Why I think that Google Glass is Not a failure

The interaction between medical providers and patients has been really compromised over the last few years.

According to Dr. Eric Topol ( as in his new book The Patient Will See You Now ),  in the US, the average return visit to the doctors office lasts seven minutes and a new consultation twelve minutes”.  Administrative requirements, reimbursement rules, government regulations and the inadequate use of technology, are among the factors to blame for this decline in the quality of medical care, at least in respect to the HUMAN quality of healthcare.

We have allowed technology to sequester what it meant to be a doctor, a healer-person connecting with the one seeking our help, our advice, our touch; a direct eye-to-eye link that could comfort and bring relief just by the mere act of taking the time to do it.

The SMART use of the RIGHT technology, can indeed improve the process, enhance the time and the interaction, paradoxically making us more, better HUMAN healers.

That’s one of the things that Google Glass can do in medicine.

Wearable devices, and specifically GoogleGlass, has started a tide of change and innovation, a true awakening of the minds, that only can be viewed as a major success, at least in that respect.

As a surgeon and innovator, the FIRST one to ever use Glass in the operating room, and NOT the only surgeon excited about this technology, I see this trend as the beginning of a new way to do medicine.

http://bulletin.facs.org/2014/07/surgeons-see-future-applications-for-google-glass/#.U7raMMRDbC8.blogger

Thanks for Sharing it.

@ZGJR

Embracing Technology for a Healthier Future

Once again, I really want to send a public note of appreciation to Maine Magazine (@Themainemag), for their recent article about my work. I think that Sophie Nelson (writer) and Nicole Wolf (photography) are amazing professionals that really represent some of the incredible talents that Maine has to offer.

I humbly want to thank them for their comments and views, and for helping spread some of my vision and passion regarding the potential for innovation technology in healthcare and education.

This is the link to the article:

The Maine Mag/ October, 2014

Simply, GOOGLE GLASS…in DIGITAL HEALTH, a health sensor & beyond

Well, NOT SO SIMPLE.

Once in a while, an electronic wonder comes along that shakes the status quo; a gadget that makes everything change, that rewires our thoughts and ideas and gives us hope for a possible better future, here and now.

Sometimes, it is not really just one device, but many-in-one, with multiple capabilities and features that excite the imagination of the users, explorers, problem-solvers or “wannabes”.

Do you remember the Swiss Army Pocket-knife?  

Let’s take Google Glass, for example; it is basically a wearable, smart-phone-like device, a communications tool. It allows you to make a phone-call (Glass-call, really), send a text message, e-mail and tweet. Taking photos, video (form the users point-of-view) and searching the Internet are also included. A formerly available feature, the video “Hangouts” and live video calls are not possible for now, but will return soon, and, reportedly, with much-improved quality.

All of these capabilities have, for the last year, inflamed the imagination of many people, among many disciplines, in my case, the field of Digital Health, Healthcare and Medical Education.

When I first saw Glass in live action, in the hands (forehead) of one of its inventors, Babak Parviz, at the Singularity University-FutureMed program 2013 (http://exponential.singularityu.org/medicine/ ), I immediately knew that this device had the potential to change the game, or even better, “creatively destroy” how the game was played.

I applied and got selected to the Google Glass Explorers program, while dreaming about its uses in my field of work; I was able to buy it very early last year, started using it, became amazed with its potential and possibilities, performed the FIRST surgical operation with Glass ever documented, (http://t.co/W0EJQy9U8s), and then, suddenly and spontaneously became an advocate for it, sort of an evangelist for the use of the device in Healthcare and Medical Education, as well as an advisor to many start-ups and individuals who saw in this technology a true, exponential breakthrough in the computing device platform. Alongside, gave three TEDx talks related to GoogleGlass in Healthcare and Education (http://youtu.be/fo3RsealvGI http://youtu.be/DVzkw7y4_u4 http://youtu.be/k_d0vfgBYm4

BUT we have yet to see, much beyond its intuitive applications.

