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Google Medicine

Google Glass Making Its Way Into Operating Rooms 120

kkleiner writes "Among the possible uses for Google Glass that early adopters are dreaming up, you can now add 'surgical assistance' to the list. With approval from the institutional review board, a UCSF cardiothoracic surgeon recently utilized Glass during procedures by utilizing its voice activation features to refer to patient x-ray scans. Aimed at providing surgeons with the most up-to-date patient data, a startup named VitaMedicals is building apps to stream in patient records and live scans to the device. Even though it's early days for Glass, its potential in the medical space is huge and could revolutionize how doctor's access and apply information from patient records."
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Google Glass Making Its Way Into Operating Rooms

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  • How much does Google stand to lose with something bad happens?

    As they may get sued if there is a mess up.

    • by ArmoredDragon ( 3450605 ) on Monday December 02, 2013 @01:17PM (#45575595)

      I doubt it, all they have to do is state that they never intended it for medical use. So long as they don't advertise it as such, they're fine, any liability is on the doc and/or hospital.

      • by Anonymous Coward

        Then it will "Never" be used in medicine, There are Laws/Regs. that "ANYTHING" used in medicine must be designed and more importantly carry liability Insurance from the Manufacture.

    • Re: (Score:3, Informative)

      by AK Marc ( 707885 )
      Normally there'd be a computer, and the doctor would shout directions to a nurse that would bring up the images. The screen is not a "medical device" and if the computer crashed, it wouldn't bring liability on Dell or MS. It isn't a "medical device" but an imaging device.

      Holding Glass liable in that situation would be like suing Nike if the doctor tripped over his laces, as I rarely see doctors barefoot, shoes must be medical devices, right?
      • by Anonymous Coward

        You are mistaken. A screen showing data and providing feedback to the surgeon is a medical instrument. It's the same a blood pressure monitor showing the sensor data. If you display erroneous information the you will be liable.

        • by Webcommando ( 755831 ) on Monday December 02, 2013 @01:43PM (#45575879) Homepage Journal

          If you display erroneous information the you will be liable.

          Previous poster pointed out that this is true if sold as a medical device by an OEM. Medical device OEMs have a strict set of guidelines they need to follow for the creation of these devices--risk management, CAPA processes, demonstration that design outputs are tested against design inputs. (FDA 21 CFR Part 820, for example)

          That being said, a hospital has a much less stringent set of requirements (though I believe there is much discussion in the FDA related to this). With the proper research agreements, IRB review (Institutional Review Board), and following proper research procedures (e.g. patient consent), a doctor can try new ideas, technology, or off-label use of existing device. However, Google would not be liable unless they want to sell a healthcare version.

        • by AK Marc ( 707885 )
          So the Dell screen I've seen in an OR is a licensed medical device because it could show medical information? I don't believe you.
          • No, but the software on it is. The Dell monitor was implemented by the solution provider and tested to be capable for the job.
            • by AK Marc ( 707885 )
              I don't believe you. When I looked, the only licensed software are the packages that include diagnostic functions. If it's purely a display, it doesn't need to be certified any more than the paper that holds the bill for your OR visit.
              • by ColdWetDog ( 752185 ) on Monday December 02, 2013 @02:38PM (#45576361) Homepage

                You're correct. We have monitors all over the place. In the OR / ER / nurses station. We transmit patient data all of the time. Images / text. We buy whatever we need from the open market. I've had a bit of an issue getting IT not to buy the absolute cheapest panels on the planet, but anything mid spec these days is perfectly fine.

                Anything electrical needs to pass some simple leakage tests, but our bio med tech does this on every piece of electronic equipment at least once a year anyway. But no certification is required.

                Radiologist like these idiot expensive BARCO monitors (about 5 grand a pop). They have a 16 bit data path from the card to the screen (everybody else uses 8 or 10 except most laptops which are typically 6 bit paths) and do a wonderful job of greyscale display, but they're not 'medical' devices.

                • But they are medical devices as they are diagnostic quality monitors. 5 grand a pop is cheap. Typically for a 5 Megapixel monitor pair and video card we would be 27 grand. The reason you need 5 Megapixel is because it is what is required by the FDA to interpret diagnostic mammography. The manufacturer has to show that the monitor complies with DICOM rendering standards and they have to be calibrated by a physicist regularly. For MRI, Ultrasound, and Computed Tomography (CT) a typical monitor can be used. Digital Computed Radiography (CR) aka Digital X-Ray, you need at least a 3 Megapixel monitor to properly display the diagnostic information contained in the images.
      • by zlives ( 2009072 )

        this is why the doctor has liability insurance, if he does trip and stab the patient or look at a wrong chart, he is liable not the device.

