Walter Greenleaf PhD
Converging to Transform Healthcare
Virtual Reality, Machine Learning, Biosensing
The work we do is important
The work we do is meaningful
We work together to
move the field forward
7th Annual
Virtual Reality and Healthcare Global Symposium
Current technologies and concepts are
founded on more than 30 years of research
and development
Recent changes in cost and access make
clinical VR systems affordable
Medical VR/AR Systems – Overall Status and Opportunity
On the horizon - enhanced, ubiquitous, informative and integrated
After years of study and use by early adopters –
validated systems are poised to move to the mainstream
+ AR + MR = XR
Immersive Systems
Extended Reality
Functional Training
Objective Assessments
Improved Interventions
Facilitated Adherence
Distributed Care Delivery
Prevention and Wellness
VR/ AR systems are currently used for -
Now is the time for VR & AR (XR)
XR technology is now affordable,
scalable and accessible
Meta - Oculus
HP - Reverb Sony – PlayStation VR
Microsoft - HoloLens
HTC - Vive Apple -
The HMD is what you think of when you think of VR-
But there is so much more going on “behind the screen”
Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare
Healthcare Crisis:
Aging Populations
0
50
100
150
200
250
300
350
400
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2015 2020 2025
Age 85+
Age 75-84
Age 65-74
Age 45-64
Age 5-44
Under Age 5
In 1970, there were roughly half as many people in the
world as there are now
Healthcare Demand is Evolving
As we extent our longevity, we see a higher percentage of people living with diseases of “old age:
Alzheimer's, Parkinson’s
Physical Disabilities – Restrictions on Mobility
Mild Cognitive Impairment
Acute and Chronic Pain
Stroke
Cataracts, Macular Degeneration
The fight continues against the more intractable ‘old enemies’:
Cancer
Heart Disease
Respiratory Disease
Kidney Disease
Healthcare Demand is Evolving
Shifts In demographics & lifestyle have led to new expressions of disease
Anxiety Disorders Depression
Burnout
Diabetes Obesity
Addictions
TREND: Moving Health Care to the Left
Value Cost
Health Status
20% of Population Generate
80% of the Costs
Healthy /
Low Risk At Risk High
Risk
Chronic
Disease –
Early Stage
Acute
Disease
Chronic
Disease
Progression
End of Life
Care
Benefits of Proactive Mitigation of Disease Risk
Cost of Care Delivery / Day
Health
Independent
Living
Community
Clinic
Doctor’s
Office
Assisted
Living
Skilled
Nursing
Facility
Quality
of
Life
$10,000
$1,000
$10
$1
Specialty
Clinic
Home Care
Supported Care
Community
Hospital
Intensive
Care
Acute Care
0%
100%
Chronic
Disease
Management
$100
TREND: Where Healthcare Happens
Transforming HealthCare with Technology
The Stanford Laboratory for
Brain Health Innovation and
Entrepreneurship
Medical Mixed Reality
Program
Wearable Electronics
(eWear) Initiative
ENGINEERING
Academic Affiliations
Childhood Anxiety
Reduction through
Innovation and Technology
VR & Immersive Technology
In the Department of Psychiatry and
Behavioral Sciences
TAKE
PAUSE
Ellipsis Health
Joyance
Partners
Digital Health
Revolution
• Mobile Health / eHealth
• Machine Learning
• Wearable Sensors
• Patient Centered
• Leverages Internet:
social, quantitative, collaborative
Every Medical Device Reinvented - & Now Digital
Digital Heath
World
Population
7.98 Billion
Mobile Phone
Users
5.34 Billion
Growing Exponentially...
Digital Health Platforms deliver interventions to patients, and
parse data for enhanced analysis and improved protocols
Prescription Digital Therapeutics
Combination Therapy - Digital Health Platform
App-based system
designed to enhance
medication efficacy
Medication with
clinical benefit
Prescribed
combination product
with enhanced
efficacy
=
+
New methods are being developed that will allow us to collect and analyze
biomarkers that reflect our cognitive and emotional status.
Here are four examples…
Brain Health BioMarkers - Passive Data from Smart Phones
Voice Analytics as a BioMarker of Depression
Facial expressions in response to a VR Challenge
Cognitive function assessment using AR and smartphone sensors
Digital Systems Are Not Just Measuring The Physical Parameters of Our Health
Prescription Digital Therapeutics
Create Value In Areas Of High Patient Need
Combination
Therapy
PDTs can monitor toxicity and personalize treatment
Can leverage sensor data.
Dose
Optimization
PDTs can monitor and address comorbid conditions: insomnia, poor
nutrition, anxiety, depression, activity levels, use of nicotine and alcohol, etc
Address Comorbid
Conditions
Software-based therapies have been shown to be effective as stand-alone
interventions – there is incremental effectiveness when PTDs are used in
combination with standard treatment
Facilitate
Adherence
Collect Utilization
And Efficacy Data
PDTs have several tools to facilitate adherence –provide key information,
close the feedback loop, show progress, connect to the care team, leverage
games and other motivational tools, provide reminders and sound alerts, etc
PDTs collect de-identified utilization and efficacy data – combined with sensor data
Advancing research, facilitating improved formulations, and allowing for personalized
protocols based on large-scale studies.
Emerging and
Confluent
Technologies
CONVERGENCE of Several Fast-Moving Technologies
New technologies provide an avenue to address many previously intractable
problems, transform cost models, & greatly improve patient outcomes
AI / Machine Learning – Improved Diagnostics, Precision Clinical Therapies
Digital Health Platforms – Remote Monitoring, Assessments, Therapeutics
Human/Machine Interface - Wearables, Prostheses, Implantables
Pharmaceutical Development - Decentralized Trials, AI Drug Discovery, Combination Therapy
Robotics - Microsurgery, Telesurgery, Rehabilitation, Disability Solutions
Nano-Medicine - Tumor Detection, Drug Delivery, Imaging, Tissue Engineering
Genetic Medicine – Gene Therapy, Personalized Medicine, Predictive Medicine
Wearable Sensors – Improved Diagnostics, Telemedicine, Precision Medicine,
Sensors Are Evolving, Connecting, Promulgating
Sensors 1.0
Sensors 3.0
Sensors 2.0
Measure and record
Integration with web;
Sharing and accessing data
Passive data gathering;
Aggregation and
meaningful interpretation
Entering the Era of Medical Wearables
Machine Learning & Predictive Analytics
Leveraging technology that senses, interprets, and
adapts to how you feel and act –
And factors in your health status, your goals, and
your priorities.
The future is about personalized experiences
Technology that personalizes experiences-
Technology that senses, interprets, and adapts to how you feel and act
Soon, the broadly adopted technology used for our
interactions with our environment
… and with each other … will change.
All will be facilitated by technology that personalizes
experiences, that is, technology that senses, interprets,
and adapts to how you feel and act
Our interactions with the built environment,
communications systems, entertainment platforms,
transportation systems, social platforms, etc -
Affective Computing
Affective Computing is the study and
development of systems and devices
that can recognize, interpret, process,
and and in some cases simulate human
affects.
It is an interdisciplinary field spanning
computer science, psychology,
engineering, and cognitive science.
One goal of Affective Computing is to develop systems that can interpret our
emotional state and adapt their functionality accordingly– to be able to generate an
appropriate response to the user's emotional state.
A Voice-Based Vital
Sign for Mental Health
Using voice as a biomarker for mental
health and wellbeing along with machine-
learning algorithms, Ellipsis Health
generates a clinical-grade assessment of
the severity of anxiety and depression, with
just a short sample of speech.
