Surgical VR
April 26, 2022 · 11 min read

Everything you need to know about Making a Medical VR Simulation

Is your company ready to add a VR surgical training simulator to your arsenal of sales tools? Everything you need to know to make a successful medical VR training program.

So… This medical VR thing is starting to really take off. Medical trainers are able to carry an entire operating room in a briefcase. Physicians have access to an unlimited supply of virtual patients, each exhibiting the ideal pathology for the desired training. Sales reps can meet with four times as many surgeons in half the time regardless of location using remote live training technology. The benefits of VR have become obvious but getting the VR program you need requires a bit of research.

Everything you need to know about planning and budgeting for your first medical VR simulation is about to become clear. Read on and ready yourself for the future.

Step 1: Get a VR headset and play a whole bunch of different games and experiences to get an idea of what’s possible when it comes to user interface and interactive content. We suggest an Meta (previously Oculus) Quest 2 headset because they are cheap, available, and provide a portable, easy to use experience. If you need some suggestions for VR apps to try, please check out the list below.

walkabout minigolf vr game
Walkabout Mini Golf

We get together at least once a week with our VR development team to putt the balls around a whole bunch of well designed courses. We suggest you give this title a whirl because it is good example of how a group can easily communicate using the headset’s built-in microphone and interact with each other regardless of geographical distance.

ShapesXr VR prototyping

This application is no toy. ShapesXR is a 3D design tool that allows you to create interactive prototypes and share them with them with other users. Though it won’t easily make a surgical application, it does showcase a powerful immersive multi-user environment for collaboration over any distance.

Ghost Productions Wraith-VR Surgical VR for quest 2

If you want to try out an actual surgical VR simulation program, we suggest you try our own surgical simulator. This Quest 2 application utilizes our own Wraithmatrix peer-to-peer network that allows you to pass a scalpel to someone across an ocean as easily as if they were across the surgical table.

Step 2: Define your goals and be specific. Do you want to convert 30% more surgeons to use your implant without increasing the size of your sales force? Do you need to train 400 nurses across the U.S. while minimizing travel expenses? Perhaps the goal is to evaluate performance and ensure that 100% of the people getting their hands on your instrumentation are qualified to use it safely. Simulation-based training in VR, can, when designed correctly, give your sales and training staff the ability to be everywhere with everything they need to conduct business at a moment’s notice. Be able to explain to your developer what you need to do, if they are worth their price, they’ll know what they need to do to help you achieve it.

Step 3: Pick a developer that can show you examples of their work that closely matches your needs. Your developer should be able to show you they’ve already built the core technologies for instrument handling and anatomy modification that fit your application. Look for developers that can provide an intuitive interface. Poorly designed VR/XR can destroy the whole project for everyone who tries to use it. A good developer knows how to make VR feel like a natural experience closely resembling a real world approximation. Don’t settle for less. If live remote multiuser collaboration is needed, they should be able to show you that without much stalling. Networked multiplayer app development is no cake walk! Unless you see an example closely matching what you need functioning well from great distances with your own eyes, ears, and virtual hands, don’t count on them being able to deliver it for your application.

Step 4: Pick a developer that specializes in medicine: Just because it is on the menu, doesn’t mean it is a good idea to order lasagna at a sushi bar. We’ve been hired to fix more than a handful of other developer’s best efforts and epic fails. Developing new software is challenging enough without also needing to turn laypeople into medical experts along the way. Choosing a dev company that knows their way around a pedicle screw and a mayo stand will save you a lot of time and revisions down the line and you have a lot of decent companies to pick from. Ghost Medical, PrecisionOS, OssoVR, and Fundamental Surgery all specialize in making highly functional medical simulations. If your application needs to be medically accurate, pick one of us from the get-go or face the consequences of an app that is failed, flawed, or forever in revision. 

Step 5: Prepare to budget for the cost of development, licensing, support, hardware costs, device management, and customer success.

