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Patients communicate with their families using "VR home experience"

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Shubhankar Kulkarni
Shubhankar Kulkarni Sep 23, 2022
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The idea is to help patients communicate with their families using the VR home experience.
Why?
  1. Patients are usually bored in the hospital and need to talk to their families and friends
  2. Studies have shown that the rate of delirium (due to drugs or surgical complications) post-surgery reduces when the patients communicate with their families.
  3. Communication with family is also known to reduce the length of hospital stay of patients.
  4. I did not find any reports of hospitals using VR to enable a "home experience" for patients. I think it will further ease the hospital stay for the patients and help improve their condition faster, ultimately reducing the length of hospital stay.
Is VR effective for patients?
  1. A study used “Virtual Home” (Home environment via VR) to simulate the home environment before discharge. This may help the patients to identify relevant safety concerns, anxieties, and activities that might prove difficult to manage in the home environment. It could also help the therapists in establishing realistic expectations and discussing/ explaining management strategies. It could enable patients to feel supported about their discharge to home and informed about further care at home.
  2. VR technology is currently being used to treat patients. The technology is explained in the cited paper.
  3. In a study on patients with spine surgery, VR reduced pain more than that in the non-VR group. Most VR group patients appreciated VR use and advocated it.
How does it work?
There are two different ways:
  1. The patients wear the VR headset and call their families. They talk to their family members as if they were with them at home. Real-time virtual reality could be more effective, but it may be harder to realize and more expensive. Double robotics is another great piece of equipment that is basically an iPad on wheels, which the user can control from a distant location. They are expensive though.
  2. Secondly, another piece of equipment can be used to map the patient's home to "gather the environment". The environment will then be fed to the patient at the hospital. Here, the patient could check whether they will be facing any difficulty in roaming around the home and doing the chores seamlessly. If they feel some chores are difficult, like taking out stuff from the top shelf (in the case of people with spine surgery who are instructed to not stretch their back), the family members could make those changes before discharge.

[1]Eghbali-Babadi M, Shokrollahi N, Mehrabi T. Effect of Family-Patient Communication on the Incidence of Delirium in Hospitalized Patients in Cardiovascular Surgery ICU. Iran J Nurs Midwifery Res. 2017 Jul-Aug;22(4):327-331. doi: 10.4103/1735-9066.212985. PMID: 28904548; PMCID: PMC5590365.

[2]Zolfaghari M, Arbabi M, Pedram Razi S, Biat K, Bavi A. Effectiveness of a Multifactor Educational Intervention on Delirium Incidence and Length of Stay in Patients with Cardiac Surgery. Journal of Hayat. 2012; 18 (1) :67-78 URL: http://hayat.tums.ac.ir/article-1-39-en.html

[3]Threapleton K, Newberry K, Sutton G, Worthington E, Drummond A. Virtually home: Feasibility study and pilot randomised controlled trial of a virtual reality intervention to support patient discharge after stroke. British Journal of Occupational Therapy. 2018;81(4):196-206. doi:10.1177/0308022617743459

[4]Bakker A, Janssen L, Noordam C. Home to Hospital Live Streaming With Virtual Reality Goggles: A Qualitative Study Exploring the Experiences of Hospitalized Children. JMIR Pediatr Parent. 2018 Dec 13;1(2):e10. doi: 10.2196/pediatrics.9576. PMID: 31518293; PMCID: PMC6716480.

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Creative contributions

How to minimise virtual reality sickness?

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Subash Chapagain
Subash Chapagain Sep 23, 2022
Using VR as a supplementary tool seems like a transformative approach, especially in palliative care. While there can be many benefits to using VR to aid the curative phase of treatment, I think it would be wise to consider some caveats and work towards addressing them before deploying VR. Virtual reality sickness (also termed simulator sickness and cybersickness) is an affliction similar to motion sickness, and it is experienced by the users of virtual environments with immersive visual displays that track the user’s viewpoint to coordinate a virtual scene. Similar to motion sickness, VR sickness can result in nausea, headaches and dizziness. In some cases, the symptoms can extend to eye fatigue and disorientation.
Hence, if we use VR in hospital settings and if the patients are prone to VR sickness, the use will be counterproductive. It can be even argued that the use could further worsen the health and well-being of the patients, given the fact that at the curative phase an individual is physically and psychologically more vulnerable. Hence, this issue needs to be considered seriously. The causes of VR sickness need to be identified and minimized if possible. According to a systematic meta-analysis that looked into the dynamics of VR sickness, the causes can be broadly categorized into Equipment-related factors and Human factors . Hardware factors
Display type and mode, hardware field of view (FOV), latency and flicker are the factors that dictate VR sickness. Besides such hardware features, the content itself is also responsible for sickness in many cases. Also, optical flow and the graphical construct of the content are equally important in determining whether a user will experience such sickness.
Human factors
The user’s own physiological and biological features are also important. For example, studies have shown that older people can be more prone to VR sickness than younger groups, though the observations are not always consistent. Another human factor that influences the risks for VR sickness is prior VR experiences and motion sickness susceptibility.
Hence, it is useful to use the causes and apply the first-principles approach to address the issues of VR sickness. This can ensure that the intended results will be attained and the side-effects of VR usage in hospitals can be kept to the minimum possible level.

