"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012

Virtual Environments for Healthcare

Parvati Dev, PhDCEO, CliniSpace

www.InnovationInLearning.comwww.clinispace.com

http://www.InnovationInLearning.com/

© 2012 IIL Inc. Serious Play, August 21, 2012 2

My co-pilot has never flown this model of plane

before …

… but I have flown 200 hours on the simulator

and am certified for this model


My resident has never done this

surgical procedure before …

… but my chief is watching me very carefully as I do it.

WHY DOES THIS MATTER ?


The Cost in Life and Money

The cost of medical errors is huge– $22-38B (source: AHRQ)

An example – Septicemia– 2% of hospital discharges in the U.S. include septicemia– Average charge is > $60,000 per case

Prevention requires systemic change through training– One case prevented can pay for the training

Prevention training is difficultKnowledge, Skills, ATTITUDErequires emotional engagement

Learning through Role playing is emotionally engaging


WHY VIRTUAL ENVIRONMENTS MAY BE THE BEST APPROACH TO ENGAGEMENT


Medical Training

Current approach:– Classes, e-learning, manikins,

standardized patients

– Problems in scalability, expense, lack of engagement


Virtual Environments are immersive

And immersive experiential learningIs DISRUPTIVE


So immersive that it’s real

© 2012 IIL Inc. Serious Play, August 21, 2012 9Comm. of the ACM

Virtual Emergency Room Environment


HOW EFFECTIVE ARE VIRTUAL ENVIRONMENTS ?


Comparison of Team Leadership Before and After Practicing Four Resuscitation Scenarios on a Human Patient Simulator (HPS) or in an Online Virtual Emergency Department (VED) with Virtual Patients

The Data Show . . .

WHAT ARE VIRTUAL ENVIRONMENTS ?


Scientific meeting inWorld of Warcraft (May 2008)


Azeroth


Scientific meeting inWorld of Warcraft (May 2008)


20 JUNE 2008, VOL 320, SCIENCE, www.sciencemag.org

‘Congressional Hearing’ in Second Life


PROTOTYPE VIRTUAL ENVIRONMENTForterra, 2005


Multi- casualtyIncidentTrainingEvent

@ Stanford

– 2005

Multi- player,OnlineGame

Technologyby

Forterra–

2005

CliniSpace Virtual Emergency Department


COMPONENTS OF A MEDICAL VIRTUAL ENVIRONMENT


REALISTIC CLINICAL SPACES, INCLUDING IN BATTLEFIELD

© 2012 IIL Inc. 21Serious Play, August 21, 2012

PHYSICIAN, NURSE, THERAPIST, PATIENT, SOLDIER, BABY AVATARS


VIRTUAL PATIENTS, DYNAMIC PHYSIOLOGY AND ACTIONS


VIRTUAL OBJECTS THAT INTERACT WITH PATIENT AND EACH OTHER


CASE AUTHORING, USER ACTION TRACKING AND ASSESSMENT


Example of use

http://vimeo.com/41082428


http://vimeo.com/41082428

INTERMEDIATE QUESTIONS


ANOTHER WAY OF LOOKING AT VIRTUAL ENVIRONMENTS


The Virtual Environment is the ‘System’ around the Virtual Patient


Virtual PatientVirtual Patient

Protocols, policies, rules

People/ Team(real, computer)

Devices, supplies, meds

The Virtual Environment is the ‘System’ around the Virtual Patient

It is the “theater” -- environment -- within which you can “role play”

The “virtual patient” may play a Key or a Supporting Role

Virtual environments extend the usability of virtual patient Virtual

PatientVirtual Patient

Protocols, policies, rules

People/ Team(real, computer)

Devices, supplies, meds


THE ‘SANDBOX’ AND THE ‘CAMPAIGN’


Which one to build?

SandboxExplore the environmentUnguided ‘play’Automated responsiveness to

player input

Play has its own rewards– Engaging - Save the patient

Environment rich enough to satisfy

CampaignTrigger actions cause game to

advance – the ‘narrative’

Reward is in advancement– Levels, side missions– Earn badges and promotion– Compete with self, others,

teams

Carefully crafted ‘story’


http://www.gamasutra.com/view/feature/4081/the_history_and_theory_of_sandbox_.php?print=1

Our experience: Which one to build?

