Second Life in Health Care

Peter Yellowlees, MD, Director of the Health Informatics Graduate Program at UC Davis,  author of Your Health in the Information Age — How You and Your Doctor Can Use the Internet to Work Together, and instructor for an online UC Davis Extension course, has asked the class to consider Second Life and its role in the doctor-patient relationship. Second Life is a cyber-world where participants basically interact with others using an "avatar" or digital character and move through the land of Second Life by teleporting to different islands--many exclusive and requiring invitation. The potential of Second Life as a tool for health care is interesting in that patients can interact with the provider as two avatars "talking" and not have to look each other in the eye and without the input of nonverbal communications which could influence the conversation. Perhaps its benefit will be in reaching patients that don't enter the system now because they feel discriminated due to appearance, age, sex, sexual orientation or simply cannot show up in the office. This approach may get these patients connected to the health care system.


Interacting via Second Live might free a patient to discuss difficult topics that he might not otherwise want to bring up in person. With headphones and a microphone the avatars can speak or participants can use a chat field to type communications. The disadvantage for the practitioner is not being able to visually assess the patient. Another consideration is that if this method would allow patients to be more open, would it also get providers to be more open? Could this create new relationships with patients where in the past, clinicians are taught to keep a professional distance and demeanor?  Perhaps providers, too, could find the part of themselves that wants to be in connection with other human beings. 


There is potential for patient education where providers could send patients to a virtual simulation class so that they could understand an upcoming procedure and perhaps go through a simulation. Claustrophobic patients might be able to desensitize through MRI or CT simulations. There are many possibilities for extending care and communications using Second Life. There are just as many issues about using it including trusting who is at the keyboard, i.e. who is running the avatar? Another concern at the moment (technology changes quickly) is the learning curve to have an avatar and find your way around Second Life. I have spent about 3 hours reading guides and entering Second Life. Luckily, I knew a friend who offers Writing as Healing classes in Second Life so I was able to call him (first on a land line) and then our avatars walked around together and he showed me the ins and outs of the cyber world including a tour of the virtual hallucination clinic that Dr. Yellowlees and his colleagues created so avatars can experience what it is like to have schizophrenia.


Not having any gaming background nor interest in virtual worlds made this more awkward and I would be hesitant to meet my doctor in this space until I had some mastery of it. Perhaps future versions will be easier to use. A classmate's avatar happened to fly by and we were able to bumble around together which made it less boring and upsetting of an experience. It's interesting how landing in this new world brings up familiar experiences of being new at school and having to meet people.


Will it improve relationships or make health care more accessible or affordable or higher quality?   Who knows but considering all that is happening in health care, we need to look at everything that we can.