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_{MIXR convenes at IHC in North Bethesda to share progress and discuss opportunites and challenges ahead.}

Published on UM-IHC website | April 22, 2025

Extended Reality (XR), which draws concepts from virtual reality (VR) and augmented reality (AR), is redefining industries by offering new ways to engage with digital and physical environments. Whether through fully immersive simulations or digital overlays that enhance real-world experiences, XR is opening doors for innovation in fields such as health care, education and scientific research.

At the forefront of this field is the Center for Medical Innovations in Extended Reality (MIXR), a pre-competitive consortium dedicated to accelerating the responsible integration of XR into health care. Now part of the University of Maryland Institute for Health Computing (IHC) in Montgomery County, Maryland, MIXR brings together industry leaders, academic researchers and regulatory experts to drive progress through collaborative research, shared standards and open communication across sectors.

Industry partners—including the Air Force Research Laboratory, MediView XR, Cook Advanced Technologies, Cleveland Clinic, and the U.S. Food and Drug Administration (FDA)—work alongside academic institutions to shape the next generation of XR-driven health care solutions. Current university partners include the University of Maryland, College Park (UMCP); University of Maryland, Baltimore; University of Michigan; and University of Illinois Urbana-Champaign.

“XR has the potential to transform many aspects of society, but medicine offers one of the most compelling and immediate opportunities for impact,” said MIXR lead principal investigator Amitabh Varshney, a professor of computer science and dean of the College of Computer, Mathematical, and Natural Sciences at UMCP. “It carries the potential to not only enhance clinical productivity and training, but to ultimately improve patient care. Through MIXR, we are working to solve foundational challenges such as hospital integration, regulatory frameworks and user acceptance, establishing a roadmap for how XR will ultimately shape the future of health care and beyond.”

For its bi-annual Industry Advisory Board meeting in February 2025, MIXR convened at the IHC in North Bethesda to share progress and discuss the opportunities and challenges ahead. Several key themes emerged:

• Headset usability and hardware/software costs remain significant barriers to adoption in clinical environments.
• Cybersickness and latency are technical challenges that can impact training effectiveness and procedural accuracy.
• Hospitals need clearer, standardized processes for evaluating and implementing new XR tools within existing infrastructure.
• Widespread adoption will depend on demonstrating clinical value, gathering data and addressing real-world health care needs—not just creating impressive technology.

MIXR will advance six research projects in the coming year to address these industry-identified priorities:

1. Strategies to Optimize XR Training Across Levels of Technical BackgroundThis project focuses on using XR technology to train health care professionals at different career levels, from beginner medical students to seasoned clinicians. The team will use central line placement (a common medical procedure) as a test case to study how users interact with the platform, how much time they spend learning, the role of instructors and how well users develop the necessary skills. The goal is to create adaptable training programs that fit clinical demands and keep up with advancing technology. This approach could help health care institutions standardize XR-based education while catering to different learning styles.
2. Light Field Simulation Assets: Content Generation and Validation MethodsTo make XR simulations more immersive and clinically relevant, this project focuses on creating high-fidelity, realistic 3D content using light field imaging. The team will capture real medical instruments and procedural actions using the HoloCamera Studio at UMCP and a mobile curved array and then integrate those assets into XR environments. Researchers will also develop optimized video compression and streaming techniques to ensure high performance on resource-constrained devices like standalone headsets. The result will be a more accessible pipeline for producing XR content that is both realistic and responsive, which will lower development costs while expanding reach.
3. AI-Driven XR Simulation for Collaborative Medical TrainingThis project is building an AI-assisted XR training platform for procedures like lumbar puncture and congestive heart failure diagnosis and treatment. The system includes self-guided instruction, real-time feedback and adaptive case scenarios, helping learners at all levels build confidence and competence. The platform is designed for use in on-site and remote settings, making high-quality training more widely accessible. Future development includes refining virtual patient interactions using generative AI to enhance realism and engagement.
4. Quantifying Cybersickness in XRCybersickness remains a significant challenge for users who spend extended time in headsets. This project uses EEG monitoring and biometric data to investigate the physiological signals associated with VR-induced discomfort. Participants are exposed to various XR environments and conditions, and their responses are tracked and analyzed using both traditional symptom surveys and neural data, providing insights to ultimately make XR a more comfortable tool for education and clinical use.
5. Quantifying Latency and Procedure Performance in XRLatency, which is the lag between a user’s action and the system’s response, can severely affect clinical performance in XR environments. This project investigates how latency impacts task execution, accuracy and decision-making, especially in procedures that rely on real-time feedback, such as central line placement and transthoracic echocardiography. By creating controlled simulations and measuring performance across varying latency levels, the team aims to generate evidence-based guidelines to inform XR system design and integration into hospital workflows.
6. Standardizing XR Integration into Health Care FacilitiesDespite growing interest in XR, many hospitals struggle with how to effectively implement new technologies within existing IT frameworks. Working with IT teams from the University of Michigan and UMCP, the project team is identifying common challenges, establishing baseline protocols, and proposing a set of technical and procedural standards to support streamlined, scalable implementation.

Through these projects and continued partnerships, MIXR is shaping a future in which XR is safe, effective and seamlessly integrated into everyday health care. By starting with medicine, a field where safety, precision and evidence matter most, MIXR is laying the groundwork for better health care training and XR’s broader adoption across clinical trials, at-home care and high-stakes environments like pharmaceutical manufacturing.

As the program grows, MIXR will continue to welcome new partners, expand its research portfolio and advocate for the thoughtful integration of XR in health care and beyond.