New Directions for Virtual Worlds for Health


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Keynote presented at Games for Health, Boston, for the Virtual Worlds and Social Games Day, May 25th. (First three slides are to introduce the pre-conference. Rest are my talk.)

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  • What is the killer app
  • What is the killer app
  • What is the killer app
  • What is the killer app
  • What is the killer app
  • What is the killer app
  • We do know that practice for fire saved numerous lives.
  • New Directions for Virtual Worlds for Health

    1. 1. Virtual Worlds and Social Games for Health Day<br />Games for Health, May 25, 2010, Boston<br />Word Cloud design, courtesy<br />
    2. 2. Welcome!<br />This year’s theme - Convergence<br />An interactive day<br />Housekeeping<br />Evening reception<br />
    3. 3. Agenda<br />
    4. 4. New Directions for Virtual Worlds for Health<br />Parvati Dev, PhD<br />Innovation in Learning Inc.<br />
    5. 5. Let us stop and think about our direction …<br />What has succeeded<br /> Possible barriers<br /> Our solution / new direction<br />
    6. 6. Virtual Worlds are effective …<br />Entertainment and socializing<br />
    7. 7. Virtual Worlds are effective …<br />Tourism<br />
    8. 8. Virtual worlds are effective<br />Games and Quests<br />
    9. 9. Virtual worlds are effective<br />Mirror worlds<br />
    10. 10. Virtual worlds are effective<br />Perception<br />Attitude change<br />A study with residents and nurses at Stanford Hospital and San Mateo General Hospital<br />CBRNE simulation based on Forterra OLIVE<br />
    11. 11. Virtual worlds are effective<br />Learning<br />Med students learn interaction skills just as well in virtual environments as in physical ones.<br />A study with medical students and first year residents at Stanford.<br />ATLS (Advanced Trauma Life Support) Protocol<br />Pre-test and post-test student scores<br />Source: June 2007 Elsevier Saunders journal article “Virtual Worlds and Team Training” by Parvati Dev, Patricia Youngblood, W. LeRoy Heinrichs, and Laura Kusumoto<br />
    12. 12. If virtual worlds are effectivewhy isn’t their growth explosive?<br />
    13. 13. Sample comment<br />Stephen Manning<br />On Virtual Worlds Roadmap group, Linked In<br /><ul><li>Why do we need them?
    14. 14. Why is the average person going to incorporate them into their daily life?
    15. 15. I have spent a lot of time exploring SL, and … beyond the "gee-whiz" factor, why (are) these environments valuable to most people.</li></ul>and<br /><ul><li>These are all examples of uses for specialized, proprietary simulations.
    16. 16. I don't think these qualify as "virtual worlds" at least in a broad consumer sense.
    17. 17. Like most people, I'm not in the Army, an oil rig crew or the medical profession.
    18. 18. How do I apply this technology to make a mainstream consumer life better?</li></li></ul><li>Possible barriers, issues, mistakes….<br />
    19. 19. Are we targeting the right users?<br />Differentiate between users of MMOs and MMORPG<br />Even for MMOs,<br />there may not be a single enormous user base.<br />Many fragmented user segments.<br />Difficult to scale<br />Learners<br />Information seekers<br />Event attendees<br />Gamers<br />Federal agencies<br />……..<br />
    20. 20. Are there usability barriers?<br />Rich keystroke interface for gamers<br />Limited mouse/menu interface for others<br />“difficult to navigate”<br />“too many viewing options”<br />“long learning curve”<br />“can’t tell who is who”<br />“can’t tell who is talking”<br />Example: Medicine<br />Social gestures are of limited use.<br />Numerous specialized movements.<br />Numerous interactions with patient and with medical objects.<br />Example: Wii<br />Successfully supports laparoscopic surgery movements<br />Ideal: Camera captures and translates gestures and body position into actions in world.<br />
    21. 21. Are there content barriers?<br />Every object must be modeled – or purchased.<br />Every behavior must be animated.<br />(Some behavior support from physics and from artificial intelligence – navigation, crowds)<br />Interaction between objects needs synchronized animations.<br />Very very time consuming.<br />Example: Defibrillation, or CPR<br />Example: Patient deterioration<br />Ideal: Much more procedural or simulation-based generation of behavior and emotions<br />
    22. 22. Are there deployment barriers?<br />Example: Hospital<br />A multi-user client server system raises numerous issues:<br /><ul><li>Server installation and setup is a technical task
    23. 23. An external third party-maintained server must be accessed through a firewall
    24. 24. Ports must be opened
    25. 25. May require a separate VPN from network with patient data</li></ul>Browser-based server access reduces some, but not all, the problems.<br />Graphics cards are an issue.<br />
