ATLANTIC INSTITUTE | BEING HUMAN
PODCAST 04 | VIRTUAL HEALTH

TRANSCRIPT

MUSIC Outro sting – Rovador for AudioJungle, Fantasy Cinematic

F Sweeney: Hello and welcome to Atlantic Fellows Conversations. I’m Fionnuala Sweeney.

Today, Alice Wroe, the Atlantic Institute’s Augmented and Virtual Realities Lead, joins me to discuss the use of AR and VR in healthcare, how it can ease pain and the ethical challenges it presents.

You will also hear from Deepa Mann-Kler, Chief Executive of Neon, who – with Jeremy Lim, Atlantic Fellow for Health Equity in Southeast Asia – took part in an Atlantic Fellows webinar on the topic earlier this year.

Now over to Alice for more about the webinar.

A Wroe: We heard from Deepa Mann-Kler, who is an immersive health specialist as well as being the CEO of Neon, and we also heard from Jeremy Lim, who is an Atlantic Fellow for Health Equity in Southeast Asia.

Deepa is an incredible thinker because she is able to put care and humanity at the absolute centre of all of her work, and in health sometimes things can feel quite abstract or a little bit intimidating, but Deepa has so much heart you just intuitively understand them.  What Jeremy brought was a really wonderful expert eye, so he could ask the question from the health perspective, but then he would instantly loop his question into what it really means for us, as patients or as health professionals or as just people in society, what is health innovation, how it impacts us.  I was so grateful that Jeremy was able to steer the conversation from that expert angle.  Both of them were so caring and kind and really visionary in what they were saying and the work that they’ve done.

F Sweeney: And you spoke at the beginning of the session, I’m going to quote here, “Ignite our imagination and invoke the (k)new”, with K in brackets.  In other words, invoke the K-N-E-W, where we draw on our histories and our narratives, and all forms of knowledge, and bring it into this space.  Explain a little more about that because this is something we talk about a lot in the Atlantic Fellows’ community.

A Wroe: This idea of the new is from the ‘Atlanticology’; it’s like a pedagogy that has been developed within the Atlantic Institute and the Atlantic Fellowship community.  I absolutely love it because what we say at the beginning of all of our sessions is, “Bring with you your past, your experience, your expertise, your life, bring your whole self to these conversations and to these learnings that we’re undertaking together”.  

For me, when I read that idea in the context of everything that Atlantic Fellowship does, I couldn’t believe how pertinent it was within a tech context, because so often, when we’re thinking about technology, when we’re looking at innovation, we’re kind of frozen in this state of, “Oh my gosh, I have nothing to bring to this, I don’t understand the coding or the language”, but actually our lives and our experiences are so relevant when we’re thinking about technology.  It’s this idea of bringing the (k)new with this bracketed K. I wanted to extra cherish that in the Being Human series because it’s so relevant.

F Sweeney: It makes the whole AR/VR space less alienating and distant I think for people if they know that they can bring what they already know historically, personally and through their cultures and communities to it.

A Wroe: Yeah.  What you already know from your work life, from your personal life, and also what you just feel in your gut.  So often, when we’re thinking about technology, you kind of know if it freaks you out, if it inspires you, if it makes you want to rush out and buy something, or if it makes you want to run away and write a piece about it, and it’s about owning those feelings, working out where your intuition comes from, and then learning with each other.  I think what the ‘(k)new’ with a K is all about is that there is no such thing as an expert. We’re all experts in our own lives and our own experiences, and it’s about cherishing that expertise and bringing it with us as we approach new situations.

F Sweeney: Let’s move on to the very practical applications of AR/VR.  AR/VR, as we were hearing in this session, can control pain.  Where are those developments and how exciting are they, that we can solve real world problems, like controlling pain?

A Wroe: I’m not an expert in health, but from listening to Deepa and to Jeremy, the exciting thing for me was, it was kind of about distraction.  When you put on this headset, it can alleviate pain because you’re focusing on something slightly other, which was interesting because that is the roots of virtual reality in gaming. All about escapism, and actually that is what this health application is borrowing from, this idea of immersing yourself in a different environment, that takes you outside of your pain somewhat.

