How Google Glass could revolutionize medicine

Iltifat Husain MD contributed to this article 

The age of wearable computers is upon us.

There has recently been a slew of media attention to the possibility of an Apple Watch, and the soon to be released Google Glass.

For those not familiar with the Google Glass Project, it is essentially a wearable device that mimics eyeglasses.

The hardware includes Wifi and Bluetooth capabilities (can work with Android and iOS devices), cameras, voice-activation commands, and a heads-up display.

This device will find many uses with the general populace, but what about the healthcare field, what does it mean for medicine?

Imagine several medical scenarios using Google Glass:

  • An emergency responder arriving at a motor vehicle accident is able to live stream to the emergency department the status of the patients and the associated trauma suffered to a patient. The ER is then able to assemble and prepare for a patient’s emergency treatment.
  • A surgeon live streams to residents and students a live surgery–so that they can see what work goes into a medical procedure first hand.
  • A visiting nurse seeing a patient in their own home video records and captures images of the patient’s wound (for which they are caring for) and sends them back to the physician.
  • A resident’s physical exam of a patient is streamed back to an attending physician, who can critique their work and make recommendations on questions to ask in real time.  This could especially be useful when a resident consultant evaluates a patient while their attending is at home overnight.
  • A cardiologist in a cath lab overlays the fluoroscopy as they perform a femoral catheterization for a patient with a recent myocardial infarct.
  • A nurse scans the medication they are about to give the patient and confirms the correct drug and right patient by overlaying their patient profile with the person in front of them–possibly stopping a medical error.
  • A student brings up their notes and lab reports as they present their patient case to their attending, with data available in real time.
  • An oncologist can overlay the MRI scan over a patient, and show the patient and their family where the cancer exists.
  • The electronic health record at the hospital is available to caregivers, and able to be updated on major changes in the patients they oversee. For instance, the recent cultures from a septic patient’s wound comes back positive for MRSA and the physician changes their broad spectrum antibiotics to appropriate therapy based upon sensitivities.
  • A pharmacist is able to scan medications and verify the proper drugs after comparing the drug with images available in the database, ensuring the right drug is dispensed.
  • A physical therapist can see past sessions with a patient from previous recordings, overlaying their current range of motion, identifying changes as well as progression.
  • Any healthcare professional could walk up to a patient’s bed and instantly see all their vitals such as pulse, BP, O2 Sats, etc.

Could these be major changes that can be implemented by Google Glass or wearable computers? Let’s face it, medicine is changing. We are heavily involved with real time data to treat patients whose status frequently changes. The ability to utilize tools that can keep us connected and up-to-date may help prevent medical errors. It may also increase efficiency of care, collaboration with fellow providers, help educate new students, and lead to a potential major change in medical practice. No longer do we use the black bag of the 19th century physician, but rather we have graduated to using technology to increase our level of care.

I want to be able to walk into a room, and bring up a patient’s EHR, their recent labs, see their medication list, and see what changed from the previous night or visit. I want the most recent data. I want the ability to be in a room and share my interaction with students or fellow practitioners should I need their input.

What if there is a wound the patient brings to my attention? What if I could share it with a fellow dermatologist and get their immediate input? They could tell me to look at it from different angles and what maneuvers to perform to help them build a better idea. Indeed, telemedicine could be changed in a major way.

However, this cannot happen without our input. We need to become a part of the developmental process. Developers need our advice and critiques to create technological marvels that will bring us into the 21st century. Just as we have seen mobile medical applications created by third party developers that have no medical background, and expect us to consume their product — we should not be blocked out of this process as well.

Google’s Glass Youtube video demonstrates people dancing, skydiving, and playing with their children. But where is video showing how this can help medicine? We need to give Google an answer, and let them know that we want to be part of this development. Let them know with the hashtag on twitter: #ifihadglass.  And leave a comment with how you would use Google Glass in medicine.

Author:

Timothy Aungst, PharmD

Digital Pharmacist seeking to integrate technology and mHealth into pharmacy practice and patient care. Assistant Professor by day, blogger and writer by night.

