effectively howdy everybody and welcome to vrx how digital therapeutics will revolutionize medication i am brennan spiegel and i am the director of well being providers analysis right here at cedars-sinai medical middle in l. a. and on behalf of our digital actuality program and our vr analysis staff it is my pleasure to welcome you to at the moment’s webinar the place for the following two hours we’ll be exploring a brand new discipline of medication this can be a discipline that the fda now acknowledges and calls medical prolonged actuality or mxr and we will be studying about what mxr is and the way digital actuality is educating us about our personal consciousness about how our thoughts and physique are linked and the way we will use this new know-how which is admittedly an previous know-how however now getting used on the entrance strains of medication to interact our sufferers in new and other ways and to reinforce conventional therapies in medical supply now at the moment is also the discharge date of the brand new e-book uh vrx uh which is a e-book that i wrote that tells the tales of our personal analysis at cedars-sinai utilizing digital actuality in affected person care and likewise tells the entrance line tales of sufferers and researchers and docs world wide who’re utilizing digital actuality to care for a number of the most tough to deal with situations in all of medication and at the moment we will hear from a number of of the researchers and the sufferers who’re featured in vrx and i am so excited to have them at the moment to inform their very own tales which i inform within the e-book as effectively so we will get began uh with my very own slides to kind of kick us off right here and earlier than we get too far i simply need to thank our supporters particularly cedar sinai medical middle which is behind me with out whom this is able to not be attainable and the management at cedars-sinai our digital medication program at cedars-sinai and particular due to utilized vr and confideo for his or her assist of at the moment’s webinar they’re serving to to convey this to you on this youtube premiere occasion now earlier than we get too far when you’ve got questions throughout this occasion you may kind them in to the remark field and our members of our staff will attempt to get to you and reply these questions as they come up now right here is an outline of a number of the audio system who might be listening to from at the moment as i stated these are esteemed physicians and researchers and affected person companions uh who’re featured lots of whom within the e-book and who might be telling their tales and describing how they’re utilizing digital actuality to assist handle a variety of various situations or have used digital actuality to handle their their very own situations this can be a cowl of the e-book as i confirmed you already vrx and in the event you’re excited about selecting up copy there’s a qr code that you would be able to scan that’s linked to at the moment’s webinar and you can too purchase it wherever books are bought particular due to primary books for publishing this e-book and serving to to inform the tales of medical prolonged actuality so the remainder of the world can find out about this new and thrilling discipline of medication so i need to give an outline of what we’ll be listening to about at the moment i will give the primary speak however the second speak might be from raphael grossman who’s honorary school at singularity college and a world-renowned technologist and a surgeon he was the primary surgeon to make use of google glass within the or and since then he has used vr within the or and all kinds of different applied sciences and he’ll be telling you about how he is utilizing these completely different blended actuality applied sciences in his medical observe and supply some projections for the long run the place this discipline is headed then we will hear from danielle collins certainly one of our affected person companions who will give a rare discuss how she noticed her mind and the way it modified her life at a really susceptible second in her life and that i inform her story within the e-book however nothing higher than listening to it from herself and we’ll be studying about how she used digital actuality and the way she has now gone on to champion digital actuality for a variety of situations we’re then going to go on and have some panels the primary panel might be uh on the neuropsychology of digital actuality this might be chaired by dr etai danovich our chairman of psychiatry at cedars-sinai and we’ll characteristic these three richard researchers judy paul from usc um nancya sufana from ucla and professor skip rizzo additionally from usc and these three researchers have been utilizing digital actuality for years to assist handle and perceive all kinds of neuropsychological situations every part from alzheimer’s illness to post-traumatic stress dysfunction and we’ll hear a bit about their analysis and the way they’re utilizing digital actuality and leveraging its perspective taking capabilities to assist handle these very tough situations then we’ll be listening to from affected person companions these three sufferers and we’ll introduce them in somewhat bit this might be shared by uh dr brandon burkhead from our group at cedars-sinai and matthew stout from utilized vr and we’ll be listening to their perspective of how they’ve used digital actuality in their very own care so i would wish to get began with my a part of the webinar returning to the quilt of the e-book vrx i titled it vrx as a result of if digital actuality is a remedy then we’d like a vr pharmacy and we have been studying about all of the completely different ways in which digital actuality may also help handle sufferers the completely different mechanisms by which it really works and we have additionally been speaking with our sufferers over the previous 5 years studying from them and discovering out how they work together with this know-how and the place do they need to go what fantastical locations if for instance they’re in a hospital room and must uh discover different worlds as a substitute of feeling like they’re within the hospital and we have discovered loads from our sufferers and we have used digital actuality now in over 3 000 sufferers at cedar sinai medical middle and we be taught one thing from each single certainly one of our sufferers so i can present you a number of knowledge and analysis research and that i’ll present you some however there’s actually no substitute from simply listening to from our sufferers and that i’d wish to share with you a few our sufferers proper right here all of whom have been very gracious to permit us to indicate their picture and inform their tales a few of whom i describe within the e-book with the music and every part is actual peaceable oh it is individuals hey that is cool that is what you suppose it is actually it is fairly stress-free uh-huh particularly with the music and every part after which the completely different surroundings prefer it was only one half the place it was um like a waterfall you are sitting in a cave proper and so we’re all falling proper subsequent to you nearly made me overlook i used to be right here like like since you’re there proper it is such as you’re actually there you listening to the waterfall and every part is such as you go searching and it is the entire surroundings proper it is such as you’re immersed in it there is usually a new type of ache administration and ache therapy in the event you you understand we proceed in the best path the breeze is blowing by way of i am sitting on the prime of kenneth hahn and there is downtown there’s the hollywood signal and there is my home that is that is simply surreal the solar is beaming down on me like i nearly really feel like i can really feel the rays oh man i i imply i am a tech man and i am a younger techie however i by no means thought know-how would come this far so far as well being is worried not in my lifetime and that i additionally by no means imagined that know-how could be used like this in healthcare till we began to discover and be taught and we began to listen to from our sufferers we realized we would have liked to begin finding out this ourselves and utilizing digital actuality to be taught extra about it now these are a few the various kinds of headsets that we work with these are two of the businesses we work with oculus and pico and we have used different headsets just like the samsung gear vr and these applied sciences now can be found previously individuals have used digital actuality in psychology laboratories and elite universities however till lately we’ve not had these very efficient top quality and reasonably priced headsets additionally that we will clear um to make use of on the entrance strains of healthcare and since we’ve these new applied sciences we’re taking this analysis that is been gathered over years and bringing it to the entrance strains now earlier than i speak concerning the therapy alternatives i additionally simply need to briefly speak concerning the instructional alternatives in healthcare for utilizing digital actuality you understand proper now i am giving a really conventional speak i am utilizing powerpoint slides however powerpoint is two-dimensional the world is three-dimensional what if we might truly stroll proper into slides what if i might use digital actuality to interact with my college students and truly present them what micro organism seem like proper within the slide itself and that is precisely what i used to be in a position to do right here in a chat that i gave utilizing software program developed by confideo a really modern firm that’s permitting very various kinds of trendy digital actuality studying utilizing these reside stage blended actuality platforms and you understand on the best is one other instance of a chat that i’ve given the place i am in digital actuality and i am participating with these completely different pictures and in a position to have interaction with them and present the viewers these quite complicated ideas that in the event that they have been proven on a two-dimensional display or in a textbook could be tough to to grasp however when proven on this three-dimensional area on this case i am speaking concerning the mind intestine axis and the way the mind and the intestine talk alongside the spinal twine and that i can go proper into the physique and interact the spinal twine and even peel it aside and look proper at it and level out key attributes and bodily traits of how ache is shifting up and down the spinal twine now on the underside proper is yet one more alternative for utilizing on this case augmented actuality or ar the place an knowledgeable can stroll proper up onto your literal desktop and she or he can have interaction you about some form of matter and do a lecture proper there in entrance of you now this occurs to be mike moret from confideo who’s exhibiting his personal software program and discussing how the information exhibits that it actually engages learners in a really completely different method so that is trendy digital actuality three-dimensional studying and though i am giving this speak in two dimensions the world is three-dimensional now the primary time that i ever used digital actuality was about six years in the past and also you’re an image of what i noticed a few of you will have heard this story earlier than however most of the individuals on at the moment’s webinar haven’t heard the story or haven’t even used digital actuality and that i did not know what vr was it was one thing that you understand youngsters could also be used for video games however i hadn’t actually imagined the way it might be utilized in healthcare till professor walter greenlee from stanford got here to my lab and he put a headset on my face and impulsively i am standing on a window washer rig going up the facet of a 50-story constructing and that is actually what i noticed and i have turned the sound down however i might hear the sound of creaking cables i can hear the wind i can go searching and really feel this teetering platform that i used to be on and i am somewhat bit afraid of heights however no less than i felt safe with that railing in entrance of me so i used to be in a position to go searching and soak up a number of the particulars like that rotary down there and the vehicles going across the dents in that metallic bar in entrance of me and i used to be simply beginning to really feel snug when impulsively that railing simply falls off the window washer rig and it plummets 50 tales to that onerous concrete floor down under and that i can actually hear it clink because it hits that after which they advised me simply go forward and soar off the constructing and that i stated no likelihood i am not going to do this they stated effectively you understand that your toes are standing on carpet proper i imply i used to be in a convention room and there was a white board behind me and that i stated effectively you understand i do know that like intellectually however my physique is unable to disambiguate standing on this digital world and being in a convention room on the identical time so we’ll simply soar off and i used to be in a position to do it it took all this braveness and that i jumped 50 tales and the wind was blasting by way of my ears and that i landed and that i hit the bottom and that is the primary time that i used digital actuality and i believed to myself oh my god this know-how it overcame me it hijacked my mind this was not simply an emotional expertise so this was a full physique expertise and i believed if digital actuality might be used for evil then certainly we will use it for good and it seems for years individuals have been utilizing it for good and for the six years since this time i have been exploring and studying how we will take benefit or leverage this capability to assist enhance constructive cognitions quite than scaring individuals to loss of life actually leaping off of buildings now that is the primary time that i died in digital actuality and now i need to inform the story of the second time that i died in digital actuality it was on the college of barcelona the place i visited the laboratory of professor mel slater and professor slater has been finding out digital actuality for good for a few years and that i begin my e-book vrx by telling the story that i am about to let you know now the place he put me into this room in his laboratory a quite nondescript form of darkish room with these black curtains there is a chair and there is a espresso desk within the center and so they requested me to take a seat down on that chair and kick my toes up on the espresso desk and that is uh certainly one of professor slater’s postdocs ramon oliva who’s handing me a headset and he put vibration motors on my wrists and on my ankles and he put the headset on and that is the very first thing that i see impulsively that room has been changed by this scene which is a front room that appears actually fairly lovely it has this wooden paneling and there is a chandelier on the ceiling and that i can see my toes in entrance of me on that espresso desk after which they requested me to begin shifting my toes round on the espresso desk and as i did that i used to be in a position to see these blue strains that they drew and so they requested me to hint these strains with my legs and that i did it i began to appreciate like whose legs are these i imply they seem like my legs they transfer like my legs they’re in the identical place as my legs in order that they have to be my legs however i additionally notice that someplace in that room there was a pc working hundreds of strains of code convincing my mind into considering that that was truly my physique that these legs have been mine however those who’s a digital doppelganger that is in fact non-existent these legs that is occurring on this digital world now the following factor that they did is that they dropped these balls from the ceiling no less than they seem like balls they’re digital spheres however they got here from the ceiling and every time it hit my physique i might actually really feel it in actual actuality as a result of i might really feel somewhat vibration in my physique and the cat swimsuit that i used to be sporting and it was an ideal one to at least one synchrony and at this level i had what slater calls kind of full embodiment or full physique possession i believed that that was my physique now what occurred subsequent is difficult for me to place into phrases it is kind of indelible it is laborious to explain in english however i will present it to you and i will do my greatest to explain it as i do within the e-book as effectively what occurred subsequent is impulsively i began to