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Google Glass in the ER? Health Care Moves One Step Closer to Star Trek

New technology brings specialists to the bedside

Imagine that a person walks into an emergency room (ER) with a serious rash and waits hours to see a doctor until, finally, a physician who doesn’t have specific knowledge of the person’s condition gives him or her an ointment and a referral to a dermatologist.

That kind of care could change if a technological device such as Google Glass –– a wearable computer that is smaller than an ink pen and includes a camera function –– could be strapped to an ER doctor’s head or to his or her eyeglasses and used to beam a specialist in to see patients at the bedside. Not only would a patient receive a more specific initial diagnosis and treatment, but a second visit to a dermatologist might not be necessary.

Researchers did just that for a small group of people at the emergency room of Rhode Island Hospital in Providence. They found that 93.5% of the patients who were seen with a skin problem liked the experience. In addition, 96.8% of the patients were confident that the video equipment was accurate and that their privacy was protected.

“There had been a lot of talk about using Glass in health care, but at the time that we designed the study, no one had actually tried it. No one knew if it would work,” said study author Dr. Megan Ranney.

ER doctors normally have to page an on-call specialist –– in the study, a dermatologist — to talk through the patient’s condition. With that information, the dermatologist makes a judgment call about the treatment, usually without ever seeing the patient. If no dermatologist is available, which can often be the situation, doctors do what they can, but then refer the patient for follow-up dermatological care. Many rural and community hospitals do not have dermatologists on staff, and it’s up to the emergency physician to care for the patient.

In the study, researchers instead had the physicians connect via Google Glass, enabling the specialist to see on his or her office iPad or computer what the ER doctor was seeing in person. The ER doctor was able to communicate with the dermatologist, and both physicians could ask questions of the patient in real time.

“You’ve rolled the first and second visit into this one visit. You have the specialist at the bedside, and if you get better, you don’t need to have follow-up,” said co-author Dr. Paul Porter. “There’s nothing more frustrating [for the patient than] to be seen, leave with diagnostic uncertainty, and have to go somewhere else. People don’t want that answer.”

ERs across the U.S. may already use telemedicine technology for patients with skin or other visible conditions, but many of those machines can cost as much as $60,000 — not to mention the expense of maintenance and support. Google Glass costs less than $2,000.

In addition, many ERs either don’t have the funds to obtain a telemedicine “cart” or don’t use it because its size –– four to six square feet –– can be too large for that setting, said Dr. Edward Boyer, a professor of emergency medicine at the University of Massachusetts Medical School in Worcester.

“The crowding in emergency rooms means we physically do not have enough room to manage the patients they have in them. A dermatology cart is not a little thing, and a lot of ERs don’t have that much spare room to store and wheel around one of those things,” Boyer said.

Next, the authors plan to study whether Google Glass or similar headset technology could be used for other ER patients, such as those showing signs of stroke or who may have been exposed to poison. In the latter instances, poison control center toxicologists are always available, although they are mainly consulted via the telephone. But these patients commonly have visual symptoms, such as seizures, said lead author Dr. Peter Chai. And if a person is severely ill due to poisoning, they are flown by helicopter to the closest major hospital, he added.

“If we could see them virtually, could we save the money of transport, keep them in the community intensive care unit, and give better patient care?” Chai asked, noting that even if ERs in smaller or rural settings don’t have access to telemedicine, they may be able to afford this type of device.

The authors surveyed 31 people with skin conditions in the Rhode Island Hospital emergency department for 6 months, and their findings were published April 15 as a research letter in JAMA Dermatology.

Google Glass is currently not available commercially, but health care providers can obtain the device through health-care technology companies.

Source: Kaiser Health News; April 20, 2015.

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