Hardware

How Virtual Reality Improves the Pediatric Care Experience

Physicians are using VR tools to educate, to distract and to reduce the need for pain medication.

Chris Hayhurst is a contributor to the CDW family of technology magazines.

Already seen in the medical arena as a safe and effective training tool for physicians, virtual reality is finding a new purpose: to help patients manage the pain and anxiety that can accompany a medical procedure or hospital stay.

“As a distraction-based intervention, virtual reality can be incredibly useful,” says Dr. Sam Rodriguez, a pediatric anesthesiologist at Lucile Packard Children’s Hospital Stanford in Palo Alto, California, which pioneered the concept three years ago. The hospital maintains about 70 VR headsets — including the HTC VIVE, Lenovo Mirage, Oculus Go and Samsung Gear VR models — used for thousands of interventions each year.

If a child is to receive an injection, for example, or have the dressing changed on a wound, they may put on a headset to “focus their attention away from the painful stimulus and engage in this fun activity instead,” says Rodriguez, also the founder and co-director of a Stanford initiative known as CHARIOT (Childhood Anxiety Reduction Through Innovation and Technology).

Rodriguez worked with colleagues and developers to create original games for patients to play while receiving care. One game, “Pebbles the Penguin,” puts children in the role of the titular character, sliding down a hill, controlling their direction with their heads or handheld controllers. Another, “Space Pups,” involves a puppy navigating the outer limits of the solar system.

Depending on situational needs, a clinician can guide the patient’s virtual interactions and physical position by making adjustments to the game on the fly.

“You can reorient the child so they’re sitting up or lying down, and you can even do things like change the cognitive load,” says Rodriguez. “So, if you’re about to poke your patient with a needle, you can hit a button to make the game more intense to kind of put it into ‘turbo mode’ so they focus even more.”

Immersion Technology Serves as a Welcome Distraction for Patients

The technology, which to some might seem like supplemental fun and games, has measurable benefit. A 2019 report published by the American Academy of Pediatrics found that every child in a randomized clinical trial preferred VR over traditional pain-reducing interventions such as topical numbing cream or distraction by a nurse.

Another recent study, which surveyed adult patients at Cedars-Sinai Medical Center, found that the use of VR for “relaxing and meditative experiences” brought significant reductions in pain for users with a variety of ailments, including gastrointestinal disease and cancer.

“I would say the use of virtual reality in healthcare is still in its infancy,” notes Avi Greengart, founder and lead analyst at the research and advisory firm Techsponential. “But if you think about how effective even a television can be at distracting you from pain in the dentist’s office — VR is much more immersive than TV, and that really says something about its potential.”

Chantel Barney, a clinical research scientist at Gillette Children’s Specialty Healthcare in Saint Paul, Minnesota, has seen the results firsthand. “I’ve been astounded by the capacity for VR to reduce anxiety and the need for pain medications,” she says.

I’ve been astounded by the capacity for VR to reduce anxiety and the need for pain medications.”

Chantel Barney Clinical Research Scientist, Gillette Children’s Specialty Healthcare

Gillette first launched a virtual reality initiative in 2017 in partnership with AppliedVR. A year later, the hospital was named one of the first recipients of a grant from the Starlight Children’s Foundation, which helped the facility expand the program with free Lenovo Mirage Solo headsets preloaded with age-appropriate VR content.

Barney has studied the effects of virtual interventions for several years. Children wearing the headsets as they’re receiving anesthesia prior to surgery, she notes, “fall asleep more calmly, they wake up more calmly, they don’t even notice what’s going on around them.” An experience that may have caused uncertainty and stress for a child is now a near nonevent.

“That child isn’t really thinking about the procedure,” Barney says. “They’re just playing a game.”

LEARN MORE: Read a CDW and Front Porch white paper about virtual reality in senior care.

Virtual Tours Prep Patients for Difficult Procedures

At the University of California San Francisco Benioff Children’s Hospital Oakland, doctors are using the technology in the early stages of a patient’s journey, such as preoperative surgical planning.

“I can sit down with a kid and put on these headsets, and we can basically shrink ourselves down to a mosquito’s size and fly around and explore” an image of the patient’s brain, says Dr. Kurtis Auguste, a pediatric neurosurgeon at UCSF Benioff Oakland.

Children with tumors requiring surgery, he explains, may not understand why they’re in the hospital, let alone the anatomy inside their heads. “It’s a huge boon, as a pediatric specialist, for being able to communicate with my patients and hopefully empower them and put them at ease,” Auguste says. “I can finally explain to these children what’s been causing their headaches and seizures, why they’re not like the other kids.”

He and other UCSF Benioff Oakland clinicians use custom-designed virtual reality programs from two different companies and view the images via Samsung Gear VR headsets. At first, Auguste assumed the technology would simply help him prepare for difficult procedures, but once he realized the tool’s versatility, he began looking for other opportunities.

Recently, the hospital has been offering VR immersion to children scheduled for MRI scans. By viewing a program that introduces the MRI experience, “they can kind of prepare for what it’s going to be like, this scary event that’s claustrophobic and loud,” Auguste says.

Children receiving chemotherapy or who require a long-term hospital stay can play VR games to pass the time and take their minds off the process.

UCSF Benioff Oakland plans to mail inexpensive VR headsets to incoming patients so they can see the facility.

“Imagine how hard it might be for a kid to go to this hospital they’ve never seen, so why not let them take a virtual tour first?” Auguste says. “Maybe they’ll feel just a little more confident and less like they’re walking into the unknown.”

Get Connected

Setup and maintenance of virtual reality tools in healthcare are relatively simple, says Dr. Ellen Wang, medical director of clinical informatics for perioperative services at Lucile Packard Children’s Hospital Stanford. She offered tips for getting started:

Connectivity: Most VR programs don’t require an internet connection for clinical use, but Wi-Fi is helpful for extracting data about usage of various applications.

Comfort: Consider your audience. At Lucile Packard Children’s, standard straps on off-the-shelf VR headsets are replaced with plastic bands that can be adjusted easily to fit smaller heads.

Logistics: Determine which patient scenarios and procedures are best served by the option of VR distraction. Train staff in best practices and device operation.

Sanitation: Plastic straps are easier to clean than fabric or Velcro ones (which aren’t infection-control compliant). Use hospital-grade, germicidal disposable wipes between deployments.

Security: Radio-frequency identification tags are affixed to each VR helmet at Lucile Packard Children’s for inventory management and loss prevention.

Photography By Robert Houser