Hartford Hospital, Yale Explore Possible Uses For Google Glass In The ER, Training

Doctors Take Google Glass For Test Drive

Hartford Hospital, Yale Explore Possible Uses In The ER, Training

August 03, 2013|By WILLIAM WEIR, bweir@courant.com

To get Google Glass — the much-discussed wearable computer that hasn't yet hit the market — Hartford Hospital had to explain in an application why it wanted the device.

Chris Madison, a simulation technician for the hospital, got to the point: "I said, 'We want to save lives.'"

That was good enough for Google.

Finding out whether Google Glass can actually do that is the mission of Madison and his co-workers at the hospital's Center for Education, Simulation & Innovation.

What if, for instance, updates on a patient's lab results can be shot right into a doctor's fields of vision during an operation? What if it could bring a little more order to the frenetic communication of the emergency department?

Earlier this year, Google distributed no more than 8,000 of the devices in the world. Applicants had to explain their potential use for it in 50 words or less. If selected, they paid $1,500 for the device.

Google Glass, which looks like the frame of a pair of glasses, houses a small camera for video and photos and a tiny screen display, both in the upper right hand corner. The touch pad is on the right side of the frame. The device provides many of the same features as a smartphone or iPad, allowing the user to search for information, communicate, and take pictures and video. The difference is that Google Glass is mostly hands-free and the information comes to your field of vision, although you have to look up slightly to see it.

For people who wear glasses, there are special sets that fit over the glasses, and there are prescription sets that comes with lenses.

Whether Google Glass ends up proving to be a genuinely useful tool or just a nifty gimmick is an open question. Suggested uses have included GPS navigation for drivers, an instructional display for everyday tasks (for instance, mounting a large-screen TV), an educational tool for schoolchildren, a sheet music display for orchestras, and an audio/visual guide for museum tours. Some police departments are exploring whether it could aid in investigations.

Hartford Hospital's education and innovation department has had its Google Glass for the past few weeks and is brainstorming possibilities. Madison applied for the Glass after speaking to hospital officials about it, but he wasn't alone in thinking that a hands-free computer might be a help to doctors and nurses. He said he knows of about a dozen others in the health-care field who have one. Yale-New Haven Hospital also received a Google Glass, and its simulation team is now focusing on its potential in as a training tool.

Exactly how many hospitals have one is hard to say. Google technically has provided the device only to individuals, not institutions. A Google spokesperson said the company couldn't provide specifics about recipients.

One of the more high-profile medical uses of Google Glass took place in June, when Dr. Rafael Grossman, a surgeon in Maine, wore the device while inserting a feeding tube into a patient. For the sake of documentation, he used the device's camera to stream the procedure live on the Internet. Grossman told Forbes magazine that it's a "wonderful teaching tool."

Hartford Hospital and Yale-New Haven have proceeded more cautiously, so far keeping the device inside their simulation centers, where the staff can practice medical procedures on mannequins.

Dr. Thomas Nowicki, an emergency medical doctor who doubles as Hartford Hospital's cognitive simulation director, said he thinks the hospital's high-tech simulation center convinced Google to provide them with a Glass.

"Having access to this environment is really advantageous because we can test it here without having to go through all of the steps to get it in place in a patient care environment where those things need to be figured out," he said.

But not everyone is so quick to embrace new technology. Nowicki said that when nurses use iPhones — probably calculating medications or using some other medical app — some patients think their caregivers are emailing friends. The hospital had to restrict iPhone use because of the patients' perception, Nowicki said.

So that raises another question to be figured out: Will patients will be happy to have a doctor with what appears to be a third eye looking at them?

Madison said he got mixed results wearing Google Glass in public. For the first two weeks after Google sent the device, Madison wore it virtually non-stop. Getting used to the device itself only took a few hours, but the social aspects of Google Glass were a little harder, he said. He got a lot of funny looks, and many people came up to ask questions about the device. He said he was treated like a celebrity when we walked into a Best Buy recently, with clerks clamoring around him.

One of the first things Hartford Hospital has considered is whether the device can improve communication in the emergency department. Right now, a medical alert for a patient needing special attention is issued over a speaker in the emergency room. The doctors take turns responding to the alerts, but with so much going on, they can sometimes lose their place in the cycle.

What often happens, Nowicki said, is that three or four doctors will respond to the same alert.

One possibility is that all the doctors in the emergency department would be outfitted with Google Glass, and the alerts will be sent visually to a specific doctor.

"When the medical alert comes in, the recipient taps the side of the device to accept the call," Madison said. "If he doesn't, the alert moves onto the next physician after a certain amount of time."

When or if this or any of their ideas can be put into practice is hard to say, Madison said. For one thing, Google isn't expected to put the device on the market until sometime next year.

"We started with it being more of a research project to see if these things can be a benefit," he said. "And if they can, then we ask, 'How do we implement it?'"

Yale-New Haven also is looking at the potential for Google Glass to improve communication. For a recent trauma simulation on a mannequin, the team leader wore the device to record the procedure. Simulation supervisor Jason Fenstermaker pointed to the video of the procedure on the large screen in SYN:APSE, the hospital's simulation center, when two medical residents appeared to be talking over another resident.

"You can go back and look at that footage and see where those communication issues are," he said.

David Dias, a simulation technician at Yale-New Haven, said that there are other cameras a person can wear, but that Google Glass also allows communication with other people while using the camera. And because the footage goes to Google, he said, it's easily accessible to many people.

It could also help doctors coach residents in training because the doctors could see the procedure in real time, Dias said.

"You could even have some off-site — we have facilities in Greenwich, we have facilities in Bridgeport — you could have somebody from that hospital actually doing the coaching here, or vice-versa."

Another possibility is to have put the device on a training mannequin, which would give the medical staff a good idea of how patients can perceive what's going on around them.

"Having the clinicians hear what they're talking about over a patient — good things, bad things — and the patient hearing what they're talking about, it might have them adjust where they would have those conversations," Dias said.

Once the device is on the market, the simulation team at Yale-New Haven hopes to have everyone wear Google Glass in order to watch a mock procedure from every possible perspective.

At Hartford Hospital, residents wear the device while going through simulated procedures. Nowicki and Madison have simulated patient data, such as potassium or sodium levels, which are then flashed to the physician's field of vision. The goal is to see whether this will allow a more efficient process by eliminating the need for a doctor to go to a conventional computer to get the same information or to have a nurse read it aloud.

One obstacle to putting this into practice this is that Glass operates on Google's servers, so putting patient information through it could violate patient privacy laws. Madison is working on a prototype app in which the information would be conveyed through private servers.

"We want to send mock data in a simulated environment and see if there's any benefit to doing that, and if there is, then there's the potential of talking to these companies about building a full-fledged app that actually integrates with hospital systems," Nowicki said.

Might wearing the device be a bit distracting for a doctor? That's one more thing to find out.

"Obviously, anything that's in a doctor's vision can be distracting, so I think that comes with the learning curve," Fenstermaker said. "I think that's why simulation is a good jumping ground for trying stuff. Doctors use this and they can say 'Is this too distracting for this procedure,' or 'Is this not distracting for that procedure?'"


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