Proximie Archives - Tech Trends

How Virtual Practice Makes Perfect

Alice — Fri, 20 Apr 2018 08:10:07 +0000

The Internet democratized knowledge, but immersive technologies like AR and VR will democratize access to experience – and revolutionize learning.

Prestigious medical institutions such as Imperial College London are using HoloLens devices in operating theatres to spot key blood vessels, bones, and muscles helping to make procedures quicker and safer.

Surgeons have traditionally used a handheld ultrasound scanner to find vessels under the skin by detecting the movement of blood. However, this is very time-consuming and still requires some guesswork
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Patients who have suffered an accident may have open wounds that require reconstructive surgery. Skin and blood vessels are taken from a healthy part of the body and used to cover the wound, enabling it to close and heal properly. A vital step in the process is connecting the blood vessels of the “new” tissue with those at the site of the wound, so oxygenated blood can reach the area.

Surgeons have traditionally used a handheld ultrasound scanner to find vessels under the skin by detecting the movement of blood. However, this is very time-consuming and still requires some guesswork as to where the vessels are and their path through body tissue, explained Dr Dimitri Amiras – a Consultant Musculoskeletal Radiologist at Imperial College Healthcare NHS Trust – as he walked me through the demo.

Prestigious medical institutions such as Imperial College London are using HoloLens devices in operating theatres to spot key blood vessels, bones, and muscles helping to make procedures quicker and safer
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The technology allows surgeons to take CT scans that have previously been completed and overlay 3D digital models of them onto a patient’s limb during reconstructive surgery
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The technology allows surgeons to take CT scans that have previously been completed and overlay 3D digital models of them onto a patient’s limb during reconstructive surgery. It has been used to help surgeons successfully move blood vessels from one part of the body to another in order to help open wounds heal more quickly.

At the Global Education and Skills Forum (GESF) in Dubai I got a chance to try it out first-hand, and it was pretty amazing, specially knowing that the Holograms I was looking at were based on real CT scans. Patients so far have included a 41-year-old man who injured his leg in a car crash, an 85-year-old woman who fractured her fibula and a person who developed an infection that required surgery.

“Mixed reality offers a new way to find these blood vessels accurately and quickly by overlaying scan images onto the patient during the operation. This technology allows us to experience the data that we have collected from patients before their operation in the most realistic and natural way. You look at the leg and essentially see inside of it; you see the bones and the course of the blood vessels,” he said.

Dr Philip Pratt, a Research Fellow in the Department of Surgery and Cancer at Imperial, said using the HoloLens is allowing surgeons to understand a patient’s unique anatomy very quickly and accurately and to collaborate more efficiently in teams as multiple surgeons wearing the headsets can also see what their colleagues are specifically looking at.

As well as a powerful visualization and collaboration tool for working surgeons, immersive technologies can also help solve a growing problem: the global shortage of such professionals, specially in the developing world. Training facilitated by immersive technologies can be instrumental in addressing the chronic shortage of trained professionals in areas such as teaching, healthcare and the digital economy.

Bassem F Hashash, from Augmented Reality training and collaboration platform Proximie, says an estimated five billion people worldwide do not have access to surgery This is due partly to the chronic lack of specialists available to perform such procedures, and the difficulty and expense involved in training new surgeons.

An estimated five billion people worldwide do not have access to surgery
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At the Global Education and Skills Forum #GESF in Dubai I got a chance to try it out first-hand, and it was pretty amazing, specially knowing that the Holograms I was looking at were based on real CT scans
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Training at scale is a real challenge, specially in areas such as healthcare, as you can only fit a small number of students in an Operating Room, and observation and practice is how one learns the crucial skillset necessary in such professions. Yet with immersive technology is possible for experts and students to virtually transport themselves into settings which allow them to flexibly collaborate and train. They can, in other words, become a democratizing force in education, by enabling students to virtually access experiences that would otherwise be out of their reach.

