Wearable computing at BIDMC

By John Halamka
08:19 AM

Here’s a real BIDMC experience described by Dr. Steve Horng:

"Over the past 3 months, I have been using Google Glass clinically while working in the Emergency Department. This user experience has been fundamentally different than our previous experiences with Tablets and Smartphones. As a wearable device that is always on and ready, it has remarkably streamlined clinical workflows that involve information gathering.

For example, I was paged emergently to one of our resuscitation bays to take care of a patient who was having a massive brain bleed. One of the management priorities for brain bleeds is to quickly control blood pressure to slow down progression of the bleed. All he could tell us was that he had severe allergic reactions to blood pressure medications, but couldn’t remember their names, but that it was all in the computer. Unfortunately, this scenario is not unusual. Patients in extremis are often overwhelmed and unable to provide information as they normally would. We must often assess and mitigate life threats before having fully reviewed a patient’s previous history. Google glass enabled me to view this patient’s allergy information and current medication regimen without having to excuse myself to login to a computer, or even loose eye contact. It turned out that he was also on blood thinners that needed to be emergently reversed. By having this information readily available at the bedside, we were able to quickly start both antihypertensive therapy and reversal medications for his blood thinners, treatments that if delayed could lead to permanent disability and even death. I believe the ability to access and confirm clinical information at the bedside is one of the strongest features of Google Glass. "

We have been live clinically with Google Glass for a limited set of four emergency physicians serving as beta users since 12/17/13. Since then, we have been working on improving stability and adding features to improve usability. Some of these modifications include the addition of an external battery pack, increasing the wireless transmission power, pairing the headset with our clinical iPhones, using head tilt to control vertical scrolling, revamping our QRcode reader to improve application stability, adding an android status bar to show wireless connection strength and battery power.

In addition to our four beta users, we've also had impromptu testing with at least 10 other staff members since 1/24/14 to get feedback to refine the user experience.

As a device being used in clinical care, we needed to rigorously test our setup to ensure that the application is not only reliable and intuitive, but improved the workflow of clinicians rather than impede it.

I believe wearable computing will replace tablet-based computing for many clinicians who need their hands free and instant access to information.

After almost 3 months of beta testing, we anticipate a full roll-out to all interested clinical providers in the ED within the next 2 weeks.

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