Digital Twin Paradigm
For Precision Healthcare
A data stream for physicians to manage patients between visits
Includes specific
Rx compliance
tracking capabilities
Focus on issues
disease worsening,
new symptoms
Includes Alerts to
Care Team and
integrates at POC
Sensor Tech PatientApp Wearables
PA
TIENTS
PhysicianApp
PHYSICIAN
Office Visit Office Visit
Injection
issue
GI issue Relapse?
Sleep issues Tingling,
weakness
Actionable, avoid
events, costs, ROI
path to payment
fNIRS and Other Imaging
Lab-on-Skin and Related Systems
5G connections – Forecast to Exceed 5.9 billion by the end of 2027
Single-digit millisecond latencies with Edge Computing
Cloud-Rendered AR and VR content
Real-time Analytics for Machine Learning, Predictive Modeling
Digital Healthcare Business Trends
Shifting Business Models –
Tech Titans, Direct to Consumer
Shifting Regulatory Landscape
Telemedicine Gains Traction
Focus on Mental Health
Virtual Reality & Augmented Reality Technology
Immersive Systems
First general purpose
and commercially
available VR
systems.
VR Technology Has Evolved
1987
My 36 Year Journey….
Stanford University
VR Technology Has Evolved
Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare
SpiderWorld VR for
phobia treatment
1997
Phobias
2003
Burns - Pain
SnowWorld VR
for burn pain
management
2007
Landmark Study - Pain
VR immersion for
pain relief
2021
Clinical
Acceptance
2021+
Mainstream Adoption
Proliferation of start-
ups, use at-home and
clinical environment
+2000 peer-reviewed
publications in 2016
2002
PTSD
VR therapy for PTSD after 9/11 attack
(virtual planes flying over the WTC &
jets crashing…)
2016
Research
Milestone
First FDA-approved at-home VR
therapy: EaseVRx for back pain
Dr. Hunter Hoffman Dr. JoAnn Difede Dr. Albert “Skip” Rizzo Dr. Walter Greenleaf Dr. Jeremy Bailenson
Academic research has indicated that Virtual Reality can effectively treat a
wide variety of clinical problems – ranging from addictions, to stroke, to PTSD
Scentware
Other Dimensions of Sensory Input - Enhanced Immersion
9 scent actuators with interchangeable cartridges
Library of over 250 scents
Custom scent creation
Aaron Wisniewski
Other Dimensions of Sensory Input - Enhanced Immersion
Virtual Humans For Training, Support, Assessments, and Care
“Smart Avatar” with a virtual voice,
image and mannerisms via AI
AI-driven Avatar –
For conversational mental health
checkup.
Conversage
Virtual Worlds – Multiuser Immersive Experiences
Cloud-based 3D real time rendering
Learning &
Retention
Muscle
Memory
Presence & Context
Motivation/Engagement
Clinical VR/AR Systems Have Impact
Facilitate Cognitive Engagement
Promote Adherence
Active Involvement: XR systems provide users with
immersive experiences that maximize cognitive
engagement.
The Neuroscience of How VR/AR Systems
Support Clinical Care
Immersive systems support training and
improve clinical care by taking
advantage of the way our brain’s
learning and reward systems function
Activate neuroplastic change via reward systems
Shorten the reward feedback loop –
show progress
Leverage mirror neuron systems
VR/AR systems can:
Key Mechanisms of Impact
Active Involvement: XR systems provide users with
immersive experiences that maximize cognitive
engagement.
Feedback: learning is reinforced by direct, immediate and
relevant feedback that reinforces the experience and
the lessons learned.
Engaging and Motivating: the dynamic nature of XR
systems provides users with agency and can provide
immediate rewards for progress.
Cost Effective: XR systems extend the reach and reduce
the cost of face-to-face training.
Novels
Theater
Film
Games
AR/VR
Wired for Narrative Stories
Research shows that STORY:
• Provides superior retention
(memory and recall)
• Provides improved understanding
• Creates context and relevance
• Creates empathy
• Promotes engagement and participation
• Enhances the creation of meaning and
personal relevance
More than 1/2 of the participants in mental health app studies
drop out in week #1
Lack of engagement is the biggest DTx go-to-market risk
High dropout rates present a threat
to the validity of RCTs of Mental Health Apps
High Dropout Rates for Mobile Mental Health Apps-
Dropout rates in clinical trials of smartphone apps for depressive symptoms: A systematic review and meta-analysis
December 2019
Journal of Affective Disorders 263
Immersive Systems - Improved Adherence
Ability to change
attitudes and behavior
after “being” one’s
future self
Leveraging Mirror Neurons
Acute Pain
Addiction
Medicine ADHD
Anxiety
Management
Autism
Spectrum
Disorder
Chronic Pain
Cognitive
Assessments Depression
Disability
Solutions
Emergency
Medicine
Medical
Education
&Training
Ophthalmology
Orthopedics Palliative Care
Patient
Education
Phobias
PTSD
Physical
Medicine and
Rehabilitation
Preventive
Medicine
Respiratory
Medicine Senior Care Stroke & TBI
Surgical
Procedure
Planning
Surgical Skill
Training
Uncomfortable
Procedure
Distraction
More Than 300 Emerging Medical VR/AR Companies
Targeting Multiple Clinical Sectors and Specific Indications
ACTIVE USE CASES
• Suicide prevention and
suicidal ideation
• Spinal cord injury and disease
• Anxiety
• Depression
• Social isolation
• Substance use disorder
• Addiction recovery
• PTSD
• Phantom limb pain
• Pain management (acute,
chronic, acute on chronic)
• Physical, occupational,
recreation therapy
• Procedural use
• Low vision rehabilitation
• Falls risk assessment
• Neurological assessment
• Palliative care
• Creative Arts therapy
• Facilities management
• New employee orientation
• Empathy training
• Employee wellness
• Employee education
• Firearms safety
• Pre-surgical planning
CLINICAL IMPLEMENTATION:
NATIONAL EFFORTS as of 2/2023
In-vivo exposure for PTSD
• 7 sites
• 75 headsets
Imaginal Prolonged Exposure
• 28 sites
• 28 headsets
Radiology phobias
• 4 sites
• 20 headsets
Chronic pain and suicide prevention
• 60 sites
• 300 headsets
At-home management of chronic
low back pain
• 18 sites
• 250 uses of 8-week regimen
Creative Arts Therapy
• 73 sites
• 460 Headsets
Community Living Center Use
• 9 sites
• 45 headsets
Physical Therapy Business and Care Pathway
• 5 sites
• 25 headsets
Physical Therapy Implementation
• 18 sites
• 56 headsets
CleanBoxe
s provided
for Infection
Control
STAFF ENGAGEMENT
Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare
Global VR in Healthcare Market Revenue & Forecast 2017 - 2028
Market 2020(M) 2028(M) CAGR
North America 358.5 4.285.4 36.5%
Europe 227.8 2,879.5 37.6%
Asia Pacific 168.4 2,639.6 41.5%
MENA 50.2 678.2 38.8%
Latin America 80.9 1,175.1 40.1%
Total 885.7M 11,657.8M 38.3%
CAGR (2021 - 2028)
38.3%
Functional Training
Objective Assessments
Improved Interventions
Facilitated Adherence
Distributed Care Delivery
Prevention and Wellness
VR/AR Technology Will Significantly Impact Medical Care
Clinical Skill Training
Surgical Skill Training
Interpersonal Skill Training
Use of Equipment and Tools
Team Training - e.g.: Emergency
Department, Surgical Team
Emergency Response Training
and Rehearsal
Facilitate Empathy
Clinical Training
Virtual Standardized Patient Simulators
Mursion’s virtual standardized patient (VSP) simulators offer
medical educators a powerful way to enhance both technical
and interpersonal skills.
