What will Google Glass do for health?

As early adopters test out the new technology, many are excited about its potential for improving care – but some are sounding alarms.
By Mike Miliard
10:29 AM

It's probably the most anticipated and potentially transformative new gadget since the smartphone. But unlike the iPhone, Google Glass has also been heralded with a healthy dose of controversy.

Although few folks have yet managed to get their mitts on a pair, lots of people have some pretty passionate ideas about what the technology – which enables hands-free Web and camera access – will mean, for healthcare and society at large.

Earlier this year, Google put out the call "Explorers" who might be willing to test out prototypes of the device. Interested folks were encouraged to head to Twitter and Google+ and say what they'd do if they were lucky enough to get a pair in advance, appending the hash tag #ifihadglass.

The winners were famous and infamous (Neil Patrick Harris, Newt Gingrich, Soulja Boy). Responses ranged from "id travel around the world and film the experience" to "I would help push the limits on #AugmentedReality in #hollywood."

Unsurprisingly, healthcare and wellness figured into many potential users' plans. "I'd use it to revolutionize healthcare. Imagine images filing directly to EMR charts and dictation on the fly all from Glass," wrote one entrant. "I would get into Telemedicine," wrote another.

Daniel Kraft, MD, executive director, of FutureMed and the medicine track chair at Singularity University, was expecting his Google Glass any day when he spoke with Healthcare IT News earlier this spring. He was already bursting with ideas.

"The first time I tried a pair on, wearing them for an hour or two gave a new level of appreciation for how you could integrate information into your data feed," said Kraft. "And when you can hone that through voice commands and take photos it immediately had clear applications for use across medicine."

A surgeon in the OR can use Google Glass to see a checklist and images from his patients, for instance, or share the view he has with another surgeon to figure out a case. Or the specs could be used "for an anesthesiologist to pull up vital signs that would ordinarily be on monitors," said Kraft. "Someone on their rounds could have a patient's chart pop up.

"I think there will be a lot of information we can't predict yet," he said, pointing out that the iPhone and the Android far exceeded even the most Polyannaish predictions for their usefulness, becoming "innovation platforms with thousands of apps, some of which we never would have guessed."

But could Google Glass ever be as ubiquitous as the smartphone?

"I'll make a prediction that it will be relatively ubiquitous in certain healthcare settings," said Kraft. "We're at, what, 70 percent market penetration of tablets right now, with docs bringing them to work? These are all just different platforms for transmitting information, whether you're looking at your phone, or a screen. Well, now we can free up our hands. Get an urgent message while you're scrubbed up or into a procedure? Now you can respond."

Downstream? There could be even more exciting applications. "Augmented reality," for instance: "You're looking at someone's arm, and overlaying the CT scan data. You would have X-ray goggles, in a sense, by layering in different modalities."

Or consider what artificial intelligence, such as IBM's Watson, could do in tandem with the technology. "That's going to tie into Google Glass as well, said Kraft. "If you're a dermatologist and looking at a rash, what if Glass could compare that to a database and come up with a diagnosis?"

The future is wide open, he said – and "I think it will move pretty quickly."

Bryan O'Rourke, an entrepreneur and executive who focuses on fitness and wellness, is also awaiting his Google Glass. His pitch was to use the technology to help "public health communities see how the platform can help solve the obesity epidemic."

"I believe that the smartphone is going to disappear," he said, and that smaller and more integrated gadgets will become the norm. "Processing power is keeping with Moore's Law. Miniaturization is happening. Connectivity, the ubiquity of the Internet, is also happening. Some pretty smart people are going to do some pretty cool things. and at a cheaper and cheaper cost."

What's more, as "prevention and wellness become more important," the potential for beneficial outcomes from these new devices, "are really going to drive a huge adoption."

But not everyone is so optimistic. Many are raising alarms about what Google Glass might mean for privacy and security – and even safety. The New York Times noted in May that the device has already been "preemptively banned by a Seattle bar. Large parts of Las Vegas will not welcome wearers. West Virginia legislators tried to make it illegal to use the gadget … while driving."

