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Posts Tagged ‘virtual reality’

TeleRobotic Procedures via VR Cockpit are closer than you think

May 15, 2016 Leave a comment

       Back in 2011 I had the opportunity of assisting Singularity University’s first FutureMed (now known as Exponential Medicine). I was exposed to several exponential technologies. Relevant to this post was the talk given about Driverless Cars by Brad Templeton. Back in 2011, in general, people said this was not feasible and it would take more than 20 years for this to happen. Well , I believe everyone now understands how deceiving exponential trends can affect our daily life.

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      As a Pioneer in the incorporation of Augmented Reality and Virtual reality in the medical field, in particular, Interventional Cardiology which is my specialty.

      In the last couple of years I have focused in the implementation of Virtual Reality in the cathlab and was the first one to record with Jaunt VR some procedures. Once I reviewed the recorded 360 experience I understood the wide array of possible applications and implications. I have mentioned medical education, patient education, decreasing stress and anxiety, decreasing arrhythmias in the hospital setting and one that seems more far away the Virtual Reality Cockpit which could guide telerobotic procedures.

    This last month 2 very important research studies have been released:

1) The CORA-PCI Study (presented at SCAI) evaluated the feasibility of performing PCI in patients with complex coronary lesions using robotic technology to remotely control coronary guidewires and stents. Dr. Mahmud showed how at this point in time robotic technology to perform PCI is a viable alternative to manual PCI. Key words are AT THIS POINT IN TIME. As a technology enthuthiast I guarantee you this will change to be the norm and will allow us to perform intervention in a quicker and safer manner. (I know many will think this is nonesense, but everything I have been saying since a medstudent regarding implementation of technology has eventually happened and always considered nonesense. So let me just say this will happen)

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2) As A VR pioneer and enthuthiast I find the following study tremendously exciting. Even more exciting is that this comes from @DisneyResearch which I just find it as a breath of fresh AIR! The study is “A Hybrid Hydrostatic Transmission and Human-Safe Haptic Telepresence Robot”

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The latter is not directly related to medicine but this just proves that what I said at @CRT_Meeting is true. (Which I managed to record in 360 immersive video, pardon the youtube quality) The Virtual Reality Cockpit is coming and it will allow us to perform TeleRobotic Procedures.

 

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Interventional Cardiologist Explores Virtual Reality in Medical Procedures with Jaunt VR

There are several reasons why I believe virtual reality will be an extremely disruptive technology in medicine, and it will start with education. In order for people to understand why this is the case they first need to understand what exactly virtual reality is.  I would describe virtual reality as a technology that allows the individual to ‘teleport’ to a different environment as an invisible spectator. Effective VR is a ‘brain hack’ so strong that it can actually trick the user into believing they are someplace else, which potential leads to interesting therapeutic applications1. A virtual reality scene can be either computer-generated or captured with 360º cameras. Both approaches have tremendous potential for medical applications.

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When I experienced Virtual Reality for the first time, the first thought that came to mind was the tremendous potential of such technology in medical education. For this reason I decided to explore possibilities to capture an immersive 360 environment. Shortly after my search began I quickly realized the task was more daunting than I initially expected. After evaluating the options one quickly stood out from the rest. Jaunt VR, a startup in Palo Alto, CA developing 360º video technology and considered by many as the leader in cinematic VR production. According to their senior engineer, Adam Somers, “Jaunt VR develops end-to-end solutions to enable the capture, production, and distribution of cinematic VR content. There is tremendous potential to apply live-action VR recordings to a number of industries, including medicine. Our collaboration with Dr. Assad represents an important first-step in the exploration of immersive media for educational and therapeutic applications.”

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On March 25, 2015 at El Camino Hospital, Mountain View, California we explored the potential of virtual reality by capturing important teaching pearls in interventional procedures that could potentially lead to better patient care and outcomes.

  • The Ultrasound Guided Access initiative. This I learned in my advanced peripheral endovascular fellowship with Dr. James Joye and has proven to be a very valuable technique that without a doubt can avoid disastrous complications if used properly.
  • With the assistance of the Medtronic team we were able to setup up a simulator to evaluate feasibility. We explored capturing the steps involved in the preparation and deployment of a Medtronic CoreValve. The value of capturing and perfecting this content in VR could completely change the dynamics of training courses, not only for this device but for all others as well.

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Once the footage was obtained and processed by the Jaunt VR team I had the opportunity to experience it through Oculus technology. The results surpassed my expectations and therefore I stand by my initial vision. I firmly  believe that with the right leadership and initiative this will be a game-changer in medicine. Why you may ask?

  • Physicians learn procedures by repetition. The concept of ‘see one, do one, teach one’ is, in my opinion, is outdated. Maybe this worked in 1850 since it was the only option, but it is unacceptable in this day of age. VR allows the in-person demonstration to be repeated as many times as desired, and you can change your point-of-view with each viewing to take in even more information than if you were actually present for the procedure.
  • The fact that one can be next to the individual performing the procedure over and over and focus on different aspects is priceless. Unlike traditional video displays, VR provides a human-scale, interactive facsimile that is potentially indistinguishable from reality.
  • Exponential growth in technology drives down the price of many devices, including smartphones. By 2020 80% of the adult population will have a smartphone2. This is important because along with a $5 to $20 the Google Cardboard, your smartphone turns into a VR Headset3. Most recent android phones support Cardboard and you can try it for yourself with Jaunt VR’s publically available apps4. This does not mean that everyone should be producing content but it does mean that everyone can learn from it, from simple stitching to familiarizing oneself with more advanced technologies like CoreValve implantation.

