Why surgeons are a key target for some Google Glass app developers

Before he even knew that Google Glass was in the works, Partho Sengupta was salivating at the potential for smart eyewear in healthcare. In a draft article for a top medical journal two years ago, the Mt. Sinai cardiologist said he gushed so effusively about the possibilities for such a device that his wearable technology comment was edited out because it was deemed too futuristic.
But maybe his sentiments would be received differently now.

Noble Ackerson, a Google Glass Explorer and vice president at Silica Labs, demos his Glass app.

Noble Ackerson, a Google Glass Explorer and vice president at Silica Labs, demos his Glass app.

That’s because, these days, uber-early Google Glass adopters are actually wearing their high-tech headgear around town.  And as they show off its hands-free and voice-activated features, it’s becoming increasingly clear that medical professionals – who spend hours each day on their feet and with their hands engaged – could be among those to benefit most from the new technology. Even skeptics, who doubt the consumer appetite for Glass, say they see a much brighter future for it in medicine.
“There are so many dimensions to the world that we’re not able to recognize. But I think Google Glass will scale up our primary senses. Within the next one to two years, I think you’re going to see a huge disruption in healthcare from it,” said Sengupta, who’s starting to gain some fame within his field for his futuristic thinking and high-tech (and holographic) presentations.
For fans of the new technology, Google Glass could elevate everything from telemedicine and medical education to surgery and the electronic health record.
In the case of a cardiac arrest, Google Glass could enable a paramedic to share the results of a patient’s electrocardiogram and other images with a doctor immediately and start making critical care decisions before they even reach the hospital. In the operating room, where surgeons may need to process a traffic jam of incoming information from a variety of other specialists and screens, it could help doctors make faster decisions. And in rural, under-resourced areas, its ability to let users share their field of vision could give nurses and physicians a way to get real-time feedback from remote specialists while still conducting procedures and tests.

Cost? Launch date? Development kit?

But despite the excitement, developers creating Glass apps for health and providers eager to embrace them are working with several unknowns. First, there’s the price: Glass costs developers and early adopters $1,500. Some (wishful) pundits say it could be as low as $400 at launch, but, really, it’s a question mark. Next, there’s the launch date itself, which is estimated to be in early 2014 but isn’t set in stone. Then, there’s the fact that many health-related applications will require more robust apps that are native to the device, and Google has yet to release a glass development kit  — or even a launch date for it.
“There are a few challenges here,” said Antonio Zugaldia, chief technology officer at Washington, DC-based Silica Labs, which is developing apps for Google Glass and other wearable technology platforms. “We’re taking our time before jumping and developing something quickly. We want to be sure that whatever we build makes sense.”
For now, the company is focused on testing the limits of the Mirror API, which enables developers to build more limited apps for Glass, and organizing Google Glass Meetups to hear from doctors and others in healthcare what would be most valuable to them.

Silica Labs' GlassFit app is its first foray into health and wellness apps for Google Glass.

Silica Labs’ GlassFit app is its first foray into health and wellness apps for Google Glass.

Ultimately, Zugaldia said he sees a great deal of potential in creating apps for enterprise health customers. But the company’s first foray into health-related Glass apps is more of consumer fitness product called GlassFit, which is essentially a virtual personal trainer that gives users a no-hands way to follow more involved exercise regimens (and could also be used to help rehabilitate those who have suffered injuries or strokes, the company said).
Other developers, however, are working with a more aggressive timeline. Austin, Texas-based Pristine, for example, is determined to have a marketable product ready by the time Glass launches, which founder Kyle Samani believes could happen as early as November. By August, he said, the company plans to start piloting its app with a large academic medical center. Beyond disclosing that they’re focusing on surgery, the company won’t share exactly what the product will do.
“The nature of a surgeon’s job is to play with toys… they’re also high-powered energetic folks and they’re efficient,” said Samani. “We can either make them more money or get them home earlier.” Another reason they’re targeting surgeons? Large dollar volumes. The price of a procedure is fixed for the patient, so if they can help surgeons be more efficient and squeeze an extra operation in or be able to finish earlier, he said, they can save the hospital money.

Could glass rival tablets in healthcare adoption?

Their product doesn’t just assume that Google Glass will be on the heads of the surgeons — it assumes that nurses and other medical professionals, too, would be wearing it. In fact, Samani’s very bullish estimate is that by 2018, all medical professionals in the U.S. will use Glass.
Others in the health field, however, take a more moderate view. John Halamka, the CIO of the Beth Israel Deaconess Medical Center in Boston, is also pro-Glass but estimates that adoption, which will be driven by doctors who purchase Glass for themselves, will be slower than tablets because the form factor is more foreign. Ultimately, he thinks adoption will be significant but less than tablets, which a recent survey said are used by 30 to 40 percent of doctors depending on the size of the practice.

Augmedix founders, Ian Shakil and Pelu Tran, are building a Google Glass app for physicians.

Augmedix founders, Ian Shakil and Pelu Tran, are building a Google Glass app for physicians.

San Francisco-based Augmedix, which was recently joined the Rock Health startup accelerator, is also keeping the details of its service under wraps, saying only that it is exclusively focused on physicians because they have high salaries and overheads, are increasingly in short supply, and need to process a tremendous amount of information and documentation. It, too, plans to have a product ready for providers by the time Google Glass launches and says it’s already testing at multiple pilot sites.
But even the most ambitious developers acknowledge that creating apps for a new platform is a challenge. While he expects that Google will clean up its code by the time it officially launches Glass, Samani said the biggest hurdle in developing native Android apps for the platform is that it’s “incredibly buggy and undocumented.”

Liability and security

Other key areas that need to be ironed out are liability and security. Augmedix said that in their testing, patients (even those outside of tech-savvy San Francisco) are receptive to doctors using Google Glass. But that confidence could erode in the wake of a major breach (earlier this month, a researcher found a vulnerability that has since been patched up). And while video recording and sharing could be valuable Glass features, hospitals would need policies to mitigate risks to patient privacy.
If apps use Google’s cloud, that could be another issue for healthcare providers. Under new HIPAA rules, providers’ “business associates” have specific compliance obligations and it’s unlikely that Google wants to sign contracts formalizing that relationship, which means hospitals (if authorities checked) could be considered in violation of the rule, said Kirk Nahra, a partner at Washington, D.C.-based Wiley Rein LLP who specializes in health care.
But as he pointed out, Google Glass isn’t so unlike other new technologies that have come before. Its form factor may change the way people perceive and interact with it, but it’s hardly the first device to move into medicine that can capture video, collect data or process information.
“It’s like any other development,” he said. “It has a different feel and you have to think through how you’re going to protect it.”