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The challenge

Developing a patient simulation experience

Smileyscope was founded by Dr Evelyn Chan, who identified the opportunity to use virtual reality (VR) or augmented reality (AR) to improve patient experience and outcomes during healthcare procedures.

Smileyscope: using virtual reality to help young patients

The first product developed by Smileyscope, partly with assistance from Innovation Connections, is a VR experience for children undergoing needle procedures in which real world sensations are reframed in the VR world in a supporting and engaging way. Smileyscope's innovative therapeutic platform has changed paediatric needle practice worldwide, and international vascular access guidelines now recommend Smileyscope.

The next area that Smileyscope identified to focus on is Medical Resonance Imaging (MRI) procedures. MRI is an anxiety-provoking, claustrophobic and noisy procedure lasting between 20 to 90 minutes. To ensure high-quality images, patients need to lie very still and comply with instructions during the procedure. Often children under 10 years old are sedated under a general anaesthetic for MRI, and even in adults around five per cent of MRIs are aborted during the procedure due to patient anxiety and claustrophobia.

Smileyscope’s plan was to develop MRI simulation experiences to help young patients understand what to expect. Optimising patient preparation for MRI procedures in this way may improve waiting list times and MRI quality, while reducing sedation rates.

Our response

Collaborating on a pilot study

Smileyscope worked with Innovation Facilitator Joseph Dodd, who helped identify that collaborating with Monash Children’s Hospital under the expertise of Prof Michael Ditchfield, Head of Paediatric Medical Imaging, would best suit Smileyscope’s vision.

Through an Innovation Connections Business Researcher Placement, one of Smileyscope’s engineers was placed at the hospital to collaborate on a pilot study to investigate whether virtual reality is a feasible and acceptable preparation and assessment method for awake MRI in children aged four to 10 years. Monash Health and Monash University provided recruitment and access to patients undergoing MRI procedures, access to clinicians, ethics approval, governance, collection and publication of the data.

Smileyscope engineers were able to access feedback from patients and families while testing and refining the VR software and storyboards, and undertook diagnosing, documenting, and fixing of bugs reported by testers and users to attain quality assurance to medical standards. They then trained clinicians with the use of the VR equipment and refined the VR software user interfaces and storyboards based on feedback from the clinical research team.

The results

Creation of Smileyscope MRI virtual reality tool

The project has led to the creation of Smileyscope MRI, a VR tool for use in MRI preparation for children, offering a more streamlined imaging process to save time and resources for the hospital, and result in less stress and discomfort for both patient and clinician.

"The Smileyscope is a great tool enabling children to cooperate and keep still for MRI scans. They finish the scan happy, and we have diagnostic images," said Prof Michael Ditchfield.

The new VR tool gamifies the MRI scenario, turning it into a bakery, and challenges young patients to keep as still as possible to balance as many donuts as they can. The feedback from the child's performance in the VR game is then provided to the clinician to enable them to analyse whether the patient is likely to stay still for the MRI procedure or would require sedation. Once in the MRI the patient can then relate the scenario to the VR game which also helps them to relax and lie still.

Smileyscope MRI is already being used in Monash Health hospitals and Smileyscope is starting to sell the tool to other Australian hospitals and in export markets.

The Innovations Connections program has been instrumental in bringing this innovative work to life.

— Dr Paul Leong, Chief Medical Officer, Smileyscope

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