Blog: The Five Ways Augmented Reality (AR) will Disrupt the Care of Vestibular Disorders
Dizziness related disorders are one of the most common forms of disability impacting quality of life today. Prevalent more among adults as they advance in age, dizziness has become one of the most commons type of chronic disabilities, affecting between 9-11% of the population. Vestibular disorders that reduce cognitive function and balance result in over 7.5 million new patients per year. Despite the complexities and difficulty many Audiologists, Otolaryngologists, and specialized Neurologists face with making a complete and accurate diagnosis, 95% of patients are ultimately referred to a physical therapist post diagnosis, many of which require extensive rehabilitation periods of up to 12 weeks. Overall, this places a tremendous burden on the healthcare system, for a complex condition with limited diagnostic and therapeutic solutions.
Medical centers providing elite standard of care for vestibular disorders are uncommon, however demand for care has continued to rise based on the growing prevalence. Many patients, when symptoms emerge and care is sought, are placed on a waiting list for up to six months, after seeing their Primary Care Physician (PCP). At the time of their visit, they are often required to be driven to multiple appointments by a family member, with both an Audiologist and Otoneurologist or another specialist. In total these appointments can last over 90 minutes.
Nystagmus based assessments are common in the workup of vestibular disorders. These are often conducting using Videonystagmography (VNG), a device that is equipped with video enabled infrared goggles that are connected to a nearby laptop computer. The VNG records the eye movements looking for the presence of involuntary eye movements while the clinician manually performs a series of assessments. After 20-30 minutes, the assessments are completed, and the Otoneurologist reviews the eye movement records to arrive at a diagnosis. Even with the aid of the VNG, specialists often feel that arriving at an accurate diagnosis in one visit is an extremely difficult process.
Augmented Reality (AR) use cases in healthcare are growing by the day. Their sleek design, wireless remote form factor, and long duration wear capabilities represent an opportunity to improve service delivery for a growing number of common disorders, including vestibular conditions that are highly prevalent but difficult to diagnose. However, there are a myriad of benefits that advanced technologies like AR can bring to vestibular diagnosis and treatment, with the most impactful discussed herein.
Clinical Workflow Automation
Currently, nystagmus-based evaluations are conducted manually by the clinician, while the VNG records the patient’s eye movement response. Developing a sophisticated digital workflow for the clinician that executes their preferred test battery is possible in AR, all at the push of a button. This would save valuable clinician time, and improve patient throughput, likely positively impacting the wait times for the most severe disorders that require triage for a more immediate evaluation.
VNG systems do not provide robust quantitative measures of dysfunction and severity of disorder, largely because data collection can be compromised with certain head motions and eye and facial structures. This requires the clinician to rely on more qualitative data (patient history, symptoms, etc) when making diagnostic decisions, a process that would be eliminated with AR. With robust eye gaze metrics included with infrared video capture, clinicians can make more specific decisions based on objective data, resulting in a more specific prognosis and treatment plan.
In many cases, the patient is responsible for providing much of the qualitative information during their specialist appointment. PCP medical records, including patient history, as well as intake forms and other evaluations performed at other specialist appointments like a neurologist or audiologist. Typically, front office staff and administrative personnel must gather this information in advance of the testing appointment to provide additional data the clinician will use to support the diagnostic and therapeutic decisions, including the patient’s candidacy for various medications. This process could be mitigated with AR, as many systems come equipped with HIPAA compliant cloud-based data storage and high-capacity API integration. This would enable a centralized integration for patient information and test results.
Due to their easy portability, AR headsets are the perfect patient monitoring tool. As many vestibular sufferers can attest, attacks of vertigo and other disorienting symptoms often occur episodically in the home and not at the physician’s office, making it more difficult to capture and effectively categorize. AR changes the entire system for how vestibular specialists can make effective diagnoses by augmenting the pre-visit requirements. Providing a home use headset to capture the automated test battery will allow the clinician to make the diagnosis right after it happens by sharing test results through remote access or enabled API. This in effect could allow for better prioritization of more severe patients, expedite the intake process, and get patients the most appropriate therapies immediately. Telemedicine also has a role to play in further monitoring the effectiveness of therapies while reducing patient wait times.
Today, AR devices are available for approximately one tenth the cost of traditional nystagmus based diagnostic medical devices. As AR systems develop more diagnostic utility, and specific therapies are utilized within the headset, the value of the platform increases, allowing for a more centralized ecosystem of data collection and sharing between the patient at home, the physician monitoring the patient, and the physical therapist guiding the rehabilitation process. AR will undoubtedly become a more cost-effective mechanism for ensuring the full integration of care providers treating a single patient.
There may be no better match for AR in healthcare than that of the many vestibular disorders that plague so many of us each year. Its technical capabilities will unlock a new standard of care and streamline a process for clinicians and providers that is ripe for disruption.