Stanford Children's Health CHARIOT program is using VR experiences to distract pediatric patients and reduce their pain and anxiety.
When Blaine Baxter suffered a major accident during one of his go-karting races, the long road to recovery involved multiple skin grafts and a lengthy hospital stay at Lucile Packard Stanford Children's Hospital.
The painful daily dressing changes required as part of the healing process made him so anxious that doctors were forced to prescribe high-dose narcotics and anti-anxiety medication to calm him down. In looking for other options, Baxter’s pain management team tested out virtual reality experiences that would transport him out of the clinic where the procedure was happening, and into foreign environments like kelp fields deep under the ocean or the depths of outer space.
Almost immediately the need for high-dose medication was eliminated and Baxter received his own headset to use at home as part of his rehab process.
Those VR experiences were developed as part the hospital's Childhood Anxiety Reduction through Innovation and Technology (CHARIOT) program, which was founded by Stanford anesthesiologists Tom Caruso and Sam Rodriguez.
The goal of the program is to leverage the use of technology to ease stress and anxiety through distraction across a variety of medical settings, including before and after surgery and during minor procedures like blood draws or injections.
“Children can cry or exhibit aggressive behavior, and sometimes you have to hold children down in order to induce anesthesia. It’s sad, we’re not doing this because we want to, we're doing this because the child needs the procedure,” Caruso said. “The hope is that we can transform the angst and anxiety to potential happiness – or at least momentary distraction – through technology.”
One key factor in distraction is the value of “novelty,” an area where VR technology sets itself apart. Studies indicate that when children are engaged in VR, there’s less movement, fear and, in some cases, lower pain scores.
High levels of stress can lead to psychological problems including continued anxiety, poor sleep, minor PTSD and even possible phobias that can linger into adulthood. As a testament to the technology’s effectiveness, the team’s distraction-based VR therapy has spread throughout Stanford’s Children's Hospital and beyond, to facilities like the University of Minnesota and Texas Children’s Hospital.
Luke Wilson, the CEO of Weightless Studio, which helped to develop much of CHARIOT’s VR technology, said it is a continual learning process to determine how best to design immersive experiences that can be effective across multiple clinical settings. In order to be used across different procedures, experiences have to be viewable from a variety of positions, while also being constantly engaging. The devices themselves also have to be customized for use in a children’s health care setting, which means resizing headsets and making them easier to sterilize and clean.
“It’s great that we can get immediate feedback from providers to how we make this content fit with clinical workflows and be accessible to as many patients as possible.” Wilson said.
Looking forward, CHARIOT is working on expanding both the digital techniques used as part of their program, as well as possible use cases. The group is working on ways to utilize their VR technology in areas like chronic pain management, physical therapy and even as a tool used to keep expectant mothers calm as they receive an epidural.
In a field where novelty and staying ahead of tech trends is vital, CHARIOT is also developing augmented reality experiences for patients who want the benefit of digital distraction while still being able to interact with their outside environment. Earlier this year, the group launched an AR experience designed for pediatric patients receiving IVs where two holographic alien-like characters are able to explain the procedure to the patient as it's happening.
“Our overarching mission is to help as many children as we can,” Caruso said. “As we build out more experiences, we’re continuing to move from distraction-based therapy into rehab therapy and potential physiological-based therapy for phobias and fears.”