July 31, 2017 SARAH MAHONEY
What's new about recent VR and tech innovations is that they attempt to “treat” empathy rather than conditions themselves.
It's no secret that American healthcare suffers from an empathy deficit. While brusque doctors have been blighting patient-satisfaction surveys for years, providers themselves increasingly say it's a problem: In a Harvard Medical School survey, 53% of doctors reported declining levels of patient empathy.
Pharma is increasingly unhappy with the status quo. In conjunction with their health-tech peers, more organizations are leaping into the empathy breach, using new approaches that go beyond the emotional and theoretical underpinnings of human kindness.
Rather than asking non-patients to imagine what it's like to have Parkinson's disease, Klick Labs' SymPulse tele-empathy device wirelessly transmits patient tremors to another individual so that person can try to clutch a coffee cup with trembling hands. Similarly, Embodied Labs' Alfred Project VR experience recreates the isolation that comes with hearing loss and macular degeneration as felt by a 74-year-old man. And Sanofi Genzyme, which markets Lemtrada and other MS drugs, based its Impact of MS Experience, a computer challenge to help doctors, around feeling the frustration of early disease symptoms.
While the conditions and technologies differ, the so-called empathy machines approach their task from the same philosophical place: That experiencing illnesses from a patient's point of view can help providers and caregivers better understand an illness, which in turn should increase both their empathy and effectiveness in their roles.
It would be easy to credit the wave of new approaches to the headset-obsessed world of Silicon Valley, but these interventions actually owe more to breakthroughs in the science of empathy itself. There's growing proof that empathy pays off for healthcare: A recent Massachusetts General Hospital study found that 65% of patient satisfaction — now linked to reimbursements in many cases — is attributed to physician empathy.
And while experts once believed some doctors were either blessed with empathy at birth or destined to go through life alienating patients, there's now solid evidence HCPs can learn to be more empathetic. That research, pioneered by Harvard Medical School associate professor of psychiatry Helen Riess, M.D., is turning up plenty of information about the physiological underpinnings of empathy.
“We looked closely at doctor-patient interactions and realized their distress in difficult interactions mirrored one another,” she explains. “As doctors, we need to learn to practice self-regulation in these encounters so we aren't so emotionally hijacked ourselves.”
In the wake of her research, Riess cofounded Empathics, a Boston-based firm that creates tools and training materials to increase provider empathy. One of the tools provides concise bite-size coaching via a mobile app.
HOW TECH FACILITATES FEELING
VR and other tech innovations already have a host of medical uses and have invaded popular consciousness: A VR game that treats military-related PTSD even plays a supporting role in the latest season of House of Cards. But what's new about these efforts is that they attempt to “treat” empathy rather than conditions themselves.
Klick VP Yan Fossat believes these empathy boosters have plenty of potential in and around healthcare. He says Klick decided to focus on Parkinson's because, while it affects about 10 million people in the U.S., “so much of what has been happening in the wearables space focuses on heart rate and there's been very little in movement disorders. The technology was ready for this.” Klick has begun a clinical study to measure the amount of empathy SymPulse creates in doctors and nurses, which Fossat says makes it the first medical device to be examined for this purpose.
On the other hand, Acadia Pharmaceuticals' Parkinson's empathy effort focuses on the psychoses that affect as many as 50% of patients. Its project uses Oculus Rift headsets to simulate the sound of someone trying to break into a patient's home in the middle of the night — even as the patient's partner keeps insisting nothing is wrong. The experience is meant to be unsettling and frightening. But what's key from an empathy perspective is that observers watch as others try it out and see the very real fear on their faces.
Not all empathy experiences are this high-tech. For example, Sanofi rejected the use of VR for its Impact of MS Experience and instead offered a two-minute laptop-based medical adventure. Impact of MS asks people to perform short basic tasks while a timer is running and obstacles are put in their path. For example, they need to compose an email, but their vision is distorted and the keyboard misbehaves to mimic the tactile problems that can occur.
“The disconnect between patients with early multiple sclerosis and providers is a big problem,” explains Erin Fawcett, senior account director at Invivo Communications. “That's because, to a large extent, those symptoms are invisible — blurred and jumbled vision, for example, and difficulty with cognitive functioning.”
Doctors tend to dismiss them as minor, since patients are still walking and working. As a result, they miss just how anxious these new symptoms make patients feel.
Of course, the whole “walk a mile intheir moccasins” approach is hardly new: George Orwell lived as a tramp to chronicle poverty in Down and Out in Paris and London way back in 1933, while John Howard Griffin medically darkened his skin to write Black Like Me in 1961. And healthcare has long had a soft spot for empathy gimmicks, with childbirth instructors strapping cumbersome “empathy bellies” onto expectant dads and hospitals encouraging physicians to don fat suits to better relate to the obese.
But VR is spurring new thinking about empathy. One example is Clouds Over Sidra, a United Nations-produced film about refugees that has generated more buzz than many big-budget action movies.
THE CASE AGAINST "FAKE EMPATHY"
That new thinking, of course, has some tech experts crying foul. Robert Yang, a game developer and professor at New York University's Game Center, wrote in a recent blog post that the lauded U.N. film “is an extremely cynical use of pain and suffering” to sell people on the power of VR. Walking a mile in someone's shoes, he argues, sometimes comes dangerously close to simply appropriating their shoes.
“Medical applications might be different, since they are talking about very specific relationships and often very specific symptoms,” he says. “That's different than some abstract political empathy that doesn't even involve a real person.”
But just as a refugee might object to the idea that a nine-minute “experience” can approximate what it's like to be displaced, pharma needs to be careful not to presume that simulated symptoms can truly teach them what it feels like to be sick. GlaxoSmithKline's Excedrin received plenty of kudos for its Migraine Experience, an augmented-reality effort aimed at consumers. But the program generated its share of backlash, too.
“If you don't get migraines, you'll never understand how excruciating they are,” wrote blogger Sarah Emerson. “Sorry, but unless you've ever had your face in a toilet, throwing up because the blinding pain running up your neck and out of your eyeballs became too painful to internalize, I doubt you'll get it.”
And that, points out Invivo president Andrea Bialecki, continues to be the major stumbling block. “One of the greatest criticisms of experiences meant to build empathy is that there is no way to convey pain in virtual reality,” she explains. “And pain is something patients really want doctors to understand.”
http://www.mmm-online.com/technology/pharma-vr-technology-patient-empathy-rx/article/678054/
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