Last week I had the opportunity to test Google Glass.
It’s basically an Android smartphone (without the cellular transmitter) capable of running Android apps, built into a pair of glasses. The small prism “screen” displays video at half HD resolution. The sound features use bone conduction, so only the wearer can hear audio output. It has a motion sensitive accelerometer for gestural commands. It has a microphone to support voice commands. The right temple is a touch pad. It has WiFi and Bluetooth. Battery power lasts about a day per charge.
Of course, there have been parodies of the user experience but I believe that clinicians can successfully use Google Glass to improve quality, safety, and efficiency in a manner that is less bothersome to the patients than a clinician staring at a keyboard.
Here are few examples:
1. Meaningful Use Stage 2 for Hospitals – Electronic Medication Admission Records must include the use of “assistive technology” to ensure the right dose of the right medication is given via the right route to the right patient at the right time. Today, many hospitals unit dose bar code every medication – a painful process. Imagine instead that a nurse puts on a pair of glasses, walks in the room and wi-fi geolocation shows the nurse a picture of the patient in the room who should be receiving medications. Then, pictures of the medications will be shown one at a time. The temple touch user interface could be used to scroll through medication pictures and even indicate that they were administered.
2. Clinical documentation – All of us are trying hard to document the clinical encounter using templates, macros, voice recognition, natural language processing and clinical documentation improvement tools. However, our documentation models may misalign with the ways patients communicate and doctors conceptualize medical information per Ross Koppel’s excellent JAMIA article. Maybe the best clinical documentation is real time video of the patient encounter, captured from the vantage point of the clinician’s Google Glass. Every audio/visual cue that the clinician sees and hears will be faithfully recorded.
3. Emergency Department Dashboards – Emergency physicians work in a high stress, fast paced environment and must be able to quickly access information, filtering relevant information and making evidence-based decisions. Imagine that a clinician enters the room of a patient – instead of reaching for a keyboard or even an iPad, the clinician looks at the patient. In “tricorder” like fashion, vital signs, triage details, and nursing documentation appear in the Google Glass. Touching the temple brings up lab and radiology results. An entire ED Dashboard is easily reduced to visual cues in Google Glass. At BIDMC, we hope to pilot such an application this year.
4. Decision Support – All clinicians involved in resuscitation know the stress of memorizing all the ACLS “code” algorithms. Imagine that a clinician responding to a cardiac arrest uses Google glass to retrieve the appropriate decision support for the patient in question and visually sees a decision tree that incorporates optimal doses of medications, the EKG of the patient, and vital signs.
5. Alerts and Reminders – Clinicians are very busy people. They have to manage communications from email, phone calls, patients on their schedule, patients who need to be seen emergently, and data flowing from numerous clinical systems. They key to surviving the day is to transform data into information, knowledge and wisdom. Imagine that Google Glass displays those events and issues which are most critical, requiring action today (alerts) and those issues which are generally good for the wellness of the patient (reminders). Having the benefits of alerts and reminders enables a clinician to get done what is most important.
Just as the iPad has become the chosen form factor for clinicians today, I can definitely see a day when computing devices are more integrated into the clothing or body of the clinician. My experience with Google Glass helps me understand why Apple just hired the CEO of Yves Saint Laurent to work on special projects.
Ten years ago, no one could imagine a world in which everyone walked around carrying a smartphone. Although Google Glass may make the wearer appear a bit Borg-like, it’s highly likely that computing built into the items we wear will seem entirely normal soon.
I will report back on our Google Glass experiments as they unfold.
John Halamka, MD, is the CIO at Beth Israel Deconess Medical Center and the author of the popular Life as a Healthcare CIO blog, where he writes about technology, the business of healthcare and the issues he faces as the leader of the IT department of a major hospital system. He is a frequent contributor to THCB.
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drchrono’s EHR has full functionality with Google Glass and has the 5 mentioned features! Check it out.
I think Google glass was great inventions. It lets you work hands free all you need is voice commands and once in a while few taps. Like you said it is similar to a cell phone the difference is you don’t have to take it out every time you want to check something.
This is great, cept all of the fts you mentioned would need to integrate with enterprise system EMRs, big challenge in that aspect. Doesn’t help the most highly regarded vendor Epic is not open source.
It’s hard not to get excited about the revolutionary impact of this – sign me up for a demo Google !!! I’m imagining people will be doing a lot of experimenting in emergency rooms and clinics. Health care systems with geographic issues to contend with will have a new set of options that seem intriguing.
The economic implications for partnerships are interesting as well – “Ok, Mr. Smith we’ll be doing an online consult with our colleagues at Cleveland Clinic / Mayo / Big Academic Brand Name Institution”
Most likely to be useful, in my mind, is point-of-care decision support, esp if coupled with intelligent info processing that makes it easy to get the right info for the right situation.
Video of encounters could be useful as a reference — and would be interesting in terms of how clinical behavior might change — but doesn’t address the need for clinical documentation to summarize essential findings and plan, to be shared with patient, caregivers, and other clinicians. (Do I want to watch videos of what the specialist discussed with my patient? Not very often.)
Should be interesting to see how the google glass experiment works out in the ED.
I, as the patient, will have my Google Glass too. I sincerely hope I get to see #1, 2, 3, 4 and some of 5 – just like my ER doctor does. This is what patient engagement and Blue Button Plus is all about, isn’t it?
Great post, mostly great responses and links. Thanks all. Anxious to see what new advances will continue to be made with meditech. I’m 65, hope I live to see lots of it. 🙂
Great post. Thanks for sharing.
As a Surgeon / Glass Explorer, I’ve been using Glass for a few weeks now. im attaching two links to some of my experience with it. I truly believe their potential in Healthcare is only limited by our imagination. Don’t have much time to write now, but I’ll follow up with some more comments at a later date. There’s more info in my blog Rgrosssz.Wordpress.com
Best
Rafael Grossmann, MD,FACS
@ZGJR
Google Glass In The Operating Room! http://t.co/bMR64jVCTQ via @Forbes
“OK Glass:..Teach me Medicine!” New post on #GoogleGlass & the future of #MedEd #simulation http://t.co/0vYPZcrzKk
Spot on, John. Even though I work at Microsoft (not Google) I too believe that wearable, or at least far less intrusive modes of computing, are needed in healthcare. While tablets may be the rage today, we have only begun our journey toward a more natural user interface in mobile computing for clinicians. Like you, I’m frustrated with EMR technology that essentially only digitizes our paper-laden processes of the past. Why do we describe a rash in the medical record when a picture is truly worth a thousand words. Why do even attempt to “template” the patient’s chief complaint and history of present illness when a recording, as you suggest, would provide a far more accurate documentation of what actually happened. Thanks for your thought leadership. I look forward to future reports.
Bill Crounse, MD
So I’d say its an even split – pros (revolutionary ability to access information while at patient bedside ans in OR/ED) versus freaky Orwellian sounding possibilities that will make privacy advocates cringe
Google “Google Glaas + Advertising + Potential”
# cautiously optimistic
Whatsen-
Frequent THCB contributors and readers are well aware of your negative nancy comments (dare I say trolls) toward all things HIT.
Why not humor us all this time and provide more detailed criticism? Gee, why not go out on a limb and even provide a drawback to each example John highlights in the piece? He provides an exceptional opportunity for you to make your point clear.
Probably more productive than patting yourself on the back for clever use of the term jabberwock.
Oh yeah, brilliant idea. Just do not trip over the crash cart while you focus the jabberwock, now in your glasses.