The fact that Glass has a second camera that points towards the wearer’s eye, a forward camera, a microphone, a bone conduction audio transducer, a touchpad, a gyroscope, a GPS, an accelerometer, a gyroscope, a magnetometer, an ambient light and proximity sensor and that it is head-mounted, in contact with the skin of the forehead, gives it incredible leverage to develop as a multi-tasking device in medicine.

Glass can detect you eye movements and hence its ability to translate those movements into commands. Imagine navigating your screen, texting, typing, etc. , just by looking to different directions. It might sound silly, but think of quadriplegics (a person paralyzed from the neck down), and how this feature could open marvelous opportunities for then to functionally reintegrate, back to life.

Some time ago, I tried “The Muse” (@ChooseMuse   www.choosemuse.com ) and also became fascinated with it. It is basically a portable, wearable EEG (Electro-encephalogram, to detect, read and display your brain waves). It just works! You put it on, sync it with the app in your smartphone, and it displays an indirect measurement of your brain’s electrical activity. Plain amazing! Just imagine the potential to help you “train” your brain, to learn to focus, relax, meditate, provide biofeedback, etc.  Think PTSD therapy! http://youtu.be/YI5uXlTnNms

And then, I thought, this goes pretty much in the same position, in your forehead were Glass usually sits; how about integrating Google Glass + Muse, and add this incredible feature to the mix?

How about navigating the Glass menu with your brain’s electrical activity? (Think: “OK Glass, take a picture”!). Or train your brain, again with instant feedback, to give commands and navigate a computer screen menu. http://youtu.be/ogBX18maUiM

Then, a few days ago, I read and article and watched a video, from a group in MIT/Georgia Tech, who is developing the fantastic idea to use the many embedded systems within Glass (the gyroscope, the magnetometer, the accelerometer, etc.), to basically provide accurate measurements of heart frequency and breathing rate (BioGlass). In addition to the obvious uses in medicine and fitness, this functionality could potentially detect your alertness and anger levels, whether you are falling asleep or not paying enough attention.

Now you could be relaxing and slowing your brain’s activity, and getting immediate feedback on your cardiac and respiratory rates…Awesome. A yogi’s dream!   http://youtu.be/-t4PkEbowJg

As a surgeon, I also envision its uses in medical care, allowing patients, and providers, the right state of mind to undergo a procedure, to control pain with drug-free anesthesia or analgesia, to perform a procedure in a relaxed state, taking away pain, stress and frustration…

There’s another very clever gadget that allows your forearm muscles’ electric activity to be translated into commands to drive your electronics, and navigate their menus, allowing you to use hand gestures instead of a touch pad or a mouse; it’s called “The Myo”. WWW.thalmic.com

For sometime now, I’ve been playing with it and engaging with developers who are kindly sharing their software “spells” and abilities to help me trial and evaluate an integrated Glass-Myo interface.  http://youtu.be/b8xGfzoP58E

I can go thru the Glass menu and screens just by moving my hand. Since this device “reads’ the electrical signals at the muscle level, then it potentially can act as an EMG (Electromyogram), and not just read but also evaluate muscular activity (think of the many muscular disorders that could benefit from this); couple this with The Muse, and you come up with a tool to give instant brain feedback related to muscular contraction and movement (Tai-Chi on steroids!), allowing the training, re-training and/or tuning of a particular group of muscles.

As I have said many times before, I think that Google Glass represents the beginning of the natural evolution of the computer (computing) platform.

Technology develops and progresses exponentially.

Google Glass use and applications are only limited by our creativity and imagination, and only the future will tell what’s possible and Beyond.

Stay put and don’t change the channel.

Thanks for reading.

Best,

Rafael Grossmann, MD, FACS

Follow in Twitter @ZGJR for more updates and to contact me.

www.linkedin.com/in/rafaelgrossmann/

 

 

GoogleGlass on Steroids!

 

In medicine, when we say that something is “on steroids“, it usually means that it is super-charged, greatly improved and much better (think of how the steroids are usually, Ilegally used to improve athlete’s performance!).

