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Metaverse: The Next Iteration of Online

Executive Summary
Over the course of the last few years, the healthcare and life sciences have all gotten far more comfortable leveraging technology to close geographical gaps. Zoom meetings are the norm, conferences are hybrid, and businesses are leveraging the power of social media and the widely available platforms better than they ever had. During the pandemic, the collective hand was forced. They had no choice but to do a “giddy-up” in the adoption of technology to keep their businesses afloat. In healthcare, telehealth, which was once a fringe option, became the norm. They utilized multi and omnichannel approaches to marketing much more skillfully. The idea of the metaverse, that is, an immersive shared virtual reality (VR) is the logical next step, and the infrastructure and technology are growing with the evident need. This whitepaper explores the multiple use cases of metaverse within life sciences
Since the advent of the internet and the democratizing of development, there has been exponential growth that was unfathomable not that long ago. Businesses have been asked to be more agile than ever, responding to the requirement of the marketplace and the expectations of an increasingly demanding customer base. Healthcare and the life sciences have not been immune to this change. Extraordinary patient and customer experience is now the key to success. How can this experience be accomplished in an industry that moves cautiously under the weight of compliance and regulatory guidelines? A good place for industries to start is by leveraging new technologies to help reduce costs and facilitate incredible experiences.
Over the course of the last few years, the healthcare and life sciences have all gotten far more comfortable leveraging technology to close geographical gaps. Zoom meetings are the norm, conferences are hybrid, and businesses are leveraging the power of social media and the widely available platforms better than they ever had. During the pandemic, the collective hand was forced. They had no choice but to do a “giddy-up” in the adoption of technology to keep their businesses afloat. In healthcare, telehealth, which was once a fringe option, became the norm. They utilized multi and omnichannel approaches to marketing much more skillfully. The idea of the metaverse, that is, an immersive shared virtual reality (VR) is the logical next step, and the infrastructure and technology are growing with the evident need.
The term metaverse was coined long before it was a reality. It came from a 1992 science fiction novel, Snow Crash. In this book, Neal Stephenson paints a picture of a grim, dystopian future where there is an all-encompassing digital world that exists in parallel to the real world.1 Although, thankfully our world today is not reflective of that dystopian future, there is an evolution in the way people interact with computing and the internet. The definition of what the metaverse is today is tricky to get your arms around as it is nebulous and ill-defined, and it is still in its infancy. At the core of the metaverse is the union of VR and a digital second life.2 Metaverse is a shared, interactive, digital space that is immersive and hyperrealistic.
On the spectrum of bringing technology beyond a screen, there is augmented reality (AR), mixed reality (MR), virtual reality (VR), holograms, and more. All of them together come under the umbrella of extended reality (XR). A few of these experiences are briefly discussed below to better understand the landscape.

Augmented Reality

This is a technology often experienced via smartphones, wherein users can see the world around them with superimposed components into the real world visualized on their screen, as if they are in the real world. AR is already widely adopted and probably many would have experienced it without realizing it. If people have ever shopped online and have an option to “see it in your space,” allowing them to look through their phone into their living room and “try on” different couches in their space – that is AR. If a kid is obsessed with Pokémon GO and had to go to different places around the town to “catch” Pokémon – that is AR. Snapchat filters are another example of AR in daily life.
There are tons of applications for AR as it relates to learning and development and in life sciences – showing how a device comes apart and how it is used. In manufacturing, one can add hotspots and superimpose information around each step.
It is an incredible technology that allows industries to extend the potentials of how they see the real world and can be incredibly effective in the right use case.

Mixed Reality

MR is similar to AR – however, the big difference here is the environment can interact with the superimposed 2D or 3D virtual layer. Viewed via a smartphone or tablet, one could interact with the virtual and real world, and the virtual world will react to changes in the real environment.

