Metaverse Hopes and Hazards

You can be forgiven if your understanding of the Metaverse is a bit hazy. There are as many definitions as there are tech journalists, UX designers, and swaggering entrepreneurs. Exactly what the Metaverse is depends largely on who you talk to and what they’re selling. As for its implications for healthcare, that, too, is hard to nail down. For sure there’s something there. Exactly what is open to discussion. So let’s spend the next few minutes exploring what the Metaverse is (sort of), what it means for healthcare now and in the future (maybe), its opportunities and risks (potentially), and what we can do to manage those risks (if anything).

Less a thing than a concept

The Metaverse has been described as the Web 3.0. It is a convergence of technologies that includes the internet, artificial intelligence, virtual reality (VR), augmented reality (AR), the internet of things, quantum computing, and robotics. Many add 5G, digital twins, and block chain to the list. What’s crucial is that these constituent technologies combine to enable a 3D experience, instead of the 2D experience of the internet that we now know. More succinctly, the Metaverse can be described as a parallel plane of existence enabled by all digital technologies. You know you’re in the Metaverse when what you are experiencing is immersive, interactive, and communal—with at least one other participant and potentially thousands. That’s about as clear a definition as you are likely to find.

Where will the Metaverse most likely take hold first? Its most obvious applications are in the gaming, fitness, socializing, retail, and virtual learning industries. That is not to say the Metaverse will be limited to those fields. Business leaders in just about every industry are taking note. And capital is pouring into Metaverse development from many different directions.

Last year, investors plunked down about $57 billion. That figure has more than doubled to $120 billion in just the first half of this year. Among those who see great potential in the Metaverse are healthcare executives.

Already and not yet

It’s early days, but the Metaverse is already making inroads in healthcare. One area where this is especially true is in medical education and training. For example, VR is now being applied to the training of surgeons. It takes a long time for surgeons to hone their skills in carefully controlled live-case settings. VR allows them to develop advanced skills at an accelerated pace.  VR shows much promise in other areas of physician training, as well as in patient education.

But it’s not just training and education. Before the pandemic, just 48% of healthcare facilities had a telepresence capability. Today, 95% do. That has opened the door to increasingly ambitious forms of telepresence. VR is now being used by psychologists and psychiatrists to desensitize patients with anxiety disorders by safely exposing them to trigger situations.

Extending the reach of physicians through telepresence is an important strategy in responding to the worldwide shortage of healthcare professionals. It may also prove to be a practical strategy for driving patient satisfaction scores and ultimately increasing revenue for providers. 

Gaming has been an important feeder industry for the development of the Metaverse. The technology that allows gamers across the world to interact in real-time within a shared environment also allows healthcare professionals to collaborate on difficult cases they might rarely come across in the clinic. The technology developed by gaming companies to realistically render human skin is now being applied in dermatology. These technological advances can help overcome the lack of reference cases involving non-Caucasian skin in the medical literature.

We’ve mentioned the use of VR in the training of surgeons. The Metaverse has also made its way into the practice of surgery. Last year, neurosurgeons at Johns Hopkins did their first operation with the help of an ARheadset. Surgeons are beginning to overlay digital twins on live patients to guide procedures involving tumor resection and spinal repair. Digital twins have also been applied to the treatment of patients with chronic pain.

But the full promise of digital twins is still a ways off. The holy grail is a highly personalized model of a patient corresponding to the precise details of his or her individual anatomy and physiology. It is hoped that such a model will one day allow physicians to virtually apply a treatment, hit fast-forward, then see what the outcome would be ten or fifteen years down the road. Better yet, digital twins could allow physicians to test-drive several different treatment options and see which would deliver the best outcome. That is the vision. But we’re not there yet.

Neither are we there yet when it comes to the Metaverse and patient information. One hope is that block chain technology will enable patients to have unhackable control over their medical information. But that hope remains in the offing.

Utopia or dystopia?

For all the hype and promise surrounding healthcare in the Metaverse, there are many unanswered questions and outright concerns. One fundamental question is, how will patients respond? Will they gladly embrace care delivered in a virtual 3D environment? Or will they always think of it as second best? That is a big unknown.

Another big concern is around equity. Since it is highly dependent on access to technology, will the Metaverse only serve to amplify existing healthcare disparities between the haves and have nots?

We know that the Metaverse will be built on the shoulders of the existing internet. But the internet itself is beset with major issues, including those related to security and misinformation. Will the Metaverse only serve to exacerbate these problems?

Breakthrough technologies always provide amazing new opportunities for human development. But they always come with a whole slew of unintended consequences. Perhaps one of the most devilish challenges of the Metaverse is the very unpredictability of its impact.

Progress with open eyes

It’s easy to get carried away whenever a potentially breakthrough technology comes into view. That’s probably a good thing. The Metaverse is exciting. Now is a time to think big, to imagine the future with optimism and creativity. But now is also a time to think practically and soberly. As visionary thinkers dream the Metaverse into existence, policymakers, ethicists, and engineers need to get busy, too. Now is the time to be thinking about all the unglamorous safeguards the Metaverse will need. Things like data security, privacy, ethics and regulatory compliance, physical health and safety, sustainability, equity and fairness. These things won’t come about by themselves. They need to be baked in. 

The foundations of the internet were laid over the course of decades, mostly by academic institutions, government research labs, and individual technologists. They were working largely outside of for-profit organizations. They worked cooperatively to create open standards that would facilitate collaboration. The Metaverse is different. It is being created by big technology companies with a commercial mandate. For better or worse, their decisions will largely determine what this idea called the Metaverse will eventually become. They are making their investments and their decisions right now. That means now is the time for users, developers, consumers, and voters to exert their influence.