maneuver again and that i imply my myself my considering self instantly indifferent from this physique and began to drift again and up into the ceiling these balls adopted me and that i continued to really feel them however i seemed down and that i noticed a immobile physique that i had simply occupied and now it appeared vacant it appeared immobile my physique was in movement however that physique was not that physique was nonetheless i had died i had simply had an entire out of physique expertise and by some means this pc with digital sleight of hand had violated one thing as important as my bodily coordinates in area and had precipitated me to imagine that i’ve vacated my bodily physique so i began to suppose to myself what does this imply about my consciousness that a pc can so simply idiot me into having this out of physique expertise and furthermore i had this sense that i actually had died however it wasn’t catastrophic it wasn’t it was truly extra mystical nearly religious and it seems professor slater has repeated this experiment many instances on this examine he printed referred to as a digital out of physique expertise reduces concern of loss of life he discovered that when individuals have been randomized to this expertise in comparison with one other expertise the place they proceed to maneuver that physique and so they checked in per week later they discovered that folks feared loss of life just a bit bit much less and that i can let you know personally that i additionally concern loss of life somewhat bit much less having gone by way of this expertise now i do not need to die do not get me incorrect however i can say that by some means by going by way of this digital actuality expertise i’ve a sturdy cognition that loss of life needn’t be catastrophic and it is modified ever so barely my notion of the particular technique of passing away and that’s profound and what it factors out is that digital actuality is a instrument that modifies notion and if it is used to recalibrate unhealthy perceptions perceptions of the world round us perceptions of the world inside us then vr can turn out to be a radical new remedy to enhance high quality of life if used along with different conventional therapies so in fact there are different methods to vary perceptions of the world meditation is an more and more well-liked method aware meditation to only set up what’s referred to as non-dual consciousness that means you turn out to be basically one with the world round you by inhibiting the ruminating thoughts inside us the thoughts that plans and schemes and thinks that tasks into the long run and lives previously however does not essentially expertise the ability of now that’s one method to transform our notion of the world one other method is thru pharmacology medicines or on this case psilocybin the energetic ingredient in magic mushrooms psilocybin is a psychedelic that can also inhibit the ruminating thoughts so i convey this up as a result of one query is can vr be like a cyberdelic that inhibits the ruminating thoughts as effectively by way of its energy of notion altering and it seems this has been checked out in actual fact that is one examine that straight in contrast a type of digital actuality that you just’re seeing on this picture straight in opposition to a psychedelic psilocybin and within the examine from neil seth and colleagues from the college of sussex within the uk they randomized individuals to both expertise this weird world by way of this blended actuality platform the place there have been individuals strolling by with bells and canine heads and shimmering dolly-esque surfaces round them or they used psilocybin the magic mushroom after which they requested each teams to explain afterwards what their expertise was like utilizing a regular standardized altered area of consciousness questionnaire and right here you are seeing the ends in the type of a radar diagram the place they’re evaluating each teams throughout these completely different domains of altered consciousness and the factor that stands out is each strains are almost superimposable the expertise or the so-called phenomenology of being within the cyber delic versus the psychedelic right here referred to as a hallucination machine on the backside have been almost the identical suggesting that vr can act nearly like a psychedelic and inhibit the ruminating thoughts now we have been leveraging this energy of vr to inhibit the ruminating thoughts utilizing software program like this for to assist individuals each within the hospital and out of doors the hospital who might have anxiousness or who might must take a break from their ruminating thoughts that is software program created by journey vr which is particularly designed to assist entrain the mind right into a so-called circulate state a circulate state which is basically a state the place you are considering with out considering the place the mind the ruminating thoughts is inhibited and the remainder of the mind can begin to make lateral connections it is nearly like in the event you invite the conductor of an orchestra to go away for a couple of minutes then the remainder of the orchestra can have jam classes and you understand they could have cacophonous music which is a nasty journey or perhaps lovely inventive music kind of a very good trick and that is the objective right here is to have a very good journey in fact so vr has this means to counteract the ruminating thoughts and that will have advantages for anxiousness for melancholy for phobias and we’ll hear extra about that at the moment as effectively and the objective of all of this whether or not it is meditation medicine psychedelics or cyber scrumptious is to get some headspace away from your personal overheated overthinking thoughts now i need to offer you an instance of one other method of attaining some headspace and what i am doing right here is i am again in professor slater’s lab on the college of barcelona the place they’re taking images of me to be able to create an avatar of my physique after which put that avatar right into a digital actuality world after which what you are going to see in a second is a really weird type of speak remedy the place i will get some headspace from my very own head so as soon as they did this they put me on this digital world and what you are right here is my first individual view of my fingers sitting at a desk throughout from someone else so you may’t fairly see but i will present him in a second however i will let you know proper now that his identify is daniel dennett and a few of chances are you’ll know professor dennett he is a well-known thinker at tufts college he is well-known for his ted talks and he occurred to be certainly one of my mentors when i used to be a philosophy main as an undergraduate at tufts college a few years in the past and we used to have debates at school concerning the existence of god and what we’re about to have here’s a simulation of a type of debates so let me present you what occurs now look within the mirror to your left when the sunshine subsequent to you turns inexperienced clarify the problem to the individual in entrance of you utilizing your personal phrases how am i able to clarify consciousness with out invoking a god why do that you must invoke a god i do not perceive why that even issues uh it is laborious to clarify in any other case how what looks as if an immaterial expertise might be conveyed by way of materials substance effectively that is a basic uh dualistic idea that the thoughts and the physique are separate and distinct however there is not any purpose to invoke an immaterial element to our consciousness within the first place so kind of a false premise and on and on we travel so i am simply exhibiting you a little bit of the video and that i inform this story within the e-book and i’ve a hyperlink within the e-book to the complete video of our digital backwards and forwards however as soon as once more i am dropping to professor dennett he is arguing me down concerning the existence of god and you understand as you are watching this you’ll be questioning how is it that he can reply so fluidly to my feedback is that this some form of synthetic intelligence or one thing effectively it turns on the market’s no ai by any means behind his avatar it seems i am not exhibiting you the complete story right here what occurs is after i communicate i’m subsequent put into his physique i’m transported straight into professor dennis avatar and that i look throughout the desk by way of his eyes by way of his ears by way of his physique and that i see me throughout the desk i then must summon his voice i must summon what’s it that he would have stated to me after which i would like to reply and it has been over 20 years and i’ve and it is as if the vr tapped into this latent a part of my thoughts and made it manifest i used to be in a position to like a ventriloquist summon his phrases and communicate proper again to me the way in which we did years and years in the past so that’s me arguing with me besides that my voice appears like his the pc has permuted my voice to sound like daniel dennett’s voice however i am simply arguing with myself on this twisted unusual weird ego-busting digital actuality alternate i am actually getting headspace from myself by transporting myself into one other physique now that is one other use of digital actuality and it seems it is getting used to assist handle anxiousness and melancholy the examine on the prime is entitled conversations between self and self as sigmund freud this can be a examine additionally by mel slater and colleagues on the college of barcelona the place he exhibits that you would be able to have your personal type of self remedy within the backside examine is a examine by skip rizzo who we’ll hear from later who’s utilizing digital actuality for one more software in post-traumatic stress dysfunction he makes use of it in somewhat little bit of a special method however what these each have in frequent is utilizing digital actuality for psychological well being situations like phobia melancholy and ptsd now i need to transfer on in my final a part of my speak to debate one other alternative for digital actuality and that is for managing ache and what you are here’s a well-known examine from hunter hoffman on the college of washington the place he used digital actuality to assist handle ache and what you are seeing are two scans utilizing useful mri mind scans in the identical affected person on the identical analysis topic and on the left this analysis topic is experiencing ache there is a thermal probe being positioned on the topic’s foot and on the best can be experiencing ache however is utilizing digital actuality you will discover on the left that there are extra alerts within the mind than on the best there’s like a kind of a flame nearly like somewhat hearth conflagration within the mind on the left so it isn’t simply that there are extra alerts on the left it is the situation of these alerts so for instance the situation is each within the sensory cortex the place the ache is felt and skilled but additionally within the insula additionally within the limbic system within the middle of the mind the place the emotional expertise of ache happens so not solely is there a discount within the bodily expertise of ache depth but additionally the emotional expertise of ache and that is essential as a result of we have recognized for a very long time that there are two arrows of ache it’s buddha who stated that ache has two arrows the primary arrow is when the archer strikes you and it hurts it simply bodily hurts however the second arrow is the self-inflicted wound that is the place you take a look at the primary arrow and also you suppose oh my god i will die that is the anxiousness that comes from figuring out that you’ve got been injured figuring out that you just’re having ache so it seems that digital actuality can tamp down each sorts of ache in distinction to one thing like a narcotic or an opioid which may cut back the bodily expertise of ache however might not do something concerning the emotional expertise of ache and these are two research that display the flexibility of digital actuality not solely to scale back the sensory expertise of ache but additionally the cognitive and the affective expertise of ache in each of those research sufferers are randomized between vr or no vr on the left a examine from the college of washington in individuals with extreme burn accidents who’re present process dressing modifications a really severe and painful expertise and on the best from the college of michigan girls present process childbirth and on the left and on the best you may see that these in vr had much less ache on the left it is the black bar and on the best it is the white bar however in each circumstances digital actuality cut back the quantity of ache but additionally the time spent occupied with the ache and the unpleasantness of the ache and curiously individuals present process burn dressing modifications had extra enjoyable after they have been experiencing digital actuality on this examine from college of washington this can be a examine that we lately printed out of cedar sinai led by melissa wong and kim gregory from her ob gyn division the place girls present process labor cedar sinai have been randomized between a management situation or a lamaze-style respiratory intervention the place they use digital actuality and you may see that on common there have been larger drops in ache rating within the teams and the group that obtained digital actuality we have additionally checked out various kinds of ache all through the hospital at cedars-sinai and this can be a examine the place we randomized 140 hospitalized sufferers to 2 teams one group obtained a library of various vr experiences that have been developed developed by utilized vr and the opposite group was in a position to watch a well being and wellness channel on the television of their room and once we in contrast the digital actuality to the television over the course of their hospital keep we noticed a bigger drop in ache scores within the vr group versus the television group and importantly within the sufferers with the best quantity of ache these with scores of eight 9 or ten we noticed the biggest drops in ache with vr versus the television that is some visualizations that we use courtesy of utilized vr and you may see how subtle and delightful the graphics have gotten and it achieves this psychological sense of presence the place the mind actually feels current inside these environments now the very last thing i need to discuss is utilizing digital actuality for what we name ingestive habits or simply consuming and this can be a um examine that i need to present you from the college of tokyo that exhibits how the attitude altering means of vr and different blended actuality platforms can change what we understand to be actual and that might have an effect on how a lot we eat so what you are is an oreo cookie and utilizing this vr it will probably make the cookie look bigger or the cookie can look smaller it seems that has implications for the way a lot individuals are prepared to eat this can be a analysis topic who’s requested to eat as many cookies as he can and so they seem like a standard sized cookie and he will get full after 11 oreo cookies which is quite a bit the following day he comes again and the cookie appears larger it is the identical dimension cookie however now after seven cookies he cannot eat anymore he is full and it simply exhibits that notion turns into actuality and so that is a technique to consider learn how to alter our notion of how a lot we eat there are different methods to handle uh consuming issues and this can be a analysis examine from giuseppe riva from italy who’s been utilizing vr for each weight problems and for anorexia and on this occasion he is utilizing it for weight problems the place he makes use of digital actuality and sufferers use it after which they’ll see of their imaginative and prescient a standard sized avatar and so they turn out to be this normal-sized avatar and it actually modifications their view of their very own physique and their very own cognitions about their very own physique and in a randomized trial professor riva was in a position to present that sufferers who have been on this vr avatar remedy when mixed with cognitive behavioral remedy had larger weight reduction a yr later in comparison with those that weren’t uncovered to the digital actuality so if i had one other couple days i can discuss all of those different alternatives for digital actuality i talked about a few of them at the moment and there is so many extra and we’ll hear somewhat bit extra about a few of these as the remainder of this goes on however as i stated firstly if vr is