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"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012

Pavarti Dav speaks about "Virtual Environments for Healthcare" at the 2102 Serious Play Conference ABSTRACTS: Healthcare training is an apprenticeship when so many other professions have incorporated simulations and virtual environments for their training. Flight simulation for pilots is so powerful that a pilot trained on a simulation of a new plane is considered competent to fly the real plane for the first time with a full load of passengers and cargo. What should virtual environments for healthcare look like, be capable of, encourage, constrain? What are the barriers to use? We will explore these questions and examine the current status of healthcare virtual environments.

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"Virtual Environments for Healthcare" By Pavarti Dav- Serious Play Conference 2012

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  1. Virtual Environments for Healthcare Parvati Dev, PhD CEO, CliniSpace www.InnovationInLearning.com www.clinispace.com

  2. My co-pilot has never flown this model of plane before … … but I have flown 200 hours on the simulator and am certified for this model 2 © 2012 IIL Inc. Serious Play, August 21, 2012

  3. My resident has never done this surgical procedure before … … but my chief is watching me very carefully as I do it. 3 © 2012 IIL Inc. Serious Play, August 21, 2012

  4. WHY DOES THIS MATTER ? 4 © 2012 IIL Inc. Serious Play, August 21, 2012

  5. The Cost in Life and Money The cost of medical errors is huge – $22-38B (source: AHRQ) An example – Septicemia – 2% of hospital discharges in the U.S. include septicemia – Average charge is > $60,000 per case Prevention requires systemic change through training – One case prevented can pay for the training Prevention training is difficult Knowledge, Skills, ATTITUDE requires emotional engagement Learning through Role playing is emotionally engaging 5 © 2012 IIL Inc. Serious Play, August 21, 2012

  6. WHY VIRTUAL ENVIRONMENTS MAY BE THE BEST APPROACH TO ENGAGEMENT 6 © 2012 IIL Inc. Serious Play, August 21, 2012

  7. Medical Training Current approach: – Classes, e-learning, manikins, standardized patients – Problems in scalability, expense, lack of engagement 7 © 2012 IIL Inc. Serious Play, August 21, 2012

  8. Virtual Environments are immersive And immersive experiential learning Is DISRUPTIVE 8 © 2012 IIL Inc. Serious Play, August 21, 2012

  9. So immersive that it’s real Comm. of the ACM 9 © 2012 IIL Inc. Serious Play, August 21, 2012

  10. Virtual Emergency Room Environment 10 © 2012 IIL Inc. Serious Play, August 21, 2012

  11. HOW EFFECTIVE ARE VIRTUAL ENVIRONMENTS ? 11 © 2012 IIL Inc. Serious Play, August 21, 2012

  12. The Data Show . . . Comparison of Team Leadership Before and After Practicing Four Resuscitation Scenarios on a Human Patient Simulator (HPS) or in an Online Virtual Emergency Department (VED) with Virtual Patients

  13. WHAT ARE VIRTUAL ENVIRONMENTS ? 13 © 2012 IIL Inc. Serious Play, August 21, 2012

  14. Scientific meeting in World of Warcraft (May 2008) 14 © 2012 IIL Inc. Serious Play, August 21, 2012

  15. Azeroth 15 © 2012 IIL Inc. Serious Play, August 21, 2012

  16. Scientific meeting in World of Warcraft (May 2008) 20 JUNE 2008, VOL 320, SCIENCE, www.sciencemag.org 16 © 2012 IIL Inc. Serious Play, August 21, 2012

  17. ‘Congressional Hearing’ in Second Life 17 © 2012 IIL Inc. Serious Play, August 21, 2012

  18. PROTOTYPE VIRTUAL ENVIRONMENT Forterra, 2005 Multi- casualty Incident Training Event @ Stanford – 2005 Multi- player, Online Game Technology by Forterra – 2005 18 © 2012 IIL Inc. Serious Play, August 21, 2012

