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Bridging the gap between immersive technology and healthcare
personHayley Tanner eventJul 3, 2019

Bridging the gap between immersive technology and healthcare

H&C News recently met with Sarah Ticho, the Founder of VR healthcare platform, Hatsumi. Hatsumi develop and curate immersive experiences across arts, health and virtual reality technology.

Sarah Ticho

Founder & CEO, Hatsumi

Sarah Ticho is a producer, researcher and curator specialising in arts, health and immersive technology. She has extensive international experience working with leading cutting-edge organisations, thinkers, and artists to develop projects, research and experiences that challenge our perceptions, invite conversation and spread radical new ideas and ways of thinking.

I understand that your initial interest and segue into VR from film and contemporary art was through your interest in simulating lived experience of mental health in virtual reality?  

It started in 2015, when I went on holiday to Thailand and was staying on one of the islands in the South. I believe it was a combination of jetlag, resulting in severe sleep deprivation and likely some underlying things I hadn’t dealt with, but this triggered what was later diagnosed as a psychotic episode. 

It’s impossible to describe in just a few words how an experience like that shifts your whole world view, and whilst at times it was of course frightening, it was one of the most incredible experiences I’ve ever had. Colours, tastes and smells were so deeply intense, and the world was saturated in a layer of meaning that often only features in fantasy novels. I continued my travels across the country for the next 10 days before returning to the UK - luckily unscathed but fairly shaken. 

Being referred to the healthcare system and coming to terms with the diagnosis was the most difficult part. It felt like a death sentence, and I remember being deeply frustrated feeling that I wasn’t able to convey the depth and meaning of the experience.   I was lucky to not have to take medication (well, refused), and following a review of how I care for my own mental wellbeing, I haven’t had another experience like that since. However, following this, I became intrigued by how people are able to communicate the nuance of mental health conditions and emotional states. 

In 2016 I moved to Sydney, where I saw a talk by Dr Jordan Ngyugen at TEDx, on the potential of virtual reality. I became fascinated by this tool which enables people to put the viewer into the shoes of another person and immerse them in a world they would never experience otherwise. A few months later I attended a virtual reality hackathon, where I learnt about the mechanics and different applications of VR. From there I caught the bug, which ultimately led me down the rabbit hole of developing a career around immersive technology, arts and healthcare.

2018 marked the birth of Hatsumi, please can you tell us about the concept behind it and how the project was first launched?

Following from the hackathon in Sydney, I was given an incredible opportunity to become a virtual reality curator at The Big Anxiety Festival of Arts + Science + People in Sydney. I worked with the team to put on an exhibition exploring mental health and immersive technology. We showed a series of experiences ranging from interactive experiences like Hue and Parragirls, to projects that change your mood and energy levels (Liminal) and works used in hospitals to help children relax and escape for a brief period (Dream3d by Phoria).

Source: Hatsumi

Whilst working with the festival, I met Prof Katherine Boydell from The Black Dog Institute, who had been utilising a fascinating arts and health research method known as body mapping. Body mapping encourages people to illustrate different forms of emotion and lived experience by tracing around their body on a large piece of paper.  Using different colours and textures to convey their stories. I participated in a body mapping workshop during the festival and was excited by the prospect of translating it into a virtual environment. 3D drawing experiences such as Google Tilt Brush had been around for a while and I adored how compelling and emotive the brushes were - from electricity and fire to smoke and neon rainbows. Through digitising the experience, not could we only provide users with compelling, interactive drawing tools, but also open up possibilities for saving, sharing them. 

After the festival, I moved to the US and started working at Stanford University, Palo Alto as a research assistant. During this time I attended a VR Wellness Hackathon at Google Launchpad in San Francisco, and pitched the idea - I was surprised and utterly delighted to have won most financially viable, best mind/body app, and best non-coded app. A developer called Charlie Zannormann approached me afterwards and expressed an interest in working together to create a  prototype, which we did with a games artist turned hypnotherapist Stephen B. Lewis and Lisa Padilla from NewPath VR who were interested in this space. We went to Boost VC, a VR accelerator in San Mateo, and hacked together a prototype in a day. My visa was coming to an end, and so armed with a new prototype I moved back to Brighton last May to more formally begin development. 

Upon returning to Brighton, I have been working with a variety of artists and developers to create the programme, including CTO Nico Smith. I have also recently been collaborating with Ed Silverton and Nicholas Slack who are both residents at The Fusebox, a VR co-working space in Brighton where we’re all based. We are now seeking further funding support to help us co-design and test the experience with healthcare professionals, academic institutions and people living with chronic pain and mental health conditions to ensure its to developed with the user in mind, and that it has the most meaningful impact. 

In September of last year, in collaboration with TOMTech, Hatsumi VR presented ‘NoöSphere: Mindfulness in a Hyper-Connected World’ at the Brighton Digital Festival. Please can you tell us about the exhibition and the works involved? 

