November 28, 2017
Transforming healthcare and saving lives with Extended Reality (XR)
By: Matthew Short and Shailee Samar

Extended Reality (XR) is revolutionizing the medical field by injecting innovation into the healthcare experience.

The XR healthcare market is predicted to reach $5.1 billion worldwide by 2025, spurred by growing adoption and investments in the incredibly dynamic healthcare IT. Doctors and surgeons increasingly leverage XR for medical procedures, and hospitals are utilizing XR to streamline medical processes and improve healthcare, from patient care and surgical imaging to resident training.

For example, surgeons are using XR to develop a unique approach for a particular patient and plan ahead for each step of complicated surgeries, whether they are removing tumors or separating conjoined twins.2 Medical students are exploring virtual organs in 3D to deepen and accelerate their learnings.3 And, patients are reporting less pain during recovery if they are immersed in XR simulations. 4

Let’s dive in and explore some of these examples.

Helping surgeons visualize the complexities of the body

Surgeons often face challenges related to exploring the target organ before surgery, visualizing the nuances of each patient’s unique body, or quickly interpreting vital information without losing focus on the patient. XR can help medical professionals overcome these challenges.

Traditionally, doctors rely on X-rays, CT scans, MRIs and other imaging sources, and their own minds to understand a particular patient's body and visualize a surgical approach. However, an X-ray image is an imperfect road map that can misrepresent organs and distort the actual body.5 And, the X-ray’s 2D images are cognitively limiting because they are difficult for our brains to process, overload working memory, and are difficult to recall.6 Moreover, given our cognitive capacity and neurological tendencies to simplify and over-generalize, it can be difficult for our imaginations to capture all the intricacies of the body, especially because organs differ across patients.

XR helps medical professionals visualize organs in 3D and 100 percent scale. In May 2017, Virtual Reality (VR) helped Daniel Saltzman, the chief of pediatric surgery at University of Minnesota’s children’s hospital, separate conjoined twins. Saltzman and his team explored detailed VR models of the twins’ hearts, “virtually embedding themselves inside the walnut-sized organs as if the infant’s anatomy had been blown up to the size of a living room.”7 Within minutes of using the enhanced perspective, the surgeons discovered connective tissue between the twins’ hearts, completely changing their original surgical plan and leading to a successful surgery.

How Virtual Reality Helped Separate Conjoined Twins

Video of surgeons leveraging XR technology to surgically separate conjoined twins

In addition to helping surgeons visualize patients, XR also enhances their sight. Scopis developed The Holographic Navigation Platform, which projects an Augmented Reality (AR) overlay on the patient to help surgeons track pedicle screws and other surgical markings. Berlin Humboldt Hospital’s Spinal Surgery Clinic Chief Christian Woiciechowsky believes these technologies can make surgery more “effective, safe, and precise.”8

Spine Surgery Using Scopis Holographic Navigation and Microsoft HoloLens

Example of using HoloLens for spinal surgery

Additionally, AR provides surgeons and doctors with real-time patient information. In 2013, Accenture Labs and Royal Phillips built a proof-of-concept that uses Google Glass, provides surgeons and physicians with hands-free access to critical clinical information so that they do not need to look away from the patient for even a moment.For patients in life-threatening conditions, every second counts, so direct access to information is critical.

Training residents and providing remote expertise

The need for continuous medical training has been increasing. In 1950, the amount of medical knowledge and research was doubling every 50 years. In 2010, the doubling time was 3.5 years. In 2020, it is projected to be a mere 73 days.10  How can we help our medical professionals stay up-to-date with cutting-edge practices?

Research has shown that after two weeks, we remember 20 percent of what we hear, 30 percent of what we see, and up to 90 percent of what we do or simulate.11  This “cone of knowledge” relates to the difference between active and passive learning. Active learning, which happens when participants directly engage with the material through hands-on participation or visual elements, leads to better retention and a deeper understanding than passive learning, which happens when participants sit and listen to a lecturer.

XR is a learning tool that promotes active learning. Medical students often practice on cadavers, cadavers can be expensive. Instead, Dr. Narendra Kini, CEO at Miami Children’s Health System, explains that a VR training session can lead to an 80 percent retention level after a full year, compared to traditional training’s 20 percent retention after a single week.12  XR helps train medical professionals by boosting their understanding of anatomy, consequently reducing potential complications and costs.

