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."
How much does Google stand to lose with something (Score:3)
How much does Google stand to lose with something bad happens?
As they may get sued if there is a mess up.
Re:How much does Google stand to lose with somethi (Score:4, Informative)
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.
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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.
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If they marketed it as medical-grade, I imagine they might well, yes. In this case, either Google is marketing Google Glass as medical-grade or, much more likely, doctors/hospitals have decided to use a non-medical-grade product as an aid in surgery.
What's the worst that could happen?
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Are you certain they use off-the-shelf computers in OR's? Frankly I got out of the medical electronics business a long time ago, but I recall that any electronic equipment had to be designed so that there was no chance of it creating a spark and doing fun things with the flammable anesthetics. Sparks don't have to be like the things you get from Tesla coils. For example, switches (even relatively low current/voltage) can produce small sparks. You might not even notice if you were looking. Also, something li
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We haven't used flammable anesthetics in the US in a looooooong time. Newer ORs don't even have the "restricted to nonflammable anesthetic agents only" signs.
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We haven't used flammable anesthetics in the US in a looooooong time.
Non-flammable? Wusses.
Like I said I got out of the medical electronics biz a looooooong time ago, and OR stuff wasn't our mainstay. Maybe even then it was a legacy thing in case somebody still had a few tanks of the good stuff lying around.
Thanks for the update.
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Some rural hospitals used the flammables as late as the seventies, but by around 1980 (AIUI) they were pretty much gone. The texts from the era about how to ensure a spark-free environment are pretty interesting, though. Staff had small chains that dragged on a conductive flooring surface, you couldn't use cautery, etc.
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Probably not much, as long as they got certified. From Justices Shield Medical Devices From Lawsuits [nytimes.com]
IANAL, this is not legal advice, etc.
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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?
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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.
Re:How much does Google stand to lose with somethi (Score:4, Insightful)
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.
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Re:How much does Google stand to lose with somethi (Score:4, Informative)
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.
Re:How much does Google stand to lose with somethi (Score:4, Informative)
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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.
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Surgical scrubs include shoe coverings that cover laces. Someone, somewhere, thought of that.
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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.
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What I'd like to see (Score:4, Interesting)
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.
"She-ing"? (Score:1)
Are you implying that this type of technology would only be useful in male-to-female sexual reassignment surgery?
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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
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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
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I have seen demos of exactly this. Don't know if it is on the market yet.
Voice activated (Score:2)
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.
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a UCSF cardiothoracic surgeon recently utilized Glass during procedures by utilizing its voice activation features to refer to patient x-ray scans
Shouldn't he have looked at those scans pre-operation? And people really think Google glass (a ui overlaying important, more relevant real life view) can replace a xray white board slightly to his left?
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I'd love to have a surgeon with an eidetic memory. Those are pretty rare, though.
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I don’t know about you, but when I plan a road trip or plan to hit multiple locations in a single trip I plan out my route. I then check my route as I go along. Don’t do things on the fly, don’t do things from memory.
Most medical errors at not the big things, it is failing to execute on the small things. Checklist move anesthesiologist from one of the most error prone (i.e. high rate of malpractice suits) to one of the least error prone. (not sure if google glasses is the way to go, but it
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Operations are complicated, messy, things, and surgeons are very interested in heads-up type displays to help answer questions like, "is my scalpel actually placed where I think it is?" Just like fighter pilots, they frequently do not want to take their eyes off of what they are doing. (I have worked in medical telepresence, and one of the things the surgeons most wanted was these kinds of headsup displays.)
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Medical software and hardware should be separately developed and certified.
Yes. Let's let a bunch of people die so that we can reduce the already microscopic risk of harm a bit further. Medical technologies are one place where we really, desperately need serious risk management.
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I see no reason to change my opinion.
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Anyone who trusts consumer hardware + OS as sufficiently robust to deliver faithful medical imaging in the middle of an operation is off my list of doctors I want operating on me.
So changing from Windows 7 with an imaging program to Glass is a step back? And Win7 with a commercial imaging program was a step back from having to mess with a pile of printouts? You want the surgeon focused on the patient, with supporting information available, not focused on accessing the supporting information, with breaks to cut on the patient.
Head Mirror 2.0 (Score:1)
So now instead of this [mentalfloss.com] we have this [digitaltrends.com]?
What about HIPPA compliance? (Score:1)
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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
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For more information, google it yourself.
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I saw person-portable "heads-up displays" in Radio-Electronics magazines 15 years ago. What's different this time?