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48 Responses to How Google Glass could revolutionize medicine

  1. Grant Grindle March 11, 2013 at 8:13 am #

    Google Glass is a remarkable invention to the Healthcare industry. A Paramedic or EMT, wearing Google Glass, can scan the scene of an accident(MVA) or Multi Casualty Incident (MCI), which can indicate the severity and mechanism of injury to the receiving ER. The ER can use this info to prepare themselves,and categorize, for the incoming patients.

    • Timothy Aungst, PharmD March 12, 2013 at 8:40 pm #

      I think this is one of the most interesting components of Glass, as it may serve as a link between in the field medicine prior to admission to a hospital. I would be curious what the military would make of this for their services as well, and if it could be used by their medical services for urgent situations.

  2. David Chen, MD March 12, 2013 at 10:26 am #

    One of the most significant revolutions in modern health care delivery has been the implementation of checklists and protocols for patient safety/harm reduction. Imagine being able to do digital time outs for procedures not only in the operating room, but before starting any procedure on the floors or elsewhere, or having ready access to video tutorials/refreshers (for the residents or emergency point-of-care personel) on how to perform such procedures. Imagine running a code without needing a recorder, one that recognizes your voice commands and keeps a log of medications delivered with doses and times of administration, shocks delivered, etc… and reminds you at the 2 min mark to give another round of epi, or suggests other interventions. Or imagine being able to pull up a contextualized differential at the bedside in the emergency room, or medication dosing recommendations, or antibiograms, or any of the other data resources we rely heavily on.

  3. Edward Bender, MD March 12, 2013 at 2:01 pm #

    I don’t think I’ve been more excited about a new piece of equipment since the iPhone. I can imagine utilization in multiple scenarios in addition to the excellent list compiled by the authors. I’m a cardiac surgeon, and it would be great to pre-load cardiac cath films for review in a real time fashion during a CABG, or watching a pre-op TEE during a mitral valve repair. Additionally, I can imagine device reps being able to send video and image data to a surgeon during implantation of a device that the implanter has no or limited experience. I could go on and on. Exciting stuff!

    • Timothy Aungst, PharmD March 12, 2013 at 8:43 pm #

      Absolutely! The ability to perhaps overlay images or videos from diagnostic imagery during realtime situations or surgical procedures may be very beneficial. I think this is something third party developers should definitely investigate. One thing I would not be surprised to see is a specialized ‘Glass’ for medical procedures or practitioners that would incorporate further camera development and perhaps ways to encrypt data for EHR integration due to HIPPA and similar privacy regulation concerns.

  4. Sofía. Patient. March 12, 2013 at 8:33 pm #

    On the patient side, if people with sight loss (AMD, Stargardt) could scan labels or codes at the supermarket and stores and get info, price…simply legible size words on the screen. I don’t know how it actually works but if the image is reflected on the outer retina it’ll be great!

  5. Dr.Venkatachalam March 15, 2013 at 11:06 am #

    Will this glasses have inbuilt memory? Any one knows the
    tech specifications of this?

  6. Tim Leeuwenburg ki-docs.com March 17, 2013 at 7:17 am #

    Me? Rural and remote physician in country Australia. Google
    Glass and #FOAMed will revolutionise the way we work – imagine an
    ambulance crew streaming images from the accident scene to me even
    before they package patient for transfer to our small rural
    facility via Glass…when patient arrives, I can video the resus
    for training and audit purposes. If they need a rapid sequence
    intubation, I can pull up a checklist to make sure we don;t miss a
    step in this vital procedure – and once apnoeic, a timer will alert
    me via Glass as to elapsed time…and overlay of vitals like
    SpO2…once tube is in, a reminder for post-intubation sedation and
    protocol for sedation regimen via Glass…whilst we share images
    with the retrieval team who are en route to take patient to
    tertiary care…once there, Glass allows recording of arrival in
    ED, move to Theatre, then ICU and eventually rehab – with a record
    of the patient journey throughout the stay, recording salient
    procedures and conversations. AWESOME!

    • Tamy Loiselle June 13, 2013 at 10:10 pm #

      I am with you Tim, I hope my country in USA should start to use the Google Glass. Two things are helping to save the cost of billions of US dollars which it would help the Doctors treat the patient with the aware of what was happen and prepare for it.
      Secondary, Patient would be treated correctly without stay overnight in the hospital and faster recovery.

  7. Noval March 21, 2013 at 9:24 am #

    You can send on real time the CT or MRI to oncologist, or elsewhere. Cool, I like !!!!