When I thought of writing this post, my mind had been for days revolving around the fact that, despite being an amazing device, with great potential, GoogleGlass is still fairly limited and rough, in order to overly improve the way we do or teach medicine.

There have been several updates to the software, and the Glass we enjoy today is significantly better than the one I got in early June, 2013, a few days before I performed the first ever documented surgery procedure using this incredible gadget. The software runs smoother, the battery lasts longer, the features and menu are improved…Unfortunately, we are still missing the very important ability to live-stream video, since it was “recalled” several months ago ( a move that was necessary, since that feature was really not worth of the Google standard ). Some time ago, I had the chance to speak with the current head of Glass, Ivy Ross, , and she explained the reasoning behind the decision and also mentioned that, in the near future, something better will be brought back-…I can’t wait!). As I have emphasized in the past, this unique characteristic of Glass is really one of the reasons why, right out-of-the-box- this marvelous wonder could potentially revolutionize Healthcare and Medical Education, among many other disciplines.

Over the last year, many” wonder” coders, individuals, start-up companies and Universities have developed “spells” that really allow us to do the” magic” with Glass.We have gone far, but we are still just in the beginning, barely scratching the surface…

I have said it before, GoogleGlass represents the “Natural Evolution” of the computer (hardware ) platform, and its use is only limited by our imagination and creativity; I believe that we have seen a lot of that fantastic creativity in action, but there’s still a lot of ground to cover, a lot of potential to be fulfilled…

http://www.youtube.com/watch?v=Psq-T2O0LDs

 

One of the features that is still missing, is the ability to integrate a completely “touch-less” control to Glass, enabling the navigation of the menu without a “swipe” or “tap”, without voice, wink or tilting of the head. The more intuitive way to do it, is to use hand “gestures” (moving, pointing, squeezing, etc.) in a virtual field, up in the air in front of our face (and Glass). For someone as myself, for example, for whom hands need to remain absolutely sterile at all times while operating, a virtual menu, which I can navigate without physical contact, would be to be “on Steroids”!

For some time time, I have been collaborating with a few brilliant teams of individuals, who will make this happen. New, and older devices, like the Myo (http://www.thalmic.com), LeapMotion (http://www.leapmotion.com), Kinect (http://www.xbox.com/kinect) and incredible interfaces like TedCube (http://www.tedcas.com) will augment GoogleGlass in ways that we can only dream of now.

Enabling touch-less commands and navigation of menus, will for sure make this  wearable device run “on steroids”, increasing the performance, our performance, and allowing us to, legally…get the gold we all deserve.

 

 

 

 

“OK GLASS”: Improve Health Care! Now

June, 2013.

Well, a couple of weeks ago, I finally got my Google Glass.The experience to pick them up was just as great as I expected; they host you at Google and present you with several options of colors to choose from.I decided on black, just to be neutral, and thinking that it would probably make them less noticeable, since my main idea and objective is to use them at work, caring for patients. They custom fit them to make them comfortable and to make sure they do not block your field of view.They register and connect them for you, and suddenly, “OK Glass”: magic starts to happen…right in front of your eyes (Your RIGHT EYE, actually!).

For weeks, I have been thinking of ways to apply Glass to my daily routine of taking care of patients.I’m a surgeon and depending on the day, I can be in one of many areas, from the clinic, to the OR, from the ICU to the ED or the Trauma Bay;taking care of patients during rounds or teaching third or fourth year medical students.

The idea of having a device that allows me to instantly and effortlessly look up a concept or an image, take a picture or record a video
(and share it, if I choose to do so) or connect with someone by live video (thru a “Hang Out”) is a bit mind-blowing.

I imagine performing an operation and connecting live with group of students or surgeons, anywhere, doing a live “Hang Out”, letting them virtually “BE” in the OR with me, SEEING what I’m seeing, pointing to anatomic structures and different steps of the procedure, THRU my eyes…I envision the possibilities in distance MedEd, taking surgeons thru a complicated procedure, or one that they might not be so familiar with (surgical missions without leaving the country!).

