Last weekend saw NHS Hack Day London 2016. It was right in the middle of all my coursework deadlines, but there was no way I was missing it.
Saturday morning arrived and despite a rubbish night’s sleep I was excited to get going. When I got to King’s College the room was already buzzing. I spotted Simon who I had worked with last year and made a beeline for him. We had a great catch up and discussed continuing the project we had started together. There seems to be some pretty exciting developments and I’m looking forward to spending more time on it!
Then, the pitches started. There was some great ideas pitched including ‘beat the bleep’ an alternative to the bleep system used in hospitals, a CBT app, a low maintenance solution to patient records in field hospitals during highly contagious epidemics such as Ebola.
The one that caught my eye was looking at the use of virtual reality in a clinical setting.
Keith was originally asking for developers to create, from scratch, a 360 video viewing app which he could use in his practice.
A group of us were interested in getting involved but our skills didn’t really match his initial idea. After a lot of feeling like spare parts and chatting we finally decided that we could focus on the use of VR in clinical settings and settled on exploring how available consumer VR technology could be used to manage phantom limb pain in amputees.
We managed to come up with a few different ideas of how VR could be used in a clinical setting and experimented from there.
- The first technique we attempted was to record Keith moving his hands using a Rico Theta S camera mounted the Gorrillapod and duct taped onto his chest. We then tested this out using the Samsung Gear VR to see how it would be to look down and see our own arms replaced by his doing movements.You can see the videos and/or try them at home with your own VR headset here.
It was bizarre. You looked down and could tellthat the hands in front of you weren’t yours but as they moved there was a weird sensation in your own arms and they would move in a similar way. Odd. Very odd.
- The second idea we tested was to create a low fidelity 3d animation of a persons legs. A few of us tried our hand at Unity to do this but with no luck. I got close but it wasn’t what I wanted. In the end I convinced Mussadiq to download 3DS Max onto his laptop from my autodesk account since I am now fairly confident using that software. We then create a 3d representation of legs doing exercises filmed from a human perspective. We had issues with exporting this in 360 degrees which was frustrating, so couldn’t test this using the VR headset.
- Our next idea was to see if we could use virtual reality as a form of analgesia through distraction.To do this Keith and myself volunteered to do a Cold Pressor Test. This involved placing one hand into a bucket of cold water and ice and timing how long we can last.We then repeated this (after our hands had recovered!) but this time whilst wearing the Samsung Gear VR headset and watching a recording that we had filmed earlier (of our hands in the bucket without the ice water, again using the Rico Theta 360 camera).You can see the footage of me attempting to hold my hand in ice here.
The results were really quite interesting – I had originally managed to hold my hand in the ice for 1 minute 30 seconds, whilst Keith accomplished 1 minute 11. They then both lasted a full 2 minutes longer with the use of virtual reality.Out of curiosity we also tested Reno with his hand in the ice water and watching a VR film. He lasted a full 4 minutes 22 before we got worried about his hand and pulled it out. He reported that during this experiment he not only forgot about the pain in his hand but also the pain he had been suffering in his back. One thing he did note that was when he looked down he couldn’t see his hands and that this pulled him out of the experience and triggered some pain.
These experiments show some real potential for the use of distraction therapy in painful procedures (such as wound packing) in particular.
- We decided that in the case of phantom limb pain an idea would be to recreate mirror therapy but using a more immersive VR experience. To do this we trialed recording a 360 video of Keith doing arm exercises. We then edited the footage in Adobe Premiere Pro to add a mirror effect vertically through the centre of the film. This had the effect of duplicating his left limb on the right hand side. When using the VR headset this then gave the impression of having two arms.It would be important to make it as similar to the person’s real limb as possible. Therefore, this could be used with patients over a period of time where you record them doing certain exercises using a 360 video device, the footage is then taken away and edited to include the mirror effect and then used with the patient at a later date.Going forward this is something we would like to test with patients suffering from phantom limb pain.You can try the video out for yourself at home if you have a VR headset from here.
- We spent some time trying to mirror live streamed footage from the Ricoh Theta S to the Gear VR Headset but sadly found the the lag in transmission meant that this was ineffective in our tests.
You can read the full details of our project at virtualanalgesia.net
Then it was time to pitch. The progress groups had made on their projects was amazing. Some of my favourites included:
- A CBT web app – which you can view here
- Daily Pollute – an app to track daily pollution exposure.
- A digital anesthetic chart
All in all a pretty fascinating weekend for me, surrounded by really lovely and interesting people from all walks of life. I’m already looking forward to the next one.