Let’s hear from Deepa how VR can be used to alleviate pain.

DMK01: how VR can be used to control pain

D Mann-Kler: VR has the capability to retrain our neural networks and pathways in a really positive way through a process called ‘neuroplasticity’, where we can actually rewire our brains and change it on a cellular level.  VR reduces sensory pain, there are fewer pain signals and less emotional pain, but, at the same time, the positive areas of resilience and cognitive processing are increased.  There’s a double-whammy effect, less perceived pain combined with the positive effects of increased resilience.  While technology offers solutions that does give people choice, the use of technology can also enable people to share their experiences, and in doing so give hope and enable people to feel human again.  For me, effective VR and AR teaches people skills that they can use in real life.  My mother has suffered from chronic pain for the past 25 years.  I believe that technology will finally give people choice, that people like my mother have not been afforded to date.

F Sweeney: We often talk in the Atlantic Fellows’ community about the importance of being present and the fact that there’s time to help shape the conversation around the use of AR/VR.  In other words, the need for an ethical framework, a global ethical framework, because without regulation or standards this technology can be used unethically.

A Wroe: You’re so right.  And that is exactly why we invited Deepa to be part of this series because she speaks so powerfully about the ethics of AR and VR, and what we need to do as activists in this context.

DMK02: need for ethical framework

D Mann-Kler: The ethical framework and the value basis has to underpin everything.  I think that’s unfortunately been missing in terms of commercial conversations around innovation and technology, because the drivers are often financial.  So, my approach is always human-centric, and whatever R&D project you’re involved in the person who is going to be affected by it or is going to be used or for whom you’re developing that benefit has to be at the centre point.  That’s with whom you start your conversation, and they have to be there every step of the way, and that’s the only meaningful way for this to happen.

A Wroe: There was a very interesting point that Jeremy bought up, about what could we, as a Fellowship, do if we came together?  It was about creating almost like a council, where we’re thinking about what could AR and VR be used for, and what safeguards can we put in place to make sure that it doesn’t become manipulated, as you say, and where do we land as a community in terms of what’s positive and what’s negative.  In the Zoom room everybody kind of sparkled when Deepa talked about a VR experience that’s been developed to help the process of children being vaccinated.  As a child puts on the headset the nurse follows the experience on their phone, and then all of the physical moments of touch for the child are mirrored in the VR world, and it makes the child be able to recontextualise what’s happening and the process is so much more imaginative and relaxed, and there’s not this pain and fear that’s permeating through everything.  That felt like an ethical way to use VR: it was solving a problem, it was imaginative, it was kind, and it slipped seamlessly into a health context.  

But other examples, particularly around dealing with grief and sometimes replicating the experience with a loved one that has died, ethically that feels off to us.

DMK03: Korean VR example - risk of unintended consequences

D Mann-Kler: The project about the Korean virtual reality experience, that is fascinating on many, many levels.  A mother and father, they had lost a young daughter, but they used the second sibling that was left behind in terms of the facial scanning and modelling. Then the mother got to meet the daughter in this virtual reality environment for one last birthday.  I was left thinking, “What’s the impact of this on this sibling that’s been left behind, who’s too young to actually give consent to this in terms of the trauma and the healing?”  It’s the unintended consequences and effects, how do we futureproof our innovation?

A Wroe: It’s about working out where are those lines drawn, and as a community how could we start to build that framework.

F Sweeney: As we’re talking there about using AR/VR tech in a health context, it does raise the pertinent issue, which we’ve touched on before, digital exclusion.  There will be people, communities, countries, where there will not be access to this kind of technology.

A Wroe: Deepa spoke at length around exactly that. How can we make sure that AR and VR doesn’t widen health inequity rather than close that gap?

