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article imageQ&A: Virtual reality can aid medical learning and development Special

By Tim Sandle     Oct 4, 2018 in Science
Osso VR is a virtual reality surgical training program being used globally to train residents and surgeons. The developer of the system explains the benefit of VR to train the next generation of surgeons
Osso VR is a virtual reality surgical simulation platform with advanced hand tracking. It is designed for surgeons and hospital staff of all skill levels. The product, according to Forbes, offers highly realistic hand-based interactions in an immersive training environment that contain the latest, cutting edge procedures and technology.
To understand more about the technology and its application as a training aid for surgeons, Digital Journal spoke with Osso’s CEO Dr. Justin Barad.
Digital Journal: How popular is virtual reality set to become in the medical field?
Dr. Justin Barad: Very! There is intense interest in virtual reality in the world of medicine and it has shown effectiveness in a wide variety of use cases. VR is being used for CT and MRI visualizations, surgical planning, pain therapy, psychological applications, ophthalmologic applications, neurorehabilitation, telesurgery and most importantly (and what we do), training and assessment.
In general VR is thriving in areas where it is solving a critical problem for the healthcare system, and validating the value proposition by the technologies and approaches being pioneered by early innovators have been very promising.
DJ: What types of applications are possible?
Barad: For us, almost anything is possible. We are able to simulate nearly any kind of surgical procedure, including simulating rare cases and complications. We initially focused on the orthopedic space as this lined up well with where the technology was currently at and there was ample demand from the market. As we move into 2019, we have made inroads into robotics, and are keenly interested in spine and interventional cardiology, as well as additional specialties and applications. Eventually, we anticipate having content and curriculums for nearly all specialties for surgeons, OR staff, and sales reps.
DJ: Why was Osso VR developed?
Barad: When I was in high school, I originally wanted to become a video game developer, however illness in my family inspired me to try and use my passion for software and technology to solve medical problems. To better understand the problems facing doctors and patients, I chose to become a physician.
During my training in orthopedic surgery, I experienced first-hand what I believe is the biggest problem facing healthcare today: how we train and assess the technical skills of our healthcare providers. It is well studied that a surgeon’s skill level impacts patient outcomes, so the training system for a surgeon must set them up to become proficient. Unfortunately, our system for medical training is falling flat and hasn’t evolved in a century to keep up much with the pace of innovation in techniques and devices. This is impacting new and veteran surgeons alike. Today, 30 percent of residents cannot operate independently at graduation. One of the key factors influencing this is how work hour restrictions and other requirements of the job, like entering data into the EHR, have cut into hands-on training time.
For veteran surgeons, a two-day course on a new device leaves them uncomfortably dependent on medical device reps. With sometimes hundreds of steps to learn in a new procedure, studies have shown that achieving proficiency in more complex procedures can take 100+ cases. Additionally, this all puts a burden on the medical device industry with increased rates of product misuse that thwart adoption.
During the time of my residency, VR was having a renaissance. With my gaming background and concern for the growing training gap I was observing, I decided to do something. I brought a prototype I built to a professional game developer, Matt Newport, and together we co-founded Osso VR in order to address the training gap and improve patient outcomes, increase the adoption of higher value medical technology and democratize access to modern surgical education.
DJ: Who did you consult for the development?
Barad: What makes our team special is that it is built from the ground up for developing a virtual surgical training platform. Our team consists of practicing clinicians, medical device industry veterans, professional game developers and medical illustrators from top institutions. As we have grown rapidly we have taken on a stellar advisory board which is run by Dr. Tom Krummel, professor and chair emeritus of surgery at Stanford University School of Medicine and co-director of Stanford biodesign. Dr. Krummel was an early pioneer in the surgical simulation space and is keenly aware of the challenges present and technologies necessary to solve them.
DJ: How was the VR tested out?
Barad: Given our clinical background, it was important to the team that our training platform led to real world skill transfer. We put together a study to test this hypothesis. In the study, we took a group of 10 medical students and randomly split them into two groups. One group was trained with Osso VR, while the other group was trained through “traditional” means (didactics and text materials).
After the training period, each participant performed a physical runthrough of the real world procedure, and a blinded observer graded the quality of their performance. What we found was that the VR group doubled the performance of the non-VR group. To confirm these results, we have run this study with an even bigger group, and are currently gather the data.
DJ: Which institutions have adopted the technology?
Barad: Eight top U.S. residency programs are using Osso VR’s training platform as a part of their curriculum: Vanderbilt, Long Island Jewish Medical Center, Columbia University, David Geffen School of Medicine at UCLA, Harvard Medical School and Hospital for Special Surgery. We are also working with several of the top orthopedic medical device companies in the world. Recently, we officially expanded our offering to the UK and Europe. Our mission is to democratize access to surgical education for all healthcare providers around the world, and we have some upcoming key global initiatives that we will soon be announcing.
DJ: Do you have plans to adapt the technology further?
Barad: The pace of improvement of our platform has been blistering. Every month, it seems we’re having a major technical breakthrough and our customers and users have been delighted with the progress they’ve seen. This year we’ve seen successful initiatives as we push into more precise training and assessment, the launch of our collaborative training functionality, the launch of our residency training network called the OTN, and an upgrade to our analytics system. In 2019, we will see further enhancements to our analytics as we start to integrate AI elements into the platform, rapid expansion of the OTN and more exciting features.
DJ: How do you differ from competitors?
Barad: Since we launched our disruptive approach, we have seen several new entrants into the market which has been very exciting and validating for the massive opportunity we have discovered. Some companies are taking a similar approach to us, however, what makes Osso VR incredibly unique is the depth of our content library, our interaction toolset, and the credibility of our customer and user base.
We have also seen some interesting approaches with grounded kinesthetic haptics, a two decade old technology that seems promising but has multiple drawbacks, including high cost and lack of effectiveness. We have taken a unique approach in this area by focusing on the value haptics adds to the experience for our surgeons, ensuring any haptic feedback we incorporate makes sense and doesn’t “break” the immersive experience. Finally, to date we haven’t seen any other entrant in this space scientifically validate that their approach leads to real world skill transfer, which is a huge next step for VR’s value in healthcare in general.
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