Google GLASS timeline. Is Medicine embracing change quicker?

April 19, 2014 Leave a comment

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Tele-Mentor gives procedure impacting advice to Interventional Cardiologist performing PFO closure through Google GLASS

November 26, 2013 4 comments

In the past, fellow GLASS Explorers like Rafael Grossman and Heather Evans have demonstrated how Google GLASS can help doctors obtain important recommendations from other experts via live-streaming.

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In a recent sequence of serendipitous events occurring at UAMS,  Dr. Eudice Fontenot, Pediatric Interventional Cardiologist from Arkansas Children’s Hospital provided valuable insight to a team of interventional cardiologists (Dr. Barry Uretsky, Dr. Abdul Hakeem and GLASS explorer Dr. Christian Assad-Kottner) who  performed  a Patent Foramen Ovale  (PFO) Closure

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PFO closures are usually performed in children and adolescents who have symptoms secondary to significant Right to Left shunts, in non-medical terms, significant non-oxygenated blood mixing with oxygenated blood.  On occasion, secondary to anatomical changes in adulthood, a PFO which was not significant can turn into a defect which needs correction. Such was the case we recently encountered. A PFO closure is not something performed frequently in adults, and an even an expert interventional cardiologist could have accumulated 25-50 cases through their career. Even though the procedure could have been done safely by the operator, we decided to contact a pediatric interventional cardiologist, who performs this procedure  more frequently.

 

Uretsky agreeing with Fontenot and retrieving amplatzer with Dr. hakeem. ThROUGHGLASS

This is where we saw an opportunity to  use of Google GLASS as a way of Livestreaming the procedure to the telementor and obtain his advice in real time. The next step was obvious, before anything, I spoke in detail with the patient (which by the way I will be disclosing his name soon because he wants me to do so as well as his family). I explained to him how we would use GLASS and Hangouts to stream the procedure to an expert who has abundant experience on PFO closures on children, and if needed he could instantly provide his advice. Needless to say, he understood the potential of such a dynamic and was excited to be part of it.

Nov 19 the procedure occurred. We initially had planned to stream the hangout to the tele-mentor at Arkansas Children’s Hospital, but due to heavily leaded walls in the catheterization lab affecting the current data connection, and GLASS being a beta-gadget, we decided to have the expert nearby in case we needed him.

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Patient was anesthetized, intubated, and  Transesophageal echocardiogram  performed to guide the implantation of the Amplatzer closure device. Shortly after, access was obtained with a femoral sheath and the device was inserted and advanced to the left atrium across the PFO. At this point in time, the interventional cardiology team spotted a mobile artifact within the tip of the amplatzer highly suggestive of thrombus. These images were transmitted live to the tele-mentor who agreed on the diagnosis and suggested at this point to retrieve the device to avoid the possibility of a thromboembolic event. When the device was retrieved, we confirmed our suspicion, a thrombus in the tip of the amplatzer was observed. The tele-mentor further guided us on how to flush the sheath and adequately clean the thrombus from the device. At this point in time we decided to end transmission and ask the tele-mentor to come to  the cath lab to provide further recommendations.  Soon after the device was reinserted, deployed with excellent angiographic, echocardiographic and physiologic results.  Procedure was a success and patient was subsequently discharged with adequate arterial oxygen saturation, effectively treating his problem.

After discussion with my colleague and Google GLASS pioneer Rafael Grossman MD, we agreed that this was the first time that the advice given by an expert through Google GLASS directly impacted and helped the decisions made in a medical procedure.

Example of looking at TEE monitor with GLASS to demonstrate quality

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AMplatzer deployed without complications

Whole story to be released soon via another source, with procedure pictures, names and more details

Twitter: https://twitter.com/Christianassad

Categories: Health, Social Media, TechMed

Are we protecting patient information more than the patient?

September 23, 2013 1 comment

We are living an era of disruption in which exponential technologies have the potential to change dramatically the way medicine is practiced but in order to do so certain regulations need to also do so.

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As other Medical Google GLASS explorers, I am disappointed and frustrated on the concern of incorporating such technology in a faster pace in the hospital. Yes, there are pros and cons but let me mention what is the most important pro, PATIENT OUTCOMES!

Every time I stumble with people asking me about what GLASS can do, I am happy to do so. In addition I tell them about my projects in medicine as well as how colleagues are using them in telemedicine and telementoring like Rafael Grossman. Needless to say they are all impressed. After talking with them I go ahead and describe a scenario.

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“Imagine you are in the cathlab or in the operating room and your doctor is performing a particular procedure.Suddenly he/she faces a situation in which he would like a second opinion from a colleague to make sure he is making the right call. In order to do this your doctor could use Google GLASS and communicate via HANGOUTS. Your information could be intercepted by wandering eyes in the transfer, but at the end your doctor will get relevant feedback. If this impacted your outcome, would you care about your privacy in this point in time?

So far, out of approximately 50 people I have asked this question, 100% said they could not care less. If this will help the doctor GO AHEAD! It is the patient’s data! Shouldn’t he/she decide how it is going to be used?

