Bringing in new technology can be a great way to differentiate your practice, add new patients, and subsequently improve patient outcomes and revenue. In today’s article, we are going over how to add virtual reality into your practice and why this could be a novel approach to helping grow your clinic and patients!
What is virtual reality?
Virtual reality is where a headset is worn that contains a small screen that allows the viewer to immerse themselves in a different setting where potentially they do not have the physical limitations they currently have.
Virtual reality is still a relatively new medical treatment and technology, with new companies, new software, and new research coming up all the time.
You can use virtual reality in neurologic, orthopedic, chronic pain and so many other types of patients. A short list of examples could include:
- Stroke
- Amputation
- Spinal cord injury
- Traumatic brain injury
- Multiple sclerosis
- Parkinson’s disease
- Failure to thrive
- Chronic pain
- PTSD
- Balance conditions
- Vestibular conditions
- Autism
- Developmental delays
- Cerebral palsy
- Many pediatric conditions
- And really anyone could benefit!
How would you use virtual reality in your practice?
Virtual reality can be used for many diagnoses and for many purposes. Perhaps you have an unmotivated patient, have them put on the headset and have some fun playing a bowling game. They won’t even know that they are bending, twisting, and moving their arms and legs.
Perhaps you have a patient with a recent amputee who has phantom limb pain or has just received their prosthetic. You can use virtual reality to help the client move their amputated limb and feel like he has his limb back.
Perhaps you have a patient with a spinal cord injury and poor trunk control. You could have them sit unsupported while wearing the VR headset, and have them go shopping – reaching for objects, while trying to maintain balance.
Some of the physical movements performed when wearing the virtual reality headset may be the same as without the headset, but you now can place them in a more realistic environment that mimics a functional day like shopping, moving around in the home, driving vs just being in the clinic. It also may be the same, but when you are playing a game, all of a sudden, a task that are hard become easier, and virtual reality can change the mindset of the person performing the “exercises”.
What are some companies that could you use for virtual reality?
There are several ways you could offer virtual reality in your clinic. One way would be to buy a headset, usually the Oculus headsets are the most recommended, are they run between $300-500 one off cost. And then you can pair that with the various apps you may find on the app store here https://www.oculus.com/experiences/quest/view/777073612853145. There are guided meditation, Les Mills workout, Holofit, fishing, and tons of other apps that are either free or very low cost.
The 2nd way to provide virtual reality is through companies such as Neuro Rehab VR (https://www.neurorehabvr.com/). The one con of this is that this software can be very expensive and often comes at a monthly cost. But the pro is that this was created for healthcare environments and includes more specific healthcare metrics and settings.
What do the studies say about virtual reality in the therapy practice?
There is still relatively limited research about the effects of virtual reality in a variety of settings and diagnoses. But there was a positive study published on June 2019 in the Medical Science Monitor that compared standard physical therapy to virtual reality for patients with Parkinson’s suffering from gait and balance deficits. (Feng H, Li C, Liu J, et al. Virtual reality rehabilitation versus conventional physical therapy for improving balance and gait in parkinson’s disease patients: a randomized controlled trial. Med Sci Monit. 2019;25:4186-4192. doi:10.12659/MSM.916455). Of the 28 patients followed for 12 weeks, both studies showed improvements but the VR group showed greater improvements, especially in the Unified Parkinson’s Disease Rating Scale and especially when over 150 hours of VR training was provided.
There was also a meta analysis in vestibular rehabilitation that found that over 7 studies, the use of virtual reality was safe and effective in reducing vertigo symptoms and balance deficits in vestibular patients. (Bergeron M, Lortie CL, Guitton MJ. Use of virtual reality tools for vestibular disorders rehabilitation: a comprehensive analysis. Advances in Medicine. 2015;2015:1-9. doi:10.1155/2015/916735)
Although more research is needed, there are quite a few research articles and also personal testimonializes of it’s effectiveness. The one downside is that virtual reality doesn’t yet have clinical practice guidelines that outline duration, frequency, and other specifics but that will likely be challenging as this can vary so much from a patient to patient case.
What to charge and would insurance accept virtual reality treatments?
Virtual reality can be performed within cash practices very easily and what you would charge can really vary based on your comfort, the cost of living in your area, what competitors are charging and perhaps also the benefit you’ve found within your other patients.
We’ve seen practitioners charge the same as normal therapy sessions that do not use VR or charge more and include a virtual reality kit they’ve created.
Insurance may also reimburse you for virtual reality treatments if documented appropriately, although right now it appears that only 17.6% of providers are able to charge for these sessions (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259364). Companies like XR Health have created a whole business solely around virtual reality and have both cash and in network insurance providers that they bill. In 2019, there were new codes that help to account for use of digital solutions in medical care – you can see our remote codes guide here that may help with the insurance reimbursement for virtual reality.
Summary:
Virtual reality is a novel way to improve your patient results, differentiate yourself from other practices, and attract new patients with your devotion to innovation patient care. There is still a lot more research and guidelines needed to help with a clinic’s confidence in VR, but if this is conducted in a supervised session, this could really make a difference in your patient’s lives and your clinic will hopefully benefit too as a result!