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