Why an Orthopedic Clinic Opened a Virtual Practice in the Metaverse

September 20, 2023 - As demand for convenient digital access to healthcare services grows among United States consumers, provider organizations are leveraging numerous tools to bolster their digital healthcare offerings. From online scheduling to virtual visits to patient outreach via mobile devices, providers are working to meet people where they are. One orthopedic practice has even gone all the way to the metaverse.

Earlier this summer, New York City-based HandSport Surgery Institute launched a virtual practice in the Decentraland metaverse.

"As far as I know, it's the first medical practice of any kind in the metaverse," said Mark E. Pruzansky, MD, hand surgeon and director of the institute, in an interview. "Our practice in Decentraland is the first phase of our build-out. It's designed to help bring awareness to current and potential patients about what we do in a more exciting and modern way."

Decentraland, a blockchain-based virtual world, is the first decentralized metaverse. Users can use the Decentraland platform, which can be accessed via an internet browser or desktop client, to "create, experience, and monetize content and applications as well as socialize and attend a wide range of daily community-driven events," the Decentraland website states.

According to a TechTarget explainer, the metaverse experience includes virtual reality (VR) and augmented reality (AR), as well as new decentralized finance technologies like blockchains and non-fungible tokens (NFTs). In Decentraland, users can create an "avatar" or a metaverse version of themselves. They can then use their keyboard to move the avatar and explore the virtual world. They can also talk to others via a chat box.

HandSport Surgery Institute's virtual practice includes an office with a receptionist and two treatment rooms. People can walk around, explore the space, and interact with the receptionist using their avatar. They can book appointments through the metaverse-based receptionist by identifying themselves, providing contact details, and noting the preferred day and time for the appointment. A staff member from the institute then calls the patient back to confirm the appointment and note down their insurance details.

The virtual practice in Decentraland provides a launching pad to send potential patients over to the practice's internet website, where patients can get more information about hand and upper extremity disorders, as well as nonsurgical or surgical treatment.

"We have brochures and an internet presence, including a website with information about hand injuries and treatments and our practice and all that, but we thought this would be a little more exciting," Pruzansky said. "We believe that AR, VR, blockchain technologies will continue to rapidly change the healthcare landscape."

According to Pruzansky, the virtual practice gets about 60 to 100 visits per week.

To create the virtual practice in the metaverse, the HandSport Surgery Institute team worked with independent contractors.

"Decentraland and the technologies used are in their infancy, so the team went through a lot of trial and error to create this initial presence," Pruzansky said. "There were lots of bugs and time delays to try to work it out."

He described the virtual environment as 2D-plus, not entirely 3D but more than 2D, which is a "different technological skill to work with."

Essentially, building the virtual practice involves buying parcels, or "plots of land," in Decentraland. The number of parcels determines not only the amount of space you have to build your metaverse-based structure but also how much detail you can include.

"To overly simplify it, the number of parcels you buy will determine how many pixels you get, which, over there, are actually little, tiny triangles... You're making pictures out of tiny triangles, as far as I know," explained Pruzansky.

"We're very happy about how it turned out, and we've gotten positive comments from patients and other orthopedic surgeons," he added.

The virtual practice has not added any administrative burdens to the clinic's staff, and patients also do not appear to be having challenges navigating the metaverse-based facility.

"You get your avatar, you go walking, jumping or running around, and you go exploring the office or leave the office and go explore all kinds of other spaces in Decentraland," said Pruzansky.

There are numerous places to explore in Decentraland, including buildings where people can play games and events they can attend. People can even buy items for their avatars in a virtual marketplace.  

"I guess the patients like the introduction to this kind of new environment. It's stimulating because it's new," he said. "And there's some kind of emotional connection to the avatar and exploring."

Next, the HandSport Surgery Institute plans to open a second floor where the users will be teleported to a classroom. Here, they can participate in virtual lessons educating them on various aspects of the hand, wrist, and elbows in addition to the corresponding conditions, injuries, and treatments. These educational resources exist on the practice's website, but Pruzansky wants to bring them to the Decentraland virtual office.

"Then we'll also integrate more surgical and examination scenes to give patients an idea of what happens behind the scenes," he said. "We were even thinking of — might be a little kitschy —but we were thinking of offering virtual lessons. And then they take a test, and when they pass the exam, we give them a virtual lab coat or something that their avatar can wear."

The practice is in the initial stages of this next build-out, but Pruzansky noted that it could be a while before the additions come to fruition. Unlike websites, the complexity of the metaverse makes additions more time-consuming.

While measuring the virtual practice's return on investment (ROI) is difficult, Pruzansky is satisfied with the traction the practice is gaining in the metaverse and believes it is helping drive patient interest.

He likened it to investing money in a billboard sign. People seeking medical care may remember a billboard sign for a particular practice they saw while driving, which could lead them to contact that practice.

"In a case like this, you've got these hand surgeons who have a metaverse site with the good intention to educate people as well as to amuse them," he said. "The idea is that they're going to think that much more of us."