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November 5, 2013 by AAS Webmaster

OK Glass, Take a Picture!

If you attended the American College of Surgeons Clinical Congress this October, you might have overheard this, or seen a woman wearing bright tangerine colored glasses without lenses. That was me at the Social Media booth in the exhibit hall, demonstrating Google Glass to a curious group after an invitation from the ACS Committee on Informatics to share this new device and the possibilities for how it might change our interactions with data and each other.

I am a bit of a geek, I’ll admit. As an early adopter and a surgeon, I’m inspired to discover how we can improve the care of patients with the help of technology. I first heard about Google Glass in February, when Google launched a clever marketing strategy: a contest called #ifihadglass. To my astonishment, my entry in 140 characters was one of about 8,000 selected and I became a Glass Explorer. Instantly, I had access to a brand new community of innovators, developers, a relatively few folks in healthcare, and even a smaller group of surgeons. We hungrily reached out to each other and connected virtually, enjoying exploring this bleeding edge device and Google’s existing Google+ infrastructure to support our collaborations.

Google Glass is a wearable computer. It’s essentially a combination of a heads-up display, a speaker, a camera, a battery and a flash drive mounted on a titanium eyeglass frame. It comes with two removable blade-like lenses, a shaded one for sunglasses and a clear one that lends itself perfectly to eye protection. It does many of the same things you can do with your smart phone, but as it is mounted just above your right eye, it allows you to readily share your vision to the world. And you really can’t underestimate the wonder of this experience it evokes this childlike feeling of first discovery that we rarely connect with as adults. To actually see what someone else sees as it is evolving, particularly if it is something unfamiliar or involves a specific skill? Well, it’s like walking on the moon. #glassface

While I took photos and video liberally in the public market in the Embarcardero moments after picking up Glass, it took me nearly three months to ready myself to wear it in the operating room. I was cautious to avoid possible violations of privacy in patient care areas, and I rarely wore Glass in any other area of our medical center out of respect for my colleagues. It was too new, too intrusive. But to my surprise, I was met with universal curiosity and excitement at the potential for using Glass to improve care not just from my fellow surgeons, but also my patients. As I became more facile with the voice-activated features and the connectivity settings, I learned how to transfer videos and photos to a secure place off the device. The default duration of a video clip is only 10 seconds, and this requires some practice to wake and control the device with a head gesture and voice commands. Recording the entire operation, as we often do during laparoscopy, is a much easier alternative.

Google Glass example
Using Google Glass in the operating room to capture photos from the surgeon’s point of view. Here, gaining access at the beginning of a laparoscopic inguinal hernia repair. (credit: Evans, 2013)

While no one knows when Google will release Glass to the public for mass consumption (currently, you can’t buy Glass, unless you’re an Explorer), it will likely be within the next few months. This past week, the company made a big announcement: the next version of the hardware is available and Explorers may invite up to three friends to purchase Glass. With this, Glass sightings will become more commonplace, and we will be forced to confront some major issues of privacy and security. One of my goals in bringing Glass to the College was to encourage surgeons to interact with the unit firsthand, to understand its capabilities, so that the first encounter would not be with a patient who donned them in an exam room. We are busy, without the time to learn a new technology, but we need to figure out where we stand on the use of Glass in surgery:

Is it a tool for surgeons…

To enhance intraoperative documentation and teaching?
To facilitate a real-time intraoperative consultation with a remote colleague or a master surgeon?
To bring additional information to inform intraoperative decision making?
To optimize skill-building through multimedia feedback and structured training?

Is it a tool for patients…

To maintain a personal health record by recording interactions with healthcare providers?
To navigate a preoperative program to prepare them for surgery, such as an exercise program?
To enhance post-discharge communication and recovery?

Perhaps the answer is “all of the above,” but application of Glass will undoubtedly bring about unintended changes in our workflow, our patterns of communication, and the scope of what we consider medical care. Now is the time for us to participate in the conversation about how Glass, and other wearable computing solutions, can be integrated into surgical clinical care, quality improvement and research. It is our opportunity to advise technical developers using our unique perspective, emphasizing the particular concerns we have as surgeons (e.g., impacts on ergonomics and attention, patient-provider relationship and health information privacy). We owe it to our patients, our trainees, and each other to responsibly evaluate how to balance the possibility of instantaneous data sharing and real-time consultation and teaching with security and discretion.

Related articles
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  • Technical Skill and Surgical Outcomes: An Interview with John Birkmeyer, MD
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AAS Webmaster

Webmaster at Association for Academic Surgery
The Association for Academic Surgery was founded in 1967 and has grown significantly over the years being widely recognized as an inclusive surgical organization with over 2,500 member surgeons. Active members have traditionally held faculty appointments at a recognized academic center. Active membership is also available to senior/chief residents and fellows in approved training programs in general surgery and the surgical specialties. The impetus of the membership remains research-based academic surgery.

@AcademicSurgery

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