Meta’s VR Advancements Aid Surgeon Training and Patient Care, Cost Challenges Persist.
Just days prior to assisting in his inaugural major shoulder-replacement surgery last year, Dr. Jake Shine, a third-year orthopedics resident at Kettering Health Dayton in Ohio, engaged with cutting-edge virtual reality (VR) technology.
In the medical center’s designated VR lab, Shine, accompanied by his supervising physician, donned Meta Quest 2 headsets to immerse themselves in a 3D simulation of the intricate surgery ahead.
This procedure, known as a reverse total shoulder arthroplasty, typically spans around two hours and demands surgeons to navigate with utmost precision around neurovascular structures and the delicate lung area.
Following the simulated practice, Shine took the VR headset home to refine his skills, practicing approximately twice a day leading up to the surgery. He described the advantages of this immersive VR training, stating, “You can fine-tune and learn what to do, but also what definitely not to do, with zero risk to the patient.”
The actual surgery proceeded without complications, and the patient experienced a full recovery. According to Shine, the procedure likely went more smoothly and quickly than it would have if his attending physician had to guide him through each step as extensively as they did during the VR simulation.
While consumer VR technology remains a niche market and a considerable financial investment for Meta CEO Mark Zuckerberg, it is undeniably demonstrating its value in select healthcare applications.
Kettering Health Dayton is just one of numerous healthcare systems in the United States experimenting with emerging technologies like VR to aid doctors in training and patient treatment.
The term “extended reality” encompasses a wide spectrum, including fully immersive VR headsets like the Quest 2 and augmented reality (AR) devices, which overlay digital information onto the real-world environment.
Whether this nascent technology can ever become cost-effective across the medical industry remains open, but early trials are showcasing VR’s potential to enhance health outcomes.
Meta, previously known as Facebook, entered the VR market by acquiring Oculus in 2014. Three years later, the company introduced its first standalone headset. In 2021, Facebook underwent a rebranding as Meta, with Mark Zuckerberg committing to investing billions in the belief that the metaverse would be “the next chapter for the internet.”
Since the beginning of the last year, Meta’s Reality Labs unit, responsible for developing the company’s VR and AR technologies, has incurred losses exceeding $21 billion.
Apple is also gearing up to enter the VR market, targeting high-end users with the anticipated $3,500 Vision Pro set to debut in the near future. Meanwhile, Meta is slated to release the Meta Quest 3 as early as next month.
Apple has yet to provide comment on potential healthcare applications, directing inquiries to a June announcement concerning Vision Pro’s software developer kit.
In that announcement, Jan Herzhoff, President of Elsevier Health, was quoted as saying that their “Complete HeartX mixed reality offering” would aid in preparing medical students for clinical practice by using hyper-realistic 3D models and animations to enhance their understanding and visualization of medical issues, such as ventricular fibrillation, and how to apply their knowledge when treating patients.
Extended Reality for Patient Treatment
Virtual reality (VR) has found a significant application in healthcare, primarily in pain treatment. Dr. Brennan Spiegel, the director of health services research at Cedars-Sinai in Los Angeles, emphasized that VR can be a powerful tool for managing pain.
Pain has physical and emotional components, with signals sent to different brain parts. VR can help alleviate pain signals in both areas by guiding individuals to shift their focus away from their painful experiences, addressing both the physical and emotional aspects of pain.
Cedars-Sinai is preparing to launch a virtual platform to assist individuals with gastrointestinal issues such as Crohn’s disease, celiac disease, or acid reflux. They are also developing VR applications for anxiety, addiction, and perimenopausal health.
The U.S. Department of Veterans Affairs (VA) has also adopted extended reality technology at over 160 facilities to aid patients in pain management, behavioral therapy, and physical as well as cognitive rehabilitation.
Caitlin Rawlins, the immersive program manager at the VA, highlighted more than 40 separate use cases for extended reality across the agency’s different sites. The VA began incorporating extended reality in a limited capacity around 2015 and has expanded its usage as the technology has advanced.
Rawlins shared compelling stories of patients benefiting from VR. For instance, an elderly patient who had just undergone knee replacement surgery found relief from severe pain after a short VR session.
