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.
The new tech hub at Houston Methodist has trained hundreds of physicians in telemedicine practices. Natalie Harms/InnovationMap

Houston Methodist's recently opened its new Center for Innovation's Technology Hub in January, and the new wing has already been challenged by a global pandemic — one that's validating a real need for telemedicine.

The 3,500-square-foot tech testing ground was renovated from an 18-room patient wing and showcases new digital health technologies like virtual reality, ambient listening, wearables, voice control, and more. The hub was focused on giving tours to medical professionals and executives to get them excited about health tech, but in the middle of March, Josh Sol, administrative director of Innovation and Ambulatory Clinical Systems at Houston Methodist, says they saw a greater need for the space.

"We turned the technology hub into a training center where physicians could come on site and learn telemedicine," Sol says. "We had some foresight from our leadership who thought that telemedicine was going to be heavily utilized in order to protect our patients who might go into isolation based on the outbreak."

The hub has trained over 500 physicians — both onsite and digitally. Sol says that at the start of March, there were 66 providers offering virtual care, and by March 25, there were over 900 providers operating virtually. On March 12, Houston Methodist had 167 virtual visits, Sol says, and on March 25, they had 2,421. This new 2,000-plus number is now the daily average.

"Telemedicine is here to stay now with the rapid adoption that just happened," Sol says. "The landscape will change tremendously."

Another way new technology has affected doctors' day-to-day work has been through tele-rounding — especially when it comes to interacting with patients with COVID-19.

"We are putting iPads in those rooms with Vidyo as the video application, and our physicians can tele-visit into that room," Sol says.

It's all hands on deck for the tech hub so that physicians who need support have someone to turn to. Sol says the hub used to have a two-person support team and now there are eight people in that role.

Sol says the iPads are a key technology for tele-rounding and patient care — and they are working with Apple directly to secure inventory. But other tech tools, like an artificial intelligence-backed phone system, an online symptom checker, and chatbots are key to engaging with patients.

"We're looking at how we can get our patients in the right place at the right time," Sol says. "It's very confusing right now. We're hoping we can streamline that for our patients."

The hub was designed so that in case of emergency, the display hospital rooms could be transitioned to patient care rooms. Sol says that would be a call made by Roberta Schwartz, executive vice president and chief innovation officer of Houston Methodist Hospital.