Welcome to the Metaverse: An Avatar’s Guide to the Health Care Galaxy | Deloitte US has been saved
By Neal Batra, principal, and Kushan Biswas, senior manager, Deloitte Consulting, LLP
The adoption of virtual health might have been the first significant step into the metaverse for the health care and life sciences sectors. The metaverse uses connected virtual experiences to simulate actual experiences of the physical world. Three years ago, Deloitte outlined its vision for the Future of HealthTM, where digital transformation removes barriers (such as cost and geography) that can limit access to health care and to specialists. Here’s a look at how this future might play out.
Welcome to the metaverse! The year is 2040, and Jimmy “Crash” Kraszniak is a professional e-sports player in Laramie, Wyoming. One morning—after a close win over an e-sports rival—he wakes up to a severe shooting pain in his left knee. The pain is likely related to his triumphant leap and awkward landing after clinching victory the night before. From his bed, Crash asks his digital assistant to schedule an appointment with a top orthopedist. Dr. Amethyst Rian has an office in New York City and is one of the highest rated orthopedic surgeons in the US. Thanks to her AI-driven scheduling platform, a last-minute cancellation is reflected in her system, and Crash receives the slot. Prior to the appointment, he describes his injury, pain, and other relevant facts to his digital assistant through a smart speaker, which transcribes the information and transmits it to Dr. Rian.
Although the patient is nearly 2,000 miles away, Dr. Rian feels comfortable treating him in the metaverse. Shortly before the appointment, Crash receives a notice reminding him to wear his haptic sensors during the exam. Haptic devices use tactile sensors to mimic the sense of touch by applying forces, vibrations, or motions. A realistic digital image of Crash, which is generated by various sensors attached to his body, appears in Dr. Rian’s metaverse office. Dr. Rian’s AI-enabled digital assistant reviews Crash’s medical history via cloud-based platform and compares that information against his intake description. The digital assistant identifies several likely underlying conditions for the doctor to review.
In the metaverse, the sensors in Dr. Rian’s hapic gloves allow her to feel how Crash’s knee responds to simple diagnostic tests. She is confident he has a torn ACL but will need an MRI to confirm it. Crash’s digital assistant locates a nearby clinic that operates a mobile MRI service and makes an appointment. The images are transmitted to Dr. Rian’s system, which uses an AI-based radiology platform to assess the scan before it is reviewed by a radiologist. The imaging confirms a torn ACL. Dr. Rian’s digital assistant sends a questionnaire to Crash to help inform her recommended pathway forward. In the past, Dr. Rian recommended ACL reconstruction to about 90% of patients in Crash’s age demographic. However, her patient population skews heavily toward professional athletes who tend to heal faster because they typically have better access to treatment and tend to be highly motivated to comply with rehabilitation regimens. An e-athlete like Crash might not want to return to active sport, so an ACL reconstruction might be unnecessary. However, after triaging Crash’s medical history and lifestyle, Dr. Rian determines an ACL reconstruction is the best path forward.
The score takes care of itself
Through superior outcomes tracking, Crash’s health insurer can see that Dr. Rian’s patients tend to recover more quickly and are less likely to have complications than other patients who undergo similar procedures. As a result, value-based care measures have increased her total payments from procedures, so she tends to invest heavily in upfront preparation.
Two weeks before the surgery, Dr. Rian writes Crash a prescription for a digital twin. A local clinic scans Crash’s body, which renders a digital replica of the patient in the metaverse. By interacting with this digital twin, Dr. Rian creates a custom surgical plan and practices the procedure prior to the actual in-person surgery. She documents critical notes that will be available to her during the procedure, including insertion angles, screw positions, and anatomical traits specific to Crash.
Simulating the impact of various anesthetics allows the anesthesiologist to concoct the ideal balance of desflurane, midazolam, and hydrocodone. The anesthesiologist’s digital assistant flags Crash’s past substance-abuse issues. This helps inform the post-operative pain-management strategy that will optimize pain relief while minimizing abuse potential.
Digital and physical worlds collide
Just a few weeks after their initial contact, Dr. Rian is ready to operate, and Crash’s digital assistant books an airline ticket to New York City. A self-driving car takes him from the airport to Dr. Rian’s state-of-the art surgery center. He was initially frustrated that the procedure couldn’t be completed virtually at a local hospital. Dr. Rian explains that while robots routinely perform straight-forward procedures, an ACL repair is still too complex to be performed without extensive human intervention.
