Three decades of medical virtual reality with Stanford's Dr. Walter Greenleaf (2023)

XR has come a long way, baby, and we have one of the technology's first pioneers on tonight's episode. Dr Walter Greenleaf has been in the field for 33 years, from the days when virtual reality was little more than a wink to scientific researchers. Now he and Alan talk about how far technology has come and how far it still has to go.

Alan:Welcome to the XR for Business Podcast hosted by Alan Smithson. Today's guest is Dr. Walter Greenleaf, a behavioral neuroscientist and medical technology developer at Stanford University. With over three decades of research and development experience in the field of digital medicine and medical virtual reality technology, Walter has been considered the leading authority in the field of this industry for 33 years. Amazing experience. dr Greenleaf has designed and developed numerous clinical systems over the past 33 years, including products in the areas of surgical simulation, 3D medical visualization, telerehabilitation, clinical informatics, clinical decision support, point of care, clinical data acquisition, ergonomic assessment technology, automated sleep staging Systems, psychophysiological diagnostics and simulation-based rehabilitation technologies, as well as products for behavioral medicine. The focus of Dr. Greenleaf has always been into computer-aided clinical products, with a particular focus on virtual reality and digital health technologies to treat post-traumatic stress disorder, anxiety disorders, traumatic brain injury, stroke, addiction, autism and other challenging conditions. and physical and behavioral problems. He is currently a Distinguished Visiting Scholar in Stanford University's Media X program at Stanford University's Virtual Human Interaction Laboratory and Director of Technology Strategy at the Center for the National Institute of Mental Health at the University of Colorado. To learn more about the work of Dr. To learn more about Greenleaf and his team, you can visit the Human Interaction Lab at Stanfordvhil.stanford.eduand a new organization called the International VR Health Association

Welcome to the show, Dr. Walter Greenleaf. So good that you exist.

Walter:thanks Alan I'm glad to be here with you.

Alan:It is an honor. He is considered one of the godfathers of this technology. You've been working on this your whole life. And I want to personally thank you for laying the groundwork that allows people like me, the new people that are getting involved here, to really pick up where they left off and where they've driven this whole industry forward, and really allow us to do that. Build on the knowledge of your life. So thank you for paving the way for us.

Walter:Thanks Alan And really, without the work of everyone else and my colleagues and the work of you and others that help set the trends for something that has long been a rarity in the research lab and something that the boundaries really haven't escaped of Academy. . Now we have that in the world. And I'm particularly excited about all the advances that have been made in applying VR and AR technology to difficult health issues. It's a very emotional moment for me.

Alan:I'm aware of all the different things that appear in my feed, and I have a health and medicine folder. And it's interesting because last year I had to break it down into a mental health portfolio as well as traditional health and medicine. So there's a huge amount of not just research but real practical applications being created for this. You know, one of them that impresses me the most is the possibility of using virtual reality to treat lazy eyes or strabismus. I just thought it was amazing. In just a few sessions, people see a complete reduction and elimination of lazy eye using virtual reality. And that's just one of thousands of use cases for this technology. So maybe show us the work you're doing in the Virtual Human Interaction Lab and what are some of the big use cases you're seeing right now?

Walter:It's okay, well, sure. Jeremy Bailenson is the director of the Stanford Virtual Human InteractionLab, and I serve there as a medical consultant and expert. Stanford's Virtual Human Interaction Laboratory is focused on exploring and investigating how VR technology can encourage prosocial behaviors, e.g. B. to help us better understand how our behavior affects the world's ecology, how our behavior affects other people, and to explore how we can change attitudes and change. Behavior with virtual reality technology. The lab is actually one of the pioneering research groups in the field of virtual reality and behavior modification. And I encourage you and your listeners to visit the site. There's a lot of really incredible research material accumulated in there. But my role is more or less to transfer that research and the research of other groups in academia into the field of medical devices. So in addition to my work at Stanford and the National Center for Mental Health Innovation at the University of Colorado, I am advising some of the early and late stage medical VR startups that have received investment funding to develop products and get to market. to bring. Then help these groups connect with the healthcare ecosystem, the pharmaceutical industry, the medical device industry, the healthcare industry, insurance companies, and make sure that they make everyone in the healthcare ecosystem aware of the power of VR technology and AR and how it works. make a big difference in health.