  8. Vincent Rietveld MD March 21, 2013 at 9:38 am #

    The applications for healthcare seem endless ! WOW!
    As an emergency physician with special interest in ultrasound I can imagine having the ultrasound images made with a (wireless!) transducer being transferred directly to Google Glass. There could be overlays of previously made images , examples of pathology, normal findings and specific ultrasound-protocols . Also excellent for realtime teaching purposes, especially in ultrasound-guided procedures. Sharing the images directly with residents, colleagues , other specialists and even other hospitals would be another added benefit.
    This could indeed be the start of a revolution in the way medicine is practiced!!

  9. lzrdoc March 21, 2013 at 11:53 am #

    The potential is great. Those in the millenial age group will pick it up rapidly, older providers perhaps not so rapidly. As was indicated in Dr Husain’s comments, the task will be to introduce it to, and educate, different potential users, as unless this happens, there won’t be enough support to warrant businesses investing in this. Hopefully innovative business interests will help this to happen. Dr Leeuwenburg’s comments really indicate the broad perspective that is necessary. I would love to introduce this in our setting.

  10. Rich Covert March 21, 2013 at 12:40 pm #

    This poses the ultimate telemedicine opportunity. Whether you are a physician, nurse, paramedic or even a bystander, the ability to add video and potentially interact in ways that Skype or FaceTime don’t afford, is incredible. Where can i get a sample just to demo it and test its functionality in real time?

  11. Chris March 21, 2013 at 8:10 pm #

    Just a recurring noemclative bugbear…. There is no such thing as a “heads-up” display. HUD is an acronym for “Head Up Display”, meaning you don’t have to look away from what’s out there in the real world in order to see important (but non-obstructive) digital information displayed for you.

  12. Donald March 23, 2013 at 11:09 am #

    This seems to be merely another technology interfering with the interaction of patient and doctor- an entertaining yet distracting impediment that will require another layer of concentration to activate. What if “google glass ” refuses to understand commands?

  13. Rafael Grossmann March 24, 2013 at 9:44 am #

    Agree. It’s going to be Disrupting! PLEASE CHECK:
    #GoogleGlass future uses in medicine. Interview w Dr. R.Grossmann by @blogbrevity > http://t.co/0JL5enT10N #mHealth

  14. MarylandMD April 6, 2013 at 9:04 am #

    Before everyone gets too worked up with all their great ideas for Google Glass, just think about this: Doctors, nurses and staff walking around the hospital or the outpatient office wearing video recording devices on their faces as regular eyewear. Do you understand what this means? Really? And I was getting creeped out by all the video cameras hanging off the buildings as I walk down the street…

    I would never go to a hospital or a doctors office where everyone is wearing Google Glass. Just stick to your iPhones, folks…

    • Rafael April 6, 2013 at 2:28 pm #

      Respectfully disagree.
      The Glass would be on ( recording, taking photos, etc) only when the user activates it.
      Rather than having “all human knowledge” at your fingertips, it will b in front if your eyes. Rather than turning your eyes or/ and body away from a patient, to input or look-up data on a screen, you’ll be looking directly at the patient, face to face at all time.
      The Glass will streamline the process, the interaction between us and the device.

      • MarylandMD April 6, 2013 at 5:18 pm #

        The idea that your doctor, or the staff walking down the hall, or another patient in the waiting room could be recording you while you are in a physician’s office or in a hospital is creepy. You say the glass would only be on when the user activates it. How do you know when it is active and not active? As long as there is a video recording function to the glass, it will not be allowed in a medical setting.

        You can wax poetic about the wonderful implications of a heads up display and I can see it might be useful, but it seems to me even that will be at least a bit unsettling to patients. Yes, you are looking right at them, but they will always wonder if you are paying attention to them or just playing Tetris.

        • Rafael April 6, 2013 at 10:57 pm #

          Again,
          You see people in the hallways, walking, with their hands and eyes on their smartphone, in front of them… How do you know they are not recording/filming you?!!!
          It’s just a cultural change. It will be ubiquitous sooner than we think.
          The positives aspects FAR outweigh any potential negatives. It represents the natural evolution of computer interphase. From here, to implanted computers-contact lenses style screens, etc.

