How Can Facebook’s Spaces VR Program Help Patients and Consumers?

First published April 20, 2017

Overnight at Facebook’s F8 conference, Mark Zuckerberg officially announced the launch of Facebook Spaces in beta. Using the Rift platform and available on the Oculus store, purportedly all that’s needed is Oculus Touch and an Internet connection.

 

Essentially, this means Facebook is adding virtual face-to-face interaction. This is a huge win for patients and healthcare consumers.

There are several ways in which we think virtual reality through Facebook will help patients, consumers and clinicians.

Patient communities are a burgeoning interest in healthtech. The Mayo Clinic Connect is an online messaging and education platform where patients and carers can chat with others suffering the same or similar illnesses. Australian app CancerAid is also building patient communities and sharing the burden of cancer with the millions affected by cancer worldwide, through their app for iOS and Android. Imagine the potential for communities to virtually “talk” with each other.

 

Patients can create avatars and share vivid experiences with each other, including their Facebook photos and 360 degree videos. Imagine taking a 360 video of your community hospital’s dialysis unit in Chile with your smartphoneand sharing that in real time with your friends in Norway.

 

facebookspaces1.jpeg

Screenshot from Facebook Spaces Oculus’ launch video.

The potential for healthcare education is huge. Facebook Spaces includes a drawing function, meaning that potentially, clinicians could educate patients and families in a more hands-on way, without needing to be in the same room as them. Of course, this helps students and clinicians train for procedures and study for exams, as well.  This could come in handy for rural and residential communities who may not be able to travel to the city for care so readily. Hospitals, clinics and education centres producing educational video content (such as the Royal Children’s Hospital) could potentially integrate their videos into Facebook Spaces, and nurses and staff could help teach with the added drawing function inside the virtual classroom. Imagine teaching a patient about what to expect from a hospital visit through a virtual tour on Facebook Spaces. (Or through our anaesthetist friend’s made-for-VR video!)

 

Facebook Spaces also adds another potential dimension to telehealth. Using Facebook Messenger, video calls can be made, including outside of Facebook to the “real world”. We imagine chatbots for Messenger like Amelie, the mental health chatbot, will have incredible functionality here, where the user’s virtual avatar can consult “face-to-face” with the chatbot counsellor. Sometimes it’s easier to chat to someone you can’t look directly in the eye, and we can imagine people who are too uncomfortable to talk to a face-to-face counsellor or who can barely get out of bed when in a bout of depression may find it easier to start with a chatbot. (One of Amelie’s functions is to guide the participant to further help, rather than replace a professional psychiatrist or psychologist.)

And from a global health perspective, users will be able to virtually “travel” with chatmates and experience different environments. This could help with disaster resource planning, for example sharing VR videos and 360 photos of earthquake – ravaged zones with aid organisations to help their planning for resources and deployment. Similarly, can you imagine how design of healthcare spaces will be impacted? Oculus’s YouTube video above shows a user sharing photos of the apartment she just bought. Again, the virtual tour aspect of public buildings and clinics can help plan for better patient care through architecture and design. Imagine sharing 360 pictures of your Emergency Department layout with other EDs around the world at conferences; or performing emergency simulation training through VR tours and demonstrations.

Are you an app developer or health tech startup founder? Now you have a whole new avenue of possibility to think about when integrating social functions into your product.

Of course, cautions about security and encryption of call content apply here, but just imagine the potential…

Got any ideas for how you will use Facebook Spaces in healthcare or for leisure? Comment below and please share this article if you enjoyed it. Sign up for our mailing list if you’d like more updates like these. 

How Can We Be Leaders Through Healthcare Technology? Day 3 of HiNZ and the New Zealand Nursing Informatics Conference

First published November 7, 2016

This week, we’ve been inspired by the many speakers who have made career leaps: from clinician  to academic; from clinician to ICT (Information and Communications Technology) specialist; and even from accountancy to the public service in healthcare. Here are some of their insights from Day 3 of HiNZ, and the concurrent New Zealand Nursing Informatics Conference:

1) Videos of nature scenes played via app, with or without music, can help reduce pain perception and level of anxiety in the perioperative period. Professor of Nursing, Margaret Hansen of the University of San Francisco,  was inspired to investigate the power of visualisation in dealing with pain, after experiencing a severe illness herself. Her feasibility study, performed as a randomised controlled trial, has shown these promising effects, and will lead to further study- perhaps even in Virtual Reality!

