Reimagining heart teams: advanced cardiovascular collaboration through virtual reality in the metaverse

Introduction

Multidisciplinary heart teams (MDHTs) have become a fundamental component in modern cardiovascular care, recognized for their role in improving outcomes for patients with complex heart diseases. These teams, consisting of specialists such as cardiologists, cardiac surgeons, anaesthesiologists, and radiologists, work collaboratively to deliver comprehensive assessments and personalized treatment plans. Despite their recognized importance, the implementation of MDHTs may be inconsistent, particularly in smaller or resource-limited institutions, which may lack the necessary expertise. To bridge this gap, the concept of the ‘Meta-Heart Team,’ utilizing virtual reality (VR) technology, presents an innovative approach to enhance collaboration and accessibility in cardiovascular care (Figure 1).

Multidisciplinary heart teams and their disparities

The landscape of cardiology is evolving at an unprecedented rate, particularly in the management of complex heart diseases. Amidst this dynamic change, the establishment of MDHTs has become a cornerstone of cardiovascular care, endorsed as a class I recommendation by the ESC/EACTS guidelines on valvular heart diseases.^1,2 These teams, comprising cardiologists, cardiac surgeons, anaesthesiologists, and radiologists, collaborate to provide comprehensive assessments and optimize treatment plans tailored to each patient’s needs.^3,4 They are not just a regulatory formality but a necessity to enhance patient outcomes through collaborative expertise. The creation of MDHTs in tertiary healthcare centres has underscored the demand for multifaceted proficiency in managing intricate cases. However, the deployment and efficacy of MDHTs are not uniform across all medical institutions, particularly smaller institutions with less frequent complex case volumes. They often struggle to establish such comprehensive teams due to resource and expertise constraints and are at a disadvantage, lacking the specialized knowledge and experience that MDHTs bring, potentially compromising patient care and access to advanced therapeutic strategies. This disparity not only affects the quality of healthcare but also the equity of healthcare access across different geographical and economic landscapes, highlighting the need for novel approaches to enhance collaboration across physical boundaries and to overcome institutional limitations.

The burgeoning technology of VR, especially within the construct of a metaverse digital environment, offers a promising solution to these disparities.^5,6 The concept of a ‘Meta-Heart Team’—a virtual MDHT—that operates within metaverse environments could potentially revolutionize collaboration among cardiologists and other specialists. This approach leverages the benefits of MDHTs and utilizes the capabilities of VR and metaverse to transcend geographical and institutional constraints, providing an inclusive platform for cardiovascular care, especially to hospitals with limited on-site specialists.⁷

Meta-Heart Team: a virtual reality solution

The design of the Meta-Heart Team room in VR may closely mimic a high-tech medical conference room, providing an immersive experience that closely parallels real-life settings. This environment could be customized to include realistic models of medical equipment and tools, offering a more intuitive interface for specialists accustomed to traditional settings. The layout could also be modular, allowing for easy updates or changes based on the specific needs of each session.

The participants may access the virtual meeting space via VR headsets and be represented by personalized digital avatars, allowing them to interact in real time, as if they were physically present in the same room. The Meta-Heart Team room would accommodate multiple large screens displaying vital patient data, including medical history and electrocardiograms as well as echocardiograms, coronary angiograms, and CTs. This allows for a multidimensional analysis of patient cases, providing participants with comprehensive data that facilitates informed decision-making. Each participant would manipulate and interact with the displayed data independently. This could include the ability to zoom, pause, and replay visuals from patient-specific imaging data such as coronary angiography or cardiac computed tomography images and videos. Such capabilities ensure that every team member can closely examine details relevant to their specialty, enhancing the collaborative diagnostic and planning processes.

Artificial intelligence–powered collaboration

Integrating artificial intelligence (AI) could enhance decision-making by analysing complex datasets, including past medical records and predictive models.⁸ Artificial intelligence can swiftly identify key insights and suggest focal points for discussion, aiding specialists in developing personalized treatment plans that surpass the limitations of human analysis. Another development being explored for the Meta-Heart Team involves testing haptic feedback to enhance virtual presence with tactile sensations, which could enable remote clinical assessments.⁹ Further enhancements like improved AI facial recognition and motion tracking are also being considered to produce more lifelike avatars, narrowing the divide between real and virtual interactions. Another innovative prospect is the potential inclusion of patients in virtual sessions. While patients currently do not participate directly in MDHT meetings, the use of anonymous digital avatars could enable their virtual presence, fostering a more patient-centred approach, where patients play an active role in discussions about their treatment plans while maintaining privacy.

Challenges and considerations

While the concept of the Meta-Heart Team holds great promise, there are several challenges that must be addressed for widespread adoption. One significant hurdle is the need for high-end technology and sophisticated hardware, including VR headsets and robust internet connections, which can be cost-prohibitive for smaller or under-resourced facilities.

Data security presents another critical challenge. The handling of sensitive medical information within a VR platform must comply with strict data protection laws such as the General Data Protection Regulation and the Health Insurance Portability and Accountability Act. Ensuring robust cybersecurity and establishing clear guidelines for responsible VR use in patient care are critical, requiring both significant investment in security infrastructure and careful navigation of ethical and regulatory challenges to protect patient safety and privacy.¹⁰

Another challenge lies in the potential for technical difficulties during virtual meetings. Even with high-quality technology, issues such as internet disconnection or software glitches might disrupt the flow of discussions. While these technical problems are not insurmountable, they highlight the importance of a reliable technical infrastructure for the success of Meta-Heart Teams. Adapting to a VR environment could be daunting for clinicians who are less familiar with such technology. Providing adequate training and support is necessary to ensure all participants can fully engage with the VR system, which may strain resources.

Finally, regulatory and ethical considerations must be addressed. Establishing guidelines for the responsible use of VR in patient care and managing virtual consultations involve navigating complex ethical and regulatory landscapes to ensure patient safety and privacy.

The path forward

As we look to the future, the Meta-Heart Team concept offers a promising glimpse into the evolution of medical decision-making, blending cutting-edge technology with the complex needs of cardiovascular care. While challenges remain, the integration of VR, metaverse, and other digital technologies into healthcare could redefine the parameters of patient care and professional collaboration. Could this digital approach be the key to unlocking universally accessible, top-tier medical expertise, transcending possible barriers that currently divide the medical community?

Declarations

Disclosure of Interest

All authors declare no disclosure of interest for this contribution.

References