E-health: can virtual reality and other technology be used to reduce cancer disparities?

e-health and VR

According to Dr. Sanjeev Arora “cancer is a disease of health inequity and disparity. The vast majority of patients will not receive best practice care”.

Research continually shows that despite advances in cancer medicine, individuals in developing nations and racial and ethnic minorities in developed nations experience a lower quality of health care—they are less likely to receive routine medical care and screening and face higher rates of cancer related morbidity and mortality. The plenary session on reducing cancer disparities globally with innovative technology was presided over by Dr. Sanjeev Arora from the ECHO institute at the University of New Mexico. The session began with an introduction by Dr. Arora followed by reports from the three co-facilitators, Dr. Maria Bishop from University of Arizona, Dr. Eric Bing of Southern Methodist University, and Dr, Sanjeev Arora.

The plenary session brought together oncologists, cancer education experts and cancer prevention and treatment stakeholders to coordinate and collaborate in the UICC initiative to reduce cancer treatment inequity worldwide by sharing evidence-based practices and strategies that advance the goals of the UICC and discuss the potential measures currently used in the field.

“Besides providing excellent training in low resource settings, the use of virtual reality training engages multiple areas of the brain deepening the learning experience,” says Dr. Eric G. Bing, a psychiatrist, professor of global health, and a leading expert in providing worldwide health initiatives, including serving as co-leader of a Pink Ribbon Red Ribbon partnership, an $85 million public-private program designed to combat cervical and breast cancer in Africa and Latin America.

As recognized by Dr. Bing, there are many sources across health systems, providers, patients and managers that contribute to disparities with health care disparities occurring in the context of broader inequality. Eric G. Bing, MD, PhD, MBA is a professor of global health in the Department of Applied Physiology and Wellness in the Annette Caldwell Simmons School of Education and Human Development and in the Department of Anthropology in Dedman College of Humanities and Sciences at SMU. He has a concurrent appointment with the George W. Bush Institute as senior fellow and director of global health.

Dr. Bing spoke on his work developing low-cost innovative virtual reality training technology to improve surgical oncology training. When surgeons are trained to perform a procedure, the old rule of thumb is watch, then perform under guidance, and then teach others. Practicing procedures on cadavers, reading about them, or just watching someone else are never going to be as effective as doing things yourself — but in most lower income countries getting the necessary training is very hard to receive. Dr. Bing developed a virtual reality technology founded on the principle of training surgeons in low-cost settings with real skills that can be directly applied to save lives. Dr. Bing discussed how he was motivated to be a vanguard for change after his mother passed away from cervical cancer due to the lack of quality of care she received during her own medical treatment. The technology centers on the Oculus Rift, a virtual reality headset based on smartphone technologies. The Oculus Rift provides an immersive experience. Dr. Bing’s innovative technology using an oculus rift is now being used worldwide to train health care providers to screen for cervical cancer and on providing lifesaving oncology surgeries such as radical hysterectomies. His technique using virtual reality technology to train the next generation of lifesaving oncology surgeons via use of oculus rift virtual reality headsets is an innovative tool to combat health inequity.

“Project ECHO is a better alternative to telemedicine as it is a capacity enhancer. Unlike telemedicine which replaces one health care provider for another, ECHO provides training to doctors already present in the areas of need with the use of cellphone and videoconferencing technology” says Dr. Sanjeev Arora, a gastroenterologist and liver specialist who developed project ECHO. Project ECHO started as a way to meet local and global healthcare needs. Sanjeev Arora, M.D., a liver disease doctor in Albuquerque, New Mexico was frustrated that thousands of New Mexicans with hepatitis C could not get the treatment they needed because there were no specialists where they lived or that cancer treatment health inequity continued to be a persistent problem worldwide.

He created Project ECHO so that primary care clinicians could treat hepatitis C in their own communities. Launched in 2003, the ECHO model makes specialized medical knowledge accessible wherever it is needed to save and improve people’s lives. By putting local clinicians together with specialist teams at academic medical centers in weekly virtual clinics or teleECHO clinics, Project ECHO shares knowledge and expands treatment capacity. The highly successful ECHO model has been shown to increase physician self-efficacy, reduce wait times to see a specialist, and has improved health outcomes. At the moment, there are 70 ongoing ECHO projects providing varying facets of health care training around the world.

Dr. Maria Bishop spoke on the distance mentoring program on global cancer training and care provided by the American Association for Cancer Education (AACE). The program champions the highest standards for cancer education through evidence-based practices to achieve quality outcomes. This program provides mentoring pathways for cancer professionals and provides workshops and seminars on cancer care and the overcoming challenges faced. Dr. Bishop emphasized the importance of global collaboration and mentoring mechanisms. She encouraged the establishment of technology based mentoring pathways, through online webinars and other technology. She believes these global coordination mechanisms and partnerships create physicians and health care providers who are well trained. She also recognized the vital role that cancer education plays in creating physicians, health care providers, stakeholders, and organizations attuned to providing culturally competent healthcare. The use of online technology by the session co-facilitators affirmed the potential to contribute to reducing health disparities by serving as an accessible pool of information and a database for relevant practices.

Article contributed by Bukunmi, Gesinde