Google Glass: An Eye For Doctors

In December 2013, plastic surgeon Dr.  Anil Shah wore a device called Google Glass while performing rhinoplasty to repair a broken nose. In January 2014, Dr. Salene Parekh used the device while performing foot and ankle surgery at a conference for doctors from India at the United States.

Also in January 2014, Dr. Rafael Grossman, a general and trauma surgeon at Eastern Maine Medical Center (EMMC) in Bangor used the new Google device to transmit a live stream of a surgical procedure to adjust a patient's feeding tube to an iPad several miles away, although the live stream could have been sent anywhere in the world. Dr. Grossman used the device to live stream images of the patient's digestive tract that otherwise could only be seen through endoscopy in much less detail, avoiding the need to put the patient through two procedures.

What Is Google Glass?

Google Glass is a wearable computer. Mounted on the same kind of frames used for eyeglasses, the miniaturized computer has a video display in an optical head-mounted display, also known as the OHMD, just in front of the right eye. The device responds to spoken commands, and includes Bluetooth, GPS, and, of course, a microphone. It can record and send live streams of videos, and translate the user's voice into other languages. The device sends vibrations in the wearer's mastoid bone so that only the user can hear the audio.

What Are the Advantages of Google Glass in Surgery?

Early adapters of the new Google technology such as plastic surgeon Dr. Anil Shah believe that this device could revolutionize the practice of surgery. As Dr. Shah told Medical News Today, the greatest advantage of the device is that it allows the surgeon to keep an eye on the patient. Instead of glancing between a screen displaying film from an MRI or CT scan and the patient, the surgeon can have diagnostic images displayed on Google Glass while operating on the patient. 

Additionally, Google Glass eliminates the need for a "runner" between the operating room and waiting families outside. Connected to the Internet or Skype, the device enables the surgeon to speak directly to people in the waiting room. 

Google Glass also allows the surgeon to speak with colleagues during the procedure. For instance, an oncologist removing a tumor could describe the exact size and location of the tumor to other doctors for a second opinion regarding the best way to remove it. The device allows the surgone to consult the patient's medical records during the procedure. And the device could provide a permanent record of a procedure for forensice and legal purposes later.

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New Privacy Concerns

Google Glass gives surgeons a tool to access the cloud while operating on a patient--but without appropriate attention to privacy settings, it could also give the cloud a tool to access a patient during surgery.

Dr. Grossman carefully set his Google account procedures to limit access to patient data during the test procedure, and avoided looking into the face of the patient, which would have been transmitted across the Internet. Grossman was careful to secure informed consent from his patient before the procedure, and sent no personal identifying information about the patient across the Internet while the procedure was being livestreamed.

What You Need to Know If Your Doctor Uses Google Glass

Not many doctors are using Google Glass yet, but chances are that many more will choose Google glass or similar products soon. On the whole, this is a good thing for patients. Doctors can spend less time searching for information, consultations can take place in real time, and families can get timely updates on loved ones. But if your doctor is using Google Glass, there are certain concerns you and your doctor should address:

• Google Glass usually is not appropriate in the exam room. You and your doctor may develop an understanding that allows for the use of Google Glass during your medical exams, but usually there is no reason a physician has to look at you and a superimposed medical image at the same time. In the doctor's office, Google Glass may lead to less attention to your needs, rather than more.
• Google Glass has a "transmit" mode. Your face, your private parts, and every word you say can be transmitted over the Internet in real time through Google Glass. It's not out of line to ask for assurances this is not happening, and to find another healthcare provider if you don't get the assurances of your privacy.
• Using Google Glass usually requires a privacy notice and a privacy waiver. These typically have to be printed out on paper and manually signed. 
• Some pharmacies are planning to use Google Glass as a wearable scanning tool. Check your medications the first few times they use this technology. New systems are prone to error even if they have been beta-tested. Pharmacies are also planning to use Google Glass to provide step by step instructions for compounding medications, making them from scratch. But do you really want your medication compounded by a pharmacist who has to use an instructional video to complete the task?
• If your surgeon uses Google glass, don't be hesitant to ask questions about the device itself. Are the images shown on the device as high-resolution as provided on a conventional viewing screen, and will this make a difference during your procedure? All surgeons trained without the device of course, so they can perform your operation without Google Glass, but it's not unreasonable to ask the question. Also, it's not unfair to ask if the battery's charge will last your entire operation. Medical examiners testing Google Glass during autopsy found that the battery lasts on average about 2 hours during constant use. Many surgical procedures take longer than 2 hours. Transmitting a single image, in one field test, took a little less than 1% of the battery's charge. It is fair to ask whether your surgeon can use Google Glass to live stream your entire procedure.

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Google Glass will probably prove to be a boon to surgery. But be sure your doctor gets your informed consent before using Google Glass while treating you, and don't hesitate to share any concerns about the technology.