Following last week's highly successful and interesting 'DWF Catastrophic Injury Conference' [13th March 2018] I thought that I would take the opportunity to begin a series of articles related to Virtual Reality Healthcare in its many guises.
I suppose the starting point is that one needs to accept that adherence to a typical physio regime increases the prospects of an optimum rehabilitation outcome. From there the question is how can we help individuals to restore levels of function following injury?
As someone who has had his fair share of physio over the years there are three [main] things that always irritate me about the process:
1. It’s hard;
2. It is so S L O W…
3. Did I mention it can be PAINFUL??!!
At ACRM's 93rd Annual Conference in Chicago I attended an excellent presentation by Reflection Health’s Chief Clinical Officer, Anang Chokshi who stated that if an individual is asked to perform a physio exercise every day then only 9% of people will do so. If asked to perform an exercise x3 a week then only 23% of people will do so…
That's pretty poor isn't it?!
So how can we encourage people to have better compliance with the physio regime which they have been set? How can we help to ensure that their ‘form’ when completing the exercises is as good as it can be?
The approach being taken by Reflexion Health is to use home based technology similar to the X-Box Kinect in order to allow individuals to mirror on screen demonstrations performed by an avatar. Check out the short video on their website. Effectively it is the gamification of rehab to the extent that scores are recorded for accuracy and completion.
The system also allows for recordings of the individuals to be reviewed online by a physio working from a central hub. It is secure and feedback can be given regularly. It doesn’t replace the need for face to face contact with a physio but it allows for a longer gap between appointments and, hopefully, greater motivation to comply [with the regime] during that period.
The data obtained by Relexion Health shows that use of their system has significantly improved compliance. It has been expanded considerably since I first saw it with the introduction of the VeraHome portal which now contains pages dedicated to exercises, education, surveys, contacts and virtual therapy visits. It's impressive but the range of treatments needs to expand [at the moment it is limited to knee replacement surgery] before it becomes of greater applicability.
In June of last year, however, I had the opportunity to speak to a new company based in Boston, MA who are developing a virtual reality physio system for use in treating [initially] neck and upper limb injuries VR Physio.
The system as demonstrated to me was certainly immersive and very impressive. We again have similar trends towards the gamification of physiotherapy to encourage and motivate participants to comply with their regime. It seems to me that this is highly important element and takes us right back to where we started with the statistically abysmal rates of compliance with a physiotherapy regime as detailed by Reflexion Health.
VR Physio generates reports for the treating physio to be able to monitor compliance and the accuracy of movements. It seems to me that as the hardware for delivery of VR applications becomes cheaper and cheaper that moving this type of platform from the clinic to a patient's own home could produce widespread benefits.
As I understand it VR Physio's system is designed to work with any decent VR headset (it was demonstrated to me using the Oculus Rift) and whilst it currently requires a gaming level PC in order to run smoothly the company's partnership with Microsoft is set to deliver benefits in terms of the level of hardware and graphics required.
Facebook recently paid $2 Billion dollars for Oculus so whilst VR Physio may still be in its early development phase the future must nevertheless be exciting and we should be able to expect rapid advancements.
Consider a world where a relatively simple neck injury could be rehabbed remotely and efficiently using VR technology: the individual wouldn't need to waste hours on end trudging backwards and forwards between outpatient clinics: they could be motivated to engage in a virtual world of rehab wherein their movements and compliance with their rehab regime could be monitored and any necessary feedback given using secure online chat.
Both of the systems described above are incredibly exciting in terms of the future. Whilst primarily designed against the backdrop of the bundled payments system being introduced into healthcare within the US the reality must be that the technology (whilst still in its early stages) could well be interesting for the UK insurance market in terms of where it might take the future of post injury rehab.
Plenty of things need to happen in order to reach this panacea but we shouldn't forget that the demand needs to be there in order for these companies to invest and develop the technology.
Watch this [virtual] space… :)
As described above, back in June 2017 I had the opportunity to meet with and get a hands on demonstration of the VR Physio platform. It doesn't appear that the company has stood still over the intervening period.
I was in touch with them earlier this month and I understand that their plans involve a move into Europe in the next few months: I don't have anything more specific than that but I will keep an eye on developments particularly given they have just kicked off a funding round which, given the amount of information which it sets out about the business is an interesting read in itself. Details can be found here subject to the caveat that DWF's BIRG is in no way connected to VR Health and, clearly, offers no investment advice.
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