ok glass : help me be more patient centered

These are images from the Google Glass Tech Focus that we filmed at the Kaiser Permanente Center for Total Health (@kptotalhealth) on July 11, 2013 (see: Photo Friday: Technology Focus Broadcast , featuring Google Glass | Ted Eytan, MD), which are actually mockups because Google Glass (@GoogleGlass) can’t do this automatically .. yet. Now that I’ve had some time to work with Glass, I can see a situation where a QR code might be presented on the exam room monitor or somewhere else in the workflow to allow the practitioner quick access to electronic health record details, or of course through voice commands (but I think QR might be quicker..).

There is a lot of discussion about using Glass for surgery and high tech health care (and there’s nothing wrong with that, I love surgeons and was trained by excellent ones as a family physician), so we created a scenario that involves using technology to connect us to patients better.

In the image above, you can see that the device is helping the clinician/practitioner know how the patient would like to be addressed, including the correct pronoun (whose incorrect use can be a source of disempowerment for vulnerable populations, especially trans people – see Now Reading: Electronic medical records and the transgender patient – to eliminate, not create, disparities | Ted Eytan, MD ), occupation, languages spoken, and where the patient lives.

These may seem like obvious pieces of knowledge for us to have to the lay community, however, I have observed many a clinician visit where the physician/nurse/clinician doesn’t ask or inquire about what the patient does during the day, where they live, or what their “health” environment is like. At the same time, I have seen the converse (and have always asked myself), and see how it changes the interaction to be much more tailored to the patient’s life goals rather than their biologic status.

You’ll see the next screen shows a map of Mrs. Smith’s neighborhood and the location of the nearest farmer’s market, again going beyond health care and supporting total health of Susan and her family. (Credit to Washington, DC’s MV Jantzen (@mvs202) for creation of cool Google Map / USDA Farmer’s market mashup. Innovation is everywhere around this city.

Could wearable technology help remind/support the human side of the relationship in the exam room and beyond? See what you think. Thanks to Yen Greene (@yengreene), the operations manager of the Center for Total Health for acting in the role of Mrs. Susan Smith, and Stephanie Nguyen (@nguyenist) of Washington, DC’s Silica Labs (@silicalabs) for her awesome graphic artistry. Comments welcome.


Hello Dr. E – Watching this demo in real life may address some of my quibbles, but I’m concerned that the entire focus here (as it always is elsewhere too when it comes to Google Glass) is restricted to the Glass-wearing physician’s perspective.
From a patient’s perspective, here’s what it’s like: I’ll be sitting there, waiting patiently in the exam room for my doctor to enter, and when she arrives, I’ll look up at my Glass-wearing doctor’s face – even more intently than usual, in fact, because she’s now sporting this dorky new eyewear. Which she will have to explain in considerable time-consuming detail for me and every other patient who’s seeing Glass for the first time.

But she is not looking at me.  Instead of making normal eye contact with me, or asking about my kids, or attempting to put me at ease because I’m there to learn my latest test results, my doc’s eyes will regularly flit skyward as she reads informational text about me on the small screen above her right eye.  Real live conversation will be awkwardly interrupted because she can’t talk and read the small screen info at the same time. In between, she is tapping, scanning, and (oh please!) using voice commands to move from screen to screen to retrieve yet more data about me.

Honestly, I find it difficult to imagine how any physician who “doesn’t
ask or inquire about what the patient does during the day, where they
live, or what their health environment is like” is somehow going to turn into the kind of physician who gives a damn about such things simply because one of many, many Glass screens can offers this and far more data.   
Exciting whiz-bang technology? Yes. 
Technology that will enhance doctor-patient communication or the patient’s actual lived experience of each physician visit?  The answer may emerge only when doctors walk a mile in our hospital booties.

Google Glass and Patient-Centered Care? We Patients Need Google Glass!
The following is from my column Google Glass and the Future of Healthcare …
What will patients think when they see their physician wearing Glass? In my opinion, it will become just another tool they associate with healthcare workers (less obtrusive than the head mirror that used to be a symbol of the medical profession). The bigger question should be, what will physicians and others think when they see a patient wearing Glass? 
Glass won’t disrupt and transform healthcare unless patients, not just providers, begin to use it (I told you I was going out on a limb! I know lots who’d disagree!). I look forward (well, sort of) to Glass telling me how many calories are in that second slice of cheesecake, that 65 percent of my followers forgo it – in real-time, while I’m reaching for it. 
When a busy specialist lists alternatives and contraindications heading out the exam room door, I want to review the video, including automatically inserted links. God forbid, someday, when I am (hopefully temporarily) too weak to lift a mouse or smartphone, let alone a tablet, I want to stay in touch with relatives, friends, and colleagues. 
Soon, if it hasn’t already happened, someone will emerge from surgery and his or her first words will be, “Where’s my Glass? Could you put it on me? OK Glass…” And, if someone doesn’t happen to own Glass, give them one when admitted, to help navigate from place to place, to access educational material, and to, generally, pass the time in a more interactive way than staring at the hospital room TV.
So, yes, I predict Google Glass will have a big impact, used by clinicians, on healthcare. But it’ll have an even bigger impact on healthcare if it is wildly successful outside healthcare. 
Let’s just say I’d like patients and physicians to meet eye-to-eye, so to speak.  
Doctors Are Patients Too

Carolyn Thomas Hello Carolyn, and please, call me Ted!
If the scenario you depict comes to pass, we should all be dissatisfied.
What we do here every day, is figure out how to use technology to connect better, not to get in the way of a connection. What you describe is very much getting in the way, and your comment is instructive for anyone coming to this space.
In the actual event, we did film a segment from the patient’s perspective – she was wearing glass while her practitioner was talking to her about post-discharge diet and activity.
To your comment about will this turn into a physician that is more ..(fill in your desired quality)….I would say, “we don’t know, we should find out, because this is the kind of physician we want to have, the kind that knows who I am as much as what my health is like.” I don’t think I’ve met a physician that wants patients to be in poorer health, so I don’t think we’re trying to change the person, we’re trying to remind them of what helps the person they serve.
…and imagine what it would be like if physicians could walk in their patients’ footsteps. Stay tuned, we are doing more with Glass than the 10 photographs above can show. We didn’t even have our own devices when these mockups were made, part of the innovation journey,

Ted Eytan, MD