And as you mentioned, it really is enough. We're seeing some really amazing products being developed in education to help people not only perform surgical procedures, but also work as a team on difficult problems, how to break troubling news to a family or patient, how to conduct interviews effectively conduct a patient . A wide variety of training apps. But in addition to training, we also have a whole new wave of systems like the ones you described for strabismus that help therapeutically with clinical problems. And it ranges from, well, he listed a few of them, stroke and traumatic brain injury, treatment for anxiety and depression, PTSD, addiction support, autism support. The list of interventions is very long. And one of the things that I'm really excited about is that VR also allows us to better assess people, measure how they move, measure their mood and behavior in a way that we didn't have tools before. . We can now make better objective assessments instead of subjective measurements. And that gives us some very powerful tools.

Alan:One of the tools that we're seeing online right now is eye tracking and motion tracking, which can really give us data points about people that we never had before. Is this something you're working on?

Walter:Absolutely. And what I find really exciting is because we can measure how people move, because we can measure where they look, what they pay attention to, things that we used to collect subjectively and analogically, now we can collect reproducibly and objectively. , and that gives us new research tools, but also new evaluation tools. Let me give you some examples. For example, if we're trying to understand a neurodegenerative disease like Alzheimer's or Lewy body disease or maybe Parkinson's. And we subjectively ask people or their family members to make a subjective report of how someone is doing cognitively. It's very, very difficult to measure. And that means that the development of new pharmaceutical interventions, new behavioral interventions, are all limited by the fact that we don't have very precise tools. But if we can measure how people move, if we can measure what people are looking at, if we can measure what people are looking at, if we can measure behavior, then we're better able to design new interventions, whether by pharmacists or by cognitive-behavioral therapy, which can help with whatever issues they deal with. And that really puts us in a better position to move forward in terms of product research and development.

Alan:It's unbelievable. Your work 30 years ago, how was it? How has that changed from your early days in this technology to now, and where do you see it in the next five to 10 years?

(Video) Dr. Walter Greenleaf - Stanford University

Walter:Wow, what a great question. As for the advances we've made, decades ago we knew that virtual reality could be a powerful tool to help with some very difficult problems, like treating phobias or post-traumatic stress. We can use a simulation to support what is called exposure therapy. For example, for someone who is afraid of flying, we can create a simulator that allows them to experience, or fear of heights, or fear of spiders, or really anything that has a fear response to it. The counselor or committee can gradually expose the patient to what he fears in a controlled manner and teach him how to deal with these fears and sometimes accustom him to a learned fear response. And we were able to do that, for example, with Larry Hodges and Barbara Rothbaum developing a virtual Vietnam in the early 1990s that was very effective in treating post-traumatic stress disorder for Vietnam veterans, some of whom suffered from it. of PTSD for decades. And with the help of this exposure therapy method, he was able to make a big difference.

To answer your question, we've known for a long time that we could treat issues like addiction, issues like PTSD, issues like phobias, a whole host of clinical issues with Virtual Reality, but it really wasn't affordable. And it wasn't comfortable to wear either. Spending too much time in VR sometimes caused motion sickness in the simulator. And it was so expensive that a head-mounted display could cost $70,000. A computer used in the investigation can cost four or five hundred thousand dollars. But now we have better systems that I can order from Amazon. It is breathtaking. What happened are some of the paths that were laid out in the early days to show what works, what doesn't, what is a fruitful path of effort, what is not. We know. And now we can go deeper with technology. We can do studies on a larger scale. We can reproduce the original research, done with small samples and equipment that seems very rudimentary. We can really go out and build it better, and probably more importantly, get it to the people who need it.