A synthetic graft with a near-zero risk of rejection is used in the surgery. Insertion angles and screw positions have been programmed in the surgical robot, and a 3D image of Crash’s knee—as well as his vitals—are displayed through Dr. Rian’s augmented-reality (AR) headset.
Medical research isn’t what it used to be
Dr. Rian and her anesthesiologist take a multi-pronged approach to pain management. Crash received an immediate post-operative infusion of ketorolac, an anti-inflammatory drug, to help him handle the pain. During recovery, he will have a high-dose prescription of ibuprofen, as well as access to a digital therapeutic focused entirely on pain management.
Crash is a professional gamer but is dubious that a video game could chemically alter the brain like an opioid. He contacts a friend who has expertise in neurochemistry, and they decide to meet at a metaverse café. Mariah, who heads pain management R&D at a biopharma company, confirms that digital therapeutics are highly effective at treating physical pain. The magic, she explains, lies in the immersive environment of the metaverse, which triggers neurochemical reactions comparable to reactions generated by a pharmaceutical intervention.
Mariah’s job requires a deep understanding of not only neuroscience, but also 3D molecular modeling, software engineering, artificial intelligence, and machine learning. Rather than screening compounds in a lab for activity, she leverages virtual reality to visualize drug interactions and to synthetically test and develop molecules to advance clinical testing. She considers digital therapeutics to be just as powerful as drugs when it comes to treating neurological conditions.
Flexibility + incentives = superior outcomes
ACL rehabilitation can be a grueling proposition, even in 2040. Crash opts for a flexible, on-demand approach to rehab. Each week, he meets with his physical therapist in the metaverse. He also has access to hundreds of immersive rehabilitation programs and guides designed to improve recovery time.
Crash experiences the recommended activities in three dimensions. Biosensors generate a video of his performance, and his physical therapist provides feedback on his form. During the first few weeks of rehab, he only performs 30% of the prescribed activity. That triggers his health plan to offer a set of rewards for reaching certain milestones. For each completed workout, Crash receives a digital token that can be used to reduce his out-of-pocket costs. The health plan has also partnered with celebrities who Crash finds inspirational. When his motivation begins to lag, Crash receives a personalized message from one of those celebrities who encourages him to stay focused. He also receives messages from Dr. Rian, emphasizing the importance of rehabilitation. (The rapid adoption of virtual care, and likely impact on hospitals, was outlined in our 2020 report on The Hospital of the Future.)
With money on the line, and with his favorite celebrities cheering him on, Crash’s rehab adherence skyrockets to 95%. All medical procedures come with some level of risk—even in the future. However, we expect the metaverse can transform health care in profound ways. The Future of Health might be closer than we think.
Acknowledgement: RJ Towner, Olivia Houston
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Neal is a principal in Deloitte’s Life Sciences and Health Care industry and heads Deloitte’s market-leading Future of Health™ practice, which focuses on business model and operating model innovation, re-design, and transformation. Neal’s work puts into practice the award-winning ideas that anchor the bold and visionary Future of Health point-of-view that he co-authored in 2018. Neal has more than 20 years of experience advising health organizations on critical strategic challenges, serving clients across the ecosystem, including biotech, medtech, health insurers, hospitals, and health retailers. He is also the Lead Alliance partner for Deloitte’s global relationship with the world-class, Israel-based hospital Sheba Tel Hashomer, a partnership focusing on helping provider systems and governments replicate the success of Sheba’s Tel Aviv-based health innovation ecosystem. Neal lives in New York City and holds an MBA from London Business School and a BBA from the College of William and Mary.
Kushan is a principal in Deloitte's M&A/R practice of Deloitte Consulting and an eminent thought leader in Life Sciences M&A. He has published over 20 whitepapers on topics including value creation, business model transformation, and industry convergence and is known for his deep knowledge on market shaping forces in Life Sciences. As a trusted advisor to senior Corporate Development, Commercial and Finance leaders, he continues to shape the growth agenda and transformation mandate for incumbent stalwarts and emerging disruptors in biopharmaceuticals, medical devices and diagnostics.