a remedy then we’d like a vr pharmacy and the meals and drug administration the usf us fda now acknowledges this discipline and calls it medical prolonged actuality that is an infographic from a workshop that they held simply earlier than the pandemic once we all met at fda i used to be very lucky to be part of this workshop to begin exploring the regulatory panorama round these burgeoning new therapeutics we’ve a web site if you would like to be taught extra it is virtualmedicine.well being it is also virtualmedicine.org on this web site we put up our newest analysis research movies of all of our earlier conferences so you may hear from different different individuals on this matter movies of our sufferers and on all of our webinars are situated right here and eventually as i stated we now have the brand new e-book vrx once more thanks to primary books for making this obtainable to the world to see and as soon as once more there’s the qr uh if you would like to learn extra concerning the tales that i advised you at the moment um and plenty of many others uh on this e-book vrx so with that um as a result of i come from hollywood i need to finish with credit there are such a lot of individuals at cedars-sinai who participated within the analysis that i confirmed you at the moment we’ve many collaborators our personal analysis group collaborated from inside and out of doors of cedars-sinai a variety of college students and trainees who’ve participated on this analysis and that i need to give particular due to individuals at cedar sinai together with the management at cedars-sinai for supporting our digital actuality analysis and making all of it attainable if you would like to comply with me on on social media that is my deal with on twitter the place i ceaselessly tweet about digital actuality and medication and our digital medication convention deal with is there as effectively so i would wish to get us shifting alongside to the following speaker who’s professor rafael grossman uh singularity college he is additionally a surgeon uh in maine and he’s as i stated earlier than the primary surgeon to make use of google glass within the working room makes use of mr makes use of vr he will give us a ahead considering discuss the way forward for medical prolonged actuality every part from contact lenses that use augmented actuality proper on our eyeballs to different types of know-how that may broaden our means to care for sufferers so i would wish to with out additional ado introduce raphael grossman who’s in his hospital over in maine rafael take it away hello brennan it is a pleasure to be right here congrats on this third version of this superb convention and likewise in fact congratulations in your uh unbelievable e-book i can not wait to learn it once more so with this let’s begin and that i’ll hope that you’ll be thrilled we’re within the midst of a real revolution a revolution ongoing for the previous few a long time computer systems that used to replenish a room and have little or no energy to computer systems now that match on a hoop on a watch on a music blade machine or clearly on a smartphone that all of us carry in our pockets once we take into consideration exponential know-how we’ve to bear in mind roy amara’s legislation we are inclined to overestimate know-how within the quick run and we are inclined to underestimate know-how in the long term and that’s as a result of our considering is linear however know-how develops exponentially so it is extremely necessary that when you find yourself imagining or strategizing or planning designing for the long run you retain under consideration a mars legislation as a result of in any other case you’ll seemingly be incorrect so it’s an attention-grabbing idea that i wished to to share with you particularly with this presentation that’s speaking about the way forward for vr i like science fiction and i feel that hollywood predicts the long run in very fairly predictable methods keep in mind in actual participant one a few yr and a half in the past it confirmed for the primary time throughout the road from cedars-sinai in l.a and uh individuals they thought the film was science fiction what shouldn’t be we’ve the know-how at the moment to essentially actually do nearly every part that you would be able to see in that image from a a pilots that carry the simulation of flying a airplane to a docs and future surgeons and precise surgeons who reside the fact in a digital method of working and failing with a digital affected person quite than with an actual affected person basic vr is creating this sort of a a platform to be able to enhance and excellent how we be taught and the way we train in the event you add to this a platform the ability of haptics the ability of the sense of contact and the sensation the tactile feeling then you definately go to a special stage you go to a stage the place the immersion is sort of absolute and if we take into consideration ar and xr and the hololens 2 and how one can convey pictures in to the working room into the process room and the operator the surgeon can see these pictures in entrance of of of of her of him and you cannot distract your self from the affected person then the method of caring for the affected person improves from studying with a digital instruments to additionally diagnosing with digital instruments and approaching the prognosis the interplay with the diagnostic instruments otherwise to treating sufferers with prolonged actuality the long run is admittedly right here at the moment i feel throughout the subsequent 10 years this might be very quite common within the working room you will have firms for instance like a mind lab which is a a pairing with a mighty a magic leap machine and a a mind lab is a really well-known surgical navigation platform all around the world and whenever you see what they’re doing with the surgical viewer the digital viewer and you may have a surgeon take a look at the photographs in methods by no means thought attainable earlier than not in a single two or three axis however in any axis attainable i feel that uh now you’re undoubtedly redefining the paradigm of interacting with a with a radiological imaging it’s all about interplay it’s all about spatial computing interplay and that’s the place the long run is unquestionably going to go and in the event you add physiologic variables firms like eye motions for instance which i did this with the vario headset and excessive movement sensor galvanic pores and skin resistance and a blood strain ekg temperature monitoring and you may see how the individual is definitely doing the process how the efficiency is occurring understand how you see it however how your inside physiology sees it then you may enhance the efficiency to ranges that have been by no means thought attainable earlier than eye monitoring and this measurement is unquestionably the long run and once more again to haptics platforms like haptex which is one of some haptic platforms on the market it is all in evolution however we will very cumbersome units like this one to units which can be mainly a glove and a glove nearly think about i think about a surgical glove that you just placed on and you’re in digital actuality you are feeling every part as in the event you have been current as in the event you had been teleported and in the event you add a swimsuit just like the tesla swimsuit the place you will have the potential for a sense of sensing temperature strain pressure then you understand you go to a totally completely different stage think about in remedy in rehabilitation and bodily remedy somebody has ache and you set a swimsuit on and you may carry {that a} kind of a progress by way of your illness and thru your remedy and you may measure that i feel that that may be a very very thrilling whenever you discuss using vr and ar and xr within the caring of sufferers and that i clearly have to speak concerning the pandemic proper the pandemic elevated the way in which we join a distant connectivity and communication telehealth telemedicine has lastly turn out to be a actuality proper however that is even higher that is in digital actuality an avatar that lets you join in actual time regardless of the geography the place you are in and work together with digital pictures that is beam from iso and finally the avatar probably you may consider picture volumetric avatars which have aai algorithms and you may have an individual be anyplace anytime and have the best solutions for the affected person bridging that hole between the availability and the demand of healthcare suppliers remembering the 5 billion individuals on the earth most likely do not have entry to the well being care that we take day by day for a granted so that is very very thrilling and i feel that on the finish you understand we’ve to suppose uh sit again and notice you understand you understand just some years in the past we did not even have the iphone with us or some other smartphone and now we’re as much as the iphone 12 nearly so you will have new units just like the apple watch that measures your ekg your pulse and your pulse oximetry for instance it’s actually actually thrilling the place we’re going and i feel that we’re nonetheless going to go farther very quickly inwith is an organization that has a hydrogel a contact lens with circuitry in there the potential of that circuitry to be something that you really want together with ar or prolonged actuality is actual and it is one thing that’s actually actually a groundbreaking and it’ll outline the brand new platform that we’re gonna have on us and depart you with this film clip from the matrix you need to select you’re taking the blue tablet otherwise you take the purple tablet i hope you’re taking the purple tablet as a result of we need to present you the way deep the rabbit gap goes thanks very a lot effectively thanks raphael that was as at all times a implausible speak gave us loads to consider confirmed us a number of examples of how vr and ar and mr are getting used within the or um and as a surgeon you will have a very distinctive uh perspective of that so that you’re holding some glasses um what what’s it that you just obtained in your hand effectively these are my kind of a brand new favourite these are the the v6 blade which uh this isn’t the brand new version which is coming fairly quickly however uh that is actually kind of the final word straightforward light-weight uh kind smart it is a phenomenal and the chances of this machine to combine ar and xr to the day by day doings within the hospital are fairly superb so yeah we’ve lots of people on the webinar who have not actually considered these items whenever you say combine ar inside your day by day position within the hospital like what are some examples how would you truly use this as a surgeon or going by way of the hospital yeah effectively now it is it is a actually not a part of the the usual method we we we reside our day by day lives on the hospital you understand being clinicians however uh you understand think about projecting emr alerts or or pictures or primary knowledge not the identical knowledge that you just get on a display however a partial knowledge the information that you just want for instance to to perhaps spherical on the affected person you understand the important indicators the eyes is aware of the the the what is the hemoglobin at the moment and people little issues that might be projected quite than you having to take a seat in a pc you possibly can have that knowledge come to you instantaneously perhaps even synchronously as you method the affected person’s room for instance that is one kind of a imaginative a risk you understand for this sort of glasses i feel that permits using the know-how in a wise approach to do our medical work and be extra environment friendly and have the ability to give attention to the affected person extra quite than separating us from the affected person you understand we will give attention to the affected person and in a method be extra empathetic and and and you understand paradoxically humanizing the way in which we we work together with sufferers by utilizing know-how proper proper so in my speak i i spoke loads concerning the therapeutic alternatives and actually what we’re speaking about right here is is effectivity for healthcare suppliers uh and likewise this concept of coaching healthcare suppliers uh and surgeons particularly to to be even higher um so speak to us somewhat bit about how vr and and blended actuality and augmented actuality can be utilized for simulations you touched on it in your speak what are what are you seeing that is actually thrilling to you effectively i will let you know brandon it is it is actually an exceptional velocity proper now the way in which that the vr for instance has developed in the way in which of uh representing an actual you understand simulations that it’ll it practice physicians or suppliers or college students in in a greater method it’s simply that unbelievable and sufficient it isn’t simply the the digital a rheon that appears so actual nearly i used to be utilizing the vario machine in in a type of clips that i confirmed it is nearly like wanting by way of a window you understand the the definition the excessive definition of the machine is simply unbelievable and you’ve got platforms like a basic vr or there are numerous others additionally vr or whatnot however however whenever you add to that the potential for for instance measuring a physiologic variables i discussed eye motions measuring gsr you understand the galvanic pores and skin potentials and telling whether or not you are nervous or not otherwise you’re snug otherwise you’re within the within the it you understand whenever you do a process that can measure efficiency in coaching in a significantly better method after which whenever you go to a ar or xr or mxr proper then you definately go from from training to diagnostics to them therapy i feel that uh i imagine i confirmed in my in my video a no less than briefly how you will have this uh nearly a photograph volumetric renderings of sufferers and you possibly can have a digital affected person shouldn’t be an avatar it might be an avatar it might be a visible avatar that appears actual however on this case is photovolumetric renderings of sufferers with no matter pathology you need to program into that think about a scholar taking their their their their superior trauma life assist programs or acls programs with a digital entity and interacting with an entity and in the event you add haptics and in the event you add a odor you understand that i used to be mentioning ovr is the know-how that you would be able to plug this little chip in your in your oculus quest and also you get the odor of no matter rendering you’re seeing as a gastroenterologist that might go each methods for me i assume however it might it might however think about think about the scholar who actually has to really feel how he actually feels or think about even the affected person who has to you understand actually immerse himself in what the the room goes to be like or odor like or i feel it’s attention-grabbing it is very attention-grabbing what’s taking place factors out that you understand we discuss vr as an immersive expertise and it isn’t simply the visuals i imply positive you you’re you understand visually on this world and and you understand that is that is a an necessary sense a serious sense for our mind however we can also hear issues we will contact issues we will actually odor issues and as you mentioned in your speak that there is there’s temperature there’s there’s forces there’s you understand tactile or the haptics um that you just really feel and i feel that is actually um not only for simulation but additionally for therapeutics that that is actually an immersive alternative not simply the visible expertise completely no i feel once more the chances are i i say at all times solely restricted by how inventive we’re and you understand you have proven hundreds of examples of therapeutic vr however however think about once we use this ar or mxr to do remedy on a affected person how how like if you do not have to give attention to the emr within the pc or the laptop computer however you may truly you understand give attention to the affected person the therapeutics you understand from you to that affected person are a augmented in methods which can be laborious to even you understand outline and even measure proper so i feel it is a continuum we’ve a lot to uh to be taught however it’s going so quick and it is so thrilling that that i simply can’t i can not wait to get there you understand completely effectively within the e-book i speak concerning the starting that when individuals consider vr they usually consider a gaming platform for you understand youngsters enjoying first individual