We are headed into an era where the line between our physical and virtual worlds becomes blurred. Fueled by emerging technologies that create extended reality, we are no longer constrained by our physical environments in all the ways that we once were.
The applications for this tech across the spectrum of healthcare innovation are becoming more and more evident, and at Worrell we’re most concerned with how this paradigm shift will impact the patient and care provider.
Despite the technological revolution that’s taking place all around us, there remains some uncertainty within medical communities about what extended reality and it’s related technologies really do, and how they are redefining quality care.
WHAT IS EXTENDED REALITY?
It’s important to understand that extended reality (XR) is not a single technology, but a term used to describe the output of technologies that create virtual agents and environments. Made possible by the array of emerging tech that is detailed below, extended reality is “extending” our physical world in to the virtual, and bringing us closer to people, places, and information by eliminating the barriers of time and space. For us here at Worrell, XR’s power is in its ability to bring the patient and care provider closer together.

VIRTUAL REALITY (VR)
Virtual Reality (VR) takes the user out of their real-world environments, and places them in an entirely simulated one. Typically this is achieved through the use of a headset for viewing, and hand-held controllers to navigate the virtual space. VR is changing the way we educate care providers, and help patients overcome debilitating pain and PTSD, and rehabilitate cognitive functions.

AUGMENTED REALITY (AR)
Augmented Reality (AR) overlays digitally generated objects on to the real-world. AR headsets are either transparent, or equipped with cameras to relay both the real, and virtual environments to the user. We see AR empowering surgeons with live heads-up displays that give them real-time access to higher quality decision driving data.

MIXED REALITY (MR)
Mixed Reality (MR) begins to blur the line between the real and virtual, and can be considered a form of Augmented Reality. Similar to AR, it overlays objects in to the real world, but unlike standard AR, the user experiences a relationship between these two realities. Rather than a heads up display populating information over the real objects, it can incorporate virtual objects in to the real environment.

ARTIFICIAL INTELLIGENCE (AI)
Artificial Intelligence (AI) is made up of a collection of advanced technologies that allow machines to sense, comprehend, act and learn. We’re focused on the way AI is extending reality through the creation of virtual assistants that can help patients manage chronic disease states, and assist in self-care in the home environment.
SO WHAT?
This technology, and the idea of extended reality, have applications across nearly every industry, but at Worrell we’re truly excited and optimistic about the changes that they bring to the healthcare ecosystem. Healthcare’s leaders have an opportunity and obligation to apply these technologies to improving patient outcomes, and creating deeper and more meaningful relationships with people.
Some of the meaningful applications for XR in healthcare include…
AR ENABLED OR
Live heads up displays can put surgeons closer to the information they need to make fast decisions under intense pressure. Not only can we display the basic information already available throughout the OR, but imagine loading an MRI scan in to a Hololens and giving surgeons x-ray vision. AR has a place in the OR of the future.
SURGICAL TRAINING
Virtual environments where surgical students can fail are a new frontier. We can model real surgical scenarios and physical spaces that put the learner in position to get more value out of their practice. Paired with the live 360 video streams of real surgeries, extended reality is revolutionizing the way we educate our surgical professionals.
CHRONIC DISEASE MANAGMENT
Virtual assistants can help patients more effectively manage their chronic diseases. These AI driven agents can ask questions about your current state, recording answers to draw insights from. Equipped with the right practitioner data, they can help you better understand your symptoms and make suggestions in real time for adjustments to your care tactics so won’t have to wait until your next visit with your physician.
INCREASING EMPATHY
Often overlooked as an application for extended reality is its ability to increase empathy of care providers and loved ones. Simulating patient ailments can give care providers insight on the experience of their patients and increase the empathy that goes into formulating their treatment. For example, Common Ground VR simulates what it must be like to have a visual disability, like macular degeneration or glaucoma.
REHABILITATION
Today, we can treat Parkinson’s patients, amputees, military veterans, and stroke victims to stimulate limb movements via VR. We can use extended reality technology as a medium for exposure therapy to treat PTSD.

3D MODELLING
Modelling of live tissues enables surgeons to study a specific patient’s ailment more intimately before attempting any treatment or entering the OR. VR can even allow a surgeon to practice parts of a real procedure before they ever attempt it live. Created by merging MRI’s, CAT-scans, and ultrasounds, these virtual renderings can be created to scale, and blown up to get a closer look at the small details on which the success of a surgery or treatment may hinge. This technology was recently used by the University of Minnesota to help separate conjoined twins.
WHAT’S STOPPING US?
The applications of extended reality are expansive, and more importantly, the potential for care improvement is real. With that in mind, there are a lot of applications for XR that are just outside the reach of today’s capabilities.
While we are optimistic about the future of these technologies, and are currently experimenting and applying them on a variety of projects, we are well aware that there are both technological and cultural barriers to the immediate adoption of some potential applications. This review would be misleading if it did not at least mention some of these barriers, and how they are impacting the viability of the solutions that the healthcare market can benefit from.
TECHNOLOGICAL BARRIERS
Virtual and mixed reality headsets are big, heavy, and expensive. Improved, low profile designs and lightweight components will be an essential step in seamlessly integrating XR in to our everyday lives.
Headsets will require complete wireless capability and standalone platforms for content that don’t require a PC to run. This makes high speed 5G connectivity a must. In fact, ATIS (Alliance for Telecommunications Industry Solutions) suggests that augmented and virtual reality are the primary use cases that will drive 5G network advances in North America.
Particularly relevant to the use of AI enabled healthcare IT is the issue of an incomplete digital platform. Even with the optical character recognition, which can convert scanned paper-based documents and extract text from them, AI enabled databases still may not have all of the patient data that is available for making decisions. Translating years of paper records in to a readable digital format is one of the barriers to AI acting in tandem with care providers to improve patient outcomes.

CULTURAL BARRIERS
Perhaps even more important to understand are the barriers that we build from our culturally informed perception of these technologies. The primary hurdle that extended reality technologies have to overcome before they are utilized to their full potential is gaining the trust of the average consumer. It’s one thing to play 3D games in your Oculus Rift and ask Alexa what the weather will be like before you leave for work, but it’s another thing entirely for your surgeon to walk in to the OR wearing a Microsoft Hololens or adjust the dosage of your daily prescription based on a Google Home app.
Becoming comfortable with these technologies in no-risk settings will be a key stepping stone for our relationship with them. As that relationship matures we’ll begin seeing more opportunities to leverage extended reality for enhancing our lives. We’re excited about the future for extended reality, and the positive impact that we know it can have in the lives of both care providers and patients.