One of the fast-growing companies I profiled for Healthcare Informatics’ Up-and-Comer list of companies for 2017 is San Francisco-based Augmedix, which that has developed a physician charting solution using Google Glass. Before entering the exam room, a doctor dons Google Glass and then proceeds to talk with patients, rather than typing into a computer screen. A remote scribe fills out forms, health history, lab orders, prescriptions and more for the physician to sign off on.
But charting isn’t the only way that Google Glass is being put to use in healthcare. In remote areas of Saskatchewan, nurses and general practitioners are donning Google Glasses so that specialists in a tertiary care centers, such as the one in Saskatoon, can diagnose and triage patients. A few weeks ago, I had the opportunity to speak with Ivar Mendez, M.D., who heads up the Department of Surgery at the University of Saskatchewan and Saskatoon Health Region, about this pilot project.
Mendez explained the importance of remote presence for specialists in Saskatchewan, one of the largest provinces in Canada, with a population of about a million people scattered over a territory roughly the size of France. “If you live in the northern part of the province and need follow-up care, you may have to travel for 12 hours or take a three-and-a-half-hour flight to reach one of the tertiary centers,” he said. It curtails the access to healthcare of people in remote locations and it puts a great economic burden on the province. With a single-payer system, healthcare is a provincial mandate. “The province spends around $60 million just transporting people,” he said. “If you have your hip replaced in a tertiary care center, and it is time for a follow-up visit, it may cost the government $20,000 just to have the orthopedist look at your wound. So it is an inefficient system.”
This has led the province to develop a remote presence medicine program. For several years, it has used remote presence robots that, for instance, would allow a pediatric specialist to activate a robotic system to see a child in a remote clinic and do triage and determine what treatment is necessary. The specialist in Saskatoon can activate the robot remotely and move it into the emergency room to examine a patient. The province now has 17 such robots deployed.
“Because we have had this experience for several years, we thought the next logical technology we felt was important to try was a wearable device,” Mendez explained. “A nurse or general practitioner in a remote community can put on the Google Glass and we can communicate with them through the Google Glass and see the patient. We felt that was the next logical extension of the program.”
The researchers in Saskatchewan have been working with an Indianapolis-based company called Hodei Technology to help it pilot and refine its HCview Gemini solution “We are deploying this system with all specialties and in three remote communities, including the most remote community in the province, on the border with the Northern Territories,” Mendez said. “We are trying to understand the capacity of the system for seamless communication.”
Mendez said his team is studying the satisfaction of the specialists in terms of confidence in using the device to make a diagnosis, the satisfaction of the remote nurse or physician to use the device to communicate with a specialist as well as the satisfaction of the patients.
They worked through eliminating any lag time in transmission, as well as some issues to make sure that when the person wearing the Glass moves their head, the image isn’t jerky or blurry on the specialist’s end.
He credits Hodei for its elegant, modular design and ease of use. “They built a box where the Google Glass is stored and that also serves as the telecom hub,” Mendez explained. The only thing a nurse or clinician in an emergency department has to do is open the box and put on Google Glass and wear it. It communicates directly through the box to the Internet. “They made a very convenient, modular and compact design that is very practical and user friendly. That is a critical issue.”
If the rest of the pilot goes as planned, the Google Glass program will be expanded to the 17 sites that have robots now. “If you need expert advice on a very serious problem, if it is done in real time it may save a life,” Mendez said. The transportation cost savings could be huge and it could lead to more appropriate and timely decision-making.
“We see this as part of a comprehensive program that will allow us to resolve most medical issues remotely,” Mendez said. “That is the future. Medical care will change from a model where people go to a central location for care to a model where the care will go to where the patient is.”