HouseCall VR

A major pain point in healthcare is ineffective patient education, leading to patient non-compliance and adverse health outcomes. Per a study published in 2018 (Quality Management in Health Care 2018; 27(2): 93–97), it is estimated that approximately 80 million adults in the United States have limited or low health literacy. The consequences of low health literacy lead to more hospital readmissions and higher mortality rates. Overall, the costs associated with this low health literacy were estimated in 2015 to be up to $215.1 billion per year (Int J Health Policy Manag. 2015 Nov; 4(11): 747–755). Inadequate patient education solutions have clearly become a major problem within our healthcare system. 

Additionally, healthcare providers are increasingly time-constrained to provide patient education themselves. As detailed in Health Serv Res. 2007 Oct; 42(5):1871-94, the average clinical office visit only lasts approximately 15 minutes and includes 6 healthcare topics per visit. This clinical time crunch is running headlong into a clinician shortage. Per a press release from the Association of American Medical Colleges on June 11, 2021, it is estimated that the U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034. Put simply, clinicians do not have enough time to provide appropriate patient education. 

Low health literacy and less clinical resources have combined to result in an opportunity for HouseCall VR to provide a more technologically-advanced solution that provides better patient education.

HouseCall VR is focused on providing a revolutionary patient education experience through the use of immersive, extended reality solutions (“XR”, including virtual reality, augmented reality and mixed reality). Unlike other XR solutions primarily focused on clinical staff training or direct patient treatment, HouseCall is developing a groundbreaking platform dedicated to leveraging XR exclusively for patient education. HouseCall is delivering this novel patient education approach through a proprietary software application that will reside on XR headsets to be utilized by patients within a clinical setting.

HouseCall’s team of clinical experts and technicians is developing custom XR patient educational modules on a variety of topics across the healthcare spectrum. These modules will be accessible both through the XR headset application and via a smartphone companion application. HouseCall’s product is being designed in a manner that allows HouseCall to efficiently build patient education modules from a “library” of XR assets. The product will also focus on ease of interactive use for patients and efficiency in clinical deployment. 

In the realm of patient education, the potential of XR is underscored by a scoping review by van der Kruk, et al., which notes that XR can significantly enhance the learning experience, improve retention, and provide a more immersive platform for learners. Similarly, Liran, et al., concluded that XR emerges as an effective tool in improving outcomes through patient education.

The core purpose of HouseCall’s XR patient education application is to provide patients with a more comprehensive understanding of their health so that they can have better health outcomes. HouseCall’s solution is designed to be accessible and scalable in order to have a broad impact across all communities but in particular at-risk groups who do not have reliable access to necessary healthcare resources. The potential fallout benefits of better patient education are multifold:  shorter hospital stays; efficiency gains within the clinical workflow to be able to care for more patients; reduced healthcare-related costs; and increased medication adherence for patients.

In today's healthcare landscape, patients face significant challenges in accessing quality healthcare information and resources. These issues are exacerbated by a combination of systemic barriers, socio-economic challenges, and sometimes a mistrust of the healthcare system. Accordingly, there is a pressing need to engage patient communities in meaningful ways that promote understanding, trust, and proactive health behaviors. Traditional patient education methods often fall short, lacking the cultural relevance and engagement needed to resonate with diverse populations. The absence of immersive and relatable educational tools further widens the health literacy gap, leading to missed preventative care opportunities and a lack of awareness about available healthcare resources.

HouseCall VR seeks to address this critical need by harnessing the power of immersive extended reality (“XR”, including virtual reality, augmented reality and mixed reality). By creating an engaging and culturally relevant XR platform, we aim to transform how communities interact with healthcare information. The immersive nature of XR offers a unique opportunity to connect with community members on a deeper level, allowing them to virtually "experience" and understand complex health topics, procedures, and the benefits of preventative care. Through this innovative approach, HouseCall strives to promote health equity by bridging the health literacy gap and empowering patients with the knowledge and tools they need to navigate the healthcare system effectively.

