Downloaded 16 times
Uploaded byStanford University
Walter Greenleaf - The Impact of XR Technologies on Medical Research and Healthcare
VR and AR technologies will significantly impact healthcare by enabling: - Prevention and wellness programs, objective assessments, functional training, improved interventions, increased treatment adherence, and distributed care delivery. These technologies are being applied in many medical areas including clinical training, cognitive assessments, rehabilitation, pain management, and mental healthcare. Over 200 companies are developing medical applications of VR/AR that target specific clinical areas and indications. Widespread adoption will depend on further research demonstration effectiveness and addressing barriers such as technology limitations and integration into clinical workflows.
More Related Content
Similar to Walter Greenleaf - The Impact of XR Technologies on Medical Research and Healthcare
Walter Greenleaf - The Impact of XR Technologies on Medical Research and Healthcare
- 1. The Impact ofXR Technologies on Medical Research and Healthcare Walter Greenleaf PhD
- 2. The Next ComputerPlatform Work Play Educate Socialize Shop Entertain Communicate Etc
- 3. XR Technologies Currently Disrupting Education& Training Manufacturing Maintenance Product Design Process Design Healthcare Simulation & Modeling
- 4. XR Technologies andHealthcare The Digital Health Revolution Emerging and Confluent Technologies Overall Landscape of XR Technologies Neuroscience – Why XR Has Impact History of VR - and Why it Matters Current Status – Where There is Traction Future Perspective and Predictions
- 5. VR + AR+ MR = XR
- 6. • Prevention andWellness • Objective Assessments • Functional Training • Improved Interventions • Facilitate Adherence • Distributed Care Delivery XR technology will significantly impact Medical Care
- 7. Medical XR CanAddress Several Key Problems Annual cost of problems in the U.S. alone: WEIGHT LOSS $289B SMOKING CESSATION $528B ADDICTION $181B CHRONIC PAIN $635B POST TRAUMATIC STRESS $300B Stroke & TBI $86B Alcoholism $223B Autism $126B
- 8. The Stanford Laboratoryfor Brain Health Innovation and Entrepreneurship VR-IT Stanford Virtual Reality Immersive Technology Clinic Academic Affiliations
- 9.
- 11. Healthcare Crisis: Aging Populations 0 50 100 150 200 250 300 350 400 19001910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2015 2020 2025 Age 85+ Age 75-84 Age 65-74 Age 45-64 Age 5-44 Under Age 5
- 12. Transforming HealthCare withTechnology
- 13. Digital Health Revolution • MobileHealth / eHealth • Machine Learning • Wearable Sensors • Patient Centered • Leverages Internet: social, quantitative, collaborative
- 14. Every Medical DeviceReinvented
- 15. Entering the Eraof Medical Wearables
- 16. Digital systems arenot just measuring the physical parameters of our health. New methods are being developed that will allow us to collect and analyze biomarkers that reflect our cognitive and emotional status. Here are four examples… Brain Health BioMarkers - Passive Data from Smart Phones Voice Analytics as a BioMarker of Depression Facial expressions in response to a VR Challenge Cognitive function assessment using AR and smartphone sensors
- 17. Digital Health Platformsdeliver interventions to patients, and parse data for enhanced analysis and improved protocols
- 18. Digital Twin Paradigm ForPrecision Healthcare
- 19. Medical Applications of VirtualReality & Augmented Reality (XR) Technology Digital Health Revolution
- 20.
- 21. 5G connections willsurpass one billion by 2023
- 22. Sensors Are Evolving,Connecting, Promulgating Sensors 1.0 Sensors 3.0 Sensors 2.0 Measure and record Integration with web; Sharing and accessing data Passive data gathering; Aggregation and meaningful interpretation
- 23. Ready or not… Thewearable tech, always on, always online world On the way - arriving soon.
- 24.
- 26.
- 27. Virtual Humans -Voice Recognition, Emotion Detection- Dynamic Response
- 28. Virtual Humans ForEducation, Training, Support “Smart Avatar” with a virtual voice, image and mannerisms via AI
- 29. Multi-User Transmedia InteractiveEnvironments
- 31.
