With Google Glass, the doctor can see you now

ER doctors at Beth Israel hospital use Glass to connect with information and patients

As an emergency room physician rushes to a patient, he glances at a QR code by the door to the patient's room and immediately can see the man's medical history and the nurse's notes.

The information, which the doctor can see without ever looking away from the patient and may help save the patient's life, was accessed via Google Glass.

This isn't a dream scenario for doctors at Beth Israel Deaconess Medical Center in Boston. ER doctors there are four months into a pilot program in which they're using Google's computerized eyeglasses to help treat patients.

Google's wearable computer, which is still in beta testing, is helping these doctors connect with their patients while accessing the information they need to treat people quickly.

"The grand challenge of health IT has always been about delivering the right information to the right person at the right time," said Dr. Steven Horng, an emergency physician and assistant director of emergency informatics at BIDMC. "A lot of our interaction is that connection and making patients feel comfortable. The more we can maintain that eye contact and that conversation, the better the patient feels. Google Glass helps us do that."

Google Glass brings the data to the doctors, so the doctors don't have to go find the data.

Patrick Moorhead, an analyst at Moor Insights & Strategy, said he sees a big future for wearable computing systems in the healthcare field.

"Wearables like Glass in the ER, if done correctly, could be a breakthrough for patients and hospital staff," Moorhead said. "It saves time and makes the attending doctor more focused on the patient than the computer."

BIDMC, a teaching hospital that handles three quarters of a million patient visits every year, has been running a pilot program with Google Glass since December.

The program started with two emergency room doctors sharing four pairs of the computerized eyeglasses. Last week, the hospital expanded the program to include 10 doctors.

The program next will likely expand to the cardiology and surgical groups. For the first six months or so, however, the focus is solely on the ER, said John Halamka, a physician and the CIO at BIDMC.

Halamka said 10 years ago he imagined a device that doctors could use to give them critical patient information -- medical history, X-rays, medication lists, nurses' notes, lab reports -- while they're interacting with the patient.

Before they got Google Glass, which has a small screen that sits above the user's right eye, doctors at BIDMC were using iPads. But using Apple's tablets involved some challenges. For example, doctors would occasionally forget their iPads and since they're handheld devices, the iPads had to be sanitized regularly.

Moreover, to get information from an iPad, a doctor has to look down at the screen, breaking eye contact with the patient.

"On a day-to-day basis, it's not unusual for a patient to say they don't remember the dosage of a medication or they can't remember when they had a tetanus shot," Horng told Computerworld. Without a system like Google Glass, he said, "that means we have to leave the room and look up the information when we'd really rather just keep talking to the patient and keep that conversation going. Even if there's a computer in the room, you have to turn on the computer and log in. It takes time and you often have to turn away from the patient."

For BIDMC, Google Glass is a way to better patient care, and physicians at other hospitals are interested in trying the digitized eyewear. Halamka said he receives about 20 requests a day from other healthcare organizations looking for information about BIDMC's Google Glass program.

One other healthcare provider that's using Google Glass is the UC Irvine Medical Center in Orange, Calif. Surgical teams there are using Google Glass and customized apps for live streaming of audio and video to help doctors supervise surgical residents.

Dr. John Halamka, CIO for Beth Israel Deaconess Medical Center in Boston, chats with Computerworld's Tracy Mayor about how the hospital's emergency room doctors are using Google Glass to provide better patient care.

UC Irvine doctors also are considering a program where nurses could visit patients in their homes and use Glass to enable doctors in the hospital to see the patients and get the nurse's real-time observations, according to an article in the Orange County Register.

Ryan Junee, co-founder of San Francisco-based Wearable Intelligence, which built the Android apps for BIDMC's Google Glass program, said the company is in talks with "many of the top hospitals in the U.S." about integrating its software with wearable systems. Junee wouldn't identify the hospitals Wearable Intelligence is talking to, nor would he say how many hospitals the company has been in contact with.

Wearable Intelligence was a key player not only in making Google Glass usable for the emergency room doctors at BIDMC, but also in making the technology compliant with hospital and federal privacy and security rules, such as HIPAA.

Halamka said most of the apps that come with Google Glass were removed from the device. For example, doctors are unable to use Glass to take photos or video because of concerns that the images could be shared in a way that would violate a patient's privacy. Physicians also can't use Glass to tweet or read email. Doctors primarily operate the devices by voice commands, but they can use touch capability as a backup.

BIDMC also made sure that patient information, such as medical records or medication lists, isn't stored locally on Glass systems. Such information is stored on the hospital's secure servers, and doctors can access it there.

For tighter security, Halamka and his team set up the Glass system so only specific doctors can use the technology -- and they can only use it inside the emergency room.

"I walk into the emergency room and put on my Glass and push the on button," Halamka said. "It's immediately context-aware that it's in the Beth Israel secure location because it has only one function -- to show emergency department information. If you take it outside Beth Israel, it won't function. It has to bond with our enterprise network as a secure accepted device. Outside the doors, it won't work."

He added that each doctor in the program has a specific user code. The doctor puts on Glass and looks at his own ID badge so the device recognizes that he's an accepted user.

Horng said that adapting Glass for hospital use involved some technical challenges. The biggest was battery life, since the devices need to have their screens on all the time. To address that issue, the team added an external battery pack that lasts more than 14 hours, which gets the doctors through a normal ER shift. The battery pack connects with Glass via a micro USB cable. The pack is carried in the doctor's pocket.

When patients are admitted to the emergency room, they are assigned to specific rooms. Each room has a QR code near the door, so when a doctor approaches a room with a new patient, he simply looks at the QR code and Glass retrieves the patient's medical information.

The room codes also enable to Glass to keep tabs on doctors' locations.

Halamka emphasized that the system is secure because Google Glass won't work outside of the emergency department. "If you lose Google Glass, there's no data on them," he explained. "Without being in the emergency department with a badge and in a room, you could not use the device to retrieve information."

Both Halamka and Horng noted that not one patient has asked the doctors not to use Glass.

"We thought some patients might [be averse to it], so we wanted to give them an opportunity to not have the device used with them. But they're curious about it and grateful that we have better access to their medical information," Horng said. "Once we had a conversation about disabling the camera and other features, people were very receptive to it."

Horng credits Glass with helping him save at least one patient's life.

In January -- a month into the Glass pilot program -- a patient arrived in the emergency room with a massive brain hemorrhage.

"That's very critical and requires immediate treatment," Horng said. "The patient's blood pressure was sky high, and I needed to lower it to slow the bleeding. But the patient said he was allergic to some blood pressure medicines. To access that information would normally mean leaving the room, but without stopping, I was able to access that information [on Glass] and start him on the appropriate medicine."

Checking the patient's list of medications on Glass also showed Horng that the patient was taking a blood thinner, which was making the brain bleed even worse.

"Administering an antidote to blood thinners is something you have seconds to do," Horng added. "And it could mean the difference between [the patient] walking out of the hospital and not walking out of the hospital or being able to talk or being completely nonverbal."

Because the doctor could quickly access the records without pausing from working with the patient, he said the patient not only survived but "did remarkably well."

Copyright © 2014 IDG Communications, Inc.

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