That Google will be obtaining copies of patient's data. You know, for their files.
Great for colonoscopy (Score:1)
Finally, the NSA is really going to get up our asses.
Sterilization (Score:2)
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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.
More dehumanization in medicine (Score:2)
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.
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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.
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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.
Requirements for OR Electronics (Score:3)
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?
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Let me guess...you want the computers in the OR to have Linux on them.
combine with Clippy for even more fun (Score:5, Funny)
"Hi. You appear to be performing a heart transplant. Can I help?"
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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" :)
Video medical/surgical records (Score:2)
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!
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Gladly (or not), you'll be asleep when the doctor says "glass, erase the last ten minutes of the video"
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Actually I have a med/surg background.
So, I can stand a lot...
Totally Expected (Score:2)
I'm sure many glass users will wind up in operating rooms for trauma treatment and rectal extractions.
How can doctors secure it? (Score:3)
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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
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Nothing really stops you from changing the firmware on Google Glass to a custom one, with all of Google's spyware ripped out.
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 : (Score:1)
No, Just No (Score:2)
Google Glass's resolution is not anywhere near high enough for diagnostic imaging, doing this sort of crap would be illegal in most countries.
A true game changer (Score:1)
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How is this better than a huge-ass monitor?
And how do you sterilize them?
Re:Fuck that (Score:5, Funny)
From the bacteria, or the advertisements?
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Lets see, the amount of fuel needed will kill mileage.
I don't trust the way people drive on roads. Id hate to see the bad drivers when they have an entirely new dimension to operate in.
What about the specialized training needed for safe takeoff and landing.
WIll people be required to drive following roads, or just willy nilly over peoples property? What if they crash? Into your house?
I can't i
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Is really another 1940's "Flying Car" scenario?
Yeah, you can make them, but there is no market for the damn thing.
(And they keep the hype up because they won't admit it is a market failure.)
No. "They" keep the hype up because there are still plenty of marks out there, willing to invest in flying cars. Paul Moller has monetized his Skycar for fifty years.
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But yes, they are no different than a monitor. I'm not sure why people are so frightened by a monitor. It is a voice controlled computer with monitor. So the doctor can do it himself (with voice commands) rather than bark orders at a nurse for what to display on the big-ass monitor. Or, in the old day, a separate table he had to look at with the printed materials on it, barking orders for someone else to change pages.
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I imagine they'd be easier to sterilize than a huge-ass monitor.
Huge-ass monitor can be behind a glass screen. Blast it with some antiseptic, job done.
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a huge-ass monitor.
I believe that would be a colonoscope.
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Very little is sterilized - most stuff is sanitized. Generally anything which touches the patient is sterile; the rest is sanitary. By their very nature most if not all ORs are impossible to sterilize. There are some cheap and effective measures which can be used but each also has its own drawbacks and gotchas, among them live steam, UV bath, ozone, and bleach and alcohol mists. It boils down to real-world realities, risks and costs, and practicality.
It's unfortunate state of affairs in that it's routin
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I've had four full-on procedures in the past year and was on a heavy regime of antibiotics after every one, with two infections acquired either from OR or hospital, and two that I had going in
But do you know that those infections are due to the distinction in the OR between sanitary and sterile? Some countries (e.g. Norway, IIRC) have done a good job of reducing nosocomial infections. Have they done away with this distinction? If nothing else I heard that sheep dipping the OR personnel in antiseptic had some undesirable side effects.
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Nope, dunno. Without swab and such, no way to find out. Personally I think it would be of service to do so, but the matter of expensive time and testing would likely be brought up as a bar to it.
Generally, as I understand it, if sterile extends to what contacts the patient, all else is sanitized (this means knocking down any critter population to a level that is inconsequential (based on averages, perhaps, although that's a more forgiving measure than I'm prepared to accept out of hand), the basic isolati
Re:Fuck that (Score:4, Funny)
How is this better than a huge-ass monitor?
Obviously there are some operations - especially in the US - where only a huge ass-monitor will do.
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I thought the ass-monitor was post operation.
Shows what I know about medicine.
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Easy. Far fewer disruptive head motions.
If my surgeon is deep into my chest cavity, I'd like him to have as much information on a heads up display as possible. Every repetitive head motion back and forth is a risk that a scalpel slips a bit as the rest of his body moves, cutting something important or just adding unnecessary lacerations to my insides.
Granted, robotic surgery is on its way. For the time being, though, there isn't anything quite as agile and responsive as a well trained surgeon's hands, even
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Probably keep it out of the sterile field
It's on his face.
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