The document presents an overview of BSA's VR projects in healthcare, focusing on four key XR initiatives aimed at enhancing user experience in areas such as cognitive rehabilitation, burnout prevention, chronic pain management, and autism support. It highlights insights gained from these projects, including the importance of user-centered design, accessibility, and feedback integration, as well as challenges faced in implementation such as budget constraints and technological familiarity. Key takeaways emphasize the need for adaptive, safe, and collaborative approaches in utilizing XR technology in clinical settings.

1. Shaping XR Experiences in Healthcare: Leveraging
User Experience and Feedback for
Enhancing Immersive Designs
Jose Ferrer Costa, MD, MsC
Innovation and Projects
Badalona Serveis Assistencials (BSA), Spain

2. Presentation Overview
1. Introduction and BSA´s VR Projects Overview
2. Four Key XR Projects - Insights and Lessons Learned
3. Key Takeaways
Enhancing Healthcare XR: User Experience
and Feedback in Immersive Design

3. 1. Introduction and BSA´s VR
Projects Overview
From Clinical Practice
to XR Innovation at BSA

4. 2001: FM resident
2009: MsC in TCM 2021: VR in Healthcare
2019: VR Initiation 2022: VR Research in BSA
The Future

5. The Expanding VR Projects at BSA

6. 2. Four Key XR Projects
Insights and Lessons Learned
Burnout Prevention: From metaverse to standalone VR
Cognitive Rehabilitation: Adapting for seniors with MCI
Chronic Pain Management: Interactive design for patients
Autism Support: Co-design for sensory inclusivity

7. 4 Key XR Projects
Cognitive Rehabilitation:
● MCI: 360° videos,
interactive tasks
● SUS 81.25; Cognitive
improvement trends
Projecte Benestar:
● Burnout: Standalone VR
sessions for healthcare
professionals
● Pilot Published in JMIR-
XR
REDOCVR:
● Chronic pain:
Psychoeducation,
mindfulness,
kinesiophobia
● SUS 84.87; 85%
satisfaction
Autis+:
● ASD: Nutritional
education & transition
training
● Early engagement; co-
designed

8. From Pilot to Action:
Projecte Benestar
Mindfulness
Emotion Management
Self-compassion

9. Pilot 2022-23 Results (n = 83)
Publication JMIR XR
Maslach Burnout Inventory

10. Video - BSABenestarEnvironments

11. Evolution from Metaverse World to VR Standalone
Initial Challenges
● Metaverse-Based World
○ Dependent on AltspaceVR and internet connectivity
○ Impractical in clinics with no Wi-Fi
○ Time constraints for busy healthcare workers
○ Platform shutdown disrupted access
The Redesign
○ Developed standalone VR content
○ 8 sessions for mindfulness and emotion management
○ Offline access, optimized for clinical use
○ Accessible, flexible and reliable for healthcare setting

12. Real-Life VR Integration for
Mild Cognitive Impairment Rehabilitation
Pilot Objective:
Assess Feasibility of VR use in MCI cognitive
rehabilitation. n= 45 participants.
Approach:
VR exercises & 360° videos enhancing
cognitive function and social interaction
Continuous Content Adaptation: Regularly refined
VR content for enhanced safety, immersion and
participant comfort
Findings:
High satisfaction and preference for VR
Professional endorsement of VR's integration

13. Both SUS scores were high:
The VR headset - 86.5
The VR content - 81.25
The orange and red dashed lines
represent the average and excellent
usability thresholds
Both scores are above the "excellent"
usability threshold of 80.3, indicating
high usability ratings for both
components
https://clinicaltrials.gov/study/NCT06155721
Pilot on Acceptability and Usability

14. Clinical Outcomes: Pre and Post Pilot
The cognitive RHB showed a positive trend though results were not
statistically significant
Pre- and post-intervention medians for cognitive tests with 38 out of 45 participants

15. Onboarding VR with Relaxation
Initial Engagement through Calming VR Experiences

16. 360 Video Badalona

17. Focused Interactions - Safety - Accessibility
Step-by-Step VR Integration
Visuospatial Tasks

18. Task-Specific Immersive Environments

19. Inclusive interactive Settings
HIGH TECH -HIGH TOUCH

20. Interactive Environments
Transferable skills

21. Iterative Design in VR:
Adapting to Feedback for Senior Safety and Engagement
Initial Design: VR supermarket task required bending
down, posing safety risks
-> Redesign: Introduced a basket on a table to ensure
accessibility and safety