Improving the communication skills of a doctor
delivering a negative diagnosis
Increasing the effectiveness of therapy skills of
psychologists
Enabling prospective nurses to master giving an
effective patient history and coaching interview
Allowing pediatric healthcare providers to train in
scenarios involving a parent and an elementary-age
child
Enhancing the debriefing skills of a surgical team
Preparation and Training for Difficult Situations
Pediatric Resuscitation
VR simulation to train medical students
and staff to respond in high-stakes,
low-frequency pediatric emergencies.
Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare
Functional Training
Objective Assessments
Improved Interventions
Facilitated Adherence
Distributed Care Delivery
Prevention and Wellness
VR/AR Technology Will Impact Medical Care
Activities of Daily Living
Assessments
Physical Medicine –
OT / PT
Neuropsychological
Assessments
Behavioral Medicine –
Psychology, Psychiatry
Improved Assessments
Uncovering the signals that index cognitive load
Standardized Environments for Neurocognitive Evaluation
New Approaches for Cognitive Assessment
Migrates traditional paper
and subjective evaluations
to a more sophisticated
level.
Provides robust
assessments that can
challenge cognitive skills in
a more natural,
standardized, objective and
reproducible manner.
HRV
EYE TRACKING
GSR
LASER JUMP
BIA
Metric
Calculation / Algorithm
Auto Report
Pupil dilation
Number of saccades
Number of blinks
Number of fixations
Fixation duration
• Attention Span
• Cognitive Flexibility
• Problem Solving
• Planning
• Communication • Adaptive Learning
• Agility
• Multitasking
• Prioritization
• Embracing Diversity
Joint range of motion
Shoulder alignment
Hip alignment
Center of mass sway length
Center of mass sway velocity
Beta waves
Alpha waves
Theta waves
Delta waves
EEG
Total body water
Body fat percentage
Muscle mass
Fat free mass
Visceral fat level
Beta 13-32Hz
Alpha 8-13Hz
Theta 4-8 Hz
Delta 0,5-4 Hz
MOTION ANALYZER
Jump Height
Peak Power
• Posture
• Flexibility
• Balance
• Muscular Endurance
• Power
• Body Composition
• Self Regulation
• Resilience
• Empathy
Biosensors
Metrics
Domains
Competencies
PL ATFORM
• Attention
• Information Processing
• Problem Solving
• Working Memory
RMSSD, nn50,
pnn50, SDNN
LF Power
HF Pover
LF/HF
• Self Regulation
• Resilience
• Empathy
Onset time
Offset time
Recovery time
Number of peaks
Rising time
Peak amplitude
Lens Origin
L Eye
Coordinate (2,5,6)
Gaze Point
X
Y
Z
REye
neOAUVRA
HOLISTIC SCORE
1000
AI
CONFIDENTIAL & PROPRIETARY © neOAUVRA 2022, Do not distribute without permission.
• Business Acumen
• Strategic Vision
• Innovation
• Fluency of Ideas
• Cognitive Flexibility
• Optimism
• Multitasking
• Conceptual Thinking
®
Uncovering The Signals That Indicate Emotional State
With corresponding ratings of arousal, emotional valence, and other measures
Standardized Environments for Neurocognitive Evaluation
New Approaches for Cognitive Assessment
The Emteq platform uses electromyography (EMG)
combined with multi-modal sensors to measure
autonomic nervous system responses (HRV)
Provides actionable feedback based on valence (likes/
dislikes) and the arousal response (nerve and brain
activation due to stress/ cognitive load)
Facebook’s recent acquisition of CTRL-Labs for $500M
shows that the industry’s interest in measuring intent
Cameras or wrist-worn devices do not
provide the sensitivity, data quality or
quantity of multimodal head-worn emotion
sensing technology
Our true involuntary responses to felt
emotion is largely subconscious.
This can be measured more accurately using
a multi-dimensional approach that sets
emotion responses within the context.
Uncovering the signals that indicate emotional state
BioMarkers - Cognitive and Emotional State
Collecting and analyzing psychophysiological responses in VR
Muse S: Brain Sensing Headband
Lea Williams
Brain circuit biotypes –
Used to connect brain imaging with VR
Neuroimaging measures
1. Scan brain at rest
2. Emotion regulation task
3. Cognitive control task
Virtual Reality:
1. Relaxing scene
2. Emotion regulation task
3. Cognitive control game
We envision a precision health model using VR to elicit
biotypes to help refine the intervention choices
Cognitive training TMS
Eliciting biotypes using
normed environments
Heterogeneous
Disorder
Quantify and refine
biotypes
Relaxation Negative Scene
Positive Scene Cognitive Game
1st line Antidepressants
Mindfulness-based. TMS
Non-drug and
new drug options
Matching biotypes to the
intervention “menu”
Default Mode
Negative Affect
Positive Affect
Cognitive Control
Using AR Technology to Generate A Digital Neuro Signature
To Measure Longitudinal Individual-level Change In Alzheimer’s Disease
Altoida Awarded FDA Breakthrough Designation for
Development of Precision Neurology Device for Prediction of
Alzheimer's Disease
Classified as a Computerized Cognitive Assessment Aid
Class II, 510(k) exempt
Assessment data is collected via a 10 minute set of
augmented reality and motor activities
Using a smartphone or tablet.
The Altoida Large Cohort Study
One example of using AR technology to index cognitive and motor
function is the Altoida Digital Neuro Signature (DNS) an active
digital biomarker tool.
This tool assesses a user based on a battery of tests provided over
the course of 10 min, including eye tracking, motor, and
augmented reality-based tests.
Altoida DNS evaluates cognition, motor skills, and function,
and it predicts the risk of developing MCI due to AD.
Aside from its 94% prognostic accuracy, the Altoida DNS is
a highly sensitive (0.91) and specific(0.82) tool to measure
dementia disease progression.
npj Digital Medicine (2021) 4:101
Using a Digital Neuro Signature to
measure longitudinal individual-level
change in Alzheimer's disease
Functional Training
Objective Assessments
Improved Interventions
Facilitated Adherence
Distributed Care Delivery
Prevention and Wellness
VR/AR Technology Will Impact Medical Care
Preoperative Planning & Image Guided Surgery
Stroke and Traumatic Brain Injury
Physical / Occupational Therapy
Neuro Cognitive Rehabilitation
New Approaches to Physical Medicine & Rehabilitation
NEURO REHAB VR
Penumbra
Urgent Need for New Approaches to Mental Healthcare
Generalized Anxiety Disorder
Phobias
Addictions
Social Anxiety Disorder
Depression
Chronic Pain
Cognitive Impairment
Autism Spectrum Disorder
ADHD
Obsessive Compulsive Disorder
Anger Management
Schizophrenia
Virtual environments and wearable sensors are used clinically to treat
mental and behavioral health problems
VR/AR for Pain Distraction
Clinical Research and Validation
Interactive virtual environments significantly
reduce pain from as much as 44% during the
most painful procedures
(ex: burn wound treatment)
Diverts patient attention away from perceiving and feeling
pain; (selective attention theory)
Decreases pain-related brain-activity
Reduces need for anesthesia, opioid medication
No pharmacological side effects
PTSD, Phobias, 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
Addressing Addictions
Refusal skill training
Risk avoidance training
Situational confidence training
• Improved Nutrition
• Exercise & Weight Management
• Stress Management
• Mood and Resilience
HEALTH & WELLNESS
• Disability Solutions
• Addressing Isolation
• Improved Sleep
• Personalized CBT curriculum
• Virtual reality exposure therapy
• Skill development
• Social support
M Y N D
Therapeutics
MYNDSET - Weight Management Program
Improved Assessments and Diagnostics
Addressing Isolation and Loneliness
Acute and Chronic Pain
Depression and Anxiety Disorders
Physical and Neuro Rehabilitation
Design for Disabilities
Post-Discharge Follow-up
Staff Training: not just procedures, but empathy
Applications for Senior Care
What Are The Constraints?