shooter video games of their dad and mom basement or one thing and it’s that i imply vr is a gaming platform however it’s clearly a lot greater than that i imply vr is a approach to have an effect on human consciousness in many alternative methods and it is also not simply concerning the headset as a result of as i discuss within the introduction of the e-book these headsets are going to turn out to be eyeglasses or they perhaps even turn out to be contact lenses and also you talked about that i imply it isn’t even concerning the headset it might be introduced in so many alternative methods i imply what are your ideas about you understand the place when are we going to begin utilizing contact lenses within the hospital that ought to that undertaking the well being document proper onto our eyeballs effectively i i undoubtedly suppose that uh it would occur sooner or later we’re nonetheless fairly early you understand that firm i discussed is in with and so they have the one patent to place circuits on a hydrogel identical to the one we use for contact lenses proper i feel it’s going to be most likely you understand greater than 10 years for that to occur however i actually know that glasses like this it will appear cumbersome you understand in three to 5 years from now we’re gonna have common glasses just like the those you are you are you are utilizing proper now which might be studying glasses however may also be kind of intuitively and in in instantaneously it instruments to mean you can join with the digital world outdoors or within the hospital so i feel that the place you understand i talked about mara’s legislation proper and once more we we we are inclined to to uh to to not perceive how how know-how progresses proper we overestimate it within the quick time period and we underestimated in the long run in the long run we’re gonna have these applied sciences we’re gonna have you understand identical to having our smartphones keep in mind you understand we have been carrying these these large brick telephones and we have been oh who’s that man he must have a telephone you understand subsequent to him or to her you understand 24 7. and now we’ve one two or three of those in our pockets proper so it’s one thing that that we did not even take into consideration however we’re gonna get there and it is gonna be so rapidly that it will likely be superb and you understand we take into consideration how we practice the following generations they’re gonna should to to learn about this after they’re finding out not you understand after they end their residencies yeah yeah effectively i need to thanks once more rafael for for becoming a member of us uh at the moment for this occasion and for sharing your enthusiasm and your devices and units and your imaginative and prescient for the long run uh hopefully individuals take away from this dialogue that the long run is brilliant and you understand if we’re considerate about learn how to combine this know-how with the very human artwork of being a physician and being a affected person uh sky is the restrict so thanks once more for being with us at the moment my pleasure brenda my strain and once more congratulations for every part you are doing it is superb thanks a lot so subsequent up uh it is my distinct pleasure to introduce our subsequent speaker danielle collins now danielle’s profession has spanned many alternative industries together with public relations actual property and social work however her profession trajectory actually pivoted when she underwent a surgical procedure for a life-threatening mind bleed in 2017. it was then that danielle skilled the ability of digital actuality uh created by an organization referred to as a surgical theater now this traumatic life occasion served as a catalyst that propelled her mission to make sure that all sufferers have entry to medical ar and vr know-how and he or she is a proud founding member and chief expertise officer for the empower 360 basis which is reworking affected person engagement by offering important funds to facilitate entry to probably the most superior vr in ar medical know-how no matter socioeconomic standing she holds a grasp’s diploma in medical social work from the college of maryland with a focus in worker help packages and a bachelor of journalism from the college of georgia she has an unbelievable story to inform uh and that i inform a part of her story uh in chapter 10 of the e-book however uh even higher to listen to it straight from danielle so danielle thanks a lot for being with us at the moment and you have the ground take it away thanks thanks a lot dr spiegel i’m honored to be right here at the moment and to share my story with all of you be it just about and that i’d like to begin off my speak at the moment by transporting you again to june 2017. in june i had mind surgical procedure for a ruptured avm and my proper temporal lobe was a situation i used to be truly born with and that i knew nothing about my total life till the day that it truly ruptured i invite you proper now to look at a video with me that transports you again to my days as a affected person to be able to truly expertise my journey alongside me on monday june fifth 2017 i felt the worst headache in my life like an ice choose driving by way of my cranium a cat scan revealed a bleed within the facet of my head the scale of a softball the one choice to cease the bleed was to have a craniotomy to take away it being utterly uncontrolled is terrifying it is tough to speak to sufferers about mind surgical procedure as a result of it is very summary we’re combining delivering tough information a few scary prognosis with the extra concern of not figuring out what to anticipate and never with the ability to perceive what it’s i am explaining to them once we present them the mannequin after they fly inside their very own mind they’ll see the constructions they’ll see the tumor they’ll see the aneurysm this machine creates an expertise for the affected person the place nothing is unknown anymore sufferers are on the lookout for some hope they’re on the lookout for a approach to perceive what’s taking place what’s made mind surgical procedure traditionally fairly difficult is surgeons have to have a look at two-dimensional imaging after which of their thoughts’s eye create a three-dimensional map of how they may method the operation we thought you understand what we will intervene right here and we will take mri and ct scans and fuse them collectively in our software program to create a digital reconstruction and alter the observe of medication for the good thing about the household the surgeon and the establishment it’s that individual’s anatomy varialized when i placed on the goggles my surgeon requested me if i used to be able to fly within the moments the place they have been telling me actually terrifying issues i additionally felt somewhat little bit of peace from the way in which that it was being introduced i used to be in a position to in actual time see inside my mind i used to be bodily there with them precisely what they have been attempting to speak the benefit that the digital planning and rehearsal brings to our readiness for surgical procedure is the flexibility to simulate a number of completely different approaches in an actual affected person we do not get to attempt that greater than as soon as we solely get one shot at it within the digital mannequin we will do two plans three plans 5 plans and see which one is the perfect for the person affected person make the bone look somewhat extra like bone so it isn’t translucent at first now that i can see the frontal sinus i am planning it you understand yeah yeah i used to be on the hospital within the icu for 10 days and that i had two angiograms two mris two cat scans and a craniotomy i feel digital actuality will change the face of healthcare i feel in some methods it already has individuals are demanding transparency i feel individuals should be spoken to in a method that they’ll perceive it made me extra grateful for every second that we’ve we expertise life in three dimension why ought to our medical care be any completely different in order you all witnessed within the video this life expertise modified every part about not solely my profession my private life how i considered healthcare however it impressed me to dedicate my life to bringing this chance for different sufferers to have entry to those identical applied sciences in order we undergo these slides i will clarify somewhat bit extra concerning the basis in energy 360 that may be a direct results of this expertise so taking you again as soon as once more these are just a few highlights of the particular pictures from the time i used to be within the hospital the picture on the left is put up surgical procedure i feel i used to be two days put up surgical procedure and so they had truly needed to break my cheekbone in my jaw to chop into the bone so that you’re seeing fairly vital swelling there the picture in prime middle exhibits the bleed and you may see in the event you’ve ever seen a black and white dicom picture simply the juxtaposition of how completely different and colourful and graphic the surgical theater scans have been that i used to be in a position to see as a affected person much more so when i had the vr headset truly on and was in a position to get a 360 diploma superman view of my pathology and the picture in backside middle is precise actual picture of me utilizing the headset as a affected person within the hospital and the picture on the best i fairly frankly haven’t any recollection of as a result of i used to be nonetheless closely sedated however i used to be getting back from my mind surgical procedure and i feel i used to be yeah i am giving a thumbs up so it went effectively clearly i am right here at the moment so empower 360 was actually birthed like i stated out of my expertise as a affected person and recognizing that conventional strategies of care whereas fantastic and life-changing additionally might be improved upon and so empower 360 serves as a catalyst to permit sufferers worldwide to have entry to those vr and ar applied sciences which can be in a position to assist in a myriad variety of methods all through the well being care continuum our mission assertion is that we exist to rework affected person engagement by offering important funds to facilitate entry to probably the most superior digital and augmented actuality 360 diploma medical know-how no matter socioeconomic standing we do this in a variety of methods and we’ll contact on that in a minute one of many ways in which we initially do that the which might be expanded upon somewhat bit later all through the slides is by offering grants so whether or not they be institutional analysis or management grants our sole mission and the premise of our mission is to encourage using vr and ar know-how we empowered docs and we truly endowed a chair at hogue hospital um dr rob lewis as a result of we acknowledged early on that the docs are those who’ve the flexibility to essentially implement these applied sciences and create a quorum inside a hospital system that exhibits management that these applied sciences not solely profit affected person care however they’re wanted they’re wished and there is methods to creatively give you funding we increase funds from visionary philanthropists charitable foundations and particular person donors and firms that assist our mission as of late i’ll say that given kova this has been barely more difficult the character of our work albeit necessary many would say that it does not straight relate to covet and preventing the disaster at hand i might problem that as a result of i feel now greater than ever we’re seeing psychological well being points crop up i feel sufferers now greater than ever are much less prepared to go to docs and places of work and so now given the chance from house we’re in a position to attempt to implement these vr and ar applied sciences from distant places now extra so than ever earlier than we are also persevering with to at all times search for strategic partnerships with firms and organizations who align with our mission and who’re persevering with to innovate medication by way of using know-how so whether or not that is the intel’s of the world or whether or not that is the hps of the world we’re on the lookout for and continually are on the lookout for ongoing strategic companions to assist us on this mission each philanthropically and as sound stage recommendation for shifting ahead and learn how to greatest implement our strategic mission maybe most close to and expensive to my coronary heart is the confluence of a affected person neighborhood and constructing out actually not solely only a repository database of affected person tales that sufferers would have entry to but additionally assembly these people and their households nose to nose whether or not on-line on this season or in individual and simply actually understanding their tales and the way vr and ar might have performed such an instrumental position of their restoration or the way it truly did so for me one of many best rewards has been assembly sufferers listening to their tales after which giving hope to those that comply with in our path who might and can profit from these applied sciences clearly one of many best challenges for anybody working this area proper now’s how do you the way do you construct collective consciousness among the many lots for the truth that these applied sciences exist and in the event you work in healthcare chances are high you have heard however in the event you’re in most people and you’re going through a prognosis like mine was with a ruptured avm and also you go in for a standard black and white dicom scan and you do not know since you’ve by no means heard that you possibly can placed on a vr headset and be transported into your mind to grasp your pathology in a complete new method then that is an issue and we’ve some work to do there to create consciousness and we’re at all times on the lookout for companions whether or not advertising companions or strategic companions who’ve affect with philanthropic people to create a extra sturdy plan for learn how to sort out that and clearly core to our mission is to only promote innovation to raise all the customary of care throughout the healthcare continuum you understand as a affected person i exploit vr in my hospital room however after forming empower 360 basis i’ve turn out to be keenly conscious of how far more i might have used vr all through my restoration be it for bodily remedy be it for ache administration put up surgical procedure be it for a number of the ptsd that i skilled since this was an emergent situation and it has impressed me to have the ability to it is impressed me to have the ability to have a platform to not solely discuss these items however to drag collectively sources and funding to make the issues that we discuss a actuality so simply restating we intention to make digital and augmented actuality know-how a regular instrument within the toolbox throughout the continuum of care i feel it is under no circumstances one thing that can utterly change conventional medication and i feel that is one of many largest issues that sufferers can actually assist docs perceive is that it isn’t that we’re trying to change conventional requirements of care we’re trying to improve them and increase them with issues that might make our experiences sufferers that significantly better in order i said earlier than we do that in three other ways we offer institutional grants management grants and analysis grants we’ll go into them somewhat bit extra depth now so institutional grants that is fairly self-explanatory however we intention to empower non-profit medical establishments with sources that allow them to subsidize prices for these modern applied sciences so this might embody introducing vr and ar know-how by way of the standard grant or it might comply with establishments which have demonstrated a earlier initiative the place they’ve expanded their vr and ar capabilities and must proceed to construct upon these at the moment in place packages our management grants just like the one talked about with dr lewis at hogue are actually looking for to award people docs or others throughout the medical ecosphere who’re selling these applied sciences and empowering sufferers and empowering their establishments that they work for to construct a extra sturdy program so we do that to offset a number of the prices of onboarding the applied sciences we additionally do that to offset a number of the prices of really implementing a bigger program be it at hogue you understand the place they’ve deployed this throughout a variety of disciplines all through the hospital it is truly fairly unbelievable what he is constructed