Healthcare’s Journey into the Metaverse

When Brenda K. Wiederhold, Ph.D., M.S., MBA, started using virtual reality to treat patients, let’s just say the technology was cumbersome.

“We called it the Darth Vader headset because it had a huge front load,” says Wiederhold, a psychologist, entrepreneur and pioneer in virtual reality medicine.

The headset, a hulking black helmet that allowed the user to feel like they were in a different environment — sort of — was so large that it had to be attached to the ceiling with a bungee cord to help the user manage the weight. “It was just so miserable for people,” says Wiederhold. “But it was very immersive.”

That was 25 years ago. Since then, not only have giant helmets been replaced by lightweight headsets, but the idea of virtual reality has expanded from relatively simple audiovisual simulations to the emerging, immersive blend of reality, unreality and data known as the “metaverse.”

Now technology leaders such as Wiederhold are thinking about the ways the healthcare industry can leverage the metaverse to improve the patient experience, healthcare operations and, ultimately, patient outcomes.

Going meta

If the metaverse is going to change healthcare, there is one early hurdle: answering the question, What is the metaverse?

Kaveh Safavi, M.D., J.D., a senior managing director at the consultancy Accenture, says it is not any one thing. One mistake people make is dismissing the metaverse as just a rebranding of virtual reality. That Facebook renamed its parent company Meta last year hasn’t helped clarify matters.

Safavi says it is helpful to think about the metaverse as a continuum. In a report published earlier this year by Accenture, Safavi and colleagues outlined some of the components on that continuum. One key aspect, he said, is Web3, the idea that the internet of the near future will be one where users control their own data and bring that data with them as they use applications and other services. Now whoever provides an internet-based service keeps and controls the data. The switch to user-controlled data is important because it will allow people to hop from one app to another or through an app to another app without having to reregister and recontribute everything to each app independently, says Safavi.

Such a system would have a transformational impact on a healthcare industry in which data privacy and user consent are critical issues, he says.

The metaverse could also mean turning all that data into usable solutions and scientific breakthroughs with the help of technologies like artificial intelligence (AI) and machine learning.

Where the technology goes beyond recognizable iterations of virtual reality is in something Safavi calls the “programmable world.” In this futuristic phase, the metaverse is not just about real people stepping into internet-based places. It’s about the connected world weaving its way into our everyday, real-world lives. Safavi said this programmable world marks the convergence of two trends in information technology.

“One of them is that it’s much more ambient, which means that it’s present without you physically interacting with a keyboard or screen,” he said. “And the second is that it’s actually embedded into physical things.” For example, he said, technology can be sewn into fabrics so it becomes wearable; sensors can be embedded into walls to track a person’s health or notice when they fall. “Once we add both the ambient nature [of connected technology] as well as the fact that physical items themselves can change,” he said, “it makes a lot of different things possible.”

Physiological responses

Understanding the role metaverse technologies can play in healthcare does not require one to look deep into the future. Some early versions of metaverse-type healthcare have been around awhile.

As president of the Virtual Reality Medical Center in La Jolla, California, Wiederhold uses simulations to help patients with phobias, post-traumatic stress disorder and anxiety, among other conditions. It’s something she has been doing for decades. The concept is that patients can use virtual worlds to therapeutically experience synthetic versions of triggering experiences. A person who is afraid of heights can experience the feeling of being in a high place without needing to climb to a high place. Though virtual reality tools were crude in the 1990s, they were a lot better than the alternative.

“If you just have a person sit down to imagine something they’re afraid of, your immediate response is avoidance, so you don’t do it,” Wiederhold recalls.

What made Wiederhold’s treatment cutting edge was not just that she was using technology to harness patients’ imaginations; it was that she simultaneously used technology to measure patients’ physiological responses. Wiederhold says that idea came to her at a conference where a speaker was discussing surgical simulations. The speaker suggested that combining virtual reality with physiological measurements could dramatically improve patient outcomes.

“If we put a patient into a world and measured their physiology and we could see what we were showing them and we could measure their physiology and know how they were reacting, we could more appropriately individualize the experience for the patient,” Wiederhold says.

These days, such experiences can be done virtually through telemedicine. During the COVID-19 pandemic, Wiederhold has been shipping patients virtual reality headsets and then using fitness trackers to monitor patients’ physiology while consulting via videoconference. Wiederhold notes that all the hardware she uses are widely available and relatively inexpensive.

Lately, Wiederhold says she has been using technology to help patients manage pain. She described a patient who lived in San Diego who had been unable to walk on the beach for five years because of chronic pain. She helped the patient learn to walk painlessly on a simulated beach, which, in turn, allowed the patient to develop positive cognitive associations that eventually helped him return to the real-life version.

“If I sit at home and focus on my pain, it’s worse,” Wiederhold explains. “If I go out and do activities of daily living in a paced, measurable way, it gets better through cognitive rehabilitation.”

Safavi sees such simulations as being useful in a number of ways. In addition to cognitive therapy, physical therapy and medical training, he says the metaverse could also be a way to transform informed consent by replacing written informed consent documents with immersive experiences that allow patients to see the operating room, perhaps see a version of their procedure and even ask questions of an AI-based avatar. “Our belief is that that person would have a different level of understanding of what was going to happen, and that concept of informed consent would be much more powerful,” he says.

Holistic use of data

Still, one reason Wiederhold is on the vanguard of the metaverse movement is that she leverages the physiological data of her patients. Though consumer healthcare technology is becoming more and more common, many physicians and healthcare systems never actually see — much less use — that data to guide treatment.

Safavi says the essential first step for health system leaders is realizing that the currency of the metaverse is data — not just health data, but all of the organizational data generated and utilized by the health system. The problem, he says, is that most health systems’ current information technology infrastructure is — as you might have guessed — siloed. To make the metaverse work, the systems need to find ways to free their data and then leverage it holistically. “If I say ‘data,’ they say, ‘I have an EMR (electronic medical record),’ ” he observes. “Well, that’s patient medical record data. What we’re talking about here is information that comes from everything.”

Jared Kaltwasser, a writer in Iowa, is a regular contributor to Managed Healthcare Executive®.