Using the HoloLens allows surgeons to understand a patient’s unique anatomy quickly and accurately and to collaborate more efficiently in teams
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According to Richard Vincent of Fundamental VR who was also showcasing his haptic Virtual Reality application at GESF (which let me have a great time literally messing around someone’s insides) it isn’t a matter of virtual training being “better,” but of enabling the benefits of experiential learning to become more widely accessible, allowing training to move beyond the limited model of “See one, do one, teach one” and opening up the possibilities for students to practice and perfect their skills in a safe and accurate environment.

People all over the world will be able to easily access realistic experiences and simulations, learning and practicing new skills in entirely new ways
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In developing his own HoloLens application, Vincent has seen evidence that working with Mixed Reality tends to trigger different parts of the brain through immersion, so that content is assimilated more quickly and “sticks” with learners for longer, hence its potential to add to, enhance and accelerate learning. And Moore’s law, he adds means that his company’s current training simulation system costs one tenth of what it did a few years prior, and he expects that exponential driving down of cost to continue to increase sharply over the next five to ten years.

“As the technology progresses it will become more affordable and more integrated into our everyday lives. Just as most people here are carrying some sort of smartphone, the next step will be some sort of augmented reality device,” says Dr Amiras

“This is the new interface between computers and humans. What happens with technology is that when it works well, it disappears,” agrees Vincent. “Immersive Technology in the future won’t be about a bulky headset. What we have today is the equivalent of the Motorola phone of 1987. It will be glasses and contacts. This might feel scary now but in 10 years time it will feel as natural as carrying a smartphone in your pocket does now.”

All this means that people all over the world will be able to easily access realistic experiences and simulations, learning and practicing new skills in entirely new ways. Much in the same way as the widespread adoption of the Internet facilitated broader access to knowledge, Immersive technologies can enable broader and more egalitarian access to experience itself, and that’s pretty exciting.

This article was originally published on VRScout

Mixed Reality and Medicine: Virtual Practice Makes Perfect via @alicebonasio https://t.co/3wnwW02uLq pic.twitter.com/9hkWbH2dsI

— VRScout (@VRScout) April 16, 2018

For companies looking to get into Immersive technologies such as VR/AR/MR/XR our Virtual Reality Consultancy services offer guidance and support on how best to incorporate these into your brand strategy.

Alice Bonasio is a VR Consultant and Tech Trends’ Editor in Chief. She also regularly writes for Fast Company, Ars Technica, Quartz, Wired and others. Connect with her on LinkedIn and follow @alicebonasio on Twitter

The post How Virtual Practice Makes Perfect appeared first on Tech Trends.

Changing the Way Surgeons Operate with Mixed Reality

Alice — Wed, 21 Jun 2017 07:35:34 +0000

Healthcare is one of the areas with most potential for dramatic improvement with the implementation of Virtual, Augmented and Mixed Reality Technologies

The virtual world is already having a real impact in people's lives and health
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As countries around the world struggle to find health care provision models that balance the needs of aging populations with shrinking budgets—and as startups jostle to get into operating rooms—the virtual world is already being used to impact the health care of real people.

“I could be in Cleveland and teach a group of students in, say, London with all of us able to see one another and the holograms simultaneously,” says Professor Mark Griswold, Case Western Reserve’s faculty leader for the university’s efforts with Microsoft’s HoloLens, the $3,000 developer-edition-only augmented reality glasses. “The professor can see how students are interacting with the hologram in real time, and respond immediately with additional explanations or encouragement as needed.”

Devices like the HoloLens and consumer VR helmets like Samsung’s Gear VR and Facebook’s Oculus have received the most attention as vehicles for escape, but their real-world applications are growing fastest in the workplace. IDC, which pegs current industry revenues at around $5.6 billion, says much of the growth in shipments of VR and AR headsets over the next five years will come from industrial uses (80% a year), versus consumer uses (50%), like video games, films, porn, and other entertainment. Among current non-health care HoloLens customers, for instance, are companies like Lowe’s, Volvo, and ThyssenKrupp, whose technicians use the glasses to operate on ailing elevators.

