Meta CEO Mark Zuckerberg demonstrates an Oculus Rift virtual reality (VR) headset and Oculus Touch controllers throughout the Oculus Connect 3 event in San Jose, California, U.S., on Thursday, Oct. 6, 2016.
David Paul Morris | Bloomberg | Getty Images
Just days before assisting in his first major shoulder-replacement surgery last 12 months, Dr. Jake Shine strapped on a virtual reality headset and set to work.
As a third-year orthopedics resident at Kettering Health Dayton in Ohio, Shine was standing within the medical center’s designated VR lab along with his attending physician, who would oversee the procedure.
Each doctors were wearing Meta Quest 2 headsets as they walked through a 3D simulation of the surgery. The procedure, called a reverse total shoulder arthroplasty, can last around two hours and requires surgeons to fastidiously navigate around neurovascular structures and the lungs.
After the mock procedure, Shine took his headset home to practice. He did so roughly twice a day before the surgery.
“You possibly can really fine-tune and learn what to do, but additionally what definitely to not do, with zero risk to the patient,” Shine told CNBC in an interview.
Ultimately, there have been no complications within the procedure and the patient made a full recovery, he said.
“Anecdotally, I believe it went smoother and quicker than it might have,” Shine said, than if the attending physician “was having to walk me through every step within the case the identical way that he did within the VR.”
While consumer VR stays a distinct segment product and an enormous money-burning enterprise for Meta CEO Mark Zuckerberg, the technology is proving to be precious in certain corners of health care. Kettering Health Dayton is one in all dozens of health systems within the U.S. working with emerging technologies like VR as one tool for helping doctors to coach on and treat patients.
The broad category of “prolonged reality” includes fully immersive VR headsets just like the Quest 2, and augmented reality (AR) devices, where the user can see a digital overlay on top of real-world surroundings.
Whether the nascent technology can ever be cost-effective across the medical industry could be very much an open query, but early tests are showing the potential utility of VR in helping to enhance health outcomes.
Meta, then referred to as Facebook, entered the market with the acquisition of Oculus in 2014. Three years later, the corporate introduced its first stand-alone headset. In 2021, Facebook rebranded as Meta, and Zuckerberg committed to spending billions, betting the metaverse can be “the following chapter for the web.” Because the starting of last 12 months, Meta’s Reality Labs unit, which develops the corporate’s VR and AR, has lost over $21 billion.
Apple is preparing to enter the VR market, going after the higher-end user with the $3,500 Vision Pro that is expected to debut early next 12 months. Meta is slated to release the Meta Quest 3 as soon as next month.
An Apple spokesperson didn’t provide a comment on potential uses in health care and directed CNBC to an announcement in June regarding Vision Pro’s software developer kit. In that announcement, Jan Herzhoff, Elsevier Health’s president, is quoted as saying that her company’s Complete HeartX mixed reality offering “will help prepare medical students for clinical practice through the use of hyper-realistic 3D models and animations that help them understand and visualize medical issues, resembling ventricular fibrillation, and apply their knowledge with patients.”
Meta Quest 3 VR headset.
Meta
Prolonged reality as treatment for patients
So far, one in all the first applications of VR in health care has been targeted at pain treatment.
“It’s totally hard to maintain track of pain whenever you’re in a fantastical cyberdelic world,” said Dr. Brennan Spiegel, director of health services research at Cedars-Sinai in Los Angeles.
Spiegel said that when someone is injured, there may be each a physical and an emotional component to their pain. Those signals are sent to 2 different parts of the brain, and VR can serve to tamp down the signals in each regions.
“It’s training people modify their highlight of attention so that they can swing it away from the painful experiences,” Spiegel said. “Not only the physical, however the emotional experiences.”
Spiegel said Cedars-Sinai is preparing to launch a virtual platform to assist individuals with gastrointestinal issues like Crohn’s disease, celiac disease or acid reflux disease, in addition to others for anxiety, addiction and perimenopausal health.
The technology has also attracted the eye of the U.S. Department of Veterans Affairs, which is using prolonged reality at greater than 160 facilities to assist patients with pain management, behavioral therapy and each physical and cognitive rehabilitation.