there after which lastly could be our analysis grant and that is one which’s actually close to and expensive to my coronary heart too as a result of i feel to have the ability to push the boundaries and the strains of what is attainable by additional analysis is at all times inspiring and really rewarding to offer to so on this capability we’d be giving grants to any one of many variety of issues listed under and people aren’t not simply the complete record however it’s not simply restricted to these however it will probably lengthen past as effectively however to show not solely the efficacy of those applied sciences but additionally to discover new areas that perhaps we’ve not beforehand explored earlier than so i simply need to thank every of you at the moment for permitting me to share my story with you and clarify somewhat bit extra concerning the empower 360 mission i might invite you if you’re wanting to become involved whether or not from an advisory standpoint or from a philanthropic standpoint please attain out i at all times like to make connections and in the event you’re a affected person that has a narrative to inform that is most likely the factor that will most excite me so i sit up for listening to from you and actually sit up for our subsequent visitor speaker who’s speaking concerning the neuropsychology of vr dr atai danovich thanks all a lot for listening to me at the moment and that i sit up for assembly you all in individual within the close to future okay thanks danielle for that speak and uh uh please know that we’ll have extra of danielle uh who might be on a panel afterward in at the moment’s classes it is a pleasure for me to have the ability to introduce the primary panel of at the moment’s program targeted on neuropsychology or digital actuality and actually immersive applied sciences and therapeutics we’re lucky to have three excellent specialists within the discipline all from the la space the primary is is judy paw who’s a phd judy is a cognitive neuroscientist and affiliate professor at usc within the stevens neuro imaging and informatics institute within the division of neurology neuroscience and biomedical engineering she has intensive expertise with human neuroimaging and has a analysis lab that is particularly targeted on alzheimer’s threat elements and prevention her main objectives are to develop and take a look at novel life-style interventions significantly ones utilizing know-how her analysis is supported by nih she lately obtained a big grant uh to analyze the consequences of bodily and cognitive exercise intervention by way of digital actuality and older adults and uh we sit up for our contributions on this panel uh subsequent we’ve dr skip rizzo i am additionally phd skip is a medical psychologist and neuro psychologist and professor on the usc division of psychiatry and davis college of gerontology he directs medical vr on the usc institute for inventive applied sciences and has carried out and continues to conduct analysis on the design growth and analysis of digital actuality methods and actually each single area of uh psychological cognitive and motor functioning and wholesome populations and medical populations reminiscent of ptsd tbi autism adhd alzheimer’s illness and the record goes on um skip has is his work to the sector has been actually basic he is been one of many the founders of this discipline and has been acknowledged with many alternative recognitions and awards a pleasure to have skip on the panel and uh and and eventually we’ve nantya sutana one other phd assistant professor in residence on the ucla division of neurosurgery um uh nanthia’s analysis goals to develop therapeutic cognitive remedies and instruments to the characterization of neuronal mechanisms that underlie human studying and reminiscence and particularly she makes use of digital actuality or augmented actuality mixed with wearable applied sciences in sufferers with mind implants to grasp cognitive perform and uh develop novel therapies for neurologic and psychiatric issues so um uh actually an excellent group of people doing a really attention-grabbing work on this discipline maybe to get began i might simply ask every of you to explain the way you’re at the moment utilizing digital actuality um in your work and and actually particularly uh there are such a lot of instruments so many evaluation instruments and so many intervention instruments and neuropsychology what what uniquely and particularly does digital actuality and allow you to judge or do together with your sufferers maybe you can begin with uh with you judy yeah positive effectively thanks for that actually form introduction i am comfortable to be right here at the moment so my lab is targeted on alzheimer’s prevention and so we attempt to consider that in inventive methods as everyone knows it is a horrible downside and we all know we do not at the moment have any efficient remedies so what we’re actively testing in my lab is a design that marries digital actuality with what we learn about neuroscience so it is an in-lab design of bodily and cognitive coaching utilizing digital actuality with the ability to design a paradigm that we won’t actually do on the earth we won’t safely take older adults who’re frightened about their brains or considering and inform them to exit and navigate the world that they do not know however we won’t do this in digital actuality we will create these actually attention-grabbing paradigms that they’ll bike by way of proper now we’re working with some city parks and a few atriums and that is deliberate we’re attempting to take bodily exercise and cognitive exercise and put them collectively in order that we will leverage the advantages within the mind of bodily exercise so for a very long time we thought we have been born with all of the neurons we would ever have it is referred to as neurogenesis we now know that we truly develop new neurons or delivery new neurons and that bodily exercise accelerates that what we are actually layering on prime of that with digital actuality is the cognitive element that in the event you take these newly delivery neurons which can be birthed within the reminiscence middle of the mind the hippocampus then you may truly assist these neurons train their method outdoors of the hippocampus and to different areas throughout the hippocampus to assist kind these reminiscences and to assist these reminiscences turn out to be extra long-lasting and as we all know inside alzheimer’s illness that is what we need to maintain on to is our reminiscences it is our considering it is our means to have the ability to stroll right into a room and know why we went there it is our means to have the ability to um drive in our neighborhood that we have lived in for 30 40 50 years and nonetheless keep in mind learn how to get house and so that is what vr has enabled for us is to us to get inventive to determine effectively how can we problem the mind in a secure terrific nathia are you able to inform us about your work positive hello everybody so we’re utilizing digital actuality to additionally perceive reminiscences we use it as a instrument to activate the mind and we work with sufferers who’ve implants within the hippocampus and different areas to see what’s taking place within the mind once we kind new reminiscences recall these reminiscences there’s a lot we do not perceive the neuropsychol psychological instruments we’ve now or historically been utilizing have flaws in how they assess you understand this very complicated habits so we’re utilizing vr and ar to to essentially attempt to simulate these actual life like experiences in order that we will higher perceive the mind after which on prime of that we’re additionally by way of collaborations engaged on different issues ptsd ocd these these kinds of issues to attempt to not solely perceive what’s taking place within the mind but additionally use it as a approach to know when’s the best time to interact with a therapy and in my in my lab the therapy that we use is deep mind stimulation which is a an space that’s rising uh fairly rapidly proper now for treating neuropsychiatric issues and so utilizing vr to attempt to assess you understand when when’s a very good or dangerous time to intervene and might that remedy truly translate to the true actual world uh by simulating it within the lab with vr very attention-grabbing sit up for return again to a few of that however uh lastly let me flip issues over to skip to inform us somewhat bit about your work in vr at the moment effectively my work initially started uh within the mid 90s and it was spurred on by my medical work in mind harm rehabilitation i did quite a lot of cognitive rehabilitation from uh the mid 80s to the mid 90s and i used to be very annoyed with the instruments we had obtainable to us quite a lot of paper and pencil workbook kind workouts and that i kind of seen that a variety of my purchasers who i could not have interaction with that kind of exercise would have interaction with sport boys or with video video games truly introduced in sim metropolis into the clinic which on the time was actually a very good government perform stimulation exercise however round that point i began to see the vr was um changing into one thing that was attainable as primitive because it was that and the imaginative and prescient actually was mixture my background in neuropsychology which is outlined because the examine of mind habits relationships um but additionally my work with ots the place there was a give attention to you understand not simply measuring efficiency on a take a look at however how does someone truly translate this to the true world and that i at all times noticed vr from that time on it is kind of a pleasant merger between neuropsychological rehabilitation and an ot perspective the place you possibly can in a simulated atmosphere do the sorts of neural psych and kind drill and observe actions in a managed atmosphere however do it throughout the context of a functionally related atmosphere and hopefully from a medical perspective improve the switch of coaching or the generalization to the true world so when i got here to usc uh one of many first tasks we did was with psychological rotation it was you understand utilizing blocks in a 3d atmosphere it was one thing we might do fairly effectively with the primitive know-how and pc graphics of the day we obtained actually good outcomes exhibiting that we might truly change a cognitive perform with repeated observe in an interactive 3d atmosphere went on to digital lecture rooms for testing youngsters with consideration deficit beneath a spread of controllable situations did work with the navy convey individuals in navy related contexts and testing their retention reminiscence government perform within the in these methods and all this work has grown and developed and possibly the one which i am most enthusiastic about now is definitely outdoors of usc uh working with a personal firm that is taken the digital classroom idea and now developed it into one thing that might be a product within the close to future the place we put a baby in a digital classroom they should carry out a activity it is delivered visually on a whiteboard on the entrance of the category or um auditory duties which can be embedded from the trainer or the display however we will systematically this context so we will leverage with vr headset know-how whether or not the kid is wanting on the whiteboard and lacking a goal or is a distraction like a bus going by a window college bus going by are they looking the window and lacking it isn’t even of their discipline of view this gives the aptitude for what vr is nice at uh this capability to have the ability to detect is that this distraction error is that this the lack of focus error is it a hyperactivity error as a result of the sensors and monitoring know-how within the headset enable us to select up motor motion and in order that’s the place i actually see vr shining is each an evaluation and in rehabilitation very like in you have most likely heard me say it is 1,000,000 instances very like an plane simulator can take a look at and practice piloting means we will take a look at practice train and deal with human perform in comparable sorts of simulated environments however we will do them on you understand low-cost low-cost uh vr headsets like i’ve right here you understand oculus quest and so forth um at a value level that’s cheap for clinicians to implement so i am i am actually targeted on getting this out of the lab and getting it into the fingers of clinicians for on a regular basis work mm-hmm um judy you talked about utilizing uh digital actuality to assist um uh facilitate restoration or preservation of reminiscence perform um are you able to communicate uh a bit extra about how that truly works and what which means in observe yeah so so there’s other ways to consider it proper so inside regular growing old everyone knows as as we age that we begin to turn out to be somewhat bit extra forgetful we’ve some what we name phrase discovering problem what was that phrase i used to be on the lookout for or perhaps lately assembly someone and never remembering their identify however remembering perhaps some details about them like oh yeah they only went to their daughter’s wedding ceremony so we actually attempt to goal the a part of the mind that is concerned in reminiscence um it is it is simply one thing so core to who we’re proper we we hear quite a lot of sufferers come into the clinic and so they convey a member of the family with them and that is probably the most heartbreaking factor is that mother or dad or grandma not remembers them or forgot forgot that their daughter was born and so we attempt to hone in on reminiscence as a result of that’s such a key a part of what occurs with growing old and actually appears to be selectively susceptible in alzheimer’s illness however it goes past that and that is what vr has allowed us to do is to not simply give attention to reminiscence however give attention to the networks within the mind that serve reminiscence and so everyone knows that and this actually touches upon what skip stated that if you cannot take note of one thing you are not going to be taught it however is it since you did not attend to it’s it since you did not enable that reminiscence to get encoded or is it as a result of there’s precise truly some basic downside within the the circuitry of the mind that is concerned in encoding or storing or retrieving that reminiscence and so we’ve actually tried to to focus in on the networks within the mind concerned in consideration and reminiscence and the way that modifications as we age and so we do not we do not simply take a look at individuals who have dementia who’re not in a position to keep in mind their their kid’s identify however it’s simply it is um what i name our backyard selection older adults those that are involved they could be involved as a result of they discover modifications they could be involved as a result of they’ve a household historical past you understand i noticed my mother undergo it and now i am actually frightened about myself or they could simply need to keep actually sharp and so that is what’s very nice about our paradigm in vr that we’re now testing we need to take a look at to see if it really works we we put quite a lot of time and thought with engineers and neuroscientists and neurologists to consider learn how to design it however that is what this subsequent part is that we’re shifting into is to really take a look at its efficacy is it a therapy is it one thing that may truly assist both keep reminiscence or as you have been saying restore reminiscences um i seen these reminiscence modifications however now after being on this vr paradigm on this program that you’ve for mind coaching i really feel like i keep in mind issues extra i i really feel somewhat bit extra alive and so that is what we’re actually attempting to focus on is that this grey interval between regular growing old perhaps some early delicate cognitive impairment that folk have heard about or mci all the way in which to dementia as a result of it is a continuum and from my perspective the sooner that we will intervene the higher as a result of we do not need to see mother or dad begin to decline we need to see mother and pa keep as mother and pa and and whenever you plan to match vr are there particular mind coaching packages that uh there are the gold customary and that you just plan to match it to so what’s what’s neat about our design and the way we considered it’s we’re attempting actually attempting to have a look at these interactive or the synergistic results between bodily exercise and cognitive exercise so we now know the lancet neurology one of many premier medical journals has now come out with 13 arguably modifiable