THE METAVERSE AND HEALTHCARE – PART 2,
THE UNDERLYING TECHNOLOGIES
By Carl L. Larsen, President & COO, OXIO Health, Inc.
In our previous blog titled, “The Changing Internet Landscape”, we introduced the concept of The Metaverse and how it is being envisioned. If you recall, the term is the marriage of two words “meta” and “verse” (taken from universe) and is used to imply something transcending the known (internet) universe. In fact, The Metaverse, is a “new domain” or a new “digital reality” that will introduce a completely new ‘culture’ and ‘ideology’, altering, even replacing our human interaction with our personal digital avatars that operate in a digital space, in real time as if they were us – because in The Metaverse they are us – we have become players in our own digital lives!
Having laid a foundation in Part 1 for the concepts embodied in The Metaverse, and what it is intended to be, we want to explore the how of this new “Techno-Culture”; how the use of existing technologies like AI and Blockchain contribute to building this new internet ‘universe”, how that will impact and advance healthcare, as well as how we interact with our own medical and wellness data, and with our care givers. Finally, after we have properly established a foundation, we will explore in Part 3 how The Metaverse can improve healthcare outcomes, empower the patient and provider all while reducing costs of the delivery of healthcare and wellness.
What technology stack(s) can bring all of this ‘gamification of real-life’ together, what exists now, and what is yet to be invented? According to the description of American game creator, Jon Radoff, the 7-layer elements of The Metaverse are: (1) experience, (2) discovery, (3) creator economy, (4) spatial computing, (5) decentralization, (6) human-computer interaction, and (7) infrastructure, in precedence order from the outside to the inside (from shallow to deep).
Based on available research, the main carrier of The Metaverse includes the following components.
The current, new generation of 5G broadband mobile communication technology may appear today to be ULTRA High-Speed; however, The Metaverse will demand substantially higher speed, shorter latency, and greater connection capability; substantially beyond the 5G network infrastructure that claims to be the interconnection of humans and machines. As noted in the first blog, the capacity and capability of the communications needed to handle the expected trillions of transactions per millisecond is several orders of magnitude below the current capacity of the existing 5G, even 6G (as envisioned). The Metaverse not only requires extremely high data transmission capabilities both due to transactions, but also to achieve the desired real-life affect. The communications backbone must have needed magnitude, speed, and stability of data transmissions well beyond current commercial capability.
Communications technology is a crucial infrastructure element for the development of The Metaverse. The desired experience provided by Virtual / Augmented Reality devices will demand much higher throughput to be accepted. Several developers have created dedicated technologies and chipsets for Virtual Reality wearable devices and provided downstream companies with development.
Healthcare data, in a post electronic medical record world, has started a revolution over the last 10 years and is now a major influencer on technology. First in installed applications, then on the Cloud, and now with the use of two-way remote devices and remote care. We expect that the pressure for more data and information will increase which in turn will require highly secure and protected communications. With personal medical data transmitted, patient medical and health information being broadcast, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 still requires complete protection and confidentiality of patient medical data.
Chipset (computing power)
Bear in mind that simply being able to do the computations to create the digital reality is nothing if it cannot be communicated to the end-user. We noted in our first blog that The Metaverse’s content, network, blockchain, graphic display and other functions require substantially faster and more powerful computing power – note also that this also materially increases the energy demand nearly pari-passu.
Beginning with cloud computing power, the DPU chip (data processing chip) provides a secure acceleration infrastructure ‘platform’ for various workloads in the cloud, data center, or edge environment by shunting, accelerating, and isolating various advanced network, storage, and security services.
At the local level laptop or notebook, home of the local terminal computing power, the heterogeneous chipsets must allow the CPU, GPU, FPGA, DPU, ASIC and other chips in the SoC to work together to continuously improve computing power to provide and hopefully enhance user experience, and provide true life-like (digital reality) movement and action – an expanding role for AI; however, even with AI we still need to make some large strides in innovation providing the constant fine tuning.