        • MarylandMD April 7, 2013 at 11:32 am #

          The heads up display is nice in some circumstances and could be very useful in a few, but it isn’t essential for most applications people are discussing. The arteriogram can be shown on a nearby monitor instead of on the display. In fact, most of the uses discussed could be done with a simple iPhone and the right software. Sharing images is done already, why do we need special glasses for this? Telemedicine is already being done and could be done with FaceTime.

          I am down with the utility of a heads up display. It’s the camera that raises such concerns. When people walk around with their phone, is almost horizontal to the floor–not in position for recording video. If I see anyone holding a phone upright for prolonged periods, I challenge them, because it looks like they could be recording. When I was at an accident scene, I was holding my phone a bit more upright and the police officer asked me if I was recording video (which I wasn’t). No, having iPhones around isn’t the same as always having a video camera mounted facing forward directly on your face. I foresee that hospitals will ban patients from wearing these video glasses and ban staff and physicians from wearing them as well, except in very strictly defined circumstances, and there will be large posters explaining and defining the camera use to patients and new consent forms for the patients to sign.

          If you think that patients (and the hospital lawyers) will be satisfied with a simple “trust us” from the physicians, then I have two words for you to Google: “Nikita Levy”. It isn’t a matter of “chillaxing”, it is a matter of protecting the patients privacy, which is at the core of what we do. If you aren’t convinced of that, then I have two more words for you to Google: “Hippocratic Oath”. Chillax indeed.

    • Edward Bender April 6, 2013 at 2:32 pm #

      I think a lot of us understand what that means: it means walking into a patients room with a heads up display showing the current vitals, labs, and other test results. It means seeing the coronary arteriogram while your doing a CABG. It means potentially getting peer to peer second opinions real time in the OR or clinic.

      However, it must mean “Big Brother” or illicit recordings to “MarylandMD.” Certainly a chance for invasion of privacy, but that exists with or without new technology. Or maybe it means being distracted by the display. There’s more chance of walking into a wall when your looking at your phone.

      Bottom line, I would “chillax.”

      • MarylandMD April 7, 2013 at 11:40 am #

        I have combined my response to you with my response to Raphael, above.

        • Edward Bender April 7, 2013 at 12:08 pm #

          I appreciate your concern about medico-legal issues, privacy issues, and I do agree that it is non-essential for most use cases. However, there is a lot in life and healthcare that started out as non-essential and somewhat disruptive but has become standard over time. I can remember a time when acute MI’s got taken to the cath lab and then to the OR for CABG, then came PTCA and subsequently stents. I also remembered a 25% PTCA failure rate yielding the patient coming flaming to the OR. But with refinement and adaptation, things got better. There are many more, perhaps more apropos examples of a new technology causing alarm in those used to the status quo.

          I disagree with the contention that there are always current modalities around to make a heads up display unnecessary. When I do a CABG, there are times when I do indeed consult the cath films when the anatomy seems different that what I remember pre-op. In that case I have to break scrub, go out of the sterile area so that I can manipulate the cath films to better appreciate the anatomy. If I could do this scrubbed with a HUD, I would consider that progress.

          I’m working with a company that will be using the glasses as a way to teleconference with experts remotely in situations not amenable to representing the clinical scenario using a hand held device. So, I do think this is a significant advancement that, like most other advances, has to be refined and molded to become safe and useful. I’m sure that you are not the only person with concerns (I would join you in that), but I would not discount this as invading privacy and therefore not worthy of use or further exploration. There is so much more that goes on today that has led to such privacy concerns. So instead of “chillaxing” maybe a better term or explanation would be to be cautiously hopeful.

        • MarylandMD April 7, 2013 at 12:41 pm #

          I am one of the most tech-savvy physicians in my large multi-specialty group, and I was using the nets long before they were unified and called “The Internet”. My house was wired with cat 5e ethernet and WiFi before many of my colleagues even knew what WiFi was. I am cautiously optimistic about any application and technology that I hear about.

