The COVID-19 pandemic accelerated the shift to remote patient consultations and health monitoring, leading to the advancement of telehealth delivery. In addition, we are witnessing an increase in commercial companies exploring novel approaches to remote healthcare, including metaverse-enabled healthcare, or the medaverse. The metaverse is a digital realm that blends augmented reality and virtual reality, creating a digital space where people can interact.

Although many healthcare applications within the medaverse are in their experimental stages, researchers are beginning to explore how they can be used to improve patient care and personalized treatment. However, the introduction of new technologies often brings forth new ethical issues. Below we outline three possible applications of the medaverse and discuss their ethical implications for patients, healthcare providers and insurers.

Can your twin be digital?

Digital twins are virtual replicas or representations of physical objects, processes or systems. In metaverse and healthcare context, digital twins or avatars are created based on aggregating data inputs from real patients. As a result, they can play a significant role in creating an immersive and personalized healthcare experience for users.

Digital twins mimic real-world characteristics, enabling users to interact, socialize and navigate virtual healthcare settings and clinical encounters. Users can customize their digital twins to resemble their physical appearance or create entirely new identities. The digital twin bridges the user and the virtual environment, enhancing the feeling of being fully engaged.

Digital twins are poised to transform how patients interact with healthcare providers in the medaverse, which raises ethical questions about the nature of the patient-provider relationship and clinical licensing. They can enable real-time data integration of data from wearable devices, sensors, electronic health records and other sources, enabling healthcare providers to monitor and treat patients remotely.

This technology can simulate and predict how patients might respond to different treatment options. By combining patient-specific data with computational models, healthcare professionals can virtually test various therapies, medications or interventions before implementing them on real patients. This approach can promote precision medicine by reducing trial and error and, ideally, improving clinical outcomes.

Digital twins can also aid researchers in expediting drug development. Through advanced simulations of physiology and disease, digital twins can make clinical trials and other drug development research safer for real patients, more diverse in terms of participant populations, and more efficient.

While digital twins offer advantages, they also raise data security and privacy challenges. Given that digital twins require extensive personal health data to model and monitor patients accurately, it is essential for providers and technologists to implement robust measures to safeguard protected health information. Strict and explicit guidelines and regulations must be maintained to ensure that privacy and security standards for individuals’ health data are upheld in the medaverse, just as they are in the real world.

Will the medaverse replace medical education as we know it?

The integration of the metaverse into medical education can create immersive learning environments. Through virtual reality and augmented reality technologies, learners can engage in lifelike simulations, perform procedures, make diagnoses and interact with virtual patients. These realistic scenarios bridge the gap between theory and practical experience, enabling health professionals to gain hands-on knowledge in a safe and controlled environment.

The medaverse could facilitate collaborative training among health professionals irrespective of their physical locations. Virtual spaces and avatars will allow students, doctors and specialists from around the world to come together, discuss cases, share knowledge and learn together.

Such immersive and global collaboration can promote equity by enhancing clinical skills in underserved areas and among underrepresented trainees in healthcare. Indeed, new startup companies have already begun to establish collaborative learning spaces in the metaverse, including Outlier Ventures, Veyond Metaverse, Duality, InWorld and Touchcast, among others.

Furthermore, the medaverse can assist in training health professionals to navigate complex ethical dilemmas. Through interactive decision-making simulations, learners can explore the consequences of their choices and develop ethical reasoning skills, enabling them to make well-informed and ethically sound decisions when faced with real dilemmas involving actual patients and families in the real world. Integrating the medaverse with telemedicine technologies also facilitates remote training and can potentially expand the reach of medical education.

Should patients own their own medical data? 

Medical records are typically stored in physical or electronic formats, but the medaverse could influence how patient data is managed. Blockchain and non-fungible tokens (NFTs) have been proposed to empower patients to control their data. The concept of health data NFTs is in its early stages, and scholars are actively debating issues related to data ownership and financial incentives for sharing data.

Ongoing research is exploring potential solutions, including the use of blockchain for secure and transparent data storage. Blockchain offers a robust method for data storage distributed across multiple computers, making it difficult for hackers to breach. However, it also can make it tricky to manage who has access to the data. There is a need to ensure only authorized data users have access and clarify how medaverse practitioners would adequately protect personal health information under existing privacy rules.

Preliminary findings from a trends analysis of startups and tech companies suggest that medaverse initiatives are on the horizon. This future virtual healthcare landscape has the potential to revolutionize how we manage and interpret health data and transform how we approach patient care and medical education. It is incumbent on practitioners, health policy scholars, technologists and patients alike to help shape the medaverse in ways that enable more connected, inclusive and healthier patient populations.

By Simran Kaur Sethi, undergraduate student, Scripps College, and Baylor College of Medicine, Center for Medical Ethics and Health Policy summer intern, and Dr. Vasiliki Rahimzadeh, assistant professor, Center for Medical Ethics and Health Policy at Baylor College of Medicine

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