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Feature: how is immersive technology being used in healthcare?

After years of the technology growing, health and social care providers are making use of the rise in immersive technologies such as Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR).

The use of immersive technologies have brought new possibilities and approaches, with use cases ranging from activities such as surgery stimulation, supporting illnesses like dementia or depression, to healthcare skills and training.

In this feature, we explore how immersive technologies are being used in different healthcare sectors, alongside a number of case studies from NHS trusts, the challenges presented and what the future holds for this expanding technology.

What are immersive technologies?

VR – Virtual Reality: A computer-generated, three dimensional environment with objects and scenes that appear to be real, making the user feel immersed in their surroundings through the use of a headset.

AR – Augmented Reality: An experience where parts of users’ physical world are enhanced with computer generated input. This can be anything from sound, video or graphics which responds to a change in environment such as movement.

MR – Mixed Reality: A blend of digital and physical worlds that unlock natural and intuitive 3D computer, human and environmental interactions.

An overview of different VR applications

In brief, here are some of the different immersive technology applications being used in healthcare across England.

Mental Wellness: A range of immersive technologies have played a role by engaging people in exercise and emotional wellness, such as encouraging creativity, exercise and aiming to reduce anxiety through creating relaxing environments for mindfulness and meditation. The relaxation experiences are becoming growingly popular among home users, as well as care home settings, and in some trust ahead of surgery.

Clinical Mental Health: One example development is in the use of supporting the treatments of Post-Traumatic Stress Disorder (PTSD), anxiety disorders and phobias. It has been a way to deliver therapy and control the environment and exposure of cognitive restructuring, including the ability for VR to be delivered in a home setting.

Pain Management: Immersive technologies are being explored with a hope to ‘lower the perception of pain management’ for patients and offer alternatives or changes to medication.

Healthcare Education: By training students and medical practitioners through VR and AR, before exposing them to real-life patients, the aim is to improve their skills and knowledge in ‘practice’. One example comes from hologram patients to support clinical training at Cambridge University Hospitals NHS Foundation Trust.

Rehabilitation for people with disabilities: There are VR systems in the market to help wheelchair users navigate a ‘virtual world’ to learn how to move and avoid obstacles before going out into the ‘real world’.

Case Studies – how hospital trusts have been putting immersive technology into practice

Here we have explored how a selection of trusts in England have been using different types of immersive technologies to either better the patient experience or support medical professionals.

Northumbria Healthcare NHS Foundation Trust

For the first time across the region, Northumbria Healthcare NHS Foundation Trust are using virtual reality headsets hoped to ‘distract and relax patients’ undergoing awake limb surgery.

When patients undergo surgery on their arms or legs, such as a knee replacement, they can choose to wear a virtual reality headset in combination with a nerve block. In turn the trust said, it has decreased the number of patients needing to have a heavy sedation or general anaesthetic during surgery.

Dr Caveh Madjdpour, Consultant Anaesthetist at the trust explained how there was visible results in pain reduction: “There is a clear, evidence-based link between the reduction of preoperative anxiety and lower postoperative pain, and the use of virtual reality is becoming more common in healthcare because of its ability to help people relax.

“With surgery under nerve block, a general anaesthetic or sedation doesn’t have to be given, and this avoids the extra risk of things like nausea, being groggy for the rest of the day, or allergic reactions to the anaesthetic.

“While these complications are rare, and the patients choice is most important, virtual reality gives our patients another way to pass the time during their operation that didn’t previously exist and isn’t widely available.”

Guy’s and St Thomas’ NHS Foundation Trust

New and innovative technology developed by researchers at Evelina London and King’s College London have allowed surgeons to immerse themselves in a patients heart by using virtual reality to plan surgery.

Funding from Evelina London Children’s Charity and British Heart Foundation have been able to create virtual reality technology to form a three-dimensional, digital image of the heart.

Surgeons have found that it has been helpful to further their understanding of the structure of the patients heart as they can immerse themselves in the image. The new technology has also allowed them to manipulate and interact with the images and trial options for operation.

Professor John Simpson, lead researcher, consultant paediatric and fatal cardiologist at Evelina London and King’s College London explained: “Procedures to repair the heart’s anatomy can be complex, and surgeons don’t like surprises. Each patient’s condition has individual characteristics to their heart. Our technology will allow surgeons to plan and practice these procedures, and we’re currently applying for approval for it to be used in this way.

“We think that this technology could also be used outside of congenital heart disease surgeries, to plan any procedure which aims to repair a structural problem within the heart, such as valve surgery in an adult patient.”

Somerset NHS Foundation Trust

Medical students and junior doctors have been using a new VR training technology to help them with their studies.

Using a headset and hand-held controllers, the students are able to immerse themselves into real-life operations without needing to be in the operating theatre.

It provides an opportunity for students and doctors to learn how to explain treatment plans, diagnoses, deal with challenging situations and engage with patients.

The VR technology allows them to take part in training without the need of attending in-persons sessions. It also means they can repeat the training as much as they want until they feel confident in that skill.

Dr Alex Aquilina, one of the ST3 registrars in trauma and orthopaedics, said: “This process does not substitute real-life training, but enhances it, as well as enabling our junior doctors to learn without necessarily coming into hospital during the pandemic, reducing the risk of infection to themselves and to our colleagues and patients.

“The virtual simulations allow teaching to be delivered to trainees providing an overview of the whole surgical process, from setting up equipment and prothesis, to briefing colleagues and positioning the patient correctly.”

Birmingham Children’s Hospital

Birmingham Children’s Hospital NHS FT is using VR with an aim to help young people relax and reduce anxiety for invasive medical procedures.

Even though the technology is still in its early stages of development, it is said that children aged eight and above have responded particularly well to the use of VR.

Dr Ben O’Sullivan, Consultant Anesthetist, explained: “We’ve found that the roller coaster games have been the most popular for our kids and the relaxing hypnotic backgrounds have worked really well for those with learning disabilities, to provide a sense of comfort in an unfamiliar environment.

“Being at hospital is already quite a scary time for children – so it’s really important for us to ensure that young people and children are respected, and a level of comfort is maintained throughout their time at our Children’s Hospital.”

What are the challenges?

There is a large number of research published about immersive technology in general, however there is only a small fraction of published articles where it examines the uses in healthcare.

Immersive technology in healthcare is still in its infancy, but given the clear benefits of the technology in certain hospital trusts, like for medical training and pain reduction, it’s not going to be long before the market develops further.