- 34. VR and ARTechnology is Evolving Exponentially
- 35. 11.3 16.9 27.3 41.5 56.2 68.0 Year 2 Year3 Year 4 Year 5 Year 6Year 1 • Initial adoption has been driven through game console, PC gaming and mobile phone bundling. • Within 3 years, VR will likely be adopted by 30 million users. Within 6 years, XR will likely be adopted by 70 million users *Based on agent based modeling by Lieberman Research Worldwide
- 36. The Neuroscience ofHow VR Promotes Behavior Change VR can promote behavior change by taking advantage of the way our brain’s learning and reward systems function Activate neuroplastic change via reward systems Shorten the reward feedback loop – show progress Leverage mirror neuron systems VR systems can:
- 37. Ability to changeattitudes and behavior after “being” one’s future self. Leveraging Mirror Neurons
- 38. Neuroscience Rationale Repetition isrequired It is critical to engage the brain's reward systems It is necessary to activate the associated brain system to enable neuroplasticity
- 39. Addition Mechanisms ofImpact Active Involvement: XR systems provide users with immersive experiences that maximize cognitive engagement. Feedback: learning is reinforced by direct, immediate and relevant feedback that reinforces the experience and the lessons learned. Engaging and Motivating: the dynamic nature of VR/AR systems provides users with agency and can provide immediate rewards for progress. Team Training: Multiuser experiences can provide and leverage group skill building. Cost Effective: XR systems extend the reach and reduce the cost of face-to-face training. Novels Theater Film Games AR/VR
- 40. Wired for NarrativeStories Research shows that STORY: • Provides superior retention (memory and recall) • Provides improved understanding • Creates context and relevance • Creates empathy • Promotes engagement and participation • Enhances the creation of meaning and personal relevance
- 41. Current technologies andprotocols have benefited from more than 50 years of research and development. Medical VR Technology Has Evolved
- 42. First general purpose andcommercially available VR systems. VR Technology Has Evolved 1987
- 43. My 35 YearJourney…. 1984 – Stanford University
- 44. Mitigating Post Traumatic Stress WithVirtual Reality 2008 Sichuan Earthquake 11 Years Ago
- 45. Now is thetime for VR & AR XR technology is now affordable, scalable and accessible Facebook - Oculus HP - Reverb Sony – PlayStation VR Microsoft - HoloLens HTC - Vive Google - DayDream
- 47. Academic research hasindicated that Virtual Reality can effectively treat a wide variety of clinical problems – ranging from addictions, to stroke, to PTSD
- 48. • Prevention andWellness • Objective Assessments • Functional Training • Improved Interventions • Facilitate Adherence • Distributed Care Delivery VR and AR Technology Impacts All Sectors of HealthCare
- 49. Why use XR? UniquelyCapable Extension of existing virtual capabilities Intuitive “spatial” language natural interactions streamlines engagement Deeply Personal Learning content made meaningful through user’s interaction & feedback Immersion enhances engagement, retention Making experiences “personal” drives motivation to learn & keep learning Highly Functional Experimenting with systems & concepts to better understand Applying learned concepts in practice Can do things are otherwise expensive or impossible -e.g. due to safety/cost
- 50. Acute Pain Addiction Medicine ADHD Anxiety Management Autism Spectrum Disorder ChronicPain Cognitive Assessments Depression Disability Solutions Emergency Medicine Medical Education &Training Ophthalmology Orthopedics Palliative Care Patient Education Phobias PTSD Physical Medicine and Rehabilitation Preventive Medicine Respiratory Medicine Senior Care Stroke & TBI Surgical Procedure Planning Surgical Skill Training Uncomfortable Procedure Mitigation More Than 200 Emerging Medical VR/AR Companies Targeting Multiple Clinical Sectors and Specific Indications
- 51. • Prevention andWellness • Objective Assessments • Functional Training • Improved Interventions • Facilitate Adherence • Distributed Care Delivery VR and AR technology will significantly impact Medical Care
- 52. • Clinical SkillTraining • Surgical Skill Training • Interpersonal Skill Training • Use of Equipment and Tools • Team Training - eg: Emergency Department, Surgical Team • Emergency Response Training and Rehearsal • Facilitate Empathy Medical Training
- 53.
- 54. Anatomy and PhysiologyTraining • Response to the acute shortage of human cadavers • Allows for repetitive training and self-study • More detailed examination of micro- features of organs, tissue etc. • Integration of text, video and other media to further enhance learning
- 55. Virtual Patients forClinical Skill Training
- 56. Preparation and Trainingfor Difficult Situations
- 57. Empathy for thePatient Experience Clinical Training
- 58. Patient Education &Informed Consent
- 59. • Prevention andWellness • Objective Assessments • Functional Training • Improved Interventions • Facilitate Adherence • Distributed Care Delivery VR and AR technology will significantly impact Medical Care
- 60. • Medical ImageReview • Neuropsychological Assessments • Activities of Daily Living Assessments • Physical Medicine – OT / PT • Behavioral Medicine – psychology, psychiatry DIAGNOSTIC ASSESSMENTS
- 61. Standardized Environments forNeurocognitive Evaluation New Approaches for Cognitive Assessment Migrates traditional paper and subjective evaluations to a more sophisticated level. Provides robust assessments that can challenge cognitive skills in a more natural, standardized, objective and reproducible manner.
