The new simulation-based project will train medical students to use augmented reality when visiting patients at home.
A community RN enters the home of an elderly patient for a follow up visit, wearing a device that brings the full suite of hospital technology, specialists, and resources with her. The device she uses is small and almost invisible, and it’s compatible with any available source of connectivity from WiFi to cell to satellite, providing real-time telemedicine where the patient needs it. Associated bots test the carpet for dangerous molds, an artificial intelligence identifies which specialists should be consulted, and queues up their attention automatically.
Through the eyes and ears of the onsite provider, a pharmacist reviews medications checking for dangerous interactions against the contents of the medicine cabinet, and a dietitian provides recommendations based on the contents of the refrigerator. With the provider’s eyes and hands free to examine and talk with the patient, the full picture of the patient’s needs is seen, heard, and addressed efficiently, effectively, and with a caring human touch.
This vision of the future is closer than one might think. With the recent release of Google Glass Enterprise and integrated swyMed transport protocols and software, providers and students at Loyola University Hospital will soon lay the groundwork for this dramatic change in health care delivery. A pilot program beginning late this summer will use simulations to develop best practices and procedures for using the Glass Enterprise technology and swyMed software by bringing back the home visit with a high-tech twist.
“This program is really about connecting with our patients in ways greater than what we are doing now, exploring those new ways, leveraging the technology to do so,” explains Capers Harper, Manager of the Virtual Medicine Program at Loyola University. “We are studying combining the clinical communication technology of swyMed with the hardware of the Enterprise Edition Glass technology and how that works in our focus of providing the human touch to our patients.”
Launched in 2012, Google Glass Explorer featured line-of-sight app access and video streaming, but was not well received by the public. Not only was the consumer product buggy and awkward to wear, the technology was perceived as invasive and was even banned in some places due to privacy concerns. These problems led to Google stepping back from the product in 2015 with their website stating, “Thanks for exploring with us.”
In the background, however, industries were finding that with custom software applications, the early edition of Glass was generating astounding results. Google quietly shifted focus into working with these partners to develop both new hardware and purpose-driven application software to better meet the needs of companies like GE, Boeing, and DHL, turning the technology from a high-tech toy into its naturally developing niche as a valuable tool of industry. Improvements to the Enterprise Edition hardware include better connectivity, longer battery life, faster processing, an upgraded camera, lighter weight, less heat generation, and the ability to use the device on a variety of frames including safety glasses and prescription eyeglasses.
The Enterprise Edition is only available through the Glass Partners program, which includes companies such as swyMed, Ubimax, Upskill, Aira, and Augmedix who are producing integrated software for a variety of industrial, medical, and assistive applications. Evie Jennes, CCO of swyMed states, “The reason that Google wanted us to become part of the program is because our software works on low bandwidth. We are bringing more reliability in these particular use cases that Glass will actually be able to stream. We were attracted to it because we knew we wanted to focus on the mobile side (of telemedicine), and this would add a big advantage to our providers on the patient side.”
These advances were crucial to the upcoming pilot program as noted by Marcus Shipley, CIO of Trinity Health. “By nature of being an enterprise solution, that’s what you will see that you didn’t see in the consumer world. They are putting optimization software into the platform that is purpose built for our situation.”
SwyMed’s patented transport protocols provide real-time audio and video, integrating with the Google Glass hardware to increase speed and reliability in mobile applications. To support that connectivity, swyMed has developed the DOT backpack, which serves to utilize any available WiFi or cell signal, allowing Glass to function in almost any environment. A remote satellite beacon is in development that will provide the necessary signal even if cell towers are not in range or are overloaded, a known issue during rescue or disaster scenarios.
As Jennes describes it, “We basically break up the data in such tiny little pieces that we can push it through a very small pipe, and then we organize it on the other side very quickly. That’s where our focus is. We built this backpack strictly as an enabler of the software… The backpack is brought in if there’s a connectivity issue—so in disaster response, community paramedicine, mobile tele-stroke, or remote triage.” With this innovative solution, bandwidth, cell signal, and wifi connections are no longer limiting factors for the Glass technology.
Innovative Onsite Care
“Getting that connection between patient and provider on a routine, regular, and consistent basis—that is the best way we can impact the health of our patient,” says Capers Harper. As part of Trinity Health’s Innovation Program, Loyola University Hospital will be piloting the technology in simulations of home visits to train secondary providers and medical students on this “high tech/high touch” technology, allowing “a hands-on approach to their next generation of patient, next generation of clinical technologies, and the next level of patient care.” When the process and results have been well established in simulation, the technology will move into practice. “We believe the technology is ready now,” says Harper. “This simulation will test that.”
As technology is being adopted in health care at a rapid rate, it can sometimes be seen or felt as invasive to the patient/provider experience. Holding a camera, wearing a microphone, entering notes into a device are all activities that prevent direct eye contact and the full engagement of the provider with the patient. Harper explains, “What we are looking to show through this simulation is that by having a wearable eyes and ears approach to this, it frees up the hands of the secondary provider. They are not holding a piece of technology. It is not getting in the way…We are just having a regular interaction with that patient.”
As Shipley elaborates, “It gives these physicians literally eyes and ears into the patient’s lives and homes. It gives us a way to look deeper into their unique experiences, to really meet them where they are and tailor our experiences accordingly. Our elderly and community benefit population of the poor and under-served is front and center to our mission. It will allow us to more seamlessly bring in the entire care team that supports that person at home, and this is all going to happen with no intrusion of the technology into the process. Can you imagine how much more awareness we will have of the real need of the patient when we are in their home?”
Given the projected shortage of primary care physicians, enabling a multi-disciplinary team to be virtually present in the home of the patient will increase efficiency while raising the quality of care: a truly innovative win-win.
“We hope that a positive outcome from the project will lead us to use this and leverage this wherever the patient may be—to serve their need wherever they are,” said Harper. Through the program, Loyola’s secondary providers will bring a network of services to the patient in a single visit, eliminating no-shows and streamlining the path to successful treatment, as well as allowing primary care providers to see more patients in a more impactful way.
Through this Looking (and Listening) Glass, these next-generation care providers may truly reverse the impacts of isolation and provide patients with access to a dream team of experts without leaving home. Any needed specialist may be instantly onsite no matter how remote the location and never again be limited by bandwidth or signal in providing life-saving care and guidance. Now we can see through a Glass, clearly, a future where telemedicine is so advanced, it’s invisible.