Thursday, 1 June 2023

How virtual reality is changing medical care

IEC 

The global market for augmented reality (AR) and virtual reality (VR) in healthcare is expected to reach USD 14 billion by 2030, growing at a rate of 21,5% a year, according to market research and strategy consulting company Emergen Research.

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The rising need for better medical training is one of the major factors driving this industry. For clinicians and patients, AR/VR technologies provide a more immersive and participatory experience that can improve results. “Training and simulation are a major part of what hospitals are looking to do in order to overcome challenges in staff turnover and to find a better way to train surgical teams,” explains Maayan Wenderow, VP of Marketing at an immersive surgical training provider, which is accredited by the American Association of Orthopaedic Surgeons and the Royal College of Surgeons of England.

Analysts at Frost & Sullivan say that VR accelerates skills acquisition and medical product adoption “by smoothening the learning curve”.  Fairly common is the use of VR to review cases before a surgical procedure. Dr Rafael Grossmann, a full-time general, trauma, advanced laparoscopic and robotic surgeon who practices in the US explains, “You can view images of a patient’s specific organs in VR and navigate the map you are going to cross. If your VR system has haptics, you also get some muscle memory to take into the operating room.”

Surgical simulations have been used by surgeons for decades, but VR goes one step further than practicing on mannequins or human cadavers. Kinesthetic haptics, such as those developed by Wenderow’s company, mimic the physical touch of surgical actions, and accurately simulate the sensations of bone textures, muscle and soft tissue. “You can practice certain operations with haptics such as drilling the bone or injecting the eye and master it before moving onto a human,” Grossmann explains.

VR is also being introduced to help patients understand the procedures they will undergo. “VR is a way to enhance the process of informed consent,” says Grossmann. “Patients are less afraid if you can show them in VR what you are going to do.”

Great potential for relieving pain

VR/AR is also being widely used in certain forms of treatment. Trials at Chelsea and Westminster Hospital NHS Foundation Trust report particularly good results for VR applications in reducing anxiety and pain experienced by children attending accident and emergency units. “We also saw an improvement in patients’ sleep quality in the Intensive Care Unit, and positive effects on anxiety, stress and pain in cardiac patients,” reports Tom Carlisle, digital innovation fellow at CW+, the charity of Chelsea and Westminster Hospital NHS Foundation Trust.

The hospital is extending the use of VR as a distraction tool and an alternative to pain relief. For example, headsets are being used to support women who experience loss in the early stages of pregnancy: they can observe a relaxing scene or follow a guided mediation while undergoing a manual vacuum aspiration procedure. This can reduce anxiety. “There is so much potential,” Carlisle says. “We can imagine a world where VR could be used for oncology patients in the Chemotherapy Day Unit as a form of distraction and pain relief. AR could be used to educate patients and provide faster and more effective remote diagnosis.”

Simulated environments can help people overcome social anxiety disorders. One such therapy is delivered to patients through weekly half-hour sessions. Each user puts on a VR headset and is greeted by a virtual coach who asks them to complete a range of tasks, such as travelling on a bus, buying groceries or going to a doctor’s office. These kinds of situations are common triggers for people with social anxiety. “The immersive nature of VR provides a powerful new way to engage users and helps them to regain confidence, feel safe and overcome trigger situations,” says Director of Clinical Partnerships, June Dent.

Social engagement therapy is being deployed by the UK’s NHS while several private UK healthcare providers are also using the service. Other VR-based clinical trials include treatments for those with a fear of heights and for treating post-traumatic stress disorder (PTSD), depression and obsessive compulsive disorder (OCD) .

Perhaps the most important aspect of this approach is that the therapy is entirely automated, meaning it doesn’t require the presence of a qualified clinician – the session can be delivered by a staff member who has been trained to set up the VR headset.

Pioneering surgery using AR

Neurosurgeons at Johns Hopkins performed one of the first augmented reality surgeries on living patients in 2020. “When using AR in the operating room, it’s like having a GPS navigator in front of your eyes in a natural way so you don’t have to look at a separate screen to see your patient’s CT scan,” says Timothy Witham, M.D., Director of the Johns Hopkins Neurosurgery Spinal Fusion Laboratory who led the spinal fusion surgery.

A London-based startup recently launched a lightweight, wearable ‘smart glasses’ device that allows surgeons to share a ‘first-person’ perspective of open surgeries and minimally invasive procedures. The first-person perspective allows those observing remotely to have a far clearer picture of the surgery, providing opportunities to advise or learn from surgical techniques. 

According to the company, pilot procedures with surgeons wearing its AR glasses were conducted in the UK and US last year for colorectal, otolaryngology, orthopaedic and urology surgeries. “The fact that it’s lightweight and intuitive makes it easy and convenient for anyone to deploy in surgery, even for the first time,” says Stella Vig, Consultant General and vascular surgeon, Croydon University Hospitals NHS Trust. “Healthcare overall is trying to figure out how to do more with less, and technology like this gives us new ways of delivering care.”

According to Emergen Research, the market is confronted with several obstacles, including the still high cost of AR and VR equipment, the lack of technological know-how among healthcare professionals, and worries about data security and privacy. Additionally, regulatory barriers and a lack of standardization in AR and VR healthcare applications can restrain market expansion.

That is where IEC work comes in. Several IEC Technical Committees are developing standards for AR and VR devices.  IEC TC 100 prepares standards for audio, video and multimedia devices. It aims to standardize forward looking technology areas like haptics or even the Metaverse. It has recently published a technical report to clarify the conceptual model of haptics in multimedia systems and has set up a group to prepare standards for multimedia equipment relating to the Metaverse.

IEC TC 110 publishes standards for electronic displays. One of its working groups has developed the first edition of IEC 63145-20-20, which establishes the measurement conditions for determining the image quality of eyewear displays. IEC has also formed a joint technical committee with ISO, JTC 1, which prepares standards for information technology. One of its subcommittees publishes documents which specify the requirements for AR and VR. 

With the correct regulatory framework and appropriate standards in place, AR and VR technologies have virtually unlimited potential in the field of healthcare.

 


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