life-style elements it isn’t it isn’t cheap to ask anyone to vary 13 elements of their life but when we will goal the important thing elements which i imagine are bodily exercise and cognitive stimulation along with to managing vascular threat i feel if we will take the important thing ones which can be most likely probably the most problematic for for almost all proper so this begins to get into precision medication one mixture is not going to suit everyone and if there’s 13 modifiable threat elements effectively perhaps one two and three are good for someone else however 4 5 and 6 are good for one more individual however to attempt to influence as many individuals as we will as we will we have tried to focus on bodily exercise and cognitive exercise as a result of we actually perceive from neuroscience what the impacts are on the mind so it is vr as a mechanism to undertake life-style interventions which have been demonstrated to be efficient it is it is that is the premise of it that is the inspiration however there’s so many added complexities and layers on prime of that that vr enable us to do which is it is it is um it is personalizable proper you may adapt it relying on one’s efficiency or age or their current information base after which you may scale it so con you understand opposite to those plug-in play packages which simply perhaps do um various kinds of coaching or various kinds of assessments they’re very regimented proper and and that is not an issue as a result of they’re constructed to be regimented in a sure method they examine what we name normative values for a given age or a given gender or intercourse however what vr lets you do is the sky is the restrict proper you may design something so proper now our first world was to place someone in a park and have them navigate round and there is sure spatial cues issues like oh i keep in mind when i see that constructing i flip proper what we’re doing now’s we’re placing them beneath water we’ve a brand new atmosphere the place we’re truly having them spatially navigate beneath water which which comes with its personal set of challenges however we could not do this in actual life we’re not going to take a older grownup and throw some scuba gear on them and have them go underwater however we will in vr and what’s neat about vr is it is so immersive when individuals go in they suppose they’re underwater and when the trial ends and also you you’re taking the hmd or the pinnacle mounted machine you understand the vr headset off of their head you form of see just like the the shock response each time you understand it does not matter if it is their first time or their twentieth time in vr you get this shock response and so they they they get introduced again proper to actuality and so they’re like oh no i am simply on this like 10 by 10 room sitting right here with this one researcher um to get into covid problems now you understand we solely have one on one as a result of we need to decrease threat however they you understand take off their headsets after which they’re again to actuality however they have been so immersed and and so that is the neat factor is that you would be able to you get to be inventive i imply there’s a complete completely different dimension that you would be able to faucet into with vr nice thank you may you inform us a bit extra about um the precise software of uh digital actuality and localization and uh work round deep mind stimulation positive sure yeah we um we’re utilizing vr like i stated as a instrument to grasp the perform of the mind there’s quite a lot of overlap however the different panel is right here too which is sweet uh one factor i did not point out earlier is and that perhaps ties into a subject of curiosity right here is how will we consider these you understand paradigms these vr paradigms for eventual therapeutic you understand therapy or guiding of the remedy and so one factor that my lab is doing is to mix you understand goal end result measures like from from wearables so we measure issues like eye eye monitoring eye actions individuals dimension respiration coronary heart price pores and skin conductance like mainly you identify it something that is on the market we’ve mixed with this platform and we’re beginning to be taught loads about not simply you understand the habits however all of those organic or bodily physiological variables which can be very informative matters serving to us perceive what’s taking place when individuals put out of your mind one thing or keep in mind one thing they do not need to keep in mind like within the case of ptsd and so how that how can that these organic or physiological variables additionally inform the therapy so um i feel you understand as was talked about earlier than it is a it is a approach to immerse the the contributors the themes their sufferers in a method that we won’t do like with all these wearables effectively in the true world however in a managed atmosphere within the lab and permits us to essentially begin to reply a few of these basic questions on biology concerning the mind that we do not perceive and we have to perceive these items to go to the following step and deal with are you able to give us a selected instance it is so summary occupied with that i will give an instance of ptsd for example you understand these are sufferers which can be so extreme that nothing up to now has labored for them so surgical procedure is an choice now for them to have an implant to you understand stimulate the mind when there are undesirable reminiscences which can be coming coming to them and so we do not what we’re attempting to grasp is what’s the sign that predicts that psychological dissociation uh after they hear fireworks for example in fourth of july and so you understand how will we how will we simulate that have within the lab in an individual that is perhaps not as severely affected i do know skip does quite a lot of this work to make use of vr to attempt to simulate that have after which what we’re doing is recording from the mind alerts after which coronary heart price pores and skin conductance all these different issues to offer us to offer us perception as to when when is the best time to intervene with the remedy so when ought to we be stimulating the mind to forestall that psychological triggering of the trauma triggering you understand undesirable reminiscence in order that’s one instance um did that assist yeah yeah so we’ve examples of the 2 polls vr to forestall and be laborious to protect uh reminiscences um skip um how have you understand you talked about your work having begun within the 90s um how has vr developed and and what kinds of issues can you do now that uh you understand you might need solely dreamed a few couple days in the past a long time in the past a long time yeah effectively you understand actually the the standard of the expertise the consumer expertise that we will ship uh has developed dramatically and at a a lot decrease price that first psychological rotation software i developed it required a 200 thousand greenback silicon graphics pc uh 125 000 3d projection system you understand for easy psychological rotation exercise we ended up constructing different visible spatial apps on it to justify uh you understand the fee however it was simply loopy now you are able to do this in a uh you understand some many issues you are able to do fairly effectively on a standalone headset for 400. and so that’s that to me is um what is going on to be the realm the place we break down the boundaries to adoption um i do know for in actual fact with with brennan’s work you understand within the previous days for ache administration in a hospital setting you’d should wheel round on a cart a computer with a tethered headset that had restricted discipline of view crappy decision you understand uncomfortable heavy headsets now you may stroll round and a care supplier can pull out of their again pocket a low price headset and provides it to a consumer and and to me that is among the key parts i imply the work the work that judy and nathan have introduced right here is on the core of what we should be doing and finding out the neuroscience and the mind habits relationships that may information us clinically however all that medical info is not going to be of a lot worth except we’ve a approach to ship it at a low price and in a method that is extremely usable and with a headset that is not snug or that has graphics which can be participating and compelling and the place we’ve a software program infrastructure that permits us to systematically modify the content material um very simply you do not have to be a programmer to do this so in all of the areas over the past 20 years you understand we have seen the enabling applied sciences all come collectively on the identical level to the place we’re at the moment the place the the imaginative and prescient the the the the know-how caught up with the imaginative and prescient that we had method again then we had all these concepts method again then however we could not do it very effectively and we could not do it in a value efficient method and that’s the place the merger of you understand the true science and the medical software is enabled and the way do you see wanting ahead on the subsequent 10 years and recognizing that you understand even we nonetheless use the time period vr although it is changing into outmoded as as there’s all kinds of different types of augmenting our expertise of actuality um however how do you count on the know-how to evolve and our our use or uh you understand engagement with it to vary effectively you are actual i will simply add one actual fast level and look uh my different esteemed colleagues weigh in however i you understand i feel with 5 5g uh connectivity we’re a world the place we will have within the cloud a large library of all these various kinds of digital environments that you understand goal completely different uh processes and completely different medical situations and so forth and a clinician can at will simply click on on one for a selected shopper particular to their wants and stream this content material proper down in order that now the content material supply is not a bottleneck proper now there’s 50 completely different firms which can be all constructing completely different items of content material are you going to license every a type of and and attempt to handle it i feel it may be an aggregation of content material that is evidence-based or no less than there’s some details about the extent of proof that helps using that content material so a clinician could make an knowledgeable resolution and the way they need to use these instruments with their purchasers which have completely different wants proper nice and that i apologize in the event you guys are getting some suggestions uh from uh uh from my facet of the platform there is a hearth alarm which i imagine is a false alarm occurring let’s hope um all proper um judy and matthew are you able to uh uh share a few of your concepts of how uh you see vr getting used over the following decade yeah um i imply i do not i do not know that i’ve that rather more so as to add over what skip stated my thought and my hope is admittedly simply that it turns into extra reasonably priced and extra commonplace and so proper now whenever you hear about vr and these headsets and we see these footage they appear you understand from one other world and simply it isn’t part of our day by day nomenclature issues that we contemplate i hope that it will likely be as a result of for me as a scientist my objective is to develop after which take a look at for efficacy these various kinds of interventions and i need them to have the ability to simply be put within the fingers of customers or the individuals who can profit and so for my inhabitants it is like i stated our backyard selection older adults those that need to keep mentally stimulated those that need to get some extra bodily exercise however they can not get as motivated to get to the fitness center but when they’ve a program at house and so they have a vr headset at house and so they can simply put it on and perhaps have the ability to bike collectively on the earth and race and see who is aware of the best methods to show and the incorrect methods to show to remembers the identify of the canine then that is a win to me if if it if it proves in actual fact that our program is efficacious for sustaining mind well being and so for that to have the ability to occur simply identical to what skip was saying we’d like it to be accessible we’d like it to be a tool that someone can carry round and pull out of their again pocket or mother and pa or grandma and grandpa can run all the way down to greatest purchase and choose up the headset with the built-in program and and put it on and play it for a variety of months and really feel good as i flip uh issues over to you nathia for a remark yeah i imply i agree with every part that stated i feel that is an important what was simply stated i might i might simply add to that that i hope to see it included extra within the science within the background such that extra scientists are utilizing it to assist information and develop these remedies and i feel one of many bottlenecks to that’s hopefully you understand like with growing a web site once we first you understand began doing that there is solely sure individuals who can do this and now at the moment anyone can actually make their very own web site so hopefully in the future anyone might make their very own vr content material and check it out and if that is some if that is a world whereby the place scientists and medical well being care practitioners can do this extra simply we’ve extra room to essentially take a look at and develop all these modern issues and see which one is the perfect which is the simplest in order that’s my hope i hope that occurs you understand it appeared to me as an observer that that um uh and plenty of others have commented commented on this that the tempo of growth in on this space has been actually excessive over the past 5 years and positively the tempo of um analysis and publications and of funded analysis has been rising um throughout covid um there’s been acceleration of uh digital applied sciences to achieve out to individuals and uh and and that i’d think about maybe a change in receptivity um i’m wondering what’s been your expertise of implementing any of this work um uh you understand through the pandemic that we have confronted over the past six months and are there any explicit ways in which you see this know-how um serving to to bridge the divide that the pandemic has created and that’s more likely to be with us for no less than the following six months okay um you understand i feel in the event you take a look at the associated discipline of telemedicine and teletherapy actually that was rising however what’s occurred with covid it is a sport changer and possibly the place we are actually and accepting using teletherapy and telemedicine approaches with sufferers and and uh care suppliers being you understand remotely situated however nonetheless interacting you understand in six months it is gone the place it most likely would have taken two or three years uh with out covid to be adopted and be accepted and and to be studied much more so now as a result of it’ll be related lengthy after you understand the curve is flattened and vaccine is discovered and all that i feel we will see a wider adoption in that space and i feel it’s going to actually be the identical um with vr i feel there’s going to make certain beneficiaries in medical functions uh because of covet and one of many main areas you understand pertains to our work with the trauma with service members navy populations ptsd publicity and so forth however different strategies as effectively and that’s going to be with frontline healthcare professionals which can be being floor to a nub uh with the stress of covid and all of the challenges that it is presenting and you understand a number of the early knowledge out of china with well being care suppliers um is is um and that we have got to we have got to have the ability to deal with their wants whether or not it is direct therapy for ptsd i do not know if that i am positive there’s been a inhabitants there however different assist functions whether or not it is a cell enabled digital human coach or sensors utilizing the wearables that have been talked about to have the ability to detect when someone’s having a tough time however all these areas i feel might be introduced collectively to supply um service for those who you understand actually put by way of the ringer with covid and that you understand that features all of us however significantly healthcare suppliers considering you understand give it some thought as you