The Norfolk and Suffolk National Health Service Foundation Trust (NSFT) will be one of the first mental health trusts in the UK to provide virtual reality (VR) therapy treatment plans for patients suffering from a range of phobias. The NSFT’s Wellbeing Service uses VR headsets to progressively exposed patients with claustrophobia, agoraphobia, or frighten over objects or experiences like needles, heights or flights, to triggers that they would normally avoid in reality. This believe will assist them in managing their responses within a secure and controlled environment.
Formerly, exposure therapy requires patients to sit with their therapists and triggers are introduced in the forms of videos or real-world stimuli. With VR, a more realistic experience can be created. Patients can also have more say over the length of each exposure therapy session and how it can be better adapted based on their needs. For example, aerophobia patients may request for a change of weather conditions in preparing them for every single scenario that they may have to encounter during a flight.
In the US, in order to reach a desirable level of proficiency, a surgeon may have to perform and repeat a new procedure for 10 to 20 times. As the complexity of surgery increases, the number will need to be increased naturally by five to ten folds. However, most surgeons regard extensive practices as a form of luxury. In fact, it has been found as much as 30% of graduating general surgery residents are not capable of practicing independently.
Thus, it’s not at all surprise when surgeons may have to google in the midst of an operation to find out how a new device work. Although simulators are available, they are costly and limited to only one specific procedure. VR, on the other hand, offers greater flexibility and potential when it comes to surgical education and practice. At a glance, VR appears to have reached its efficacy, at least in the areas mentioned above (i.e., therapeutic VR and medical education), but in reality, clinical adoption remains minimal, if not, full of hurdles.
Challenges to establish credibility and form trust
Most immersive technologies adopted into the present-day medicine and healthcare were descendants of the entertainment and gaming industries. Like predictive analytics, researchers often struggle to find enough evidence to prove that VR will work in the way they desired to be. Besides, there is limited literature to support if the virtual experience is fully transferable to real-life experience and if it will have side effects after prolong use. On a positive note, some experts believe the beauty of VR is one can just bring the headset around and start demonstrating how it works.
Also, VR will not be rendered as a stand-alone solution. In the case of NSFT, VR is part of a wider treatment plan and is given to patients on top of their regular sessions with therapists. The same for the new Oxford VR social engagement program which combines cognitive behavioral therapy (CBT) techniques with VR to help patients in coping with social anxiety and anxious social avoidance. Hopefully, by establishing VR as a form of a peripheral alternative, it will cultivate more credibility and trust in the long run.
Lack of infrastructural and technical support
The other hurdle which may be halting the clinical adoption of VR is probably there just aren’t enough software to cover the demands. New synergies between immersive technology developers and medical professionals are encouraged, to create reliable solutions targeted at different healthcare scenarios or challenges. At the same time, it is important to train clinical staff, hospital support teams and even patients to be comfortable in handling the technology and troubleshooting any potential concerns.
Most of the time, there’s just so much immersive technology vendors can do to ascertain smooth deployments. By and large, healthcare institutions have to ensure how VR is used and scaled over the years. Some of these responsibilities may be shouldered by technical specialists within the medical device team to ensure VR headsets are regularly maintained and software are up to date. These individuals may also be the ones who gatekeep the changing equipment costs, its complexity, patient suitability, and safety requirement. As of now, finding and/or training suitable related expertise may still be a challenge.
How to settle the bill?
Last but not least, reimbursement is likely to be on the table for regulatory discussions. In the UK, the National Health Service (NHS) does not have an official bill to support the adoption of VR, most of the VR initiatives have to be funded externally or via other modes. NSFT had received a £10,000 digital innovation funding for Increasing Access to Psychological Therapy (IAPT) projects for its phobia treatment plans. The same for the US, there is no official billing code for VR therapy at the moment but there is one for exposure therapy. There is not enough distinction and transparency on how certain programs should be billed and all these shall entrap VR on the niche end.