Webinar Examines VR's Role in Medicine

That was the case made by Brennan Spiegel, MD, MSHS, Cedars-Sinai's director of Health Services Research, at a June 30 webinar he hosted on the use of virtual reality (VR) in healthcare.

"VR can flip desktop medicine on its head," said Spiegel, during his opening remarks of the two-hour session, "Virtual Care: The Role of VR in an Unprecedented Time."

“In contrast to other technologies that require physicians to stare at screens in lieu of facing their patients, VR reminds doctors to focus on their patients and to consider their inner lives," said Spiegel. "It prompts doctors to consider the subjective nature of illness. And it can enable patient-centered dialogue and shared decision-making."

Virtual reality, often associated with computer games, is known for the oversize goggles users wear and the immersive artificial environments that the technology creates. But Spiegel, author of a forthcoming book on virtual therapeutics titled VRx, called medical VR truly a social science and a behavioral science.

The ability of VR to engage patients and relieve their apprehensions was underscored during the webinar by another speaker, Robert Louis, MD, a neurosurgeon and program director of the skull base and pituitary tumor program at Hoag Hospital in Newport Beach.

He pointed to his use of 3D virtual reality technology to enable his patients to fly through their own brains, getting a 360-degree view of their medical issues before undergoing surgery.

Louis also pointed out that VR is used by neurosurgeons to help prepare for complicated surgeries by exploring computer simulations of patients' brains before performing the actual operation. At Hoag, he said, nurses are donning goggles to practice VR meditation to relieve stress and avoid burnout. 

Pain relief has been one of the main uses of VR in medicine, and experts say there is vast potential for growth. Beth Darnall, PhD, an associate professor at Stanford University who researches the benefits of VR in pain management, noted that up to 100 million Americans are living with ongoing pain.

"We're all going to experience chronic pain at some point in our lives, if we're lucky to live long enough. So, this is a tremendous societal burden," Darnall said. She cited an estimate that chronic pain costs the national economy $635 billion annually in direct medical costs and lost productivity.

During a panel discussion at the end of the webinar, which was organized by Cedars-Sinai Virtual Medicine and sponsored by the healthcare firm AppliedVR, Spiegel asked why VR technology isn't yet being used more widely.

Probably the biggest obstacle that was cited: The federal government still doesn't directly reimburse medical providers for most VR treatments—although medical VR leaders are hopeful that situation will change.

The image of VR as a gaming technology gives hospital executives pause, too. "People look at this as a game versus a potential for pain management, a potential for empathy or to expose people to the operating room prior to procedures," said Kate Donovan, PhD, clinical director of Immersive Technologies for the Innovation Digital Health Accelerator at Boston Children's Hospital.

Courtney Cogburn, PhD, an associate professor of social work at Columbia University whose research includes the health consequences of racism, also faulted the very traditional academic approach being taken to adopting VR.

So far, she said, the attitude has been: "We need to get all that data and read all the papers to really feel confident deploying it." She noted the inroads VR is making into medicine, education and law enforcement, but suggested that more urgency is needed in getting the technology into the hands of people who can actually test it out in the field.

Cogburn, a pioneer in VR, is a co-creator of “1000 Cut Journey,” a 12-minute VR production that allows viewers to experience racism, and develop empathy, by being put into the shoes of Michael Sterling, a virtual Black character.

Other participants in the webinar were Brandon Birckhead, MD, a project scientist with Cedars-Sinai Virtual Medicine and Matthew Stoudt, co-founder and CEO of AppliedVR.

The webinar, the first in what is expected to be a series, was scheduled after Cedars-Sinai's third annual Virtual Medicine Conference, a two-day event, was canceled due to the COVID-19 pandemic.