understand they’re on the entrance strains of this fight identical to a service member is in in a battle zone um and there is going to be follow-on penalties to that and we have got to you understand be anticip and we have got to anticipate these challenges and develop issues which may uh may transfer the needle ahead leveraging the issues we have discovered from the fight context okay i feel that that’s on a regular basis that we’ve uh it is unlucky as a result of there’s many extra inquiries to ask every of you and that i really feel like we have solely scratched the uh the floor however uh we’ve many extra issues deliberate over the course of the day and for our subsequent session i will flip issues over to brandon and to matthew to introduce our subsequent session thanks thanks for having me thanks so uh dr danovich thanks a lot for that it is very simulating panel um the neuropsychology of vr uh so i am uh brandon burkett dr brenda burkett at cedars-sinai i work within the digital actuality medical trials right here at cedars-sinai and that i additionally co-direct the digital medication convention which is now a webinar collection and so i’ve a implausible affected person panel right here co-moderated by uh matthew stout who’s the ceo of utilized vr pioneering uh at-home power ache or ache use for digital actuality remedy and this implausible panel of sufferers that i’ve obtained to know over the previous few years and so i need to have all our panelists introduce themselves however whenever you introduce your self please give the viewers somewhat bit about the way you have been launched to digital actuality and likewise your response to that have and take it away begin off with tom my identify is tom norris i am a power ache particular person i’ve had power ache for over 30 years i used to be launched to the utilized vr by dr spiegel throughout certainly one of our uh classes once we have been speaking about communication between power ache sufferers and docs uh i jumped on the likelihood to take part with utilized vr within the vr program uh i’ve uh used the the tenants the fundamental concepts of the vr program uh sponsors or reinforces for my total life ever since i discovered learn how to learn and i’ve used this these classes even with out the vr hood in power ache conditions in acute ache conditions in uh melancholy in uh anxiousness in in concern uh circumstances and it is at all times come by way of for me uh as i inform individuals the one time that uh vr does not work for me or the the the tenets of focus respiratory and diverting one’s consideration is when i am in a disaster however some other time it really works nice thanks then amanda would you give an to form of your expertise and somewhat bit about um perhaps why why you wanted to make use of vr at the moment positive um my identify is amanda inexperienced i am also referred to as l.a lupus woman so i reside in southern california and that i reside with lupus and power ache i lately um the primary time i attempted on a headset was at a hymns convention which is a well being know-how convention in chicago and i used to be exhausted after a day of being a affected person advocate and you understand it was an enormous convention days earlier than the pandemic 40 000 individuals quite a lot of cubicles and i used to be exhausted i barely thought i might make it to my the bus in my lodge room and that i noticed an utilized vr sales space for the primary time and the video behind it featured a physician from cedar sinai who’s now turn out to be my good friend and everyone knows dr spiegel and it is simply unbelievable when i used to be exhausted i placed on the headset i put down my bag and i used to be in a position to stand for about i believed it was like two minutes it was i had a headset on for 10 minutes and i used to be out in nature and that i swam with manatees and now i am swimming with dolphins and that was my first expertise and from there when i took off the headset i used to be it was like having a burst of vitality the ache from the day was gone and that i had new vitality i used to be in a position to go community and all of the cocktail events that i believed i might be sleeping by way of as a affected person advocate you will have one alternative that is an enormous convention like that and digital actuality saved the day saved the evening and altered my life that was my first expertise thanks undoubtedly and danielle heard somewhat bit however i i assume there’s some other ideas you will have or a fast intro in case perhaps others did not meet that implausible speak you gave somewhat earlier right here i am danielle collins and i am the chief expertise officer for empower 360 basis however earlier than that i used to be and nonetheless am a affected person advocate for vr and ar know-how i am a recovering and nonetheless residing avm mind surgical procedure survivor and my first expertise utilizing vr was truly in my hospital room at george washington college hospital in dc it was an organization surgical theater that allowed me to fly by way of the pathology in my mind previous to my surgical procedure to assist me perceive the surgical plan and the situation that i used to be going through and that i can say that i want i might after listening to your tales and the quantity of ache that i’ve handled since my surgical procedure i could in a short time matthew turn out to be an utilized vr advocate as effectively um as a result of i feel what’s so particular about all of our journeys and that we’ll focus on on this panel is simply that it actually does span the medical care continuum and that each affected person has the chance to have some kind of bodily or emotional or intelligence in my you understand in my case it was figuring out my pathology the flexibility to have some kind of expertise for the higher with vr ar know-how uh so so thanks for the introduction on everyone and you understand for us that apply vr we at all times suppose firstly concerning the affected person proper as a result of that is what that is why we’re doing this no less than on the therapeutic facet of this and one factor that i seen as every of you have been speaking one phrase got here to thoughts for all of this empowerment that every of you talked somewhat bit a few story of how this has helped empower you tom talked concerning the empowerment for him to be at all times out of the goggles uh for him to mirror again on that and use that to assist them get by way of danielle talked about when she was going or prepping for surgical procedure it empowered her to have extra information and perception into what was truly going to occur to her after they have been going to go and do the mind surgical procedure and the identical factor with amanda uh so it is nice to listen to that when uh when once we take into consideration uh growing this you understand the science round this all began round acute ache however one factor that i might love to listen to and firstly from tom and amanda would love to listen to somewhat bit about that there is a query round sturdiness how lengthy does it final as a result of clearly individuals cannot reside their life within the headsets and so you understand out of your expertise is that this one thing that you understand after you do a session does it final for 10 minutes half an hour an hour a day simply form of what your expertise is round that and also you need to begin with amanda um i would be comfortable to as you understand i used to be exhausted it was 4 30 chicago time and that i did not get again to my lodge room till after midnight so at i might say at 4 15 earlier than i donned the goggles my plan was to go to the lodge room and now and simply my first expertise had a greater than eight hour impact so cumulatively i imply i that was my first time i’ve used vr when i’ve bouts of extra acute power ache prefer it’s it is so dangerous the place’s my head set after which as soon as my head units out like you understand then it turns into oh i’ve this instrument that i mustn’t ever put away it simply must be there a part of my toolkit half a part of a plan it isn’t going to be the be-all end-all however when i placed on the headset i do use much less medicine i imply i really feel like i am repeating you understand stuff i’ve stated earlier than it is like i exploit act you understand much less medicine that has bodily unwanted effects the facet impact from a digital headset diaphragmatic respiratory session for me is i am extra relaxed i am much less anxious i imply let i am much less i am in additional i am extra empowered and in command of my physique which might set off my pains my neuro ache pathways and i am you understand i am not the physician i am the affected person perspective however i am in command of my physique i can i understand how to breathe when the headset’s not on me due to the teachings and the coaching that i’ve obtained and been reminded of when the headset is on proper so proper lengthy aft i would preserve going like days after it is like typically i will simply take a look at the headset after which i will i will not even should put it on and that i’ll simply breathe proper and it is nice to listen to that each one proper tom i feel i am a most likely as a special case i have been as i stated i have been utilizing the the fundamental rules that utilized vr in digital actuality that that i have been utilizing reinforces my total life and in that information has gotten me by way of i exploit the the hood as a a booster a cost uh to bolster when i really feel like i could be weak so i can go months with out utilizing the hood uh when when i i actually need it and it actually is dependent upon conditions with you understand whether or not it is the stress the pandemic or actually acute ache from a bladder operation or no matter then i will pull out the hood and i actually i am going by way of the classes after which i am good for so long as it takes it actually i feel you are going to discover out by way of examine that it is dependent upon the person and and for me it goes with the extent of my constructive considering stage of my with the ability to visualize and and and have a powerful body-mind connection does that reply your query yeah yeah i i feel what you faucet into is that it isn’t essentially a one-size-fits-all and that is one thing you understand within the research that cedar sinai has completed you understand after they have been in a position to truly present a wide range of completely different experiences particularly within the acute ache setting that they’d completely different individuals responded to various things and i feel we as an business on the event facet you understand we’re at all times on the lookout for increasingly more knowledge to determine how is it that we will truly ship one thing we’ll say customized vr we name it precision vr the place it is truly mapped on to you as a person for the wants that you’ve so yeah and that i truly i’ve a remark after which a query for danielle and a remark about form of this this this uh spectrum what we’re occupied with at cedars is is looking for these phenotypes of basically you understand is it probably that immersion or that sense of presence could also be factoring in how lengthy somebody could also be having that impact after vr and so probably you understand if we took one thing like a scale like versatility questionnaires or current scale you understand we might probably see a spectrum of people say from tom to amanda and perhaps there’s a spectrum distinction there or another affected person stage demographics and so seemingly our subsequent couple research are going to hopefully attempt to see if there may be this this you understand some measures that may predict this tail impact of vr lasting longer than you understand a number of minutes to even hours um or longer after a session we did see that within the acute and impatient unit now we simply need to attempt to higher profile that such as you stated matthew for precision vr so for danielle i you understand the tutorial facet of er shouldn’t be my space of experience however i am to listen to out of your perspective and all of the people that you just speak to about form of the immersion and that empathy issue is is there additionally um any kind of uh impact of variations between people you have met which have used vr form of in a medical training area and their response is as we have seen variations within the individuals you speak to i feel probably the most highly effective examples of that’s empathy constructing by way of coaching particularly with whether or not that is suppliers or whether or not that is relations to grasp a affected person’s perspective i feel that that is among the strongest makes use of that also has a approach to be studied in vr um alongside that very same line what one other it begs to query one other factor i am reminded of you understand whenever you consider a exercise for instance a success exercise it is actually intense and also you’re in there after which you will have the after burn impact versus a protracted regular state exercise and you aren’t getting as a lot of the after burn impact so in correlating that to what we’re speaking about right here in vr i am questioning too concerning the precise content material that we’re and i might be curious to see additional research concerning the immersiveness of the particular content material which is one thing empower 360 is at the moment exploring is that if there’s extra actual life and as {hardware} continues to develop and we’re speaking about 8k decision will that additionally then influence sufferers care probably sooner or later as a result of it would really feel extra life like and due to this fact extra immersive uh so daniel it is attention-grabbing you talked about that there is uh there’s this factor referred to as the uncanny valley which uh you will have come throughout which is one other good instance of that is the polar specific which is an uh an animated movie from most likely 15 years in the past proper and at one level uh it was so near being actual however it wasn’t precisely actual that folks could not that they had a tough time processing it proper as a result of they stated the animation they’ll simply let go they know it isn’t imagined to be actual in order that they let go of it and so they can completely let themselves get engaged within the story within the actuality proper you will get in there in israel so you do not your mind does not suppose one thing’s a kilter in that uncanny valley and that is that is the hardest factor that uh is is how do you draw the road and what would even be attention-grabbing in these strains is we have seen research previously that that confirmed it isn’t essentially about actuality versus animation it is simply i feel it is as a lot storytelling as it’s uh the precise uh the standard of the video content material itself proper and uh and that is the way you i feel actually i feel you construct engagement on the finish of the day however i do however i do imagine as we go because the know-how will get higher because the um web speeds get quicker then you can begin to do extra of that actual time or actual video and we will begin to do exploration round that completely and i like what you stated too um simply to comply with up on the storytelling piece as a result of i feel every certainly one of us has a narrative they’re all particular person and completely different on a point what we skilled in our particular person experiences with the know-how however that story telling piece mixed with the immersive element of the {hardware} and you understand the um the precise pictures as we progress sooner or later yeah i am so excited to see the place that takes us yeah you and me each precisely uh so i’ve a query for all three of you so you understand given your experiences with vr and plenty of of you’re quote heavy customers of vr would like to know what you suppose it is lacking proper now from a affected person perspective how do you suppose we will truly enhance the expertise take into consideration this each from a content material perspective from a {hardware} perspective uh we would love to listen to your views on that and why do not we uh return round we’ll begin with danielle okay so firstly i feel the kiosk facet of any kind of vr software is paramount particularly in the event you’re in an inpatient setting or be it at house fairly frankly for that matter the flexibility to onboard a affected person rapidly to have them perceive precisely learn how to use the know-how simply ease of use not solely does it broaden the vary of the people that you just’re in a position to deal with however for some who might um you understand be coping with extra power ache and so they simply they only they do not have the time or the