Enter the avatar - is this medicine's new "reality"?

From Nintendo Wii to Pokémon Go, the use of virtual and augmented reality in video games is familiar to most and, with the power of such "immersive technologies" now being harnessed for use in the medical sector, this blog looks at recent developments, and some of the legal issues that could arise.

Last year, the UK government announced that £33m of funding from its "Industrial Strategy Challenge Fund" will go to supporting immersive technologies, such as virtual, augmented and mixed reality.  

For those new to the jargon, Innovate UK's 2018 report "The immersive economy in the UK"  provides some helpful definitions to help separate the "virtual" from the "augmented". The report also highlights the potential for huge growth in the immersive technology sector, citing a forecast by Citi which indicates that the market could be worth a staggering $569bn by 2025.

Virtual reality programmes are already used in the training of medical professionals. In terms of patient treatment, research into the use of virtual reality therapy for acrophobia (fear of heights) has already been carried out in the UK and was published in The Lancet Psychiatry in 2018 (see link).

In May of this year, it was announced that the US Food and Drug Administration (FDA) had approved an augmented reality platform, "Surgical AR", which uses augmented reality and artificial intelligence to allow surgeons to visualise details which they would otherwise be unable to see during surgical procedures.

In July, a new clinical trial, "gameChange", was launched in England. The trial, which will involve over 400 NHS patients across the country (from Bristol, Manchester, Newcastle, Nottingham and Oxford), will test a virtual reality therapy for patients with severe mental health difficulties, such as schizophrenia. The therapy aims to treat the social withdrawal of patients with severe mental health issues through a step by step programme in which a virtual coach guides them through anxiety-provoking situations. It is reported to be the largest clinical trial yet of a virtual reality therapy for a mental health disorder.

More recently, it has been reported this month, that a hospital in Cardiff is conducting a trial directed at the use of virtual reality headsets for pain management during childbirth.

Whilst there appear to be significant potential benefits to the use of immersive technologies in a medical setting (particularly in the treatment of mental health issues), their introduction may raise new legal challenges.

In the video gaming sector, reports of the visuals in some games triggering epileptic seizures led to litigation in the US in the 1990s. Other potential effects that could be linked to the use of virtual/augmented reality include:

• experience of nausea or motion sickness;

• physical injury as a result of a user being unable to properly navigate their own physical environment whilst immersed in the virtual/augmented world; or

• possible interference with other medical devices.

Manufacturers of these new therapies will therefore need to take great care in:

• the design of the product visuals and any accessories (e.g. headsets and controls);

• provision of detailed terms of use and user guides, including any necessary restrictions on use, training, and education of users;

• warnings, contraindications, and disclaimers.