Alan:So we've seen a reduction in cost, a reduction in time to do these things. The one thing we don't see, and maybe you can talk about that, is mass adoption across industries. And medicine is really embracing this technology more than the other. What do you think are the reasons for the hesitation? And could... I have a theory about that. And my theory is that we've been howling the wolf for so long. "Virtual reality is going to be great!" Five more years: “VR is going to be great!” Five more years. People say, “Yeah, yeah, whatever. VR, of course." How are we going to top this?

Walter:I think that's part of it. I think part of it was also that VR is kind of a shallow phrase. I think that's a very descriptive term. But it's also a phrase that makes some people think, as you've described, that maybe it's a very light and ineffective tool for dealing with big problems. But things have changed. Now we say VR or AR and people know what we mean when we say AI. Although someone said VR five years ago, you didn't necessarily know what that meant. So let's get used to this expression. And what I think is the problem, yes, what you've described, but also the fact that it's something like what we call a virality factor of one. You almost have to see and experience it before you really get it. And that means it's not as contagious as other things that catch fire very quickly. And I think it's going to take off really, really fast. But what we have to do is develop the practical applications for the company. We are present in the areas of architecture and finance, training of qualified workers, training in soft skills and medicine. It is true that medicine, in particular, has a very adequate barrier level. We need to show what is effective and what is safe. It will take a little time to do the studies to show safety and efficacy, but we're in the process of doing that. And there are a lot of early adopters who have brought VR into their clinics, into their hospitals and are doing a great job with it. So I think things are going to catch fire very soon. But I think we made it in time now that the prices are reasonable. And I think what's holding back is that we need more people to develop the practical tools that exist in the company.

Alan:So there's tremendous opportunity for entrepreneurial students coming out of universities like Stanford that -- I think they're benefiting from the three decades of work that you and your colleagues have put in, because I think that's what I'm looking at the market right now seems ripe for a explosion. Looks like we have the rocket on the runway and all engines running. And is that the kind of vibe you're feeling in the market right now?

Walter:I think it's a good analogy. I think because the foundation has been laid and because the infrastructure is already in place. VR and AR technology uses the internet and available broadband. 5G is on the way. We use distribution mechanisms. And remember, at least in the medical field, a lot of what we do relies on other technologies like machine learning. I mean, we collect a lot of data, but we need the tools to analyze it. It is based on the technology of avatars that look much more realistic and have facial expressions and non-verbal communication aspects, making them much more realistic than what we have achieved in the past. So I think things are ready to take off because there's a convergence of technology. AR and VR technology will take advantage of AI technology, take advantage of simulation technology, which will be used in various fields other than health. And it all comes together in one place. So yes, I think it's ready and I use the term ready, but I don't mean ready to take off in ten years, not even five years. I think it's about to take off and it's going to move very quickly.

Alan:I couldn't agree more to be honest. I've studied this industry inside out and subscribe to Google Alerts for Virtual and Augmented Reality. And maybe five years ago you would get a notification every other day and it would contain a few things. I get three notifications a day and they are full. let me read something I find this interesting:

“Doctors should adapt the virtual reality application to the patient, not the patient to the technology. The agenda of VR technology in medicine. All organizations are faced with the problem of drastically increasing the amounts of data they have to deal with in their daily business. This data is increasingly found in a variety of media formats, especially in medicine, where data formats include CAT, MRI, EEG and X-ray images, as well as real-time communication with consultants. Over the past 40 years, many technologies have been offered to help with this growing problem of managing information resources. And now we have virtual reality.”

This is fromVirtual Reality Magazinefrom 1993.

Walter:[Laughs] That doesn't surprise me.

Alan:[Laughs] I happen to have three copies of this magazine. It's amazing that the promise was there 20 years ago. And now, with the advent of the Oculus Quest and these really cheap headphones, I think it's opened up the world for developers and doctors and doctors.