Healthcare revenues for VR and AR technologies reached nearly a billion dollars in 2016
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In health care, revenues for VR and AR technologies reached nearly a billion dollars in 2016, according to Kalorama Research. Some estimate that by 2025, that number could reach over $5 billion, thanks to uses in areas like telemedicine, pain relief, robotic surgery, and, increasingly, medical simulations.

VR and AR are already being used in areas like pain relief, robotic surgery and telemedicine
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Medical instructors say a VR helmet, coupled with haptic-feedback “syringes,” can help a surgeon practice a complex operation in detail before carrying it out—or help a doctor with limited access to education locally get better medical training, improving patient experience and outcomes. A pair of augmented reality goggles can put an animated “patient” in front of students, making the expensive dummies obsolete altogether. And as medical operations become more sophisticated and high-tech, computer glasses could help get practitioners up to speed faster.

The United States is facing a shortfall of 100,000 physicians by 2030
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Health care experts have proposed new technologies like these as one of various solutions to what some have called a crisis in medicine: The United States could be facing a shortfall of between 48,000 and 100,000 physicians by 2030, according to the Association of American Medical Colleges. Since it takes between five and 10 years on average to train a new physician, medical industry experts say the U.S. urgently needs more people to enter that training pipeline now, particularly in highly specialized fields: The greatest shortfall, on a percentage basis, will be in the demand for surgeons, especially those who treat cancer and other diseases more common to older people.

Using Mixed Reality simulations to train surgeons could alleviate the shortfall and bring in cost savings
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Alleviating that shortfall and upgrading decades-old simulations with mixed reality could also ferry in cost savings that can’t come soon enough. In the U.S., the cost of health care continues to surge, far beyond the price of drugs: Open-heart surgery is 70% more than the next highest country; an appendectomy over two times more. And the price for a day in the hospital is about five times more in the U.S. than other developed countries.

Better Learning Through Virtuality?

For years, surgeons have relied on 3D modeling on computers to plan complex procedures down to the millimeter, so there are as few surprises as possible. The technology proved valuable for the team that separated conjoined twins Erika and Eva Sandoval at Stanford’s Lucile Packard Children’s Hospital in Palo Alto in 2013. In that case, surgeons donned 3D glasses to study digital renderings of the twins’ organs, allowing them to perform a heart valve replacement using an incision less than half the normal size. More recently, 3D modeling has merged with VR at Stanford Health Care, where an app called True 3D technology, developed with Mountain View-based company EchoPixel, promises to increase a surgeon’s ability to visualize and plan complex procedures beforehand

“Our biggest problem is cutting into an artery or vein that we did not expect,” says Eric Wickstrom, a professor of biochemistry and molecular biology at the medical school at Thomas Jefferson University in Philadelphia, who co-authored a 2013 study on the use of 3D models in surgery.

A clinical study published last year in the Journal of Neurosurgery looked at how surgeons rehearsed their operations using a VR-based brain modeling platform developed by the company Surgical Theater. The tool, in use at New York University, University Hospitals in Cleveland and Mount Sinai among others, appeared to help surgeons reduce the time it took to repair aneurysms, suggesting it also made the surgeries safer.

15 minutes with the HoloLens could save dozens of hours in the lab
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Making Virtual Bodies Feel Real And Real Bodies More Virtual

The next step in the equation will be to accurately reproduce not only the look but the feel of any surgical procedure. HoloLens partner FundamentalVR is already working on the addition of haptic feedback to surgery simulations, says Richard Vincent, the company’s founder. The London-based startup is developing a tool called FeelRealVR, which it describes as a “flight simulator” for surgery. In its current version, students use a stylus in place of a syringe, which provides realistic levels of pressure and resistance in relation to a hologram of a patient’s open knee joint, for instance.

Vincent argues that tools like this can make for better learners. The enhanced cognitive involvement that comes from not only seeing, but interacting with the holograms triggers active “Involved Learning,” he says, a recognized teaching methodology in which students have been found to retain much more of the subject matter than with traditional approaches.

