Virtual Reality & The Design Of Healthcare Environments

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New England Healthcare Engineering Society Fall 2016 ConferenceVirtual Reality & the Design of Healthcare EnvironmentsMike Bennett, AIA, Boston, MAAilyn Mendoza, ASLA, New York, NY

AGENDA Overview of VR Technologies Real World Applications of VR Benefits

PRESENTER BIOSMike BennettHealthcare Architect, AIA EDACE4H ArchitectureGeorgia Institute of Technology, Digital Design and Virtual EnvironmentsFlorida International University, CARTAVAMC ProvidenceIntensive Care UnitVAMC ProvidenceNeurology Prosthetics Lab

over 100master plans100%healthcareover 80inpatient bedprojectsover 250over 5,000healthcare designprojectshospitalsover 100 ambulatoryprojectscare

A.O. Fox HospitalOneonta, NYAcadia HospitalBangor, MEAddison Gilbert HospitalGloucester, MAAdirondack Medical CenterSaranac Lake/Lake Placid, NYAlbany Medical CenterAlbany, NYAlice Hyde Medical CenterMalone, NYAlice Peck Day HospitalLebanon, NHAmerican Healthcare Investors, LLCCarlsbad, NMBarnabas HealthWest Orange, NJBassett Medical CenterCooperstown, NYBaylor Healthcare SystemDenton, TXBaylor Scott & White HealthTXBaylor Medical Center FriscoFrisco, TXBaylor Orthopedic Surgical HospitalArlington, TXBaylor Medical Center Trophy ClubTrophy Club, TXBayonne Medical CenterBayonne, NJBaystate Franklin Medical CenterGreenfield, MABellevue Woman’s HospitalSchenectady, NYBergen County Medical CenterParamus, NJBerkshire Health SystemPittsfield, MABeverly HospitalBeverly, MABlue Hill MemorialBlue Hill, MEBlythedale Children’s HospitalValhalla, NYBridgton HospitalBridgton, MEBronx Psychiatric CenterBronx, NYBrooklyn Children’s Psychiatric CenterBrooklyn, NYBrownwood Medical CenterBrownwood, TXCanton-Potsdam HospitalPotsdam, NYCarlos Otis Stratton Mountain ClinicStratton Mountain, VTCary Medical CenterCaribou, MECatholic Healthcare WestPhoenix, AZCentral Maine Medical CenterLewiston, MECentral Texas Rehabilitation HospitalAustin, TXCentral Vermont Medical CenterBerlin, VTChamplain Valley Oral SurgerySouth Burlington, VTChamplain Valley Physicians HospitalPlattsburgh, NYCharles A. Dean MemorialGreenville, MEChildren's Medical Center of DallasDallas, TXChildren's Medical Center PlanoFormerly Children’s Medical Center at LegacyPlano, TXclient listChildren’s Health Pediatric GroupFormerly MyChildren’sTXChildren's Health HMO/Call CenterIrving, TXClifton Fine HospitalStar Lake, NYCobleskill Regional HospitalCobleskill, NYColorado Plains Medical CenterFort Morgan, COCommunity Counseling CenterPortland, MECedar Park Regional Medical CenterCedar Park, TXCommunity Health SystemsAK, AR, AZ, LA, NM, OK, TX, WA, WYCollege Station Medical CenterCollege Station, TXConciER MedicineTXCook Children's Health Care SystemTXCook Children’s Healthcare SystemClinic at Trophy ClubTrophy Club, TXCook Children’s Healthcare SystemClinic at SouthlakeSouthlake, TXCook Children’s Healthcare SystemClinic at LewisvilleLewisville, TXCook Children’s Healthcare SystemClinic Pediatric Clinic at Heritage TraceKeller, TXCooley Dickinson HospitalNorthampton, MACopley HospitalMorrisville, VTCottage HospitalWoodsville, NHCrouse HospitalSyracuse, NYDartmouth-Hitchcock HospiceLebanon, NHDartmouth-Hitchcock NashuaNashua, NHDeaconess Medical CenterOklahoma City, OKDeaconess Medical CenterSpokane, WADown East Medical CenterMachias, MEDuke RealtyPlano, TXEastern Maine Medical CenterBangor, MEEastern New Mexico Medical CenterEastern, NMElizabethtown Community HospitalElizabethtown, NYElliot Health SystemManchester, NHEllis HospitalSchenectady, NYElmhurst Hospital CenterQueens, NYFairview HospitalGreat Barrington, MAFanny Allen HospitalWinooski, VTForest Park Medical Center Dallas Master PlanDallas, TXForest Park Medical Center SouthlakeSouthlake, TXFirst Choice Emergency RoomsCO, TXFranklin Memorial HospitalFarmington, MEFunderburgh