Walter:Well let me mention to address that point. I think there's another trend worth paying attention to, at least in medicine, the collision of continents. Consumer electronics companies like Apple and Samsung, and to some extent Google and Microsoft, and companies like Amazon are moving into the healthcare industry. And that really changes the game. The fact that with their speed of product development and knowledge of good UI design, it's really wonderful to be able to engage these groups and partner with pharmaceutical companies like Novartis and Sunovion and others, and partner with medical technology companies like Penumbra. It's time to see the consumer electronics company's speed and expertise combined with distribution channel experience and medical product development. It's like a tidal wave rushing through a racetrack. So I think things are going to start faster than any of us expect.

(Video) Not Just Games: VR to Boost Brain Health w/ Dr. Walter Greenleaf

Alan:I will read something else. This is from another magazine:

"Virtual Interface Technology offers many applications to help people with disabilities: Augmented Reality in Rehabilitation Medicine."

By Walter J. Greenleaf and Maria A. Tovar, Spring 1995,Virtual Reality Magazinespecial report.

Walter:uh huh So yeah. Finally, the things we were passionate about back then are now accessible. We've been able to do this in research labs for decades. But now we can start moving it into clinical care.

Alan:So the people who are listening... let's say hospitals or doctors, for example, or what are the practical first steps for them to start using these technologies? What would you recommend? I know you started IVRHA, so maybe you can talk about that and how these hospitals and doctors and doctors -- how can they get involved and start using it right away?

Walter:Well, first of all, I'm glad you asked about practical applications and not "the killer app" because we don't use that term in medicine. You'll be amazed at how many new companies pop up in the tech space.

Alan:[laughs] Probably the worst lineAlwaysfor medicine [laughs]

Walter:Yeah, but you know, people are still talking about the killer medicine app. But speaking of how people can get started, I think visiting the IVRHA website is a good place. You'll see a lot of medical device companies, startups and service providers coming together to explore the technology's applications, which is a great place to start. We also host an annual medical virtual reality conference and it's a great place to meet other people working in the field and experience demos.

Alan:Where will it be?

Walter:It will be in Nashville. There is a link to this on the IVRHA website. I think another way to really get started for clinical groups is a good one, I think take a look at some of the startups that are pioneering. You've described how virtual reality is used to treat strabismus and amblyopia. For example, I think for any indication you're interested in, whether it's depression, anxiety, stroke rehabilitation, pain relief, or a great way to get services, just do a simple web search to find the top Search Groups to find. and then see which product development companies base their products on a research-backed initiative, and see who cite and use established research groups as part of their advisory group. There are many people entering the field of clinical VR, turning their game development skills or sensor development skills into products. But not everyone understands the medical ecosystem. Not everyone understands the ergonomics of bringing a product into a clinical environment in a way that doesn't slow down the process, so that it doesn't create additional burden and work for clinicians and support staff.

So, as a filter, I would say I would look to product development companies that would bring in researchers and experts who know the medical ecosystem to advise on the direction of their technology and, probably more importantly, conduct validation studies. And I would also look for those who have formed alliances with some of the experts that exist in the medical ecosystem, like B. Some of the pharmaceutical or medical device companies. You are very demanding. And of course, the last criterion is that if someone has bothered to get an FDA certification, they have a product that proves its safety and effectiveness. This is really the key keyword I'm looking forward to seeing where to start to find the companies that are dealing with the problem you're interested in and have gone down this path.

Alan:Absolutely. He touched on a few use cases, one of which was pain distraction. One of the studies I read was about a 25% reduction in the use of opioids in wound debridement. And if you think about it, it's a massive reduction in drugs that have harmful effects on people and can lead to addiction and stuff just by using virtual reality.