Surgeons rely on 3D modeling on computers to plan complex procedures down to the millimeter, so there are as few surprises as possible
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AR is also augmenting instruction during real-life surgeries
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AR is also augmenting instruction during real-life surgeries. Hands-on, face-to-face lessons during real-life operations are in short supply, often limited to the limited number of students who can fit inside an operating theater. Surgeons who can teach are in such high demand, meanwhile, that experiential learning can be increasingly infrequent at medical schools, taught only once to a small group.

“Surgery is very visual. You can read it in a book if you want but it’s not the same as watching it live,” says Dr. Nadine Hachach-Haram, a NHS registrar in plastic surgery at the Chelsea and Westminster Hospital. “Yet it’s physically difficult to get many medical students in the operating room at any time.”

Hachach-Haram is cofounder of a company called Proximie that developed a way to use augmented reality to let a distant surgeon virtually place his or her “hands” or instruments onto a patient’s body. The idea is to let experienced practitioners guide operating teams on where each incision should be made and how to proceed. After being selected by the U.K. Lebanon Tech Hub Accelerator, Proximie is now rolling out a training pilot at The Royal Free Hospital, allowing 150 of its students to log in remotely to watch surgery through the application.

Mixed reality is also improving operating rooms in less obvious ways. ByDesign, a HoloLens app, helps surgeons, nurses, and technicians save precious time in configuring the setup of operating theaters. Whenever there’s a rotation, operating rooms need to be carefully reconfigured to meet each team’s very specific requirements, since even minute errors in that context can have dangerous consequences for both patients and practitioners.

Two surgeons hundreds of miles apart can both stand in different rooms looking at accurate holographic renditions of the same equipment
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Traditionally that means multiple people moving around heavy, delicate, and expensive equipment to test various configurations. In an environment where most facilities already operate near capacity, this resource-intensive process translates into higher costs and slower delivery of care, says Andy Pierce, president of Global Endoscopy at Stryker.

By donning an AR headset, practitioners can visualize objects in full-scale 3D, with the flexibility of being able to easily move virtual objects. Two surgeons hundreds of miles apart can both stand in different rooms looking at accurate holographic renditions of the same equipment, moving them around until they’re satisfied the optimum setup has been reached. This can then be saved and relayed to those in charge of setting up the operating rooms themselves.

Upgrading The Cadaver

A review of augmented reality in medical training published last year in the journal Surgical Endoscopy couldn’t say whether the technology would contribute to patient safety. But author Esther Barsom, a researcher in the department of surgery at the University of Amsterdam, noted that AR is “preeminently suitable” for helping improve the training of situational awareness during operations, a facet that is “lacking in medical curricula.” And, she wrote, “as training methods become more engaging and reliable, learning curves may be expected to become steeper and patients will ultimately benefit.”

Prof. Wickstrom of Thomas Jefferson University suggests that virtual simulations could also widen the recruiting pipeline: By making medical education more interactive and engaging, the medical field could become more accessible and attractive to those who previously might have been put off by traditional medical learning.

As training methods become more engaging and reliable, learning curves may be expected to become steeper and patients will ultimately benefit
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The time-honored way of teaching anatomy, for instance, is to have students spend months dissecting cadavers. But these procedures—not unlike the realistic mannequins at SimLearn—can cost tens of thousands of dollars. And cadavers can only be used by a limited number of students, and, naturally, only once.

Under Prof. Griswold at Case Western Reserve, anatomy students use the HoloLens to interact with virtual patients and organs, allowing them to pull back the various layers of the human body, visualize the muscles on top of the skeleton, and understand exactly where things are located. AR means that medical students are not confined to learning the terrain of a single body, but can see accurate visualizations of particular conditions such as cancers, heart disease, or spinal injuries.

“In the fall we did a pilot test of HoloLens with medical students who already had studied the cardiothoracic region for several weeks in the cadaver lab,”Griswold says. “After one session viewing the same area of the body wearing the devices, 85% said they had learned something new.”

Just 15 minutes with the HoloLens could have saved them dozens of hours in the lab, students who participated in the pilot told Pamela Davis, dean of the school of medicine. Case Western is now in the process of developing a broader holographic anatomy curriculum. “The quicker our students learn facts like these, the more time they have to think with them,” Davis said at last year’s Microsoft’s Build conference. “We are teaching them to think like a doctor.”

