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9 www.ihdelivery.com July 2014 Integrated Healthcare Delivery ■ Physicians in rural hospitals can confer with specialists around the world in real time. ■ Out-of-hospital providers can confer with a patient's physi- cian regarding issues or care plans while with the patient, involving him or her in the process. Images of the patient and potential hazards can be recorded and captured. ■ In the prehospital setting, EMTs and paramedics can send streaming video from the field to an emergency department physician who can view the trauma scene for mechanism of injury. In the case of a multi-casualty incident, video from the scene may assist local hospi- tals preparing for patients. ■ Electronic patient care records can become available to all caregivers, from emergency responders to hospitals, and can be updated in real time to include major changes in the patient's condition. It could be particularly helpful for EMTs and paramedics responding to an unconscious patient. With the patient's records, the providers can see if there is a history of diabetes, seizures, strokes or brain trauma. Other critical information could include allergies or recent hos- pital stays or procedures. ■ A physical therapist can call up past sessions with a patient, identifying changes, as well as progression. Copies of these reports can be added to the patient's medical record. ■ Live streaming of procedures can be used for training purposes, especially critical procedures such as emergency intubations. One advantage of Google Glass is that, unlike a camera, it is less intrusive and there is less concern about infection control. Since it records the procedure through the eyes of the wearer, it pro- vides the perfect camera angle for instructional purposes. ■ It can generate immediate access to tutorials to refresh a provider's memory during seldom-used procedures. ■ The technology can serve to protect healthcare providers in cases of liability and pro- vide accountability. ■ Google Glass can even assist patients by reminding them to take medications. Even though Google Glass isn't specifically available for use in the medical field, third- party service providers are already beginning to develop add-ons. Dentyzion has intro- duced the first Google Glass loupe for dentists and surgeons. OneDX offers a software platform for sharing patient medical reports such as exams, reports and images. Augmedix is working on a clinical applica- tion to allow healthcare provid- ers to view patient care reports directly on Google Glass. Some hospitals are already piloting projects involving Google Glass. Rhode Island Hospital in Providence is said to be the first hospital in the nation to officially test Google Glass in a real-time emergency setting. The six-month pilot is limited to emergency depart- ment patients with skin condi- tions. Beginning in March, physicians could send a live streaming feed of a patient's condition to remote specialists for a consultation. To address patient privacy concerns, only patients who sign a release are included in the pilot. In May, the University of California, Irvine School of Medicine announced it will be providing Google Glass devices to third- and fourth-year medical students for use in the operating room, emergency department and rotations. First- and second-year medical students will use the technol- ogy to study basic science courses and clinical courses. University of Arkansas cardiologists are using Google Glass to provide expert supervi- sion of complex procedures. As with any new technology, there are challenges that must be addressed. Primary among these is a concern for privacy. Efforts will need to be made to encrypt data to conform to HIPAA regulations. Not all patients will be thrilled to see that their healthcare provider is "wired." Some workplace issues may need to be addressed regarding recording employees. Finally, the cost may be an issue for some. The Google Glass Explorer became available to the public in May for $1,500. Although the initial introduc- tion of Google Glass has been focused on its social function, the healthcare profession has quickly recognized its potential for application in the medical field. If so, Google Glass could offer a vision of fundamental change, enhancing telemedicine by improving quality, safety and efficiency of patient care. IHD_08-09_TechToday0714REVISED.indd 9 6/17/14 10:23 AM