    26. 26. Are there cost barriers?<br />Costs are both explicit and hidden.<br />Enterprise sales<br /><ul><li>High initial cost of acquisition
    27. 27. High development and maintenance cost</li></ul>Individual or lab sale<br /><ul><li>Low subscription or free model
    28. 28. Cost of virtual goods and land
    29. 29. Unpaid cost of labor</li></ul>Event sale<br />- Configuration costs<br />Example: Medicine<br />Need off-the-shelf preconfigured medical spaces<br />Example: Conferences<br />Some good meeting spaces<br />
    30. 30. CliniSpace™<br />A Virtual Medical Environment for Learning<br />
    31. 31. Issues addressed<br />Are we targeting the right users?<br />Are there usability barriers?<br />Are there content barriers?<br />Are there deployment barriers?<br />Are there cost barriers?<br />
    32. 32. Briefing Room and Hospital(CliniSpace™)<br />
    33. 33. Urgent Care and Ward(CliniSpace™)<br />
    34. 34.
    35. 35. Virtual Patient (DynaPatient™)<br />
    36. 36.
    37. 37. Goal<br />A 3D realistic immersive environment<br />Easy for non-gamer to install and use<br />Runs on commodity computers ________________<br />Avatars of normal everyday people<br />Accurate portrayal of medical environment, procedures, scenarios<br />Accurate patient pathophysiology<br />Web access to amplify functionality of environment<br />Scalable expandable environment based on a modular platform<br />
    38. 38. DEMO<br />CliniSpace™<br /><ul><li>Environment set up ahead of time. Traverse reception, locker room, ED. (LeRoy, Ashima, do the same.) Set up patient B and run till first bleed. Pause. Return to reception for demo.
    39. 39. Test that it projects correctly. Test for audio (of patient).
    40. 40. Open and test skype. … hold here ..
    41. 41. Transfer to CliniSpace window from powerpoint.
    42. 42. Introduce LeRoy, Ashima
    43. 43. Show navigation. Look around reception. Move into hall. Show patient board. Enter conference room.
    44. 44. Explain briefing function of room. Also access to slides and pre-stored movies. Explain open-endedness through web access. Mention telephone.
    45. 45. Teleport toUrgent Care
    46. 46. Look around. Click on IV, cabinets, to show menu access.
    47. 47. Explain that patients are launched through control panel. Can be paused, resumed, changed.
    48. 48. Launch a patient in bed A. Show bed control, patient on side, history, physical, “Ouch”.
    49. 49. Show monitor. Give fluids. Point out bag. Give vasopressor.
    50. 50. Walk over to bed B. Explain that patient is paused. Resume simulation. Explain that the bleeding cannot be stopped by pressure etc. If Urgent Care cannot stabilize and treat, surgery option is available.
    51. 51. Thank everyone and ask for questions.
    52. 52. Close the demo and return to powerpoint.</li></li></ul><li>New directions<br />Barriers or Issues<br />Solution<br />Function<br />Target<br />Users<br />Usability<br />Content<br />Scalability<br />Deployment<br />Cost<br />Training<br />Sim Center, Hospital Administration<br />Healthcare professionals<br />Direct manipulation, easy navigation<br />Authentic realistic spaces/patients<br />User generated content (scenarios)<br />Commodity computer; browser access<br />Low barrier to entry - subscription<br />
    53. 53. Conclusion<br />When will we deal with BIG problems?<br /> – medical or other<br />Nationwide deployment of EHR<br />The obesity epidemic<br />Quality and safety in hospitals<br />Patient at the center of care<br />Aging population<br />And their basis remains:<br />Simulation<br />Training<br />Social networks<br />Engagement and fun<br />
    54. 54. Thank you!<br /><br />Innovation in Learning Inc.<br />
    55. 55. ABSTRACT:<br />Scenario-based learning, using virtual patients in 3D immersive environments, has been shown to be effective in changing attitudes and behaviors in medical environments. However ease of use and ease of access has limited the usage of this tool, while onerous pricing models have deterred exploration of useful medical applications. We reviewed the literature as well as verbal and written feedback from learners using our prior implementations of virtual environments. Negative feedback fell mostly into two categories: System (lack of adequate graphics computing in the installed base of computers and difficulty of installing software through a firewall) and Usability (steep learning curve and too many options). We also examined IT policies at medical institutions, pricing models in use for virtual worlds, and potential high priority training issues in the health care system. We will present our findings and discuss possible new directions for virtual worlds in health. We will then present some of our own work in developing a new 3D, browser-based immersive environment platform, CliniSpace, in response to the issues above. <br />