Originally published on the Fast Company website

The unreal, bleeding-edge tech that’s helping doctors make the cut https://t.co/g1dV4I5BBp pic.twitter.com/707KhPVUXz

— Fast Company (@FastCompany) June 20, 2017

Tech Trends’ Virtual Reality Consultancy services offers support for companies looking to get a foothold in the growing Mixed Reality spectrum and enhance their brand strategy with these exciting new technologies.

Alice Bonasio is a VR and Digital Transformation Consultant and Tech Trends’ Editor in Chief. She also regularly writes for Fast Company, Ars Technica, Quartz, Wired and others. Connect with her on LinkedIn and follow @alicebonasio on Twitter.

The post Changing the Way Surgeons Operate with Mixed Reality appeared first on Tech Trends.

Training the Next Generation of Surgeons with Augmented Reality

Alice — Tue, 05 Jul 2016 16:02:10 +0000

Two-thirds of the world’s population don’t have access to safe surgery. That’s as many as 5 billion people.

And of the 313 million procedures undertaken globally every year, only 6% occur in the poorest areas where over one third of the world’s population lives.

To cope with this huge problem, it is estimated that by 2030 we will need to train over 1.27 million additional surgical providers, which of course presents some enormous logistical and financial challenges.

Proximie is a start-up looking to solve this problem with an Internet-enabled software tool that allows doctors to guide, help, support and train surgeons through the use of Augmented Reality. According to its Co-founder Dr. Nadine Hachach-Haram, the key advantage it offers is that it’s much more interactive than traditional simulation or live streaming tools, thus enabling higher levels of collaboration and better learning outcomes.

Two thirds of the world’s population don’t have access to safe surgery
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The Augmented environment is created by overlaying two live video feeds, one in the surgical theatre filming the operation, the other pointing to a blank surface connected to the surgeon’s tablet or laptop. This allows the surgeon to draw on their screen while looking at the live surgery feed, and for the remote team to see the marks made by the surgeon and follow them precisely at their end.

Surgery is a very visual so it’s far more useful, interesting and engaging to watch it live
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They are one of the companies being supported in their rapid growth by the UK Lebanon Tech Hub and have been attracting significant praise and attention from both the scientific and technology communities, winning the prestigious Royal Society of Medicine prize for Innovation in e-Health and being invited to join the MIT “Arab World Meets Silicon Valley” forum at TechCrunch Disrupt in September.

Dr. Hachach-Haram, a Lebanese surgeon based in the UK is passionate about the use of the software as a training aid for students:

When we had the old-fashioned viewing galleries, dozens of students were able to watch surgery without affecting or crowding the surgical area, and could engage with the surgeon and ask questions,” She recalls. “Fast-forward to 2016, where we have much smaller operating theatres, reduced facilities and overstretched operating lists- this environment is much less amenable to surgical education and engagement from medical students.

So Proximie is effectively updating that viewing gallery experience using 21^st Century technology, so that a large number of students can log in and watch a procedure from wherever they are in the world.

Surgery is a very visual, precise and anatomical part of medicine and no matter how many times one reads it in a book, it’s always far more useful, interesting and engaging to be able to watch it live, ask questions, and visualise anatomy and pathology.

In September they will launch a pilot in partnership with UCL’s Royal Free Hospital to integrate Proximie into their surgical curriculum. The educational version of the platform also has a student dashboard function, which allows them to access elements relevant to their educational curriculum, giving the ability to take notes and screenshots for later review, for example.

A cohort of students will be given access to the platform and will be able to log in to a number of operating theatres to observe the surgeries in an interactive way with the added elements of annotation, AR and other great features that will make this a completely new way of learning.

This cutting -edge technology (no pun intended) includes features such as the ability to annotate live streams and medical records integration, meaning doctors can easily access information about a patient during surgery and take snapshots during the procedure which are automatically added to that patient’s records.