  19. CliniSpace Virtual Emergency Department 19 © 2012 IIL Inc. Serious Play, August 21, 2012

  20. COMPONENTS OF A MEDICAL VIRTUAL ENVIRONMENT 20 © 2012 IIL Inc. Serious Play, August 21, 2012

  21. RE AL I S TI C C L I NI C AL S PAC E S , I NC L UDI NG I N BATTL E FI E L D 21 © 2012 IIL Inc. Serious Play, August 21, 2012

  22. PHYS I C I AN, NURS E , THE RAPI S T, PATI E NT, S O L DI E R, BABY AV ATARS 22 © 2012 IIL Inc. Serious Play, August 21, 2012

  23. V I RTUAL PATI E NTS , DYNAMI C PHYS I O L O G Y AND AC TI O NS 23 © 2012 IIL Inc. Serious Play, August 21, 2012

  24. V I RTUAL O BJ E C TS THAT I NTE RAC T WI TH PATI E NT AND E AC H O THE R 24 © 2012 IIL Inc. Serious Play, August 21, 2012

  25. C AS E AUTHO RI NG , US E R AC TI O N TRAC KI NG AND AS S E S S ME NT 25 © 2012 IIL Inc. Serious Play, August 21, 2012

  26. Example of use http://vimeo.com/41082428 26 © 2012 IIL Inc. Serious Play, August 21, 2012

  27. INTERMEDIATE QUESTIONS 27 © 2012 IIL Inc. Serious Play, August 21, 2012

  28. ANOTHER WAY OF LOOKING AT VIRTUAL ENVIRONMENTS 28 © 2012 IIL Inc. Serious Play, August 21, 2012

  29. The Virtual Environment is the ‘System’ around the Virtual Patient Protocols, policies, rules People/ Team (real, computer) Devices, supplies, meds Virtual Virtual Patient Patient 29 © 2012 IIL Inc. Serious Play, August 21, 2012

  30. The Virtual Environment is the ‘System’ around the Virtual Patient It is the “theater” -- environment -- within which you can “role play” Protocols, policies, rules The “virtual patient” may play a Key or a Supporting Role People/ Team (real, computer) Devices, supplies, meds Virtual environments extend the usability of virtual patient Virtual Virtual Patient Patient 30 © 2012 IIL Inc. Serious Play, August 21, 2012

  31. THE ‘SANDBOX’ AND THE ‘CAMPAIGN’ 31 © 2012 IIL Inc. Serious Play, August 21, 2012

  32. Which one to build? Sandbox Campaign Explore the environment Unguided ‘play’ Automated responsiveness to player input Trigger actions cause game to advance – the ‘narrative’ Reward is in advancement – Levels, side missions – Earn badges and promotion – Compete with self, others, teams Carefully crafted ‘story’ Play has its own rewards – Engaging - Save the patient Environment rich enough to satisfy http://www.gamasutra.com/view/feature/4081/the_history_and_theory_of_sandbox_.php?print=1 32 © 2012 IIL Inc. Serious Play, August 21, 2012

  33. Our experience: Which one to build? Sandbox Campaign Unguided ‘play’ Environment must be rich enough to be satisfying Trigger actions cause game to advance – the ‘narrative’ Carefully crafted ‘story’ This is CliniSpace today CS BattleCare, etc Need much more content And still need specified goals Sub-goals, overall goal are liked But want some exploration ! 33 © 2012 IIL Inc. Serious Play, August 21, 2012

  34. BUSINESS MODELS FOR VIRTUAL ENVIRONMENTS 34 © 2012 IIL Inc. Serious Play, August 21, 2012

  35. System Overview Users Users Content Applications Platform 35 © 2012 IIL Inc. Serious Play, August 21, 2012

  36. Platform businesses Integration with other technologies (Characters with AI, Natural language processing) Trainers, curriculum Trainers, curriculum developers developers Customization (branding, layout, language) Users Users Further specialization (Equipment testing in virtual OR) Specialized worlds (medical, kids, adult entertainment) Specialized worlds (medical, kids, adult entertainment) - Simulations of disease, equipment - Simulations of disease, equipment Third Party developers Custom development Platforms New platforms (Second Life, OLIVE, Unity) 36 © 2012 IIL Inc. Serious Play, August 21, 2012

