Extended reality (XR) could revolutionise neuro-rehab, but challenges remain – including in terms of lack of access and the need for more clinical evidence. But Floris van der Breggen, founder of SyncVR Medical, is an entrepreneur on a mission to unlock its potential by building the “Netflix of health XR”, as Andrew Mernin reports.
Putting on a VR headset at a busy international exhibition feels disconcerting at first.
The white light of the vast conference centre is replaced by moonlight, which catches the surface of a virtual lake.
While all around, rehab professionals sweep past on their way to the next presentation, gentle music ushers me into a purple forest.
“This can be used during surgery, needle procedures or pain episodes,” says a voice breaking the tranquillity.
It belongs to Floris van der Breggen, founder of SyncVR Medical.
“Stroke patients are also using a VR programme from our platform to train their executive and physical functions, thereby making their rehabilitation more enjoyable and effective.”
Floris is building the Netflix of healthcare-focused, medically-verified apps delivering extended reality (XR) – comprising virtual, augmented and mixed realities.
Programmes on its platform fall into three main categories – rehab, education and pain/anxiety/stress reduction; and supporting better neuro-rehab outcomes is a big part of Floris’ plan.
Trialling another application, I’m standing next to a virtual skeleton. From here I can select different parts of the body to explore in depth.
“If I’m a doctor and you’re my patient and I need to help you understand what I am going to do to you, I can show you here,” says Floris.
“There are over 12,000 anatomical structures and actions, which is great for anatomy training in physiotherapy for example, with hip flexion and so on. You can zoom in on microscopic tissue, so it’s great for educating student health professionals and for patients.”
The seeds of Sync VR were planted in the Netherlands four years ago at a hackathon – a mini-Woodstock for coders characterised by collaboration and rapid development.
“That first project was to see if we could use VR to reduce loneliness among the elderly. In a previous start-up I had been working on anything that used technology for social impact, using the newest technologies to solve old problems.
“When we were doing this project and putting headsets on people that were over 80 years old, it became apparent that there was so much this technology could do for these people but they just weren’t accessing it.
“These headsets were being made for gamers and youngsters, but they could do so much for elderly people. They could get into other worlds that they would not be able to access otherwise.
“Their world was so small. The VR world was so much larger than their regular world. So we saw the impact it could have and I wanted to make this more than just a hackathon project.”
Floris then recognised that focusing on the health sector, rather than just elderly care, would enable his embryonic enterprise to have greater impact.
“I wondered where I would find the most people with mental and physical issues that could be helped with VR and realised it was hospitals and medical centres.”
The journey began with a pitch to the Dutch Cancer Society to apply VR to improve the quality of life for patients undergoing chemotherapy.
“That was the first time we were accepted into a hospital, to test the technology with 120 oncology patients.
“Before that, I’d had to explain to everyone what VR even was. People were laughing at me, saying it was a toy. The only thing we could was to talk our way into a hospital to prove its worth, and so we did an informal trial run by a number of nursing students and followed it up with a questionnaire.
“Ninety-one per cent of the patients said they would use it again, 96 per cent would recommend it to others and 84 per cent said that during treatment the VR enabled them to completely forget about their cancer. There is nothing else that can transport the brain to such completely different place like VR can.”
News about the power of VR spread within the facility, which is one of the biggest general health hospitals in Rotterdam. Five other departments, including paediatrics, dialysis and rehabilitation, also wanted to try it.
“From that point we realised there might be a larger problem to solve by bringing together the best XR health apps from all around the world and building a platform rather than individual apps.”
Today there are over 3,000 devices within hospitals, clinics and educational institutes across Europe plugged in to SyncVR’s dashboard. This serves as a gateway to a continually growing stable of XR health apps. In the UK, the platform is used in around 25 NHS trusts.
While SyncVR has developed three apps itself, its aim is largely to integrate the best global XR healthcare apps into the platform.
The platform is hardware agnostic, minimising potential cost barriers faced by medical facilities in having to buy multiple types of VR device.