These ‘end-user computers’ do not currently exist and will likely require materially expanded motherboards. We envision the need for two or more ‘stacked boards’ until chip technology catches up. Even then, we must deal with the issues of heat rejection which is problematic in an already small device given the energy that the power density of these devices will require.
GPU is currently the mainstream of SoC chips due to its superior ability to handle parallel computing. FPGAs, as a supplement to AI inference operations, enhances the AI computing capabilities of automotive SoCs. In the future, as the autonomous driving technology matures and finalizes, more ASIC chips will be introduced into the car’s main control chip. ASIC is the current trend of growth in autonomous driving applications; however, in the author’s view, this is still several orders of magnitude below the capacity and capability needed to manage several trillion computations per millisecond.
Cloud and edge computing
Cloud computing and edge computing provide users with required computing resources, lowering of the threshold for users to reach the beginning of The Metaverse. At the same time, the cloud and the edge complement each other. The resources at the edge of the network mainly include user terminals such as mobile smartphones and personal computers, high-capacity notebooks and tablets, Wi-Fi access points, cellular network base stations and routers, as well as other cloud infrastructure. As noted earlier, due to the tremendous level of processing needed, the current architecture in distributed processing will need to be greatly expanded. We predict that by the end of the decade, the average person over 65 in the U.S. will have three (3) to five (5) permanently connected healthcare related devices in their homes or on their person (i.e., advanced smart watch, to monitor and aid providers in their care).
Artificial Intelligence (AI)
AI will be broadly used in The Metaverse. AI will help create The Metaverse assets, ‘life plane’, and other content, as well as improve the software and processes used to build all this content. In other words, AI will contribute both in the development of The Metaverse, as well as its operational areas.
We’re not near being done as the ‘carrier’ of The Metaverse still requires a number of complex technologies. For example, to enhance the real experience of The Metaverse, GPU-based image processing technology needs to be continuously optimized; relying on the penetration of the Internet of Things (IoT) for such things in the future such as IoT terminals like automobiles and home appliances that could also become Metaverse interfaces. Current technology applied to remote patient management (RPM) is wholly inadequate to address the expanded use of VR, AR and IR (infrared) and sonographic live pictures of the patient in situ; however, we believe that once perfected, the gains in more accurate and faster patient diagnoses will be substantial.
Blockchain – a keystone
Why we think blockchain is the key technology of The Metaverse. Based on its own unique technical characteristics, a blockchain will naturally adapt to the key application scenarios of The Metaverse. Blockchain is a traceable chain data structure that combines continuously generated “blocks” of information sequentially in a logical and chronological order. It is a form of “cryptographic method” that ensures the data cannot be tampered with and cannot be forged, i.e., it is immutable and sovereign. Given its own characteristics, a blockchain can be used for digital assets, content platforms, game platforms, sharing economic and social media platform applications. The other important dividend the blockchain provides is in making healthcare application data secure, immutable, and accessible anywhere with security, and integrity across an enterprise that is ‘open source’ and has many different developers of content.
That said, why is blockchain such a pivotal element to the success of The Metaverse?
- The application of a blockchain in digital assets recognizes that each transaction is initiated by peer-to-peer communication, and the accounting method of unspent transaction expenditure is used to store complete transaction records for each participant and maintain a distributed (multi-tenant) database.
- On the content platform, the blockchain records original information and interactive records on the platform also go through the blockchain – this is to ensure that the records cannot be tampered with, and to reward outstanding content creators and third parties who provide services through a transparent algorithm.
- The technical application of the blockchain in the game platform is to maintain all transaction records, smart contracts and Consensus mechanism.
- Application of blockchain technology in the sharing economy is to encourage both parties in sharing economy transactions and conduct automatic transactions through smart contracts and ensure the security of smart contracts so they cannot be tampered with through blockchain technology.
- The application of blockchain technology on social platforms is to maintain personal information and provide distributed storage services for users on social platforms, as well as process specific transaction fragments in parallel through each node.
Blockchain technology is different from other technologies because it effectively bridges the bottom and upper layers of The Metaverse. In the overall structure of The Metaverse, above the infrastructure, data and algorithm layer, and below the application layer, a complete, rigorous and mature technical system is required to support the governance between the individually developed and integrated areas of The Metaverse.
