Blog XR Healthcare: Overcoming Barriers in XR Implementation Interview with Ross O'Brien

What originally convinced you that there was real power in XR healthcare?

Ross O’Brien: We simply took a headset out into the streets of West London with a blue banner that said NHS. What was incredible for me was consistently everyone that came up to us put the headset on and when they took it off they said, wow, that’s incredible. Then we said we were there to support locals. At that moment people completely opened up and were much more open to discuss and share their feelings about a severe fire accident that affected the community a few days before. You put a headset on somebody and the link between you and them just completely bonded you. It was so powerful.

What is still the biggest barrier to implementing XR healthcare in therapeutic practice?

Ross O’Brien: We saw lots of innovators going to the NHS with promising technological innovations. The first questions they were asked were: is it compliant with our regulations? How do you know it’s clinically safe? Those are the major barriers, and because of that even investors turn around and say this is a technology which is not going fast enough. There are so many barriers to accepting it and there is not even regulation to regulate it. It has been a really difficult situation.

What was done to change that?

Ross O’Brien: The NHS invested 20 million pounds and UK Research and Innovation invested 20 million pounds in a program called Mindset XR. They took our recommendations and over three years systematically invested in 74 companies to help them grow and scale in the NHS. They provided seed funding to do research, look at regulations and find pilot sites. We are finally at the point where there is now a tried and tested route.

What advice would you give UK studios building XR healthcare solutions today?

Ross O’Brien: If you are UK based, go to a health innovation network and take your work there. Talk about whether you can follow a similar process to Mindset XR. There are networks and NHS forums designed to take new tech and support implementation. The next piece of work for us is taking that case study to other European, North American and Asian countries and showing governments that if you do this systematically you will see returns for every pound you invest.

Why is scaling outside the UK harder?

Ross O’Brien: In the UK there is quite a clear centralized national health service which is government run. Taking this model into Europe or North America is harder because there are very different health system models. Whether we are able to run national initiatives will be tougher. It is not going to be copy paste. We will have to prove the model again with insurers, payers and large health systems.

Can you share an example of a game making a real healthcare impact?

Ross O’Brien: My favourite example is Sea Hero Quest. It is a game where you navigate underwater environments. The developers realised they could diagnose early onset dementia purely through how accurately people navigated. The game itself is fun to play, but they have data on hundreds of thousands of users and how likely they are to develop dementia. That is incredible. Yet they still struggle to get healthcare organisations to take it seriously.

Why focus on system architecture instead of the technology itself?

Ross O’Brien: What we learnt with the development of the healthcare XR programmes in the UK is we should not be thinking about the technology. We know the system is not ready to accept any of it. For us it is doing the boring stuff, talking to strategic leads, policy makers, regulators and investors. It is creating an environment or set of conditions so whatever the technology is, the structure is right so it can be accepted. That is the key.

What mistake do founders often make?

Ross O’Brien: If you have the most fantastic idea that is going to change the world but you have not talked to the clinicians and service users, the chances are the system does not need your fantastic thing. It might be too big or too shiny or too generalistic. Think about the whole patient journey. How do people onboard? How does the data flow back to the electronic health record?

If you were building a company today, what would you build?

Ross O’Brien: Pragmatic Ross would build a platform to get the health tech out to providers, the actual physical hardware for multiple companies and solutions. An individual company with a product struggles to scale because the cost of headsets, distribution, upkeep, training and wifi setup is such an industry in its own right that it inhibits products getting out there. If one player supported hardware distribution for many providers, scale would be enhanced.

And what would creative Ross build?

Ross O’Brien: What we have seen is early stage treatment of mental health issues with mild and moderate symptoms getting strong feedback. There is a company called Tend with a mindfulness based therapy programme that is currently getting better results with their headsets than a human led approach. The intervention of VR and clinical practice melded together creates muscle memory and benefits patients more than a human led approach. That space is exciting.

What trends are emerging in XR health right now?

Ross O’Brien: Now we see a real shift into treatment modalities, which is needed. We are starting to see good evidence that these tools are not only effective but in some cases better than standard interventions. Along with that, clinical skills training in XR healthcare is more effective, cheaper and produces better results.

Why is AI integration in XR health is still immature?

Ross O’Brien: We are going through a very rapid escalation and maturity of AI. Companies specialising in AI are just about staying on top of the evolution cycle. XR healthcare is a separate discipline. Marrying those two requires depth of resource and a broad skillset. There are very few companies with the experience to meld them properly. We will see it in future, but at the moment there is no clear standout use in solutions themselves.

What collaboration is most critical for unlocking scale?

Ross O’Brien: The key collaboration is bringing together the healthcare provider, policy and regulatory bodies. You need that finely tuned orchestra so innovators are accepted. Without everyone understanding the actual problem and why solutions do not scale, we will not get anywhere fast. We spent years having this conversation before things finally moved in the UK. There is still a long way to go.

What inspires you about the future of XR health?

Ross O’Brien: There was a clinician who created upper limb rehabilitation games for children in serious accidents. They were so effective he had to cap how long they could play so they did not over rehabilitate. I still get goosebumps thinking about the possibilities. It is finding those gems, organisations doing fantastic things in mental health and rehabilitation, changing how surgeons operate. Seeing XR healthcare bring everything alive in such a different way inspires me.