Group Editor Marty Kauchak interviewed Richard Vincent, CEO and Co-Founder, FundamentalVR.

FundamentalVR is expanding its Fundamental Surgery platform, which permits medical professionals to learn and rehearse precision surgery skillsets. It is the first SaaS platform to combine VR, haptics, deep data, AI and multimodal learning and provides immersive education simulations that allow users to experience the same, sights, sounds and sensations they would in the real world.

At the core of the platform is FundamentalVR’s proprietary and patented Haptic Intelligence Engine. This engine is used to deliver HapticVR, which in turn provides full kinesthetic force feedback haptics into a variety of handheld devices, ranging from base station held instruments through to haptic gloves within a submillimeter of accuracy.

Left: Richard Vincent, CEO & Co-founder of FundamentalVR.

To meet its customers’ increasing expectations, the company is bringing to bear a wide array of capabilities including scalability, agnostic hardware compatibility, multi-user inclusion, and HapticVR to deliver more capable solutions to medical educators and medical device and life science companies around the globe. At the same time, FundamentalVR is expanding its use of data, performance measurement and related enablers to provide even more robust simulation-based training.              

Four Core Technology Thrusts

London, England-based Richard Vincent first outlined the measured , advancements occurring in the company’s Fundamental Surgery platform.

The educational surgical platform remains scalable to permit it to be “‘future proof’ and hardware agnostic.” While Vincent admitted this broad goal is very challenging to meet in the fast-moving, contemporary technology arena, he added, “we think it is essential to do that if we are going to provide a valuable solution for our customers.”

One glimpse of the company’s efforts to remain ahead of the technology bow wave, was seen last April. In a well-timed product roll-out, the company announced the expansion of the Fundamental Surgery platform with the addition of its new education modality, @HomeVR, which brought its simulations to standalone headsets.

The CEO reflected on events in this sector during the last 12 months. Vincent reported a “massive acceleration in the desire to adopt VR, and a lot of that is coming from this entry-level, standalone device.” True to the company’s technology vision of being hardware agnostic, the @HomeVR modality can be used with Oculus Quest, HTC Vive Focus Plus and other like products, keeping this offering low-cost, light-weight and easily transportable.

@HomeVR has found favor across the healthcare industry as it facilitates blended learning.  The @HomeVR modality compliments the gold standard education capabilities of the HapticVR modality and expands the platform to provide even more flexible and cost-effective learning opportunities. @HomeVR is a superb tool for the early stages of learning where VR environments and simulations allow for basic understanding/training of a procedure or technique. During this phase of learning people are acquiring knowledge and simple understanding before progressing to true, precise skills transfers by gaining practical experience in lab or HapticVR environment.

FundamentalVR has reportedly seen “good, heavy use for clients in our enterprise businesses and medical schools, particularly for users such as medical students or medical sales people where basic understanding during phase one of learning is critical. 

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The new @HomeVR modality is also being delivered to FundamentalVR’s partner hospitals around the globe. One institution, NYU Health Langone (New York City), used @HomeVR to remotely support last August’s annual assessment and other in-processing requirements – historically completed in person, on-site.

In a second, closely aligned technology thrust, FundamentalVR has strengthened the multi-user capability across its platform. While Fundamental Surgery and its @HomeVR modality enabled successful, remote collaboration throughout the pandemic, the CEO called particular attention to his company’s multi-user capability in VR, “which has been instrumental in keeping our solutions alive and allowing our customers to use them wherever they are. Almost every simulation we have on our platform is in use with one of our enterprise-based clients comprised of medical device and life science companies. They are using multi-user capabilities to bring proctors, sales people, end users and surgeons together to collaborate around various use cases whether that be going through a specific procedure or processes, in a virtual OR or meeting within our teaching space, to go through pre-planning or bringing up and reviewing scan data, and even using tele-monitoring – creating live feeds from the operating room into our VR shared spaces.”

Mirroring other product and system advancements in adjacent high-risk training spaces, FundamentalVR is also stepping up its pace in its haptic capabilities – and with good reasons.  The CEO pointed out, “For us, haptics is essential for advanced learning and the acquisition of precision skills.” Indeed, the company’s vision for haptics is at a higher level – to learn and rehearse how to stich, place an object with great procession in the body and other rigorous tasks. “This is where haptics come in. We see it as absolutely essential for precision skills transfer, but not essential for every education need – precision is where it really matters.”