SandboxUnguided ‘play’Environment must be rich

enough to be satisfying

This is CliniSpace today

Need much more contentAnd still need specified goals

CampaignTrigger actions cause game to

advance – the ‘narrative’Carefully crafted ‘story’

CS BattleCare, etc

Sub-goals, overall goal are likedBut want some exploration !


BUSINESS MODELS FOR VIRTUAL ENVIRONMENTS


System Overview

Content Applications

Platform

UsersUsers


Platform businesses

Platforms (Second Life, OLIVE, Unity)

Specialized worlds(medical, kids, adult entertainment)- Simulations of disease, equipment


Custom development

New platforms

Customization (branding, layout,

language)

Further specialization(Equipment testing in

virtual OR)

Third Party developers

UsersUsersIntegration with other

technologies (Characters with AI, Natural

language processing)

Trainers, curriculum developers



CliniSpace: A Medical Platform


Platform businesses

Platforms (Second Life, OLIVE, Unity)



Custom development

New platforms

Customization (branding, layout,

language)

Further specialization(Equipment testing in

virtual OR)

Third Party developers

UsersUsersIntegration with other

technologies (Characters with AI, Natural

language processing)




BUSINESS ECOSYSTEMS


Ecosystem around a platform- from “Virtual World Monetization”, Stanford, 2010

3D virtual sets for

machinimaFace

customization

Animations3D

medical avatars

Automatic assessment

of performance

Dynamic pathophysiolog

y models

Virtual actors

Medical furniture

MedicalPlatform

Behavior therapy

Embedded knowledge (nursing, medical)

Curriculum development

Fitness support

Experience designer

Resell spaces – branded or white label

User-generated

content

Designing game or

competition dynamic

Virtual goods

Behavior alteration

through avatar association

Therapy sessionsIncrease

engagement of traditional

interactive content

Standardized role players

Greeters, patients, sales

person

Actors for machinima

moviesProduct

design using VR/AR

Adding sensor networks to

worlds

“Normalize” very different people and activities so that they can exercise together



3D virtual sets for

machinima

Animations3D

medical avatars

Dynamic pathophysiolog

y modelsVirtual actors

Medical furniture Medical

Platform

Experience designer

Virtual goods

Standardized role players

Greeters, patients, sales

person

Actors for machinima

movies




Automatic assessment

of performance

MedicalPlatform

Embedded knowledge (nursing, medical)

Curriculum development

User-generated

content

Designing game or

competition dynamic

Increase engagement of traditional

interactive content

Product design using

VR/AR

Adding sensor networks to

worlds


Face customization


MedicalPlatform

Behavior therapy

Fitness support

Behavior alteration

through avatar association

Therapy sessions

“Normalize” very different people and activities so that they can exercise together


Distribution/Revenue Models

Per clinical session per patient e.g.

therapy

Link with music and movie assets to drive

serious uses

subscriptions

Freemium

Grants and federal funding

Certification

Rent a seat or space

Virtual goods

MedicalPlatform

courses

Per virtual patient per

year

Loss of federal reimbursement

(Medicare / Medicaid)

Per actor-hour

License for bundle of seats

per year



In conclusion …...

Virtual environments can impact the cost of healthcare

- By changing attitudes by training with role playing

A virtual environment is an entire ‘system’ around a virtual patient (or patients)

To succeed, virtual environments must scale up to include multiple business models and a business eco-system


[email protected], CLINISPACE, INC.

©© 2012 IIL Inc. 46Serious Play, August 21, 2012

http://www.clinispace.com/

mailto:[email protected]

THANK YOU & QUESTIONS

Slides are on SlideShare.Search for ‘parvatidev’ or ‘clinispace’

Email us [email protected]@clinispace.com


Useful Links:

www.seriousplayconference.comwww.seriousgamesdirectory.comwww.seriousgamesassociation.com

Contact:

[email protected]

"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012

Technology

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