DMK04: digital exclusion and digital poverty

D Mann-Kler: Digital exclusion and digital poverty have become even more polarised over the past year, and we’ve seen that with COVID.  For me, I think augmented reality and digital phone innovations are going to be really interesting, because the cost will come down, it will be accessible on people’s phones.  There’s talk of contact lenses, there’s talk of glasses, which people have been talking about in the industry for a few years now, and the costs do come down, but if it can be shown to help in, say, preventative healthcare, so that you’re investing for the long-term, and that is a financial incentive to governments to invest in it, then maybe that will be a driver.  I know in the West that our funding in terms of health and social care tends to be driven by the election cycle. It’s so short sighted. It needs to be on a 20-25 year basis. It needs to sit above party politics if we want to see meaningful change in terms of our population health and if we want to reduce inequities in health and if we want to just have a decent society where everybody is valued.

A Wroe: Deepa’s point is so pertinent there, about needing a society where everybody is valued, and it speaks to this further question that, if only a few people have access to this sort of technology, is it really moral for the medical profession to jump on board with this sort of innovation?

F Sweeney: And then there’s the question of in-built bias, the bias that’s already put into the design of artificial intelligence.  It’s fair to say, presumably, that a lot of the developers, the majority of developers, are white, maybe American or European, what does that bring with it?

A Wroe: Yeah, when you stray into artificial intelligence and the datasets that are informing this sort of technology, particularly in a health context, it becomes exceptionally important that the datasets are diverse.  And this was one of Deepa’s main concerns.

DMK05: AI and danger of built-in bias

D Mann-Kler: One of my fears is that artificial intelligence is beginning to be used increasingly in terms of the design of various systems.  I am concerned about how AI is being designed, because it can only be designed by using datasets, and often that dataset is biased and tends to be racially disproportionate, it’s generally white European in terms of the way it’s done.  We’ve had facial recognition technology that’s been developed that is appalling at picking up faces that are African or dark skinned because those datasets were never part of the initial programming.

A Wroe: This isn’t a new problem.  When you look back in medicine, this happens again and again and again, where health innovation is designed around male bodies particularly, when you think of it from a feminist perspective, and this is happening in a health context today, for sure, in artificial intelligence, around race and around gender.  We didn’t touch on that hugely in this session because we were thinking more about augmented reality and virtual reality, and lots of therapeutic methods and diversion tactics and pain management. But you hit the nail on the head in terms of the big question around AI and datasets, absolutely, and that’s something we need to keep a really close eye on in terms of the discourse.

F Sweeney: We touched on earlier the whole issue about digital exclusion and digital poverty, and that COVID has simply further exposed already existing inequities.  Might it actually be the case that COVID might accelerate accessibility to this technology and the hardware that accompanies it?

A Wroe: I really hope so.  Deepa has this beautiful metaphor where she talks about trees and the nutrients under each of the trees, and when one tree is unwell the other trees send these nutrients to that particular tree to uplift it, and they share all their nourishment so that they can look after each other and make sure that no one is unwell.  

She talks about the future of technology needing to follow that model, that actually technology shouldn’t be there for the elite, to uplift the privileged, but actually it should be there so we can send, under the soil, all these nourishing things to each other and use technology to uplift those that need uplifting.  

I loved speaking to Deepa and hearing snippets of how AR and VR in the future can achieve that, that would be the dream, that we come out of COVID closer to understanding how technology can uplift all of us rather than only uplift those that have privileged access.

F Sweeney: There’s still another session to go in this podcast series. What’s next, Alice?

A Wroe: Next in the series is an exploration of AR and VR from an indigenous perspective.  We’ll be joined by Atlantic Fellow for Social Equity, Shane Webster, who will be in conversation with Mikaela Jade, founder of Australia’s first indigenous edutech company.  We’re going to consider the power of this medium for storytelling and for safeguarding indigenous knowledge.  We are delighted to bring these two thinkers and activists together to explore AR and VR from an indigenous perspective.

F Sweeney: And that was Alice Wroe, Augmented and Virtual Realities Lead at the Atlantic Institute.  Our next episode will be on indigenous approaches to AR/VR.  

You’ve been listening to Atlantic Fellows Conversations.  I’m Fionnuala Sweeney. To find out more, visit our website at www.atlanticfellows.org.

MUSIC Outro sting – Rovador for AudioJungle, Fantasy Cinematic

ENDS | Duration: 14’ 57

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