Augmented reality: the potential is unreal

The success of augmented reality games like 'Pokémon Go' has presented a huge opportunity for healthcare. There is strong evidence that the use of media can improve healthcare outcomes. 'Pokémon Go' has succeeded in mere days where concentrated efforts in public health have met mixed success for years, getting people exercising. Believe it or not, augmented reality applications have been around for years and we have only seen the tip of the iceberg. What is below the surface may be marvellous.

What is augmented reality?

'Augmented reality' applications work on the premise of utilising technology to superimpose artificial information (be it images, sound or other) on the world in real time through a 'display' unit. The simplest example is a phone camera taking an image of the world, the program placing an animated 'animal' in the foreground, and presenting the combined image on the phone screen as 'real.' This technology is not limited to visuals, but can utilise any technology attached to the device (for example, sound). This is aptly demonstrated in 'Pokémon Go'.

There are already more complicated examples where the use of information projected within a screen in real time has allowed for medical success. Early trials using guiding 'hands' during surgery where an experienced surgeon can beam an image of his hands into a colleague's visual interface have already been used successfully. The surgeon operating simply wears a screen over his eyes that show both the real world and the augmentation. Google glass promised similar advances, allowing you to bring up information on a person via facial recognition, which could be very useful in clinical situations.

Why is augmented reality exciting in medicine?

Any new technology will drive advances in healthcare, both in and outside of the hospital. The use of interconnected data sources, visual displays and real-time monitoring has allowed doctors to better treat patients for years. Imagine a surgeon who can project a high resolution MRI image of a patient over their body whilst they operate, or a resuscitation officer who can see the patient's ECG in the corner of their glasses, whilst monitoring the rate of drug input. Data in any form guides healthcare decision-making and improves outcomes, and better access can only assist further.

Simple examples of augmented reality apps like 'Pokémon Go' utilise gaming to generate interest, encouraging exercise to complete tasks. This could encourage exercise in users who may otherwise be too self-conscious to attend a gym or participate in any formal exercise regimes. It's not only targeting children, either.

Early demographic data suggests that 40% of adult users in the U.S. are over the age of 25. This degree of 'light exercise' uptake is unprecedented in the video game industry and could lead to a significant impact on cardiovascular disease statistics in the future. With a nation battling obesity and associated comorbidities, any way of motivating change must be beneficial.

Future technology could utilise a wide range of patient-led initiatives using up-to-date information. The use of a surrogate physiotherapist, allowing your phone to monitor the form of prescribed exercises and recommend new ones based on your physician or therapist, would improve the treatment of joint pain and reduce need for hospital appointments. It seems that we are not far away from prescribing an app to optimise treatment.

Imagine now the use of augmented reality in learning. Anatomical models projected over moving figures could help build the surgeons of the future. Quick reference to a patient's most recent observations, sent via a pair of glasses or phone, could help physicians identify decline earlier. Exercise applications could have you chase a virtual opponent. Food applications tell you the calorie content of a burger and recommend an alternative down the street. Information would help you make healthier choices and keep your doctor sweet. An augmented apple a day…

The greatest value of these ideas is that collected data would allow for up-to-date and detailed monitoring of success, far beyond what is achievable in intermittent appointments. The limit is really the technology and imagination. I'm sure you have a few ideas already.

What does the future hold?

Technology advances at a runaway rate. We are already seeing early trials in using brain electricity to create images and guide robotic apparatus. Combine this with augmented reality using up-to-date information with portable visual and sound devices and you have some idea of where we are going. Your future surgeon could take out an appendix from his lounge.

There are limitations and some risks. There is fear that spending time in a virtual world may remove people from reality and create a fear of living without augmentation. Although this fear has some basis in those 'living' in huge online multiplayer games, the risk must be weighed against potential benefit and trust placed in patients. All new technology can be abused and misused. The vast majority of those using online games and applications are healthy and we must remember that people can live their lives how they want.

Another more practical risk is the level of data and power needed for real time applications. Privacy concerns are a real issue and the need for high performance batteries and long-life devices may exceed current technological ability. These are issues that will have to be ironed out in the future, and we can anticipate a stormy legal climate for a time. Regardless, early work and the huge success of simple augmented reality applications presents a real opportunity for healthcare growth. The financial savings to the NHS and profit to developers present incentive to policy makers.

The only limit is imagination. The rest will follow.

Any opinions above are those of the authors alone. Guidance is based the best available evidence at the time of writing. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice. There are no conflicts of interest.


Dr Ben Janaway MBChB is a young NHS doctor in the Southwest. His interests include neurology, health communication, and medical ethics. He is also an avid advocate of compassionate care and quality improvement, running a project in the Southwest around medical humanities. Please follow and support: Dr Janaway on Facebook Dr Janaway on Twitter

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