Virtual Reality

VR is a term used to describe an immersive, digital environment.3 Usually accessed via a head-mounted device (HMD) such as the Oculus, it allows a user to be “placed” into a completely different environment and typically manipulate the surroundings. Generally, VR has been an individual experience. Because of the HMD, VR is not as ingrained as part of everyday life as AR, but it has been adopted widely in business applications. So many different applications – from education and training, to design, to research – have all been successfully deployed in VR.
XR
Extended Reality

The entire experience spectrum from completely virtual to completely real

VR
Virtual Reality

User is completely immersed into a virtual environment

MR
Mixed Reality

"Environment aware" 2D or 3D content is overlaid onto the physical space

AR
Augmented Reality

"Non-environment aware" 2D or 3D content is overlaid onto the physical space

The term Web3, or Web 3.0, refers to the next big leap forward of the internet, which is nebulously defined like the metaverse, but the central tenet is that it will be decentralized. Blockchain is a relatively new way to store data in a public ledger that is immutable once it is created. It is also distributed across many computers or servers.4 In the same way Facebook and YouTube were the products of advances that enabled data uploading and cloud storage, many believe that the metaverse will be the “face” of blockchain technology.5 The metaverse is, by design, decentralized. No one owns the metaverse; the same way no one owns the internet. However, there are major players – just like the internet. Google is obviously a major player, but not the owner of the internet. Similarly, the metaverse does not have one owner. Due to the decentralized nature, the ability to shop, game, socialize, learn, and do business in the metaverse is therefore not codified by a single set of rules, standards, and so on. On the positive side – it allows for a democratized growth of this shared space. On the other hand, issues like avatar portability between apps/spaces, or how to keep kids safe is not governed by one central decision maker. Therefore, different “places” within the metaverse could have vastly different structures and become almost islands.
Focusing on the life sciences, healthcare, biopharma, and medicine in general, the metaverse is going to enable incredible patient experiences. The exciting use cases and potential benefits of them will be discussed further in this paper. However, the focus of the discussion so far was about the decentralized and therefore, not standard nature of the metaverse. Although there are clearly certain advantages to this approach, for life sciences there are challenges. As there are no universally accepted standards, security is not provided. Privacy is another major hurdle to unleashing the potential of the metaverse in life sciences. Life sciences, healthcare, biopharma, and medicine are highly regulated industries – and for good reason. There are highly specific guidelines around what constitutes a “safe” environment to have sensitive conversations, how to protect data, how to store data, and so on. All these guidelines will need to be managed in the course of thinking about the use cases. There are some people who feel a cloud IT layer could satisfy the security requirements, and others feel that blockchain is the perfect way to secure data, specifically patient data. Hence, how we as an industry view security is a big issue that needs to be addressed.6
However, healthcare does not need to wait for the security issue to be solved before taking advantage of this technology. By creating a “private metaverse” that is completely outside of the public space and metaverse zeitgeist, there exists the opportunity to essentially creating a hidden bubble for interactions. This bubble, or a “private metaverse,” could contain immense virtual spaces and allow pre-defined users to interact. This takes away the idea of needing to allow general access or putting the app in a centralized, public place. By doing it this way, it is essentially the same as adding an app to a phone without needing to go to the Apple Store or Play Store to download it. It would only become accessible to the users if they were pre-defined as part of the “bubble,” and it was opened up to them.
In this way, some incredible use cases of the metaverse immersive and shared realities are explored to make meaningful impacts across the industry.

Use Cases for the Metaverse Within Life Sciences

Learning

One of the most easily adopted, and potentially a huge game changer, is the use of technology in the learning and development space. The way we teach has changed vastly with the advent of new technologies. Once, not too long ago, everything was done in person. There were big training binders filled with a ream of paper with everything that anyone would need to know. Later on, there was an increase in PDFs and learning via reading on a computer, along with some trainings in person pull-through. Later still, the arrival of m-Learning or e-Learning also gave trainers the ability to train using interactive, engaging platforms that had an audio and visual component, was trackable and could measure how the learners were doing centrally. Today, learners will often have a mixed modality approach for their learning needs, with an emphasis on e-Learning, PDFs, videos, and in person or web-based synchronous meetings and workshops.
What has remained constant is that learners have always valued the in-person learning opportunities (whether as the main modality or as context/pull-through) to solidify what they have learned in other modalities and put it into practice in a safe space.