[1]https://www.frontiersin.org/articles/10.3389/fnhum.2020.00096/full

[2]https://link.springer.com/article/10.1007/S10055-016-0285-9

[3]https://www.tandfonline.com/doi/full/10.1080/10447318.2020.1778351

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Shubhankar Kulkarni
Shubhankar Kulkarni2 years ago
Great point! I think the hardware-related factors will be minimized with time as technology improves based on user feedback.
In the case of human factors, the underlying reasons need to be addressed. Is VR sickness more common in the elderly since they find it difficult to adapt to any new technology, in general? Even the concept of 3D might be novel to them, unlike in the younger generations. If not, age might be a factor that interferes with the VR experience. In that case, VR might not be suitable for the elderly and should not be prescribed for them.
Also, do we know what proportion of VR users experiences the sickness? If it is very common (more than 50%), there might be something wrong with the VR technology itself; it might not be suitable for human physiology. In that case, it needs some kind of an adapter, a bridge between technology and human physiology. Again, with time, technological advancement will improve it. If it is not that common, we need to find the type of people who develop sickness. In the course of this research, we may identify the type of people and the underlying reason. VR, may, then, act as a diagnostic tool :).
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Home Security Camera paired with a VR headset through an add-on feature

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jnikola
jnikola Sep 26, 2022
Design an add-on that could easily connect any VR headset to the mentioned camera.
Why?
  • prerecorded virtual environments require scanning of your home and can be very boring since nothing is happening (just a set of pictures that you can "go through"
  • you cannot directly interact with objects or people in these virtual environments, since it's not real-world/real-time
  • the mentioned camera is just one of the cameras that can be used for real-time monitoring and interaction (you can turn the camera around, talk to people, listen to them, etc.)
Why not a more complicated VR home experience?
As you explained it, I can see your idea going in two different ways. The first one would be patients using VR sets to have their homes visualized and be walked through. In this scenario, patients could talk to their family members using mobilephones while walking through a prerecorded VR home environment. The second scenario where this could go could be a real-time experience through a robot, gadget or monitor (or a few of them) put around the home that could be the patient's "eyes and ears". Here I am exmaplining the use of existing technology to achieve this.
How would it work?
A person in hospital connects to home camera and can look what's happening, talk to people and listen to them. If there are more cameras, a person can use simple smartphone app to switch between the cameras and "be home". If a patient want a more advanced solution to "be home", they could use any VR headset and an add-on for the app (that we developed) to see what camera sees. It would basically be just switching camera and microphone to VR headset.
There actually is a home security camera that comes with a VR headset that can be used for the camera. However, it's really expensive.
What do you think?
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Shubhankar Kulkarni
Shubhankar Kulkarni2 years ago
The real-world/ real-time monitoring that you explained is what I was aiming at with this session. I visited the home security camera link you suggested. Here is an advanced version of that. It is basically an iPad on wheels that you can control from a distant location. You can drive it, it could be self-driven, you can turn the camera direction, etc. If you could connect that to VR, it would be amazing. It costs $4499 though, pretty costly for hospital therapy. It would be great if your insurance covers it. The insurance could cover renting the technology. Upon discharge of the patient, the instrument could be returned to the hospital.
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jnikola
jnikola2 years ago
Shubhankar Kulkarni Whoaa, that looks really cool. What I had in mind is much cheaper (Xiaomi camera that can do all of the mentioned things costs 40-50 USD), but cannot be moved around. Still, it could serve as a cheaper solution for the people that can be satisfied with a non-moving cameras and speakers.
Please leave the feedback on this idea
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Shubhankar Kulkarni
Shubhankar Kulkarni2 years ago
J. Nikola Yes, we can probably start with what you propose, since it is way cheaper, and hence, more feasible. The collected data will tell us if this system is effective. If we find it effective, we can go for the expensive version. The expensive version (where you can move the camera around the house remotely from the hospital) will be appreciated by the younger patients.
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