Project Timeline
Spring 2023
12 weeks
Role
Product Designer
3D Prototyper
Researcher
Project Type
Virtual Reality
Academic Research
UI/UX
Tools
Blender
Bezi
Unity
Figma
The project unveils a virtual reality environment built with Weill Cornell Medicine for PTSD treatment. It presents a whole new approach to healthcare, allowing both doctors and patient to immerse themselves in a virtual replica of the ICU environment. Within the simulated space, the medical professionals can monitor the behavior and condition of the patients suffering from PTSD to provide a unique tailored treatment to assist in overcoming their trauma. This project is an innovative application of virtual reality technology in therapeutic treatment to create a safer and more controlled space for patient recovery.
Overview
Problem
Patient
PTSD patients suffer from long term psychological distress
ICU patients often develop PTSD upon physical treatment and suffer from varying symptoms and poor mental health impeding their ability to reintegrate into ordinary life.
Hospital
Medical facilities cannot treat PTSD patients not in control
Doctors and nurses have difficulty anticipating patients’ mental response thereby risking of unforeseen reactions mid procedure. Conducting medical interventions on a PTSD patient risks of physical harm and ethical breaches.
Social
PTSD patients avoid seeking medical attention and help
Most ICU related PTSD patients who are under treated will refuse to revisit medical facilities out of fear. This would put their physical and mental health in danger out of not receiving proper treatments for illnesses.
Process
Research
Before ideating, we had to understand the needs and causes to the problem
Research existing studies on patients who developed PTSD from ICU experience
Interviews with the target users (hospitals / doctors)
Interviews with the target audience / recipients of the solution (PTSD patients)
Create personas
User Insights
PTSD treatment is a challenging complex because its causes are diverse and can stem from a multitude of sources.
The primary contributing factors to PTSD include intrusive medical treatment, fear of dying, confusion, sleep deprivation, limited mobility, pain, hearing impairment, communication barriers, prolonged use of medical drugs, and administration or cessation of sedatives. Identifying the component of the treatment that stimulated the development of PTSD presents a significant challenge.
Class of ICU related PTSD patients are under treated, having been indirectly affected and never entered the ICU.
Many PTSD patients developed the trauma from having to make critical decisions for a patient and saw the negative consequences. “study suggested that the risk was as high as 33% for a family member with the main decision-making role.”
PTSD susceptibility can be anticipated because pre-existing health factors and behaviors can contribute to the risk.
Common misconception is that the likelihood of PTSD depends on severity of illness. However ICU patients who have existing minor brain impairment conditions, anemia, and respiratory system problems/diseases have a significantly higher chance of experiencing PTSD from the treatment. Additionally, the usage of psychoactive drugs can also elevate the risk of developing PTSD.
Patients with ICU-related PTSD experience cognitive and mental distress because of inevitably delays in treatment.
In the immediate post ICU phase, urgent physical treatments and recovery are required that cannot wait upon patients to naturally recover from PTSD. Patients suffer from impaired physical health, mental health, and cognitive ability manifesting as nightmares, flashbacks, anxiety, depression, memory loss, and concentration difficulties. Hallucinations can also occur from delirium. These challenges risk patients of developing social isolation and maladaptive substance abuse.
Personas
Background
Survivor of a serious car accident requiring painful emergency surgery and extended ICU care.
Current condition
Limited mobility and severe pain from waist down
Recurring nightmare flashbacks of the surgery
Imminent recovery process is dependent on PTSD treatment
Needs
Reduce recurring nightmares and anxiety tied to the surgical experience
Build emotional resilience in medical environments to undergo subsequent interventions
Pain points
Stress responses during treatment require monitoring and quick intervention
Unclear triggers behind PTSD episodes in ICU
Restricted mobility limits frequent in-person medical consultations
Background
Assumed responsibility of critical decisions and paperwork for his daughter, who tragically passed away in the ICU.
Current condition
Suffers from nightmares his child in the ICU
Experiences emotional numbness and depression
Unable to return to work and ordinary life
Carries guilt over the child’s loss of life
Needs
Build self awareness of PTSD diagnosis
Develop coping mechanisms to manage mental health and reintegrate into daily life
Process traumatic memories and reduce recurring nightmares
Pain points
Mentally fragile due to chronic sleep deprivation from constant nightmares
Never personally entered ICU environment, the mind conjured exaggerated imagery
Solution Storyboard
Craig suffered from a car crash and was admitted into the ICU to receive treatment for a fatal head injury
Upon surgery, Craig survived the lethal injury but is traumatized by the ICU experience and suffers from nightmares
The medical facility helps Craig undergo psychological rehabilitation for PTSD through using a VR headset
The doctor and Craig enter a virtual simulation of the hospital and ICU where they undergo exposure therapy
The doctor accompanies Craig in the virtual environment while monitoring his heart rate, blood pressure, and reaction with the nurse
Craig panics, and clenching his teeth as his heart rate raises. The doctor immediately is able to pause or end the session by shutting down the VR headset.
