VR to lower hospital expenditures: A brief review of an NPJ-published economic analysis
Is virtual reality therapy a valid alternative to patient care within a hospital setting? Could it lower hospital expenditures? We take at one recently published study that presents its findings on an economic analysis performed of VR therapy implementation in an inpatient pain management program. In an article published in Nature Partner Journals (NPJ) Digital Medicine in 2018, investigators Delshad, Almario, Fuller et al. presented an economic analysis of implementing virtual reality (VR) therapy for pain among hospitalized patients. They explored different cost and effectiveness cut-offs that would potentiate VR therapy as a means to cut expenses within an acute hospital setting like an inpatient pain management program. The findings presented by authors are, to state the least, insightful and promising. This post aims to assess those findings briefly, as it relates to the efficacy of digital therapies like VR in overall hospitalization cost-savings and healthcare productivity.
The effectiveness of VR in reducing hospital expenses.
Investigators from this study observed that implementing a VR therapy program in an inpatient setting resulted in better cost-savings per patient when compared to usual care. While the range of savings extended from $11.00 to $156.17, the average cost-savings per patient was $5.39. This figure, at first glance, does not seem much. However, let’s consider the three underlying factors that contributed to that mean:
- Patient acceptance of VR
- Patient eligibility
- Hospital length of stay (LOS)
When patients were eligible for and open to VR therapy, cost-savings per individual increased dramatically to an average of $98.49. That is an eighteenfold increase! 
This reporting suggests two main takeaway messages as a result:
- Virtual reality by itself paves the way for savings in hospital expenditures.
- Further reductions in expenditures are possible if patient acceptance and eligibility of VR increase and more importantly, hospital LOS decreases.
If ever there is a doubt about the use of virtual reality therapy within a hospital setting, then this study underpins that implementing such a program can indeed be economically beneficial to both health systems and patients.Additionally, suppose doubt continues to remain due to the initial, high costs associated with developing a program. In that case, we need not look further beyond this separate yet similar study by Farra et al.Investigators observed thatwhen neonatal intensive care workers underwent training for hospital evacuations during a disaster with the use of virtual reality, costs per participant was much higher when compared to live drills ($327.78 vs $229.79, respectively). However, because virtual reality was not a fixed cost, unlike live training, the initial investment in virtual reality was amortized over three years with the inclusion of more participants. This study, like that of Delshad, Almario, Fuller et al., reiterates that VR lays the groundwork for savings and manipulating certain variables can invite fewer expenses. 
Less pain, more to gain
Although listed above were three primary factors influencing cost-benefit analysis of VR therapy, other factors were in play as well; in particular, opioid utilization. Investigators stated that direct cost savings from a reduction in opioid utilization were not enough to offset VR expenditure. Is this to mean that VR does not have as much an impact on medication use, so as to lower costs in the long term? Well, not quite. Investigators performed the analysis, including expenses associated with medication use and complications only during the initial hospital stay. They did not consider substance dependence potential, post-discharge complications or quality of life. This is a particular, relevant limitation for those questioning the efficacy of VR in hospital cost reduction and more interestingly, overall patient care and satisfaction. A recent breakthrough metanalysis of VR in substance addictions revealed virtual reality could establish a more ecological environment with more control and safety over exposition for better patient treatment. And if these additional factors could be assessed in prospective studies? In such a scenario, there exists the possibility that health systems and patients have more to gain (and less painful costs) with the integration of virtual reality therapies. —If your health organization or practice is curious about implementing a virtual reality program, we at Amelia Virtual Care can provide you with a demo session and further details to enjoy all its cost-saving benefits and more.
