VR to the rescue

Houston Methodist is tapping into virtual reality technologies to ease the pain for cancer patients

Houston Methodist is researching the effect of virtual reality on cancer patients. Photo courtesy of Houston Methodist

Virtual reality goes far beyond playing games with titles like Arizona Sunshine, Moss, Robo Recall, and Tetris Effect. VR also is playing an ever-growing role in health care settings. The global market for VR in health care could reach $3.8 billion in 2020, according to one estimate.

VR is touching all corners of heath, including robotic surgeries, training, pain management, and behavior modification, according to InterbrandHealth, a health care branding agency. And these technologies are happening right here in Houston.

Researchers at Houston Methodist Cancer Center are exploring whether exposure to nature, through either a real garden or VR, can ease pain and distress in cancer patients who are undergoing chemotherapy. This approach might decrease the need for prescription painkillers.

Houston Methodist and Texas A&M University are leading this test. Renee Stubbins, a clinical dietitian at Houston Methodist Cancer Center, and Ashley Verzwyvelt, an infusion oncology nurse at the cancer center, proposed the research after several years of studying ways that nature can boost the healing process.

"Anything that affects our patients' comfort — including easing pain and anxiety, and possibly reducing the need for pain medications — is important to their recovery," Stubbins says in a release. "People have an innate connection to nature, and we hope the patients will respond positively."

Three dozen cancer patients receiving chemotherapy infusions every two weeks during at least six cycles will be randomly assigned to one of three rooms: a live-garden-view room; a window-less room, and a room where nature can be experienced through a VR headset.

Teaming up with Houston-based Skyline Art Services, local artist Gonzo247 produced a nature-inspired mural on a wall behind the live garden to create an immersive environment. The mural depicts a flowering garden, blue sky and sunset that enhance the live garden of Texas wildflowers in the foreground.

Researchers will measure pain, distress, blood pressure, heart rate, and saliva cortisol at the beginning and end of each infusion visit. Saliva cortisol, a hormone produced when the body is stressed, helps gauge a patient's condition.

"If this study proves that real or virtual elements of nature help the healing process, then it has potential to positively impact our patients," Verzwyvelt says. "Some of them are hesitant to take pain medication due to concerns of addiction and adverse side effects, so I'm excited to see the possibilities this kind of research could bring."

Houston Methodist Cancer Center says the VR experiment could have implications for treatment of an array of patients who are immobile or whose immune systems are compromised.

"We looked at multiple studies that showed exposure to nature can reduce stress levels and actually increase productivity and creativity," says Ann McNamara, associate professor in the Department of Visualization at Texas A&M. "We want to see if we can reproduce those effects in a natural environment in virtual reality."

The study is being financed by the Center for Health & Nature, a joint initiative of Houston Methodist, Texas A&M and Texan by Nature, a nonprofit conservation group founded by former first lady Laura Bush. The Center for Health & Nature, housed at Houston Methodist Hospital, debuted in 2018.

"There's a gap in research regarding what nature factors lead to increased health, what exposure to nature means, and how much exposure is needed," Bush said when the center was announced.

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Meet MIA — Houston Methodist's new voice technology assistant. Photo via Getty Images

Hey, MIA. Start surgery.

These are the words Houston doctors are learning to say in the operating rooms, thanks to a first-of-its-kind voice technology developed by the Houston Methodist's Center for Innovation in collaboration with Amazon Web Services. In the same way we use programs like Alexa or Siri to make our everyday tasks easier, the Methodist Intelligent Automation, or MIA, is allowing medical professionals to improve the way they interact both with technology and patients alike.

"There's been a push in the industry for a long time that people sitting behind computers and typing and staring at a computer screen is inadequate," says Houston Methodist Chief Innovation Officer Roberta Schwartz. "There's been a desire to return people back to each other rather than physicians and look at a screen and patients look at a doctor looking at a screen."

Currently in its pilot phase, MIA is working to do just that through two key functions that shift the way medical professionals work in what Schwartz calls the "era of electronic medical records."

The first is through operating room voice commands. Here medical professionals can run through a series or checklists and initiate important actions, such as starting timers or reviewing time of anesthesia, through voice instead of by typing or clicking, which can become cumbersome during lengthy and highly detailed surgeries. Information is displayed on a large 80-inch TV in the operating suite and following surgery all of the data captured is imported into the traditional EMR program. The technology has been prototyped in two Houston Methodist O.R. suites so far and the hub aims to trial it in a simulation surgery by the end of the year.

Additionally, the hub is developing ambient listening technology to be used in a clinical setting with the same goal. Houston Methodist and AWS have partnered with Dallas-based Pariveda to create specialized hardware that (after gaining patient permission) will listen into doctor-patient conversations, transcribe the interaction, and draft a note that is then coded and imported directly into the EMR.

"For EMR the feedback is that it's clunky, it's click-heavy, it's very task oriented," says Josh Sol, who leads digital and clinical innovation for Houston Methodist. "Our goal with the Center for Innovation and this technology hub is to really transform that terminology and bring back this collaboration and the patient-physician relationship by removing the computer but still capturing all the pertinent information."

The ambient listening technology is further off and is currently in user acceptance testing with clinicians.

"They've had some great feedback, whether it's changing how the note is created, changing the look and feel of the application itself," Sol adds. "All feedback is good feedback at this point. So we've taken it in, we prioritize the work, and we continue to improve the application."

And the hub doesn't plan to stop there. Schwartz and Sol agree that the next step for this type of medical technology will be patient facing. They envision that in the near future appointment or surgery prep can be done through Alexa push notifications and medication reminders or follow up assessments could be done via voice applications.

"It's all going to be of tremendous value and it's coming," Schwartz says. "We may be taking the first baby steps, but each one of these voice technologies for our patients is out there on the horizon."

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