What are the gating-steps to adoption?
Body of literature is expanding with encouraging results,
But remains insufficient
Available research varies by condition treated
Lack of randomized controlled trials
Population-specific studies
Obsolete platforms and equipment
Small sample sizes
Research Gaps
Perception of VR as a Gaming Platform
Busy Clinics – limited time, limited Budget
Evidence-based treatments are already available
Products Need To Be Aligned With
Healthcare System Needs
What is the financial and time benefit?
Does it interfere with the clinic workflow?
Areas of Significant Value in the next 5-10 Years:
Effective Data Integration
AI-Enabled Preventative Care
Remote Surgery & Telemedicine Immersive Procedural Skill Training
The challenge of integrating data will be
exacerbated by large companies competing for
market share of digital health records
Solving integration issues for large datasets
will be highly valuable
Telemedicine and remote surgery technology
will help create smaller, more efficient and
dispersed healthcare delivery sites, either
integrated with long term care, or close by
Advances in immersive technology will help
practitioners learn procedural skills more quickly
and with lower risk to patients
Better insight into the benefits of
preventative care will prompt more
investment from employers
Enterprise health and mental wellness
market will grow
In Summary
The Role of the Doctor
Evolving systems will emphasize integrated patient data
and predictive modeling to deliver more accurate care
Post-discharge care will utilize avatars and
conversational agents to provide improved access and
reduce burden on the clinician
Next-generation care models will place greater emphasis
on the clinician’s ability to motivate the patient to adhere
to treatment plans.
Due to the expansion of catchment areas enabled by
telemedicine, clinicians will be called upon to manage a
larger number of patients - they will only be able to do so
by leveraging digital technology
Increasingly an Informatics-Based Profession
Estimated 150 hours/week of study to stay
current as a physician in a specialty area
The Next Generation of Healthcare Technology Will Evolve Business Models
Not Destroy Them
Remote operations & Telemedicine may
give rise to smaller-scale, more specialized
sites of care that are a part of larger health
systems
Data can improve understanding of hospitals
and clinicians, increasing effectiveness in
resource allocation and procedure
methodology
Improved analytics will prompt employers to
invest in preventative care for employees,
reducing long term healthcare costs and
improving employee productivity
Existing stakeholders will need to adapt
Incumbents are best positioned,
-will they rise to the occasion?
Areas of Significant Value in the next 5-10 Years:
Effective Data Integration
AI-Enabled Preventative Care
Remote Surgery & Telemedicine Immersive Procedural Skill Training
The challenge of integrating data will be
exacerbated by large companies competing for
market share of digital health records
Solving integration issues for large datasets
will be highly valuable
Telemedicine and remote surgery technology
will help create smaller, more efficient and
dispersed healthcare delivery sites, either
integrated with long term care, or close by
Advances in immersive technology will help
practitioners learn procedural skills more quickly
and with lower risk to patients
Better insight into the benefits of
preventative care will prompt more
investment from employers
Enterprise health and mental wellness
market will grow
Current technologies and concepts are
founded on more than 30 years of research
and development
Recent changes in cost and access make
dynamic assessment and intervention systems
affordable
Medical VR/AR Systems – Overall Status and Opportunity
On the horizon - enhanced, ubiquitous, informative and integrated
After years of study and use by early adopters –
validated systems are poised to move to the mainstream
The work we do is important
The work we do is meaningful
We work together to
move the field forward
7th Annual
Virtual Reality and Healthcare Global Symposium
5th Annual
Virtual Reality and Healthcare - Europe
Helsinki October 19-20, 2023
Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare

More Related Content

PDF
A CONSULTING REPORT ON MARKET ENTRY STRATEGY FOR BEN & JERRY’S IN INDIA
PDF
Research Directions for Cross Reality Interfaces
PDF
The Metaverse: Are We There Yet?
PDF
RapportPFE_IngenieurInformatique_ESPRIT
PDF
A Metaverse Primer by Kent Bye, Voices of VR Podcast
PPT
Baskin Robbins Global Marketing
PDF
The Ultimate Potential of VR: Promises & Perils - Kent Bye SXSW
PDF
Matterport's $3B SPAC pitch deck
A CONSULTING REPORT ON MARKET ENTRY STRATEGY FOR BEN & JERRY’S IN INDIA
Research Directions for Cross Reality Interfaces
The Metaverse: Are We There Yet?
RapportPFE_IngenieurInformatique_ESPRIT
A Metaverse Primer by Kent Bye, Voices of VR Podcast
Baskin Robbins Global Marketing
The Ultimate Potential of VR: Promises & Perils - Kent Bye SXSW
Matterport's $3B SPAC pitch deck

What's hot (20)

PDF
AN OVERVIEW OF THE METAVERSE
PDF
Methods and Challenges for Metaverse Analytics.pdf
PDF
Virtual reality and healthcare - the past, the present, and the future
PDF
Building the Metaverse
PDF
What is Metaverse ? What is Not ?
PDF
EON Reality Knowledge Metaverse Program (EKM Program)
PPTX
IOT wearable device case study
PDF
Digital Business Transformation | Strategy + Execution
PDF
What's Digital Transformation?
PDF
Metaverse - The Future of Marketing and Web 3.0.pdf
PPTX
Augmented reality
PDF
Metaverse
PPTX
Ar and vr in business
PPTX
Industry X.0 - Realizing Digital Value in Industrial Sectors
PDF
Metaverse - the attraction of new identty
PDF
Digital transformation
PPT
Mixed Reality
PPTX
Change! Digital Transformation
PDF
The Impact of VR and AR on Medical Research and Healthcare
PPTX
Future of Augmented Reality
AN OVERVIEW OF THE METAVERSE
Methods and Challenges for Metaverse Analytics.pdf
Virtual reality and healthcare - the past, the present, and the future
Building the Metaverse
What is Metaverse ? What is Not ?
EON Reality Knowledge Metaverse Program (EKM Program)
IOT wearable device case study
Digital Business Transformation | Strategy + Execution
What's Digital Transformation?
Metaverse - The Future of Marketing and Web 3.0.pdf
Augmented reality
Metaverse
Ar and vr in business
Industry X.0 - Realizing Digital Value in Industrial Sectors
Metaverse - the attraction of new identty
Digital transformation
Mixed Reality
Change! Digital Transformation
The Impact of VR and AR on Medical Research and Healthcare
Future of Augmented Reality
Ad

Similar to Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare (20)

PDF
Virtual Reality and Healthcare - The Past, the Present, and the Future
PDF
Digital Therapeutics, XR, AI, Precision Medicine The Future of Sensor-Driven ...
PDF
Dr. Walter Greenleaf's presentation for the IVRHA Meeting -August 2020
PDF
Virtual Reality Technology, Machine Learning, Biosensing Converging to Transf...
PDF
An Overview of VR Technology and Smulation in Healthcare
PDF
Walter Greenleaf - The Impact of XR Technologies on Medical Research and Heal...
PDF
7 Best Points of The Future of Digital Technology in Healthcare | The Entrepr...
PPTX
Healthcare Innovation Technology Group Meeting
PPT
Ambient Intelligence and Immersive Virtual Telepresence in Health Care
PPT
Is Pervasive Healthcare Old Wine on a New Bottle?
