The VR doctor is in: Cedars-Sinai adds AI-powered therapy app to Apple Vision Pro headset

An app developed by Cedars-Sinai for use with Apple’s new spatial computing headset is putting a new spin on the concept of virtual care.

The telehealth services that have exploded in popularity since the start of the COVID-19 pandemic work by remotely matching patients to licensed (human) physicians, typically via text or video chat. Not so for Cedars’ technology: The eXtended-Reality Artificially Intelligent Ally, or Xaia, uses artificial intelligence to generate a totally virtual therapist that can lead a patient through an immersive therapy session.

The Xaia technology—which is now available on Apple’s newly released Vision Pro virtual reality headset, Cedars announced Friday—was developed with the support of the health system’s Technology Ventures enterprise. It has been licensed to VRx Health, a company started by the two Cedars physicians who developed Xaia, for commercialization.

When installed on the Vision Pro headset, the Xaia app displays a 3D avatar—which looks like a robot, with extra-large eyes, expressive brows and an “empathetic and understanding voice,” per VRx Health, presumably to assuage any fears that it may attempt to overthrow the human race—in calming environments like a beach or meadow that can fill the headset’s field of view, supplanting a wearer’s view of the real world.

The software’s generative AI has been programmed to mimic the role of a human therapist, providing mental health support through cognitive behavioral therapy, supportive talk therapy, motivational interviewing and relapse prevention therapy techniques. The Xaia app can also guide patients through deep breathing and meditation exercises.

“Apple Vision Pro offers a gateway into Xaia’s world of immersive, interactive behavioral health support—making strides that I can only describe as a quantum leap beyond previous technologies,” Brennan Spiegel, M.D., director of Health Services Research at Cedars-Sinai and co-founder of the Xaia technology said in a Cedars release. “With Xaia and the stunning display in Apple Vision Pro, we are able to leverage every pixel of that remarkable resolution and the full spectrum of vivid colors to craft a form of immersive therapy that’s engaging and deeply personal.”

Though Cedars-Sinai didn’t provide any insight into whether the Xaia avatar can calm the anxiety that may come with spending $3,500 on the Apple Vision Pro headset, or fears of robots holding sway over humans’ mental well-being, it did cite a recent study showing that the virtual tech can be both safe and effective for behavioral health support.

According to the study, which was published in Nature Digital Medicine last month, Xaia was trained using transcripts of interactions between trained psychologists and their patients, which taught the avatar to recognize certain conversational patterns and ideal responses from a therapist.

When the resulting AI model was put to the test in conversations with 14 participants, it responded with empathy, support and pertinent follow-up questions. Though some of the participants said they would still choose a human therapist over the virtual option if given the choice, all said they would recommend the software to others. Per Cedars’ report, the patients described the avatar as “friendly,” “approachable,” “calming,” “empathic,” “empowering,” “unbiased” and “intelligent.”