“We’ve built the infrastructure to get the best apps on our app store and get them distributed to hospitals. Just like Google has the Google Play store, or Netflix has built its infrastructure, we are building the infrastructure to connect the best of what’s out there.
“We work together with the main organisations in Europe that provide accreditation, such as ORCHA [the Organisation for the Review of Care and Health Apps]. They assess XR healthcare apps for their acceptability and technical readiness for being used by patients and we seek CE marking and equivalents.”
With the consumer market for XR gaming exploding currently, however, are we likely to see a rush of mainstream gaming developers into the healthcare space?
“No,” says Floris. “There are a number of regulatory steps each app needs to go through depending on the patient need, including in DTAC [the Digital Technology Assessment Criteria], a specific framework in the UK for use in the NHS. There is also data privacy certification.
“If you take the case of a stroke patient, for example, a key thing is that you don’t want to overstimulate them. You want to start at a level that is compliant with their cognitive and physical abilities.
“That is very different from the needs of a regular gaming XR consumer.”
Given the pressures of clinical compliance, Sync VR has an unusually white-coated team compared to others in the XR world.
“We have a scientific officer who is also a doctor in the NHS. As part of our platform, it has been essential to develop everything based on the influence of clinicians. For example, we have a rehabilitation app that has been led by a physiotherapist.
“Also, in our company goal setting, as important as revenue is the number of scientific studies that show effectiveness for our platform. We are running around 45 clinical studies with applications on our platform to show their impact.”
Floris describes his company as a “central hub in the ecosystem” of healthcare XR.
“On one side we have the users and on the other, the suppliers. Both of those sides are growing. On the side of the healthcare organisations we need to reach out and educate them about what the technology can do. We have to be proactive as they will not reach out to us. On the other side there are all of these applications.
“All around the world there are new apps being built. Young people are being inspired to build the next big global VR app so we are reaching out to them, and them to us, and we’re connecting the best developers with our platform.
“We see part of our responsibility as helping developers pass through the accreditation process and complying with regulations. We will represent them and make sure they comply to data standards.”
Video below: The 3D Organon, one of the educational programmes on Sync VR’s platform
Although healthcare facilities are a primary target for the company currently, remote rehab in the home is a growing area.
“We now have around 3,000 devices in seven countries connected to the platform which are mostly in hospitals, where nurses or therapists provide XR treatments to patients or professors gives their students some VR education.
“What we are seeing now is that more patients are doing these treatments in the home setting on consumer devices or those borrowed from hospitals. We are moving towards a time where everyone has such an asset at home. The patient could then access their treatments via the Sync VR platform and do them on a consumer device.
“Of course not every treatment can be done remotely, and some do need therapists present, but for those where it’s possible we will see more of them moving to the home.”
Floris’s longer-term vision, meanwhile, is for XR to revolutionise wider aspects of human health, with Sync VR leading the way in doing so.
“Right now we are building the metaverse and everyone sees that XR technology is going to impact society. Healthcare being a cornerstone of society, there is a giant position that this technology will take in healthcare.
“We are building the ecosystem of XR in healthcare. This is a virtual place where a patient gets their treatment, a therapist provides their treatment, students get their education and insurance companies provide reimbursements for a certain treatment. Also where you can access the pharmacies, diagnosis and education – a central place for XR in human health.”
Although this vision may be several years into the future, a small step towards it, says Floris, is for “one diagnosis to include several XR treatments or apps”.
“For example, we are currently working in long COVID rehabilitation which brings together three apps,” he says.
“Just as you can be prescribed three different pharmaceuticals, now you can get your combination of apps. Imagine the future physician could say ‘I see your digital profile as a patient right here. based on all the data we’ve gathered I can see that this combination of rehabilitation will be best so here’s your personalised XR treatment’. With data and algorithms we could define the ideal personalised treatment.”
Among various items keeping SyncVR busy before that vision is realised is the process to receive NICE approval for a pain an anxiety-related application.
This year is also likely to see the findings of 10 to 15 randomised controlled trials involving the platform published. Areas of focus include neuro-rehab, stroke, COVID rehab and intraoperative stress release as a replacement for sedation.
Follow NR Times for details as they come to light.
