Feature

Telementoring just the beginning for Google Glass in medicine

Google Glass, a wearable computer that displays smartphone-like information and responds to voice commands, is already being used for telementoring and telemedicine and has the potential for many other applications in cardiology.

Medical applications for Google Glass already being evaluated include early detection of MI and stroke, telemedicine, telementoring, use of checklists and quick access to electronic medical records, Homero Rivas, MD, MBA, FACS, director of innovative surgery at Stanford University, said at the Society for Cardiovascular Angiography and Interventions Scientific Sessions in May.

“This will be the ultimate telemedicine platform, where we can share with people what we are actually doing,” Rivas said. “This has already been implemented on many occasions.” Telementoring is an application that will catch on quickly because for the most part, it does not require medical-grade imaging resolution, which Google Glass does not yet have, according to Rivas.

Quick access to data

The technology can be used to transmit information from the ambulance to the hospital, Rivas said. “The admitting physician is already getting feedback live into his [Google] Glass and, as soon as the patient gets there, he will already know what’s happening and will be able to record an initial assessment that will be put into the [electronic health record], and then he will be able to immediately get a consultation with another specialist,” he said.

Heather L. Evans, MD, said Google Glass has “great potential,” but challenges remain.

Heather L. Evans, MD, said Google Glass
has “great potential,” but challenges remain.

Photo courtesy of: Heather L. Evans, MD

The technology could be very useful in emergency situations, Bharat Rawat MD, DM, FACC, FAPSIC, FSCAI, chief of the department of cardiology at Norvic International Hospital, Kathmandu, Nepal, told Cardiology Today.

“In interventional cardiology, one of the things we need sometimes is very quick access to the patient’s data, especially when you’re doing an emergency procedure,” Rawat said. “At that time, access to the data may be very crucial and critical in deciding the way you treat a patient with, for example, a heart attack. To know about their past diseases, the medications they are taking, and whether other investigations were done is very important information, and technology like this could help us get access to it when needed.”

At Stanford, Rivas said, doctors are using this technology as a reminder of guidelines and safety protocols during procedures. “The variability of [safety] checklists is dramatic, so if you have something that you can customize, you can increase the safety of your procedure.”

Rethinking dictation

Another potential application for Google Glass is transforming the operative report, which a physician dictates after a surgery or other procedure, Maulik D. Majmudar, MD, associate director of the Healthcare Transformation Lab at the Corrigan Minehan Heart Center of Massachusetts General Hospital Institute for Heart, Vascular, and Stroke Care, said in an interview.

“The document serves a really good purpose for legal and billing aspects, but doesn’t serve a purpose beyond that; it’s kind of antiquated,” he told Cardiology Today. “Why don’t we leverage technology such as Google Glass to make that process more efficient and more educational?”

Maulik D. Majmudar, MD

Maulik D.
Majmudar

Majmudar submitted a proposal to use Google Glass for that purpose in the MedTech Boston Google Glass Challenge. “As you say verbal commands, Google Glass triggers a structured dictation,” he said. “If you say ‘estimated blood loss’ and then ‘50 cc,’ it would document it in that format. By the end of the whole surgery, you would have your dictation done.”

The digital op note could also be used for educational purposes, Majmudar said. “You can not only take pictures but also do video recordings of key moments during the surgery,” he said. This enables medical students who cannot attend the procedure to learn from it, and it can also serve as patient education, he noted. “You can take it back to patients and say, ‘Your arteries are really clogged up by cholesterol and this is what it looks like.’ Prior research found that if you show the patient a CT scan or angiogram of their arteries, they actually improve their lifestyle and health habits.”

Challenges remain

Heather L. Evans, MD, MS, FACS, assistant professor of surgery at the University of Washington, said at SCAI that many challenges remain before Google Glass can be widely used in medicine, including ensuring HIPAA compliance with data collection and encrypted transmission, educating physicians on how not to get distracted by the technology, and educating patients on how it is used — and not used.

“Right now, the device is a solution looking for a problem,” she said. “It has great potential, but we have to remember that it’s in beta.”

For now, Majmudar said, doctors can get the consent of individual patients to photograph or film their procedures with Google Glass, but “mass adoption will have to wait until communication channels are HIPAA-secure both ways.”

The technology has great potential to change the way collaborations in medicine occur, Rawat said.

“There are colleagues of mine who are doing procedures in the cath lab when I am not there. I can be in my office and we can share information about what to do,” he said. “I could even give guidance and make suggestions from a conference.”

‘Telepresence’ enabled by Google Glass may lead to some radical rethinking of hospital operations, Majmudar said. “An example is anesthesia. Currently, anesthesiologists can cover only one or two operating rooms and have to go back and forth. Imagine if Google Glass could display vital signs for live OR cases. You can become a central unit where you could get 10 OR groups’ data transmitted to you. You can imagine that would really reduce costs.” – by Erik Swain

Evans HL. Applications of Google Glass to improve outcomes in interventional cardiology: Can I use it in my hospital? What are the challenges for implementation?
Rivas H. Applications of Google Glass to improve outcomes in interventional cardiology: Applications to improve medical care. Both presented at: the Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 28-31, 2014; Las Vegas.
Heather L. Evans, MD, can be reached at Harborview Medical Center, 325 9th Ave., Box 359796, Seattle, WA 98104; email: hlevans@uw.edu.
Maulik D. Majmudar, MD, can be reached at Cardiac Unit Associates, 55 Fruit St., Boston, MA 02114; email: mmajmudar@partners.org.
Bharat Rawat, MD, DM, FACC, FAPSIC, FSCAI, can be reached at PO Box 14126, Thapathali, Kathmandu, Nepal; email: rawatb67@gmail.com.
Homero Rivas, MD, MBA, FACS, can be reached at Bariatric and Metabolic Interdisciplinary Clinic, 900 Blake Wilbur Dr., Garden Level Room W0048, Stanford, CA 94304; email: hrivas@stanford.edu.

Disclosure: Evans, Majmudar, Rawat and Rivas report no relevant financial disclosures.