22. RedocVR - Chronic Pain Management in Primary Care
VR Sessions - Empowering patients with skill-
building in mindfulness, emotion management and
self-compassion techniques
VR and AR Interactive Games for Guided
Exercises - overcoming kinesiophobia through
immersive engagement

23. Multicentric Pilot: 20 chronic pain patients across 3 primary care centers
https://clinicaltrials.gov/study/NCT06361706
Key Results:
Usability: SUS score 84.87 (high usability)
Satisfaction: Average satisfaction 85%
Preliminary Clinical Outcomes:
Improvements in emotional well-being (HADS) and
Euroqol

24. RedocVR - Chronic Pain Management in Primary Care

25. RedocVR - Insights
Technical Skills Gap: Professionals
struggled with VR/AR setup
Safety in Groups: VR posed risks,
especially for mobility issues
Workflow Barriers: Wi-Fi
dependency slowed adoption
Training: Role-specific support
reduced frustration
AR in Groups: Safer and practical
for therapy
Offline Setup: Simplified workflows
ensured adoption
Challenges Lessons Learned

26. RedocVR - Insights
Adoption Hurdles: Frustration risked
tool abandonment
Feedback: Improvements boosted
usability
Controller Complexity: Non-intuitive
for patients
Hand Tracking: Intuitive and more
accessible
Challenges Lessons Learned

27. Autis+: Co-Design for Sensory Inclusivity in ASD
Subprojects
NutriVR
Interactive game teaching healthy food choices.
Uses gamification to engage children with ASD in real-life decision-
making tasks.
TransiTEA
360° video-based VR tool designed to train and ease transitions for
children and adolescents with ASD.
Focuses on reducing anxiety and improving adaptability in new
environments.

28. NutriVR - VR gamification for nutritional education

29. NutriVR Design Process
Therapist Testing: Refined
activities for therapeutic goals
Iterative Validation: Tested with
users; integrated feedback
Usability Fitting: Adapted
for comfort & accessibility
Stakeholder Engagement:
Presented to community and
autism representatives
Parent Co-Design: Tailored
content with parental feedback

30. Optimizing NutriVR Content
Sensory Adaptation: Adjustable visuals and sounds
Inclusive Design: Hand tracking, intuitive interactions
Therapeutic Alignment: Gradual pacing for hypersensitivity
Stakeholder Input: Iterative feedback from parents and
therapists
Predictability: Familiar, consistent environment

31. Optimizing 360o Videos for VR Headsets in TransiTEA
Key Considerations
1. Frame Rate: Stable 90 FPS reduces motion sickness
2. Resolution: Balance clarity with performance to maintain FPS
3. Sensory Settings: Customizable brightness and contrast to prevent overstimulation
4. Gradual Exposure: Versions with increasing sensory complexity for user adaptation
5. Supervision: Guided use to ensure comfort and safety

32. 3. Key Takeaways

33. Key Insights Across XR Projects
User-Centered Design
Training and Support
Usability and Accessibility
Collaborative Approach
Safety and Adaptability
Practical Integration
Data Privacy

34. Main Challenges in VR Implementation in Healthcare
Budget Constraints in
Public Healthcare
Addressing Safety
Concerns
User Familiarity
with Technology
1 2 3

35. Budget Constraints in Public Healthcare
Institutional and Professionals Support:
- Key Protagonist as directive board and final
users
Collaborations:
- Alliance to bring VR technology and develop
interactive experiences for patients
Financing:
- Grants or Donations
- Research Projects

36. 1. Custom Intuitive Content
2. Gradual Sensory Exposure
3. Supervision and Immediate Support
4. AR: Safer for Groups
Addressing Safety Concerns

37. Encouragement and Support
1. Orientation and Pre-briefing
2. Familiarization Sessions
3. Simplified Interface - Intuitive Design
4. Continuous Supervision and Support
“Hight Tech - High Touch”
5. Iterative Adaptation
User Familiarity with Technology

38. Thank you!
José Ferrer Costa MD
jfcosta@bsa.cat