Virtual reality (VR) and Augmented Reality (AR) hold a significant place in the future of healthcare… Tech evolution over recent years has been instrumental to the forward-thinking attitudes of clinical practice; embracing the computer-generated, sensory technology enables a further mechanism to facilitate positive change within medical education and disease detection – ultimately providing enhanced outcomes in patient care.

VR is helping healthcare, see how with these real-life case studies…

Stepping into the history of virtual reality healthcare –

“It was meant to be the next big thing in the 1990s,” says Steve Dann, chief executive of Medical Realities, of virtual reality (VR). – “But the technology wasn’t up to it, it couldn’t deliver what our imaginations [envisaged], and it withered on the vine.”

Consequentially leading on to say the missing ingredient, was access to substantial computing power — power that once was reserved for large enterprise users; but now readily available within standard smart phones.

Later years have seen an increase in processing power; whilst experiencing a drop-in cost of VR hardware, allowing healthcare organisations to begin experimenting with the technology…

Case studies: Using VR and AR in medicine –

1

Augmented reality assisting clinical procedures:

Initially virtual reality simulators seized the medical market, now all new technology like augmented reality headsets, such as Microsoft HoloLens and the formerly known Google Glass are functional devices designed to display overlays, which enable virtual objects to be displayed onto the real world; creating a mixed-reality experience.

Google Glass –

In 2015 Dr Maksymilian Opolski, an Interventional cardiologist at the Warsaw Institute of Cardiology, first embarked on utilising the virtual reality glasses – known as Google Glass – for a PCI procedure, where he navigated the inside of the patient’s heart via picture overlay projected onto the heads-up display.

Opolski first used Google Glass to assist with a complicated PCI case, where the patient’s arteries where closed off. CT images of the patient’s blood vessels were displayed on the augmented reality glasses and used to guide the catheter through the veins, to the heart.

Dr Opolski’ first Glass-assisted procedure was over three years ago, since then he has conducted around 15 more procedures with the VR technology. In most PCI cases images of the patient’s heart are displayed on monitors; in the pilot, they were projected onto head-mounted augmented reality glasses worn by the surgeon.  This is just one-way human anatomy VR is being used in medicine and surgery.

The innovative technology harbours the potential for widely leading the way in the future use of medical-assistance wearables… One day, it could be common practice for clinicians to start wearing a pair of Google Glasses alongside their scrubs. – This is only just the start for AR in medicine!

The tech was released in 2013, but numerous issues were faced, such as pricing and privacy, meaning Google ended sales of the first edition headset two years later. However, in 2017 Google relaunched Google Glass as an enterprise tool, targeting industries such as manufacturing and healthcare.

Potential future of VR in medicine:

Emerging applications of virtual reality in cardiovascular medicine are now being explored to see if CT angiography pictures can be combined with AR technology, which would offer a new, innovative, way to view inside heart vessels. – A brilliant real-life situation to display how virtual reality technology works in medicine.

Microsoft HoloLens helping surgeons – 

Microsoft’s HoloLens is helping surgeons to plan operations…

The use of virtual reality is helping the team at Alder Hey hospital, Liverpool, hope to utilise the mixed-reality headset to visualise patients’ scans during procedures, which interact with the real world, facilitating surgeons to view up-to-date patient information whilst operating.

Furthermore, three surgeons, in separate hospitals across the globe, have used the tech to assist in a virtual multidisciplinary team, which combined efforts to surgically remove bowel cancer.

Surgeons at Queen Mary’s Hospital have also been experimenting with the HoloLens, augmented reality, headset whilst performing surgery. Enabling them to directly overlay the patient’s anatomy, on to their body, in the form of a map – providing quick and efficient identification of blood vessel paths and the course of muscle groups. The map is created via patient CT scans, allowing surgeons to navigate away from important or sensitive structures during surgery. Which could potentially reduce patient recovery time, thus the time spent in hospital, and similarly reduce the need for any secondary or corrective surgery.

2

Medicinal VR application to help mental health patients – Oxford VR

Mental health and VR may seem an odd combination in the first instance, but when you dig a little deeper the logic is definitively apparent… Trialling of medicinal VR technology has been undertaken to help mental health patients deal with fears, psychosis and anxiety 

Oxford VR, a spinout of the University of Oxford, have been experimenting with simulated environments and virtual coaches to aid patients in their fear of heights. 