Realty GroupArlington, TXGables at East MountainRutland, VTGerald Champion Medical CenterAlamogordo, NMGifford Medical CenterRandolph, VTGlens Falls HospitalGlens Falls, NYGoodall HospitalSanford, MEGrace Cottage HospitalTownshend, VTGracie Square HospitalNew York, NYHallmark HealthMedford, MAHarvard Medical SchoolBoston, MAHealth Source SaginawSaginaw, MIHealthcare Building SolutionsRichardson, TXHealthcare RealtyDenver, COHealthcare Realty TrustFrisco, TXHerkimer Health CenterHerkimer, NYHospice of Southern MaineScarborough, MEHospital for Special SurgeryNew York, NYInland HospitalWaterville, MEInter-Lakes HealthTiconderoga, NYJohn T. Mather Memorial HospitalPort Jefferson, NYKingston General HospitalKingston, Ontario, CanadaLahey Hospital & Medical CenterBurlington, MALake Area Medical CenterNorthfield, VTMayo Regional HospitalLake Charles, LALakeridge Health OshawaOshawa, Ontario, CanadaLand Plan Development CorporationFort Worth, TXLantheus Medical ImagingNorth Billerica, MALawrence General HospitalLawrence, MALawrence Memorial HospitalMedford, MALehigh Valley Health SystemAllentown, PALHP Hospital GroupPocatello, IDLifePoint Hospital PalestinePalestine, TXLifePoint Hospital Vernal CityVernal City, UTLincoln County HealthcareDamariscotta, MELittle Falls HospitalLittle Falls, NYLittle Man Real EstateHurst, TXLittle Man Real EstateLewisville, TXLittleton Regional HospitalLittleton, NHLong Island UniversityBrooklyn, NYLong View Regional Medical CenterLong View, TXMaine Behavioral HealthSouth Portland, MEMaine General Medical CenterWaterville, MEMaine Hospital AssociationAugusta, MEMaine Medical CenterPortland, MEMaine Medical Center - Scarborough Surgery CenterScarborough, MEMaine Mental Health PartnersPortland, MEManchester Memorial HospitalManchester, CTMansfield Orthopedics at CopleyMorrisville, VTMary McClellan HospitalCambridge, NYMassachusetts General HospitalBoston, MAMat-Su Valley Regional Medical CenterPalmar, AKMayo HealthcareNorthfield, VTMayo Regional HospitalDover-Foxcroft, MEMedical Center of DallasFarmers Branch, TXMedical Partners of AmericaMansfield, TXMedifactsHurst, TXMemorial Medical Center Las CrucesLas Cruces, NMMemorial Sloan Kettering CenterNew York, NYMemorial Sloan Kettering Center Sleepy HollowSleepy Hollow, NYMercy Health PartnersScranton, PAMercy Tyler Emergency Department RenovationScranton, PAMercy HospitalPortland, MEMercy Medical CenterSpringfield, MAMerrimack PharmaceuticalsCambridge, MAMid Coast HospitalBrunswick, MEMid-Hudson Regional HospitalPoughkeepsie, NYMiles Memorial HospitalDamariscotta, MEMillinocket Regional HospitalMillinocket, MEMimbres Memorial HospitalDeming, NMMoffitt Cancer CenterTampa, FLMonmouth Medical CenterMonmouth, NJMontefiore Medical CenterBronx, NYMoses Ludington HospitalTiconderoga, NYMount Ascutney HospitalWindsor, VTMount Desert Island HospitalBar Harbor, MEMount Sinai School of MedicineNew York, NYMountain View Regional Medical CenterLas Cruces, NMNavarro Regional Medical CenterCorsicana, TXNew London HospitalNew London, NHNew York City Health and Hospitals Corporation (HHC)New York, NYNew York-Presbyterian HospitalNew York, NYNew York-Presbyterian Hospital WestchesterWestchester, NYNew York University / Langone Medical CenterNew York, NYNew York University / Lutheran Medical CenterBrooklyn, NYNewark Beth Israel Medical CenterNewark, NJNewport HospitalNewport, RINewton-Wellesley HospitalNewton, MANew Hampshire Veterans HomeTilton, NHNorth Country HospitalNewport, VTNorth West Medical CenterTucson, AZNorth York General HospitalNorth York, OntarioNortheastern VT Regional HospitalSt. Johnsbury, VTNorthern Berkshire CampusNorth Adams, MANorthern Maine Medical CenterFort Kent, MENorthern Westchester HospitalWestchester, NYNorthwell HealthFormerly North Shore-LIJNew York, NYNorthshore University HospitalManhasset, NYCohen Children’s Medical CenterNew Hyde