  1. Development Cost: Most straightforward surgical procedures will cost between $150k-$250k. Some highly complex procedures with all the soft-tissue deforming bells and whistles may cost even more. A great way to keep the costs lower is to stick with the dev company’s standard surgical environment, avatars, and base UI. Custom features can cost an arm and a leg and rarely provide ample ROI. No matter how cool it might be to perform a discectomy in the sick bay of the Millenium Falcon dressed as Boba Fett, stick with the basics until the basics perform flawlessly.
  2. Licensing: Most VR developers who’ve created their own development tools operate at least to some degree as a SAAS (software as a service) and will charge an ongoing fee to use their software. Depending on their licensing strategy this could be a per seat license for each headset you have in the field, or a per-session or even per minute spent in a multi-user training session. We chose a floating license strategy because it gives our clients the most freedom to use the software as it benefits them most. A floating license means you buy a set number of virtual operating rooms but can load the software on as many headsets as you wish. They can also conduct as many training sessions as you’d like as well. If you buy 5 virtual operating rooms, you can conduct 5 surgical training sessions with up to 8 users per room at the same time. 
  3. Support: Any decent developer should support their software for 6 months to a year after delivering their first MVP (minimum viable product) or V1.0. This means they should guarantee the software runs and continues to run as promised on the target hardware platform no matter how often the hardware manufacturer forces firmware updates to make incompatibility issues problematic.
  4. Virtual Reality Headsets: Hardware costs for VR are affordable. Expect to spend as little as $300 for the cheapest standalone headset to $1500 for the one that looks and feels much better. PC tethered systems can run more, a lot more, like $5k-$12k more depending on how insane you want your graphics to get. Varjo, for instance makes a headset that handles augmented reality and virtual reality in a way that is nearly indistinguishable from reality. These headsets are beasts and the computers and graphics processors that run them are just as beastly. If matching photorealism is your requirement, it can be dune but expect to shell out a premium for premium performance.
  5. Device management: Fleet deployment is often handled by a 3rd party cloud-based MDM (mobile-device manager). This allows you to install the software on a whole fleet of headsets at one time, update them remotely, and see where they are and when they are used. MDMs charge between $10-$12 per managed headset per month. The leaders of this field are Manage.xr, Arborxr, and VMware.
  6. Customer Success Management: CSM goes way beyond technical support, it is like having a guarantee that your investment pays off. A developer offering CSM is capable of monitoring field tests and optimizing the software to ensure a frictionless experience. They can also train the customer’s employees to use the VR hardware and software to maximize its potential. It is common for us to go along and run a client’s VR attractions at tradeshows, or handle their first few months of virtual training or sales sessions. Unlike paying a production company to produce a medical animation, or design a web page, VR is a new medium and unless your staff are already VR savvy, they’ll need to learn how to properly wield a tool this powerful. Spending around 10-18% of the total development cost on CSM is the final budgeting needed to ensure your goals are met and ROI is achieved.

Step 6. Schedule for Development: Depending on the scope of your project, development can take as little as a few months, or longer than a year, before they deliver a minimum viable product that you can use for its intended purpose. Your developer will likely utilize one of many different AGILE project management styles and development cycles known as Sprints. Sprints usually run 2-4 weeks long and at the end of each sprint, the developer should release a new version of the software for review and testing. Our goal is to release a prototype test build as quickly as we can, by the end of the first sprint if possible. We’ve found that this helps our clients get a sense of the overall project flow right out of the gate and helps steer the rest of the project moving forward.

Using this guide to help you plan, budget, and pick the right developer, you are ready for the future. Before you know it, you will have a highly functional, fully immersive VR simulation that allows you to put your products right in the hands of your customers no matter how far away. A medical VR training program or sales app is more powerful than any media we’ve ever made and they are well worth the effort. Just remember to establish your goals before you begin and make sure that every test build gets you closer to achieving them.

Stephan Kuslich painted

Stephan Kuslich

Company Founder / Head of Wraith-VR Department

“I can’t tell if I’m good at making great software because I know what makes software great, or I’m just so annoyed by bad software that I am unable to allow it to exist.”

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