The virtual reality tech comes in the form of a headset, which is combined with bespoke software to create virtual representations of real-life environmentpatients find difficult. This facilitates theto explore situations safely, therefore enabling increased comfort to be developed 

Professor Daniel Freemanfrom the University of Oxford’s Department of Psychiatry, commented ‘When VR is done properly, the experience triggers the same psychological and physiological reactions as real-life situations. And that means that what people learn from the VR therapy can help them in the real world.’ 

 King’s College and the South London and Maudsley trust have tested VR therapy for improving auditory hallucinations in people with schizophrenia, while also the tech has been used by outreach workers at the Central and North West London NHS trust (CNWL) to help families affected by the Grenfell fire. 

 Another great real-life example of showing how virtual reality and augmented vision in medicine can be of great benefit and advantage to patient care. 

3

Reducing chronic pain with virtual reality

Virtual reality is being used in digital medicine to combat pain… In excess of 11% of Americans – 25 million people – suffer from chronic pain. An increased proportion are developing painkiller reliance to assist with making everyday life less of a struggle.

With the opioid epidemic in mind, healthcare providers seek safer, non-addictive alternatives to help patients with chronic pain. Thus, looking to seek a solution in virtual reality; studies have found that virtual therapy can help reduce pain by 25%…

Medical VR has been evidenced in stopping brain processing of pain, therefore reducing pain levels in hospitalised patients. In turn, leading to shortened lengths of patient stay, which correlate to lower costs of care.

Farmoo, a project developed by SIAT student and cancer survivor, Henry Lo, and friend Janice Ng, was created to help distract the minds of chronically ill patients by focussing on VR worlds, which helps them alleviate pain and release stress. – The game was inspired by popular online games Farmville and Gardening Mama, giving patients the chance to escape their existing hospital surroundings by immersing their mindset within the game, rather than focussing on their treatment.

Furthermore, a US based company, Karuna Labs, utilises virtual reality to treat patients with chronic pain. The devised software is designed to mitigate the threat response which causes pain, while fixing brain incongruities, via motion and visual-based sensory experiences.

Via the technology patients are taught how pain works throughout the varying levels of the brain, then aims to rehabilitate them, and throughout time facilitates patients to live a normal, less painful life again.

Karuna’ real-life case study focussing on improving a patients chronic upper limb, neck and headache pain.

4

Immersive virtual reality helping autism patients overcome phobias

Newcastle University’s Institute of Neuroscience has developed a unique immersive VR software in conjunction with Third Eye Technologies, named The Blue Room. The technology is designed to help those with autism overcome phobias. Again, the software re-creates real-world scenarios through virtual reality, however in this instance there is no need for a headset…

The patient is accompanied by a psychologist in a 360-degree screened room, enabling them to be completely surrounded with audio visual images delineating the ‘real world’. The service design is unique and one which is extremely important for treating patients with autism to minimise distress.

The Blue Room provides situation flexibility which cannot feasibly be sought in real life, this is achieved by allowing scenes to be gradually built up in complexity and noise level, facilitating a controlled graded exposure.

Tried and tested scenarios include boarding a busy bus, crossing a bridge, going shopping and speaking with an avatar shop assistant. The psychologist supports the child via breathing and relaxation exercises to help them learn how to cope with the situation. Furthermore, the room facilitates parent observation via a video-link, enabling them to watch the techniques utilised in assisting their child.

This is one instance of how virtual reality is being applied to medicine throughout the UK… The treatment is now available on the NHS.

5

Operational VR  live stream – Helping to train medical students…

The UK digital health ecosystem is growing, one of the most well-known pioneering examples in the AR and VR space was the first operation to be 360-degree live streamed, the procedure, which was performed over three years ago, was carried out at the Royal London hospital. The multitudinal live stream allowed over 55,000 medical students to view the operation, in vivid detail, via live video footage, instead of a select few squished trainees struggling to catch sight of the intricate procedure in the operating theatre.

Dr. Shafi Ahmed, a practicing cancer surgeon who specialises in laparoscopic, or keyhole, colorectal surgery, and virtual reality proponent is leading the way in training medical students via the technological means.

In the below CXO Talk you can watch Dr. Ahmed discussing the innovative technology, the benefits of VR and AR for medical education training and how can virtual reality be used in medicine…

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