The TOMTech team kindly gave us the opportunity to present an exhibition during the Brighton Digital Festival last year. We wanted to explore some of the different ways that immersive technology can be used as a tool for positive mental wellbeing and elevate states of relaxation and create new forms of perspective. We showed three different experiences exploring mindfulness and how technology can be used to explore new stories and understand ourselves. 

Attendees were able to sit in the waiting room area, which showed The Great Wave: Chill Edition by Bushra Burge Studio, a data visualisation of the number of sick days taken every year due to mental health.  They would then be led into small rooms resembling GP consultation rooms, each of which contained a different piece of work, including the heartbeat responsive biofeedback AR experience, Inner Eye, by Keisuke Suzuki, Sackler Centre for Consciousness Science, the preview of the breathtaking Trail of Angels by Kristina Buozyte and Vitalijus Zukas ahead of their opening at the Venice Biennale, and the Hatsumi prototype. We were also joined by Dr Isaac Akande, a clinical psychologist who facilitated discussions in the waiting room area on the connection between technology and mental wellbeing. We were pleased to have a sell-out show and received a great response from the audience. Of course with VR then you can only show a limited amount of people an experience, but we wanted to create something that felt intimate and personal, and I think we really achieved that.

Source: Hatsumi

VR is being used for numerous medical advances, whether that be training doctors and nurses in new techniques, treating patients, or helping them overcome phobias.  Please can you tell us how Hatsumi aims to bridge the intersection of healthcare, art and technology?

Virtual reality is being used in such a diversity of ways, and what I love about this medium is that it naturally does bring together people from interdisciplinary backgrounds to develop such a wide variety of experiences that range from training to education, health and wellbeing. 

Our ultimate goal is to create an opportunity for people to explore and gain a new perspective on their own lives by creating artworks that reveal hidden and unseen experiences, such as emotion and pain. Through taking people through a mindfulness-based experience, and transporting them to a virtual space, they are able to holistically reflect on their lived embodied experience and think about how they would visually translate that onto a body using 3D painting tools, and other forms of sound and verbal annotation. One of the little known senses that we have is something called interoception, which helps you understand the internal experience in your body and the physiological connection between emotions, stress, and pain. When we increase our interoceptive awareness, we’re able to respond to internal cues, and take action before perhaps things may escalate. It’s been found that those with heightened interoceptive capabilities, tend to go to the doctor and use medication less frequently and spend fewer days in hospital. 

Art has long been used as a tool to communicate the incommunicable, and there is a long history of exploring pain and mental illness through art. We are providing an opportunity for people to create a more structured literal translation of the experience, and use it as a tool to communicate with doctors, friends and family members, and indeed the wider public. 

Imagining and exploring what an emotion or pain looks like, and giving it a colour or a texture is incredibly powerful as it makes it a reality, not just for yourself, but something that you can show others too. 

From that, we’re exploring what happens when you can learn to augment these illustrations. Thus far, virtual reality has provided predominantly as a distraction tool for managing pain. However, we’re turning this on its head and enabling people to truly sit with it, and explore what happens when we make our experiences visible and then provide the opportunity to change it. If you have created an illustration of your pain, you are already deeply connected with it, so just as when we write letters and burn them, we want to test if over time, if you’re able to make pain and other invisible and indeed difficult experiences visible, and subsequently morph it, can that be effective in reducing the experience of pain? Already that has demonstrated success in the management of phantom limb and other functional neurological disorders such as chronic pain. 

Towards the end of last year, you worked with Immerse UK to develop an event (Immersive Technologies for Healthcare) bringing together artists, clinicians, academics and people with lived experience of disability and mental health conditions to explore the future of immersive healthcare. What was the main driver of this event? 

Whilst working at Stanford University, I attended the monthly Stanford Psychiatry Immersive Technology Consortium. It is a monthly meeting that brings together people from academia, healthcare and the tech/startup industry to explore current news and developments, share research and projects and support the wider climate of immersive technology in healthcare. Cedars-Sinai hospital also runs an annual conference titled Virtual Medicine, which brings together an even wider group of stakeholders in immersive tech for health. I was surprised when returning to the UK that there didn’t seem to be a particularly connected community here yet. I was just starting up my own company, and going through an accelerator programme at the time, receiving mentoring advice from investors and industry experts. 

However many were sceptical and unfamiliar with the health applications of virtual reality. VR offers some very unique challenges when applied to healthcare, and there have been very few startups that have had success here in the UK. During this time I met with other founders at varying points in their own journey. They too were often struggling to convince sceptical investors, when they so firmly believed in what they were creating, and the evidence supporting it. As a new and constantly emerging and evolving medium linked mostly with entertainment and games, we need to create a critical mass, and a strong database for evidence, and for that, we need to work together.