Margaret Hansen VR hinz.jpeg

Prof Margaret Hansen of USF demonstrates one of the app’s Nature videos at the NZ Nursing Informatics Conference 2016. Pic: The Medical Startup

2) “We need to collaborate with our international colleagues,” said Lucy A. Westbrooke, who is the New Zealand ambassador for the International Medical Informatics Association – Nursing Informatics (IMIA – NI). From her diverse career in nursing, leading to executive and chairperson positions in New Zealand health informatics and telehealth, she described some of the various international meetings and opportunities helping to achieve this goal.

 

3) “You don’t design systems for the most technologically agile; it has to be for the users,” Dr Simon Kos, Chief Medical Officer of Microsoft advised. Having experienced healthcare both as a clinician and as a software engineer, Dr Kos gave insights into the future of medical education with virtual reality through Hololens. 

dr simon kos hinz.jpeg

Dr Simon Kos, Chief Medical Officer of Microsoft at HiNZ 2016. Pic: The Medical Startup

4) Finally, NZ Ministry of Health Director General Chai Chuah posed the question: What kind of leader are you (in healthcare)? “Today’s global leaders understand and lead the art and science of disruptive change,” he said, acknowledging the combination of both art and science in medicine, technology and healthcare.

Leadership isn’t always about being the first to present an idea, or the first to use a new technology. Leadership can occur at an individual level. As an example, guiding a patient to a tech solution enabled by a District Health Board (DHB), such as A.Prof Robyn Whittaker has done with her project with Waitemata DHB. Her research findings from a messaging reminder service for behaviour change showed that patients benefited from this service. Or coordinating an entire Australian Territory’s telehealth services, as Michelle McGuirk does in the Northern Territory; or encouraging a patient to keep an app-based symptom journal.

robyn whittaker waitemata dhb hinz.jpeg

A/Prof Robyn Whittaker, Medical Doctor and Digital Health lead at Waitemata DHB presents her Behaviour Change Messaging project findings. Pic: The Medical Startup

You can view sessions from 2016 and 2015 at HiNZ.org.nz with membership. Catch up on Day 1 and Day 2 highlights as well.

We thank HiNZ for providing media access to the conferences and opening our eyes up to these incredible experiences.  

The Virtual Ward Round Is Here: Highlights from Day 2 HiNZ, Successes and Failures in Telehealth, and the Global Telehealth conferences

First published November 2, 2016

We’ve been very inspired from the talks and positive atmosphere at HiNZ, SFT and the Global Telehealth conferences this week. New Zealand is a country that deserves a lot more credit for their innovation in medicine and global healthcare. Here are some of today’s highlights:

1) Virtual Ward Rounds and Consults help patients and clinicians alike feel supported and at ease with care. Dr Eddie Tan, nephrologist from Waikato Hospital, spoke about the “hub and spokes” model of care that Waikato Hospital and its satellite rural hospitals and clinics run. With hundreds of kilometres between sites, Dr Tan and his colleagues are on planes at least every fortnight for clinics that may last just a few hours before returning back to Waikato. This is problematic when rural patient emergencies develop; however, Telemedicine with videoconferencing to the satellite clinics has helped the Renal team conduct assessments, minus the hours and dollars spent on travel (and minus hours of patient/family stress). It has also prevented unnecessary hospital presentations, and brought critical patients to hospital sooner.

Eddie Tan Hinz.jpg

Dr Eddie Tan, kidney specialist at Waikato Hospital NZ discussing Telehealth in Renal failure. Pic: The Medical Startup

Dr Tan’s colleague, Waikato District Health Board (DHB) renal nurse Jenny presented her research paper on how palliative care decisions were made easier with telehealth’s videoconferencing capabilities. This meant that difficult and time-critical family and patient conversations could be had in the comfort of the patient’s home, without wasting precious time in the potential final days of life arranging hours or even days of transport for the same consultation.

Dialysis ward rounds also help Dr Tan assess end-stage renal patients who may deteriorate very rapidly and become fluid overloaded.

Similarly, Rehabilitation ward rounds by telemedicine has helped patients in a rehabilitation ward feel happy and secure with their care. Registered Nurse and PhD candidate Sophie Gerrits’ research has so far found that rehab patients and staff at Thames Hospital, Waikato DHB New Zealand, are happy with the consults, and the elderly patients have adapted well to the new technology. The Ward Registrar goes from bed to bed with a telecart, and the Rehabilitation Physician or Geriatrician video-calls weekly in from the tertiary hospital, in addition to their usual weekly face-to-face visit.

 

Staff appreciated having a second chance during the week to ask questions and raise issues that had arisen in the days since the last visit. The main issue to overcome was “patient jitters” at not knowing what to expect from a video consult and what was expected of them. This reinforces the need to counsel patients prior to a consult; that they can speak, behave and ask questions just as they would if the clinician was in the room with them.

