virtual reality applications in medicine
TRANSCRIPT
How VR Technology Will Revolutionize Healthcare
And… How VR Will Transform Behavioral Medicine
by Leveraging Neuroscience
Walter Greenleaf, PhD
Digital Health Revolution
Mobile Health Wearable Patient Centered Leverages Internet: social, competitive, collaborative
Medical Applications of Virtual Reality
Technology
Digital Health Revolution
Current technologies and concepts are founded on more than 30 years of research and development
Changes in cost and access make VE affordable
VR tech is currently used for prevention, evaluation, treatment and chronic disease management
After years of validation, and use by early adopters, the technology is poised to move to the mainstream
On the horizon: enhanced, ubiquitous, informative and integrated
Virtual Reality Technology For Medicine
Relevance For The Medical Product Industry
Interactive media and VR technology will significantly impact Medical Care
Prevention
Behavior Change
Objective Assessments
Compliance and Patient Management
Distributed Care Delivery
Management of Chronic Conditions
Now is the time for VRVR technology is now affordable, scalable and accessible to the marketplace. The VR category is attracting interest and investments from major players.
Facebook - Oculus
Samsung - GearVR Sony - Project Morpheus
Microsoft - HoloLens
A Personal Journey …
I starting my research in
VR in 1984
Now is the time for VR
Medical Applications of Virtual Reality Technology
Although entertainment, social connection and gaming will drive the initial adoption of VR technology, the deepest and most significant market for VR will be in clinical care and in improving health and wellness. The list of clinical interventions made possible by VR is long. VR technology also facilitates clinical assessments and medical training, as well as providing for improved surgical skill training and procedure planning. Personal health and wellness can be improved by using VR to engender better nutrition, promote healthy lifestyles, and to reduce stress and anxiety. As the cost of healthcare rises, VR technology can serve as an effective telemedicine platform to reduce costs of care delivery, and improve clinical efficiency
Academic research has proven Virtual Reality can effectively treat a wide variety of mental health disorders – ranging from addictions to PTSD
MEDICAL APPLICATIONS OF VR
Medical Interventions
Clinical Assessments
Medical Training
Health & Wellness
Rapidly
becoming the standard for
training…
…and soon to be part of the
standard of care
Surgical Training Preoperative Planning & Image Guided surgery
Virtual Airplane for Fear of Flying
• Patient wears Head-mounted Display – Position Tracker – Covers Entire Field of View – Hears only audio from
earphones (including therapist)
• Sits in Airline Seat
• Simulates – Sitting in plane on runway,
engine on/off – Taxi – Takeoff – Flight in good weather – Flight in bad weather – Landing
PTSD, Phobias, and Anxiety Disorders Exposure-based treatments can be conducted in the safety
and comfort of an office setting Effective tools for treating a variety of clinical problems, in
particular anxiety and addictive disorders Fully immersive environments, with include the use of a
head mounted display, 3D sound, tactile stimulation via shaking platform, and olfactory stimulus are used for PTSD therapy
RISK AVOIDANCE TRAINING
VR for Team Medical Procedure Training
Build physician empathy for patients receiving
difficult diagnoses
Preparation and Training for Difficult Situations
Stress Inoculation – Risk Preparation
Virtual hospital tours could be used to relieve pre-procedure anxiety
Stroke and TBI Rehabilitation
VRecover
Virtual AA Meeting
Virtual Reality To Hit $150 Billion by 2020
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16.9
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Best Worst
Year1 Year2 Year3 Year4 Year5 Year6
Initial adoption will be driven through game console, PC gaming and mobile phone bundling Within 3 years, VR will likely be adopted by 15-30 million users
*Based on agent based modeling by Lieberman Research Worldwide
Within 6 years, VR will likely be adopted by 40-70 million users
MUVE Technology
VOIP
Graphic
Processors
Broadband
Movement Tracking
Algorithms for
NVB
Low Cost Computers
Smart Phones
Tablets
Virtual Environments have progressed to the point of acceptable visual realism, believable real-world physics, and adequate sensory immersion
World building tools are now inexpensive and easy to use
MEDICAL APPLICATIONS OF VR
Medical Interventions
Clinical Assessments
Medical Training
Health & Wellness
MEDICAL INTERVENTIONS
• Post Traumatic Stress Disorder
