Healthcare in the Metaverse [Extended Reality]
When Mark Zuckerberg and Facebook released a demo video in October of 2021 introducing the metaverse and rebranding his company as Meta, there was no shortage of excitement in the media over the new direction of the social media giant. The hour-long video provided glimpses of what the metaverse promised to be – covering potential use cases and capabilities, technologies that would power the metaverse, and insights into near-term projects and launches. Despite its infancy, the metaverse is growing at an exponential rate. The metaverse was valued at $41.9 billion in 2020, and is expected to reach $1.2 trillion by 2030, yielding a compounded annual growth rate of 40% (1). As a proposed evolution of the internet, the metaverse could play a major role in the outlook of many industries across the economy. Accordingly, we must look forward with a critical eye at how the technology of tomorrow may reshape healthcare – an industry traditionally defined by its risk aversion and conservative uptake of technology. Analyzing and identifying potential opportunities and hurdles along the way will help prepare the industry to maximize the value of this technology and determine its benefits to society.
The COVID-19 lockdown proved that medicine and care could be delivered in a far more asynchronous and distanced manner than previously believed, and many of those adaptations are now here to stay. Similarly, the promise of healthcare in the metaverse may well lead to a paradigm shift in the way the industry’s services are delivered. Based on our analyses of the technological promise of the metaverse and our assessment of the US health system, we’ve identified three major areas of application in which innovation is likely to thrive. These areas include digital therapeutics, healthcare education, and digital twins. Below, we expand our perspective and provide greater detail on the apparent opportunities.
The use of digital therapeutics, specifically within mental health, is likely to be accelerated in the metaverse. Because the VR experience fundamentally allows for the creation of a sensory experience separate from that of one’s immediate surroundings, there is considerable opportunity in the realm of mental health treatment. Clinicians can design an entire environment tuned to their therapeutic focus and make it available to patients in their own homes, thereby significantly reducing the barriers to entry or adoption for both parties. Further, the inherently customizable nature of the metaverse platform means it can adapt to the needs of numerous treatment paradigms, from aversion therapy for addiction, applied behavioral analysis (ABA) for autism spectrum disorder, and cognitive behavioral therapy for phobias. Other indications for which digital treatments are currently pursued through VR include PTSD, depression, and anxiety (2). Through leveraging VR simulation in the metaverse, patients could receive routine treatment by placing them in safe, targeted, and specifically designed scenarios that would be difficult to recreate in the real world (3).
Medical education and training represent another segment of the healthcare industry that is well-poised to benefit from innovations around VR and AR in the metaverse. While on-the-job training is crucial and has long been a staple of medical training, VR and AR technology can serve as a high value complement to such experiences. Indeed, this transition is already underway, with training for medical students and EMT training for first responders increasingly relying on VR to simulate high-risk situations and enable providers to hone their craft in a safe environment (4). An additional inherent value of VR for medical training is in its ability to provide frequent low-cost training on highly specialized or new treatments for providers who may lack the access to such training (rural practitioners, providers in LMICs) (5). While the technological confluence for immersive haptics and surgical precision remains on the horizon, in their current state, these simulations still offer the opportunity to improve decision making and solidify one’s knowledge of medical procedures.
Digital Twins are dynamic copies of real-world entities that exist on virtual platforms and are capable of behaving identically to their real-world counterparts. Their ability to receive and process data allows them to replicate real-world processes, simulate scenarios, and predict possible outcomes. While applicable to a host of industries, their potential value add to the healthcare space cannot be overlooked (6). A digital twin of a patient could be subject to many different simulations to analyze future outcomes of drugs, treatments, clinical trials, medical device implants and surgeries prior to any real-world decision. A patient’s medical history including prescribed medications, genetic tests, scans, and vitals could be aggregated and analyzed to determine the best course of personalized treatments. Large scale population analyses could be simulated to determine the outcome and response of disease outbreaks and vaccines. Fundamentally, Digital Twins technology is the converging point of extended reality, artificial intelligence, and the internet of things (7). The rise of the metaverse could provide a final layer of complexity to the digital twins technology by providing an improved interface and connected platform for digital twins to exist, fully encapsulating its potential capabilities.
Despite the abundant potential use cases of healthcare in the metaverse, we recognize that there are several key hurdles that the industry will have to clear in order to realize the full potential value of the metaverse. We believe these hurdles include the trajectory in the development of the metaverse platform, enhancing interoperability, ensuring secure and effective management of personal health data and privacy, and cementing healthcare laws and regulations in the metaverse.
The Development of the Metaverse Platform
The largest obstacle that can hinder the existence of healthcare in the metaverse is the metaverse platform itself. There is no guaranteed success of the metaverse. Given how infant the space is, the long-time horizon before its maturity, as well as the large capital investments involved to create this world there is an extremely high uncertainty of success. Widespread use, assurance, acceptance, and stability must be fully established in the metaverse before incorporating anything as sensitive as healthcare. Healthcare will not be the first industry in the metaverse.
