Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

Abstract

Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation.

Patient Perceptions of Wearable Face-Mounted Computing Technology and the Effect on the DoctorPatient Relationship

“…Examples of such technologies include Google Glass (Glass) TM , the newer Microsoft HoLolens TM , and Oculus' Rift® [1][2][3]. Entrepreneurs believe these devices can add value to and even improve health care delivery [4][5][6][7], and a previously released version of Glass has already been used to monitor vital signs, search health records, offer video streaming of operating rooms, and provide medical education opportunities [8][9][10][11][12][13]. However, because these devices are conspicuous, they challenge established social etiquette [14], and they are therefore distinct from technology like tablets, cellphones, or other wearable technologies that have been integrated into everyday clinical practice.…”

Using Google Glass in Surgical Settings: Systematic Review

“…The vast majority of the studies examined the potential use of Google Glass as an intraoperative intervention (27/31, 87%) [ 12 - 31 , 35 - 42 ], whereas others observed its potential use in preoperative (4/31, 13%) [ 19 , 27 , 32 , 33 ] and postoperative (5/31, 16%) [ 15 , 19 , 27 , 30 , 34 ] settings. Only a few studies evaluated the use of Google Glass in more than one of these settings (4/31, 13%) [ 15 , 19 , 27 , 30 ].…”

“…Five studies used Google Glass as a videoconferencing tool to communicate with remote surgeons intraoperatively (5/31, 16%) [ 15 , 27 , 28 , 31 , 36 ]. Twenty-one studies (21/31, 68%) used Google Glass as a videography and photography device to document surgeries, laboratory images, or patient electronic medical records (7/21, 33%) [ 21 , 26 , 29 , 30 , 32 , 34 , 38 ], to assist in telementoring (4/21, 19%) [ 14 , 16 - 18 ], to document patient consultations (2/21, 10%) [ 19 , 33 ], to broadcast live streams (2/21, 10%) [ 31 , 37 ], and to enhance surgical education (7/21, 33%) [ 12 , 15 , 17 , 19 - 21 , 23 ]. One study used Google Glass as a hands-free search engine in the operating room (1/31, 3%) [ 27 ].…”

“…In preoperative settings (4/31, 13%), Google Glass was used in cardiac surgery (1/4, 25%) [ 32 ], neurosurgery (1/4, 25%) [ 19 ], pediatric surgery (1/4, 25%) [ 27 ], and emergency medicine (1/4, 25%) [ 33 ]. In these studies, Google Glass was tested primarily for its use in laboratory imaging interpretation and documentation (2/4, 50%) [ 32 , 33 ], surgical consultations (2/4, 50%) [ 19 , 33 ], teleconferencing (1/4, 25%) [ 27 ], and surgical education (1/4, 25%) [ 19 ].…”

“…Most studies (20/31, 65%) conducted formal follow-up surveys with study participants to determine the feasibility and usability of Google Glass [ 12 , 16 - 20 , 22 , 24 - 27 , 30 , 32 , 33 , 35 , 38 - 40 , 42 ]. Of the 31 studies, 28 (91%) studies assessed feasibility, usability, and/or acceptability by physicians only [ 12 - 25 , 28 - 32 , 34 - 42 ], two by both physicians and patients (6%) [ 27 , 33 ], and one by patients only (3%) [ 26 ]. The two studies (7%) that reported patients’ perceptions of using Google Glass cited a generally positive response toward its use [ 27 , 33 ], although one group of patients reported anxiety related to being recorded without their informed consent [ 27 ].…”