A lot is at stake in healthcare. Every big and small decision made has an impact on somebody’s quality of life. There is very little room for mistake or corrections, very few opportunities of do-overs. The care delivery team needs to obtain highest quality of education and the training for health outcome improvements. It also needs to be easier to learn in order to have higher knowledge retention.
Traditional education & training in healthcare has been focused on classroom training with a lot of documentation and real-life observation or practical training. Both methods have limitations. Classroom based training includes books & notes & a lot of written and verbal communication. The students are left to imagine & visualize on their own. The videos & pictures also do not help much since it does not provide the depth perception. The written information is very static while the human body is not. It is very essential for the clinicians to understand the Physiology & Pathology without depending completely on their imagination or worse, risking the patients. Mixed reality is the perfect technology to make the education & training more realistic & accurate.
Mixed reality (MR) (Virtual as well as Augmented Reality) education and training provides completely new perspective to the user. It allows the users the interaction of physical & digital objects in the simulated environment. That not only gives full control to the students on how / what they want to interact with, but it also enables the instructors to add additional guidance elements which will not be available otherwise. The instructors could monitor the progress remotely allowing the rural users access to world class education. MR based education also allows breaking down the abstract, long procedures into, manageable sequential tasks that could be practiced & perfected individually before attempting the complete process or protocol.
There are great use cases for MR training for biomedical engineers for repair & maintenance of healthcare equipment. But I won’t cover it since there is nothing healthcare specific in these use cases. These are service engineering use cases across all domains.
MR education & training in healthcare needs a bit different ecosystem compared to other mixed reality training ecosystem. The healthcare MR education ecosystem consists of the high-fidelity MR content expected in any domain use cases that has high realism mimicking the actual environment & ambience thus increasing the user immersion in the virtual environment. The technology required to play the content includes high resolution audio- visual effects, motion detection technology, secure and reliable cloud platform to host the training management platform & high-performance processing power to compute and transmit all (real time / near real time) interactions & information with near zero latency. Additionally, the healthcare training ecosystem also needs advanced haptic capabilities (bidirectional stimuli) to include the important aspect of tactile feedback that is very essential for the clinicians during their care delivery (diagnosis and treatment) in the virtual environment interaction. This could include standard feedback devices such as joysticks, gloves or other specialized tools such as surgical tools. This ecosystem can include other VR sensors or biomarker trackers to measure the user position, movement & basic vital parameters.
The MR based education in healthcare also has its share of disadvantages. If the training content lacks the required high fidelity or has incorrect simulation model, the users are at the risk of learning inappropriate or incorrect moves & protocols, especially in unsupervised environment. The cost of development & maintenance of MR ecosystem & content can also get very high and requires special skilled personnel.
The healthcare education can be classified into multiple categories:
1. Pre-clinical education for students
2. Clinical prep for clinicians
3. Care plan training for nurses
4. Disease management post-operative care training for patients
5. Patient wellness, recovery, empathy training for clinicians
Pre-clinical training that includes the education of subjects of anatomy, physiology and pathology is the most significant category. The virtual reality training content is the best simulation methodology to be used for this type of education and training. The students can learn about these topics in the virtual, simulated space with 3D rendering & visualization as well as learn time-based functions of living organism or the clinical protocol. The students can interact with the objects using the specialized instrument to experience tactile feedback that is crucial for the realistic experience in such training. All of this is done without harming living organisms or live human patients or without risking the health outcome.
The healthcare support staff also needs to have the training in the simulated environment where the virtual patients are in the simulated ambience where the commotion & chaos from real environment can be simulated in order to train the nursing & other staff effectively to improve their performance in the real life. This training can also be very effective in paramedic training for effective response to trauma to improve the probability of saving the life.
Same is true with patient education. For the patients to participate actively in their own health & wellness, they need to understand their body, their condition, the intervention that’s planned, post-operative care & disease management. Many patients get intimidated by the complexity of medicines the care protocols & their own body. That results into non-adherence & lack of patient, finally engagement impacting the outcomes negatively. Mixed reality based education provides a dramatic improvement over the traditional methods.
Healthcare provider, payers or vendor companies have all started their mixed reality education journey already. Based on the discussion I have had with various customers, I have seen a lot of enthusiasm towards beginning their MR education journey. The desire & the interest is very encouraging. However, it is equally crucial to implement the right first steps to make the journey successful in the long term. It is important to ensure that the journey does not get impacted with ‚Pilotitis‘ where the initiative starts with a bang but does not move beyond the initial proof of concept or pilot and is not across the organization and deployed in actual use. Here are some key tips to ensure that the initiative is set for success.
- Discuss the long-term objective: Consult various groups within the organization before defining the long-term goal. specific use cases across various groups or departments are going to provide the broader landscape of the mixed reality journey.
- Don’t miss the forest among all the trees: The individual use cases, upon deeper analysis, will provide a lot of common elements which will enable the solution architects to build the future ready ecosystem that will help not only the initial implementation of use cases but allow future extension work. It will also help build robust back bone of the ecosystem by developing crucial elements early on that are flexible enough.
- Plan the gamification effectively: The simulated environment provides the ability of real time feedback through gamification. Utilizing proven techniques of gamification can be used enhance the knowledge retention and repeatability. The gamification can be as simple as awarding points for the user upon completion to create multilayer rewards embedded within the training content itself. This will be a great design element to differentiate the training from the competition.
- Define the evaluation criteria: The training content should be defined such that their validity, transferability of the taught steel to the real world, the acceleration of learning curve and the retention period of the skills is equivalent or better than the traditional training methodology. Define the ecosystem so that these parameters can be & evaluated recorded easily through the existing system during usage.
- Seek stakeholder feedback: As soon as the skeleton structure & basic user interactions are ready, go to the users & seek feedback. As much feedback you can get early on, the acceptance appetite or the user comfort will be known early on & the system can be tweaked accordingly.
- Make FDA your active consultants. The mixed reality training can be only put in the use when it passes the regulatory compliance criteria in various countries. FDA & other regulatory bodies & government agencies are eager to help in designing & consulting such tools so that the road to regulatory compliance is much easier. Reach out and seek help as early on so that the required documentation & evidence can be maintained early on & continuously.
I will provide some examples of mixed reality based training currently in use in some of the leading care delivery centers and healthcare companies in my next blog.
It’s an exhilarating journey that is very fulfilling. Good luck!