"This is just the beginning," Timothy Toohey, a Los Angeles privacy lawyer, told the Times. "Google Glass is going to cause quite a brawl."

Edward Champion is a writer and journalist who this past March wrote a long, 10,000-word blog post titled "Thirty-Five Arguments Against Google Glass."

"I was instantly horrified – not only by the immediate social implications that begin brewing in my mind, but by the way in which largely affluent white guys accepted it as a late stage adolescent fantasy," said Champion. "This seemed more diabolical and less useful than the iPhone: a way to extirpate that vital line between real and digital."

Champion concedes that "augmented reality may very well have some positive benefits for healthcare. But I think we should consider how the present system is serving doctors and patients alike. If there is no appreciable gain with the technology, or if the threats outweigh the benefits, then it seems wise to wait for the technology to work out the kinks before unloading it on a vast industrial scale."

Arguments nine through 11 on Champion's list are especially germane to healthcare.

Number nine? "We have no idea what health problems Glass will create," Champion wrote. He noted that, "unlike the smartphone, which is only placed near the head when answering a call, Project Glass will be constantly on the head. … Will Google Glass lead to an uptick in brain cancer?"

Argument 10 makes the case that Glass "may increase violations of doctor-patient confidentiality and attorney-client privilege." Champion notes that research shows that just 44 percent of providers encrypt their devices. "This leaves one to wonder what fresh hell Google Glass will unleash. Will doctors become hooked on Glass in the way that they are presently reliant on smartphones? And, if so, will the images and records that doctors collect be secure enough for the HHS?"

And number 11 is a familiar threat to many medical devices nowadays: "It could be hacked." Champion reminds us of 2010, when "Google was hit with a highly sophisticated hacking attack from China. The hackers stole intellectual property, scoured source code, and peered into the Gmail accounts of human rights activists." Similar violations earlier this year, he wrote, "demonstrate that the attacks are far from over."

Simply put, Google Glass "is clearly not ready for prime time," he said. That's why it's worrisome for him to see so many well-meaning technophiles happily falling under its spell."

"I'm not sure if you can print the word 'glasshole' in your publication, but it's a suitable word that expresses what worries me," said Champion. "I am deeply vexed by a world in which people abandon respect and decency for others because they have become too intoxicated by the technology."

Docs are not immune to the temptation, he said. "I think physicians could become more addicted" – than they already are to smartphones – "simply because of Glass's one stop shopping interface. Glass, with its hard and unified overlay, is worse than cruise control."

"If Glass can demonstrate that it is significantly more useful than a smartphone, it will creep into healthcare," Champion predicted. "But given how physically and mentally demanding the operating room is, I have a feeling that there will be a Glass backlash from healthcare professionals, if not those who are concerned with medical malpractice claims on the defense side."

Lisa Gualtieri, assistant professor in the Department of Public Health and Community Medicine at Tufts University School of Medicine, is another person tapped to be a Google Explorer based on the strength of her proposal: "I'd provide context-sensitive, evidence-based exercise, diet, & adherence reminders & risk warnings to improve public health."

Gualtieri, who teaches about mobile health design and digital strategies for health communication at Tufts, is not so alarmed about privacy.

"I'm more concerned about how to walk down the street, go for a run, or teach a class wearing them so that they enhance without detracting!" she said.

At any rate, the potential benefits of Google Glass far outweigh the drawbacks, Gualtieri argues.

"The democratization of medical information was a gradual process started by the Internet and accelerated by mobile devices and sensors," she said. "Google Glass immediately struck me as the next step in this evolution."

While initially the technology "will be on the periphery because of limited access to them (and) not everyone is as lucky as me to win a pair," said Gualtieri, she's excited about the potential. "Suppose patients and doctors worked together to plan how Google Glass could increase self-management skills and health education? Suppose public health departments could reach citizens during a crisis?"

The "possibilities are endless," she said. "I'm hoping to do something really significant to improve healthcare with them.

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