Virtual world healthcare has real world benefits, Toronto researchers find

The Women’s Health Center at the Ann Myers Medical Center might be a virtual healthcare facility, but the nurses and physicians that volunteer here are real. They work here to reach out beyond the physical boundaries of the hospital and work past the innate discomfort of demonstrating good technique for self-examination mammograms.

Note cards are given out to each visitor explaining the importance of these self-examinations. Another room contains an accurate model that represents a mammogram machine.

Avatars can walk through the process of using it while tour guides encourage taking these virtual experiences to the next level and doing them in real life.

“If you have to get a mammogram and you can walk through the process before it happens, it may help you get more informed and ask more reasonable questions of your healthcare practitioner,” says Dr. Jennifer Keelan, with the Dalla Lana School of Public Health at the University of Toronto. “I’ve never been taught to do a breast self-exam before. I found it interesting as a woman to go through that exercise, and I think the detail was sufficient for a person to try in real life.”

University of Toronto researchers put their avatar through the paces of a virtual mammogram.

In the most recent Journal of Medical Internet Research the University of Toronto contributes a study that takes an in-depth look at the healthcare activities taking place in Second Life.

Authored by student Leslie Beard and supervised by Keelan, the study takes stock of 68 virtual sites where health is being taught or supported. Even if healthcare is conducted in a virtual world, it may have real world applications.

Of those 68 sites, 34 are taking part in health education or awareness raising activities just like the Ann Myers Medical Center.

Health researchers believe that the Web 2.0 world may be able to teach them something that the medical industry has never been able to master — the ability to make people feel comfortable and at ease when dealing with their own health.

Second Life was released in 2003 by San Francisco-based Linden Labs. About 16 million people have created 3D avatars that are virtual representations of themselves – though they look completely different. In this 3D world, users can rent out space and exchange original currency in transactions. They can create their own clothing and determine their own appearance. They can create their own buildings and objects, and tell them how to behave.

Now, that world may be a new domain for healthcare.

“It is one of those sorts of application areas where there are more advantages than others in using a virtual environment,” says Steve Prentice, a vice-president at analyst firm Gartner Inc. “You avoid the embarrassment issues and privacy issues of doing things face to face.”

Second Life allows people to gain a contextual understanding of things, he adds. People can look at the layout of a virtual hospital ward and practice interacting with the virtual equivalent of a medical tool. Then when they go to face the real thing, it doesn’t seem too daunting a task.

Prentice, who is based in the U.K., covers virtual worlds and is quick to point out they are inhabited with fewer residents than you think. Although 16 million user accounts have been created, only about 1.4 million users have been active in Second Life over the past 60 days. So there’s only a small number of people using this for healthcare purposes, but it is worth an exploration by institutions.

“A whole range of areas are now seeing a slow yet steady move towards virtual presence,” he says. “Businesses are saying they’re no longer prepared on spending time or the money sending people to a meeting when they can do it remotely.”

Of course, virtual worlds aren’t the only option for remote meetings.Video conferencing or Web meeting products are well-known and more popular in the business world. But a certain combination of features and qualities might make the virtual world setting the right place for healthcare collaboration.

“We’re already using teleconferencing to connect people but this may be an easier platform for trying to coordinate,” Keelan says. “You can leave messages and drop in at odd hours. It could increase connectivity.”

Anyone with a fairly modern PC and an Internet connection can access Second Life. That makes it ideal for healthcare professionals who are often working while on the go, and might only get a chance to check in with messages late at night or early in the morning.

For patients, Second Life forces anonymity by assigning a last name based on a limited list. This alias and the avatar that comes with it creates a level of abstraction that can often lend confidence to those who want to explore health-related issues that are sensitive in nature. The University of Toronto study found that support group sites were the second-most common type of health site in Second Life, with 14.

Anonymity may explain why the Transgender Resource Center – Peer Support & Social Activism site is so popular. It was one of the most trafficked sites found by the study, with 2,313 minutes spent there by unique avatars on Dec. 18, 2008. (That was the date selected by researchers to gauge snapshot popularity of the sites.)

“Every time our avatar entered the site, there was another active avatar there,” Keelan says. “Often, you’ll find sites deserted. But this one had an enormous amount of activity.”

Volunteer support workers fill the site, ready to provide information to the transgendered and family members. A room full of seats has a large screen, where the trailer for the movie Transamerica can be viewed. It helps normalize the experience.

“It provides an opportunity for very sensitive health issues to be explored,” Keelan says. “Particularly in the U.S., where seeking health information can sometimes have expensive insurance implications.”

Virtual support groups can also make it easier to meet for those who are challenged with mobility or live in remote areas. It is often a less expensive way to meet, and can be accessed at any time to create for spontaneous support experiences and less formal groups forming around common healthcare scenarios.

Of course, Second Life’s real draw for physicians may be simply the same as for may users – a pretty good approximation of the human body. Albeit in a sort of cartoon representation.

“The cartoon nature makes it easier sometimes,” Prentice says. “If you start showing real breasts, then people are going to start having issues.”

But the realism is still decent enough, he adds.

“There’s quite a lot of mobility of body parts in Second Life, although it’s not an area that I’ve explored in detail,” he says.

At the University of Toronto, the research report may lead to a virtual home to call their own in Second Life. It has applied for a research grant to build on a virtual island and staff it with on-hand physicians.

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