In another case, an Army veteran who used a wheelchair experiencing cognitive decline transformed into a different person while using VR, interacting with virtual nature scenes and animals.
Dr. Spiegel and Rawlins emphasized that their organizations are adaptable regarding hardware, utilizing headsets from companies like Meta and Apple as long as they support the necessary software.
Although Meta has loosely identified healthcare as a target market, it remains more focused on gaming and entertainment. While healthcare applications are available in the Meta Quest Store, they are less prominently marketed or easily discoverable than entertainment content.
Meta did not provide a comment but referred CNBC to a post highlighting the transformative impact of metaverse technology, including its role in surgery training and various other industries positively affecting lives.
Embracing Extended Reality in Medical Education and Practice
Extended reality technology is gaining prominence in medical education and practice. At Kettering Health Dayton, VR has become a mandatory curriculum component for first-year orthopaedics residents.
These new doctors participated in a month-long “boot camp” that combined morning clinical services with VR practice in the afternoons. They are now required to complete a minimum of three VR modules each week, achieving a score of over 70%.
While more senior residents like Dr. Jake Shine still need to be obligated to undergo VR training, Kettering Health Dayton is actively working on integrating it at all levels of their program. This shift represents a significant departure from traditional medical education methods, where learning primarily involved reading books and attending lectures.
Dr. Reem Daboul, a first-year resident, acknowledged that VR cannot fully replicate the physical sensations of a medical procedure. However, she found VR invaluable in familiarizing herself with the steps of an anterior hip replacement, a process that many orthopaedic surgeons typically only learn later in their residency.
Kettering Health Dayton employs software developed by PrecisionOS, a company specializing in VR modules for surgical training, medical residency programs, and medical device representatives.
PrecisionOS co-founder and CEO Dr. Danny Goel revealed that the company serves nearly 80 customers worldwide. The University of Rochester’s orthopaedics residents also utilize PrecisionOS software, lauded for its sophistication and realistic portrayal of medical procedures.
Retired professor Dr. Richard Miller at the University of Rochester, who actively supports the implementation of VR technology in the orthopaedics department, highlighted the advantages of VR for residents.
It allows them to practice without the immediate pressures of the operating room, even from the comfort of their homes. Collaborative learning sessions can also occur in virtual settings, where mentors and residents can perform procedures together.
Despite the benefits, Miller and others in the field acknowledge certain challenges. Keeping the VR software up to date with evolving standards of care and surgical techniques is crucial. The cost of implementing such technology in healthcare settings can be significant and needs to be more transparent.
PrecisionOS declined to disclose specific pricing details, emphasizing that costs vary depending on the institution and the extent of partnership. Dr. Bamberger at Kettering Health Dayton noted that besides software challenges, VR hardware still faces limitations, including bulkiness.
Dr. Rafael Grossmann, a surgeon at Portsmouth Regional Hospital, has been advocating for the use of emerging technologies like extended reality in healthcare for years.
He believes that headsets have improved significantly but have yet to be ideal for healthcare settings. However, he sees a substantial market for these technologies, particularly in healthcare.
Regulatory Hurdles and Ongoing Research
As with any technology in healthcare, extended reality must navigate regulatory hurdles. The U.S. Food and Drug Administration (FDA) has a team focused on “regulatory science” related to AR, VR, and mixed reality devices.
The FDA’s efforts, led by physicist Ryan Beams, involve collaborating with experts to establish best practices for testing and safely bringing promising devices to the market. The goal is to ensure that innovative devices are not delayed due to uncertainties about testing procedures.
Dr. Brennan Spiegel of Cedars-Sinai, a pioneer in this field, co-founded the American Medical Extended Reality Association in late 2022. This medical society brings together physicians, clinicians, and healthcare professionals to shape the future of extended reality in medicine.
The society, currently with about 300 members, is expected to grow significantly in the coming years. It also plans to launch the Journal of Medical Extended Reality, its first official peer-reviewed journal.
Dr. Spiegel emphasizes that extended reality is no longer on the fringes of science; it has become mainstream. While challenges persist, substantial advancements have transformed it into a recognized and evolving healthcare science field.
