Our Evolution

Hi, I’m Dr James Clarkson, co-founder of Wide Awake VR and Walant Surgical Solutions. I am a Hand and Plastic Surgeon with roots from the British National Health. Since 2016 in Michigan, I have been offering hand surgery awake in the office environment under local anesthetic (WALANT). I found that up to 30% of my patients were unwilling initially to agree to this change of location, and so I introduced Virtual Reality to help the patients’ experience during surgery, and 100% agreed to proceed. I have since performed over 3000 office procedures with this method.

Surgery 1.0 (2016-2024)

Since 2016 I operated on over 3000 hand surgical patients in the office setting receiving only the surgical fee without institutional billing. Virtual Reality was pioneered for the patient experience.

Discoveries:

• The patients preferred it, their access to care, experience and safety were improved.
• The efficiency and collections increased, allowing more cases in less time.
• Payers saved $25 million over 8 years for 1 surgeon.
• There were fewer infections than the hospital operating room
• The surgical team had fun
• VR reduces anxiety and improved quality and patient education

So we are launching Surgery 2.0: in 2025

• More surgeons can offer Office based surgery this way
• The payers, the surgeons and the patients can share in the money saved
• Surgeons network to gain access to the Self Insured market place through Walant Surgical Solutions
• Virtual Reality technology is available when needed.

Wide Awake VR and Walant Surgical Solutions

Wide Awake VR was launched at the end of 2021 by myself, Joe Gough, and David Wheeler as a standalone VR system controlled by physicians using a tablet. This innovation revolutionized how patients perceive office-based surgery, significantly enhancing their overall experience.

USA learning experience

Since the end of 2021 we have been seeding Wide Awake VR across the US at dozens of venues, raising $850K. We have learned a lot about how awake office-based surgery can grow in the US health system, and how much impact it can make to patients, payers and physicians. We have networked with thought leaders such as Dr Don Lalonde and other forward thinking Hand surgeons, Vascular surgeons, Urologists, Colorectal and GI Surgeons, Oral surgeons and Spine surgeons and PM&R physicians.

What we learned

As we toured the US presenting publicly and networking with physicians, investors, payers and patients we learned about the barriers that needed to be crossed to increase office based surgical options.

The obstacles to office based surgery

• A health system that promotes complexity
  • In the US, the expansion of office-based procedures in different surgical specialties has been stymied by restrictive payment structures and a tendency for Insurance-Healthcare Conglomerates to funnel patients towards high-acuity settings even for minor surgical interventions.
• Site of service denials
  • Insurance and CMS can use “site of service” to deny payment for selected office procedures.
• Cutural inertia
  • The motivation for US surgeons to move patients from the operating room to the office procedure room requires financial assistance and a steady stream of patients who can be authorized for payment in the office as a site for surgery.

Wide Awake VR pivots to Walant Surgical as a solution

Recognizing this, we are now building Walant Surgical Solutions, a network of providers who offer office-based surgery directly to patients and payers such as self-insured companies seeking to reduce healthcare costs associated with more expensive, complex environments. The surgeon receives patients referred specifically for office surgery with a higher surgical fee for saving money and hosting the surgery.