Park, NYNorthwestern Medical CenterSt. Albans, VTOASIS HospitalPhoenix, AZO’Connor HospitalDelhi, NYOneida Nation Health CenterOneida, NYPalo Pinto General HospitalPalo Pinto, TXParkland HospitalDallas, TXPediatric Assoc. of SalemSalem, MAPenobscot Bay Medical CenterRockport, MEPenobscot Valley Medical CenterLincoln, MEPlanned ParenthoodVT, NH, NY, MAPortneuf Medical CenterPocatello, IDPorter Medical CenterMiddlebury, VTPortsmouth Regional HospitalPortsmouth, NHPresbyterian Hospital of DentonDenton, TXPrim Construction LLCFort Worth, TXPromise HospitalsFL, LAMiami Lakes Medical CenterMiami, FLPromise Hospital of Florida at The VillagesThe Villages, FLPromise Hospital of Miss LouVidalia, LAPromise Hospital of Bossier CityBossier City, LAQueens Hospital CenterQueens, NYRabin Medical CenterTel Aviv, IsraelRegional Medical CenterAbilene, TXRendina Healthcare Real EstateAK, AZ, ID, TXRetreat Health CareBrattleboro, VTRidgeland Capital PartnersHouston, TXRockwall Hospital CorporationTXLakeside Hospital at BastropBastrop, TXPatients Medical Center at PasadenaPasadena, TXRegional Medical CenterSunnyvale, TXRumford Community HospitalRumford, MERutgers UniversityRutgers, NJSaint Andrews HospitalBoothbay Harbor, MESaint Barnabas Medical CenterLivingston, NJSaint Mary’s HospitalLewiston, METhe Sanders TrustBirmingham, ALScarborough TerraceScarborough, MESchneider Children’s Medical Center of IsraelTel Aviv, IsraelSchuyler HospitalMontour Falls, NYSeacoast Mental HealthExeter, NHSebasticook Valley HospitalPittsfield, MESelect Health ServicesGrapevine, TXSeton Medical Center Harker HeightsHarker Heights, TXSoroka Medical CenterBeer Sheva, IsraelSouth Shore HospitalWeymouth, MASouthside HospitalBay Shore, NYSouthwestern Vermont Medical CenterBennington, VTSpecialty Care Center at RichardsonRichardson, TXSpring Harbor HospitalWestbrook, MESt. Ann HomeDover, NHSt. Joseph HealthcareBangor, MESt. Joseph’s Children’s HospitalTampa, FLStony Brook Medical CenterStony Brook, NYSugar Hill Retirement CommunityWolfeboro, NHSugarland Surgical HospitalSugarland, TXSunbury Community HospitalSunbury, NJSunbury Primary CareBangor, MESundance Behavioral HealthcareFort Worth, TXSundance Psychiatric HospitalFort Worth, TXSunnybrook Health Sciences CentreToronto, OntarioSUNY at Stony BrookStony Brook, NYSUNY Farmingdale State CollegeFarmingdale, NYSUNY Upstate Medical HospitalSyracuse, NYSurgical Care AffiliatesTXSurgical Center Flower MoundFlower Mound, TXTenet HealthcareTXTexas Health Surgery Center CleburneCleburne, TXThe Aroostook Medical CenterPresque Isle, METhe Atrium Alzheimer’s FacilitiesNew EnglandThe Neal Richards GroupTXTitus Regional Medical CenterMt. Pleasant, TXYork HospitalYork, MEYorkshire Realty AdvisorsDallas, TXTrammell Crow CompanyTXTri-Town Regional HospitalSidney, NYTexas Health ResourcesDenton, TXTexas Orthopedic SpecialistsBedford, TXUniversity of Connecticut HealthFarmington, CTUniversity of Massachusetts Memorial Medical CenterWorcester, MAUnited Surgical Partners InternationalAZ, CA, CO, FL, MO, MT, OK, TXUniversity of Vermont Medical CenterBurlington, VTUpper Connecticut Valley HospitalColebrook, NHVeterans Administration Medical CenterNorthport, NYVeterans AdministrationMA, ME, NY, RI, VTValley Health ServicesHerkimer, NYVeterans Administration Medical Center NorthamptonLeeds, MAVermont Children’s Hospital ofUniversity of Vermont Medical CenterBurlington, VTVillage at Farm PondFramingham, MAWaldo County General HospitalBelfast, MEWeill Cornell Inpatient Psychiatry UnitNew York, NYWentworth-Douglass HospitalDover, NHWesley HealthCareSaratoga, NYWestview MeadowsMontpelier, VTWilliam Osler Health CentreBrampton, Ontario, CanadaWindsor Regional Hospital Metropolitan CampusWindsor, Ontario, CanadaWinkler County Memorial HospitalKermit, TXWomen & Infants HospitalProvidence, RIWoodlawn CommonsSaratoga Springs, NYWynmark CommercialMansfield, TX