Proximie is hardware agnostic and requires minimal infrastructure, working with any tablet, smartphone or laptop and providing an intuitive interface with no need for expensive tools. Surgeons can literally use AR to draw on their screen using something as simple and affordable as a capped bic pen.

Proximie's cutting -edge technology includes the ability to annotate live streams and medical records integration
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This technology could have a significant impact in the quality of care provided to patients in conflict zones such as Gaza and Syria. The software allows an experienced surgeon to be virtually “parachuted in” to support and guide a procedure with their specialist expertise, without any of the danger and cost of physical travel.

There are, of course, some logistic challenges associated with live streaming technology, as anybody who’s ever been on a pixelated Skype call knows. Dr Hachach-Haram says that in situations where in remote areas or conflict zones they have modified the application so that it will still provide high quality video stream even at lower network speeds. “It’s an all-round adaptive solution, and while we’re a commercial platform, we’re also committed to social impact projects, as that’s a core component of our DNA. Proximie offers free licences to charities to support them in tackling inequality in surgical knowledge and expertise.”

Currently the telesurgery feature needs to be scheduled in advance, but future iterations are already planned where the service will host a database of surgeons all over the world listed according to expertise, allowing colleagues to check their availability and seek assistance and advice in real time.

Even in developed countries such as the UK, the potential for this type of technology to maximize efficiency is enormous, as surgeons would be able to support procedures in different hospitals without the time and costs associated with commuting to various locations. It would also ensure better patient care, as the best specialist for a particular procedure could support it regardless of their geographical location at any given time.

Even in countries such as the UK, the potential for this technology to maximise efficiency is enormous
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Dr. Hachach-Haram says they will be watching the developments in the Virtual Reality market with interest, and it is not difficult to imagine how, as VR technology and hardware become more accessible and pervasive, it will offer even greater possibilities for immersive learning and expertise sharing.

Virtual and Augmented Reality certainly represent a booming sector, and there is a growing interest in the medical applications for these technologies. According to a recent report from Frost & Sullivan the next 10 years are set to redefine the future of both business and consumer processes and interactions and will be adopted widely across industries by 2025.

“AR and VR will be a giant step in transforming and democratising education and businesses, especially in medicine, where immersive technology can facilitate education and access-at-a-distance for medical care,” said Dr Rafael Grossmann, who was the first person to stream a live surgical procedure with Google Glass, and his company Medical Realities, led by colleague Dr Shafi Ahmed, live-streamed the first VR surgery from The Royal London Hospital, with 54,000 viewers virtually present in the operating theatre.

From all around the world, they gained an exclusive point-of-view demonstration and interacted in real-time with the surgical event. Imagine how this level of interaction can deliver next-generation education for students worldwide, especially in developing countries, added Dr Grossmann.

There are also interesting developments in the hardware arena, with Georgian start-up InGlove developing a VR glove which could prove useful for applications such as medical simulations, and Purdue University researching a system called DeepHand, which uses a “convolutional neural network” that mimics the human brain and is capable of “deep learning” to understand the hand’s nearly endless complexity of joint angles and contortions. It uses a depth-sensing camera to capture the user’s hand and figure out where the hands and fingers are, applying algorithms to then replicate those motions in real time. Karthik Ramani, director of the University’s C Design Lab says that in Virtual Reality it is crucial for your hands to be able to accurately interact with the virtual world in order to provide full immersion.

Imagine how this level of interaction can deliver next-generation education for students worldwide
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It will be interesting to see how immersive tech develops and find new applications across areas such as medicine and education, and many agree that this will be the crucial factor in determining how quickly VR becomes pervasive.

For companies looking to get into VR/AR/MR our Virtual Reality Consultancy services offer guidance on how these technologies can enhance and support your brand strategy.

Alice Bonasio is a VR Consultant and Tech Trends’ Editor in Chief. She also regularly writes for Fast Company, Ars Technica, Quartz, Wired and others. Connect with her on LinkedIn and follow @alicebonasio and @techtrends_tech on Twitter.

The post Training the Next Generation of Surgeons with Augmented Reality appeared first on Tech Trends.