2) Telestroke Improves Door-to-Needle Time in New Zealand

Yesterday, Dr Chris Bladin of the Victorian Telestroke Program discussed the very promising findings from the Victorian Telestroke Program research in rural hospitals, with hopes to expand to other Australian hospitals. Today, New Zealand Neurologist Dr Anna Ranta showed that since Telestroke has piloted from 3rd June in the Capital and Coast DHB, door-to-needle median time has reduced from 80 minutes down to 54. With cerebral ischaemia being a critical matter of seconds, this is a significant early finding, and along with other positive outcomes, will hopefully help push for a Telestroke rollout in other DHBs.

 

GTC 4 nations hinz.jpeg

1,100 delegates attending HiNZ this week. HiNZ Awards Dinner at Shed10, Auckland, sponsored by Microsoft. Pic: The Medical Startup

3) The finalists for the Sysmex Award for Health Informatics at the University of Auckland have promising ideas for mobile health applications. The winner, Daniel Surkalim, was announced tonight at the HiNZ Awards dinner. By creating visually appealing, simplistic views of patient data, his project, GRID(Graphical Relational Integrated Database) will help solve the clinician bugbear of “too much data, not enough sense” that occurs in many existing EMRs (electronic medical records). The other finalists deserve commendation for their work; Frances Toohey with Dr.Doctor for clinicians and patients to track eReferrals, and Kyle Frank’s MedScript to facilitate e-prescribing solutions for patients and doctors.

4) Tele-ophthalmology in India aims to cut waiting lists for a population short of ophthalmologists. Dr Sheila John of Chennai, India has done extensive work with diabetic retinopathy and machine learning, and inspired us with her dream to help rural villages be screened for diabetic retinopathy accurately and safely without a long waiting period for an eye specialist. Dr John quotes 60 million people in India as suffering from diabetes, with nearly 20% experiencing diabetic retinopathy, a cause of blindness if left untreated.

 

GTC 4 nations hinz.jpeg

Speakers from four different nations closing the Global Telehealth conference today; L-R: Global Telehealth co-chair Dr Kendall Ho of Canada; Dr Karen Day of NZ; Dr Laticha Walters, South Africa; and Dr Sheila John, India. Pic: The Medical Startup

With four events running this week, it’s impossible to catch all sessions at once. Watch the conference on demand, even after this week, with a Virtual Ticket, including one year’s worth of membership with HiNZand HIMSS Asia-Pacificamong other benefits. We thank HiNZ for providing media access to the conferences and truly enjoyed the experience.  

Interview with Dr Gregory Sam, Psychiatrist and Director of Conduit Health: Part 1

First published April 26, 2016

 

Dr Gregory Sam is a consultant psychiatrist who founded Australia’s first bulk-billing telehealth psychiatry consulting service, Conduit Health, in 2014. Focusing particularly on rural and remote communities, Greg currently runs Conduit Health along with his private practice work in the city. In this three-part interview series, Greg kindly shared his tips for success, the road to Conduit Health, mixing business with medicine, and rising from failure.

Image credit: Dr Gregory Sam

Image credit: Dr Gregory Sam

 

How did you get the idea for Conduit Health?

I think the idea started during my rural rotation of training in 2009. It was often a whole-day affair to see these clients, 4-5 hours’ trip each way, and that was disheartening to see people suffer so much. It’s supposed to be easy access. But they had to wait ages before seeing a psychiatrist.

So I aimed to fill that gap.

I started because I was so frustrated at the way things were.

I found so many deficiencies in rural mental health care, and thought, how do I improve things? There area lot of difficulties and shortcomings in the system. I was always into tech stuff. So I tried to think of the amalgamation of the healthcare and mental health care sectors. Telehealth was in its infancy then. So I thought, why can’t we assess the patient through telehealth conferencing?

I struggled to get through my exams, failed 3 or 4 times, and started to get a bit disillusioned about my career in general. I wasn’t sure why I wasn’t getting through. A lot of thoughts were going through my head. Is this the life for me? Should I be changing careers? A whole heap of stuff. But I thought, there’s still good things I can do in this field, whether it’s as a registrar or consultant or not. I’ve learnt a whole heap about my specialty through this. 

How long did it take you from having the idea to taking action, alongside your clinical work and studies?

Honestly, a few years. My idea has been since 2009, and it’s very tempting to get distracted by training. I was so focused on training that all these other things I could do fell by the wayside. I had the idea for a few years, but only started something solid in 2014.

I think 2014 was when overcoming all the inertia of starting a business occurred, planning and actually doing things. 

Failing my exams gave me that opportunity to start thinking outside the box. I took 3 months off work to have a break. I think that’s the best thing I did during training. I focused on badminton and other things I like doing, and started to make moves on my company. I had meetings with colleagues and friends in business, picked their brains, tried to absorb as much as I could from them, both guys and girls, to understand what it’s like to get into business. My business friends said, “it sounds like a brilliant idea, why don’t you do something about it?” So that gave me a kick to start.