Seeing the Human Brain in 3D

Research has also shown that the human brain is well-aware of stereo and motion cues, which explains why we might find 3D representations simpler to understand and digest than 2D representations.13  So, medical schools such as Stanford Medicine and Case Western Reserve University have been utilizing XR to train residents because it visually depicts the human body in 3D and to scale, especially for students who struggle with spatial reasoning. After the residents and professors wear headsets, they walk through the different portions of a brain, point out skull deformities, and manipulate the view to understand how tumors appear from different angles.14  Case Western medical school’s dean, Pamela Davis, explained that “students have commented that a 15-minute session with HoloLens could have saved them dozens of hours in the cadaveric lab.”15  As shown by these examples, XR accelerates learning in healthcare and medical school, settings where students and doctors are constantly squeezed for time.

Microsoft HoloLens Lets Case Western Reserve, Cleveland Clinic Reimagine Health Education on Youtube

Students from Case Western Medical School explore the benefits of XR

Sometimes, medical residents and EMTs need assistance with patient diagnoses. XR can enable remote guidance to connect the onsite medical staff with experts elsewhere. In 2015, Rhode Island Hospital’s emergency department successfully used Google Glass for dermatology consultations. A resident evaluating a patient transmitted the video to a remote expert through Google Glass. The consulting toxicologist rated the consult 89 successful and six patients received medication they would not have otherwise received.16  As such, XR can increase the success of residents and emergency staff.

Not only do these XR technologies improve learning, they do so while reducing costs. For example, the 65,000 elderly care facilities in America spend $3,000 per employee to teach tracheal insertion. On the other hand, Next Galaxy’s tracheal insertion training in VR costs just $40 per employee and eliminates the need for travel to training centers and the dependence on live subjects.17 Hospitals, then, can significantly reduce training costs by leveraging XR.

XR also democratizes learning. In April 2016, cancer surgeon Dr. Shafi Ahmed at Barts Health NHS Trust performed the first operation streamed live in 360-degree video.18  Through the “VR in OR” app, eager medical students across the world could secure a free, front-seat view in the life-changing cancer operation.

Dr. Shafi Ahmed Performs the First Operation Streamed Live in VR. This opens a new window.

Dr. Shafi Ahmed performs the first operation streamed live in VR

Helping and Treating Patients

For many patients, the entire healthcare process from doctor’s appointments and blood tests to surgical recovery can be painful and stressful. Can XR increase comfort and quicken recovery?

One frequently used diagnostic tool around the world is a blood test. In fact, there are around 2.4 million vein sticks in the US every day but still, 30 percent of patients require multiple sticks to find a vein. AR can assist medical staff draw blood with one stick by projecting the peripheral veins on the skin. For example, the AccuVein device has been used in 3,000 hospitals, resulting in 39 percent less pain for the patient.19 Per a survey conducted by the company, 93 percent of respondents were more satisfied with facilities that used such AR technology.20 So, AR can make blood tests more comfortable.

The recovery period can also be painful and stressful. Luckily, VR can help reduce pain, including chronic pain. For example, VR has been used as distraction therapy for burn victims. The University of Washington reports that during wound care, over 86 percent of burn victims reported experiencing severe to excruciating pain, even with standard amounts of opioids.21 The VR game SnowWorld helps alleviate pain by immersing burn victims in virtual snow. As per a military study, SnowWorld worked better than morphine for easing the pain of burn victims by up to 50 percent.22

Not only can XR soothe patients with physical injuries, it can also support patients with mental-health issues. As per the Anxiety and Depression Association of America, anxiety disorders affect 18 percent of Americans and cost more than $42 billion a year, with the majority spent on easing symptoms.23 Exposure therapy through VR can calm patients and help them overcome their fears. Studies indicate that VR therapy can decrease PTSD symptoms for as far as six months after patients halt treatment.24 In fact, 100 military bases have been using simulations from Bravemind, an academia-Pentagon VR venture, for veterans psychologically scarred by deployments in Iraq and Afghanistan. They found that stress symptoms, including depression, decreased by as much as 80 percent after the treatments.25 Although more research needs to be conducted in VR therapy, the studies so far are promising.

Parting Thoughts

Even though these XR technologies are nascent, healthcare organizations are already reaping the benefits. With XR, medical students and surgeons can better visualize the human body, patients can gain access to consultations and guidance, and doctors can provide better restorative therapy.

The exciting part? These use cases are not restricted to healthcare.

Just as surgeons can better understand their surgical plans in 3D with XR, engineers and designers can more thoroughly examine their envisioned product designs in 3D in XR. Or, similar to how medical residents work with remote consultants when conducting appointments, industrial workers could repair machines faster with remote, over-the-shoulder coaching through smart glasses.

Follow this XR blog series to tune in for other industry deep-dives, including how engineers, designers and industrial workers can enhance their work with XR. And, hear more perspectives on XR’s potential and best development practices in enterprise. Contact the Accenture XR group or Accenture Labs to learn more.


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