The doctor can see you now: The surgeons using Google Glass in the operating theatre

With an 'enterprise edition' of Google on the way and likely to be focused on healthcare, medics are already showing wearables have a future for teaching and more.
Written by Jo Best, Contributor

Surgeons at Warsaw's Institute of Cardiology using Google Glass recently. Image: Warsaw Institute of Cardiology

Since Google wound up the consumer version of Google Glass earlier this year, rumours have continued to build that an enterprise build of the networked eyewear would arrive before too long.

Google's Glass webpage, for example, carries the message: 'the journey doesn't end here', and a link to the Google for Work program. Of the 10 Glass for Work partners Google lists, five of them are involved in healthcare. For some medics, the journey is far from over.

Dr Maksymilian Opolski, of the Institute of Cardiology in Warsaw, was part of a team that recently used Google Glass for a procedure known as a percutaneous coronary revascularisation of a chronic total occlusion - where doctors will restore blood flow to a patient's heart by clearing or circumventing blockages in the arteries that supply the organ with blood - on a 49-year-old man.

During the procedure, the team could view CT scans of the patient - detailed 3D images of heart and its blood vessels - on their Google Glass headsets, navigating and zooming in on them by using voice commands. The team used the CT projections to direct a guide-wire through the blockage in the artery, allowing it to act as a path for the stents - small tubes that are used to keep the arteries open - that followed.

The app allowing them to navigate through the images was developed by a team of physicists from the Interdisciplinary Centre for Mathematical and Computational Modelling of the University of Warsaw.

"Personally, I think that the interdisciplinary and collaborative approach integrating physicians and computer scientists is the cornerstone for crossing the borders between diagnosis and treatment using modern technologies," Opolski said.

Dr Jordan Sarfirstein, an interventional cardiologist, was one of the first 1500 people to trial Google Glass under the original Explorer program.

As well as being able to view scans of the same type as the Warsaw Institute of Cardiology or combine them with other imagery, Safirstein envisions a day when medical personnel arriving on the scene of an accident could be communicating with their colleagues through Glass while still being able to move freely and attend to the patient.

"The voice-activation feature could feasibly connect them with the Emergency Department by phone and send out a text message to multiple parties with one voice command, activating the cath lab or trauma team before the patient even arrives. The camera could also send a copy of the ECG or vitals to the receiving MDs and all without [emergency medical personnel] taking hands off of the patient," Sarfirstein said.

The cardiologist initially got Glass with a view to using the headset as a training tool.

"I thought it would, at the very least, act as an amazing teaching instrument to show people a first person view of how exactly I perform a procedure and permit live interaction as if they were watching the live case in the room with me. The ability to interact with the audience and transmit live video feed...would literally replace AV equipment that costs tens if not hundreds of thousands of dollars to accomplish the same task," Sarfirstein said, adding that Glass' "inconsistent connectivity, numerous privacy issues, clunky interaction" are all drawbacks to using the device as a teaching aid.

While it may be some years before Google Glass is as much a part of a doctor's kit as a stethoscope, the networked eyewear is already being used to train the next generation of surgeons at Barts and the London School of Medicine and Dentistry.

As part of an initiative called Virtual Medics, the medical school first used Glass in 2014 to livestream an operation on a 78-year-old to over 13,000 viewers watching live via the web. Viewers, treated to a surgeon's eye view of the procedure, were able to ask questions to Mr Shafi Ahmed as he removed cancerous tissue from the patient's bowel. During the operation, Ahmed would respond verbally to the queries as they popped up on his display.

While taping operations isn't new, the ability to broadcast a live, first-person perspective of the procedure and have students able to discuss the operation with each other and the surgeon remains novel. "You can record surgery with static cameras, but you lack that interactivity," Oliver Trampleasure, co-founder of Virtual Medics, told ZDNet.

After the initial livestream, Barts has run a series of similar surgery broadcasts although on a smaller scale - making them password-protected and available to view by a thousand or two medical students at a time. Traditionally, only a handful of medical students can be present in an operating theatre, and only one of those has a decent view of proceedings from the surgeon's elbow. With Glass only worn by consultants so as not to compromise patient safety, a potentially unlimited number now have the opportunity to observe the most senior surgeons at work.

While the use of Glass has not been without challenges - notably, the device's short battery life meant any operating theatre using Glass has two spare sets in case original runs out of charge - it's still the best of the available hardware, according to Trampleasure: "we tried out a number of wearables - none are perfect, but Google Glass is the best compromise between usability and quality."

Glass is also being used to record other teaching videos - such as emergency care scenarios - from the doctor's perspective for use by medical students at the school. And it's not just patients who have come under Glass' eye - medical students have too. By being having a 'patient' wear Glass during a consultation, the students can watch their own performance back afterwards from the patient's eye view. By taking note of their own body language and speech, they can see where to develop their communication skills.

The ultimate aim for Virtual Medics is to use Glass and other remote learning tools to help increase the number of surgeons in training - at present, over five billion people are thought to lack access to safe surgery.

"We need to train more surgeons," Trampleasure said. "You could increase the number in training at medical schools, but most are running at capacity. Or you could shorten the amount of time taken to become a surgeon, but then you'd have quality control issues. Another way would be to reduce the amount of workload for teaching - and have elements taught remotely."

Less complex elements - learning the necessary knots for stitching, for example - could easily be taught through video alone.

"With Glass and the internet, you can connect to that wherever you are. If you had a mobile phone with an internet connection, you can watch it anywhere. It can bring world class education to anyone."

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