When I went back to work, I left business for awhile and focused on passing exams. Once I passed, during our year of Advanced Training, I set learning goals on things like, “I want to learn more about drug and alcohol,” and other goals which I did in my day job, and also focused my energy on Conduit Health. That’s when the wheels started turning.

2015 was the launch date. Our first consult was February 2015, so 2015 has been a big year in that it’s a startup, and for most startups it’s about sustaining that growth, so 2016 is another big year. A lot of planning happens with regards to how to continue that growth, otherwise it’s too tempting to have a firework effect where it starts then fizzles up. 

Overcoming inertia is hard, but once you overcome it, things start rolling, and you can’t stop.  It’s a lot of commitment but so rewarding, more rewarding than my day job. I find treating patients rewarding, I can help them and their families as a psychiatrist. Whereas with Conduit Health, I’m helping so many more people across the country. We’ve had referrals from far and wide, from every state, and remote locations like the Kimberley and the Great Barrier Reef. I’m working with primary health networks (PHNs) across the country to expand our reach. 

How does a typical consult run?

Conduit Health , Telepsychiatry Service. Photo courtesy of Dr Gregory Sam.

Conduit Health, Telepsychiatry Service. Photo courtesy of Dr Gregory Sam.

Either the psychiatrist dials in (from their location), or the patient (who’s hosted at their GP clinic) dials into us, then the psychiatrist introduces the consult. We need to say at the start that we’re doing it via teleconferencing, that there’s no one else in the office, and check who’s in the office. This sets the scene so the patient can understand that there are no unseen people in the room. We discuss confidentiality, unless risks in which case we need to notify particular people. It’ll go between five minutes to an hour, we state our aims, then start the diagnostic interview.

The video quality is quite good, but if there’s any lag or dropout, we disconnect and call back. We check at the start, “can you see me? Can you hear me?” We check camera position so the webcam points directly at the patient and so the patient can see us. We also make sure it’s appropriate, eg. the psychiatrist is in a quiet isolated room, not at the beach. We set rules for our psychiatrists. They use the Conduit Health backdrop. 

Sometimes a mental health care nurse will be there. We offer to GPs, if you want to be present for the whole assessment or in the last 5-10 minutes, you can. Some GPs stay for the whole interview, others come in the last 5 minutes and ask the psychiatrist, “what’s your diagnostic impression and what’s your plan?” They can get immediate feedback, (and sometimes help with scripts and so on).

We also get constant feedback from other GPs. My role is partly to ask patients and GPs, “how are you finding the process? Can we make things better for you?” Constantly evolving the company.

One benefit of Conduit is confidentiality. You don’t need to go into a psychiatric facility where everyone knows it’s a psychiatry facility, and sit in a waiting room with other mentally ill patients. Patients have said that’s a benefit, so people don’t have to know they’re seeing a psychiatrist. In a way that’s also bad. We’re not trying to promote stigma of mental health, but unfortunately this is a barrier to receiving care.

How did the name Conduit come about?

I was building a house at the time, and working with the builders, one said, “I want to dig a tunnel under your garden to create a conduit for your electrical wires to go through.” Also from my cardiothoracic surgical rotation in med school, “they harvest the conduit” in bypass surgery, and they explained what a conduit was to me. I then thought about what Conduit Health does, it takes away big distances and gaps.

The logo is a bridge, to embody bridging gaps.Suddenly, 300 kilometres to go to an appointment doesn’t matter anymore. It’s a link, a conduit, from point A to B. So patients don’t have to travel.

I don’t think telehealth will replace traditional face consults, but it can address geographical barriers.

Would you expand Conduit to non-psychiatry services?

The immediate next need would be psychology. It would be great to have psychologists who can do tests and consults. But at the start, I want to focus on psychiatry. Some companies have one of every specialty, but I want to focus (for now). If there is demand later on, for say, neuropsychology, social work, we will expand to fill the need.

What about your plans for aged care?

A big arm we’re developing in 2016 is to work with residential aged care facilities. There’s such a huge need, patients can’t often go see a psychiatrist. Aged care services are often floundering, “can we get the psychiatrist to come here?” but not many psychiatrists want to do that to see one or two patients, it’s not feasible. But we can go in and have a session there, and it’s immediate. So 2016 will be a big year for Conduit Health Aged Care branch. We want to expand to all the big aged care facilities. 

To learn more about Conduit Health, click here

Stay tuned for Parts II and III of Greg’s interview, in which he discusses his business inspirations, his insights on failure, and running a business as a medical professional.