The early use of virtual reality (VR) was centered mainly on entertainment like games and movies. This technology is gaining traction in medical care as universities and hospitals in Hong Kong increasingly adopt it for patients’ rehabilitation and medical professionals training.
Global Industry Analysts projected that the global market for VR in healthcare will reach $3.8 billion by 2020. Asia-Pacific is estimated to be the fastest growing market with CAGR of 23.2 percent, led by developing healthcare infrastructure and strong demand for innovative medical technologies.
As VR hardware and software are getting cheaper, a growing number of physicians, scientists, and other medical practitioners use VR in diverse medical disciplines. They include rehabilitation, robotic and minimally invasive surgery simulation, and immersion therapy such as depression and phobia.
Pain relief therapy
To some physicians, VR immersion can be used as an adjunct to medical treatment to help patients reduce pain and distress associated with various medical procedures such as severe burns, cancer pain and chronic pain.
“VR is not just the distraction but the total immersion. We engineer the environment and take patients to another place where they can exert mental control. They become interactive with their avatars, and can leave their hopelessness and helplessness,” said Alex Cahana, senior vice president of digital strategies at TRT International US Ltd at the Healthtech Asia 2017 in Hong Kong last month. He has been a pain physician for over 25 years.
Cahana said that in clinical settings and experimental studies, patients immersed in VR experiences like VR games can reduce levels of pain or relieve distress.
TRT International was established by the traditional Chinese medicine company Tong Ren Tang. Marrying technology such as VR, mobile and machine learning with traditional Chinese medicine, TRT International aims to improve the wellness of people.
“The future is a combination of high touch [Chinese medicine] and high tech,” he noted.
In Hong Kong, universities or medical practitioners have developed VR for different applications. Some of them started off as research projects in universities and were later commercialized in the business world.
The Hong Kong Polytechnic University (PolyU)’s VR-based training software originated from a research project at the Department of Rehabilitation Sciences. The software is now licensed to a local rehabilitation services firm.
Named VRehab and Virtual Reality based Vocational Training System (VRVTS), these two non-immersive VR software simulate real-life scenarios such as supermarkets, bus stops, and boutiques. They help people with cognitive impairments to boost their daily living and working skills respectively.
In a virtual supermarket of VRehab, patients learn the skills of grocery shopping and money management. In a boutique environment simulated by VRVTS, patients assume the role of a shopkeeper and learn sales techniques.
“VR provides a safe and comfortable environment for patients such as those suffering from dementia to improve cognitive functions like attention, memory, and problem-solving skills,” said the department’s professor David Man. “It can be customized to meet patients’ progress in training, increasing their motivation and confidence to carry on rehabilitation.”
In conventional rehabilitation training, paper and pencil tests like card sorting and calculation games are used to enhance patients’ cognitive functions. Patients are also brought to the community such as supermarkets and bus stops to learn community living skills.
Therapists sometimes face difficulties in conventional rehabilitation training.
“Lots of manpower such as social workers, therapists, and caretakers are needed in every outing with patients. Manpower aside, environmental factors like bad weather, footfall in supermarkets or traffic situations on the road will also interrupt our training,” said Ben Yip, founder and managing director of C2 Innovations & Research Ltd. He is also a registered occupational therapist.
Yip created the VR software with Professor Man when he was a Ph.D. student at the PolyU. He optimized the software to address market needs after he founded his company.
Data analysis to assess patients’ progress
Running on standalone PCs or tablets, this VR software collect patients’ training data including reaction time, the number of errors made, the time taken to complete a task and the use of frequent prompts etc.
Therapists use the collected VR training data and conventional cognitive tests to assess patients’ progress such as whether patients can transfer the learned skills to a real environment.
Artificial intelligence will be added to the software to help customize training for patients such as the difficulty levels of training to match the skills and progress of each patient. This will minimize repetitive training and increase the motivation of individuals.
A number of public hospitals, rehabilitation service centers and elderly care centers have deployed VRehab. They include Queen Mary Hospital, Castle Peak Hospital, Tuen Mun Hospital and Caritas Lok Hang Workshop.
“As the [VR training] data sets are getting bigger, we are interested in exploring an opportunity to collaborate with our customers to use the data for further study on cognitive impairments or VR-based rehabilitation,” said Man.
Medical professionals training
Apart from PolyU, other local universities have also deployed VR for medical training.
The Faculty of Medicine of the Chinese University of Hong Kong (CUHK) uses VR and robotics to train surgical trainees in performing Minimally Invasive Surgery (MIS).
“Before operating on a real patient, surgeons can undergo two-day training in our center to boost the precision and safety of real surgical operations,” said Professor Philip Chiu, director of CUHK Jockey Club Minimally Invasive Surgical Skills Centre. “We have trained over 1,200 surgeons since 2008.”
The VR laboratory inside the MIS Skills center is equipped with simulators and 3D VR workstations, which allows surgeons to work with multi-imaging data for the clear understanding of anatomy and improved treatment training.
The Open University of Hong Kong (OUHK) has installed an immersive VR system in the Virtual Reality Education Unit in the Clinical Nursing Education Center. OUHK has started to use VR in the nursing education curriculum.