JMIR Publications

ABSTRACT

Virtual reality (VR) and the Metaverse are attracting interest in mental healthcare, particularly for older adults with cognitive impairments. Taking an immersive teleclinic for neuropsychological consultation and testing as a case study, this article adopts a public health perspective to examine the potential contribution of such environments to integrated care pathways. Immersive teleclinics may complement conventional assessments through interactive and ecological tasks that better reflect everyday functioning and generate novel behavioral markers. Combined with longitudinal monitoring and data from connected medical devices, these markers could help clinicians track changes, anticipate trajectories and tailor care, provided that systems are interoperable. VR may also foster patient engagement, while additional modules for therapeutic education, relaxation, cognitive stimulation or peer support could contribute to more integrated mental healthcare. Finally, remote access could reduce travel time and costs for both patients and professionals and improve access to specialist care in underserved areas. However, challenges must be anticipated. Unequal access, digital literacy and age-related usability barriers may deepen health inequalities. The generation of volumes of sensitive data raises issues of privacy, ownership, governance, interoperability and clinical interpretation. Technical limitations affecting non-verbal communication and social presence may impair therapeutic relationships and the detection of emotional distress, while professional reluctance could hinder adoption. Clinical validation, stakeholder involvement and research are therefore required to ensure that immersive teleclinics are safe, equitable and integrated into healthcare systems.