At the hospital

I spent the day with Glass at a large community teaching hospital in an outer borough of NYC, my first experience using Glass in a patient care setting. I came away with the following conclusion: at this stage in my training (a 4th year medical student), working on a medicine teaching service, Glass in its current iteration did not add significant value to my workday. Even so, I continue to believe that Glass will eventually revolutionize healthcare (or at least parts of it), because Glass's value proposition changes drastically depending on the user and clinical situation.

In my short experience with Glass, I found it to be very distracting. It was a physical barrier in my peripheral vision when interacting with patients and providers, and it sometimes woke up when I was trying to carry on a conversation (even with the wake angle set very high). It also served as a conversation piece much more often than it served as a tool. 

Reactions varied. One resident recognized Glass immediately, and his first comment this morning was "No way!" followed by wanting try them on. But for the uninitiated, trying to ask a resident about a patient's labs yielded, "What's with the high tech gear?" A presentation on rounds was met with, "Did you know that, or did your robot glasses tell you?" Using the Glass touchpad elicited, "You look like an insane person." And my favorite comment of the day: "When you write about your experience with that thing, are you going to talk about how we made fun of you all day?" Notably, not one patient remarked on Glass. (Did they not notice? Not care? Not want to be intrusive?)

I met the good-natured mockery like any nerd would: with enthusiastic explanations of the features of Glass. For people who had never heard of it, my sound byte explanation was "it can do everything an iPhone can do, but hands free." But then I started to wonder what benefit being "hands free" actually confers. Consider the following scenarios:

Scenario 1: Looking up patient records or Googling for information
Using Glass's voice input is unreliable and distracting. It's easier to use an iPhone or tablet to look up information like this. I used my iPhone instead of Glass to look up information during rounds this morning.

Scenario 2: During a patient interaction
Glass is useful in that it lets one check the time and glance at urgent messages or emails while talking to a patient. (I admit that I found myself looking at the clock while talking to particularly long-winded patients.) But this is a double-edged sword, in that it detracts from quality time spent with a patient.

Scenario 3: Performing a procedure
I think there is a lot of possibility here for recording procedures (such as a central line) and later receiving feedback as part of a training or evaluation process. This is one area in which Glass is clearly superior because of its handsfree capability. I would have liked to record a procedure today, but I didn't feel comfortable asking the patient's permission to record, and I didn't have an established relationship through which I could have received feedback. Also, sharing personally identifiable health information (such as video that includes a patient's face) via Glass without specially secured software (that I don't have) is a HIPAA violation.

Scenario 4: Performing surgery
This is an area where Glass shines, and it's where I see the most potential for use. In the OR, surgeons are already committed to operating devices in a handsfree manner. There are already awesome companies out there like Pristine.io that recognize this potential.

The benefits of Glass, therefore, are very different for, say, an attending surgeon, than a 4th year medical student on a medicine floor.

I do believe that one day we will live in a world where Glass is pervasive in the hospital. We will teleconference and consult, have lab results served to us before our eyes as soon as we walk into a patient's room, and learn from our mistakes captured by Glass, all without lifting a finger. To do that, we need pervasive Internet connectivity (the hospital where I am currently working still doesn't have reliable wifi!), better battery life (Glass died after about 8 hours of intermittent use), and most of all a cultural shift that makes "robot glasses" commonplace on the floor.

I'm relieved to return to the hospital tomorrow without Glass. It's really an amazing product that feels so different to use than anything I've used before, and it's been a privilege to try out this technology while it's still in its infancy. But I will be glad to be able to talk to patients tomorrow without a computer on my face. Okay Glass? 

Benji Jack

@benjijack

Contact(s)

I'm a lucky guy. Henry Wei recently reached out to me out of nowhere to talk about my healthcare startup. Given Henry's bio this is an of itself was an exciting and noteworthy event, only exacerbated by the following email from Henry a few hours later: "Hey by the way would you be interested in joining my Google Glass experiment?... I’m a Google Glass explorer but hardly ever have time to tinker & play with my Glass.  I gathered a bunch of Cornell Med students interested in it, and wanted each of them to try it for a couple of weeks and write a blog post or two about their vision/ideas since typically med students are less cynical and more visionary = better ideas for the future... No one responded to my last call for volunteers so if you’d like I can hand it off to you before thanksgiving to try out." 

You can imagine how long it took me to decide.

So, I picked up the Glass (or simply "Glass" as the convention goes) last Friday evening from Henry's doorman. I found out when I first opened the box Saturday morning that either contact lenses or good eyesight are strictly required to use Glass, and I had neither. So on Sunday, I got myself some shiny new contact lenses, and I sat down tonight for a proper test drive.

It's worth pointing out: the fact that I don't typically wear contacts (although I wore them regularly many years ago) adds to the mystique of Glass. I actually have to place a device directly on my eyeball before I don Glass. 

The 30 minutes or so I've spent with Glass have left me feeling that I've undoubtedly experienced something from the future. It reminds me of the first time I signed on to Prodigy. On its face, there's nothing that Glass can do (take a photo, make a phone call, tweet, check the weather, etc.) that a phone can't. But the fact that you can do all of these things hands-free, with a subtle movement of your head, by simply looking up instead of taking a phone out of your pocket, make these technological actions feel more like an extension of yourself and of your body. There is a big philosophical and experiential difference between speaking "text John I'm running late" into a phone that you're holding in your hands and simply speaking the words out loud and making it so. The video call feature is particularly mind-blowing.

I am excited to bring Glass to the hospital. It seems to me that it would be most useful during surgery when one's hands are otherwise occupied. But I have no doubt that I and others will find uses on the medical floors too. It's practical uses at this point in time will likely be limited by HIPAA-compliance issues, spotty wi-fi, and the other IT issues that only the healthcare industry is fortunate enough to experience. (It's also still socially unacceptable to wear unusual contraptions on one's head during rounds when the attending has just figured out last week how to use a smartphone.) But wait until you put one of these on your own head -- look up into the corner of your vision, and get a glimpse of the future.

Benji Jack

@benjijack

Through the looking Glass we go...

Here we go, everyone!  This is an excerpt of the email I sent to several med students that Laura had helped invite after I randomly found her on Twitter and asked her for help getting the word out:

"Y'all emailed me in response to the favor I asked of Laura (thanks!) to let med students know that I had a Google Glass unit and wanted to give everyone a chance to try it out, think creatively and/or critically, and let the world know about their thoughts through a blog (tentatively: http://bigredglass.blogspot.com ).  I really appreciate all your interest!

...
[Here are the rules]
a) do no harm to patients or to my Google Glass unit (i.e. don't break or lose the actual equipment)
b) respect patient privacy and try to go above and beyond what HIPAA requires
c) make it your job to find the next person who's turn it is and get it safely to them and teach them how to use it
e) when you receive it, email me with your name & contact info
d) when you hand it off, email me the next person's name & contact info, and give them this set of rules
d) write at least one blog post -- doesn't matter how short or so long, and you can do more than one, before, during, or after you're done letting the world know what you think.  even better if you write multiple blog posts over time as your thoughts develop.
e) invite at least one other Cornell med student and/or doctors along for the ride and send them along to me if they're interested
f) have fun

Henry Wei, MD