PRESENTER BIOSAilyn MendozaDirector of Client ExperiencePrior:Dland StudioMichael Van Valkenburgh AssociatesSWA StudioHarvard University, Graduate School of DesignFlorida International University, CARTA

BACKGROUNDAt IrisVR we tackle the frustration that comes from designingand working in 3D but experiencing spaces in 2D formats.By developing software tools which leverage VR, AR andgaming technology for professional workflows.2014EstablishedHQ in NYCSoftware Products16 Team MembersDaily Coffee Intake

VR PRIMER: WHAT IS VIRTUAL REALITY?

VR PRIMER: WHAT IS VIRTUAL REALITY?“the computer-generated simulation of a three-dimensional imageor environment that can be interacted with in a seemingly real orphysical way by a person using special electronic equipment, suchas a helmet with a screen inside or gloves fitted with sensors.”

VR PRIMER : TYPES OF HMD’sHead Mounted Devices (HMD)Google CardboardOculus RiftMOBILE VRSamsung GearVRDESKTOP VRHTC Vive

VR PRIMER : TYPES OF DEVICESNOT CREATED EQUAL

VR PRIMER : MOBILE VR

VR PRIMER : MOBILE VRHardware: Untethered Headset SmartphoneGoogle CardboardMOBILE VRContent: Image/JPEG (rendered from 3D model)Pros:Cons: Inexpensive headset ( 100) Single fixed view point Accesible on smartphone Requires 360 full rendering tobe made Easily to travel withSamsung GearVR Not for quick iteration

VR PRIMER : DESKTOP VR

VR PRIMER : DESKTOP VRHardware: Tethered Headset Powerful ComputerOculus RiftDESKTOP VRHTC ViveContent: 3D Model (Revit, Rhino, Sketchup, OBJ)Pros:Cons: Fully immersive experience Requires hardware User can freely explore Not “briefcase” friendly True to scale environment Mac does not supportheadsets

