Some people have called me a “Telemedicine Innovator”. To me, the fact is that I only try to make the workflow easier, more efficient, intuitive and, at the end, provide as good or better patient care with new ideas and the tools already available.
I work at a tertiary care hospital, which means that we get referrals from a vast area, underserved in regards to many medical specialties, including mine, which is General Surgery and Trauma. The surface area that only ONE surgeon covers, at any particular moment, 24/7, is larger in size than the combined area of Ma., Vt. and NH!
More and more and this will only get worse!, the demand for specialty medical services increases, much faster than the supply of medical professionals, which actually, in most acute care specialties, trends in the opposite direction. An added big issue, is that the cost of healthcare is currently unsustainable and this will also get worse!, with an expected expenditure of approximately 33% of the GDP by 2050.
We have been using telemedicine for several years, in order to improve the access to our system. In prior entries, I have recounted how mobility in telemedicine is an advantage and how using an iPodTouch we could connect to several hospitals in our telehealth network in a more efficient manner, faster and with no added real cost or disadvantage. Since then, we evolved, to be able to use any smartphone device, enabling us to connect agnostically to any device through the appropriate software (our administration chose a commercial, medical grade application called ClearSea, which so far seems to be working very well).
So, almost every time I’m on duty call, I have been using ClearSea thru my iPhone to connect to a remote tele-trauma device in any of our telehealth network hospitals. I have been trying to use more and more frequently, almost replacing the “phone call” , if indicated and if possible.
One big limitation, is the fact when the remote, referring provider tries to “show” me a specific lesion, wound or burn area in a “difficult-to-see” location. Let’s say in a patients back or between the legs, axilla, etc. The fixed wall cameras and even the mobile units (camera on top of a screen in a cart) are almost useless for this purpose.
If we had a device that allowed for a “point-of-view” of the user perspective with synchronous (live) streaming conferencing capability , so that we could see exactly what the other person (the referring provider) was seeing, that would be a “game-changing” tool!
Well, nowadays, we have such a device; Google Glass has all of that, and much more. (See the GoogleGlass advertisement videos that follow)
Google Glass really allows for a direct view of what the user is seeing. For instance, when we are trying to show someone, how to perform a procedure, to get the best view, they really have to “peek” behind our shoulder.If we had a head-mounted camera, the view would not live. Google Glass really solves that problem. There is also a “screen-share” mode , where the Glass view can be shown on a projector or a monitor, so that many people can see the actual streaming, to the minimal detail, from the “surgeon’s eye” ( a medical education dream).
The following are two videos from the last edition of an “Advanced Trauma Life Support” (ATLS) course that we offer at our institution a few times per year (all the participants gave their permission to be featured, even the “Trauma-Man”, a high tech mannequin that we use for the hands-on session, instead of animal models). The first video shows a traditional recording of the How-To-Do a thoracostomy (chest tube placement). The second video is recorded through Glass. You are the judge!
So, having Google Glass allows the user to share a direct point of view of the actual patient in a way never thought possible before. I do believe that telemedicine could potentially be revolutionized by the use of this device. The regulation regarding privacy issues and HIPAA will have to continue to adapt to the development of new technology.
I’m certain that very soon, the industry will provide Google Glass specific “apps” that will allow the video-conferencing in a secure, encrypted fashion, just as it happened when mobile telemedicine solutions were initially deployed. When we started using iPodTouch and then smartphones for teletrauma, Skype was the application of choice because of HIPPA compliance issues. Within a few months ClearSea, Vidyo, Jabber, etc. were all developed and made available to consumers.
As I have written and said before, I think the future will be brighter than we think. Technology is developing exponentially, but it is the smart application of the available technology that will allow us to provide much better and less expensive patient care, and, at the end, potentially save lives.
So, when a referring provider in a remote area , needs a surgeon NOW, Google Glass will make it happen.