PDF
The future of healthcare: Realities or science fiction?
PPTX
virtualrealityandhealthcare.pptx
PPTX
Technology forecast in healthcare industry
PDF
Unpacking AI for Healthcare
PPTX
Healthcare innovation technology group meeting wide
PDF
Kant health report
PDF
KANT Report: HEALTH
PPTX
How to intervene early: Examples in depression, epilepsy and smoking cessation
PDF
Digital medicine comes of age - ISDM E-Newsletter Feb 2020
PPTX
Serialization outlook next 5 years predictions
Virtual Reality and Healthcare - The Past, the Present, and the Future
Digital Therapeutics, XR, AI, Precision Medicine The Future of Sensor-Driven ...
Dr. Walter Greenleaf's presentation for the IVRHA Meeting -August 2020
Virtual Reality Technology, Machine Learning, Biosensing Converging to Transf...
An Overview of VR Technology and Smulation in Healthcare
Walter Greenleaf - The Impact of XR Technologies on Medical Research and Heal...
7 Best Points of The Future of Digital Technology in Healthcare | The Entrepr...
Healthcare Innovation Technology Group Meeting
Ambient Intelligence and Immersive Virtual Telepresence in Health Care
Is Pervasive Healthcare Old Wine on a New Bottle?
The future of healthcare: Realities or science fiction?
virtualrealityandhealthcare.pptx
Technology forecast in healthcare industry
Unpacking AI for Healthcare
Healthcare innovation technology group meeting wide
Kant health report
KANT Report: HEALTH
How to intervene early: Examples in depression, epilepsy and smoking cessation
Digital medicine comes of age - ISDM E-Newsletter Feb 2020
Serialization outlook next 5 years predictions
Ad

Recently uploaded (20)

PDF
Lecture 8- Cornea and Sclera .pdf 5tg year
PPTX
CARDIOVASCULAR AND RENAL DRUGS.pptx for health study
PPTX
HYPERSENSITIVITY REACTIONS - Pathophysiology Notes for Second Year Pharm D St...
PPTX
Vaccines and immunization including cold chain , Open vial policy.pptx
PPTX
Impression Materials in dental materials.pptx
PDF
SEMEN PREPARATION TECHNIGUES FOR INTRAUTERINE INSEMINATION.pdf
PDF
04 dr. Rahajeng - dr.rahajeng-KOGI XIX 2025-ed1.pdf
PDF
Forensic Psychology and Its Impact on the Legal System.pdf
PDF
The_EHRA_Book_of_Interventional Electrophysiology.pdf
PPT
Infections Member of Royal College of Physicians.ppt
PDF
Lecture on Anesthesia for ENT surgery 2025pptx.pdf
PDF
OSCE SERIES ( Questions & Answers ) - Set 3.pdf
PPT
Rheumatology Member of Royal College of Physicians.ppt
PPTX
Antepartum_Haemorrhage_Guidelines_2024.pptx
PPT
Blood and blood products and their uses .ppt
PPTX
NUCLEAR-MEDICINE-Copy.pptxbabaabahahahaahha
PDF
OSCE Series ( Questions & Answers ) - Set 6.pdf
PPTX
Wheat allergies and Disease in gastroenterology
PPTX
Introduction to Medical Microbiology for 400L Medical Students
PDF
MNEMONICS MNEMONICS MNEMONICS MNEMONICS s
Lecture 8- Cornea and Sclera .pdf 5tg year
CARDIOVASCULAR AND RENAL DRUGS.pptx for health study
HYPERSENSITIVITY REACTIONS - Pathophysiology Notes for Second Year Pharm D St...
Vaccines and immunization including cold chain , Open vial policy.pptx
Impression Materials in dental materials.pptx
SEMEN PREPARATION TECHNIGUES FOR INTRAUTERINE INSEMINATION.pdf
04 dr. Rahajeng - dr.rahajeng-KOGI XIX 2025-ed1.pdf
Forensic Psychology and Its Impact on the Legal System.pdf
The_EHRA_Book_of_Interventional Electrophysiology.pdf
Infections Member of Royal College of Physicians.ppt
Lecture on Anesthesia for ENT surgery 2025pptx.pdf
OSCE SERIES ( Questions & Answers ) - Set 3.pdf
Rheumatology Member of Royal College of Physicians.ppt
Antepartum_Haemorrhage_Guidelines_2024.pptx
Blood and blood products and their uses .ppt
NUCLEAR-MEDICINE-Copy.pptxbabaabahahahaahha
OSCE Series ( Questions & Answers ) - Set 6.pdf
Wheat allergies and Disease in gastroenterology
Introduction to Medical Microbiology for 400L Medical Students
MNEMONICS MNEMONICS MNEMONICS MNEMONICS s

Virtual Reality, Machine Learning, Biosensing - Converging to Transform Healthcare

  • 1. Walter Greenleaf PhD Converging to Transform Healthcare Virtual Reality, Machine Learning, Biosensing
  • 2. The work we do is important The work we do is meaningful We work together to move the field forward 7th Annual Virtual Reality and Healthcare Global Symposium
  • 3. Current technologies and concepts are founded on more than 30 years of research and development Recent changes in cost and access make clinical VR systems affordable Medical VR/AR Systems – Overall Status and Opportunity On the horizon - enhanced, ubiquitous, informative and integrated After years of study and use by early adopters – validated systems are poised to move to the mainstream
  • 4. + AR + MR = XR Immersive Systems Extended Reality
  • 5. Functional Training Objective Assessments Improved Interventions Facilitated Adherence Distributed Care Delivery Prevention and Wellness VR/ AR systems are currently used for -
  • 6. Now is the time for VR & AR (XR) XR technology is now affordable, scalable and accessible Meta - Oculus HP - Reverb Sony – PlayStation VR Microsoft - HoloLens HTC - Vive Apple - The HMD is what you think of when you think of VR- But there is so much more going on “behind the screen”
  • 8. Healthcare Crisis: Aging Populations 0 50 100 150 200 250 300 350 400 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2015 2020 2025 Age 85+ Age 75-84 Age 65-74 Age 45-64 Age 5-44 Under Age 5 In 1970, there were roughly half as many people in the world as there are now
  • 9. Healthcare Demand is Evolving As we extent our longevity, we see a higher percentage of people living with diseases of “old age: Alzheimer's, Parkinson’s Physical Disabilities – Restrictions on Mobility Mild Cognitive Impairment Acute and Chronic Pain Stroke Cataracts, Macular Degeneration The fight continues against the more intractable ‘old enemies’: Cancer Heart Disease Respiratory Disease Kidney Disease
  • 10. Healthcare Demand is Evolving Shifts In demographics & lifestyle have led to new expressions of disease Anxiety Disorders Depression Burnout Diabetes Obesity Addictions
  • 11. TREND: Moving Health Care to the Left Value Cost Health Status 20% of Population Generate 80% of the Costs Healthy / Low Risk At Risk High Risk Chronic Disease – Early Stage Acute Disease Chronic Disease Progression End of Life Care Benefits of Proactive Mitigation of Disease Risk
  • 12. Cost of Care Delivery / Day Health Independent Living Community Clinic Doctor’s Office Assisted Living Skilled Nursing Facility Quality of Life $10,000 $1,000 $10 $1 Specialty Clinic Home Care Supported Care Community Hospital Intensive Care Acute Care 0% 100% Chronic Disease Management $100 TREND: Where Healthcare Happens
  • 14. The Stanford Laboratory for Brain Health Innovation and Entrepreneurship Medical Mixed Reality Program Wearable Electronics (eWear) Initiative ENGINEERING Academic Affiliations Childhood Anxiety Reduction through Innovation and Technology VR & Immersive Technology In the Department of Psychiatry and Behavioral Sciences
  • 16. Digital Health Revolution • Mobile Health / eHealth • Machine Learning • Wearable Sensors • Patient Centered • Leverages Internet: social, quantitative, collaborative
  • 17. Every Medical Device Reinvented - & Now Digital
  • 18. Digital Heath World Population 7.98 Billion Mobile Phone Users 5.34 Billion Growing Exponentially...
