In 1974, Star Trek’s animated series introduced its audience to the holodeck, a bit of futuristic technology that would eventually appear in multiple iterations of the science fiction classic from television programs to the big screen. This recreation room was designed to create simulated, alternative versions of reality. In this simulated world, crew members could engage with their virtual environment as if it was the real world. Sound familiar?
Today, you don’t need a full deck on a spaceship to experience an alternate reality. We have virtual reality headsets and augmented reality apps that run off our mobile phones. While there’s certainly a home for these applications as an entertainment medium, we are increasingly seeing the strength of extended reality (XR) as a health and wellness tool that can improve patient outcomes.
Before we can explore how this technology can improve quality of care, and thereby improve outcomes, we need to define the category. Extended reality is the umbrella term that encompasses all real and virtual combined environments. It includes:
- Virtual Reality (VR) – full immersion in a digital environment.
- Augmented Reality (AR) – overlays virtual objects on the real-world environment.
- Mixed Reality (MR) – anchors virtual objects in the real world. Objects here are not just overlaid into the real world–the real world can interact with these virtual objects.
Improving Quality Through Training
According to the Association of American Medical Colleges, a traditional med school curriculum combines two years of pre-clinical science training – where students learn basic medical concepts – with two additional years of clinical study. In these clinical study years, students are given hands-on experience with patients. Extended reality technologies add a new twist to this educational model. Virtual simulations of real-life medical scenarios allow students to make medical decisions in a safe environment before they engage with actual patients. Today’s technology isn’t a replacement for real-life clinical rounds, but it can be a good supplemental component that gives students an opportunity to prepare for direct patient engagement.
Improving Quality through Surgical Walk-Throughs
Imagine if your physician could walk through your surgery before you slip into a hospital gown the day of your procedure. Facilities like Stanford Medicine are using virtual reality to change the way physicians prepare for surgery. Stanford’s Neurosurgical Simulation and Virtual Reality Center feeds conventional MRI and/or CT scans into VR technology, which allows their physicians to see the brain in 3D and walk through complex procedures via a simulated surgery. This process can help mitigate any unexpected challenges the surgery may present.
Improving Quality through Surgery Guided by Extended Reality
In 2017, a team of researchers conducted a proof-of-concept study to explore the potential benefits of using augmented reality to superimpose digital images on top of the visual field during surgical procedures. In December of that year, a surgeon used an MR headset to access patient medical data and data of the operative technique during a procedure to implant a prosthesis into an 80-year-old patient. The surgeon was also able to share his field of vision with four additional surgeons via Skype, which would allow collaborative input during the procedure. The study’s authors concluded that, “surgical practice and education can derive significant benefits from the implementation of AR and MR tools in daily practice.”
Improving Quality Using Extended Reality as Treatment
A number of studies have looked at virtual reality’s value as a treatment for psychiatric disorders and pain management. Through the course of these studies, virtual reality has proven to be an effective tool, particularly, as noted in a systematic literature review published in Harvard Review of Psychiatry in 2017, “with the most strength of evidence for use in exposure therapy for patients with anxiety disorders, cue exposure therapy for patients with substance use disorders, and distraction for patients with acute pain requiring painful procedures.”
Looking to the Future
As with any medical technology, extended reality’s value lies in its application as a tool. Effective use, for example, in medical training lies in recognizing that virtual experiences don’t replace real-life patient interaction. Simulated experiences offer supplementary practice, not substitution. Applications that tap into extended reality’s strength in pre-surgical planning, pain-management, or psychiatric treatment require thorough physician training prior to use. Like any other medical tool, medical personnel must be trained on how to appropriately utilize the technology for the benefit of the patient.