How VR and AR Technology Will

Transform Healthcare
Walter Greenleaf, PhD

Transforming HealthCare with Technology

Digital Health
Revolution
Mobile Health / eHealth
Wearable Sensors
Patient Centered
Leverages Internet:
social, competitive, collaborative
Every medical device reinvented
 Digital Health Platforms deliver interventions to patients
parse data for enhanced decision-making
Patient Facing Dashboards
Applications
Mobile Analytics access/analysis
data
Backend
Access codes Data tracking
Messaging
User auth Engagement
SDK Physician
Device mgmt Push notification RT analytics
Payor
direction App provisioning Mail service Content store
Admin
Restful API Batch/scheduling Metrics
Assessments Wearable
data
Reminders sensors
Storage Transactional Real time Data Data store
Badges
store event store warehouse
Interventions Log Deployment
Infrastructure aggregation
Monitoring
agents
Graphics
Digital Health Revolution

Medical Applications
of Virtual Reality
Technology
 Virtual Reality Technology For Medicine

Current technologies and concepts are founded on more than 30 years of

research and development
Recent changes in cost and access make VE affordable
VR tech is currently used for prevention, evaluation, treatment and chronic
disease management
After years of validation and use by early adopters - VR technology is poised to
move to the mainstream
On the horizon: enhanced, ubiquitous, informative and integrated
 Relevance For The Medical Product Industry
Interactive media and VR technology will
significantly impact Medical Care
Prevention and Wellness
Objective Assessments
Improved Adherence
Facilitated Behavior Change
Distributed Care Delivery
Management of Chronic Conditions
 VR Technology Has Evolved

Current
technologies
and protocols
have
benefited
from more
than 40 years
of research
and
development
A Personal Journey

I starting my
research in
VR in
1984
 VR Technology Has Evolved

First general
purpose and
commercially
available VR
Systems

Now, after more

than 30 years of
research and 1984
development
 Virtual Reality Technology
On the way to becoming a commodity - available at consumer prices

Facebook Purchases
Oculus for $2B!
 Now is the time for VR
VR technology is now affordable, scalable and
accessible to the marketplace.
The VR category is attracting interest and investments
from major players.

Samsung - GearVR
Sony - Project Morpheus

Microsoft - HoloLens
Facebook - Oculus
Now is the time for VR
 Within 6 years, VR will likely be adopted by 40-70 million users

*Based on agent based modeling by

Lieberman Research Worldwide
Initial adoption will be driven through
game console, PC gaming and
68.0
mobile phone bundling
56.2

Within 3 years, VR will likely be

adopted by 15-30 million users 41.5 40.0

33.0
27.3
24.4

16.9 16.1
11.3 9.9 Best Worst
6.6

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6

Virtual Reality To Hit $150 Billion by 2020
Augmented Reality Adjustable Immersion
 MUVE Virtual Environments have
Technology progressed to the point of
VOIP acceptable visual realism,
believable real-world
Graphic physics, and adequate
Processors
sensory immersion.
Broadband

Movement
Tracking

Algorithms for The acceptance of

NVB
computers and
Low Cost technology as part of
Computers
the clinical process
Smart Phones has also progressed
Tablets
 Virtual Environment Technology

The military simulation and the video game industry is huge: $1.2T 2015
In many ways it exceeds all other forms of entertainment movies, music
For example : GTA - $800 million in worldwide sales in its first 24 hours.
That was the biggest launch day ever for any piece of
entertainment-- any movie, any record, anything at all.

The technology is migrating to medicine directly and indirectly

Virtual Kitchen created in 3 hours
 Commodity Priced VR Platform
Facebook
Sony
Samsung
Google
Apple
Microsoft
LG
Zeiss
Commodity Priced TeleMedicine Platform
Mobile Platform -> TeleMedicine
 One Example Telemedicine for Anxiety Disorders

$25 per month!

 Medical Applications of Virtual Reality Technology

Although entertainment, social connection and gaming will drive the initial
adoption of VR technology, the deepest and most significant market for VR will
be in clinical care and in improving health and wellness.

The list of clinical interventions made possible by VR is long. VR technology

also facilitates clinical assessments and medical training, as well as providing
for improved surgical skill training and procedure planning.

Personal health and wellness can be improved by using VR to engender

better nutrition, promote healthy lifestyles, and to reduce stress and anxiety.

As the cost of healthcare rises, VR technology can serve as an effective

telemedicine platform to reduce costs of care delivery, and improve clinical
efficiency
Academic research has proven Virtual Reality can effectively treat a wide
variety of mental health disorders ranging from addictions to PTSD
MEDICAL APPLICATIONS OF VR

Medical Interventions

Clinical Assessments

Medical Training

Health & Wellness

 MEDICAL INTERVENTIONS
Post Traumatic Stress Disorder
Physical Therapy and Rehabilitation
Neurorehabilitaiton - Stroke and Traumatic Brain Injury
Speech Therapy
Addictions - Alcohol, Substances of Abuse, Nicotine, Opiates
Phobias fear of heights, fear of flying, social phobia
Obsessive Compulsive Disorder
Generalized Anxiety Disorder
 MEDICAL INTERVENTIONS
Mood Disorders - Depression
Mild Cognitive Impairment
Acute and Chronic Pain
Autism Spectrum Disorder
ADHD
Optical Rehabilitation Strabismus, Amblyopia
Resilience Training
Surgical Planning
 DIAGNOSTIC ASSESSMENTS

