By JULIE MINDA
It was during one of her son's recent medical appointments with his doctor that Maria Wallace witnessed the benefits that can come with new wearable technology for clinicians.
"I was discussing with Dr. Lundquist about my son's condition, and he asked me about this medication that he prescribed during the last medical visit," recalled Wallace, noting that she'd intended to ask Lundquist about that prescription during the visit with her disabled son but had forgotten to do so.
Dr. Erin Baldwin, a provider with Dignity Health Medical Foundation in Camarillo, Calif., wears Google Glass while speaking with a patient.
Wallace was so impressed that the doctor had followed up about the drugs that she asked him how he'd remembered them. "He explained to me that he's reading the medical chart on his glasses. I didn't even know because he was looking right at me.
"That made me really happy," Wallace said. "As a patient, you want your doctor to know what's going on and pay attention to you. Google Glass does that, and that's great."
Dr. Davin Lundquist is one of several doctors at Dignity Health Medical Foundation in Camarillo, Calif., who since January have been testing Dignity Health's new application of Google Glass technology. The medical foundation is the organization through which Dignity Health contracts its physicians. Google Glass is a wearable device — it looks like a pair of glasses — that can send and receive information electronically. Google Glass displays transmitted information and images on a tiny transparent screen in front of one of the wearer's eyes.
The Dignity Health application of the technology responds to spoken commands from the doctor/wearer to pull up test results and other information from the medical record during a patient's visits. The device also streams the audio and visual elements of patient visits and populates the patients' health records in real time — a proprietary feature developers say is made possible using a combination of software and human support.
The technology "allows our primary care proviuers to spend more time with patients," said Lundquist, who also is Dignity Health's chief medical information officer. "We eliminate the distraction of entering information into a patient's electronic medical record on the computer, enabling our health care providers to provide focused attention to, and interaction with, patients."
Doctors must verify the accuracy of all of the information that the software and human transcribers entered into the patient record during a live audio stream of the visit. But, Lundquist said, that verification takes a fraction of the time that the manual documentation had taken.
In search of innovation
Rich Roth, vice president of strategic innovation at San Francisco-based Dignity Health, helps lead the team that is bringing the Google Glass project to fruition. The team had been monitoring advances in wearable information technology devices, and as the devices became more practical for use in recent years (news reports say early prototypes of Google Glass weighed eight pounds; currently their weight is about the same as traditional glasses), the team began looking into how the technology might benefit Dignity Health clinicians.
To explore that question, team members got in touch with the San Francisco-based technology company Augmedix, which bills itself as "the world's first Google Glass start-up." Dignity Health enlisted Augmedix to implement and support the Google Glass application in the primary care environment. Dignity Health was a beta tester for Augmedix, which owns the software and can tailor its use for other health care providers, as it did for Dignity Health.
Roth said prior to signing on with Augmedix, his team had to satisfy potential concerns, including ensuring that all information transmitted to and from the device would be private and safe from hacking. Roth said a Dignity Health division that deals with privacy and data threats worked with Augmedix to ensure all transmissions happen on a secure private network maintained by Dignity Health and that the clinicians' Google glasses only operate on Augmedix's platform. The devices cannot access the Internet, only Dignity Health's and Augmedix's networks.
Patient acceptance
Prior to agreeing to expand Google Glass' use beyond the three pilot users, the Dignity Health team had to ensure that the main benefit the potential vendor promised — that clinicians would have more time with patients — was realistic and that patients would accept the cutting-edge technology. Google Glass has only become available to the general public within the last few months. Google began selling Google Glass to U.S. customers in the spring for $1,500. Few people have seen the devices, much less encountered them in a doctor's office.
The Dignity Health pilot with Lundquist and two of his physician colleagues helped Roth and his innovations team assess the use of the technology, since, according to Roth, "especially with start-ups, you need to look at data and measure outcomes — you can't just rely on the 'cool factor.'"
The pilot compared 523 of the doctors' visits before using Google Glass with 1,106 of their visits using the device. An analysis showed that the doctors spent 33 percent of their time charting and 35 percent providing direct care to patients without the device. They spent 9 percent of their time charting and 70 percent providing care with the device.
Lundquist admits he was among those who initially wondered whether patients would accept the device, but he said patient response has been "overwhelmingly" positive. Only 1 percent of patients in the pilot study requested their doctor not use Google Glass.
"Patients even get a little excited about the fact that their doctor is using a new technology," Lundquist said. "It gives them confidence that we're looking to whatever it takes to provide better care for them."
Lundquist added, "When (patients) come in now and see that I'm not typing, that I'm just sitting there, looking at them, waiting and listening and asking pointed questions about what's happening — they almost don't even notice I have (Google Glass) on there." This, despite the fact that patients know the device is in use, since they must give their consent prior to the start of their visit for the use of Google Glass.
Expansion
With the pilot completed and Augmedix selected as the official provider, Dignity Health now is planning to expand the use of Google Glass beyond the Camarillo medical office, although Roth declined to say which Dignity Health markets would be next in the rollout.
Lundquist colleague and fellow Google Glass user Dr. Erin Baldwin said she and her patients "love" the device. Baldwin said in a testimonial about the Dignity Health pilot, "There definitely are some aspects of medicine which I did not anticipate coming out of medical school, that is the paperwork, the workloads" and the heavy computer use. Because of the documentation burden, she said, "I actually considered getting out of medicine, and since I started using (Google Glass) I feel very hopeful that I can practice medicine the way I was trained to do."
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