Unlike generic patient education tools, HouseCall is uniquely positioned to resonate with diverse populations. By collaborating with content creators from varied backgrounds and actively seeking feedback from diverse patient communities, we ensure that our educational material reflects a wide range of cultural perspectives. Additionally, our commitment to multilingual support, which goes beyond mere translation to capture cultural idioms and nuances, ensures that the content is both culturally sensitive and relevant. This multifaceted approach to cultural relevance fosters a deeper connection and understanding for patients from varied backgrounds.

HouseCall's leadership team is unique in several ways that will allow the team to provide better patient education and related healthcare outcomes through its novel solution.

First and foremost, HouseCall is a clinician-led team who understands the challenges and downstream effects of low health literacy. Dr. Linda Ciavarelli, Co-Founder and CEO and Team Lead, has over two decades of clinical experience as a podiatrist that have deeply informed HouseCall’s mission. Dr. Ciavarelli’s firsthand encounters with the detrimental consequences of inadequate patient education fuel her commitment to this venture and provide a guidepost for how HouseCall can design its product to impact patients' lives for the better. 

HouseCall is committed to having clinical staff help form its core leadership so that we are always reminded of why our mission is to revolutionize patient education. In addition to Dr. Ciavarelli, HouseCall has worked with: Dr. Susan Woods (who is an Internist, informaticist, researcher, health tech co-founder, and educator); Dr. Laura Aymerich-Franch (who assists HouseCall’s patient education content creation with a focus on behavioral transformation); Dr. Betsy Greenleaf (a women’s health expert and entrepreneur); and Elizabeth Bloomfield (a practicing Physician Assistant and virtual reality engineer).  Also, HouseCall seeks to work with leading clinical experts within a given healthcare field in order to assist with designing the script and storyboard for each of HouseCall’s patient education modules. To date, HouseCall has worked with experts in the fields of diabetes, nutrition, podiatry, dentistry, sports injuries, and addiction.

Importantly, the HouseCall team also has varied experience outside of a clinical setting that is targeted towards building a sustainable business model. AG Ciavarelli, Co-Founder and COO of HouseCall, has legal and operational expertise that ensures that HouseCall's development plan and implementation are streamlined and efficient. His role is pivotal in translating our vision into actionable strategies. HouseCall’s Tech partner (Ivan Reyes) has a wealth of experience in a corporate setting and with project management of technological innovation projects. Notably, Ivan has been working in virtual reality for over a decade and has a true passion for this groundbreaking technology to make a difference in people’s lives. Lastly, Jimmy O’Neal is a seasoned artist who leads up HouseCall’s creative ideas and initiatives.

HouseCall is also an incredibly experienced team. The HouseCall team averages over 20 years of experience and is well-positioned to use that experience to execute HouseCall’s vision for patient education. The entire leadership team is at a point of their careers where they can put their energies and skillset into a venture that is meaningful and impactful to society in a way that they may have not had the opportunity to experience in prior roles and are committed to seeing HouseCall’s vision through to the end.

HouseCall has spent the past two years conducting rigorous market research and needs assessments to identify gaps and opportunities in healthcare education that extended reality (“XR”; including virtual reality, augmented reality and mixed reality) can address. In the realm of patient education, the potential of XR is underscored by several peer-reviewed articles which highlight that XR can significantly enhance the learning experience, improve retention, and provide an effective tool in improving outcomes through patient education. 

With this research as its foundation, HouseCall went about socializing its XR patient education product concept with industry leaders at numerous leading conferences focused on the use of XR within the healthcare industry. HouseCall’s co-founder (Dr. Linda Ciavarelli) has also established herself as one of the leading voices and industry leaders on the benefits of XR within healthcare and has spoken on numerous panels and podcasts about HouseCall’s vision for XR patient education providing better access to health information and better outcomes for a more diverse set of patients. As such, HouseCall has quickly established itself as a trusted leader within the medical extended reality industry. 