Caitlin Rawlins, the immersive program manager on the VA, said there are currently greater than 40 separate use cases for the technology across the agency’s different sites. The VA first introduced prolonged reality in a limited capability around 2015, and has found more opportunities to place it to make use of because the technology has improved.
“I’ve seen it change an entire lot,” Rawlins told CNBC in an interview. “The primary virtual reality headset that I used was this big clunky headset that had all these wires it needed to be connected to a laptop to operate.”
Rawlins said what drew her to prolonged reality was seeing the immediate response from patients. She recalled the primary time she watched a patient use VR. He was a person in his 80s who had just undergone knee alternative surgery. The pain was so severe that opioids didn’t help, Rawlins said.
After mere minutes in VR, he told Rawlins he couldn’t feel the pain in his leg anymore.
“Just using that for an easy 30-minute session can mean the difference between excruciating pain, unable to do the exercises and the ambulation that they should, to really stand up and move and prepare to go home,” she said.
Rawlins described one other patient as a “surly” wheelchair-bound Army veteran who was experiencing some cognitive decline. The VA had the patient try VR to see if it could lessen the necessity for antipsychotic medications.
With the headset on, Rawlins had the patient navigate through a virtual nature scene, walking through the woods, climbing rocks and interacting with birds and deer. Rawlins said the patient was smiling and laughing and was transformed right into a “completely different person.”
“To see a patient who has been wheelchair-bound for like 15 years attending to walk through the woods and interact with animals again, it was a reasonably powerful moment,” Rawlins said. “Those are the type of experiences that we keep seeing again and again and once more.”
Each Spiegel and Rawlins said their organizations are hardware agnostic, meaning they will use headsets made by Meta, Apple or another company so long as they will support the suitable software.
Spiegel said there’s “potentially tens of millions and tens of millions of people that is likely to be willing to really buy a headset” but who see them as a gaming and entertainment devices and do not know concerning the health applications.
Meta has loosely identified health care as a goal market. The corporate has released case studies and promoted short videos depicting futuristic surgeons in training.
Nevertheless, it doesn’t seem like as much a priority as gaming and entertainment. For instance, while Cedars-Sinai can technically make its software available within the Meta Quest Store, users would should go to a bit of the shop called the App Lab to access it. Software within the App Lab will not be marketed traditionally or as easily discoverable via search.
Meta didn’t provide a comment, directing CNBC to a post on Sept. 7, about uses of metaverse technology. The post says: “Training for surgery is just one in all the numerous industries being transformed in ways which can be positively impacting lives.”
‘Together within the virtual world’
Doctors at Kettering Health Dayton practice with VR headsets.
Source: Kettering Health Dayton
The technology can also be becoming a fixture in lots of medical schools and residency programs.
At Kettering Health Dayton, VR recently became a compulsory component of the curriculum for first-year orthopedics residents. In July, the brand new doctors accomplished a monthlong “boot camp,” where they carried out clinical services within the mornings and practiced in VR within the afternoons. They now have to finish no less than three modules per week in VR with a rating of over 70%.
For more senior level residents like Shine, VR training will not be yet mandatory, but Kettering Health Dayton is actively working to construct it into each level of this system.
“The way in which I trained within the late 80s, I mean, principally you read the books,” said Dr. Brent Bamberger, the director of the orthopedic surgery residency program at Kettering Health Dayton. “We did not have the videos at the moment. Chances are you’ll go to a lecture, chances are you’ll get lucky and have a specimen lab or some kind of lab to do it, but you were learning by watching.”
Dr. Reem Daboul, a first-year resident on the hospital, said headsets cannot replicate the physical feeling of a procedure. But she’s found them very useful in necessary ways. She will already use a headset to walk through the steps of an anterior hip alternative, which many orthopedic surgeons don’t learn until their third 12 months of residency or later.
“With the ability to have something help me and see what I’m presupposed to be doing and have the ability to walk through the steps, it has been super helpful for me,” Daboul said in an interview.
For its orthopedics program, Kettering Health Dayton uses software developed by PrecisionOS, an organization that builds VR modules for training surgeons, medical residents and medical device representatives. PrecisionOS co-founder and CEO, Dr. Danny Goel, said the corporate has nearly 80 customers across the globe.