(Video) Walter Greenleaf on medical applications of VR and AR technology | ApplySci @ Stanford

Walter:It's very exciting. You're talking about Hunter Hoffman's work. And Hunter has done a great job of not just showing how we can use virtual reality to, say, reduce the need for narcotics in a burn clinic. But how the reduced need for narcotics translates into less likelihood of addiction after discharge. And this is a really important thing. A large part of the problems that we are currently facing in our country with opioid addiction is due to the fact that people start using drugs because they are in a hospital and receive adequate medication to relieve pain. But if we can increase pain medication and decrease the need for pain medication, if you use virtual environments as a pain distraction gate, even better. And virtual reality has also been used to help people with chronic pain learn how to cope with chronic pain through cognitive behavioral therapy and other approaches. It is not only a painful process during the acute phase, but also during the post-discharge phase after the acute phase.

Alan:When people think about it, what would we call performance metrics in business terms? How do you measure the success of one thing versus another modality? What are the typical actions when you first start using VR versus something else used in your clinic? How would you measure that success? How does it look?

Walter:This is a very good question. I would say that for a medical product it really matters if we are teaching a procedure that is very different from when we have a clinical evaluation and very different from when we have a clinical intervention. They all have different metrics. When measuring the ability to use VR to enhance a training process, I wouldn't just consider how much more proficient the training process is in terms of mastering a skill, for example B. a surgical skill or diagnosing a patient. but you also want to know it by comparing it to traditional methods. Is it less expensive? In general it would be. Medical schools often have to hire actors and actresses to help with part of the training process to use very expensive simulation machines. You will also want to know what a withholding tax is. Are people retaining the lessons they've learned in a more experimental subject using VR compared to other ways of learning like B. watching a videotape or reading a book or dissecting a cadaver? By the way, there are some medical schools that are now switching to all electronic cadavers, which is not only cheaper, but in many ways more dynamic, they can overlay the cadaver image with additional information and have a more structured education. So for training we would have these metrics.

For diagnosis, would it be possible to make a cheaper, more efficient and more accurate diagnosis for a better differential diagnosis, perhaps to get less false positives and false negatives as diagnostic criteria? We would use that. And with all of those things, we also have to look at the costs. The additional cost of implementing a VR system and not just the cost of acquiring the equipment, but also the cost of integrating it into the hospital ecosystem, maintenance and support? Additional personnel may be required to keep batteries charged. So you really need to look at the full impact of introducing new technologies into the medical ecosystem. So that has to be part of it. And do we save money by using virtual reality as a clinical intervention? Do you save in the long run? Does it lead to better health outcomes? And you know, I have to tell you Alan, when I look at the metrics of those three things, training, assessments and interventions, VR can really make a big difference. It's really profitable. But again, it needs to be placed properly and not pushed into the clinical ecosystem in a way that creates an undue burden. They want doctors to be able to go home sooner and not have to say something later to do more paperwork.

Alan:It's interesting that he says this because one of the things that came out of LiveWorx was device management. We're used to managing phones, iPads and the like, but this adds a whole new element to device management. It's something people don't even consider until they have 50 or 500 of them to deal with.

Walter:Exactly the problem. But I think smart product developers will appreciate this and incorporate into their systems ways to reduce paperwork, improve clinical workflow along with a new tool.

Alan:The investment is worth it in my opinion. Given the numbers you're seeing, what results can you expect? Let's say using this for autism, for example, it's very difficult to say with a number which is more efficient or something like that. It's almost anecdotal, but there should be numbers to show that this technology far outperforms anything we've ever developed.

Walter:Well, part of the way we do this in medicine is long-term follow-up. For example, when we use virtual reality to support stroke rehabilitation, both in the acute phase after a stroke and in the post-acute phase, when people go to a clinic for follow-up or for home rehabilitation, when we look at how it's doing a few years after and compare this to people who received standard care, there are fewer permanent disabilities people return to work sooner people are more functional and engage in activities (daily living is the term we use) more effectively, after using Interventions enabled for VR and AR instead of standard, that tells us something, and we can put a number in terms of dollars saved to prevent permanent disability and help people get back to work sooner. The same goes for... well, let's take the example of treating someone who has a fear of heights or a fear of flying. We can compare people who used a virtual reality system to overcome these problems and see how they do a few years later. How many of them are still flying? How many of them might need to take anti-anxiety medication to get on a plane compared to those who don't? If those who received the VR treatment are doing better, that tells us a lot and we can quantify the value of that.