In one area of the VR haptics piece of its portfolio, FundamentalVR was able to discuss its work with the Swiss-based firm Novartis. For this project, now deployed in 25 nations around the globe, FundamentalVR created a haptic simulation for a sub-retinal injection. The product uses VR with haptics integration to simulate the highly precise surgical delivery of ocular gene therapy in the sub-retinal (rear) space of an anatomically accurate human eye. Vincent emphasized, “The supported, actual procedure requires “pin-point accuracy; if it misses by a few millimeters, it is not going to work. Getting it right is essential. Getting it wrong is a very expensive problem, because of the value-based patient care. That is where our HapticsVR platform really comes in.”

The corporate executive further provided a vital datum point on the use of VR haptics in medical training. The insight has huge implications for civil aviation and other high-risk sectors, and their credentialling/governing organizations, just now setting their course to initially establish, or expand, their use of haptics and VR, in certification training. To point, Vincent called attention to the fact that parts of the National Health Service of England are mandating the use of VR haptics for orthopedic surgeons’ training. In this instance, “the surgeons need to be able to show in the simulation, using our haptics platform they can achieve the right outcome before they can move forward in a ‘live’ situation. We think more and more of that is going to happen.” In an attempt to remain ahead of this trend, FundamentalVR’s business strategy includes building its software so that it can work across multiple haptic hardware products, anytime, anywhere.

Vincent then cast his sights further out into the haptics sector, calling haptic gloves “the next frontier.” Noting that while for industrial use cases, “there aren’t really any yet that are commercially available at scale, because of cost or infrastructure requirements,” he offered, “they are coming really fast; for instance, HaptX and what they are doing is really exciting, and then there’s the Manus VR haptic gloves. There are good contenders out there. We would love to ‘plug-and-play’ with the best of them.”

Scalability remains a fourth technology focal point for FundamentalVR. Near-term (in the next 12-24 months), envisioned product additions to its VR haptics offerings include authoring tools. Vincent further disclosed, “We’re striving to create a working software development kit that allows people who will take up positions inside those organizations to have a great tool kit to work with.”

While FundamentalVR’s product development focal points include hardware agnostic compatibility, multi-user inclusion, VR haptics and scalability, the company is also increasingly eyeing measurement of performance data and other capabilities, which are burgeoning in use in other high-risk training enterprises.  

Data and Other Common Threads               

After wryly noting “data is the new oil or fuel,” Vincent explained on one end of the data equation, there are the “basics”: who did what and when, where did they go wrong, and those type of things. At the other end you are in the fully immersive VR haptic world in which FundamentalVR operates, where nearly every action can be tracked and measured. “You can start getting into telemetry of movement, angle of attacks and even track eye movement and then start to equate those to behaviors. In turn, you can start to apply those to machine learning to predict outcomes.” This end point is vital, as the CEO emphasized that everything his company does, “we try to hook it to a validated research point.”

Regarding eye movement, Vincent noted that a “really good surgeon, and I’ll bet this is true of a really good engineer in adjacent industries, will have a very, very limited eye movement, unsurprisingly, very focused on exactly what they are doing. Whereas a resident/trainee surgeon will be looking all over the place all the time. If you can narrow down the field-of-view and teach them, beyond just making them aware, and then start creating focal points, you can teach them to focus in exactly where they need to be looking at the right time, and improve someone’s performance. It is that type of basic telemetry that is really important to the future. This is a big part of what we are working on. I the next several years, we will be applying more and more to that area of insight.”

Future Focus

FundamentalVR’s business focus will remain precision surgery well into the future. While last October the company’s HapticVR technology architecture expanded to include data-driven medical educational simulations for ophthalmology, Vincent added, “the sub-millimeter training capability provided in this new field can be applied to some of other finer areas of surgery – cardiovascular, neuro and general surgery are the areas in which we are interested as we move forward, along with the megatrend of robotics,” and concluded, “We are in the robotics space already where haptic interfaces will also be a critical component.”