The characteristic of a Metaverse governance link is that The Metaverse is planned to be jointly constructed by many hundreds of centralized institutions and millions of individuals. So, it should be distributed, decentralized, and self-organized, as well as self-governed – the truest of “Open Source” enterprise applications. A veritable patchwork quilt of programs and applications that must interact seamlessly with full interoperability while maintaining the sovereignty of each element – this is yet to be done!
In addition, with blockchain technology, Metaverse participants can receive rewards based on their contribution (time, money, content creation). In addition, based on the blockchain, it can provide the exclusive NFT (Non-Fungible Token) as an incentive depending upon the specific ‘application’. For instance, an individual may receive an incentive for releasing their ‘de-identified’ medical records to a research institution through a smart contract and without any mining required – a strict peer-to-peer transaction, physician/provider reimbursement could come in milliseconds instead of weeks and so on.
As with all emerging technology there are several risks: the known, the known and unknow, and the unknown-unknown. The following are identified risks in each of the key capability areas:
- Technology development of The Metaverse involves a complex technical framework and careful balance of technology. The interrelationship of the technologies is crucial to success, and it is a bottleneck in a single technology area that could limit the development of The Metaverse;
- The adoption rate of The Metaverse into mainstream use is difficult to predict due to the material changes in innovation, ability and context of use outside of internet games; however, we are confident that the adoption rate within the healthcare context will be accelerated by the need for providers to be able to handle more patients with higher quality of care and lower cost that many of the innovations we have envisioned will provide;
- Decrease in user retention rate: The ‘gamer ecosystem’ is an uncertainty and none of the gamers may be put off about the construction leading to a loss of user stickiness and the amount of time needed to adapt to the new platform;
- There are numerous potential policy and regulatory risks in games, digital currency and other fields that have not been fully identified, thought out or resolved;
- The business models or companies, such as Facebook (aka ‘Meta’), Roblox and Epic are yet to be fully implemented: The Metaverse is still mostly in the conceptual stage with most companies still looking at an uncertain business model; however, we see the ability to move forward immediately with several early-stage healthcare initiatives that provide promise.
In summary, Metaverse is the product of integrating multiple technologies, and blockchain is indispensable in these technologies, and it is undoubtedly the key technology of Metaverse. Clearly, the birth of The Metaverse hinges on the construction and improvement of several underlying technologies, including but not limited to chips, communications, VR/AR, AI, blockchain and predictive BIG DATA analytics.
We see many of these moving parts and some will make it and expand, and others will not. However, we are excited about The Metaverse and its implications for advancing the science of healthcare, improving patient outcomes, empowering the patient and enabling the physician. The challenge for those of us in healthcare technology is to address what can we do NOW that will migrate into a Metaverse environment and offer present value to the patient and provider.
The Metaverse is an extremely complex concept incorporating almost all current high-tech. This is good and bad for the development of The Metaverse. The advantage is that The Metaverse can integrate a variety of top technologies at the same time to create products that condense and crystallize human experience and wisdom. The disadvantage is that the ultimate value of The Metaverse lies in experience. If a technology fails to meet the expectations of experience, it will have a devastating effect on the realization of the meta-universe.
The Metaverse & Healthcare – Part 3
In the next blog, we will explore how the plethora of technology in blockchain, virtual/augmented reality, AI and predictive analytics can combine to accelerate the delivery of healthcare to patients. Further, we will dive into the wellness to the public, and lifting the practice of medicine to a new plateau in which physicians can interact with patients in a way that enhances both the patient experience and the accuracy of the physician’s diagnosis. On the consumer side, the capabilities and functionality that will arise from the RIGHT application of these technologies and can be used by the public to analyze and compare their data to enrich their lives and improve their wellness. Obviously, both combine synergistically to improve the quality of care and life, as well as reduce the cost of healthcare and individual wellness.
– Carl L. Larsen, President & COO, OXIO Health, Inc.