Within this strong foundation built on document research and industry connections, HouseCall developed a prototype on diabetic neuropathy in 2023 to gain early feedback on how XR could be utilized for an improved patient education experience. HouseCall’s prototype was warmly received by peers within the healthcare community so we are now in the process of developing our minimal viable product (MVP) that will focus on a full suite of patient education modules focused on diabetes. The goal of HouseCall’s MVP is to provide a mobile platform that leverages focused immersion, active learning, improved retention and simplification of complex concepts in XR to transfer high quality medical information that is necessary for the health success of the patient in the most impactful manner. The MVP will leverage open standards in XR and artificial intelligence to deliver portable, device agnostic, and customizable patient educational content to the widest audience possible. 

The development of the MVP will begin with emphasizing the core functionalities of basic patient educational modules that envision a path to interactive modules for personalized learning experiences. The initial MVP development will also include a clinical interface for module deployment to patients. As the MVP is further developed, the platform will be configured in a manner that allows for collection of anonymized metrics of users viewing the healthcare education modules so that feedback loops can be created to further enhance modules for optimal absorption. The concept for HouseCall’s MVP is patent pending via the filing of Provisional Patent Application No. 63/591,239 in late 2023.

HouseCall anticipates that its initial MVP will be ready for third-party evaluation during 2024. At this stage, HouseCall will work with key healthcare partners who will be critical in assessing the MVP's feasibility for deployment in a variety of clinical settings. HouseCall envisions this partner feedback to include observations on quality of patient education modules, user interactions with the MVP, ease of use, clinical workflow efficiency, and adaptability to a variety of clinical environments and communities. Feedback from these key healthcare partners is crucial for iterative MVP design improvements and will ensure that the MVP evolves to meet user needs in the best manner possible across demographics.

As a young company, HouseCall could greatly benefit from the network of advisers and expertise within the MIT Solve ecosystem in order to get the resources and support it needs to grow and mature its company. In particular, HouseCall’s leadership team has ample experience in delivering clinical solutions to patients but could benefit from getting a better understanding of how to build its Tech team and deliver its technical solutions in the most efficient manner possible. HouseCall also looks forward to speaking with other MIT Solve participants in order to share best practices in building a company and establishing a sound foundation for success in order to deliver solutions that have the widest possible impact to improve our health system. In addition, the opportunity to partner with supporters of MIT Solve to help tackle the challenge of improving patient education and outcomes for under-resourced groups of people could allow us to further scale and refine our product in order to best serve patients. We look forward to leveraging the MIT Solve innovation ecosystem to provide more equitable patient education solutions to communities in need.

Currently, patient education is delivered via antiquated methodologies that have proven to be underwhelming in delivering health information to patients in an effective manner. To this day, the most prominent methods for imparting health information to patients tend to fall in two major categories.  

The first involves a clinician attempting to verbally explain a patient’s condition during a quick clinical visit. This methodology is generally insufficient given that the clinician’s explanation to the patient is often hard to understand and is done too quickly given most clinician’s very busy schedules. It is also very difficult for patients to remember the information provided by their clinician after the visit given that the patient often does not have the capability or support system to process highly clinical diagnoses and treatment plans. The stress of a clinical visit for a patient also is not conducive for the patient to retain the health information in a sustained manner. 

The second most common way for clinicians to provide patient education is via a written brochure. These brochures tend to be long documents written in technical jargon that are not designed to be consumed by a lay-person who does not have a clinical background. Oftentimes, the brochure is never reviewed by the patient and is simply set to the side or thrown in the garbage. Even if a brochure is read by the patient, it generally lacks a visual and interactive component that would make the information more digestible. Importantly, the brochure is also not adaptable for a patient’s specific circumstances or needs. For example, the vast majority of brochures are written in English with no capacity to be adapted to a patient’s native language. 

The lack of effectiveness of verbal explanations and brochures in imparting necessary health information to patients often leads to patients going to “Dr. Google”. Although the internet is a wealth of information, this information is not targeted to specific patient needs and diagnoses. This tsunami of information often confuses patients and alarms them in ways that are not proportional to their health condition. 