The potential for remote presence medicine, TELEMEDICINE, is also amazingly exciting. I could be “video-connected” with a physician who needs my advice, and then even see and listen to the patient him/herself. I could advice a child’s parent and give them reassurance, while looking at their eyes…All these without having to go to a tele-station, hold a device in front of me or be limited by “where and when” I am. What I see and what I hear thru Glass, ONLY I can see and hear (the image is right in front of the users right eye, and audio happens via bone conductivity, so it is not audible to anyone else but the Glass user)

I imagine being in the middle of a difficult surgical case and suddenly finding the unexpected. Just by a voice command, being able to call for help, having a colleague to “virtually join” me and and give advice; or encountering an unusual finding, and sending the image or recording of it to a pathologist or sub-specialty colleague, for their opinion on the gross appearance and their opinion on how to proceed.

Imagine how “Grand Rounds” could be revolutionized. Doing them at a distance, with both presenters wearing GoogleGlass, and doing a simultaneous “Hang Out”. Even connecting two groups or classes, in different schools/surgical programs (even different countries). The potential for a better exchange of information, ideas, experiences, knowledge, is only limited by our creativity.

There are so many ways to use GoogleGlass in medicine and not have to worry about breaching patient’s privacy. Until there are “secure”, “encrypted” and HIPAA compliant applications, its use can exclude any mention of a patient’s identifying information.
But when this applications are developed (and they will be!), the game will change even more radically. Then, we will be able to exchange any health private information without worrying about legal or ethical penalties. Envision Glass on the field for EMS providers, connecting them to hospitals, being guided thru difficult procedures if needed; or having them advise the receiving hospital’s set up in case of disasters or major traumas. Giving set up instructions before patient’s arrival, based on their “first responder’s” knowledge of the situation (chest tube set-ups, massive transfusion protocols, OR teams, etc.) It would certainly be a “time saver” and, in trauma, “Time is Gold”.I think that if one aspect of the trauma care process could be improved, it is the communication between the teams.

Have you been to a doctor’s office and then have someone sit close to you, turn around and look at a monitor screen, while they ask you questions, while you face their backs? Imagine then, a doctor accessing patient’s images, medical history, tests and laboratory results or any EMR data, all of these without leaving the patient’s presence, or turning away from them, to look at the computer screen. Not just obtaining data but uploading it, with verbal commands, right to their charts, in real time. Medicine will be “personalized” again. We could be in front of a patient, face-to-face, again.

There have been a few, well publicized and ingeneously marketed reports of live “Tweeting” during surgeries in recents
months. Well, I ask myself, what’s a tweet in front of a “Hang Out”? (Sorry Tweeter!). A story like this would be all over social (and “regular”) media.

A Health System should embrace this innovation. A system should support and encourage this radical thinking, which can only bring advertisement and great PR to its grounds.

A professional association (I mean you, American College of Surgeons) must BE THE CHANGE YOU WANT TO SEE. Surgeons are leaders, innovators, “ground-breakers”! Let’s do it! Help me do it.
I, and a few other physicians and surgeons, would really like to lead this revolution. Not a revolution, BUT the EVOLUTION of the current, decadent Health Care. From inefficient to efficient. From obsolete, to “cutting edge”.From slow to “as-fast-as-your-High-Speed-or-Fiber-Connection”; from error-prone, to designed-for-safety; from unsustainably expensive, to cost conscious ( I do believe that, while technology can be expensive, the smart use and application of technology to solve problems and improve processes, is the best way to decrease costs in healthcare).

For many years now, doctors and health care providers have been using machines, technology and the internet to optimize the care of patients.
GooGoogle Glass is just one more step in the right direction. One more gadget people might say…but what a gadget! This is the natural evolution of the interaction between human, device and the Virtual Highway.I do believe that in medicine, it will make our work better, and that only means, “OK GLASS”: improve patient care, now!

Rafael J. Grossmann, MD, FACS

@ZGJR

Rgrosssz@Gmail.com

Rgrosssz.com