Verbalization/Role Play

Owing to the pandemic, the past two years have seen the increased use of technology to bridge the physical distance. In-person workshops were shifted to meeting platforms. Synchronous touchpoints, even on these sorts of platforms, continued to be essential. However, the general consensus seems to be that these platform-based sessions have not been a 1:1 swap with in-person meetings. There are distractions at home and it is all too easy to lose focus on what is going on. If there is a role play or verbalization, it can be challenging for it to feel real or organic. There is no “water cooler” chat or hallway run-ins with your team – which is an underappreciated component of getting together in person.
In the private metaverse scenario, learning teams can create immersive scenarios that allow users to be in the settings that they will encounter in their day-to-day job. This allows users to interact in a safe environment with their peers and role play/verbalize to practice skills. For instance, a pharmaceutical company has a new class of sales reps that are coming on board. Three years ago, they may have had a week of in-person training, followed by some home study, then come back together to put it all together, practice, and certify that they know the material and are ready to be in territory. During COVID-19, they did asynchronous home study studded by synchronous web-based meetings to check for understanding and add context. Certification may be done via the web-based meeting platform. Now that most companies are coming back to the office at least in some capacity, maybe the company has taken a middle-ground approach where they use the home study upfront and bring people into a workshop setting for practice and certification. There are huge costs associated with bringing people in house for these workshops – and time is limited. In this scenario, imagine if during the onboarding process, learners were able to access an immersive virtual doctor’s office early and often during their learning. They could watch facilitators show what good looks like, and then jump in and practice with their peers. As they learn a skill, they could go into this world and immediately practice and apply it. Hence, they could reduce the difference between the way it feels to verbalize in a hotel conference room with their peers to how it feels to have a conversation with a doctor, in a doctor’s office.
From a learning perspective, there are incredible gains to be seen using this approach.

(Forced) Focused Attention

This is a huge potentially unintentional benefit. With the HMD on a learner’s face, there are no opportunities for distractions. There is no checking of phones, multitasking, being distracted by an email, or the many other things the learners may be distracted by. Not only that, which, in and of itself is worth its weight in gold – but from a learning science perspective, learners can only create neuroplasticity in the adult brain by engaging with focused attention. Having the HMD be the conduit to this immersive space, they are putting literal blinders on to the rest of the world and engaging fully in the experience. This will allow the learners to not only be truly present, but it will also help with retention and learning as the attention is focused.

Engaging/Novel

This medium for learning is new. It is fun. It is immersive. For 9 out of 10 of the learners, this will probably be the first time they are experiencing anything like this. What that means is that the learners’ brain will be on a high alert, taking in as much as they can. It is novel, it is new – it is engaging. Engagement is one of the most important pieces in adult learning as we try to achieve true neuroplasticity. Kids, up until around 25 just soak it all in, and don’t need to try or focus in order to create changes in their brains. As adults, the science says we must have focused attention and engagement with the content in order to make brain changes. Said another way, to create changes in the brain (learning) focused attention is a prerequisite, and the learner must truly engage with the material.
This medium is new and novel and demands engagement. It is not a passive experience.

Shared Experiences/Peer Learning

Learning is more impactful with others. Having a social component is now a well-established best practice of a curriculum. This modality encourages peers to interact, role play, and share best practices. Moreover, company culture is more important than it ever has been, and fostering relationships among peers is an easy way to pull through that aspect of the company. Those water cooler chats that have been lost are fostered in the open format of the space.7

Safe Learning Environments

No one would argue that verbalization is a key skill when they are training representatives. Representatives are being asked to have potentially challenging or unnatural conversations with stakeholders to gain insight or alignment. Allowing learners to practice their skills early and often during the training gives them a safe, realistic place to practice with peers, “fail forward,” and keep practicing until they feel comfortable. Being in the virtual space and hearing the spatial audio makes learners really feel like they are in the office setting, and can give them the same nerves and “stage fright” that they may have the first few times in the field. Being able to practice in such a realistic setting means the leap from training to field is much smaller.