Every week, Craig returns to the medical facility to undergo more sessions of exposure therapy
After many sessions, Craig has overcome his PTSD and can happily return to normal life as well as visit hospital for regular checkups without any unease feeling
User Journey
Prototype Testing and Iterations
We planned 3 key experiences to address the needs and pain points for patients, medical staff, and society
To conduct usability testing, we created lo-fidelity prototypes in a virtual reality environment to test the features and User Flow of our concepts for each key experience
We had 3 participants who each went through 3 rounds of testing to experience the onboarding, patient User Flow, and doctor User Flow
Key experience 1: patient onboarding
Before
Users find it difficult to know whether the onboarding process is complete. There is no call to action upon completing the onboarding to let users know what to do next. Users felt that the onboarding information was brief enough that the preview was unnecessary.
After
Based on the feedback, we improved visibility of system status and enhanced guidance by labelling the progress and actions needed. We added a clear call to action button at the end to ensure users recognize the completion of the onboarding and the affordance of starting the treatment. We streamlined the onboarding process for succinctness by removing the preview screen helping users grasp only the essential information.
Key experience 2: medical staff monitoring patient status
Before
Users liked functionality of the concept but find the menu and status panel repetitive. The frosted screen and status panel background was distracting the immersive interactions of the hospital environment and blocks the vision of the patient’s behavior.
After
Based on the feedback, we made the interface more minimalist by merging the patient status with the menu. We improved the natural mapping by allowing users to directly click into patient status details from the monitoring window. We also removed the frosted background to make the UI blend with the environment so users (doctors) can see the patients undistracted.
Key experience 03: patient exposed to ICU to identify root stimulus
Before
Users find it unclear about what triggered the warning from both within the environment and their own health readings. When the warning is triggered, users want the freedom and ability to exit the treatment more easily and quickly without waiting 3 seconds if not forcefully backed out by the medical staff.
After
Based on the feedback, we improved the clarity of the warning by labelling the triggering health reading and attaching the warning to the object in the room that likely evoked the reaction based on eye tracking of the user within the environment. We eased the user controls to allow backing out of the experiment in fewer steps upon the warning suggesting a pop up exit frame that allows users to quit the treatment instantaenously.
Final Design
Refined Prototype
Key experiences of the VR:
1. User goes through onboarding process inputting background information and getting accustomed to the virtual reality space
2. A doctor monitors the data of the patient; can terminate the process if any vital becomes abnormal
3. The user explores and interacts with the space while their health condition and actions are monitored to identify the root stimulus for PTSD
Onboarding
Patient background input: Users choose their role in the treatment and patients use the VR to enter background information for doctors to review and analyze.
Rationale: The background information is inputted through the VR to help users onboard the headset controls. Existing health conditions also help doctors determine PTSD condition causes.
How medical staff interact with user
Monitoring Patient Status: Doctors and nurses can enter the virtual hospital to observe the patient’s actions while monitoring their health readings of heart rate, blood pressure, and points of abnormalities.
Rationale: We wanted to allow medical staff to be able to pause or quit the treatment in first response when patient experience stress responses given the pain point that traditional treatments and surgeries are difficult to stop once it begins.
User interaction with virtual space
Identifying root stimulus: User interacts freely within the virtual hospital environment. When the user interacts with or sees a component that causes their health measurements to uprise as a result of their PTSD condition, a warning sign will pop up attaching itself to the object that likely evoked the stress response from tracking the eye and head movement of the user. Actions including a tightened grip on the controllers also induces the warning. Upon the warning popups, users can choose to continue or exit the treatment.
Rationale: The constant exposures help treat the PTSD condition through exposure therapy. The warnings label potential stimulus for the users condition and help doctors create a more personalized treatment for the patient. Labelling the stimulus also resolves the pain point of the current shortage of data on PTSD for varying stimulus.
Impact
Outcome
Final prototype tested with 200 real patients
More than 80% of patients saw an increase in the time they were able to confront the ICU environment
Doctors and nurses were able to understand the root stimulus and condition of the patients in 60% less time
Reflection
What I learned?
ICU related PTSD is very widespread affecting 1 in 5 ICU survivors and 1 in 3 close decision maker or family indirectly
PTSD treatment is highly conditional and dependent on patients’ root stimulus so existing methods are limited to exposure therapy and cognitive therapy / counseling
Patients with similar backgrounds and stimulus often experience similar conditions requiring similar treatments
Next Steps
Develop PTSD case database product: Currently, the field of PTSD lacks data to use formula treatment given the variable root causes. Building a system that eases the recording and lookup of previous cases helps the business goal of both the hospital and society to treat more patients in a more effective manner with less experimentation, time commitment, and costs.
Incorporate person to person / AI interaction: The current product exposes users to wholistic hospital and ICU environment where doctors only play a role of guiding and over watching the patient but in the future, it is possible to incorporate medical staff and AI to simulate the communication between users and other people in the environment to improve the social aspect of the product and increase the realistic replication of the setting to ease the transition for users to a real hospital after treatment.
Explore alternative senses exposure: Observation and feedback from the 200 real patients showed that there was still a small group of users who’s stimulus was exposed to. The current product focuses of visual exposure and interaction due to the limitation of the headset but in the future, it would be possible to explore physical and olfactory senses through haptic feedback to replicate the pain in treatment and the use of chemicals to replicate the smell of the environment like sanitizing products.