I once had to accompany a young, very nervous cousin for an MRI scan. He was reluctant to enter the hospital, increasingly anxious when waiting his turn and downright panicky when he saw the machine itself. He lay down, changed his mind, got up, talked it over, lay down, changed his mind and walked out. It just wasn't happening that day.
Jonathan Ashmore, an MRI physicist at King's College Hospital, thinks he has the answer to this particular predicament with his new My MRI at King's app, developed with KCL learning technologist Jerome Di Pietro.
It takes the same ideas we've seen in VR immersion therapy-style apps such as Psious for people scared of flying and applies it to children having a scan.
Essentially, the NHS app takes you through the whole experience of getting an MRI scan from arriving at the hospital to the waiting area to lying down and getting in the machine. All from a child's height and with Monsters Inc playing on a screen during the scan.
Inside the scanner
Normally you would never, ever put something like a camera in the scanner
Out on the Play Store now - and coming soon to the App Store - the free app is a two-minute-or-so interactive experience designed to be used with both Google Cardboard VR headsets and tablets, at home and on the ward with play specialists. It's been in development for around a year after Ashmore asked for a Ricoh Theta S for Christmas 2015. (He upgraded and shot this footage on a Samsung Gear 360).
"My role in the hospital is also an MR safety officer and normally you'd never, ever take anything into the scanner but I thought - I'll take the risk and see if you can take the camera in," he said. "Normally anything would break if you put it into a really high magnetic field. But I sticky taped it to the scanner and it worked. So I thought - great, I can actually take some footage inside the scanner."
Around this time, play specialists - staff who work with children to help them understand medical procedures - were requesting photos of the scanner to show young patients and heard about the 360 video idea. Together, they developed booklets that have been trialled at King's College Hospital since the start of the year.
"The app is brilliant but it's the interaction with the people that is where it can really come into its own," said Ashmore. "Play specialists are amazing at appeasing the anxieties of children. It's this interplay that's required. But play specialists only work with kids with strong anxieties so we can give others this app or send it home."
The idea is to make children feel more comfortable in the machine and also to make sure they know to lie still. This also reduces the need to give children an anaesthetic when it might not be needed. Two families who have been using Cardboard headsets at home even said that their child was now excited about coming in and having a scan.
360 degree hospitals
At the launch event, ten year-old Matthew Down, who has annual MRI scans to check up on him after brain surgery in 2014, was an absolute pro at the gaze controls and knowing that he could look around in any direction - something adults struggle with. Down is one of the kids that has trialled the VR experience and found it useful.
"I think it's a really good way of getting [children] to know their surroundings and experience the actual scan," he said. "When I tried it, I knew I shouldn't be afraid."
What's exciting is that there's a lot of scope to expand the project within the NHS. Other hospitals could use this VR experience themselves - after all, most scanners look the same - or create their own 360 production to live inside the same app. Ashmore has already shot footage from a higher perspective and with his radiologist actor talking to the viewer as an adult and a version for grown-ups is "in the pipeline".
It's no secret that the NHS is strapped for cash. Any initiative that's cheap to produce - the footage is easy to film - but saves the time of staff and speeds up the time each patient spends in expensive equipment sounds like a winner.
"Lots of people who work within child health have shown an interest and they want to roll it out for patients that are going to have surgery," explained Ashmore. "So you show the child being taken into theatre, put the gas mask over their face or having a liver biopsy where they stick a needle into someone's liver. It's a local anaesthetic but it's extremely traumatic for the child."
Now, we're just waiting for the dentist's chair edition.