Cost and Time Effective

Not having to spend on travel to bring people to one central place, not having meeting, lodging, or food costs is a significant savings. Learners have less time away from their families. In addition to those savings, learners are not losing out on the interactions that made in-person instruction so important to the learning journey.

Gamification

The metaverse is ideal for games. Roblox and Fortnite are two examples of what a metaverse is – a digital equivalent/avatar is interacting in a persistent virtual space with others.8 Couple that with the understanding that gamification is big in the learning space because it works.
Creating immersive learning games in a private metaverse can allow L&D teams to exploit the best parts of gamification in a truly engaging and powerful way. Imagine teaching the anatomy of the cardiovascular system. While an e-Learning or video on this topic can be easily made available, what if one could shrink the learners down “Magic School Bus” style and allow them to navigate the cardiovascular system from the inside, see how the blood moves through the heart and lungs and is circulated out to the body and then back into the heart. What if they could see atherosclerotic disease firsthand and work together to “fight it” by changing behaviors of the “host”? Maybe you could watch the impact inside the cardiovascular system as these behaviors or medicines take effect, understanding firsthand what can be achieved, and the difference it makes. That would be an incredibly immersive and engaging experience that could be fun and impactful.
Organizations can gamify anything, and in this modality – make anything much more tangible to learners. Annual compliance training has been a tough nut to crack as far as making this mandatory and important training come to life and gain focused attention. Compliance is such an important topic, and all too often they see these training programs as a “check the box” exercise. What if they could immerse users into situations that were tricky? Make compliance come to life, and make it truly an application-based scenario? For instance, place learners at a speaker program and let them work together to identify deficiencies or areas of concern.

HCP Education and Detailing

Healthcare Provider (HCP) education is another obvious use case for this technology. From teaching new techniques to allowing doctors to practice surgeries, HCPs can learn new techniques and information in a novel way. This platform can allow for communities of practice get together, have conversations, and even showcase best practices. Key Opinion Leaders and HCPs can have discussions in this space, and others can either watch or join in the discussion. This is more than a platform; it is a new way of communicating.
In the not-too-distant future (once some of the security issues have been ironed out), organizations can expect to see HCP detailing within the metaverse. Reps could “visit” doctors, and have focused, thoughtful discussions. From the perspective of reps, not only is it great to have the undivided attention of the HCP, but as there is no drive time/transportation time and they can be more efficient with the number of hours they have in a day. Rural areas could be covered as effectively as the more populated areas.
Imagine if doctors had a question real time and could just put on their headset and be able to connect to the right person immediately. Like an “always on” chatbot – companies may decide to staff an “always on” approach in VR.

Patient Education/Experience

Patient education is a great application. A patient could learn more about their disease, shrink down, and be transported inside their body to understand at a micro level what is going on, and what the therapies or surgery hope to accomplish. This sort of immersive content would help the patient understand what is happening and has the potential to be a great patient experience.
Communities of patients could get together in a common area, discuss what they are going through and be able to see others going through the same thing.
There was a study done out of St. George‘s Hospital in the United Kingdom that had patients undergoing surgery with a local anesthetic. They wore headsets and engaged in VR before or during the surgery and had much better outcomes. All of the patients said the headsets improved their experience. A whopping 94% said they were more relaxed, 80% reported less pain, and 73% reported less anxiety.9
There are also physical therapy applications for this sort of technology. For many patients that struggle with transportation, this can be a phenomenal replacement. It can also increase the patient follow through for physical therapy. Platforms can be gamified, and the physical therapists can continue to monitor their progress closely.

What Is Next?