Alan:Let me ask another question from a different angle. Have you ever seen a time when virtual reality was no more awesome or better than the traditional way of doing things?

Walter:That's a good question, Alan. We're still at a stage where we've mapped out the VR issues and I can't think of anything. I'm sure there have been situations where we thought VR would be the best way to approach this problem and found it not really cost-effective. But I must say I'm really at a loss to find a good example. I think mainly because the technology was so expensive for many years that we thought very carefully about how to use it properly. Now I have to say I've seen a lot where I think it's not always necessarily the best use. Lots of VR technology to help people relax. And I think some of these VR environments are not that different from listening to a recording or just closing your eyes and imagining yourself sitting in a quiet place. I think there are some amazing mindfulness training programs out there that encourage active involvement where you're not just on the beach listening to the waves. And they are very exciting. But I think there are some where the incremental value of a VR environment isn't as incredible as it could be, but it's still a learning curve. We are learning how to get the most out of technology.

Alan:One of the things I saw was, and I think it was, the Cubicle Ninjas VR meditation, it could have been them or someone else: they actually connected their smartwatch to their VR headset so their heart rate could be read. You were able to do these guided deep breathing exercises, it's like a guided meditation, deep breathing, and you can actually see your heart rate drop as you control your breathing.

Walter:This is a good example of a good use case where not only do we use visualization technology, but we also include the measurement of psychophysiological signals and use them to dynamically change the environment. So, as with anything, there's a spectrum of innovations that can be applied. And I think when you asked me where VR isn't really that effective, I'm just thinking of our times where it's effective but not as effective as it could be. When we add extra layers of analytics, or extra layers of social connections, or extra layers of using gaming technology to make things more rewarding and exciting. Then again, we're really starting now. Now that the products are more accessible, I think you're going to see an increase in the number of people using them for medical issues. And we'll probably see some that are a little bit poorly designed and boring, but I'm sure we'll see some that are great too.

(Video) Walter Greenleaf on VR in healthcare | ApplySci @ Stanford

Alan:Yes, I have to say, we're past the point where we know which VR techniques make people sick. So I'm getting really, really sick.

Walter:uh huh

Alan:I'm the office guinea pig. But yes, there are still some companies that do things that make people sick.

Walter:Yeah, and I think it's a matter of bad design, if you move the world around someone it makes them feel bad. But when you give them the ability to move around the world, it's very different. Let me talk about one way that we're applying virtual reality and augmented reality technology in medicine that I'm particularly excited about. Now there's a focus in medicine that's moving more towards what we call precision medicine, where instead of taking a one-size-fits-all approach to treatments, you take a clinical path and say, well, let's try this and see. if it works, and if it doesn't, we'll try something else that uses the genomic information about the individual, the measurements we can get about their behavior and physiology. And we challenge them with virtual environments, for example, to see how they react. And we create a precise treatment path based on your specific body type.

One of the projects that we do at Stanford University is a project led by B. Williams called Project Engage, where we look for people who have depression and weight issues at the same time. And we follow them over a period of years as they learn to manage their weight and moods. And they have a variety of different interventions. But as they move along this treatment path, we scan their brains with a functional medical imaging device. And we also measured their behavior using data collected by: they consented for us to collect data on their smartphones about how fast they type, how fast they swipe and how active they are in general. And we also use virtual reality to challenge their neural circuits to see: we have a challenge, similar to Beat Saber, where they have to learn to react correctly and maybe at other times control their reaction. And the idea here is to create a system based on virtual reality that can be used to identify different biotypes of neural circuits and generate a more accurate approach in the treatment of depression, for example. So, for biotype A, we can recommend that they try this treatment for depression, and another biotype, in turn identified by how it responds to a stimulus in a virtual environment, can be recommended to choose treatment route B, and a third person can do this Follow path C, all based on your assessment of what we can do with virtual reality. So it's a research project, but based on the vision that we can use not just virtual reality technology, but also sensor technology, biosensor technology, and machine learning technology to find a better way to tailor our medical interventions to the specifics to be cut individually.