  • 19. Digital Health Platforms deliver interventions to patients, and parse data for enhanced analysis and improved protocols
  • 20. Prescription Digital Therapeutics Combination Therapy - Digital Health Platform App-based system designed to enhance medication efficacy Medication with clinical benefit Prescribed combination product with enhanced efficacy = +
  • 21. New methods are being developed that will allow us to collect and analyze biomarkers that reflect our cognitive and emotional status. Here are four examples… Brain Health BioMarkers - Passive Data from Smart Phones Voice Analytics as a BioMarker of Depression Facial expressions in response to a VR Challenge Cognitive function assessment using AR and smartphone sensors Digital Systems Are Not Just Measuring The Physical Parameters of Our Health
  • 22. Prescription Digital Therapeutics Create Value In Areas Of High Patient Need Combination Therapy PDTs can monitor toxicity and personalize treatment Can leverage sensor data. Dose Optimization PDTs can monitor and address comorbid conditions: insomnia, poor nutrition, anxiety, depression, activity levels, use of nicotine and alcohol, etc Address Comorbid Conditions Software-based therapies have been shown to be effective as stand-alone interventions – there is incremental effectiveness when PTDs are used in combination with standard treatment Facilitate Adherence Collect Utilization And Efficacy Data PDTs have several tools to facilitate adherence –provide key information, close the feedback loop, show progress, connect to the care team, leverage games and other motivational tools, provide reminders and sound alerts, etc PDTs collect de-identified utilization and efficacy data – combined with sensor data Advancing research, facilitating improved formulations, and allowing for personalized protocols based on large-scale studies.
  • 24. CONVERGENCE of Several Fast-Moving Technologies New technologies provide an avenue to address many previously intractable problems, transform cost models, & greatly improve patient outcomes AI / Machine Learning – Improved Diagnostics, Precision Clinical Therapies Digital Health Platforms – Remote Monitoring, Assessments, Therapeutics Human/Machine Interface - Wearables, Prostheses, Implantables Pharmaceutical Development - Decentralized Trials, AI Drug Discovery, Combination Therapy Robotics - Microsurgery, Telesurgery, Rehabilitation, Disability Solutions Nano-Medicine - Tumor Detection, Drug Delivery, Imaging, Tissue Engineering Genetic Medicine – Gene Therapy, Personalized Medicine, Predictive Medicine Wearable Sensors – Improved Diagnostics, Telemedicine, Precision Medicine,
  • 25. Sensors Are Evolving, Connecting, Promulgating Sensors 1.0 Sensors 3.0 Sensors 2.0 Measure and record Integration with web; Sharing and accessing data Passive data gathering; Aggregation and meaningful interpretation
  • 26. Entering the Era of Medical Wearables
  • 27. Machine Learning & Predictive Analytics
  • 28. Leveraging technology that senses, interprets, and adapts to how you feel and act – And factors in your health status, your goals, and your priorities. The future is about personalized experiences
  • 29. Technology that personalizes experiences- Technology that senses, interprets, and adapts to how you feel and act
  • 30. Soon, the broadly adopted technology used for our interactions with our environment … and with each other … will change. All will be facilitated by technology that personalizes experiences, that is, technology that senses, interprets, and adapts to how you feel and act Our interactions with the built environment, communications systems, entertainment platforms, transportation systems, social platforms, etc -
  • 31. Affective Computing Affective Computing is the study and development of systems and devices that can recognize, interpret, process, and and in some cases simulate human affects. It is an interdisciplinary field spanning computer science, psychology, engineering, and cognitive science. One goal of Affective Computing is to develop systems that can interpret our emotional state and adapt their functionality accordingly– to be able to generate an appropriate response to the user's emotional state.
  • 32. A Voice-Based Vital Sign for Mental Health Using voice as a biomarker for mental health and wellbeing along with machine- learning algorithms, Ellipsis Health generates a clinical-grade assessment of the severity of anxiety and depression, with just a short sample of speech.
  • 33. Digital Twin Paradigm For Precision Healthcare
  • 34. A data stream for physicians to manage patients between visits Includes specific Rx compliance tracking capabilities Focus on issues disease worsening, new symptoms Includes Alerts to Care Team and integrates at POC Sensor Tech PatientApp Wearables PA TIENTS PhysicianApp PHYSICIAN Office Visit Office Visit Injection issue GI issue Relapse? Sleep issues Tingling, weakness Actionable, avoid events, costs, ROI path to payment
  • 35. fNIRS and Other Imaging
  • 37. 5G connections – Forecast to Exceed 5.9 billion by the end of 2027 Single-digit millisecond latencies with Edge Computing Cloud-Rendered AR and VR content Real-time Analytics for Machine Learning, Predictive Modeling
  • 38. Digital Healthcare Business Trends Shifting Business Models – Tech Titans, Direct to Consumer Shifting Regulatory Landscape Telemedicine Gains Traction Focus on Mental Health
  • 39. Virtual Reality & Augmented Reality Technology Immersive Systems
  • 40. First general purpose and commercially available VR systems. VR Technology Has Evolved 1987
  • 41. My 36 Year Journey…. Stanford University VR Technology Has Evolved
  • 43. SpiderWorld VR for phobia treatment 1997 Phobias 2003 Burns - Pain SnowWorld VR for burn pain management 2007 Landmark Study - Pain VR immersion for pain relief 2021 Clinical Acceptance 2021+ Mainstream Adoption Proliferation of start- ups, use at-home and clinical environment +2000 peer-reviewed publications in 2016 2002 PTSD VR therapy for PTSD after 9/11 attack (virtual planes flying over the WTC & jets crashing…) 2016 Research Milestone First FDA-approved at-home VR therapy: EaseVRx for back pain Dr. Hunter Hoffman Dr. JoAnn Difede Dr. Albert “Skip” Rizzo Dr. Walter Greenleaf Dr. Jeremy Bailenson
  • 44. Academic research has indicated that Virtual Reality can effectively treat a wide variety of clinical problems – ranging from addictions, to stroke, to PTSD
  • 45. Scentware Other Dimensions of Sensory Input - Enhanced Immersion 9 scent actuators with interchangeable cartridges Library of over 250 scents Custom scent creation Aaron Wisniewski
  • 46. Other Dimensions of Sensory Input - Enhanced Immersion
  • 47. Virtual Humans For Training, Support, Assessments, and Care “Smart Avatar” with a virtual voice, image and mannerisms via AI AI-driven Avatar – For conversational mental health checkup. Conversage
  • 48. Virtual Worlds – Multiuser Immersive Experiences Cloud-based 3D real time rendering
  • 49. Learning & Retention Muscle Memory Presence & Context Motivation/Engagement Clinical VR/AR Systems Have Impact Facilitate Cognitive Engagement Promote Adherence Active Involvement: XR systems provide users with immersive experiences that maximize cognitive engagement.
