recover from an injury, you might just find yourself doing it in virtual reality.
While burn patients are resting, pain medicines can be reasonably effective. But when bandages are being changed, or the wound is cleaned, the pain is excruciating, and not even morphine or other opiods can help.
But virtual reality did.
When Howard Rose first began working on using virtual reality to treat pain at the Human Interface Technology Laboratory at the University of Washington 10 years ago, the virtual reality headsets cost between $30,000 and $40,000 each.
The virtual environment was a simple, low-resolution snow-covered landscape — but it worked. Children and adolescents reported large reductions in pain while in virtual reality, significantly more than while being distracted by a regular video game. Since then, more than 200 studies have come out that demonstrated the pain benefits of virtual reality.
“There’s a relationship between immersion and presence and pain reduction,” said Rose. “The more we can immerse them in a virtual world, the less pain they feel.”
Since then, Rose has founded DeepStream VR, to turn the past decade and a half of research into commercial applications. “Now the exciting part is that we can make it affordable and take it out to the real world,” he says.
The first product, Cool!, is based on the original “Snow World” simulation. It is currently in trials at Canada’s Simon Fraser University and in use at at a chronic pain clinic in Tennessee. There’s a lot of interest from children’s hospitals, he added, as well as with veterans and other adult populations.
In addition to using off-the-shelf virtual reality headsets, DeepStream VR also offers its own headset, designed specifically for medical environments. “Sterilization is a really important part of what happens in clinics and hospitals,” he says.
The company’s proprietary headset sits on a gooseneck, and instead of being able to look around in all directions, the patient sits still and faces in just one direction.
“When you have patients in a wound-care situation, you don’t want them moving because you have nurses around them,” he says. Plus, by keeping the display immobile, less computing power is needed to create the virtual environment while still providing an effective immersive experience.
Any virtual reality experience, by diverting attention away from the medical setting, can be helpful to some degree. But some are not necessarily appropriate for a medical setting.
“Most games are built on a play, die, repeat model,” said Rose. “They’re designed to stress us out. Our games are built more like a playground.”
He said it’s common to see a reduction in reported pain of 50 percent.
Virtual reality has also found a niche when it comes to the treatment of phobias and PTSD.
“It allows you to essentially recreate moments that happened, or to live completely new experiences,” says Greenlight VR’s Leibach. “For Iraq war veterans, there are companies that are recreating those experiences for them to confront those fears in a very realistic setting. Obviously, it’s impossible to recreate them perfectly, but virtual reality is getting very close, to the point where they’re able to confront their fears and potentially overcome them.”
Psico Smart Apps, S.L. was founded about a year ago and provides virtual reality systems to psychologists who are treating patients with phobias and anxiety.
“Right now, we have fear of driving, flying, fear of public speaking, fear of heights, fear of bugs, fear of needles, as well as practice relaxation exercises to reduce anxiety,” says company co-founder Xavier Palomer.
According to Palomer, if it normally takes between 10 and 15 sessions for a patient to get over their fear, but with virtual reality therapy it can take between six and eight sessions. “You can get better, faster,” he says. In addition, the virtual reality environment helps improve patient engagement and reduces drop-out rates.
The company’s software currently runs on high-end mobile-based headsets, such as the Samsung Gear VR, which works with late-model Samsung smartphones, and the Homido headset, which works with both iPhones and Androids.
The interactive virtual environments put more control in the hands of the patient, reducing psychological barriers to therapy. But the software also allows the therapist to adapt each experience to the patient, and to monitor the entire experience.
But virtual reality can be used to help patients with physical conditions, not just psychological ones. When paired with motion capture devices, the technology is being used for physical rehab and sports training, says James Martin, owner of MobaCap and a certified trainer for sensor technology vendor Noitom.
“We’re seeing some innovative stuff happening here,” he says. “Behind-the-scenes analysis where athletes are assessed for physical abilities and attributes… It’s used in the golf industry to develop and assess a player’s swing.”
On the other end of the price scale are smaller-scale motion capture devices, such as Microsoft’s Kinect and the Leap Motion controller.
Pairing these devices with virtual reality environments can create a more engaging therapy experience for patients, one that they would stick with for a longer time — and where doctors can track improvements in great detail.
Korolov is a freelance writer. She can be reached at maria@korolov.com