As described in our response below to the question of “What are your impact goals for your solution and how are you measuring your progress towards them?”, the current modes of delivering patient education are not fulfilling patient’s needs. Fortunately, the use of XR in patient education represents an untapped area within the U.S. healthcare system. HouseCall is poised to utilize its XR platform to develop a new medium for delivery of patient education by offering a solution that could significantly improve patient outcomes and understanding as described further below in our response to “Describe in simple terms how and why you expect your solution to have an impact on the problem”. Importantly, HouseCall’s solution also offers the promise of mainstreaming the use of XR within healthcare and acting as a shining example for other companies on how to use XR across the healthcare industry for the betterment of patient outcomes.

As opposed to the current modes of transmitting patient education in a verbal or written format, HouseCall’s patient education platform utilizes XR and video solutions to provide patient communities with the tools they need for better health outcomes. 

The key differentiator for HouseCall’s patient education platform is that it utilizes XR to allow patients to feel like they are going within their bodies to better understand their health. Each of HouseCall’s modules is designed to address a specific health condition and focus on the kernels of information that are most important for patients to get better health outcomes or manage their existing healthcare conditions. 

HouseCall’s patient education modules are also designed to be interactive in order to reinforce key concepts and lessons. Additionally, the modules will have a “teach-back” component towards the end of the experience in order to allow patients to demonstrate their level of understanding on the applicable healthcare topic. Data garnered during this teach-back component will be shared with the patient’s clinician in order to inform items that may need to be reiterated with the patient for better results. 

The patient education modules will also be customizable in important ways that are tailored to impart better learning that is focused on the patient’s unique circumstances. For example, the XR modules will be adaptable in a way that allows the voiceover to be done in the patient’s native language. With the advent of generative artificial intelligence, these customizations are now more attainable in an efficient manner that will be incorporated into our modules at scale. 

In addition, HouseCall plans on having a smartphone companion app where patients will be able to view their patient education modules in a 2D format. This will allow patients the ability to reinforce concepts learned while they were in virtual reality for better and more sustainable learning. The smartphone app will also allow family members and caregivers the ability to view the patient education modules along with the patient so that a patient’s entire support system is aware of the healthcare management plan in order to assist the patient towards successful outcomes.

The current methods of delivering patient education (verbal and written) have led to a state of affairs where 9 of 10 adults are health illiterate. This health illiteracy leads to approximately 30% more hospital readmissions and higher mortality rates. It also results in approximately $200 billion in associated costs. Sources for above include: J Health Commun. 2013; 18 Suppl 1(Suppl 1):273-89 and BMC Health Serv Res. 2015 Jun 27; 15:249. HouseCall’s goal is to develop a product that demonstrably improves a patient’s health literacy and outcomes. 

The R&D required for HouseCall’s solution encompasses not only technical development and content creation but also extensive testing to ensure efficacy and safety. As part of the development of its product, HouseCall will be working with a select number of healthcare partners to test and provide feedback on its solution. The key partners currently include: (i) an incubator program through the U.S. Veterans Hospital Administration whose program is designed to assist companies with ideation on feasibility of products within a clinical setting; (ii) a large state university that wants to utilize HouseCall to test the efficacy of XR solutions within a pharmacy setting; and (iii) a private clinical practice that will deploy HouseCall’s product within its clinic to test the feasibility and efficiency of its use with its patients. As HouseCall develops its product further, it will be working with key partners to incorporate their feedback and suggestions to further refine and validate the MVP for its eventual commercial deployment.

As evidenced by its name, HouseCall’s solution will focus on utilizing virtual reality and other extended reality solutions in order to provide a better patient education platform. HouseCall’s proposed product transcends straightforward engineering or incremental product development. It is a novel rethinking of patient education through an XR lens that is not currently in use in clinical settings.

