By Just days before participating in his first significant shoulder replacement surgery last year, Dr. Jake Shine embarked on a virtual journey, donning a Meta Quest 2 virtual reality (VR) headset. As a third-year orthopedics resident at Kettering Health Dayton in Ohio, Dr. Shine stood in the medical center’s VR lab, accompanied by his attending physician, who would supervise the upcoming procedure.
Both doctors were immersed in a 3D simulation of the surgery, a reverse total shoulder arthroplasty, a complex procedure lasting approximately two hours. This surgery requires precise navigation around critical structures like neurovascular tissues and the lungs.
After completing the mock procedure, Dr. Shine took his VR headset home to continue practicing. He dedicated roughly two sessions a day to fine-tuning his skills and becoming well-acquainted with the surgical steps. The significance of this training was highlighted by Dr. Shine when he stated, “You can really fine-tune and learn what to do, but also what definitely not to do, with zero risk to the patient.”
The outcome of the actual surgery proved the effectiveness of VR training, with no complications, and the patient made a full recovery. Dr. Shine believes that the surgery went more smoothly and quickly than if he had relied solely on traditional training methods without the immersive VR experience.
While consumer VR technology is still considered a niche product and represents a substantial investment for Meta CEO Mark Zuckerberg, it is demonstrating its worth in specific healthcare applications. Institutions like Kettering Health Dayton are among dozens in the United States exploring emerging technologies like VR as valuable tools for training and treating patients.
The broader category of “extended reality” encompasses fully immersive VR headsets like the Meta Quest 2 and augmented reality (AR) devices that overlay digital information onto real-world environments.
The question of whether this nascent technology can become cost-effective across the healthcare industry remains open. Nevertheless, early tests and applications suggest the significant potential of VR to enhance healthcare outcomes.
Meta, formerly known as Facebook, entered the VR market with the acquisition of Oculus in 2014. Over the years, the company has introduced standalone headsets and rebranded as Meta in 2021, with Mark Zuckerberg’s commitment to invest billions in the metaverse concept. However, Meta’s Reality Labs unit, responsible for developing VR and AR, has reported substantial losses exceeding $21 billion since the start of the previous year.
Apple is also gearing up to enter the VR market, targeting high-end users with its $3,500 Vision Pro headset expected to debut in the near future. Meanwhile, Meta is preparing to release the Meta Quest 3 as early as next month.
In the realm of healthcare, VR has primarily been applied in pain management. VR technology has demonstrated its ability to mitigate both physical and emotional components of pain. Dr. Brennan Spiegel, director of health services research at Cedars-Sinai in Los Angeles, explained how VR helps individuals shift their focus away from painful experiences, benefiting not only physical but also emotional well-being.
Cedars-Sinai plans to launch a virtual platform to assist individuals with various health issues, including gastrointestinal problems, anxiety, addiction, and perimenopausal health. Additionally, the U.S. Department of Veterans Affairs has adopted extended reality at over 160 facilities, employing it for pain management, behavioral therapy, and physical and cognitive rehabilitation.
Caitlin Rawlins, the immersive program manager at the VA, emphasized the versatility of extended reality, with more than 40 different use cases across various sites. Patients have experienced remarkable transformations, such as reduced pain and improved cognitive states, through the use of VR technology.
Both Dr. Spiegel and Rawlins stress that their organizations are flexible regarding hardware, utilizing headsets from Meta, Apple, or other manufacturers as long as they support the necessary software.
While Meta has loosely identified healthcare as a target market, it seems to prioritize gaming and entertainment over healthcare applications. However, some healthcare institutions have found ways to make their software available within Meta’s ecosystem, albeit through less prominently featured channels.
In medical education, VR technology is becoming increasingly prevalent. At Kettering Health Dayton, VR has become a mandatory component of the curriculum for first-year orthopedics residents. These residents recently completed a month-long “boot camp,” combining clinical services in the mornings with VR practice in the afternoons. More senior residents like Dr. Shine also benefit from VR training, which provides them with valuable insights and experience in complex procedures.
Dr. Reem Daboul, a first-year resident at the hospital, acknowledges that VR headsets cannot fully replicate the physical sensations of a medical procedure. However, they offer invaluable guidance and visual representation of complex steps, even allowing residents to practice procedures that they typically wouldn’t encounter until later in their training.
Kettering Health Dayton utilizes software developed by PrecisionOS, a company specializing in VR modules for surgical training. PrecisionOS has nearly 80 customers worldwide, and its software is also used at the University of Rochester, where it is praised for its sophistication and realism.
Dr. Richard Miller, a retired professor at the University of Rochester, appreciates VR as a means for residents to refine their skills without the immediate pressures of an operating room. He emphasizes the importance of frequent software updates to align with evolving standards of care and surgical techniques.
Regulatory considerations are essential as extended reality technologies are integrated into healthcare. The U.S. Food and Drug Administration (FDA) has a team dedicated to researching the regulatory aspects of AR, VR, and mixed-reality devices. The FDA collaborates with experts to establish best practices for testing and safely bringing these devices to market.
In addition to regulatory efforts, the American Medical Extended Reality Association was founded in 2022 to engage physicians, clinicians, and healthcare professionals in shaping the future of extended reality in healthcare. The association, which currently boasts around 300 members, aims to launch the Journal of Medical Extended Reality and contribute to the mainstream adoption of these technologies in healthcare.
while VR and extended reality technologies are still evolving and face various challenges, they have already demonstrated their potential in healthcare, from surgical training to pain management and rehabilitation. As the technology continues to mature and regulatory frameworks develop, it is poised to play an increasingly significant role in improving healthcare outcomes and patient experiences.
