Activate Health has authored a new bylined feature on behalf of several of its health system and health technology public relations clients, which has been included as a cover story in Group Practice Journal. The article profiles VR-based approaches to medical education, pain management and even physical therapy developed by Arizona-based Banner Health, Cedars-Sinai Medical Center and the Cleveland Clinic, among other renowned healthcare organizations.

Group Practice Journal reaches physicians and clinical professionals through its website and monthly print magazine. Both forums regularly educate readers on the latest clinical studies, and include research-based articles authored by leading healthcare professionals.

This latest article demonstrates the potential for healthcare and health technology PR outreach in terms of reaching key buyers, decision makers and influencers across the industry. A brief excerpt of the story follows, including profiles from three leading healthcare institutions. Subscribers to Group Practice Journal can read the article in its entirety here.

Reality Check: New programs explore virtual reality’s potential in medical education and care delivery
While the exact mechanisms behind VR’s ability to help patients manage pain remain unclear, researchers are currently investigating its impact on cortical activity. Recent studies suggest that VR’s analgesic effects stem from an ability to modulate the signaling pathways of the pain matrix through attention, emotion, memory, and other senses (e.g., touch, auditory, and visual).1 Others hypothesize that, much like opioids, VR influences pain-related brain activity in the insula and thalamus.2

Regardless of the mechanism, pain management is an area of interest for many clinical researchers exploring VR’s potential. That’s because many believe that this technology can serve as a “distraction” technique from the discomfort caused by comorbidities.

Case in point.
One organization currently testing this assumption is Banner Health, one of the largest nonprofit health systems in the nation. Banner has 28 acute care hospitals located across Arizona. Given the widespread impact of the opioid epidemic, its leaders were looking for new ways to reduce its physicians’ reliance on pain medications.

Mike Foley, M.D., Banner’s chairman of obstetrics and gynecology, had already heard anecdotal evidence about the value of VR in supporting patients recovering from surgery. He decided to apply the same principles to labor and delivery, helping expectant moms deal with pain with less medication. He hypothesized that this effort would enhance safe deliveries and ease transitions home for both moms and their babies.

Dr. Foley and his team gave patients the ability to experience swimming with dolphins, sitting on a beach at sunset, or climbing a mountain via a VR headset during active labor. Many of the women experiencing the immersive VR environments delayed epidurals and required far less pain medication overall than patients who did not have access to VR. Dr. Foley and the clinical leaders at Banner Health hope the soon-to-be-published study will inspire other physicians to use this technology in pain management to reduce avoidable opioid prescribing.

Researchers at Cedars-Sinai Medical Center are also pursuing a similar path as they develop a VR toolkit for patients experiencing pain due to acute orthopedic injuries. Brennan Spiegel, M.D., the organization’s director of health services research, is equally interested in pursuing VR as a means to improve patient well-being while reducing the need for pharmacotherapies. He and his research team recently partnered with Traveler’s Insurance to undertake a randomized study aimed at reducing opioid prescribing for individuals with musculoskeletal injuries. The treatment group received a digital pain reduction kit and weekly access to a digital health coach—combining both high-tech and high-touch outreach to ensure that each patient understood how to use the kit. Kits are comprised of a Fitbit tracking device, TENS neuromuscular stimulation unit, and a Samsung VR headset complete with VR software. Dr. Spiegel expects the study to be complete in the next 12 months and is working on a book that includes his firsthand account of VR use throughout health care.

“The ultimate goal for this intervention is not just to reduce reliance on opioids but instead to focus on also improving the patient’s overall well-being,” Dr. Spiegel says. “That’s why our team will also be measuring each patient’s pain score, physical activity, self-reported sleep, and physical activity measures as well as other indicators of wellness.”

Getting Patients Back on Their Feet
Potential applications for VR are not limited to pain management. Some physicians believe it can be useful in other areas, including post-op recovery. Cleveland Clinic is one organization where researchers are pursuing this unique model.

Physical activity following total knee arthroplasty (TKA) or total hip arthroplasty (THA) is an integral component of successful return to activity of daily living. However, studies show that many patients do not ultimately increase their physical activity levels after these procedures.3 Physical therapy plays an important role in promoting optimal levels of activity, and yet encouraging patient compliance with these protocols can be difficult. Researchers at Cleveland Clinic decided to determine whether VR and interactive gaming might be useful tools in overcoming these challenges.

They were encouraged by recent studies showing that VR can combat changes in diminished mobility and balance that are common to the central and peripheral nervous systems that occur with age.4 Studies have also included ease of use of the VR platform as an indicator of performance and have shown it can encourage clinician-patient interaction while offering cost savings, convenience, at-home monitoring, and coordination of care.5

According to Gary Calabrese, senior director of Cleveland Clinic Rehabilitation and Sports, “VR technology can allow for real-time interaction between the patient and therapist while allowing the clinician to assess and instruct on motor performance activities under real-world conditions. At the same time, monitoring exercise performance, progression, and technique all have added value in the patient’s early recovery period.”

The study, undertaken at Cleveland Clinic using technology developed by Reflexion Health, was recently published in the Journal of Knee Surgery.6 It showed a marked increase in compliance with recommended physical therapy exercises. In fact, 80% of participants adhered to the in-home regimens prescribed by their physicians. Patients in the study spent an average of approximately 27 minutes per day exercising over the course of an average 30 days in recovery. The study concluded that use of this technology has potential benefits that allow for patient adherence, cost reductions, and coordination of care…

Laura Reagen is creative director of Activate Health, a Phoenix- and Nashville-based firm serving healthcare and health technology public relations clients. Activate Health specializes in providing marketing, advertising, and public relations support to entities across the healthcare industry, including health technology firms, hospitals, health plans, and health systems.

I. Gold, K.A. Belmont, and D.A. Thomas. 2007. The Neurobiology of Virtual Reality Pain Attenuation. Cyberpsychology & Behavior, 10(4): 536–544. (Note: Highlights modern thinking about VR analgesia and the neurobiological aspects to VR’s pain-attenuating properties.)
G. Hoffman, T.L. Richards, T. Van Oostrom, et al. 2007. The Analgesic Effects of Opioids and Immersive Virtual Reality Distraction: Evidence from Subjective and Functional Brain Imaging Assessments. Anesthesia & Analgesia, 105(6): 1776–1783
B. Arnold, J.L. Walters, and K.E. Ferrar. 2016. Does Physical Activity Increase After Total Hip or Knee Arthroplasty for Osteoarthritis? A Systematic Review. Journal of Orthopaedic and Sports Physical Therapy, 46(6): 431–442.


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