  • 50. The Neuroscience of How VR/AR Systems Support Clinical Care Immersive systems support training and improve clinical care by taking advantage of the way our brain’s learning and reward systems function Activate neuroplastic change via reward systems Shorten the reward feedback loop – show progress Leverage mirror neuron systems VR/AR systems can:
  • 51. Key Mechanisms of Impact Active Involvement: XR systems provide users with immersive experiences that maximize cognitive engagement. Feedback: learning is reinforced by direct, immediate and relevant feedback that reinforces the experience and the lessons learned. Engaging and Motivating: the dynamic nature of XR systems provides users with agency and can provide immediate rewards for progress. Cost Effective: XR systems extend the reach and reduce the cost of face-to-face training. Novels Theater Film Games AR/VR
  • 52. Wired for Narrative Stories Research shows that STORY: • Provides superior retention (memory and recall) • Provides improved understanding • Creates context and relevance • Creates empathy • Promotes engagement and participation • Enhances the creation of meaning and personal relevance
  • 53. More than 1/2 of the participants in mental health app studies drop out in week #1 Lack of engagement is the biggest DTx go-to-market risk High dropout rates present a threat to the validity of RCTs of Mental Health Apps High Dropout Rates for Mobile Mental Health Apps- Dropout rates in clinical trials of smartphone apps for depressive symptoms: A systematic review and meta-analysis December 2019 Journal of Affective Disorders 263 Immersive Systems - Improved Adherence
  • 54. Ability to change attitudes and behavior after “being” one’s future self Leveraging Mirror Neurons
  • 55. Acute Pain Addiction Medicine ADHD Anxiety Management Autism Spectrum Disorder Chronic Pain Cognitive Assessments Depression Disability Solutions Emergency Medicine Medical Education &Training Ophthalmology Orthopedics Palliative Care Patient Education Phobias PTSD Physical Medicine and Rehabilitation Preventive Medicine Respiratory Medicine Senior Care Stroke & TBI Surgical Procedure Planning Surgical Skill Training Uncomfortable Procedure Distraction More Than 300 Emerging Medical VR/AR Companies Targeting Multiple Clinical Sectors and Specific Indications
  • 56. ACTIVE USE CASES • Suicide prevention and suicidal ideation • Spinal cord injury and disease • Anxiety • Depression • Social isolation • Substance use disorder • Addiction recovery • PTSD • Phantom limb pain • Pain management (acute, chronic, acute on chronic) • Physical, occupational, recreation therapy • Procedural use • Low vision rehabilitation • Falls risk assessment • Neurological assessment • Palliative care • Creative Arts therapy • Facilities management • New employee orientation • Empathy training • Employee wellness • Employee education • Firearms safety • Pre-surgical planning
  • 57. CLINICAL IMPLEMENTATION: NATIONAL EFFORTS as of 2/2023 In-vivo exposure for PTSD • 7 sites • 75 headsets Imaginal Prolonged Exposure • 28 sites • 28 headsets Radiology phobias • 4 sites • 20 headsets Chronic pain and suicide prevention • 60 sites • 300 headsets At-home management of chronic low back pain • 18 sites • 250 uses of 8-week regimen Creative Arts Therapy • 73 sites • 460 Headsets Community Living Center Use • 9 sites • 45 headsets Physical Therapy Business and Care Pathway • 5 sites • 25 headsets Physical Therapy Implementation • 18 sites • 56 headsets CleanBoxe s provided for Infection Control
  • 60. Global VR in Healthcare Market Revenue & Forecast 2017 - 2028 Market 2020(M) 2028(M) CAGR North America 358.5 4.285.4 36.5% Europe 227.8 2,879.5 37.6% Asia Pacific 168.4 2,639.6 41.5% MENA 50.2 678.2 38.8% Latin America 80.9 1,175.1 40.1% Total 885.7M 11,657.8M 38.3% CAGR (2021 - 2028) 38.3%
  • 61. Functional Training Objective Assessments Improved Interventions Facilitated Adherence Distributed Care Delivery Prevention and Wellness VR/AR Technology Will Significantly Impact Medical Care
  • 62. Clinical Skill Training Surgical Skill Training Interpersonal Skill Training Use of Equipment and Tools Team Training - e.g.: Emergency Department, Surgical Team Emergency Response Training and Rehearsal Facilitate Empathy Clinical Training
  • 63. Virtual Standardized Patient Simulators Mursion’s virtual standardized patient (VSP) simulators offer medical educators a powerful way to enhance both technical and interpersonal skills. Improving the communication skills of a doctor delivering a negative diagnosis Increasing the effectiveness of therapy skills of psychologists Enabling prospective nurses to master giving an effective patient history and coaching interview Allowing pediatric healthcare providers to train in scenarios involving a parent and an elementary-age child Enhancing the debriefing skills of a surgical team
  • 64. Preparation and Training for Difficult Situations
  • 65. Pediatric Resuscitation VR simulation to train medical students and staff to respond in high-stakes, low-frequency pediatric emergencies.
  • 67. Functional Training Objective Assessments Improved Interventions Facilitated Adherence Distributed Care Delivery Prevention and Wellness VR/AR Technology Will Impact Medical Care
  • 68. Activities of Daily Living Assessments Physical Medicine – OT / PT Neuropsychological Assessments Behavioral Medicine – Psychology, Psychiatry Improved Assessments
  • 69. Uncovering the signals that index cognitive load
  • 70. Standardized Environments for Neurocognitive Evaluation New Approaches for Cognitive Assessment Migrates traditional paper and subjective evaluations to a more sophisticated level. Provides robust assessments that can challenge cognitive skills in a more natural, standardized, objective and reproducible manner.
  • 71. HRV EYE TRACKING GSR LASER JUMP BIA Metric Calculation / Algorithm Auto Report Pupil dilation Number of saccades Number of blinks Number of fixations Fixation duration • Attention Span • Cognitive Flexibility • Problem Solving • Planning • Communication • Adaptive Learning • Agility • Multitasking • Prioritization • Embracing Diversity Joint range of motion Shoulder alignment Hip alignment Center of mass sway length Center of mass sway velocity Beta waves Alpha waves Theta waves Delta waves EEG Total body water Body fat percentage Muscle mass Fat free mass Visceral fat level Beta 13-32Hz Alpha 8-13Hz Theta 4-8 Hz Delta 0,5-4 Hz MOTION ANALYZER Jump Height Peak Power • Posture • Flexibility • Balance • Muscular Endurance • Power • Body Composition • Self Regulation • Resilience • Empathy Biosensors Metrics Domains Competencies PL ATFORM • Attention • Information Processing • Problem Solving • Working Memory RMSSD, nn50, pnn50, SDNN LF Power HF Pover LF/HF • Self Regulation • Resilience • Empathy Onset time Offset time Recovery time Number of peaks Rising time Peak amplitude Lens Origin L Eye Coordinate (2,5,6) Gaze Point X Y Z REye neOAUVRA HOLISTIC SCORE 1000 AI CONFIDENTIAL & PROPRIETARY © neOAUVRA 2022, Do not distribute without permission. • Business Acumen • Strategic Vision • Innovation • Fluency of Ideas • Cognitive Flexibility • Optimism • Multitasking • Conceptual Thinking ®
  • 72. Uncovering The Signals That Indicate Emotional State
  • 73. With corresponding ratings of arousal, emotional valence, and other measures Standardized Environments for Neurocognitive Evaluation New Approaches for Cognitive Assessment
  • 74. The Emteq platform uses electromyography (EMG) combined with multi-modal sensors to measure autonomic nervous system responses (HRV) Provides actionable feedback based on valence (likes/ dislikes) and the arousal response (nerve and brain activation due to stress/ cognitive load) Facebook’s recent acquisition of CTRL-Labs for $500M shows that the industry’s interest in measuring intent Cameras or wrist-worn devices do not provide the sensitivity, data quality or quantity of multimodal head-worn emotion sensing technology Our true involuntary responses to felt emotion is largely subconscious. This can be measured more accurately using a multi-dimensional approach that sets emotion responses within the context. Uncovering the signals that indicate emotional state
  • 75. BioMarkers - Cognitive and Emotional State Collecting and analyzing psychophysiological responses in VR Muse S: Brain Sensing Headband
  • 77. Brain circuit biotypes – Used to connect brain imaging with VR Neuroimaging measures 1. Scan brain at rest 2. Emotion regulation task 3. Cognitive control task Virtual Reality: 1. Relaxing scene 2. Emotion regulation task 3. Cognitive control game
  • 78. We envision a precision health model using VR to elicit biotypes to help refine the intervention choices Cognitive training TMS Eliciting biotypes using normed environments Heterogeneous Disorder Quantify and refine biotypes Relaxation Negative Scene Positive Scene Cognitive Game 1st line Antidepressants Mindfulness-based. TMS Non-drug and new drug options Matching biotypes to the intervention “menu” Default Mode Negative Affect Positive Affect Cognitive Control
  • 79. Using AR Technology to Generate A Digital Neuro Signature To Measure Longitudinal Individual-level Change In Alzheimer’s Disease Altoida Awarded FDA Breakthrough Designation for Development of Precision Neurology Device for Prediction of Alzheimer's Disease Classified as a Computerized Cognitive Assessment Aid Class II, 510(k) exempt Assessment data is collected via a 10 minute set of augmented reality and motor activities Using a smartphone or tablet.