The US was already far ahead, and with major conferences like Virtual Medicine exploring the varied applications of VR in health,  I felt there was a great opportunity to support the UK climate here too. I got in touch with Immerse UK, the Knowledge Transfer Network, and The Institution of Engineering and together we ran a one-day event exploring immersive technologies for healthcare. We heard stories from patients, artists, clinicians and startups, and now off the back of that have since developed an immersive healthcare steering committee, and are running an event series with Barclays Eagle Labs exploring pain management and VR. We ran our first in May at Barclays Eagle Labs in Leeds and our next one is coming up on the 18th July at IDEALondon, and will be continuing to run more events throughout the year. In November we will also be working with the Institution of Engineering again and do a series of events within a larger Digital Health conference in Birmingham.

Source: Ryan Winterbottom/Immerse UK

What do you feel are the current challenges and opportunities for immersive technology development within the healthcare industry? 

Right now is a deeply exciting moment for immersive tech in healthcare; new articles are constantly being published on the different ways VR is being used in health, from anxiety and pain management to surgical training and exposure therapy. As a result, more people are becoming aware of the diversity of ways it can be applied, and more people are starting to develop for VR. The VR landscape is drastically changing, especially with the launch of the new Oculus Quest - a wireless virtual reality headset which means that we can engage with immersive experiences almost anywhere. Cost and access to the right physical space have been a barrier for so long, yet with a more affordable price point, and a far simpler set up is a major change in the industry - it’s going to be very exciting to see how VR continues to grow and develop over the coming months.

The mutual agreement across the industry is that we are still very much at the beginning of the journey into exploring the possibilities of this technology, but we need to continue supporting research to strengthen this evidence base - and that means experimenting with new things. 

However, as a new industry, it’s still very much unregulated. It’s been somewhat of a grey area regarding what sort of claims you can make about a virtual reality experience, and at what point something moves from a wellbeing application to an experience where you can make medical claims. Research is beginning to demonstrate how unbelievably influential this technology is and can be on people health and behaviour, and we need to start being more critical when considering how experiences are affecting people both within a healthcare environment, and in other industries from the arts to marketing and enterprise. However, the current lack of regulation may also be seen as an opportunity for people in this space too as it’s much easier to get approval faster. Long term though, we’ll need more formal infrastructure, and potentially even an ethical approval and distribution body.

There are a host of cutting edge creatives that are really pushing the artistic boundaries of this medium, and over the next few years I hope we have the opportunity to see more interdisciplinary collaborations between artists and healthcare practitioners to develop experiences that are not only effective in treating anxiety or phobias, but visually compelling experiences that are as engaging and enjoyable as they are beneficial for patients and audiences.  

Already, organisations like the Walt Disney company are starting to show support and investment in immersive technology for paediatrics, alongside companies like Akili Interactive in the US, who have had over $68m invested in their startup, developing games for health. However, we need to really explore what the impact of major brands like Disney may have if they start to dominate the digital health industry. We need more collaboration between games designers, artists and storytellers with healthcare professionals and people with lived experience. The games industry is already completely oversaturated with developers, who often burn out fast following crunches. Perhaps there’s scope to offer a new culture around game development, and create a healthy approach to creating interactive digital experiences. 

Naturally, we are often limited by the hardware - headsets and computers are large and expensive, and new versions are constantly being released. However, the advent of standalone wireless headsets such as Oculus Quest will completely change the way we engage with VR, alongside new developments in Augmented and Mixed Reality with headsets like Magic Leap. Again, distribution and access have been problematic, and thus far arts organisations, festivals and pop-up arcades have been where we can access the majority of experiences. Some hospitals are now trialling the use of virtual reality, but it will be interesting to see how this can be more systematically rolled out. 

Alongside this, we need to start investing in startups that are developing experimental and innovative new projects, that don’t just offer immediate scalable money-making ventures but show potential for genuine long term impact. That means funding diverse projects, and diverse people behind the projects and making sure this is an industry that is representative of the people we hope to reach. 

What are the future plans of Hatsumi?  

We’re now applying for funding to support the development of the Hatsumi platform with a network of collaborators. We’re shifting to WebVR and developing opensource technology that can further benefit the medical visualisation and bioinformatics community, as well as make an easier way for people to access Hatsumi from a variety of headsets. We’re also working with local NHS communities to co-design more drawing tool and sounds that a representative of different kinds of experience, and hoping to build an ever-expanding archive of anonymous, crowdsourced creations. 

About the author
Hayley Tanner
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Hayley Tanner is Operations Manager at Hack & Craft and Editor for Hack & Craft News, the leading resource for corporate innovators. Hack and Craft has built a wide range of innovative products for startups and aspirational fortune 500s. Through Lean startup methodology and Hyper-Agile software development, Hack & Craft has driven iterative change and innovation in companies such as EDF, RS Components, Red Bull, Axel Springer, Azko Nobel and Schneider Electric.

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