Andrew Wright, MD, Amy Morris, MD, Heather Evans, MD, Jonathan Ilgen, MD, Andrew Mesher, MD, Michael Levitt, MD. University of Washington.
Google Glass is a wearable computer with integrated camera and heads-up display. It is uniquely suited to surgery because it 1) is hands-free and voice-controlled; 2) provides high quality video recording and transmission from the point of view (POV) of the surgeon; 3) enables real-time communication of video, audio, text, and voice; and 4) is extensible through the development of surgery and medicine-specific apps. A group of physicians and technology experts at the University of Washington has formed a working group to explore potential applications and pitfalls of Google Glass, as well as other wearable technology.
Google Glass is especially well suited for surgical education and telementoring. Preliminary testing has shown that POV recordings are superior to standard video recordings for demonstrating anatomy and surgical technique. Unlike other POV cameras designed for sports use (such as the GoPro camera), Google Glass does not distort with a fisheye lens and can be controlled with voice and head-movement alone. Video can be live streamed for intra-operative consultations, telementoring, or remote supervision of bedside procedures. We have used Google Glass in this context primarily in the simulation lab, due to patient privacy concerns, but have done several one-off live-streams with special patient consent. These have primarily been for training courses and continuing medical education.
Future use of Google Glass or similar technology may include video recording of surgery as part of documentation for the medical record, or as a means for assessment of surgical competency as part of ongoing professional development and certification. It remains to be seen whether such video recording with assessment and feedback will improve surgical technique or outcomes.
The ability to develop custom software for Google Glass also raises the potential for numerous surgery-specific apps. Areas for investigation include but are not limited to: augmented reality for integration of imaging with targeting or identification of tissues; real-time integration with and control of OR systems; decision-support tools; machine interpretation of imaging or test results; and EMR integration.
There are a number of security and privacy concerns that will need to be addressed before Google Glass can be fully integrated in the healthcare environment. Google Glass is not HIPAA compliant. The capacity for continuous recording or surreptitious photography may worry patients, hospital staff, and the public. An additional concern is that Google Glasses may be distracting in the operating room or add to the cognitive load of the surgeon, thus impairing surgeon performance. Subjectively this has not been an issue in our preliminary use of the technology.
Future plans include formal studies of the utility of POV video in education, real-time telementoring of bedside procedures in the simulation lab, and eventual use in the clinical environment under a pending IRB. While we recognize that Google Glass is an imperfect and new technology, the emergence of Glass signifies a tectonic shift in the way we experience the world. This will impact surgery in the future, and we must anticipate and prepare for this paradigm shift.