  • 80. The Altoida Large Cohort Study One example of using AR technology to index cognitive and motor function is the Altoida Digital Neuro Signature (DNS) an active digital biomarker tool. This tool assesses a user based on a battery of tests provided over the course of 10 min, including eye tracking, motor, and augmented reality-based tests. Altoida DNS evaluates cognition, motor skills, and function, and it predicts the risk of developing MCI due to AD. Aside from its 94% prognostic accuracy, the Altoida DNS is a highly sensitive (0.91) and specific(0.82) tool to measure dementia disease progression. npj Digital Medicine (2021) 4:101 Using a Digital Neuro Signature to measure longitudinal individual-level change in Alzheimer's disease
  • 81. Functional Training Objective Assessments Improved Interventions Facilitated Adherence Distributed Care Delivery Prevention and Wellness VR/AR Technology Will Impact Medical Care
  • 82. Preoperative Planning & Image Guided Surgery
  • 83. Stroke and Traumatic Brain Injury Physical / Occupational Therapy Neuro Cognitive Rehabilitation New Approaches to Physical Medicine & Rehabilitation NEURO REHAB VR Penumbra
  • 84. Urgent Need for New Approaches to Mental Healthcare
  • 85. Generalized Anxiety Disorder Phobias Addictions Social Anxiety Disorder Depression Chronic Pain Cognitive Impairment Autism Spectrum Disorder ADHD Obsessive Compulsive Disorder Anger Management Schizophrenia Virtual environments and wearable sensors are used clinically to treat mental and behavioral health problems
  • 86. VR/AR for Pain Distraction Clinical Research and Validation Interactive virtual environments significantly reduce pain from as much as 44% during the most painful procedures (ex: burn wound treatment) Diverts patient attention away from perceiving and feeling pain; (selective attention theory) Decreases pain-related brain-activity Reduces need for anesthesia, opioid medication No pharmacological side effects
  • 87. PTSD, Phobias, 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
  • 88. Addressing Addictions Refusal skill training Risk avoidance training Situational confidence training
  • 89. • Improved Nutrition • Exercise & Weight Management • Stress Management • Mood and Resilience HEALTH & WELLNESS • Disability Solutions • Addressing Isolation • Improved Sleep
  • 90. • Personalized CBT curriculum • Virtual reality exposure therapy • Skill development • Social support M Y N D Therapeutics MYNDSET - Weight Management Program
  • 91. Improved Assessments and Diagnostics Addressing Isolation and Loneliness Acute and Chronic Pain Depression and Anxiety Disorders Physical and Neuro Rehabilitation Design for Disabilities Post-Discharge Follow-up Staff Training: not just procedures, but empathy Applications for Senior Care
  • 92. What Are The Constraints? What are the gating-steps to adoption?
  • 93. Body of literature is expanding with encouraging results, But remains insufficient Available research varies by condition treated Lack of randomized controlled trials Population-specific studies Obsolete platforms and equipment Small sample sizes Research Gaps
  • 94. Perception of VR as a Gaming Platform
  • 95. Busy Clinics – limited time, limited Budget Evidence-based treatments are already available Products Need To Be Aligned With Healthcare System Needs What is the financial and time benefit? Does it interfere with the clinic workflow?
  • 96. Areas of Significant Value in the next 5-10 Years: Effective Data Integration AI-Enabled Preventative Care Remote Surgery & Telemedicine Immersive Procedural Skill Training The challenge of integrating data will be exacerbated by large companies competing for market share of digital health records Solving integration issues for large datasets will be highly valuable Telemedicine and remote surgery technology will help create smaller, more efficient and dispersed healthcare delivery sites, either integrated with long term care, or close by Advances in immersive technology will help practitioners learn procedural skills more quickly and with lower risk to patients Better insight into the benefits of preventative care will prompt more investment from employers Enterprise health and mental wellness market will grow
  • 98. The Role of the Doctor Evolving systems will emphasize integrated patient data and predictive modeling to deliver more accurate care Post-discharge care will utilize avatars and conversational agents to provide improved access and reduce burden on the clinician Next-generation care models will place greater emphasis on the clinician’s ability to motivate the patient to adhere to treatment plans. Due to the expansion of catchment areas enabled by telemedicine, clinicians will be called upon to manage a larger number of patients - they will only be able to do so by leveraging digital technology Increasingly an Informatics-Based Profession Estimated 150 hours/week of study to stay current as a physician in a specialty area
  • 99. The Next Generation of Healthcare Technology Will Evolve Business Models Not Destroy Them Remote operations & Telemedicine may give rise to smaller-scale, more specialized sites of care that are a part of larger health systems Data can improve understanding of hospitals and clinicians, increasing effectiveness in resource allocation and procedure methodology Improved analytics will prompt employers to invest in preventative care for employees, reducing long term healthcare costs and improving employee productivity Existing stakeholders will need to adapt Incumbents are best positioned, -will they rise to the occasion?
  • 100. Areas of Significant Value in the next 5-10 Years: Effective Data Integration AI-Enabled Preventative Care Remote Surgery & Telemedicine Immersive Procedural Skill Training The challenge of integrating data will be exacerbated by large companies competing for market share of digital health records Solving integration issues for large datasets will be highly valuable Telemedicine and remote surgery technology will help create smaller, more efficient and dispersed healthcare delivery sites, either integrated with long term care, or close by Advances in immersive technology will help practitioners learn procedural skills more quickly and with lower risk to patients Better insight into the benefits of preventative care will prompt more investment from employers Enterprise health and mental wellness market will grow
  • 101. Current technologies and concepts are founded on more than 30 years of research and development Recent changes in cost and access make dynamic assessment and intervention systems affordable Medical VR/AR Systems – Overall Status and Opportunity On the horizon - enhanced, ubiquitous, informative and integrated After years of study and use by early adopters – validated systems are poised to move to the mainstream
  • 102. The work we do is important The work we do is meaningful We work together to move the field forward 7th Annual Virtual Reality and Healthcare Global Symposium
  • 103. 5th Annual Virtual Reality and Healthcare - Europe Helsinki October 19-20, 2023