      • Surgical scrubs include shoe coverings that cover laces. Someone, somewhere, thought of that.

    • Uh, why would they even be responsible?

      As they would easily laugh this out of court, google is also not someone you mess with legally.

    • by Tr3vin ( 1220548 )
      Google isn't at risk as long as they are not selling it as a medical device. If someone wanted to create specific medical software for it they could but they would most likely need to file for FDA clearance. If something bad did happen, it would be on the entity that created the app and not Google.
    • There's often no rhyme or reason or even logic to lawsuits [wikipedia.org], so the second point is null. The answer to your first point is "probably less than they make in like a nanosecond."
  • What I'd like to see (Score:4, Interesting)

    by QilessQi ( 2044624 ) on Monday December 02, 2013 @01:11PM (#45575541)

    This is probably years away, but if X-rays/CT scans/realtime data/etc. could be turned into a 3-D image, and the coordinates of that image "georegistered" with the patient on the table, we'd have an AR system capable of overlaying invisible information onto what the surgeon is sheeing as he/she operates.

    E.g., superimposing the outlines of a tumor onto the surgeon's visual field "beyond" the visible surface of the body, so that the surgeon sees exactly where to cut and how deep.

    • by Anonymous Coward

      Are you implying that this type of technology would only be useful in male-to-female sexual reassignment surgery?

    • by Anonymous Coward

      it already exists and its called image guided surgery with its many many different approaches and applications. yes, believe it or not, people have thought of that idea. the google glass thing is just another extension of a HUD. and by the way, its not so clear cut as to whether a HUD is useful in all surgical applications. see this decent little article which explains why:
      http://www.brisbanetimes.com.au/comment/surgery-blinded-by-google-glass-advances-20130422-2iad9.html

      • it already exists and its called image guided surgery with its many many different approaches and applications. yes, believe it or not, people have thought of that idea. the google glass thing is just another extension of a HUD ...

        But, but, but ... nobody could have thought of it before. It's not from a cool company like Google or even Silicon Valley. It's impossible I tell you.

        This is why, despite the fact that there's still some great tech there, I think SV's main product has become hype. You don't have to look hard to find similar devices older than Google glass - the Wikipedia article has even has links. IIRC correctly another use for these types of HUD/camera/wireless devices is in things like aircraft repair. Crawl into some cr

    • by mbone ( 558574 )

      I have seen demos of exactly this. Don't know if it is on the market yet.

  • What's really in the "John Doe Xrays" folder?
    Surgeons were one of the few who couldn't easily "multitask" on the job.

    Let me also move my Cyber Monday surgery, just to be safe.

  • So now instead of this [mentalfloss.com] we have this [digitaltrends.com]?

  • This is a really interesting application, but I can't even begin to imagine the challenges with patient privacy on a platform like this.
    • Acronym Nazi reminds you it's HIPAA.
    • by AK Marc ( 707885 )
      Load up the images on SD card, and turn off transmit. What possible HIPAA issues could there be? Not that I take HIPAA concerns seriously from someone who doesn't know what it is. Sound it out if you forget how to spell it
      • Load up the images on SD card, and turn off transmit. What possible HIPAA issues could there be?

        If you read the article, you'd know that the images were being "transmitted over wi-fi" during the surgery. I'm guessing that means they were on the guy's Google Drive; but in any case they weren't pre-loaded onto Glass.

        And the article also talked about "manually scrubbing" all patient info from the images to comply with privacy guidelines. I have a hard time believing that would be enough - it's not like a surgeon does hundreds of surgeries in a day, it'd be fairly easy to match an image to a patient.

        Me, n

  • by Anonymous Coward

    Finally, the NSA is really going to get up our asses.

  • So how are they going to sterilize it? It is a piece of commercial kit and should not come close to an operating theatre.
    • If its in the US, they will just throw it away and charge your health care provider for a new one. Your provider will raise everyone's rates. You will still pay more than everyone else in the world.
    • Europeans' English is always so amusing. "Operating theatre" like everybody is having their spleen taken out in an old timey lecture hall surrounded by tiers of murmuring onlookers at a university. The 19th century called and they want their conventions back.
    • Why would it need to be sterilized? It's on a person's face, probably the dirtiest place in the OR. Or are you suggesting that we autoclave all the other surgeons' premium eyewear?