          Yet being cautiously optimistic means you have to temper your starry-eyed dreams with a bit of a reality check. Here and elsewhere I see a lot of (sometimes silly) optimism about Google Glass without a shred of caution. I have to speak up when I read so many people here and other discussion boards falling all over themselves to come up with uses for Google Glass that can be done just as well with current technology. (And you have to wonder–why **aren’t** we better using the current technology for such things as telemedicine, etc.–maybe the problem isn’t needing new hardware, maybe we need better software, or maybe there isn’t such a big need, or maybe there isn’t the funding–perhaps that’s where we need to focus our efforts and not get distracted by the latest hardware you read about!)

          And I also have to speak up when nobody else has raised a question about the very serious privacy implications of this technology.

        • Edward Bender April 7, 2013 at 5:54 pm #

          Its great that you are speaking up about privacy concerns. I don’t think anyone would disagree with you that that is extremely important. There are and have been technological initiatives that have succeeded and there are those that have failed. Lack of adoption of new technology may be due to poorly conceived products, thinking there was a need when there really wasn’t any, budgetary constraints, or even due to some taking a contrarian attitude towards new ideas or techniques. Those that champion new concepts or products must be aggressive and forthright in those attempts. The huge amount of money pouring into tech start-ups in medicine serves as evidence that some of those ideas are making an impact. I would hate to live in a world where innovation was stifled on the basis of fear or concern. Those qualities are important to help guide innovation to its best results and should not be used to prohibit innovative uses of new technology.

  15. Anthony Harvey June 4, 2013 at 8:52 am #

    Using Google Glass in the medical world maybe closer than we think.
    https://www.youtube.com/watch?v=Lla4hO2MlqQ bringing technology together to enhance our working lives.

    • MarylandMD June 6, 2013 at 7:06 pm #

      Honestly, lame graphics backed up by bad synth music doesn’t make me think “high tech”. It makes me think “you are wasting my time with this boring YouTube video.”

      The notion that 3D visualization would revolutionize medicine doesn’t get much traction with me. It may be useful a few times in a few specialties, but I don’t think it will bring about a sea change in healthcare. I guess every once in a while following something over time like skin lesions might be nice, but I have the nagging feeling that it will take a lot of work to fix all the registration issues that come with lining up the virtual picture with the real human, or the old picture with the current human. (“Oh, Ms Jones, I would be able to see if your skin lesion on your abdomen has changed if you only would turn about 3° to the left, and if you only hadn’t put on 20 pounds over the last 5 years…”). I love technology, but count me firmly in the “Google Glass Skeptic” category. “The right technology for the right job” is my thing, but for now Google Glass seems like a technology still in search of a big need, in health care and many other areas. Perhaps not as bad as the Segway, but in that general direction.

      And can somebody get better graphics and music in these YouTube videos by companies touting their “breakthrough technology” wares? I have the nagging feeling that current technology can fix that problem…

      • Anthony Harvey June 15, 2013 at 4:24 am #

        MaylandMD Yet another lame video backed up by bad sync music
        https://www.youtube.com/watch?v=C_l3FxRmtnM
        No I am not a company selling wares, just exploring ideas on how the patient comes first in our healthcare.
        Take a look at your patients, what is their age range, do they have a clinical degree, do they fully understand what you are explaining to them, let alone having English as their native language.
        Without the emergence of new technology Google Glass and social media we as patients and you as doctors will always be filling in forms and awaiting for pieces of paper from our physicians.
        We only need to look at the aircraft industry and as customers what we can do on the internet.
        The Healthcare Industry is always looking to replicate, where as we should be leading the way in technology for others to emulate and to follow.
        If I ever become a “company touting my “breakthrough technology” wares” remind me to send you a company share. You never know, you might want to buy some more!
        But I appreciate your comments though, and will try to make my videos less lame and more entertaining for you.
        What is your taste in music?

  16. Harvey Castro MD December 23, 2013 at 4:57 am #

    I got my google glass this week. At first, I was not crazy about them and thought of returning them. I decided to use them to record my kids soccer games, and to use at work. I slowly began to learn how to use the device and began to see places where I could use this device over my iPhone or with my iPhone. As the days, go by I find myself using the device more and can see many applications where the device would be more ideal than the iPhone. The difference will come in the apps that are made. I invite others to Facebook and join our group called google glass medical apps.

    • Jay December 29, 2013 at 1:35 pm #

      Could an app be created that would allow someone with each eye paralyzed on the left side (from a stroke) to see the complete landscape or complete the field of vision? I’m still searching for an answer. Thank you, Jay

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