Interoperability is a major issue in the current state of the healthcare industry and will continue to be a major issue in the metaverse unless measures are taken to improve data sharing norms. Blockchain technologies offer considerable promise in improving the exchange of data in a secure and transparent manner and could play a key role in facilitating the transferring of personal health records between healthcare stakeholders in the metaverse. However, a major network system will still need to be created to help organize the transfer of data within the metaverse and with external institutions. The processes of transferring data surrounding doctor referrals and clinical workflows, to name a few, need to be standardized for the sake of our current healthcare system’s efficacy, but also for the incorporation of metaverse-based healthcare.
Cementing Healthcare Laws and Regulations
The implementation of healthcare laws and regulations are extremely important to ensure protection for stakeholders, quality of care, and standardization across the metaverse. Due to the nascent nature of technology and legislative bureaucracy there has been little meaningful implementation of healthcare regulations for the metaverse and its accompanying technologies. The FDA’s Center for Devices and Radiological Health launched the Medical Extended Reality (MXR) Program that began to conduct research on regulatory gaps and challenges surrounding the implementation of VR and AR in healthcare (8). Several areas of regulation that have been identified are image quality and sensor characterization of MXR devices, interventional procedures and surgical applications of MXR, and metrics that are necessary for evaluating the safety and efficacy of emerging MXR devices. While regulating emerging technology is vital, the secure and effective management of personal health data must be a continued point of emphasis. Health data regulation will need to expand to cover services conducted on the metaverse, and the protection of patient data privacy must continue to be enforced.
There is a general lack of coherence in defining what the metaverse is because it is still being built, and accordingly the trajectory of its development is still highly uncertain. However, there is great potential for healthcare applications in the metaverse, whether that would take the form of digital therapeutics, healthcare education and training, digital twins, or an entirely new application. The metaverse aims to improve and enhance remote connectivity in a more immersive manner – undoubtedly, such concepts will be experienced if the healthcare industry collectively chooses to expand into the metaverse. Current pain points, bottlenecks and operational inefficiencies in our healthcare system could potentially be alleviated through the underlying capabilities of the metaverse. Nonetheless, its success is largely dependent on overcoming the key hurdles listed above.
It is crucial to note that there is already a growing number of VR/AR-based healthcare startups, but only a small fraction have explored the possibility of expanding into the metaverse. This raises another question whether there is a need for current VR/AR-based healthcare services to expand into the metaverse to fully reap the benefits of leveraging extended reality technology – or whether the additional return on investment into the metaverse will generate any adequate value add for patients.
At the end of the day, the main purpose of the healthcare industry is to provide high quality care for as many people as possible; its success does not rely on incorporating the latest technological trend. Not all forms of high technology are suitable for the healthcare industry. The potential downstream impact of a healthcare-based metaverse on the healthcare industry remains to be seen; however, it is an exciting space, and we continue to welcome innovative ideas that could revolutionize the outlook of healthcare.
“Insights on the Metaverse Global Market to 2030 - Rising Demand for Work from Home and Remote Working Tools during the Period of the COVID-19 Led to Growth - Researchandmarkets.com.” Business Wire, 23 Sept. 2022, https://www.businesswire.com/news/home/20220923005257/en/Insights-on-the-Metaverse-Global-Market-to-2030---Rising-Demand-for-Work-from-Home-and-Remote-Working-Tools-During-the-Period-of-the-COVID-19-Led-to-Growth---ResearchAndMarkets.com.
Magazine, Smithsonian. “Inside the Effort to Expand Virtual Reality Treatments for Mental Health.” Smithsonian.com, Smithsonian Institution, 6 May 2022, https://www.smithsonianmag.com/science-nature/inside-the-effort-to-expand-virtual-reality-treatments-for-mental-health-180979995/.
Park, Mi Jin, et al. “A Literature Overview of Virtual Reality (VR) in Treatment of Psychiatric Disorders: Recent Advances and Limitations.” Frontiers in Psychiatry, vol. 10, 2019, https://doi.org/10.3389/fpsyt.2019.00505.
Blumstein, Gideon. “Research: How Virtual Reality Can Help Train Surgeons.” Harvard Business Review, 17 Sept. 2021, https://hbr.org/2019/10/research-how-virtual-reality-can-help-train-surgeons.
Freeman, Taylor. “The Cost of Medical VR Training.” Axon Park, Axon Park, 5 Mar. 2021, https://axonpark.com/the-cost-of-medical-vr-training/.
Lawton, George. “21 Ways Medical Digital Twins Will Transform Healthcare.” VentureBeat, VentureBeat, 4 July 2021, https://venturebeat.com/business/21-ways-medical-digital-twins-will-transform-healthcare/.
Sun, Tianze, et al. “The Digital Twin in Medicine: A Key to the Future of Healthcare?” Frontiers in Medicine, vol. 9, 2022, https://doi.org/10.3389/fmed.2022.907066.
Center for Devices and Radiological Health. “Medical Extended Reality Program: Research on MXR-Based Devices.” U.S. Food and Drug Administration, FDA, 24 Mar. 2021, https://www.fda.gov/medical-devices/medical-device-regulatory-science-research-programs-conducted-osel/medical-extended-reality-program-research-medical-extended-reality-based-medical-devices.