INTERNAL DESIGN REVIEWUniversity of Vermont Medical Center

CASE STUDYSCOPENewton Wellesley HospitalAmbulatory HubNewton-Wellesley Hospital recently began construction on a new Ambulatory CareHub with Primary Care, Specialty Clinics, Phlebotomy, and X-Ray. VR was usedas for user feedback during design meetings. Doctors, nurses, and staff were ableto review the layout of equipment and furniture in the standard exam rooms,eliminating the need for building a mockup.RESULTSHad seven various designswith complex MEPUsers gave real time feedback using in-iris tools

CASE STUDYSCOPELawrence General HospitalSurgery CenterLawrence General Hospital is building a new 50 million SurgeryCenter, and E4H leveraged VR to build virtual mock-ups duringconstruction to make decisions about equipment locations, outletlayouts, and staff work area placement. They were able to avoidphysical mock-ups saving lead time and construction cost.RESULTS“Users were blown away withthis feature. A lot of thedecisions made using thiswill help with the Hybridroom. Should haveeverything wrapped up nextweek.”- Ray Boudreau,Project ManagerUsers reviewed the BIM model in the field and made decisions withoutneeding to build a physical mock-up.

CASE STUDYSCOPELoyola University MedicalCenter RenovationsMortenson Construction is the leading a 20 million dollar renovationat LUMC in Maywood, IL, focused on modernizing thegastroenterology suite, observation unit, neurophysiology unit, andinterventional radiology procedure suite.In addition, the hospital is modernizing the heating, water, cooling andelectrical systems for several buildings on the medical campus. 20mConstructionBudgetCHALLENGEHad seven various designswith complex MEPBudget and timerestrictions only allowedfor one physical mock upToo much of the client’sresources where beingspent on team’s Q&Aplus visiting otherlocations

CASE STUDYDESIGN WORKFLOWLoyola University MedicalCenter RenovationsThe team modeled all 21 rooms and additional staffworkspaces, such as the Nurses’ Station, with the requiredequipment, for the users to review.RevitIris Prospect w/ Oculus3D Revit Floor PlanNurse evaluating hallway sight lines and clearances3D Model of Patient RoomsPhysician reviewing layout of patient room

CASE STUDYKEY BENEFITSLoyola University MedicalCenter RenovationsQuick design iteration process, made easy byimporting directly from Revit into VR without Unity."With IrisVR, we cannow utilize VR faster andon a larger scale.User First - users instantly understood thespace and were able to provide constructivefeedback.It's a game changer.Not only are we savingtime and money but weare also making ourcustomers happy andimproving the finalproduct with lessresources on our end.”- Jennifer Suerth,Integrated Construction ManagerPrevented costly on-site errors by helping todetect them earlier in the construction phase.UP NEXTAfter the success with IrisVR and the VR mockup, the designand construction team agreed to build a VR mockup for theInterventional Radiology (IR) phase to confirm with the users.

CASE STUDYUniversity HospitalPediatric & Adult InfusionCenter (name confidential)SCOPEMarmonMok is leading the renovation of an existing cancer center inSan Antonio, TX.The design of the new infusion centers must account for the varyingtreatment durations and frequencies while maintaining clinicianaccess to patients.CHALLENGESizes of stations varygreatly from Adult toPediatric servicesGreater technological andequipment requirementsthan originalAccommodating for patientprivacy and practicalityfor staff

CASE STUDYUniversity HospitalPediatric & Adult InfusionCenter (name confidential)DESIGN WORKFLOWThe team began with a floor plan of the area, then moved torenderings and built one physical mock of the space. Then themodels where used as a VR component to the built mockup.SketchupRevitIris Prospect w/ HTC ViveKEY BENEFITSVerification of critical site lines from nursesto each patient.Increase engagement and sense ofownership between end users and theirspaces.

