These days, the metaverse is on everyone’s lips. With a global market volume that already exceeded 100 billion dollars last year, this immersive virtual environment will radically change the global economy and society. This is slowly being acknowledged by the institutions of the European Union (EU), which recently mandated expert reports, conducted citizen panels, and established non-legislative initiatives on this topic. However, Europe is in a global competition for the future of a healthcare-centric metaverse and must therefore act swiftly. For example, the US Food and Drug Administration is already working on the question of how medical devices can be made usable in the metaverse.

The metaverse can generate a wealth of new health-related data that is historically unprecedented in scale and granularity.

Meta – what?

The term Metaverse was popularised by Facebook founder Mark Zuckerberg, who renamed his company “Meta” – but the concept should not be confused with this single company. The idea of the metaverse describes much more than a partial use of individual technologies such as Augmented Reality (AR) or Virtual Reality (VR); it essentially refers to an immersive virtual environment that can be accessed by various means and that literally draws the users in – with all their sensory perceptions. According to the popular definition by technology expert Matthew Ball, the Metaverse is a “massively scaled and interoperable network of real-time rendered 3D virtual worlds that can be experienced synchronously and persistently”.

Healthcare is a good place to reflect on the metaverse’s potential, as virtual medical services, such as telemedicine, have become increasingly popular since the Covid pandemic. These recent experiences raise the question of how metaverse technologies can be used to better treat illness without exacerbating existing health dangers or societal inequalities, not least since the metaverse will not emerge in one fell swoop. Instead, it will emerge over time as different products, medical services, and capabilities are integrated.

The metaverse can generate a wealth of new health-related data that is historically unprecedented in scale and granularity. For example, it will enable applications that combine VR with biofeedback, such as heart rate monitoring, as well as neurofeedback. This in turn will enhance machine learning applications. Prototypes already exist for immersive virtual worlds that draw on Artificial Intelligence (AI) to automatically recognise and specifically evoke various emotions from users’ brain waves and heart signals. What opportunities does this open up for the European healthcare system?

Implications for the healthcare sector

Fundamentally, the metaverse will make life easier for medical professionals and medical companies. Already today, there is the possibility to use VR technologies to complement education and training in the real world. As there are fewer and fewer opportunities to practice with real patients, and medical professionals increasingly need to offer virtual consultations, the demand for more advanced, realistic simulation methods will continue to grow. Specialised surgeons and other experts will be able to disseminate their rare knowledge in the metaverse without having to travel. More importantly, the introduction of health services in the metaverse makes it possible to artificially alter the virtual environment in an empirically measurable way and record the results, analogous to expensive and error-prone clinical trials or manual tests by doctors. Ultimately, this will lead to better diagnoses.

At the same time, there will be growing opportunities for patients to directly utilize this new technology themselves. For instance, the metaverse will empower patients to better understand various aspects of their own health as well as the healthcare system by visualising this information as “digital twins”. Better health awareness might result from the fact that metaverse users can take on a virtual body that is different from their physical body. The immersive nature can be used in healthcare settings to distract from moments of pain. More generally, incorporating VR into therapies can increase their ease, acceptability, and effectiveness. There are rapidly evolving opportunities for virtual counselling of people suffering from anxiety, stress, or significant psychological impact. Finally, the metaverse can be used for motor development and health prevention, especially for children with neurological movement disorders. Nevertheless, the path from developing meaningful use cases to the actual usage of this technology in patient care is not an easy one.

The regulatory future – challenges and opportunities

Since the metaverse produces a variety of novel functions, the application of existing regulatory regimes is difficult. In particular, the metaverse poses a challenge to existing data protection principles – especially because the amount of biometric data is growing exponentially. In addition, there are new issues of competition and industry policy, as data and distribution monopolies could arise due to market entry barriers. Conflicting regulatory requirements may prevent healthcare providers and technology companies in the EU from offering innovative solutions to European patients in the future metaverse. This scenario must be avoided, as the metaverse and its potential for healthcare are valuable for each individual patient. What is needed now is the political and regulatory will to move forward.

The metaverse promises the integration of different technologies into a peculiarly new environment that must meet certain requirements in terms of data protection and accessibility. Since these requirements cannot be sufficiently checked by the user or the process of free competition, an external institution is needed for control and supervision. In order to promote a European metaverse for healthcare that exploits the technical potential and at the same time minimises risks, the EU should therefore introduce a metaverse certification system similar to the TÜV system used in Germany. This “Metaverse TÜV” would aim to assess and verify the security and data protection aspects of metaverse platforms in the healthcare sector. Certification criteria should include privacy, security, interoperability, ethical considerations, user privacy, and compliance with relevant regulations such as the General Data Protection Regulation (GDPR). Similar to the TÜV system, technical auditing would play a crucial role. For example, certification bodies would conduct audits of data anonymisation and vulnerability tests such as simulated attacks.

Making the metaverse work for Europe

All in all, the metaverse can enrich the healthcare system in Europe enormously, especially in view of the challenges of demographic change. A comprehensive certification system that ensures an adequate level of data protection, as well as broad accessibility, is essential to gain the trust of patients and to promote the acceptance of metaverse applications in healthcare. A transparent certification system, easily visible in a public database, would foster the formation of a European healthcare ecosystem. By targeting healthcare, the EU can play a strategic role in this evolving digital space, ranging from AI algorithms to physical devices for accessing the metaverse to the various new forms of biometric data.

This contribution is an abridged and revised version of the cepInput 8/2023.

Dr. Patrick Stockebrandt is Head of the Consumer & Health department of the Centres for European Policy Network (cep) in Freiburg and Associated Faculty at the School of Economic Disciplines of the University of Siegen. He has studied German and European Economic Law in Germany and Lithuania before gaining his Phd in law (Dr. iur) at the University of Siegen.


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