Digital health at CES: virtual reality, drug-free pain management

Brennan M. Spiegel

The Consumer Technology Association recently held its annual CES Conference in Las Vegas, where the latest innovations in technology are showcased, and a variety of experts discuss key trends and emerging advances in all things tech.

Brennan M. Spiegel, MD, MSHS, AGAF, FACG, director of health services research at Cedars-Sinai Health System, joined many other presenters at the conference’s Digital Health Summit, which focused on the role of technology in brain health, digital therapeutics, and consumer- and patient-oriented health care innovations.

Spiegel recently spoke with Healio Gastroenterology and Liver Disease about notable products on the CES show floor that caught his attention, as well as his own CES presentation, during which he shared his and his colleagues’ work on drug-free pain management strategies.

Healio: Did any notable innovations catch your eye at CES?

Spiegel: I did explore some of the virtual reality (VR) technology that was available, which is an area of some interest to me. I was interested in this new technology developed by a company called EmoShape, and they claim they have what they call an “emotion chip.” They’ve gotten some attention for this as they’re essentially trying to put the equivalent of human emotions on a chip, which sounds sexy but obviously opens up a lot of philosophical questions.

What I demoed was a VR experience that was connected to this emotion chip, and the user is in this sort of bucolic countryside environment, and based upon the head movements combined with the verbal speech of the user, the system starts to build an emotional profile and will change the metaphorical narrative around them to meet their mood. So, if you seem happy in the way you’re reacting to the experience, then you start to fly, but if you get less engaged you crash down to the ground. The whole point is to try and create an emotion-driven kind of space, which I find to be an interesting direction. I liked the experience, but though it needs work, it was probably the most interesting thing that I saw in the VR space.

I also spent some time doing a procedure in VR developed by a company called SimforHealth, which is doing some work using medical simulations of procedures. I was cannulating an artery, which was kind of cool and pretty realistic.

Healio: Tell us about the research you shared with the audience during your presentation.

Spiegel: My session focused on the opioid crisis and how health technology may be able to help with that. I talked about a couple projects that we have underway.

One of them is a VR project. We’re working with Travelers Insurance and a company called appliedVR along with Samsung and Bayer, to see if we can help reduce opioid prescribing in worker’s comp patients using a digital pain reduction kit. This is a study that we just started here at Cedars, and hopefully this time next year we’ll have some real results from it.

We’re randomizing patients with a acute musculoskeletal injury to either their usual care or to what we call a pain reduction kit, and in the kit they get a few things. They get a VR headset, along with software that they can use whenever they want to help manage pain through mindful mediation, relaxation and distraction. They also get a Bayer TENS unit for the lower back for those with back pain in particular. It’s an OTC unit with a wireless controller that’s wearable on the back to help with pain. And they get a Samsung Smartwatch they can wear and they’ll be monitored by a “digitalist clinician navigator” that will check in with them periodically to see how they’re doing, and monitor their progress and give them feedback and support.

The goal of this is to help reduce opioid prescribing by using technology as a point of care, integrating it with the patient experience.

Healio: What other talks stood out to you as particularly impactful?

Richard Migliori, MD, from United Health provided a really excellent perspective on how a payer is thinking about technology for something like the opioid epidemic, and I thought he had a lot of great things to say.

Shai N. Gozani MD, PhD , CEO of a company called NeuroMetrix, talked about the Quell project, which is a neat example of a technology that actually made it out of the lab and is now commercially available for non-drug pain solutions. It’s a device that wraps around the lower leg and has electronic pulses that “distract” the nervous system from pain — a pretty interesting concept.

Healio: What was your overall impression of CES? Would you recommend that others interested in digital health attend?

CES is sort of a dog and pony show of all the latest and greatest products and services, and it’s exciting and overwhelming to experience, but as I looked at a lot of the technology, I kept thinking about how often technologies emerge and die during their “hype cycle”. Most of these technologies are not going make it, because it wasn’t clear to me that they have been tested rigorously, or their clinical effectiveness has been assessed, or the user experiences have been appropriately evaluated. But a small number of those will make it out: the technologies where they’ve taken the time to really understand the user needs and preferences and have applied science and clinical trials to their products.

Quell is a good example. Part of the reason Gozani was on the stage is that they’ve done the work with clinical trials to evaluate their product.

However, while there’s a lot of fun, interesting stuff at CES, most of it is not going to improve patient’ quality of life or clinical outcomes in a meaningful, measurable way — but some will. – by Adam Leitenberger

Reference:

Spiegel BM. Digital Health Summit. Presented at: CES Conference; Jan. 8-11, 2018; Las Vegas, NV.

Disclosures: Spiegel reports no relevant financial disclosures.