VR Benefits in AECApplications for VR exist at every phase of a project, fromthe moment the contract is signed to the key turn over.Schematic DesignQuickly exploreconcept optionsDevelop Client Trust. Whatyou see, is really what youget.Bridge gaps incommunication betweenstakeholders and designteam

VR Benefits in AECApplications for VR exist at every phase of a project, fromthe moment the contract is signed to the key turn over.Schematic DesignDesign DevelopmentQuickly exploreconcept optionsFacilitate internal reviewsin True-To-ScaleenvironmentDevelop Client Trust. Whatyou see, is really what youget.Reduce built mock upcostsBridge gaps incommunication betweenstakeholders and designteamReceive critical buy-in andfeedback from stakeholdersQuickly generate 360panos to share progressreports through mobiledevices

VR Benefits in AECApplications for VR exist at every phase of a project, fromthe moment the contract is signed to the key turn over.Schematic DesignDesign DevelopmentConstructionDocumentationQuickly exploreconcept optionsFacilitate internal reviewsin True-To-ScaleenvironmentDevelop Client Trust. Whatyou see, is really what youget.Reduce built mock upcostsBridge gaps incommunication betweenstakeholders and designteamReceive critical buy-in andfeedback from stakeholdersIdentify collisions, conflictsand mistakes in an intuitivemannerQuickly generate 360panos to share progressreports through mobiledevicesTest modularized systemsprior to fabrication foraccuracySolve complexcoordination issues byplacing everyone within VRspaceEvaluate the implicationsof value engineering in 3D

VR Benefits in AECApplications for VR exist at every phase of a project, fromthe moment the contract is signed to the key turn over.Schematic DesignDesign ministrationQuickly exploreconcept optionsFacilitate internal reviewsin True-To-ScaleenvironmentSolve complexcoordination issues byplacing everyone within VRspaceOnboard constructionteam to project designand intricacies with VRwalkthroughsDevelop Client Trust. Whatyou see, is really what youget.Reduce built mock upcostsEvaluate the implicationsof value engineering in 3DReduce change ordersthroughout the entireconstruction phaseBridge gaps incommunication betweenstakeholders and designteamReceive critical buy-in andfeedback from stakeholdersIdentify collisions, conflictsand mistakes in an intuitivemannerReduce time spent onsite solving minorcoordination issuesQuickly generate 360panos to share progressreports through mobiledevicesTest modularized systemsprior to fabrication foraccuracyIncrease on-site safetyby testing phases andmaneuvers prior toimplementation

VR Benefits in AECReal World Phase Application & BenefitScenarioCostsVR SavingsClient requested fourphysical mocks up of thevarious patient rooms beconstructed at scale.Typical cost of physicalmock up, range from 50,000 and higher.VR can reduce the need forbuilt mock ups.Four rooms would cost 200,000.If VR reduced half of themock ups needed,it would result in asavings of 100,000.

VR Benefits in AECReal World Phase Application & BenefitScenarioCostsEvery project phaserequires several team widemeetings.At a rate of 150/hr perrepresentative, eachmeeting is costing 1,200to each consultant.For each consultant, themeeting is attended by 2representatives.If each phase has 3meetings, lasting 4hours Over the course of 4phases,a minimum of 19,200 spent onmeetings.VR SavingsVR can increase productivityduring meetings and decreasetheir frequency.If VR reduces meetings by half,each consultant decreasesspending by 9,600.

CONCLUSION Overview of VR Technologies Real World Applications of VR Benefits

Virtual Reality & the Design of Healthcare EnvironmentsSend us your thoughts & questions:Mike Bennett, AIA - Boston, MAmbennett@e4harchitecture.comAilyn Mendoza, ASLA - New York, NYailyn@irisvr.comImage Credits: E4H Architecture, HMC Architects, Mortenson Construction, Marmon Mok HDR Minneapolis

Appendix

AEC Custom WorkfowShare, edit, and explore 3Dfiles in VRConceptualization2D & 3DDevelopmentHours ofManual Conversioninto Video Animation3D content ends upprojected on 2D surface

NEW AEC WorkflowShare, edit, and explore 3Dfiles in VRConceptualization2D & 3DDevelopmentHours ofINSTANT AUTOMATICConversioninto Virtual Reality Experience3D Content seen as it ismeant to be experienced

Rockwall Hospital Corporation TX Lakeside Hospital at Bastrop Bastrop, TX . Seton Medical Center Harker Heights Harker Heights, TX Soroka Medical Center Beer Sheva, Israel South Shore Hospital Weymouth, MA . Bar Harbor, ME Mount Sinai School of Medicine New York, NY Mountain View Regional Medical Center

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