Making Virtual a Reality
The healthcare applications for VR have great potential but several factors must align.
Virtual reality (VR) is still thought of by most of us as a futuristic tool for entertainment – a hangover from countless sci-fi films where heroes don headsets to immerse themselves in strange new experiences.
But this is not Hollywood: VR & AR are today firmly in the realm of science fact rather than fiction, and – away from the entertainment world - both have the potential to provide significant benefits for patients in a variety of ways. Whereas VR replaces the real world with a simulated one, its companion technology, augmented reality (AR) adds to what the viewer can already see – for example, by overlaying digital graphics or allowing real-time images to be manipulated, which can include 3D imaging.
Early days
“It is still early days for VR and AR to get a foothold in physicians’ practices,” says Rick Krohn, President of mHealth consultancy HealthSense. “But the most exciting thing is education – there is a big push towards consumer-centric care with physicians encouraging patients to understand treatment modalities and to make them more accountable. It’s inspiring.”
AR already has some form as a formal teaching device, for instance in Microsoft’s partnership with Case Western Reserve University, which has seen the manufacturer’s HoloLens being used in the anatomy department. Teaching has traditionally been done in 2-D from books or online sources – but our bodies are of course 3-D, and the university believes that this improves students’ confidence in dealing with anatomical studies. This should, in turn, provide better outcomes for future patients.
Krohn has spent years studying and writing about VR and AR, and is excited about the possibilities for creating a better environment in which patients can be treated. The numbers are impressive too. He quotes a forecast from Goldman Sachs that healthcare VR applications will top $5.1 billion in sales by 2025, with 3.4 million active users - 1.5 million of whom will be medical professionals.
Demystifying medicine
The technology can be used to demystify medicine, Krohn believes. He suggests that AR tools will allow patients to ‘see’ their fractured bone or blood clot, making the experience of treatment both more real and less frightening. Patients can now put on AR goggles and look at their body while the doctor explains what the problem is and what needs to be corrected.
“It makes it real for them, removing the mystery of how the medicine is going to work and removing a lot of the uncertainty and anxiety,” he says. “Doctors will be able to say: ‘Here’s how your wrist is broken and here is how we are going to fix it’. That is going to create better outcomes.”
Intriguingly, he sees possibilities for patients in areas as diverse as immersive health, gamification, brain injuries, behavioral health (for example, anxiety, body image or phobias) and chronic disease management. VR and AR can also be used elsewhere in healthcare, he goes on. In the physician’s office, these applications could range from virtual diagnosis to patient education, while in pharma he sees opportunities in post-traumatic stress disorder, rehabilitation, pain management and drug efficacy.
Face-to-face
Having these tools at the point of care will create a face-to-face, team approach between doctor and patient. “It can be about behavior change, chronic treatment – there’s a spectrum of opportunities,” Krohn suggests. “Once we get past the idea of VR as just visualization, entertainment and gamification, we will see its true clinical value.”
So the clinical value is there – but there is a catch, he acknowledges. VR is expensive, it is in many ways unproven, and it has a retail – rather than scientific – association at present. “Physicians are not pioneers in the adoption of technology, and they will ask why they should introduce the associated costs of VR and AR into their practices,” he says.
The obvious means of convincing them would appear to be to explain the benefits to patients. “Improving outcomes is a compelling story,” Krohn agrees. “But there is also the way in which it is possible to create brand preference for their practice through better customer satisfaction.” In other words, using VR and AR could be a means of commercial differentiation. “Through using this technology you are making things real and tactile for the patient, and that is why this physician is different,” he adds. “But you need the proof point and hospitals and doctors are not going to provide that themselves – they need to be led. They need incentives.”
Providing incentives
Money talks, of course. The groundswell will come via payers, healthcare providers and insurers such as Medicare or Medicaid – and once you have insurance companies determining there is value in VR and AR, then they will provide incentives themselves. While this means there is no single element or business that will provide the springboard for the more widespread use of VR and AR, Krohn believes that the evidence that the technology works could be forthcoming in the next one or two years. He thinks that this, along with the more general availability of VR and AR tools on the high street, will increase take-up.
“The planets will align for VR and AR to catch fire,” he insists. “Technologies with a consumer flavor tend to have a shorter adoption curve: the price points are more attractive and patient acceptance of them is higher. If kids use it, there is a comfort level which removes a barrier to use. There are also a host of trials and once you have pilots which are able to publish results that will serve as the impetus for healthcare organizations. At the moment, no-one wants to be the first out of the box.”
There is evidence that some providers are already seeing the benefits, Krohn believes. Cleveland Clinic is using VR tools to treat Parkinson’s disease while at St Judes Children’s Research Hospital, young people with cancer are given a virtual experience in a bid to improve their quality of life. “The children aren’t able to go anywhere, they are institutionalized for a long time,” he explains. “With VR, they can go scuba diving, taking themselves out of their current situation – in terms of state of mind change, it’s very effective. Otherwise, they are in a sterile environment with few things to be joyful about. It is something that may make them more receptive to treatment.”
Price pressure
These devices do not come cheap, but Krohn believes that pressure is being exerted on price as new players enter the market. “Until a year ago, we were only talking about Sony, Google and Microsoft. But now more and more companies are coming into the picture. Prices are coming down.” While he laughs that “you can’t buy them off the rack at WalMart yet”, there are nonetheless signs that the technology itself is becoming more commoditized and, therefore, cheaper and more accessible even as the digital quality is improving. “Collectively the whole package is becoming more consumer friendly and those economic features are making it more attractive,” he says. “Patients will learn that they can use the technology at home, on demand, which will help reinforce treatment compliance and engagement.”
He believes VR has the power to change healthcare and pharma – and indeed must do so because Krohn has been staggered at the inefficiency he has seen. “When I was working with hospitals and physicians I was appalled at this spaghetti soup of activity and information,” he recalls. “I felt that workflow programs and efficiency studies had run their course. Technology is going to be fundamental to curing healthcare’s ills but technology has underperformed. We are yet to close the circle on that, but technology solutions are going to have a positive impact on care delivery and patient outcomes.”
VR and AR can be a game-changer in terms of brand preference and recasting the relationship between the rep and the doctor.
It will also help as the structure of the healthcare industry changes and shifts, not least in areas as value-based medicines, and Krohn sees more revenue opportunities, potential cost savings and quality gains.
Risk and reward
“The payer and provider will become more entwined, less islands in the stream,” he says. “I have seen presentations by pharma companies where it is obvious that they genuinely recognize the product model is dead and they will have to become more customer focused. The way that they will do that is to engage: you have to have something to offer. VR and AR can be a game-changer in terms of brand preference and recasting the relationship between the rep and the doctor. When a rep comes into a doctor’s office, they’d better have more than a box of doughnuts – you have to have something more, something that genuinely creates value for the physician.”
Therefore, although all disruptive innovation carries risk, VR and AR is an investment worth making for individual practices. “Having a more satisfied patient base will help bubble their brand to the surface,” he concludes. Moreover, it will banish the technology’s association with sci-fi forever.
For more information on how VR will change healthcare, contact Rick Krohn: rkrohn@healthsen.com