The rapid pace of Virtual Reality (VR) and interactive computer games advancements are producing significant opportunities for the health and medical communities. The Department of Defense (DoD) is capitalizing on these advancements through research centers such as the Institute for Creative Technologies (ICT); a University Affiliated Research Center (UARC) associated with the University of Southern California (USC) and being managed by the U.S. Army Research Laboratory’s Simulation and Training Technology Center. Innovations being developed by this research center represent the start of a rapidly growing field. The SimCoach project is one of the efforts pioneering this growth.
The SimCoach project employs VR-based virtual humans for use in a web-based application which has the potential to revolutionize the internet. SimCoach characters act as virtual coaches offering expert advice, healthcare information, and support to the military community in multiple arenas to include depression, stress, brain injury, relationship counseling, substance abuse, suicide, rehabilitation, reintegration and other relevant specialties. The use of VR-based virtual humans to effectively serve as a virtual coaches, mentors, and trainers are well documented. There is a growing field of research that applies virtual human characters to training and assessment of bioethics, patient communication, interactive conversations, history taking, coaching and mentoring, and clinical assessments.
The SimCoach project was developed to address current issues with the DoD and Veteran’s Administration (VA) healthcare systems. Numerous blue ribbon panels of experts have attempted to assess the current DoD and VA healthcare delivery system and provide recommendations for improvement. These reports identified a need for enhancing the healthcare dissemination/delivery system for military personnel and their families in a fashion that provides better awareness and access to care while reducing the stigma for persons seeking healthcare assistance.
For example, the American Psychological Association (APA) Presidential Task Force on Military Deployment Services for Youth, Families and Service Members report stated that they were, “…not able to find any evidence of a well-coordinated or well-disseminated approach to providing behavioral health care to service members and their families.” The APA report also went on to describe three primary barriers faced by the military community for behavioral healthcare: availability, acceptability and accessibility. Specifically the APA report indicated that: (1) Well-trained mental health specialists are not adequately available, (2) The military culture needs to be modified so that mental health services are more accepted and less stigmatized, and (3) Behavioral health services are often not readily accessible due to a variety of factors such as long waiting lists, limited clinic hours, a poor referral process, and inaccessible geographic locations. The SimCoach application addresses these kinds of challenges.
Virtual SimCoach characters interact with users, in an anonymous fashion, to determine what their specific interests, concerns, and needs are. The SimCoach application then uses this information to guide users step-by-step towards getting the assistance they need. Based on the information obtained through these user interactions the SimCoach application gathers and provides relevant material such as articles, multimedia content, video testimonials of people having similar experiences, social networks and support groups, videos and information regarding various treatment options, and referral lists of live providers. The SimCoach application also provides assistance with scheduling appointments, the ability for users to perform simple neurocognitive and psychometric tests to inform self-awareness or aid in making decisions on initial referral options, and the capability to print out summaries of the computerized sessions so that users can bring these with them when seeking treatment.
Due to the success of the SimCoach project to date and the desire to expand the selection of virtual characters available in support of a wider range of other applications the United States Army Telemedicine and Advanced Technology Research Center (TATRC) funded additional development efforts to include a web-based authoring platform to allow the creation of new virtual characters and additional capabilities by non-technical users. The authoring tool, currently being referred to as Roundtable, is built upon a broad set of virtual human component technologies developed by the ICT to include computer graphics, animation, and natural language processing. Once created the newly developed virtual characters can then be deployed to standards-based web application servers and content-delivery networks for testing and use by potential users on the web. The Roundtable authoring system has been used for various other efforts including a regional veteran support initiative called BraveHeart, sponsored by the Atlanta Braves and Emory University, as well as a virtual guide for the U.S. Army Medical Department (AMEDD) in support of an Army Surgeon General-mandated annual professional quality of life scale questionnaire (ProQOL) for healthcare providers in response to increases in provider fatigue and burnout.
In the future, the Simcoach application is planned to be extended further by providing capabilities to create web-based virtual standardized patients (VSPs) which will be made available for use for training novice health and medical practitioners in the field in areas such as interviewing techniques, interpersonal communications skills, rapport building and performing assessment and diagnosis. Educators will be able to generate various types of VSPs quickly and easily to supplement existing curriculums which use human standardized patients. Another extension to the Simcoach application which is planned in the future involves the development of virtual librarians to support user interactions with complex databases like MedLine.
In summary, the SimCoach application offers a new, exciting, and engaging means by which to empower the military population with the capability to gather healthcare information, understand their situations better, obtain advice, explore available options, obtain assistance with decision making regarding treatment options and referrals, access resources, monitor healthcare, and initiate treatment when needed. The technology is continually being repurposed and used for a variety of commercial and DoD applications.
Conclusion
Significant technological advancements in VR and interactive computer games have generated novel opportunities for the health and medical communities. Technical innovations, such as those being developed by the ICT, will continue to advance the health and medical fields and represent the start of a rapidly growing field. Additional information regarding these and other technological innovations being developed by the ICT is available at http://ict.usc.edu.
References used in the development of this article are available from the author upon request.
Mr. Joseph M. Brennen Jr. works for the U.S. Army Research Laboratory, Human Research and Engineering Division, Simulation and Training Technology Center in Orlando, Florida where he is the Chief Engineer for the Institute for Creative Technologies (ICT) Contract. ICT is a Department of Defense University Affiliated Research Center (UARC) associated with the University of Southern California (USC) which advances the state-of-the-art in immersive virtual reality systems.
