Virtual and Augmented Reality Strategies for Improving Women's Health

Allyson Brooks, MD, FACOG, a senior physician executive with Hoag, shares how the health system uses technology to improve patient experience and outcomes in women's health.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Podcast. Audio of the full interview can be found here and below.

Allyson Brooks, MD, FACOG, has experience working as a frontline provider, an OB/GYN physician, and in healthcare administration.

She currently serves as a senior physician executive for Hoag, overseeing quality, patient safety, regulatory compliance, accreditation, performance improvement, infection prevention, and patient relations at the California-based health system. She's also the Ginny Ueberroth executive medical director and endowed chair of Hoag Women’s Health Institute.

During the most recent HealthLeaders Podcast, Brooks shares how technology has had a major and positive impact on the women the health system serves, including virtual and augmented reality solutions for Hoag patients. She also shares her career background and insights into her authentic and curious leadership style.

This transcript has been edited for clarity and brevity.

HealthLeaders: How has Hoag integrated technology into its patient care, and how has it helped create a better patient experience?

Allyson Brooks: That's a loaded question because technology is sort of mainstream now in healthcare delivery. But in the obstetrical realm of healthcare, and specifically at Hoag Hospital, where we deliver the second highest volume of pregnant women every year; we had [more than] 7,300 women come to hope hospital to have their baby. The age range of those women who are entrusting their families to us is in the 20-to-40 age range, [and] they're technologically savvy. When we did some focus groups when we were designing a new hospital, what we found is that they wanted the majority of their care to be at their fingertips with their iPhone, and they wanted applications, so one of the first investments we made was in virtual lactation support.

Every woman who delivers at Hoag Hospital receives a complimentary one-year gift subscription to Hoag Pacify. It [offers] 24 hours a day, seven days a week access to certified lactation specialists and consultants that can help women that are struggling or have particular questions or concerns about breastfeeding. This is not intended to replace in-person lactation consultation or lactation support, but we all know that it's not necessarily possible to have in-person support 24 hours a day and on weekends and holidays. We've served over 8,000 women using this virtual lactation support and have received rave reviews. [Patients are] very appreciative because they're busy; they want their questions answered on demand.

Hoag is at the forefront of the application of virtual reality and augmented reality, to help not only in educational content or information but in diagnostic and therapeutic manners. We embarked on [this] about two years ago with an external virtual reality company called BehaVR; we collaborated to develop a VR application called Nurture VR. The idea was to provide education and curriculum that would take a woman from 28 weeks of pregnancy all the way through 12 weeks postpartum, with the goals of empowering her with her pregnancy or on her perinatal journey, also improving some of the bonding experiences with her unborn child. Also to increase and improve the readiness to be a new mom, and to be able to withstand or manage that postpartum or fourth trimester period of time where there's sleep deprivation, fatigue, and oftentimes feeling overwhelmed with physical changes, emotional changes, and balancing work, family, travel, the newborn, etc.

With Nurture VR, the intent was to help pregnant and postpartum women develop an individual practice of meditation and mindfulness. The concept was that when a woman is pregnant, they're more receptive to self-improvement or recommendations of ways that they can be healthier, or reduce their stress, or habits. The idea was that if we could expose them to meditation and mindfulness, and help them see the power of it, that they may develop a lifelong relationship with it that will give them improved health and life.

HL: How were you involved in the creation of Nurture VR?

Brooks: As an OB/GYN, I was approached by a neurosurgeon entrepreneur at Hoag, Dr. Rob Lewis, who established the augmented reality and virtual reality lab that we have at Hoag. He approached me and said, 'We think that the maternal/child health population would be right for this technology,' that they would be the beneficiaries. [There are] large numbers of women who are looking for an immersive experience to help empower them and educate them and help them be more engaged and in control of their pregnancy and postpartum experience. He's the one that brought me and Hoag to BehaVR.

It has taken a significant amount of time and iterations to get it to where we have it today. We are launching our clinical research to see if we're achieving the goals that we set out by enrolling women in a research trial that we're doing.

HL: What other innovations in women's health have you helped lead while serving at Hoag?

Brooks: The one that I would say that I'm the most proud of is when I did a fellowship in leadership as a chief medical officer. I was asked to design … a population health or a public health type of program, and get it launched within a two-year time period. What I selected was to have all women that present to Hoag Hospital or one of our imaging centers for mammography or breast cancer screening … complete a questionnaire on an iPad about their personal and individual and family risks of cancer, [and] also some of their other demographic information that would allow us to assess what their lifetime risk was for developing breast cancer. We put that through an algorithm and a program, and [contacted] all the women that have undergone this type of testing, letting them know if they had an increased lifetime risk of breast cancer, and then [provided] them with lifestyle improvement coaching at no cost through one of our nurse practitioners who was an advanced practice breast practitioner.

They discuss weight management, diet, exercise, as well as genetic testing and counseling, and even more importantly, the importance of regular surveillance and imaging for higher-risk women, which would be a mammogram every year and breast MRI every year. That program went into place a little over six years ago and to this point, we have screened [more than] 60,000 women and have identified 275 women who were carriers of a genetic mutation that increased their risk for breast cancer.

This program, called the Hoag Early Risk Assessment program, has allowed us to take women who are presenting for breast imaging [and give them] individualized breast cancer risk assessment, and then be … counseled and followed ongoing if they prove to be a carrier of a mutation that increases their chances.

HL: How would you describe your leadership style and how does your background as an OB/GYN physician help define that?

Brooks: It's a little bit of servant leadership, but a lot of it is curious leadership. Going out and finding out what isn't working, assessing the pain points, and then looking for solutions and getting individuals involved in designing the best solution in the shortest time so that pain point can be resolved.

I'm comfortable being vulnerable. I got a lot of my inspiration from Brene Brown. In a couple of her books, the podcast, and other things she talks about daring greatly, and being vulnerable, and having boundaries. She has a number of inspiring messages that I relate to and have tried to build in the way that I interact with individuals on a day-to-day basis that allow me to make progress in the areas of women's health, all aspects of it, the holistic approach to all of the healthcare needs and the experience for women of all ages and life stages.

HL: Do you have any advice to offer to those who want to work in women's healthcare or serve as an executive in healthcare?

Brooks: Just do it. I think it's incredibly valuable. It's very meaningful work. We have so much work to do, and there are many women, present and future generations, that depend on us driving forth and giving them the care that they need, and responding to their evolving needs, wants, and desires. We need to ask what they want, ask what their expectations are, ask what they're willing to pay for, what they're willing to drive to, and how they want to receive their care, and it's our obligation to design around that.

I encourage women to get involved in every aspect of improving how healthcare is delivered and experienced by women.