OK, Google, Remove The Patient’s Appendix
by Thomas MacMillan | May 8, 2014 3:36 pm
Posted to: Business/ Economic Development, Health, Science/ Medical
Nervous about going under the knife? Don’t worry—the surgeon wearing weird glasses is actually two surgeons. A second doctor is looking through your doctor’s eyes and whispering in his ear, guiding every slice and suture.
Welcome to the world of telemedicine, where, ideally, doctors use wearable technology to treat patients better and more efficiently.
New Haven doctor and tech entrepreneur Yauheni Solad (pictured) is working to make the above scenario a reality, using Google’s new head-mounted-video-camera-cum-internet-on-your-eyeball device, known as Google Glass. The glasses are connected to the internet and respond to voice commands like, “OK, Google, take a picture.”
Solad recently formed a new company, called Amrist, that’s trying to adapt the high-tech specs for medical use. Amrist is working on two uses for Google Glass, a product which is still in testing itself.
First, Amrist wants to give doctors a new way to input and extract information from electronic medical record systems. With “CureCast,” physicians could get lab results delivered directly to their eyeballs as soon as they’re ready.
Second, Amrist seeks to give doctors a new way to collaborate and consult. With “MyView,” Instead of being “on call”—available by telephone—Doctor A could be available by Glass, ready to advise Doctor B while looking at a patient through the video camera on Doctor B’s eyeglasses.
Just a few months into his new venture, Solad is finding some of the biggest challenges are security and privacy.
On its own, Google Glass represents the leading edge of the internet’s ongoing infiltration into every aspect of life, a step toward a world of cyborgs who might be recording and “sharing” their lives all the time, even as you’re speaking with them. Combine that brave new world with concerns about data collection by companies like Google—not to mention the National Security Agency (NSA)—and then add in all the legal and ethical requirements of dealing with medical information, and Amrist has a high bar to get over in seeking to adapt the invention to more socially constructive uses.
Solad, who’s 29, shared the details of his new venture in an interview at the Grove co-working space on Orange Street. After finishing his medical residency at Yale, Solad is now in a two-year a medical informatics fellowship, building on his experience as a software developer back in his native Belarus.
With MyView, Solad is working on providing “HIPAA-compliant video streaming to any web browser.”
Here’s how it would work: A patient comes into the emergency room, badly injured in a car accident. A new doctor, a resident, unsure how to treat the patient, puts on Google Glass, puts earbuds into his ears, and contacts the on-call doctor. The resident can transmit live video to the on-call, and the on-call can speak directly into the resident’s ear.
“It’s almost like you’re there,” Solad said.
The patient might need a “central line”—a catheter in a main vein in the neck—used to deliver medication or fluid. Putting in a central line can be tricky for a new doctor. The on-call doctor can talk the ER doctor through it, helping him find the correct insertion point quickly and efficiently. The glasses might even display a checklist of steps to follow.
As it is, on-call doctors have only telephones to work with and can be left in the dark, Solad said. They might tell a resident what to do and then ask her to call back when she’s done. But they can’t see what’s happening, as it happens.
Solad said MyView could enable doctors with specialized expertise to help patients around the world, giving more patients access to the best care for whatever particular ailment they have.
“Medicine in the 21st century is not just an art, as it used to be,” Solad said. It’s now highly technical, highly “fragmented.” There may be just two or three doctors in the world specializing in a particular form of cancer, for example. One might be in Germany, another in Japan, and the third in the U.S. With Google Glass, those doctors could help patients regardless of where they live, using another physician as a proxy.
Solad said Google Glass could also help with what has become one of the biggest headaches for health care providers—keeping up with all the required record-keeping. Physician satisfaction is plummeting, he said.
“Google Glass can finally provide some help,” Solad said. It can “return the joy to medical practice.”
Many doctors got into medicine in order to spend time helping patients, he said. Instead they find themselves with 35 minutes of notes to write after a 10-minute patient visit. “I’d rather the opposite.”
Google Glass can help doctors input information quickly, using the system’s voice recognition. It can also help doctor’s retrieve information quickly, Solad said. He envisions a doctor seeing a patient, asking out loud for details about the patient’s most recent blood work and then seeing that information come up on Google Glass.
All of this requires a new, secure version of Google Glass’ operating system, Android. Amrist is developing that software now, Solad said, so that medical information is absolutely private and accessibly only by people who have permission, within a closed-circuit system.
Solad is aware of just how sensitive this topic is, in the era of patient privacy, corporate data-collection, and government spying.
“It’s scary. It’s actually really scary,” he said. “Security is a big issue.” It’s challenging enough to keep the huge amount of information collected in the digital age separate and contained. “If you add the ability to record your real life, I think we’re dealing with real security problems, especially after the NSA.”
Apart from securing the system, patients would need to adjust to receiving treatment from doctors with internet-connected video cameras on their faces. It may come down to patient trust. If your doctor says, “OK, I’m not recording,” and you don’t believe him, “you should probably have a different doctor,” Solad said.
And doctors would need to be mindful of their position of Google Glass-given power, and the responsibility that comes with it, Solad said.
Amrist will also need to modify its operating system to make it impossible to take and share photos accidentally. Google Glass responds to voice commands, so you could accidentally take a picture and post it to the internet even while explaining the dangers of doing so, if you use the same sequence of words.
Despite his efforts to advance telemedicine, Solad said he’s personally wary of Google Glass and internet encroachment. Too much time online can lead to depression and isolation, he said.
“For me, it’s just a tool,” he said. “I will not wear it on vacation. You really need to have a real life.”
“It’s very easy, with technology, to get lost,” he said. Technology should be an used as an “additional, top layer on your life.” But the “current generation takes it as a necessity for your life.” As a result, you see the rise of things like attention deficit hyperactivity disorder, brought on by too much multitasking, Solad said.
“Proof Of Concept”
Solad recently put an Amrist prototype to the test at an emergency disaster drill at Tweed airport. Firefighter Angel Aviles (pictured) wore Google Glass and headphones as he responded to actors pretending to be injured passengers from a recently crashed plane. A doctor at UMass Amherst was in his ear, helping him triage patients.
The test run didn’t go as well as it might have. Aviles accidently shut off the connection to UMass only partway into the drill.
“We learned some valuable lessons,” Solad said. In the future, participants should have more training on the interface, so that they don’t turn it off by mistake.
Nevertheless, Solad said, “the proof of concept was successful.”
Google Glass on its own still has a long way to go. The product still has a short battery life, the microphone isn’t great in noisy or windy situations, the display can be hard to see, and the unit still needs to be connected via Bluetooth to a cell phone carried by the user.
All that will improve as Google Glass develops, Solad said. In the meantime, Amrist is working hard to get a prototype ready for testing at Yale.
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