HouseCall’s product will provide a mobile, offline platform that leverages focused immersion, active learning, improved retention and simplification of complex concepts in XR to transfer high quality medical information that is necessary for the health success of the patient in the most impactful manner. The product will leverage open standards in XR and artificial intelligence to deliver portable, device agnostic, and customizable patient educational content to the widest audience possible. HouseCall’s solution will also be designed in a manner that utilizes OpenML models to help in translating patient education content to multiple languages and is able to modify content to multiple Lexile levels to ensure the patient is able to absorb said content at their specific level of learning. As the product is further developed, the platform will be configured in a manner that allows for collection of anonymized metrics of users viewing the healthcare education modules so that feedback loops can be created to further enhance modules for optimal absorption. The concept for HouseCall’s MVP is patent pending via the filing of Provisional Patent Application No. 63/591,239 in late 2023.

Currently, the two Co-Founders of HouseCall VR work full-time on its solution. HouseCall has also retained ten individuals who work for HouseCall as independent contractors on a part-time basis. These individuals cover a variety of roles, including but not limited to: clinical input; content creation; clinical discovery; XR module storyboarding; technical development; behavioral transformation; project management; XR graphics and sound; and business strategy. HouseCall also works with a team of five XR technical development specialists who assist with the production of our XR patient education modules and are retained through a third-party service provider agreement.

HouseCall was formed by its current Co-Founders in April 2022. We initially focusing on providing patient education and other healthcare services through metaverse-based social platforms. In early 2023, HouseCall pivoted to its current solution of utilizing XR to provide a better patient education experience that is designed in a manner that is more digestible for a wider and more diverse group of individuals.

As an organization that is led and co-founded by someone from a group that has been historically marginalized and overlooked as business leaders, Dr. Linda Ciavarelli knows firsthand the importance of maintaining diversity within an organization. From day one of its founding, HouseCall has strove to identify and work with a wide variety of people from diverse backgrounds and these efforts have borne fruit in who is currently working with HouseCall today. 

HouseCall strongly believes that an organization benefits from having a team of individuals who represent a variety of backgrounds and perspectives. Out of the ten individuals who work as independent contractors for HouseCall, six are women (which is a high percentage in the historically male-dominated tech industry). Out of the four men who work as independent contractors for HouseCall, three are non-white and one of the men has a physical disability. Also, our third-party technical development specialists are based in Ukraine and provide yet another window into how HouseCall can be impactful within countries that are struggling to defend basic freedoms. We believe that these different perspectives lead to better patient education modules that can reach and impact a wider variety of cultures and demographics in a more impactful way.

HouseCall’s diversity practices are not limited to its hiring practices. When building patient education modules, we seek to frame our modules in a way that we believe is better reflective of the diverse communities in which we want to engage through our XR solutions. In particular, we seek to create avatars and images of people within the XR modules who are non-white. We also utilize AI to translate our modules into non-English languages. These steps demonstrate to our patient community that we are fully committed to serving all facets of our population with inclusive patient education modules.  

Through its hiring practices and its XR patient education solution, HouseCall believes that it is demonstrating to its team members the importance of diversity and showing that HouseCall is a place that respects and seeks out a diverse workforce within its operations.

Patient engagement solutions (including education) play a vital role in empowering patients to actively participate in their healthcare journey, fostering better patient outcomes and experiences. Based on a recent report from Roots Analysis (a business research and consulting firm), the patient engagement solutions market size is estimated to be worth over $11.4 billion in 2023 and expected to reach $96.7 billion by 2035, growing at a compound annual growth rate (CAGR) of 19.4% during the forecast period 2023 to 2035. Presently, close to 31% of the market is captured by companies based in North America.

Accordingly, our total addressable market size is approximately $3.5 billion as of today. As a subset of the broader patient engagement solutions market, chronic disease management (which includes patient education) has a dominant 41% market share as of 2023 (based on a report from Market.Us from early 2024). This equates to HouseCall’s initial target market size being approximately $1.43 billion.