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Generating and sharing content has the potential to empower and educate thousands, maybe even millions, by experiencing procedures as the second operator or from any perspective that the operator deems to be best.  As Dr. Oliver Aalami clearly put it “The reality is that it would take me one hour to review every step of a complex procedure that a video could show me in 10 minutes. In my opinion that is the true benefit…more immersive education…better comprehension in less time”

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Technology is changing at an exponential rate. Just think of what merging VR technology with haptic feedback, ubiquitous networking, and tele-robotics can enable. Initially, education is the obvious application, but there is no reason why performing surgeries this way could not be done. Consider, for example, the successful telementoring project done back in 2003 between Brazil and the United States5.

I would like to emphasize that this would not have been possible without the support from Jaunt VR who allowed me to dream a little and get a taste of what I believe will be the beginning of a great thing for medical education.

In May 6, 2015  I will give a talk at SCAI regarding the incorporation of implementation of exponential thinking and technologies. Here I will share the immersive 360 experience with my Samsung Gear VR and other means as well.

  1. http://www.nature.com/srep/2015/150423/srep09831/pdf/srep09831.pdf
  2. http://www.economist.com/news/leaders/21645180-smartphone-ubiquitous-addictive-and-transformative-planet-phones
  3. https://www.google.com/get/cardboard/
  4. http://jauntvr.com/content
  5. http://www.ncbi.nlm.nih.gov/pubmed/12816583

360 immersive Virtual Reality arrives to the Cathlab. Revamping Medical Education

March 31, 2015 Leave a comment

The implementation of augmented reality into the medical setting has been increasingly experimented with since the birth of the Google Glass explorer program.

The first publication analyzing the potential of such technology in different settings was done back in October 2013 “Wearable technology to improve education and patient outcomes in a cardiology fellowship program – a feasibility study” . Following this publication came the proof of concept on the application of Google Glass in a tele-mentoring scenario was published in JACC ““Tele-Mentoring”: An Interventional Procedure Using a Wearable Computer” in which google glass was used in a PFO Closure.

Since then questions have risen if the technology was truly ready for different implementation of glass. A recent publication “Accuracy of Remote Electrocardiogram Interpretation With the Use of Google Glass Technology” found glass not to be adequate for EKG interpretation. Which by the way I congratulate the authors on their effort, it is great to see more physicians exploring the incorporation of such technologies to improve the way we practice medicine. The truth it that the results were not surprising due to many variables but there are 2 which I consider most important 1) The need for millimetric assesment of EKGs 2) Google Glass is now “old” technology and its field of view is handicapped for such a task (Rumors have it that Google is likely already working on next gen). Another important point that this demonstrates is the rapid pace that technology has (following an exponential curve) and our slow implementation in the medical setting due to many restrictions.

Currently there are many other options more relevant than the first generation of Google Glass for such tasks. I have personally experienced Atheer Glasses, META Glasses, and most recently ODG which is used by the military and NASA. They are all great with tremendous potential and depending on the vision of the individual one can prove better suited than the other one. A company exploring this in a very interesting way is Vital Medicals. Implementing this uptodate technology is a whole different world when compared to Glass. For example, just by checking ODG’s Field of View (FOV) we see dramatic improvement with a Dual 720p 16:9 stereoscopic see-thru displays at 30fps (Full specs of ODG Glasses).

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Having said this, in addition to augmented reality we now have virtual reality. In my personal opinion, implementation of augmented reality is more challenging in the medical setting since it faces a lot of “hurdles” depending on how it is used. In the case of Virtual Reality things are different and the biggest potential for now, in addition to entertainment is education.

Last week we used COMPLETE 360 degree immersive technology for the first time in the Cathlab (maybe even in a medical procedure) to capture valuable education points; 1) Ultrasound Guided Access 2) Setting up and deploying a Medtronic CoreValve. At the moment can not disclose how this was done exactly, but just wanted to mention that VR is already being used in the medical setting.

My recommendation to everyone is start exploring Google Cardboard or Samsung Gear VR (YOU NEED A NOTE 4, this was the only reason I upgraded from my Note 3 and it is worth it!)

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Virtual Reality coming to a Hospital near you

March 15, 2015 Leave a comment

Virtual Reality is picking up tremendous speed and it is easy to see why. It’s potential is tremendous. In the following slides you will see once again the exponential trend in technology and its implementation impact on different fields. From a device created by Ivan Sutherland in 1965, which was so heavy that it needed to be attached to the ceiling to the Oculus Rift prototype created in a garage by Palmer Luckey (18) who then sold it for 2 billion dollars to Facebook.

Observe the number of devices created, in addition, they are now being incorporated to brain computer interfaces. This opens a whole new field for research potential, medical education, and therapeutic treatments. Imagine what this could do in a nursing home, cardiac rehabilitation? Virtually Teleporting patients to a beach, museum, or the rehab center?

The speed in which this and other technologies get incorporated into our profession is directly proportional to the number of individuals trying to do so. One of the beauty’s of VR is that anyone can experiment with it if they so please for 5-30dlls. Just get google cardboard and download the app to your android phone and see what the big fuzz is about. Got an iphone? No worries, this technology is soon to arrive to iOS also. Apple plans here, seems it will be available in the iPhone 6s.

I am currently working on interesting projects that I will mention later, but I wanted to create a small introduction since I have been getting a lot of questions!

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