Early Scaling of Immersive Technology within the Veterans Health Administration

Over the past several years, accelerated by the Covid-19 pandemic, immersive technologies - including virtual reality (VR) and augmented or mixed reality, also known collectively as extended reality or XR - have shown mounting promise in their ability to enhance clinical care delivery and support clinical staff. These immersive systems alongside standard of care in several areas and are at minimum used as additional ways to augment evidence-based therapies. These non-invasive and easy-to-use tools have demonstrated ability to effectively channel patient experience into therapeutic activities, facilitate home-based care, provide valuable longitudinal patient data, and enhance treatment adherence. Given this promise, immersive health care applications have spread across the Veterans Health Administration (VA), building additional evidence for efficacy and laying implementation groundwork. To date, VA has documented more than 40 indications for immersive technology utilization within our organization, with more in the pipeline. Early exploration of immersive technology in VA began with 5 sites and 10 staff engaged in a Community of Practice and has now grown to 172 sites and more than 2,300 engaged VA staff. The most uptake and impact has been seen in pain management, physical rehabilitation, and mental health care, including anxiety, depression, and post-traumatic stress disorder (PTSD). Crucial to further scaling the use of immersive technology, VA has developed standardized resources such as knowledge networks, implementation guides, electronic health record templates, and standard operating procedures. VA continues to offer opportunities for more heads in headsets, as this is an effective way to demonstrate to Veterans and staff how immersive technology can enhance care. Key to future success in VA will entail increasing equitable access; growing the scope of content; standardizing training for staff and patients; and improving processes for synthesizing and analyzing relevant data to optimize these tools. Through these activities and continued planning, VA is poised to define the landscape of immersive technology in health care and inform adoption beyond VA.