Cedars Sinai research director talks lessons learned as a "hospital virtualist"

By Jonah Comstock
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There's some technology that has to be seen to be believed. Dr. Brennan Spiegel, director of health services research at Cedar-Sinai Hospital, puts virtual reality technology in that category. And that can make it hard to sell doctors on the idea, at least at first.

"What I’ve seen is, talking about therapeutic virtual reality is completely hypothetical until you’ve experienced virtual reality yourself," Spiegel told MobiHealthNews. "It’s hard to describe the feeling until you’re in it ... So we make it available to doctors who are interested and other staff. And we frequently have people visiting our lab just to get into the headsets. Invariably, when they get in they say 'Oh my gosh, I can definitely see how this will work'. No one questions it. I don’t see anyone saying ‘This is not going to help patients.’"

Spiegel will be presenting his top 10 lessons learned using virtual reality for patient care at the Digital and Personal Connected Health forum at the HIMSS annual conference on February 19th and 20th in Orlando. He shared a few of those lessons, and some broad observations about this emerging field, with MobiHealthNews.

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At Cedars Sinai, Spiegel is leading a team experimenting with virtual reality to help patients manage pain, depression, and anxiety without drugs and to help them virtually leave the "bio-psycho-social jail cell" of the hospital. Using a library of different software programs from partner vendor Applied VR, patients can virtually explore different environments. Recent experiences sending 360 degree cameras home with patients' families have even allowed to them to visit familiar locations as well as exotic ones.

"We’re using it with a little over 300 patients now," Spiegel said. "Right now we have a couple ways we’re using virtual reality. The majority are research studies, but we’re also frequently called in as a consultation service. You know the hospital has all these consult services like cardiology and gastroenterology? We’re the virtual reality consult service. I like to call it the virtualist."

Spiegel says that when doctors see the videos of how well patients take to the experience, they're usually convinced. But when it comes to convincing hospital higher-ups, he also sees a fairly cut and dry return on investment.

"I actually teach cost-effectiveness analysis at UCLA and I’m trained in health economics, so this is very important to me for any kind of intervention, digital or otherwise," Spiegel said. "We actually have worked out some cost effectiveness models to project whether and how it would be cost effective. And we haven’t published the results yet so I can’t go through all the details. But the upshot is, if virtual reality therapy can reduce length of stay by 10 percent a fraction of the time, then it pay for itself. And by that I mean staffing and maintaining a virtual reality consult system in the hospital — not just paying for the headsets, but the maintenance, upkeep, software and the staff."

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Spiegel says that VR doesn't work for everyone — they've seen some adverse reactions ranging from dizziness to negative emotional responses, and some portion of the population, mostly older folks, refuses to try it. Some of the lessons he plans to share at HIMSS are about those experiences.

"It’s like any intervention, we need to study it and understand its potential adverse events," he said. "It’s not all rosy, but in general it works great."