When determining how HouseCall would monetize its solution within its target market, HouseCall’s Co-Founders made a mission-based decision to make the patient the primary beneficiary of HouseCall’s product but at the same time decided that the patient is not going to be the paying “customer”. HouseCall landed on this approach in order to have as many people as possible get the benefits of HouseCall’s patient education solution. In HouseCall’s business model, the paying customers will be the healthcare providers (such as hospitals, clinics, pharmacies and insurance companies) since they will be the entities getting the economic benefit of our product and are best positioned to absorb any costs. HouseCall’s revenue model has two primary components. 

At first, HouseCall will work with key healthcare partners whose expertise is critical to designing individual patient education modules and an efficient platform for use within a clinical setting. For these key partners, HouseCall will charge an “at-cost” rate for designing modules for their clinical practice in return for the healthcare partners input and guidance on module design. Currently, the rate we charge for these initial modules depends on the complexity and breadth of the module but is typically in the $15,000 - $30,000 per module range. 

Once HouseCall has its product application platform fully-formed with a library of patient education modules on a variety of topics, HouseCall envisions its revenue model moving towards a software-as-a-service (SaaS) subscription model. Although final pricing is still to be determined, the SaaS model would likely have multiple levels of annual subscription fee depending on the size of the healthcare provider and the number of patients that underlie the provider. The yearly fee would provide a license to each provider and their patients to set up accounts with HouseCall in order to utilize the full library of patient education modules. Based on our understanding of the current economics for use of VR modules within a healthcare setting, we anticipate the yearly subscription fee ranging from $10,000 - $100,000 depending on the size of the clinic.

Up to this point, HouseCall has been completely self-funded by its Co-Founders. That being said, HouseCall is actively seeking additional funding to continue to grow and distribute its solution to as many patients as possible in order to have a lasting impact on people’s health in the coming years.

Accordingly, we are seeking funding from the following sources. HouseCall is very much focused on entering pitch competitions like MIT Solve in order to begin raising outside funding to support our efforts. In addition, HouseCall is looking to raise money through state and federal government programs that provide grants to businesses. As described further below, HouseCall is also looking for opportunities to build patient education modules for paying clients on a more bespoke basis. Lastly, HouseCall has begun socializing its product and business plan with venture capital firms so that we have multiple fundraising options if we choose to raise money through VCs in the future.

As part of the development of its solution, HouseCall has already begun working with a select number of healthcare partners to test and provide feedback. The key partners currently include: (i) the U.S. Veterans Health Administration through participation within its Greenhouse Initiative that is designed to assist companies with ideation on feasibility of products within a clinical setting; (ii) College of Pharmacy faculty at the University of Georgia, who are planning to work with HouseCall to test the efficacy of diabetes education VR solutions within a pharmacy setting; and (iii) a private practice that will deploy HouseCall’s solution within its clinic to test the feasibility and efficiency of its use with its patients. 

In addition to the above partners, HouseCall is also in active discussions with the following potential customers: (i) an insurance company that is looking to deploy VR diabetes patient education modules to its insured; (ii) a large public school system that would utilize HouseCall for VR nutritional education modules for its students; (iii) a mid-sized children’s hospital to develop VR content for its pediatric cancer patients; (iv) a world-renowned hospital system to build a heart and stroke related patient education module; and (v) contacts within several branches of the U.S. federal government for the development of VR solutions to improve health outcomes. 

HouseCall has also had the following notable validations of its mission and product concept: (i) invited to submit a Phase I proposal to the U.S. National Science Foundation’s Small Business Innovation Research (SBIR) program in 2024; (ii) winner of Temple University’s “Be Your Own Boss Bowl” Digital Innovation Award in 2023; (iii) Dr. Linda Ciavarelli (Co-Founder and CEO of HouseCall) sits on the Board of its Journal of Medical Extended Reality; (iv) 2023 finalist for “Most Exciting Startup” of the American Metaverse Awards; (v) Invention of the Year finalist for the Technical.ly Awards 2022; (vi) 2024 finalist for the “Early Stage” category of Startup 302; and (vii) Dr. Ciavarelli has been an invited speaker at numerous conferences during the past few years.