bandwidth to take a seat there and never have a kiosk in model of the therapeutic so that will be firstly what would come to thoughts after which i feel simply entry and consciousness i imply constructing out a platform the place we’re persevering with to market and construct public consciousness for these applied sciences will enable extra sufferers to make use of them and notice that it’s an reasonably priced choice for sufferers to make use of and hopefully payers and suppliers may also get on board as effectively nice thanks for that amanda i am glad you requested this query um and i do not know if anyone has learn brendan spiegel’s e-book but however there is a chapter referred to as the digital pharmacy and in the event you’ve been to a digital medication convention you understand what it’s we’re we’re all distinctive and you understand as three sufferers we’d have three completely different preferences of content material as someone who lives in california i like water i need to see extra content material about like a stroll on the seashore you understand i just like the water i like nature movies i whether or not it is animated or precise um there’s a number of content material that i like that’s obtainable on youtube now that i am like oh my god that will be cool like for trend exhibits which can be streaming to placed on a headset and see not simply the fashions which can be strolling down like necessary instance of a content material that i would like that perhaps tom most likely does not need to see a trend present however it only for the ache affected person that it must be enhancing entry and making the headset accessible and it’s i imply to me i utilized vr well being the ache care vr system it is reasonably priced it is priced perhaps you are uncovered to it within the hospital however whenever you notice how good it really works you need to take it house with you and whoa you may’t i’ve one at house when individuals have seen it different sufferers have purchased they’re prefer it’s that straightforward and it is that it is that life-changing that when you consider the cost-benefit evaluation quite than the price of ache and the standard of my life it is value it so clearly decreasing the fee could be higher hey give out free ones i i imply clearly to enhance clinton ache you want extra entry it isn’t does not actually should be simpler to make use of to me it is very straightforward to make use of you placed on the headset and whenever you take it off you be sure it is charged so whenever you want it once more it is able to go so i simply need to thanks for that and i might simply say broaden the digital pharmacy with content material like for me i might you understand i am a cat individual however i do know the individuals like i need to see i need to see someone like just about stroll their canine on the seashore i placed on a headset when i when i am unable to stroll or if you understand or mainly like if i can rise up and do a kiosk setting like stroll with them if i am in i imply it is dependent upon the extent of ache i am at and if i am sitting or standing yeah however there’s simply a lot that i feel utilized vr is simply starting to assist sufferers and i believed effectively thanks for that and that i do suppose that is extra of an business factor from the therapeutic growth facet proper it isn’t nearly making use of vr however it’s about you understand all the businesses which can be moving into this area i can solely communicate from my expertise yeah i do know which is nice yeah we which we clearly admire and love um and also you’re proper it goes again to what danielle stated is how can we do extra advocacy for the business as a complete and to convey extra consciousness and uh to finally get the the payers on board as a result of that is how you are going to create the the largest accessibility right here is to get the payers to begin there must be there must be a direct hyperlink confirmed hyperlink to roi for the hospital funds and at that time i can do that now i imply vary of movement my high quality of life i imply that is nice there’s movies of me on voice i i have been a digital medication advocate for so long as i placed on the headset and that i truly shared my story on voices of america and it was over a yr in the past and that i lately you understand i shared the video and that i checked out it i am like whoa i did not notice that digital actuality has helped me been i have been in much less ache which has helped me transfer extra which i’ve truly misplaced i have been in a position to bodily really feel higher after which when i had an emotional painful expertise because of the pandemic that the power ache instrument that i’ve used for my bodily ache truly helped me you understand it did not take away the ache however like i’ve stated earlier than it made me simply breathe and be within the second and that empowered me to you understand get by way of my grief and transfer by way of by way of that emotional ache in addition to the bodily ache of you understand a process that i had the prp process i had in each ankles so it was simply conducive to my therapeutic and fewer ache which is you understand thanks proper tom i wished to ensure we uh we get your perspective on this positive uh you understand to make it quick and candy uh a dramatic improve within the availability of a wide range of packages in vr however however i’ve to say that you understand i run a assist group or truly two assist teams proper now beneath the american power ache affiliation and each certainly one of my group members uh calls me mr vr as a result of i am at all times pushing the vr i i introduced the hood that that brandon let me two conferences and it is superb to me that after the machine is accessible and someone has 5 minutes to make use of it that how a lot an individual can change i i one explicit occasion i had a person who was very very depressed she put the hood on and inside 5 minutes she was laughing now she was doing the the bear sport so you understand that is comprehensible however we actually want to have the ability to to get some number of of the vr hood out to everyone and that i take into consideration i am from virginia in a really rural county and that i take into consideration the individuals i do know there with power ache who i’ve talked to concerning the hood who quote cannot afford it does not imagine in it and that i say you understand you actually obtained to attempt i i feel it may take a sure effort to to place this factor on the street so it reaches out to individuals and in a method i assume the pandemic is an efficient factor as a result of we’re doing extra telemedicine and and this falls proper consistent with telemedicine in order that that is my two cents quick and candy so tom i obtained a fast query for you you talked about neighborhood and uh the assist teams that you just’re that you’ve got been working with have these historically have these been in individual have these been on-line i i’ve for i’ve completed assist teams uh with uh every group might be about 12 individuals nose to nose for 30 years and now i’ve taken all these to uh zoom calls it is all digital now yeah one of many areas that we take a look at is very as you are occupied with isolation each clearly from pushed by this pandemic after which simply within the growing old inhabitants there may be an rising isolationism that is occurring uh the you understand the potential for utilizing vr to create these connections uh we expect can be a really attention-grabbing space and offline we’ll about to talk with you somewhat bit extra about your experiences and share with you that we’re doing round that one different factor is i do a uh an previous of us like i’m an previous people so i do a assist group for the aged each thursday impact one this afternoon and that that is going to be a tough nut to crack as a result of quite a lot of us aged have imaginative and prescient issues and i do not understand how we will get vr to them to the purpose the place they’ll truly use it and and do greater than hear however however i feel that is an amazing market so it is open and that i’d be prepared to speak anytime and in the event you imagine elon musk then we’ll all be having a chip in our mind quickly sufficient after which we do not even must have the goggles i am prepared i am prepared one uh yeah i will let you know one factor that danielle introduced up was the benefit of use we discuss this from a design perspective concerning the three e’s uh in the event you actually are going to drive this efficacy clearly is your ticket to entry to all of these things but when you are going to drive utilization and adherence compliance it is obtained to be firstly straightforward to make use of as a result of if it is sophisticated i do not care how efficacious it’s nobody’s ever going to the practitioners aren’t going to need to take care of it and the sufferers aren’t going to need to take care of it and in order that’s our you understand the primary design precept we take into consideration and we encourage everybody that is working on this space to consider after which clearly the second piece of that’s engagement in the event you can take into consideration how do you proceed to interact that p.c uh danielle you references and the notion from the thought of emerge and how are you going to get them increasingly more ensconced into this that they need to come again and do it as a result of you understand we’re people we want the straightforward method out typically it is gonna be a tablet we have to make this simpler than a construct or no less than extra pleasing than taking a tablet and in order that engagement in the event you get the primary two then the effectiveness is the 30 then uh clearly we expect that that simply comes with it so um one other factor we take into consideration is the headset proper now has at all times been the barrier so it is you understand vr has been round for 30 plus years initially there was simply this large huge machine tethered to large you beg computer systems price fifty thousand and lived within the laboratory the place individuals stated oh is not that attention-grabbing and that i really feel like proper now we’re simply that mainly we’re barely at model 1.0 of what the headset goes to be after which we’re enthusiastic about how that is going to finally that has that headset’s going to rework and turn out to be smaller and smaller and simpler and simpler to make use of so it turns into part of everyone’s day by day life very like the cellular phone yeah ar vr has but to have its iphone second and i feel that sooner or later um within the not so distant future it would effectively let’s i feel tim cook dinner is has one thing to say about that as uh we’re ready for what apple’s gonna do on this area get some lessons yeah precisely precisely it’s going to be fascinating yeah so i truly suppose this can be a tight finish that’s attention-grabbing as a result of um we had a chat earlier on uh from raphael about the way forward for vr and he truly talks somewhat bit concerning the glasses and even contacts um so um yeah i am to see form of the primary um contactor or glasses you understand whether or not these are a bit massive form of like the primary vr headsets have been a bit bit massive and cumbersome i feel that is most likely why fb has it’s a analysis undertaking proper now for a few of their glasses however nonetheless i imply it is quite a lot of enchancment there um yeah oh some other questions we have got a pair extra uh minutes i used to be simply going to um shut it out in about three minutes however is there some other questions we need to cowl effectively it could be nice to get simply form of the final uh closing views from from every of our uh panelists right here at the moment and uh in the event you might you understand we’ll we’re gonna allow you to play a designer i am gonna allow you to play a futurist on this so in the event you have been to look forward 5 years from now and say what do you imagine the state of uh vr therapeutics goes to be or your want that it could be what would that be and let’s begin with tom on this gee thanks put me on the spot uh effectively i as as a disclaimer i’ve to say that i am i am a science fiction addict i might initially i might suppose that we wind up being uh effectively to to attract a video uh reference could be like uh prepared participant one the place it is all the physique uh sensation is included into the vr uh in actual fact let’s go all the way in which and say the the day that we will put ourselves into an atmosphere like prepared participant one i feel could be superb and implausible i might adore it personally that is quick and candy good uh amanda um i feel prepared participant one’s a number of extra years away however ideally i feel each rheumatologist ready room if we return to the standard ready rooms ought to simply have a vr headset and say attempt it and and that i imply clearly sanitize the wipes and in between use but when in the event you’re given the possibility to attempt it for 5 ten minutes that is one of the best ways engagement to empower engagement raises consciousness after which that results in the empowerment of like wow this can be a ache instrument that i did not even take into consideration and it will probably change your life proper uh danielle okay i’ve spent many months occupied with this truly so i really feel like i am dishonest however for inpatient settings i see in lieu of a television i see each affected person a hospital mattress having a vr headset subsequent to it with a with a library of content material particular to your pathology or particular to your situation that you just’re in a position to entry in your hospital room now given the pandemic and what our future might seem like i additionally see that being the place telemedicine could have a element the place you’ll be despatched a headset in a pre-packaged field at house and agnostic to any firm per se you wouldn’t solely have the ability to do your digital console together with your supplier by way of that headset so it feels such as you’re within the room with them on the hospital however from your house you’ll have the ability to be prescribed your therapeutic alongside in that very same headset remotely from house have you ever been wanting into our product roadmap right here no what however in the event you’re on the identical web page we should always speak as a result of i feel that is work that is superior that is nice so um i assume with that i am gonna shut it out and say this was a implausible panel speaking concerning the future the current everybody’s experiences has simply been nice to listen to and so i am gonna kick it over to dr spiegel for closing remarks and thanks a lot uh matthew for being co-moderator and panelist thanks a lot nice thanks brandon thanks everybody thanks thanks thanks once more effectively thanks a lot guys thanks for that excellent and once more extraordinarily insightful uh panel dialogue it is a super finish to what has been a very thrilling and informative webinar at the moment so you understand what’s what have we discovered at the moment in these final couple hours effectively you understand the massive thought of medical prolonged actuality is that it will probably leverage our energy to think about once we want it probably the most vr modifies our actuality in methods that could be laborious to perform in instances of nice vulnerability and misery by fastidiously adjusting our digital actuality once we’re sick we will have an effect on our bodily actuality for the higher vr does this in many alternative methods as we have discovered at the moment vr can seriously change our perspective of the world we will think about being someplace fantastical and therapeutic we will observe being the person who we need to turn out to be we will see ourselves from past typically actually like in my out-of-body expertise we will regard ourselves in a brand new mild in digital actuality we will confront our internal voice we will remodel our minds dramatically and in some circumstances even instantly and when it is efficient we will forge wholesome cognitions that final lengthy after the headsets are eliminated now we have already got these talents inside us however vr simply makes it simpler when instances are laborious so with that i hope this was a useful seminar this morning and that you’ve got discovered one thing novel and if you wish to be taught extra about this once more i encourage you to select up the e-book vrx and with that on behalf of all of our supporters cedar sinai medical middle our digital medication program cedar sinai utilized vr and configure i need to thanks for tuning in at the moment and need you a very good remainder of the day thanks and be effectively you