By John Halamka, Chief Information Officer at Beth Israel Deaconess Medical Center
Over the past few months, Beth Israel Deaconess has been the pilot site for a new approach to clinical information technology, wearable computing.
In the Emergency Department, we’ve developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.
Here’s how it works:
When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall. Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.
Beyond the technical challenges of bringing wearable computers to BIDMC, we had other concerns—protecting security, evaluating patient reaction, and ensuring clinician usability.
Here’s what we’ve learned thus far:
Patients have been intrigued by Google Glass, but no one has expressed a concern about them. Boston is home to many techies and a few patients asked detailed questions about the technology. Our initial pilots were done with the bright orange frames—about as subtle as a neon hunter's vest, so it was hard to miss.
Staff has definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed.
We have fully integrated with the ED Dashboard using a custom application to ensure secure communication and the same privacy safeguards as our existing web interface. We replaced all the Google components on the devices so that no data travels over Google servers. All data stays within the BIDMC firewall.
We have designed a custom user interface to take advantage of the Glass’ unique features such as gestures (single tap, double tap, 1 and 2 finger swipes, etc.), scrolling by looking up/down, camera to use QR codes, and voice commands. Information displays also needed to be simplified and re-organized.
We implemented real-time voice dictation of pages to staff members to facilitate communication among clinicians.
Google Glass does not appear to be a replacement for desktop or iPad—it is a new medium best suited for retrieval of limited or summarized information. Real-time updates and notifications is where Google Glass really differentiates itself. Paired with location services, the device can truly deliver actionable information to clinicians in real time.Within the next month we expect to begin a trial of Google Glass for all providers in the Emergency Department. We will be studying patient impressions, clinician/staff impressions, and usage patterns of staff.