- 62. Cognitive function assessmentat the primary care level – using AR and smartphone sensors 10 minute test Diagnostic accuracy of 94% FDA Class II Medical Device Continuous data of everyday functions 250 features assessed at 300Hz 3D trajectory neuromotor parameters
- 63. BioMarkers - Cognitiveand Emotional State Collecting and analyzing emotional and physical responses in VR
- 64.
- 65. Standardized Environments forNeurocognitive Evaluation New Approaches for Cognitive Assessment
- 66. We use braincircuit biotypes to connect brain imaging with VR Neuroimaging measures 1. Scan brain at rest 2. Emotion regulation task 3. Cognitive control task Virtual Reality: 1. Relaxing scene 2. Emotion regulation task 3. Cognitive control game
- 67. We envision aprecision health model using VR to elicit biotypes to help refine the intervention choices Cognitive training TMS Eliciting biotypes using normed environmentsHeterogeneous Disorder Quantify and refine biotypes Relaxation Negative Scene Positive Scene Cognitive Game 1st line Antidepressants Mindfulness-based. TMS Non-drug and new drug options Matching biotypes to the intervention “menu” Default Mode Negative Affect Positive Affect Cognitive Control
- 68. With corresponding ratingsof arousal, emotional valence, and other measures A Public Database of VR Environments
- 69. • Prevention andWellness • Objective Assessments • Functional Training • Improved Interventions • Facilitate Adherence • Distributed Care Delivery VR and AR technology will significantly impact Medical Care
- 70. Some Examples –VR and AR in Use Today
- 71. Preoperative Planning &Image Guided Surgery
- 72. Stroke and TraumaticBrain Injury Physical / Occupational Therapy New Approaches to Physical Medicine & Rehabilitation
- 73. New Approaches toMental Health
- 74. VR for PainDistraction Clinical Research and Validation Interactive virtual environments significantly reduce pain from as much as 44% during the most painful procedures (ex: burn wound treatment) Diverts patient attention away from perceiving and feeling pain; (selective attention theory) Decreases pain-related brain-activity Reduces need for anesthesia, opioid medication No pharmacological side effects
- 75. PTSD, Phobias, AnxietyDisorders • Exposure-based treatments can be conducted in the safety and comfort of an office setting • Effective tools for treating a variety of clinical problems, in particular anxiety and addictive disorders • Fully immersive environments, with include the use of a head mounted display, 3D sound, tactile stimulation via shaking platform, and olfactory stimulus are used for PTSD therapy
- 76. RISK AVOIDANCE TRAINING Refusalskill training, Situational Confidence
- 77. § Generalized AnxietyDisorder § Phobias § Obsessive Compulsive Disorder § Anger Management § Eating Disorders § Schizophrenia Virtual environments are used clinically to treat several important mental and behavioral health problems
- 78. • Social AnxietyDisorder • Depression • Mild Cognitive Impairment • Autism Spectrum Disorder • ADHD Virtual environments are used clinically to treat several important mental and behavioral health problems
- 79. Virtual Hospital ToursUsed To Relieve Pre-procedure Anxiety
- 80.
- 81.
- 82. • Improve CognitiveFunction • Promote Exercise & Weight Management • Stress Management • Mood and Resilience HEALTH AND WELLNESS • Disability Solutions • Addressing Isolation • Grief Counseling
- 83. Ability to changeattitudes and behavior after “being” one’s future self. Have a Dialog With your Future Self
- 84.
- 85. What Are TheConstraints? What are the gating-steps to adoption?
- 86. Body of literatureis expanding with encouraging results, But remains insufficient Available research varies by condition treated Lack of randomized controlled trials Population-specific studies Obsolete platforms and equipment Small sample sizes Research Gaps
- 87. Perception of VRas a Gaming Platform
- 88. Full practices –no need to attract new patients Evidence-based treatments are already available Products need to be aligned with healthcare system needs What is the financial and time benefit? Does it interfere with the clinic workflow?
