Virtual Environments for Healthcare
Parvati Dev, PhDCEO, CliniSpace
www.InnovationInLearning.comwww.clinispace.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
© 2012 IIL Inc. Serious Play, August 21, 2012 3
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 ?
© 2012 IIL Inc. Serious Play, August 21, 2012 4
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
© 2012 IIL Inc. Serious Play, August 21, 2012 5
WHY VIRTUAL ENVIRONMENTS MAY BE THE BEST APPROACH TO ENGAGEMENT
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Medical Training
Current approach:– Classes, e-learning, manikins,
standardized patients
– Problems in scalability, expense, lack of engagement
© 2012 IIL Inc. Serious Play, August 21, 2012 7
Virtual Environments are immersive
And immersive experiential learningIs DISRUPTIVE
© 2012 IIL Inc. Serious Play, August 21, 2012 8
So immersive that it’s real
© 2012 IIL Inc. Serious Play, August 21, 2012 9Comm. of the ACM
Virtual Emergency Room Environment
© 2012 IIL Inc. Serious Play, August 21, 2012 10
HOW EFFECTIVE ARE VIRTUAL ENVIRONMENTS ?
© 2012 IIL Inc. Serious Play, August 21, 2012 11
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 ?
© 2012 IIL Inc. Serious Play, August 21, 2012 13
Scientific meeting inWorld of Warcraft (May 2008)
© 2012 IIL Inc. Serious Play, August 21, 2012 14
Azeroth
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Scientific meeting inWorld of Warcraft (May 2008)
© 2012 IIL Inc. Serious Play, August 21, 2012 16
20 JUNE 2008, VOL 320, SCIENCE, www.sciencemag.org
‘Congressional Hearing’ in Second Life
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PROTOTYPE VIRTUAL ENVIRONMENTForterra, 2005
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Multi- casualtyIncidentTrainingEvent
@ Stanford
– 2005
Multi- player,OnlineGame
Technologyby
Forterra–
2005
CliniSpace Virtual Emergency Department
© 2012 IIL Inc. Serious Play, August 21, 2012 19
COMPONENTS OF A MEDICAL VIRTUAL ENVIRONMENT
© 2012 IIL Inc. Serious Play, August 21, 2012 20
REALISTIC CLINICAL SPACES, INCLUDING IN BATTLEFIELD
© 2012 IIL Inc. 21Serious Play, August 21, 2012
PHYSICIAN, NURSE, THERAPIST, PATIENT, SOLDIER, BABY AVATARS
© 2012 IIL Inc. 22Serious Play, August 21, 2012
VIRTUAL PATIENTS, DYNAMIC PHYSIOLOGY AND ACTIONS
© 2012 IIL Inc. 23Serious Play, August 21, 2012
VIRTUAL OBJECTS THAT INTERACT WITH PATIENT AND EACH OTHER
© 2012 IIL Inc. 24Serious Play, August 21, 2012
CASE AUTHORING, USER ACTION TRACKING AND ASSESSMENT
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Example of use
http://vimeo.com/41082428
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INTERMEDIATE QUESTIONS
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ANOTHER WAY OF LOOKING AT VIRTUAL ENVIRONMENTS
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The Virtual Environment is the ‘System’ around the Virtual Patient
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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
© 2012 IIL Inc. 30Serious Play, August 21, 2012
THE ‘SANDBOX’ AND THE ‘CAMPAIGN’
© 2012 IIL Inc. Serious Play, August 21, 2012 31
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’
© 2012 IIL Inc. Serious Play, August 21, 2012 32
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 !
© 2012 IIL Inc. Serious Play, August 21, 2012 33
BUSINESS MODELS FOR VIRTUAL ENVIRONMENTS
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System Overview
Content Applications
Platform
UsersUsers
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Platform businesses
Platforms (Second Life, OLIVE, Unity)
Specialized worlds(medical, kids, adult entertainment)- Simulations of disease, equipment
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
Trainers, curriculum developers
© 2012 IIL Inc. 36Serious Play, August 21, 2012
CliniSpace: A Medical Platform
© 2012 IIL Inc. Serious Play, August 21, 2012 37
Platform businesses
Platforms (Second Life, OLIVE, Unity)
Specialized worlds(medical, kids, adult entertainment)- Simulations of disease, equipment
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
Trainers, curriculum developers
© 2012 IIL Inc. 38Serious Play, August 21, 2012
BUSINESS ECOSYSTEMS
© 2012 IIL Inc. Serious Play, August 21, 2012 39
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
© 2012 IIL Inc. 40Serious Play, August 21, 2012
Ecosystem around a platform- from “Virtual World Monetization”, Stanford, 2010
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
© 2012 IIL Inc. 41Serious Play, August 21, 2012
Resell spaces – branded or white label
Ecosystem around a platform- from “Virtual World Monetization”, Stanford, 2010
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
© 2012 IIL Inc. 42Serious Play, August 21, 2012
Face customization
Ecosystem around a platform- from “Virtual World Monetization”, Stanford, 2010
MedicalPlatform
Behavior therapy
Fitness support
Behavior alteration
through avatar association
Therapy sessions
“Normalize” very different people and activities so that they can exercise together
© 2012 IIL Inc. 43Serious Play, August 21, 2012
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
© 2012 IIL Inc. 44Serious Play, August 21, 2012
Resell spaces – branded or white label
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
© 2012 IIL Inc. Serious Play, August 21, 2012 45
[email protected], CLINISPACE, INC.
©© 2012 IIL Inc. 46Serious Play, August 21, 2012
THANK YOU & QUESTIONS
Slides are on SlideShare.Search for ‘parvatidev’ or ‘clinispace’
Email us [email protected]@clinispace.com
© 2012 IIL Inc. Serious Play, August 21, 2012 47
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