Monday, October 6, 2014

Real-time Emergency Medicine with Google Glass Technology

Google Glass is a definite leap toward the inevitable future of direct mind-CPU integration.  One does not have to be a crystal-balling futurist to see that surgical chip implantation in the brain is not too far behind.

The article Google Glass May Help Emergency Physicians Improve Patient Care identified potential uses of the device in tracking, decision support, and diagnostic aid (the first tricorder).  Of course, fans of the science fiction series Star Trek, know that a tricorder is a hand-held multi-function device that Doctor McCoy depended on for sensor scanning, data analysis, recording data, and more importantly diagnosis.  During the years the original show ran, most Trekies could not even imagine the wireless world that we have now become so accustomed.  Nevertheless, it does not take much further imagination to conceive of a medical world in which past records, CT results, lab data, immediately visualization, and decision analysis all wirelessly get synthesized and collated through a common central device, such as Google Glass.  Hence, what was once science fiction is now considerably closer to science reality.


An especially intriguing potential use for Google Glass is real-time supervision and consultation.  As the number of Nurse Practitioners and Physician Assistants increases, the need for careful monitoring increases.  Thus when supervision is enabled in real-time, the system will experience delivery of coordinated care that is inherently more safe.  For academic organizations, think of an attending being able to effectively supervise more residents than could be possibly be achieved by walking from bed to bed.  And then, even in our own practices, a cardiologist might review an EKG as it is actually taken, through the device at the same time as you, naturally speeding up disposition.  The list of conceivable benefits goes on and on.

With the ability of the Google Glass to take photos and record evaluations, the encounter itself, as well as its related data can easily be transmitted to a person who may be in charge.  At the same tie, the accuracy and quality of care can be monitored and expertise and assistance, when needed, can be given immediately.  Of course, there will be some naturally expected barriers to full adoption, not the least of which will be the necessity of acquiring experience, along with the need to promote an atmosphere of cooperation among practitioners, where guidance is seen as providing real-time feedback and advice, and not as demanding or disparaging.

Additional benefit will arise if this technology enables the staffing of facilities with fewer high level and therefore more expensive individuals.  One might ask: how many physician will be needed to staff a 60,000 visit emergency department in the world of the near future?  Currently, general wisdom says one would need 12-16 physicians and 8 supporting PA and/or NPs on a full-time rotation of shifts.  One can anticipate that the balance within this ratio might well change in a Google Glass supported ED, requiring less physicians and facilitation the use of more support-level practitioners.  The Glass might enable the eyes of one ED doc to roam much further than before.  such a far-reaching vision would also be a great benefit to rural hospitals and locations that find it difficult to attract physicians, since observational immediacy could be obtained without physical immediacy.

Glass data could be sent right to the consultant to help clarify, expedite, and provide hopefully better care- how Trekies is that!  It promises to have an equally strong real-time presence in the documenting and decision-making process.  The Google Glass linked EHR of the future can well be envisioned as documented by a reviewable folder of commentaries, snapshots, an videos of what occurred.

Of course, the tricorder will not put health-care providers out of work because you will need someone like McCoy to say to the captain: "Dammit Jim; I'm a doctor not a ...!!!"




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