Medical Image Review

Neuropsychological Assessments

Activities of Daily Living Assessments

Physical Medicine OT / PT

Behavioral Medicine psychology, psychiatry

 MEDICAL TRAINING
Clinical Skill Training

Surgical Skill Training

Interpersonal Skill Training

Use of Equipment and Tools

Team Training - eg: Emergency Department, Surgical Team

Emergency Response Training and Rehearsal

Empathy
 HEALTH & WELLNESS
Weight Management
Cognitive Function Training
Sequencing, Situational Awareness, Decision Making

Exercise
Stress Management
Disability Solutions
Addressing Isolation
Grief Counseling
Mood and Resilience
 Surgical Training
Preoperative Planning & Image Guided surgery

Rapidly
becoming the
standard for
training

and soon to
be part of the
standard of care
 Virtual Airplane for Fear of Flying

Patient wears Head-mounted Simulates

Display Sitting in plane on runway,
Position Tracker engine on/off
Covers Entire Field of View Taxi
Hears only audio from Takeoff
earphones (including Flight in good weather
therapist) Flight in bad weather
Sits in Airline Seat Landing
 PTSD, Phobias, and Anxiety Disorders
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
RISK AVOIDANCE TRAINING
VR for Team Medical Procedure Training
Build physician empathy
for patients receiving
difficult diagnoses
Preparation and Training for Difficult Situations
Stress Inoculation Risk Preparation
Virtual hospital tours could be used to relieve pre-procedure anxiety
VR for Stroke and TBI Rehabilitation

$7.5M Series A

$100M Investment
At $1B Valuation
 Support Meetings
Anonymous And Confidential
 New Approaches for Cognitive Assessment

RESET
Digitized Neurocognitive Tool Set

RESET aims to restore cognitive skills to

improve quality of life and enhance duty
performance following mild traumatic brain
injury.

This product evolves traditional paper and

automated evaluations to a more sophisticated
level, ultimately reducing costs and improving
care. It also produces a robust intervention that
challenges cognitive skills.
Virtual Humans For Training, Confidential
Interaction, and Telemedicine Support
Sensely: Autonomous System to Monitor and Support Patients
 Virtual environments are used clinically to treat several
important behavioral health problems
Drug and alcohol abuse

Schizophrenia

Post-traumatic stress disorder (PTSD)

Depression and Mood Disorders

Generalized Anxiety Disorder

Acute and Chronic Pain

Depression and Mood Disorders

ADHD
 Virtual environments are used clinically to treat several
important behavioral health problems

Phobia and anxiety disorders

Obsessive Compulsive Disorder (OCD)

Developmental disabilities

Conduct disorders

Anger management Impulsive disorders

Eating disorders Learning disabilities

Neuro-cognitive disorders
 Neuroscience Rationale
It is necessary to activate the associated brain system
to enable neuro-plasticity

Repetition is required

It is critical to engage the

brain's reward systems

Attention drives Cholinergic system

Novelty drives Noradrenergic/Serotonergic system
Reward drives Dopaminergic system
Leveraging Mirror Neurons

Ability to change a7tudes and behavior a<er being ones future self.
 Your Future Self

Students interacted with 3-D avatars of future self.

Asked to allocate $1K between present expenses, a fun splurge,
checking account, & retirement account.
Participants who interacted with future self put more than twice as
much money into retirement account.
Successful Intervention Depends On Adherence
Build Empathy for Underserved Populations
 VR can increase conservation behaviors.

Short and long-term effects of embodied experiences in immersive virtual environments on environmental locus of control and
behavior Ahn, Bailenson et al
 VR can be used to help train doctors and staff to
better understand the patient perspective.

Virtual Experiences for Social Perspective Taking Raij et al., University of Florida
 Big Data Opportunity

Objective data
Behavior and activities
Linked to intervention
Population trends
 Virtual Environments and Senior Care

Improved Assessments and Diagnostics

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

 Rendever Health Project
Virtual reality systems and 360 video can be used provide mental
stimulation, recreation, education, and address isolation

Designed to expand senior living residents worlds by

Entertainment Therapy
offering immersive
Travel experiences
Bucket list items
Family Employee Family moments
Connectivity Training
Cultural events
Relaxation
Memory lane
Live events
Educational simulations
Therapy programs
Anti-anxiety
Virtual reality systems and 360 video can be used provide mental
stimulation, recreation, education, and address isolation
Virtual Environments for ADL Assessment
 Virtual Reality Technology For Medicine

Current technologies and concepts are founded on more than 30 years of

research and development
Recent changes in cost and access make VE affordable
VR tech is currently used for prevention, evaluation, treatment and chronic
disease management
After years of validation and use by early adopters - VR technology is poised to
move to the mainstream
On the horizon: enhanced, ubiquitous, informative and integrated
For More Information:

Walter Greenleaf, PHD

WalterG@Stanford.edu

@WalterGreenleaf