Health Tech: Google Glass in the Cath Lab

By Shiv Gaglani

We continue to hear from an increasing number of physicians who are leveraging the power of wearable technologies in the clinic or operating room. Chief among these technologies is Google Glass. We recently had the opportunity to speak with Glass Explorer and cardiologist, Jordan Safirstein, who has been using Glass in his cath lab where he specializes in trans-radial interventions.

What is your background in cardiology?

I did my internal medicine residency at Montefiore Medical Center in the Bronx and joined my wife at Saint Vincent's, where she was doing a pediatrics residency. I was lucky there to train under some amazing trans-radial teachers like John Coppola (on SCAI's Transradial Working Group) and Tak Kwan—doctors who I respected a great deal, not only for their procedural expertise but also for the excellent care they provided to their patients.

Interestingly, my first significant research project was in the noninvasive realm, where we used the Internet to recruit women with peri-partum cardiomyopathy (PPCM). This is also what really began my interest in the use of the Internet, social media, and technology as it relates to medicine. I believe we were the first study to utilize Google in the recruitment of patients.

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Why did you decide to get Google Glass?

I could readily see the benefits of wearable technology in the procedural space. Streaming a case to your colleagues live, and without having to break sterility, offered many benefits. I could serve as the teacher by sharing cases with residents and fellows; or, I could seek advice from colleagues who would be able to see the case as I do through Glass. I was excited by the opportunities I had not thought of and the privilege to test out something very few had.

How have you been applying the platform in your research and practice?

I have been using Glass primarily in the cath lab setting to record video and take pictures of various aspects of the transradial approach to cardiac catheterization.

What has been the reaction from your patients and your colleagues?

Everyone has been very interested and curious about Glass. I have not heard an ounce of negativity about my using it. I think in general people are fascinated by new technology–especially when it's something that could potentially be used widely in the future. I field many requests to try them on and therefore am constantly hearing the words, "OK Glass." The younger generation seems to have them on the radar and the older practitioners are often staring at me quizzically before they finally break down and ask me what the heck I’m wearing on my head.

Have there been any obstacles or major concerns around the clinical use of Google Glass?

As with all new technology there are challenges, but my most significant one is privacy; that is, HIPAA and the potential privacy violations. All cases in which Glass will be used require informed consent and I invariably wear them into the room when I see the patient before their procedure and demonstrate them to the patients, who are always very curious and kind. But beyond the cath lab, wearing them in the hospital wards/units/office would be perilous since I have no control of who walks into my field of vision.

Connectivity can also be an issue since Glass requires a WiFi connection for most of its functionality—however, it can usually function quite well using my iPhone as a "personal HotSpot" if the WiFi connection is not robust. The newer version has made "adding" new WiFi networks a bit easier. Finally, I long for the day when I can stream my videos to anyone and everyone on my contact list, or perhaps invite large groups to view a case as I do it.

Can you describe the current or potential applications of Glass in health care that you are most excited about?

They are so numerous. Let me break down a few by potential "roles" that one can play using Glass:

Teacher: Using the video feature to instruct students, residents, fellows, and colleagues in a live Hangout session

Student: Communicating with experts in your field to show them pathology or anatomy or surgery that they may have expertise with, which you do not (using the video feature once again)

First responder: In military or trauma, or even in the setting of acute heart attacks, seconds matter and the sooner the physicians and their team can visualize the trauma or ECG, the better prepared they can be to deal with it. Sure, you could just send a video back from your iPhone but you have to stop and film that as opposed to Glass, which is voice-controlled and allows the user to continue working while transmitting potentially life-saving info back to the team.

Office doc: Using Glass' "cards," it would be conceivable to have software that would allow you to see the basic demographics of your patient on the first card, followed by the clinical complaint, past medical history, prior ECG and then current ECG—all before you walk into the exam room.

Operator: Software will undoubtedly be developed to allow wearables the ability to scroll through prior relevant imaging—whether it is an orthopedic surgery or a cardiac catheterization–all by just glancing upwards as opposed to leaving the OR/cath lab to look up old films on the hospital computer.

Do you have any recommendations for other cardiologists who are interested in adopting novel technologies such as Google Glass?

Wear it, wear it, wear it. You become familiar only by putting it to use and by forgetting it's there and trying all different uses–no matter how silly they seem. New devices have to be pushed and this is no exception.

Shiv Gaglani is an MD/MBA candidate at the Johns Hopkins School of Medicine and Harvard Business School. He writes about trends in medicine and technology and has had his work published in Medgadget, The Atlantic, and Emergency Physicians Monthly.

Keywords: Internship and Residency, Operating Rooms, Privacy, Health Insurance Portability and Accountability Act, Pediatrics, Cardiology, Cardiac Catheterization, Orthopedics, ACC Publications, CardioSource WorldNews

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