Rhode Island Hospital ER begins Google Glass dermatology study

By Jonah Comstock
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Porter Google Glass Lead Researcher Dr. Paul Porter dons Google Glass in a video from RI Hospital's website.

Rhode Island Hospital has begun a feasability study using Google Glass to provide dermatology consultations to patients in the emergency room. For six months, emergency room patients who require a dermatology consult and consent to the study will be examined by ER physicians wearing a stripped-down version of Google Glass. The wearable will transmit images to an off-site dermatologist, who will access them via a tablet.

"This platform really democratizes telemedicine," Dr. Paul Porter, the principal investigator on the study told MobiHealthNews. "If you want to start a telemedicine program you need to buy a GlobalMed cart, it would be about a $100,000 investment. [Google Glass] really puts it within the reach of rural and disadvantaged urban health centers that want to link up with a tertiary referral system or even specialists."

The hospital is working with Glass-focused startup Pristine on the pilot. Pristine developed the stripped-down version of Glass that eliminates HIPAA concerns by removing some of the device's core functionality and connectivity. Specifically, a Pristine-modified Google Glass device isn't connected to the internet -- it just streams live, encrypted video and audio directly to a receiver. Nor does it record or store photos, video, or audio. Porter says HIPAA compliance has been one of the biggest hurdles faced by facilities trying to use Glass.

"It's every CIO's worst nightmare to have a breach or have video uploaded on YouTube," he said. "We know other facilities within New England had looked at Glass and given up, just not having found a solution to that technical problem, as far as encryption goes. We really put a lot of time in trying to get the best possible conditions for confidentiality, picking a specialty that we thought would be the safest for the patients. In our study, [the Google Glass consultation is] over and above the standard of care, which is a phone call plus or minus a snapshot."

Porter said dermatology is a good starting point because diagnoses are made based primarily on visual evidence, and it's not an area like trauma where every second counts -- which means if a technical problem caused the consulting dermatologist to be disconnected, it wouldn't affect the quality of care significantly. Porter said Rhode Island Hospital started using Glass with patients on March 1. The hospital sees about 100 dermatology patients a month in the ER, and once they have a study group of around 100 they'll start working on a paper, even if it's well before the end of the six month time frame.

There's been buzz about possible healthcare applications for Google Glass ever since the $1,500 wearable computer was first announced, but only now are we starting to see concrete, serious use cases. Last week, UCLA researcher Aydogan Ozcan and his team published a paper validating a Glass app that helps doctors read rapid diagnostic test strips.

If this study goes well, Rhode Island Hospital hopes to see many other telemedicine applications for Glass, including pediatric consults, stroke care, and emergency response. The current pilot will use Glass to virtually bring in specialists, but future pilots might employ it as a heads up device, allowing doctors and EMTs to see a dashboard of patient vitals without looking up from the patient. Porter suggests that it will fit easily into the workflow and make doctors more engaged with their patients.

Porter also hinted that the hospital has plans to integrate Google Glass with other connected health devices if all goes well.

"It's a piece of the platform. It's only audio and visual, but there's part of healthcare that is suited well for that. I can't speak for Apple or Google, but there's other devices in the works that we think from a healthcare prospective would integrate nicely with that. We have plans on board to do some of that early testing."

As a doctor, Porter said he sees in Google Glass the potential for doctors to regain a sense of connection with patients that is threatened by the use of computers and even mobile devices in the exam room.

"When you're talking about patient care, I think there's nothing more discouraging than sitting there watching the doctor look down at a screen and type," Porter said. "It just loses something in the doctor-patient interaction. One of the things I like about the technology is you're able to look the patient in the eye."