Orthopedics residents on the University of Rochester also use PrecisionOS. Dr. Richard Miller, a retired professor on the university, said the software is “sophisticated” and “very realistic,” especially as a strategy to learn the steps of a procedure. He finds it so compelling that he’s been actively helping the orthopedics department implement the technology despite the fact that he retired three years ago.
Miller said the VR is a useful way for residents to hone their skills without having to instantly cope with operating room pressures. They may also practice at home.
“I might be at home in my study at night, they usually might be of their dorm at night, and we will do a procedure together within the virtual world,” Miller said.
Despite VR’s benefits, Miller said the software has to have the ability to update ceaselessly to remain current with standards of care, best practices and surgery techniques.
“Next 12 months, they might change the procedure slightly bit, now you’ve gotten other tools and things are slightly bit different. Who’s going to alter that? Who’s going to bring it up thus far?” Miller said.
Those are necessary questions for quality of care. They’re also necessary because hospitals generally should work on tight budgets, and the prices aren’t all the time clear.
“I am unable to get straight answers from anybody, really, as to precisely how much it costs and who does what,” Miller said. “It’s got to be a hurdle.”
PrecisionOS declined to share specific pricing information with CNBC. Goel said costs of using the corporate’s software vary based on the institution and the partnership.
Kettering’s Bamberger said that along with the software challenges, the hardware remains to be fairly “clunky.” Others in his field also see the constraints.
Dr. Rafael Grossmann, a surgeon at Portsmouth Regional Hospital in Recent Hampshire, has spent much of his profession educating people about health-care applications for emerging technologies like prolonged reality.
In 2013, Grossmann became the primary person to make use of the infamous Google Glass during a surgery as a strategy to stream the procedure, with the patient’s consent, right into a room of scholars. Google had built a light-weight AR device that displayed tiny bits of data on a transparent screen within the user’s field of view. It was first sold to developers and early adopters in 2013 for $1,500, and quickly captured the imagination of tech enthusiasts.
But Glass never took off. The built-in camera led to fights over privacy, and the product became the butt of jokes on late-night television.
Ten years later, Grossmann said he now sees a considerable marketplace for the technology, particularly inside health care. He said headsets have improved dramatically, even in the event that they’re still bulky and never entirely functional for doctors.
“The interface is healthier than it was three years ago, however it’s definitely not ideal for really any type of health-care setting,” Grossmann said.
A gallery assistant wearing an Oculus Quest 2 virtual reality (VR) headset to view the House of Tremendous Art (HOFA) Metaverse gallery stands in front of digital artwork “Agoria, _{Compend-AI-M}_ 2022 #16” during a preview in Mayfair, London, UK, on Thursday, Nov. 10, 2022.
Hollie Adams | Bloomberg | Getty Images
A growing area of research
As with all technology in health care, prolonged reality goes to should clear regulatory hurdles.
The U.S. Food and Drug Administration has a small team of researchers which can be accountable for carrying out “regulatory science” across the technology.
Ryan Beams, a physicist on the FDA, conducts this research alongside a team, consulting with a spread of experts about emerging AR, VR and mixed reality devices. Because of this, Beams said the FDA is in a position to help establish general best practices for test promising devices and produce them to market safely.
“We will say these are the tests we want done, these are the kinds of the way you need to do the tests, after which we may also help the businesses get through those,” Beams told CNBC. “What you don’t need is a tool that potentially could help someone getting delayed because there’s uncertainty about go about doing the testing.”
Spiegel of Cedars-Sinai also helped co-found a recent medical society called the American Medical Prolonged Reality Association in late 2022. He said it was created as a way for physicians, clinicians and other health-care professionals to assist guide the long run of the sector.
The society currently has about 300 paying members, a number Spiegel hopes will reach into the hundreds in the approaching years. It is also gearing as much as launch its first official peer-reviewed journal called the Journal of Medical Prolonged Reality.
“This will not be fringe science anymore. That is now mainstream,” Spiegel said. “There’s still a number of work to do. It isn’t like it is a done deal, cake’s not baked, but we have seen massive advances on many levels that make this an actual science now.”
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