The Benefits of Introducing VR Therapy at Cedars-Sinai

Interview of Dr Brennan Spiegel, Cedars-Sinai, by Denise Silber, VRforHealth

We are grateful at VRforHealth to Cedars-Sinai for the Virtual Medicine conferences that led the future co-founders Beth Savoldelli and Denise Silber to meet. We are thus especially pleased that Dr Spiegel, an international thought leader on therapeutic virtual reality and curator of those conferences, could make time for this interview, shortly before the launch of his new book, VRx: How Virtual Therapeutics Will Revolutionize Medicine.

Brennan Spiegel, MD, MSHS, is Director of Health Services Research for Cedars-Sinai Health System and director of the Cedars-Sinai Center for Outcomes Research and Education, a multidisciplinary team that investigates how digital health technologies – including wearable biosensors, smartphone applications, virtual reality and social media – can strengthen the patient-doctor bond, improve outcomes and save money. Dr Spiegel is also editor-in-chief of the American Journal of Gastroenterology. He continues to practice clinical medicine and maintains a busy academic teaching practice at Cedars-Sinai.

Dr Spiegel is a prolific writer. His next book, VRx: How Virtual Therapeutics Will Revolutionize Medicine, is launching October 6, 2020. Here is a beautiful passage explaining how Virtual Reality helps us in time of need.

“…By carefully adjusting our virtual reality when we are sick, we can affect our physical reality for the better. VR does this by radically changing our perspective of the world. We can imagine being somewhere fantastic and healing. We can practice being the person we want to become. We can see ourselves from beyond and regard ourselves in a new light. We can empathize with ourselves and with others. We can confront our inner voice. We can transform our minds drastically and immediately, and when effective, forge health cognitions that last long after the headsets are removed. We have already have these abilities within us. VR just makes it easier when times are hard.”

Dr. Brennan Spiegel

What benefits does VR Therapy Bring to the Cedars Sinai community?

If I answer as a clinician, the first benefit is that VR therapy works. It provides a non-pharmacological, but evidence-based treatment that can improve the biopsychosocial wellbeing of our patients. Our hospitalized patients find a special benefit from VR therapy; it not only has therapeutic value, but also allows them to « escape » from their room.

Secondly, at Cedars-Sinai, we pride ourselves on our innovative research, and our work in Virtual Reality is part of that mission. We attract outstanding investigators for around the world. Currently we have a pharmacist from South Korea who is interested in digital health and helping to support our clinical VR research.

Which departments have done research on VR as therapy so far at Cedars-Sinai?

Besides gastro-enterology, which is my specialty, there has been formal research at Cedars-Sinai in orthopedics, pediatrics, and obstetrics.

The portal lists 10 VR trials for Cedars Sinai. One in childbirth and one in sphincter of Oddi dysfunction (SOD) are recruiting. There are several completed pain trials. I recall that the results were positive. Is running a clinical trial in VR therapy more complex and slower to execute than one without a headset?

Not really. The hard part right now is conducting any clinical trial during the COVID-19 pandemic. Our upcoming VR clinical trial, which will be focused on chronic lower back pain, will be entirely remote. We will send patients all the equipment by courier, including the headset preloaded with the study software, the charging cable, and a detailed instruction booklet for use. Our patients can also consent remotely online, and complete all of their symptom assessment using an app or web browser.

How are you planning to extend VR therapy beyond the occasional patient who comes through your department? I understood that your plans were delayed because of Covid-19.

You are right. Prior to Covid-19, we had a project to develop a VR clinic. And we are currently doing a re-start. We plan to create an therapeutic VR center that supports both inpatient and outpatient care. This can help scale up our VR services beyond doing clinical trials. We are in the process of working to staff and support this new clinic, which we ultimately hope to call the Cedars-Sinai Center for Immersive Therapeutics. We are also doing all the operational planning, calculating the business model for it, and so forth. We’ll advance cautiously, starting with perhaps 10 patients per week, as we ramp up the process of delivering VR clinical services. We will formalize the hygiene protocol, and hope to integrate VR therapy into the electronic health record as a formal consult. This will be quite different from doing research.

Your new book, “VRx: How Virtual Therapeutics Will Revolutionize Medicine”, is launching after three years of intense work. I’ve caught a glimpse of a few passages and they really draw the reader in. What can you tell us about it?

The goal of my new book is to reveal the power of a new kind of care: virtual medicine. The book reveals what VR teaches us about our own consciousness, how it helps to explain the connections between mind and body, and reviews cutting-edge research from pioneering scientists around the world. I begin the book by having a complete out-of-body experience in VR, and then spend time trying to understand just how that happened, and what it means about how my mind and body operate. It was a lot of fun to write a book that combines philosophy, psychology, neuroscience, technology, and clinical medicine—all of my favorite topics. The book launches on 10/6 and will be published by Basic Books in New York.

Here is a link to the book along with some early reviews:

We’ll also have a special webinar that day featuring patients and researchers highlighted in the book. You can learn more about the webinar here:

Thank you, Dr Spiegel for this interview and looking forward to the well-deserved success of your new book.

Denise Silber

Photo Credits: Dr Spiegel from the Virtual Medicine website. Cedars-Sinai panoramic view of campus, from the pressroom of the hospital website.