  37. CliniSpace: A Medical Platform 37 © 2012 IIL Inc. Serious Play, August 21, 2012

  38. Platform businesses Integration with other technologies (Characters with AI, Natural language processing) Trainers, curriculum Trainers, curriculum developers developers Customization (branding, layout, language) Users Users Further specialization (Equipment testing in virtual OR) Specialized worlds (medical, kids, adult entertainment) Specialized worlds (medical, kids, adult entertainment) - Simulations of disease, equipment - Simulations of disease, equipment Third Party developers Custom development Platforms New platforms (Second Life, OLIVE, Unity) 38 © 2012 IIL Inc. Serious Play, August 21, 2012

  39. BUSINESS ECOSYSTEMS 39 © 2012 IIL Inc. Serious Play, August 21, 2012

  40. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 “Normalize” very different people and activities so that they can exercise together Dynamic pathophysiolog y models Embedded knowledge (nursing, medical) 3D virtual sets for machinima Resell spaces – branded or white label Face Fitness support customization Behavior therapy Animations Virtual actors Therapy sessions Behavior alteration through avatar association 3D Increase engagement of traditional interactive content medical avatars Standardized role players Curriculum development Designing game or competition dynamic Greeters, patients, sales person Virtual goods Experience designer Actors for machinima movies Product design using VR/AR Automatic assessment of performance Adding sensor networks to worlds Medical furniture User- generated content Medical Platform Serious Play, August 21, 2012 40 © 2012 IIL Inc.

  41. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Resell spaces – branded or white label 3D virtual sets for machinima Standardized role players Dynamic pathophysiolog y models Virtual actors Actors for machinima movies Animations 3D medical avatars Greeters, patients, sales person Virtual goods Experience designer Medical furniture Medical Platform Serious Play, August 21, 2012 41 © 2012 IIL Inc.

  42. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Increase engagement of traditional interactive content Face Embedded knowledge (nursing, medical) customization Automatic assessment of performance Designing game or competition dynamic Curriculum development User- generated content Product design using VR/AR Adding sensor networks to worlds Medical Platform Serious Play, August 21, 2012 42 © 2012 IIL Inc.

  43. Ecosystem around a platform - from “Virtual World Monetization”, Stanford, 2010 Therapy sessions Behavior therapy Fitness support “Normalize” very different people and activities so that they can exercise together Behavior alteration through avatar association Medical Platform Serious Play, August 21, 2012 43 © 2012 IIL Inc.

  44. Distribution/Revenue Models Resell spaces – branded or white label courses Certification Grants and federal funding Per virtual patient per year Per clinical session per patient e.g. therapy subscriptions License for bundle of seats per year Per actor- hour Link with music and movie assets to drive serious uses Virtual goods Freemium Loss of federal reimbursement (Medicare / Medicaid) Medical Platform Rent a seat or space 44 © 2012 IIL Inc. Serious Play, August 21, 2012

  45. In conclusion …... Virtual environments can impact the cost of healthcare - By changing attitudes by training with role playing A virtual environment is an entire ‘system’ around a virtual patient (or patients) To succeed, virtual environments must scale up to include multiple business models and a business eco- system 45 © 2012 IIL Inc. Serious Play, August 21, 2012

  46. w w w . c l i n i s p a c e . c o m p a r v a t i @c l i n i s p a c e . c o m 2 0 1 2 , C L I NI S PAC E , I NC . © 46 © 2012 IIL Inc. Serious Play, August 21, 2012

  47. THANK YOU & QUESTIONS Slides are on SlideShare. Search for ‘parvatidev’ or ‘clinispace’ Email us at info@clinispace.com parvati@clinispace.com 47 © 2012 IIL Inc. Serious Play, August 21, 2012

  48. Useful Links: www.seriousplayconference.com www.seriousgamesdirectory.com www.seriousgamesassociation.com Contact: sbohle@seriousgamesassociation.com

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