Virtual reality is a common theme in popular fiction. Movie makers have repeatedly explored the concept of an alternate, and often sinister, existence that has been created alongside the real world. Films such as The Matrix, Total Recall and Lawnmower Man have encouraged the viewer to imagine an entirely man-made reality. But the fascination with virtual, alternate and parallel existences stretches back further than the past two decades.
Doctor Who was arguably one of the first television shows to depict different worlds that coexisted with our own, and Lewis Carroll created an elaborate and sometimes bizarre alternate existence for his heroine in Alice in Wonderland. Director James Cameron's current multi-million dollar 3D blockbuster Avatar has taken this concept a step further, with the hero being able to telepathically control and 'exist' within an alien being in another world. So is this still fantasy, or is it just possible that we are now at a point where these notions are not altogether as far-fetched as they might have once seemed?
When two worlds collide
Although computer-simulated worlds are by no means a new concept, the past few years has seen an explosion in the number and type of virtual worlds being launched. According to research and analysis company KZero, there are about 150 in existence. Indeed, investment in virtual world technology and the development of new virtual world experiences does not appear to have been significantly dampened by the recession.
Originally called MMORPGs (massively multi-player online role-playing games) they have, as the name would suggest, traditionally focused on gaming. More recently, however, virtual worlds have moved more towards social interaction and community generation, especially for children. In addition, the past 18 months has seen organisations such as Michellin and Intel start to use virtual worlds for business collaboration, training and shared learning, citing benefits in cost savings through reduction in travel, and greater inclusion of a geographically dispersed workforce.
So what do virtual worlds offer that more traditional video-conferencing, webinars or group telephone calls don't?
Central to the appeal of virtual worlds for learning and collaboration is the concept of immersion; that is the suspension of disbelief that allows the perception of actually being with other individuals in time and place. One creates a virtual representation of oneself, commonly known as an 'avatar', and interacts with others through it using voice or text chat. Just as one would do in the real world, the avatar can see everyone around them, hear what others who are near them are talking about, and move around the virtual environment by either walking or, for longer distances, flying or teleporting.
It would seem intuitive that this kind of application of virtual worlds could also be used to deliver low-cost, but high-impact health promotion and coaching to populations and specific high-risk groups. Using virtual environments to deliver health advocacy solutions is new so there is little good research about the outcomes, but there already appear to be a number of established uses of virtual worlds for health-related activities. A recent review of virtual world Second Life found 68 separate instances, covering a wide range of uses including education and awareness, support, training, marketing and recruitment for research.
Virtual world technology has been successfully used to simulate emergency hospital scenarios to train physicians and medical students. Indeed, London's Imperial College has created a virtual world hospital that it is being used to augment the training of medical students and junior doctors.
Although there is a lack of good quality published research, the medium has the potential to improve engagement and drive behaviour change if used with more traditional health management channels. Technology-based health improvement programmes have been shown to decrease health risks, improve work performance and generate a return on investment for employers.
The anonymity of participants within the environment can help with discussions about potentially sensitive health-related topics. People have a shared (rather than isolated) online experience with peer-to-peer communication and support. There are no geographical limitations to participation. And there is no need for expensive technological infrastructure, as all participants need is a PC/Mac, a broadband internet connection and a headset.
A recent pilot implementation of a virtual world-delivered healthy eating and weight management programme in Second Life showed 65% of the eligible population registered for the programme, with 54% of participants reporting at least one lifestyle change based on the information and advice received during the pilot, and a high level of acceptance of the medium. Healthcare systems need to better understand how they can use existing and emerging technologies to enhance the management of the populations they serve. Technological advances - be they virtual worlds, other social media or wearable devices - have the potential to improve societal health while managing costs. Consultations with a healthcare professional in an artificial world are no longer beyond the realms of Hollywood fantasy. These are indeed exciting times, but only if we are prepared to boldly go where no man (or woman) has gone before.
By Dr Peter Mills, population health expert