The Medical Internet of Things (mIOT) is continuing to grow. The health wearables market is only expanding. Many types of delivery methods on pharmaceuticals now have an online/connected component (insulin pumps/pens, inhalers, etc.). Companies are working on contact lenses that monitor blood sugar levels; in fact, the mIOT/devices market is expected to hit $158 billion in 2022.10,11
These items will work together and create something of a live feed for the doctor. There could be a time where the doctor calls the patient as their readings change and brings them in pre-emptively. They may have the patient come into their metaverse office, so that the patient could stay at home and just meet with the doctor virtually. Having a conversation, coupled with the data from the mIOT/devices, the doctor will be able to make sound clinical decisions without ever seeing the patient physically.12

In Conclusion

The new era of internet evolution is underway – and a major communication change is emerging. The same way cell phones went from simply a way to call each other when a landline was not nearby to a necessary component of everyday life, it seems inevitable that the metaverse will continue to grow around us. The digital world and the real world will become more blended. As the technology continues to evolve, headsets will be less bulky and the barriers to adoption will shrink. In the near future, holograms could become more prevalent, creating a blended reality.
The challenge is now how to embrace this change. How can the healthcare and life sciences industry leverage it to find the competitive edge? How can we create incredible patient and HCP experiences? How can we connect people in a more real way? While ubiquitous adoption is still a few years off, we can start standing out by embracing this technology today and keeping an eye on how to leverage it tomorrow to create lasting impact and improve healthcare.

References

1
Joshi S. The Metaverse, Explained for People Who Still Don’t Get It. Accessed 4 May, 2022. https://www.vice.com/en/article/93bmyv/what-is-the-metaverse-internet-technology-vr
2
What’s All the Hype About the Metaverse? Tech Fix. Accessed May 4, 2022 https://www.nytimes.com/2022/01/18/technology/personaltech/metaverse-gaming-definition.html
3
What is XR, AR, VR, and MR? STEAntycip. Accessed May 4, 2022 https://steantycip.com/blog/what-is-xr-ar-vr-and-mr-2/
4
Marr B. What is Web3 all about? An easy explanation with examples. Accessed May 4, 2022 https://www.forbes.com/sites/bernardmarr/2022/01/24/what-is-web3-all-about-an-easy-explanation-with-examples/?sh=159770032255
5
What Is Web3? The Confusing Term, Explained. Van Boom D. Accessed May 13, 2022 https://www.cnet.com/personal-finance/crypto/what-is-web3-the-confusing-term-explained/
6
Marr B. The Amazing Possibilities Of Healthcare In The Metaverse. Accessed May 4, 2022 https://www.forbes.com/sites/bernardmarr/2022/02/23/the-amazing-possibilities-of-healthcare-in-the-metaverse/?sh=4b6f5769e5c2
7
Sharing Experiences: A Stepping Stone To Social Learning In The Workplace. eLearning Industry. Accessed May 4, 2022. https://elearningindustry.com/sharing-experiences-stepping-stone-to-social-learning-workplace
8
Jaehnig J. Are Games Like Minecraft, Roblox, and Fortnite Types of Metaverse. Accessed May 4, 2022. https://www.makeuseof.com/are-games-like-minecraft-roblox-fortnite-the-metaverse/
9
Nowak M. Virtual Reality in Healthcare – Transforming Medical Education and Patient Care. Accessed May 4, 2022. https://concisesoftware.com/blog/virtual-reality-in-healthcare/
10 
Watts M. Smart contact lenses successfully detect glucose levels. Accessed May 4, 2022. https://www.diabetes.co.uk/news/2020/may/smart-contact-lenses-successfully-detect-glucose-levels.html
11 
Meola A. IoT Healthcare in 2022: Companies, medical devices, and use cases. Accessed May 4, 2022. https://www.insiderintelligence.com/insights/iot-healthcare/
12 
Yang D, Zhou J, Chen R, et al, Expert consensus on the metaverse in medicine. 2022;5:1-9. doi: 10.1016/j.ceh.2022.02.001

Authors

Liberty Clearwater
Liberty Clearwater