• Physical Therapy and Rehabilitation
• Neurorehabilitaiton - Stroke and Traumatic Brain Injury
• Speech Therapy
• Addictions - Alcohol, Substances of Abuse, Nicotine, Opiates
• Phobias – fear of heights, fear of flying, social phobia
• Obsessive Compulsive Disorder
• Generalized Anxiety Disorder
MEDICAL INTERVENTIONS
• Mood Disorders - Depression
• Mild Cognitive Impairment
• Acute and Chronic Pain
• Autism Spectrum Disorder
• ADHD
• Optical Rehabilitation – Strabismus, Amblyopia
• Resilience Training
• Surgical Planning
DIAGNOSTIC ASSESSMENTS
• Medical Image Review
• Neuropsychological Assessments
• Activities of Daily Living Assessments
• Physical Medicine – OT / PT
• Behavioral Medicine – psychology, psychiatry
MEDICAL TRAINING
Clinical Skill Training
Surgical Skill Training
Interpersonal Skill Training
Use of Equipment and Tools
Team Training - eg: Emergency Department, Surgical Team
Emergency Response Training and Rehearsal
Empathy
HEALTH & WELLNESS• Weight Management
• Cognitive Function Training –
Sequencing, Situational Awareness, Decision Making
• Exercise
• Stress Management
• Disability Solutions
• Addressing Isolation
• Grief Counseling
• Mood and Resilience
Medical VR Can Address Several Key Problems
Annual cost of problems in the U.S. alone:
WEIGHT LOSS
$289B
SMOKING CESSATION
$528B ADDICTION
$181B
CHRONIC PAIN $635B
POST TRAUMATIC STRESS $300B
Stroke & TBI $86B
Alcoholism $223B
Autism $126B
Telemedicine Platform
Drug and alcohol abuse
Schizophrenia
Post-traumatic stress disorder (PTSD)
Depression and Mood Disorders
Generalized Anxiety Disorder
Acute and Chronic Pain
ADHD
Virtual environments are used clinically to treat several important behavioral health problems
Phobia and anxiety disorders
Obsessive Compulsive Disorder (OCD)
Developmental disabilities
Conduct disorders
Anger management
Eating disorders
Impulsive disorders
Learning disabilities
Neuro-cognitive disorders
Virtual environments are used clinically to treat several important behavioral health problems
Neuroscience Rationale (Based on Merzenich’s Model on drivers for Neuroplasticity)
It is necessary to activate the associated brain system to enable neuro-plasticity
It is critical to engage the brain's reward systems
Repetition is required
Attention drives Cholinergic system
Novelty drives Noradrenergic/Serotonergic system
Reward drives Dopaminergic system
Abilitytochangea7tudesandbehaviora<er“being”one’sfutureself.
Leveraging Mirror Neurons
Your Future Self
Students interacted with 3-D avatars of future self.
Asked to allocate $1K between present expenses, a fun splurge, checking account, & retirement account.
Participants who interacted with future self put more than twice as much money into retirement account.
Build Empathy for Underserved Populations
VR can increase conservation behaviors.
“Short and long-term effects of embodied experiences in immersive virtual environments on environmental locus of control and behavior” Ahn, Bailenson et al
VR can be used to help train doctors and staff to better understand the patient perspective.
“Virtual Experiences for Social Perspective Taking” Raij et al., University of Florida
Big Data Opportunity
Objective data Behavior and activities Linked to intervention Population trends
Current technologies and concepts are founded on more than 30 years of research and development
Changes in cost and access make VE affordable
VR tech is currently used for prevention, evaluation, treatment and chronic disease management
After years of validation, and use by early adopters, the technology is poised to move to the mainstream
On the horizon: enhanced, ubiquitous, informative and integrated
Virtual Reality Technology For Medicine
The Neuroscience of Behavior Change
“The intelligent want self-control; Children want candy.”
-- Rumi
The Limbic System – Seat of Emotions
Prefrontal Cortex vs Limbic SystemThe prefrontal cortex dominates the system that is rational and focused on achieving long term goals
The prefrontal system is adept at predicting the consequences of our behaviors. We tend to think about ourselves in relationship to other people and within a social context – the roles that we care about.
In the limbic system are structures that are responsible for very quick emotional responding and also the stress response, areas of the brain that produce the promise of reward and the overall reward system of the brain.
When the limbic system is active, we tend to be focused on the very short term – the small picture. We’re driven by immediate gratification. We are desperate to avoid pain and conflict.
Virtual Humans For Training, Confidential Interaction, and Telemedicine Support