- 89. Rapid evolution =fears of obsolescence Mobile / PC-Based vs. All-in-One Graphics-based vs. 360 video Concerns over infrastructure needs Lack of IT support No Clear Technology Path – Too Many Options
- 90. XR Technology Trends ImpactingThe Future
- 91. The Near-Future ofXR Currently Deployed or Under Development Inside-out tracking: Tracking without dedicated external sensors will improve, greatly increasing portability & reducing setup Large-scale tracking: Beyond room-scale to significantly larger volumes, such as warehouse scale Wireless connectivity: Battery-operated headsets with wireless display/data link to a desktop computer or the Cloud New input methods: Controller interface hardware is highly iterative Mixed Reality: Seamlessly blending elements of VR with the real world, convergence of VR/AR
- 92. The Near-Future ofXR All of this will affect development & deployments done in the near-term: Shorter generation cycle (~2-3 years) than other consumer tech Significant changes between generations e.g. not an iPhone 9/10 gen Old hardware may no longer be available (replacements/spares etc.
- 93. Increased Use ofthe Digital Twin and Future Self Paradigm
- 94. 50 learning modulesto train 1M associates •17,000 Oculus headsets across nearly 4,700 U.S. stores 12 learning modules in 200 locations Adoption Deployment Pilot
- 95. Pediatric Resuscitation Training TheCHLA residency program and hospital use VR as part of a required curriculum for interns - required prior to setting foot in the emergency department. Todd Chang MD - CHLA Emergency Department
- 96. XR - AKey Component Combination Therapy - Digital Health Platform XR system designed to enhance medication efficacy Medication with clinical benefit Prescribed combination product with enhanced efficacy =+
- 97. Digital Health Platformsdeliver interventions to patients, and parse data for enhanced analysis and improved protocols
- 98. Acute Pain Addiction Medicine ADHD Anxiety Management Autism Spectrum Disorder ChronicPain Cognitive Assessments Depression Disability Solutions Emergency Medicine Medical Education &Training Ophthalmology Orthopedics Palliative Care Patient Education Phobias PTSD Physical Medicine and Rehabilitation Preventive Medicine Respiratory Medicine Senior Care Stroke & TBI Surgical Procedure Planning Surgical Skill Training Uncomfortable Procedure Mitigation More Than 200 Emerging Medical VR/AR Companies Targeting Multiple Clinical Sectors and Specific Indications
- 99. Acute Pain Addiction Medicine ADHD Anxiety Management Autism Spectrum Disorder ChronicPain Cognitive Assessments Depression Disability Solutions Emergency Medicine Medical Education &Training Ophthalmology Orthopedics Palliative Care Patient Education Phobias PTSD Physical Medicine and Rehabilitation Preventive Medicine Respiratory Medicine Senior Care Stroke & TBI Surgical Procedure Planning Surgical Skill Training Uncomfortable Procedure Mitigation Considerable Activity
- 100. Acute Pain Addiction Medicine ADHD Anxiety Management Autism Spectrum Disorder ChronicPain Cognitive Assessments Depression Disability Solutions Emergency Medicine Medical Education &Training Ophthalmology Orthopedics Palliative Care Patient Education Phobias PTSD Physical Medicine and Rehabilitation Preventive Medicine Respiratory Medicine Senior Care Stroke & TBI Surgical Procedure Planning Surgical Skill Training Uncomfortable Procedure Mitigation Relatively Underdeveloped – Significant Opportunities
- 101.
- 102. Current technologies andconcepts are founded on more than 30 years of research and development Recent changes in cost and access make digital health technology affordable XR & Digital Health Technology For Medicine After years of study and use by early adopters – validated systems are poised to move to the mainstream On the horizon - enhanced, ubiquitous, informative and integrated XR technology is currently used for - prevention, evaluation, treatment, and chronic disease management
- 103. XR Technologies andHealthcare The Digital Health Revolution Emerging and Confluent Technologies Overall Landscape of XR Technologies Neuroscience – Why XR Has Impact History of VR - and Why it Matters Current Status – Where There is Traction Future Perspective and Predictions
- 107. Improved Assessments andDiagnostics Addressing Isolation and Loneliness Acute and Chronic Pain Depression and Anxiety Disorders Physical and NeuroRehabilitation Design for Disabilities Post-Discharge Follow-up Staff Training: not just procedures, but empathy XR Systems and Senior Care
- 108. The Impact ofXR Technologies on Medical Research and Healthcare Walter Greenleaf PhD