      The disposable plastic face shield goes in front of the dirty bacteria-ridden face, glasses or not.

  • In recent years, during doctor visits about 50-80% of their time was spent looking at computer (or tablet) screen, reading, typing etc. So the time actually looking at and/or examining the patient is already a minority. Add "Google glass" - and they are not really "looking at a patient" even when they do. Great.

    • You sound like the kind of person for whom the Google Glass is always half empty.
    • I'm sort of hoping my surgeon isn't staring deeply into my eyes to make that vital human connection while I'm strapped down unconscious in the OR.

    • Well, if we didn't have to document several fold more, and got paid less for interacting with patients, we may do it. As it stands, unless a doctor is doing something to you, he/she is unlikely to get paid much. Obviously there are upsides and downsides to a system that rewards cutting but not measuring.

  • by mbone ( 558574 ) on Monday December 02, 2013 @01:49PM (#45575935)

    "Among the possible uses for Google Glass that early adopters are dreaming up, you can now add 'surgical assistance' to the list. With approval from the institutional review board, a UCSF cardiothoracic surgeon recently utilized Glass during procedures ..."

    I have been involved with getting electronics into operating rooms, and it is an expensive, complicated and time consuming process. FDA requirements [fda.gov] apply to all medical devices; with RFI [ce-mag.com] being a big problem, especially in an OR environment (which is full of "mission critical" electronic gear). To be blunt, if Google glass interferes with the electronics already in the OR, patients could die, and everyone involved with getting it there would be directly responsible.

    From my perspective, the note-worthy thing about this story would be getting the certification needed to take Google Glass into the OR, as that would probably be the hardest thing to do, much harder than some trivial HIPAA scrubbing, and it puzzles me that that is not mentioned in the article. So, I have to wonder, did they actually do this, or is Google and UCSF just winging it and hoping no one dies during their trials?

  • by SylvesterTheCat ( 321686 ) on Monday December 02, 2013 @01:59PM (#45576041)

    "Hi. You appear to be performing a heart transplant. Can I help?"

    • by youn ( 1516637 )

      reminds me of a cartoon where the doctor goes "nurse, could you please go to surgery.com and click the I am lost button"... the variation is you can ask google glass directly.... "ok google, help out, I am completely lost here" :)

  • Yeah. This is me taking out your spleen.
    That's Nurse Ratchet juggling it.
    Wait...that was your kidney...
    Why are there two of them?
    Oh crap!

  • I'm sure many glass users will wind up in operating rooms for trauma treatment and rectal extractions.

  • by Slugster ( 635830 ) on Monday December 02, 2013 @05:12PM (#45578027)
    I was under the impression that (US) doctors had to maintain medical record security. If Google is able to monitor everything the glasses are used for, how would this be possible?
    • I was under the impression that (US) doctors had to maintain medical record security. If Google is able to monitor everything the glasses are used for, how would this be possible?

      The medical institution would have to have Google sign a HIPAA form and make sure the transfer was secure. Although this is not really impossible, Google would pretty much just have to form a separate healthcare department and handle those Google Glass streams with proper security, given that they have not done so with their email yet, I doubt they'll go through the trouble to do so with Google Glass. The other solutions would be to encrypt the stream from glasses to hospital server so Google is monitoring

    • by dido ( 9125 )

      Nothing really stops you from changing the firmware on Google Glass to a custom one, with all of Google's spyware ripped out.

      Not to bring anybody down... but seriously... we intentionally left the device unlocked so you guys could hack it and do crazy fun shit with it. --- Stephen Lau, Google X Lab [google.com]

      There's source code available for the kernel as required by the GPL as well as for other essential components, so custom firmware is definitely possible for it. Someone out there will probably eventually wind up

  • Google Glass Seems to be a Great innovation in technology . if they can access all the patient data within the eyesight using google glass error free accurate operations could be possible which will directly result in high survival rate. we are surely entered in the advance future technology with google glasss
  • Google Glass's resolution is not anywhere near high enough for diagnostic imaging, doing this sort of crap would be illegal in most countries.

  • I want to get my hands on them. I think they are going to change everything. Just think, no more selfies!

One man's constant is another man's variable. -- A.J. Perlis

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