The Virtual Toxicology Service: Wearable Head-Mounted Devices for Medical Toxicology

Chai, Peter R.; Wu, Roger; Ranney, Megan L.; Porter, Paul S.; Babu, Kavita M.; Boyer, Edward W.

doi:10.1007/s13181-014-0420-5

Cited by 25 publications

(25 citation statements)

References 24 publications

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“…Moreover, the data transmission from Glass is of sufficient quality to allow diagnosis of specific toxidromes in clinical environments that lack a bedside toxicology consult service. The importance of this research, therefore, is that HMDs such as Glass can place a remote toxicologist virtually at the bedside with a physician providing direct patient care in any location [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…Their relative unobtrusiveness and acceptance by patients combined with the hands-free nature and extreme portability of the devices make them ideal for a busy, crowded emergency department [6,1]. Like other telemedical devices, privacy and security of patient information will remain paramount as breaches in data transmission can be damaging to the patient and the telemedical program [1]. Prior to deployment of Glass, we developed close partnerships with industry partners and our hospital information technology and security departments to ensure adequate steps were taken to secure data transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Toxicologists who consider a HMD as a telemedical platform should ensure enduring support in the event of device upgrades. In piloting the use of this HMD, we utilized a multidisciplinary team of toxicologists, hospital security and information technology officers, and industry partners to ensure adequate connectivity while minimizing audio and video lag [1,16]. Newer iterations of HMDs will likely lead to improved device stability and connectivity with additional functionality.…”

Section: Discussionmentioning

confidence: 99%

“…Teletoxicology has been theorized to extend the reach of medical toxicologists from academic medical centers to distant health-care facilities where most poisoned patients receive care [1]. Modern wireless infrastructure, miniaturization of hardware, and improved penetration of cellular phones, computers, and tablets have advanced the use of mobile technology into health-care settings.…”

Section: Introductionmentioning

confidence: 99%

“…Because of their intuitive control and unobtrusive nature, HMDs pose a solution that allows a toxicologist to examine poisoned patients virtually at the bedside, in conjunction with the consulting physician [1,3,5]. Glass and other HMDs, worn like a pair of eyeglasses, project information at eye level through a prism display, provide access to internet-enabled applications, and can function as a head-mounted telephone through a Bluetooth connection to a cellular phone.…”

Section: Introductionmentioning

confidence: 99%

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The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

2015

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Teletoxicology offers the potential for toxicologists to assist in providing medical care at remote locations, via remote, interactive augmented audiovisual technology. This study examined the feasibility of using Google Glass, a head-mounted device that incorporates a webcam, viewing prism, and wireless connectivity, to assess the poisoned patient by a medical toxicology consult staff. Emergency medicine residents (resident toxicology consultants) rotating on the toxicology service wore Glass during bedside evaluation of poisoned patients; Glass transmitted real-time video of patients' physical examination findings to toxicology fellows and attendings (supervisory consultants), who reviewed these findings. We evaluated the usability (e.g., quality of connectivity and video feeds) of Glass by supervisory consultants, as well as attitudes towards use of Glass. Resident toxicology consultants and supervisory consultants completed 18 consults through Glass. Toxicologists viewing the video stream found the quality of audio and visual transmission usable in 89 % of cases. Toxicologists reported their management of the patient changed after viewing the patient through Glass in 56 % of cases. Based on findings obtained through Glass, toxicologists recommended specific antidotes in six cases.Head-mounted devices like Google Glass may be effective tools for real-time teletoxicology consultation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Feasibility and Acceptability of Google Glass for Teletoxicology Consults

2015

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Feasibility and Acceptability of Google Glass for Emergency Department Dermatology Consultations

Chai

Ranney

et al. 2015

JAMA Dermatol

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that approximately 20 to 30 NMEs were approved each year from 2000 through 2013. Topical NMEs are developed at a much lower rate (0.9 NMEs per year). These findings are consistent with prior studies 5 illustrating the underrepresentation of all drugs developed for primarily dermatological uses. Dermatological illnesses are not often fatal and may be considered lower priority by policymakers. Priority designations are assigned by the US Food and Drug Administration to new drugs that represent significant improvements over existing options and command more resource investment and regulatory attention. Only 5 total topical applications and 1 topical NME were given the priority review designation compared with 45% of all pharmaceutical and biological NMEs from 2000 through 2009. 6 Beyond being considered lower priority, traditional metrics of blood and urine drug levels often do not apply to topical therapies. The lack of accepted surrogate end points may explain why the median approval time for topical medications is comparable with oral and intravenous therapies despite representing a lower systemic risk. Given these regulatory challenges, the low number of active companies with the necessary expertise to develop topical therapeutics likely contributes to the continued high cost and low availability of these drugs. Prior studies on medical innovation of devices, small molecules, and biotechnology suggest a multifaceted approach to spur future development. 7 Strategies most likely to succeed include continued research funding to study diseases that are likely to be responsive to topical therapeutics and increased collaboration between academic and industry professionals. In the short term, adoption of more surrogate end points reduces the regulatory burden and may encourage companies to invest more resources in this underserved area.

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