Alan:It's unbelievable. You talk about the three pillars: training, evaluation and intervention. But one of the things I think should be on the review page is the ability to visualize your data. As a doctor, we're just scratching the surface, when we can get data from an MRI and zoom in and go there, I think we're just scratching the surface. Have you seen real medical data visualization applications unique to virtual reality and augmented reality?

Walter:Absolutely. For example, there are some groups that do virtual colonoscopies, where they collect the colonoscopy data, but sometimes they just collect it using an imaging device instead of doing the actual physical colonoscopy and then allow a doctor to fly through the colon. for Polyps Or the same for preoperative planning. We can take CT data, merge it with ultrasound data, merge it with other data, and plan a complex surgical procedure in advance. In this way, clinicians, not only the radiologist, but also the surgeon, can visualize in three dimensions and rehearse in advance the complex process they will have to go through in their surgery.

But I would also like to complement the pillars you mentioned. It is not just about training, assessments and interventions. I think AR technology will also be very useful for promoting health and well-being, showing us the effects of our behavior and encouraging us to do what we really need to do to stay healthy. It's really hard to exercise, eat right, remember to take your meds, especially when they have side effects you don't like, and understand the consequences of not following what you're supposed to be doing. do to stay healthy. A technique developed at the Stanford Virtual Human Interaction Laboratory was to create an image of your future self, an avatar of your future self that you could talk to and who could talk to you and follow you in less time to show you your decision. So if, for example, your smartphone recognizes that you're going to a bar and you've already decided that you really want to drink less, your phone might ring and there, on the phone, is your future self. Someone who looks like you, sounds like you, but is 20 years older and says, "Hey, I thought we talked about this. Look what you're doing to me." Or maybe, if you don't exercise enough or don't eat right, you can look very sick in your future self. The same problem with addiction treatment.

So I think wellness prevention is another pillar. I think another thing to keep in mind is I think VR and AR technology will allow us to reach underserved populations. I think the focus of care will shift from the clinic to where the individual is. Of course, there are some things you have to do in a specialist treatment center where there are special machines. But I think for many things, particularly behavioral medicine, psychology and psychiatry, we will be able to do a lot more to reach underserved populations and provide effective treatments through the nature of telemedicine using VR and AR technology.

Alan:Well, that's wonderful. It's a good ending to this conversation, because if we can use these technologies to democratize wellness and health, not just medicine, not treating people when they're sick, just keeping them healthy, then I think that's the outcome. Final. Changes we need to make as a society. And I think VR and AR contribute very well to that.

Walter:Well, and especially if we can follow the paths opened by our colleagues in the field of computer games. They know how to grab people's attention and engage them in a process. So if we look at how they've learned this in the game space and apply that to some of the interventions that we're doing in the medical space, I think we can make medicine not only more effective, but also more attractive and appetizing. .

Alan:And fun. Let's not spoil the fun. I mean on behalf of everyone in the audience, including myself. thank you dr Greenleaf for taking the time to be a part of this podcast. It was really amazing.

(Video) VRTO 2017 Conference Keynote - Walter Greenleaf "How Virtual Reality Will Transform Health Care"

Walter:Thanks Alan Thanks for all the good work you are doing. Spread the word and start asking good questions today.


1. Walter Greenleaf: Leading Technologies for Treatment
2. Walter Greenleaf on Digital Therapeutics, AR/VR, and sensor-driven health | ApplySci Silicon Valley
3. Virtual Medicine Conference 2019 Walter Greenleaf
(Virtual Medicine Conference)
4. Translating VR Research into Medical Impact
(medVR Medical XR Bootcamp and Accelerator)
5. Dr. Walter Greenleaf - Keynote - Direct Supply Technology Symposium 2016
(Direct Supply)
6. ChangSchoolTalks 2018: Walter Greenleaf
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