First VR Symposium Peers into Healthcare Future

Once the stuff of science fiction, the immersive and multisensory world of virtual reality (VR) is working its way into mainstream medicine with the promise of drug-free treatments for an assortment of vexing health problems.

Yet important challenges—while easily overshadowed by the enthusiasm surrounding VR—need to be addressed, said Brennan M. Spiegel, MD, MSHS, director and founder of the first annual Virtual Medicine Conference held at Cedars-Sinai on March 28-29.

"We have to be careful about what we promise our patients in terms of what VR technology can achieve," Spiegel told the international audience of about 300 VR pioneers, health professionals, entrepreneurs and patients who attended the two-day symposium. "The key is to talk to patients to find out what works and what does not work."

Virtual medicine pioneer Skip Rizzo, PhD, has been pondering that question since getting his start in VR in the mid-1990s. Back then, the equipment was costly and cumbersome. But in the ensuing years, competition among companies targeting the consumer market has brought affordable, high-quality VR technology to the masses.

"There's no doubt that the public…is getting a taste of VR," said Rizzo, who heads Medical and Virtual Reality at USC's Institute for Creative Technologies. 

And as VR becomes more common, Rizzo predicted consumers will begin demanding it from their healthcare providers.

"When VR headsets become like toasters—everyone has one—then people may expect to use it in their healthcare," he said.

Until then, the main forces driving innovations include the prospect of a multibillion-dollar virtual medicine industry supported by headline grabbing studies that have shown—among other things—that VR can help burn victims manage extreme pain, stroke patients achieve fast-track recovery and also help veterans heal from post-traumatic stress.

What's more, studies suggest VR therapy not only increases patient satisfaction, it can save money. It can do so by reducing resources needed for care and by shortening a patient's length of stay, thereby improving the overall experience, said Spiegel, a professor of Medicine.

Doctors, too, are likely to benefit, as developing VR technology may soon allow them to conduct surgical dry-runs on an avatar of a real-life patient, said speaker Rafael Grossman, MD.

"It's the possibility of getting real patient anatomy, real patient data from CTs, MRIs and radiological studies, into the VR picture and then practicing on that patient's vertebra and spine over and over and over before you open the (real) patient's back," Grossman told the audience.

In one session Grossman led about the future of surgery and surgical training, he shared his enthusiasm over medical holography—technology that allows doctors to interact with a patient's three-dimensional anatomy as it floats in the air, like a scene out of Star Wars.

Even empathy may become teachable, according to renowned digital health and medicine researcher Daniel Kraft, MD, head of the medicine track at Singularity University. He spoke of a Tele-Empathy device that wirelessly captures and transmits real-time patient tremors—such as those a person with Parkinson's disease might experience—to an electrical arm band that a doctor or other caregiver could wear.

The hope of battling the nation's opioid epidemic with virtual therapies was another major theme of the conference.

Aenor J. Sawyer, MD, an orthopaedic surgeon practicing at UCSF Medical Center discussed its potential use as a drug-free option for patients who require orthopaedic surgery.

"We in the orthopaedic world are part of the problem," she told the audience, adding that orthopaedic surgeons are the No. 4 prescribers of opioids. "We feel responsible and want to get proactive behind it."

One way to do that, she said, is by integrating pain-blocking VR therapies that work by essentially tricking the brain into thinking it's in the virtual world, and thus diverting the patient's attention away from the pain.

Speaker Ted Jones, a pain psychologist from Tennessee, shared findings from a 30-person study he conducted to measure the impact of virtual reality on chronic pain. Patients were asked about their pain during and after a five-minute VR session. The study suggests pain was reduced by 60 percent during the session and by 33 percent after the VR therapy was over.

Similarly, studies suggest VR is an effective treatment for a number of mental health disorders.

Today's sophisticated VR technology has helped expand its use from a tool to treat phobias—such as fear of flying or fear of spiders—to the more complex treatment of PTSD in veterans, Rizzo told the group.

At USC, Rizzo's group created a form of virtual reality exposure therapy for veterans, called “Bravemind,” that uses virtual sights, sounds, movement and scent to re-create traumatic war-time events. Veterans who undergo this treatment do so with a therapist, he said.

"At first it sounds like torture, but basically, it's helping a patient to control and process difficult emotional memories in a safe environment," Rizzo told the group. "They're narrating their experience, and the clinician can control all the elements that are in the simulation in real-time from a Wizard of Oz control panel."

In his closing remarks, Spiegel said connecting virtual therapies to electronic health records will be essential before VR can secure a foothold in national healthcare.

"We're just not going to get there if we don't build it into the backbone of modern Western medicine," he said. "And we have not seen this happen yet."