VR, COVID and ensuring safety with cutting-edge tech

Not too long ago virtual reality (VR) tech might have seemed like a dream, but now it’s being harnessed by the healthcare industry for a wide variety of purposes, and during COVID-19 has helped educate physicians when real-world training isn’t feasible.

Commercial VR is still a relatively fresh prospect, but already the pharma and healthcare industries have caught onto the hype and are exploring the myriad ways this tech could be used to improve patient outcomes.

That’s not to say VR is widespread in the sector – far from it – but the readiness to adopt such a new technology from even big pharma firms is somewhat surprising considering how conservative the industry has been in the past.

Novartis, for example, has used the tech to help researchers improve the molecular makeup of a drug, by allowing them to view these structures at a larger size and in a more “natural” 3D view. Similarly, Pfizer is using the technology to allow researchers to visualise and virtually explore the human body at a molecular level. One recent study even explored how VR could be used to analyse drug candidates that target the main protease of the SARS-CoV-2 virus behind COVID-19.

Some companies are also exploring the possibility of using VR to meet other people in a virtual space in lieu of in-person conferences, or to give doctors and researchers a vivid experience of what it’s like to live with difficult conditions such as Alzheimer’s.

Meanwhile, in marketing, augmented reality (AR) and VR tech offers several advantages, including ensuring effective communication by providing immersive experiences, assisting sales representatives to give quick and appealing product illustrations, and enabling individuals to assess the impact of various treatment options, through product demonstrations or the use of ‘virtual clinics’.

According to one report, estimates suggest that more than 60% of consumers feel more engaged with a brand that offers them a VR experience; likewise, a similar percentage of US-based physicians are inclined to use such solutions for education and training purposes.

It’s easy to see why, then, the global AR and VR is expected to reach $10.82 billion by 2025.

“Although these technologies are still relatively new, the extent of their usage in the healthcare and pharma sectors is growing at a rapid pace,” says Dr Alexander Young, former trauma and orthopaedic surgeon turned founder of VR firm Virti.

“Now platforms are integrating VR, AR, and AI technology to develop cloud-based immersive training platforms providing education to physicians and patients remotely, accessible on any smart device or headset.

“Sophisticated updates to the software and hardware are constantly being developed and released.”

Young adds that in the UK, several NHS Hospital Trusts are “enthusiastically” investing in VR and AR tech, as are industry-leading pharma companies – and he has seen similar enthusiasm coming from the US.

VR in the fight against COVID-19

Earlier this year Virti and its VR HCP training platform won funding from NHSX’s TechForce19 challenge in its search for tools to help with the COVID-19 crisis.

“A common challenge encountered by HCPs is that, during a traditional medical education programme, it’s difficult to obtain high-quality practical experience,” explains Young. “Owing to constraints of time, space and opportunity, often these students encounter critical situations for the first time when they are in a position of responsibility – and that can be extremely stressful.

“VR is just like performing the procedure in real life, but there is zero risk. This means that all the learners have the same access to high-quality training, driving down medical error.”

During the pandemic, Virti has been utilised by healthcare providers to produce simulations that train hospital staff in key skills like donning and doffing PPE, navigating unfamiliar wards, and the use of ventilators (see a video demonstration here).

“We often hear it said that nothing can beat an in-person training session, but independent research has actually proven that, with the right tools, quite the opposite is true,” Young adds.

A study carried out as part of the TechForce19 challenge showed that, in the health and social care sector, training with immersive VR technology improved understanding of infection control measures by 76% and improved knowledge retention of crucial health and safety guidelines by 230%.

“This is most likely because as humans, we learn best by doing, not by listening, watching or reading,” says Young. “Traditional face-to-face or book-based training can be disengaging and far removed from the realities of using the skills.

“In contrast, when participants train using an AR or VR platform, they have the opportunity to hone their skills in a (virtual) real-world scenario. In addition, by integrating AI tools, the students can each receive personalised, objective feedback on their performance, rather than relying on off-hand comments.

“We know that students who train with these platforms don’t only come out of the process with more refined skills, but they also hold onto their knowledge and their confidence for a longer period of time after the training has been completed. “

Additional applications for the technology during COVID include delivering patient education remotely when in-person consultations are challenging.

“With telehealth and remote consultation being rapidly adopted during COVID-19, many physicians have reported anxiety around maintaining rapport and delivering difficult diagnoses over telephone or video consultations,” Young says.

“VR is excellent at ‘soft skills’ training, allowing HCPs to be immersed in emotive virtual role-plays that simulate real-life situations.”

And with many patients unable to leave their homes VR can be used to transport them to new locations and reduce social isolation, Young notes.

Clinical challenges

As VR becomes more commonplace in healthcare, questions will invariably arise as to when we may see VR become a viable technology for clinical use.

Some clinical uses have already been tested – according to a study published in Pharmacy and Therapeutics, VR has shown benefits in treating pain associated with a variety of physical and psychological illnesses, as well as anxiety and phobia disorders.

However, using such a new technology in clinical trials comes with a whole host of challenges.

The study notes that trials involving VR often suffer from poor study design, thanks to factors like sample sizes, lack of control groups, varying technical standards for VR tools (which change rapidly as the tech evolves), and a lack of consideration of economic feasibility (VR tech currently being fairly expensive).

As such, there is also currently a lack of data regarding long-term effects of using the technology for patients.

In 2018, an international working group of VR experts met in response to these concerns to standardise and create best practices for VR clinical research.

The committee members described the current state of clinical VR research as the “Wild West” with a “lack of clear guidelines and standards”, with studies often focused “more on the tech rather than the theories behind it”.

They expressed concern that much of the current research is “merely descriptive” in nature, often insufficiently powered, focused on small case reports and retrospective analyses, and often does not employ experimental designs.

The report released by the committee listed several standards for all levels of VR trials that aim to make them as robust as RCTs for drugs and other medical devices.

In particular, the report noted that it was vital to include the patient’s voice “early and often” in the development of VR treatments – as well as the voice of providers.

“The committee believes that the more attuned a development team is to the specific perspective and needs of patients, the more likely they are to design meaningful VR treatments,” the report says.

They identified three key principles that are fundamental for developing “desirable, feasible and viable” VR treatments and promote empathy, team collaboration, and continuous user feedback – inspiration through empathising; ideation through team collaboration; and prototyping through continuous user feedback.

“The committee believes that the use of these principles allows development teams to better identify users’ needs, incorporate user feedback, and institute rapid cycle improvements that generate more relevant products at lower cost,” the report says.

VR meets AI

Looking into the future of the technology itself, Young says the integration of AI tech into VR devices is likely to become an “industry gold standard”.

“It’s now clear just how powerful these technologies can be in combination, and we are just beginning to see how AI is going to underpin so many different facets of the business and the healthcare landscape over the coming years.”

Young believes VR will become the norm in several areas, such as helping surgeons prepare for complicated operations with AI-embedded virtual practice tools, new employees being assessed via AI-enhanced virtual exercises, and top salespeople working on refining their skills based on algorithm-derived feedback.

“Now that remote conferencing and learning seem set to continue for the foreseeable future, there’s no sign of a slowdown in the adoption of VR and AR technology.”

About the author


George Underwood is a senior member of the pharmaphorum editorial team, having previously worked at PharmaTimes and prior to this at Pharmafocus. He is a trained journalist, with a degree from Bournemouth University and current specialisms that include R&D, digital and M&A.

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