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Questions and Hurdles for GoogleGlass in Medicine
I was recently asked these three questions, by Dr. Jennifer M. Joe, of Mestro.com and Editor-in-Chief of MedtechBoston.com, in regards to the convergence of GoogleGlass and Medicine.
–What will be the top 5 mistakes that physicians/clinicians will have about Google Glass?
–What are the top 5 fields who will benefit from Google Glass? Surgery, Emergency Medicine, Radiology, Dermatology, and Neurology?
–What will be the top 5 biggest hurdles in getting Google Glass into the clinical setting?
Obviously, I’m not able to exactly predict the future, but I feel that my experience of several years as a surgeon and of a few years as an innovator in healthcare and, more recently, as a GoogleGlass Explorer might give me some extra advantage as well as insight to be able to come up with interesting thoughts, arising from EXPERIENCE and INTUITION.
A- What will be the top 5 mistakes-misconceptions that physicians/clinicians will have about Google Glass?
I believe that in the initial phases, as Glass is publicly released, many healthcare providers will purchase it; the interest and curiosity about the device will be based on the reports of medical peers, GoogleGlass Explorers, after several months of experience with it, along with the spectacular and exciting coverage and spread by the media.
1-I think that one of the most common mistakes that I can foresee, is that most users will assume that the device has connectivity of its own.It does not! It needs a wifi network to connect to, or a smartphone that it can tether to, in order to have internet capabilities.
2-Another issue, will be related to its inappropriate use regarding privacy regulations and HIPAA.To use this device in the clinical setting (with patients), the device needs, or should be,”cleared” by your institution’s compliance office, but ONLY when there will be transmission of patient’s data through the device, through the internet. If the device is being used during a visit, for instance, to look up information related to the patient’s condition in the internet, or to help explain a subject to a patient, using a digital resource, or in any way that does not involve patient’s Private Health Information (PHI), there should be no concerns about HIPAA compliance.
3-The device is not fully functional with only voice commands. It does need the “tap or swipe” on the right frame, to navigate certain menus; this makes it unsuitable, at least in an efficient manner, for use when the user’s hands need to remain sterile.
4- The screen on the device is the equivalent of a 28″ screen seen from approximately 6-8 ft away; despite this, the content display allowance on the screen is in no way the same to what you can fit on an equivalent “non-Glass” display.
5-The battery life of the device is very limited, and if used continuously, the charge would likely not last much more than an hour or two, almost always requiring an additional, external, portable power supply.
B- What are the top 5 fields who will benefit from Google Glass? Surgery, Emergency Medicine, Radiology, Dermatology, and Neurology?
I think that “procedural” specialties (Emergency, Surgery, EMS), as well as those that rely heavily in the direct observation and “inspection” of the patient and the gathering of visual data to make a diagnosis (Radiology, Psychiatry, Neurology) will be the ones that will initially benefit from this type of device. After the device evolves, and eventually presents itself as the next step in the evolution of the computing platform to connect us to the digital realm, any medical specialty will integrate it as part of the routine, just as we now have PC’s, laptops, tablets, etc.
C- What will be the top 5 biggest hurdles in getting Google Glass into the clinical setting?
1-I believe that the protection of Private Health Information (PHI) and compliance with HIPAA are at this point the main obstacles being faced by GoogleGlass incorporation into the clinical setting (at least in the USA). There are developers working on this topic, and also some who have come up with solutions which are currently being tested in different locations.
2-Integration with the Electronic Medical record (EMR) is a feature that must be accomplished, if GoogleGlass is to be useful in the current setting of Healthcare. The device needs to be an extension of the current platforms that we routinely use, running the same EMR software or at least agnostically conversing with it.
3-Cost has to come down for it to be universally adopted as a new platform, likely substituting the smartphone in the near future. The price would have to be competitive with the cost of current portable devices.
4-There will have to be a change of “culture”, in the side of both the providers and the patients. This will naturally happen, as it did with the smartphones and tablets.
5- The network infrastructure will have to be enhanced. The bandwidth of current cellular and wifi networks, does not allow an optimal transmission of data.Dedicated networks will have to be developed so that medical users can have priority channels to allow connectivity without delays, flaws or intrusiveness.
I think that for now, these are my few thoughts regarding these very interesting questions; I hope this helps.
Please don’t forget to connect with me via Twitter at @ZGJR, or to visit the blog for further follow up comments or inquiries regarding this topic or the general theme of Innovation Technology in Healthcare.
As always, I’m very interested in spreading this information and my vision for the use of GoogleGlass in Healthcare, as well as conversing about what the future of technology in medicine will be like. 
Always looking for speaking engagements and platforms.
Best ,
Rafael Grossmann, MD, FACS
Rgrosssz@Gmail.com
“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
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