The reader may argue on this but, If I am the patient, and my doctor wants a second opinion from another doctor, and this implies him using google glass in a non secured network to impact outcome. I could not care less…

Thoughts?

Categories: Health, Social Media, TechMed

Installing Native Apps in Google Glass: The simple way

September 1, 2013 Leave a comment
8694573611_777ace4e4f_bOne of the coolest things in Google Glass right now is installing Native Apps. Some Glass explorers are not developers, and therefore do not know how to do this…Here is a simple set of instructions (made by an md ;) to get you goingFirst Download ADB platform for NON-DEVELOPERS:
I. Non-Developers like me:http://esausilva.com/misc/android/platform-tools-osx.zip
If you are a developer… You dont need advice from a noob
II. Get Launchy.APK
http://www.androidfilehost.com/?fid=22979706399752795Do not get overwhelmed. It is easier than it looks…
=========================================================
In order to get ADB to work you must go to terminal
1) Get info of location where you have adb (cd /Users/X-Tian/Desktop/adb)
2) To take make sure Glass is detected by your computer
a. type ./adb devices
3) To install something
a. ./adb install -r /(directory/theapplication you want to install.apk)
4) To see all the junk you have installed
a. type ./adb shell
b. pm list packages
5) If you want to uninstall something. Identify the package and the uninstall
a. ./adb uninstall (package name) ex (./adb uninstall crystalshopper.android)

More helpful info at:
http://songz.quora.com/How-to-run-Android-Apps-on-Google-Glass

Thanks to Cecilia Abadie for helping me out

AbRipper for Google GLASS

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Categories: Health, TechMed

CPRGlass by team (evermed), The augmented reality APP that can help you save a LIFE

July 6, 2013 15 comments

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*UPDATE: 7/8/2013 It is my pleasure to announce that @AED4US is uniting with CPRGLASS to make it even more functional and useful! This is thanks to the vision and efforts of my friend and colleague, Lucien Engelen, Director Radboud REshape & Innovation Center / Faculty Singularity University – FutureMed / Founder & Curator, TEDxMaastricht @compassion4care @aed4US 

We have recently seen Google Glass used for MEDED purposes, from tutorials on how to do medical procedures to the Telemedicine potential (Check Surgeon, Rafael Grossman’s work in “Inside The Operating Room With Google Glass” and “How Google Glass Is Changing Medical Education”) I am part of such projects and will continue to work on these aspects but in my opinion that is not the strongest point GLASS has. In order to see the potential of glass one needs to answer the following question. What is a smartphone without the applications you install? Answer-> A simple, and mundane phone that takes pictures and video. Therefore, a smartphone’s potential is directly linked to the apps the user has installed.

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Same applies to GLASS.  Many people do not understand the potential of glass in healthcare and that is the reason why I decided to develop CPRGlass. With the help of Chris Vukin and Thomas Schwartz from the evermed team (which is disrupting the conventional EMR model with GLASS technology) we have developed a prototype of an application that will help anyone perform the best CPR possible in a given situation.

In a recent article published in Resuscitation  Urban concluded the following “Less than one fifth of surveyed laypersons know of Hands-Only™ CPR yet only three quarters would be willing to perform Hands-Only™ CPR even on a stranger. Efforts to increase layperson education are required to enhance CPR performance” This will be the most innovative effort you will see.

Before I get to how CPRGLASS works, I would recommend for you to watch the video created by The American Heart Association with Ken Jeong Hands-Only CPR( http://www.youtube.com/watch?v=n5hP4DIBCEE )in this video, the song Staying Alive marks the pace. The goal is to do 100 compressions per minute and the rythm of the song matches this pace. In addition, the hypothesis is, that the song could also help make the situation less stressfull. (This is just a hypothesis but future trials might help with this and other questions, remember this is just the initial prototype)

THE CPRGLASS SCENARIO

1)   Person walking, witnesses someone passing out (syncope)

2)   Individual says “OK GLASS, CPRGLASS”
A) Instructions appear ABC (Assess Airway Breathing and Circulation)
B) “OK GLASS, No Pulse!”      * An algorithm developed by Hao-Yu Wu et al at MIT demonstrate how a normal camera can detect a pulse in a person with strong accuracy. We are looking incorporate such algorithm aka (which will be open source) “Eulerian video magnification” to CPRGLASS for 2 reasons;
                           1) WIll help as an innovative method to assess if the compressions are adequate
                           2) Will be able to tell us if patient has regained pulse if we stop compressions, possibly, instead of even having to look for a

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3)   This triggers the following algorithm
A) Staying Alive Music starts which will guide you to do the compressions at a rate of 100/min. (Like AHA Video)
B) Gyroscope tells you if compressions are adequate enough by moving
C) Tracks TIME of CPR initiation and # of compressions given
D) Calls 911 with your GPS based location
E) Via GPS will try to find nearest AED which information is being obtained by crowdsourcing. Ex AED4US
F) Sends Txt Msg to nearest hospital with information regarding ungoing CPR for them to get prepared

* More functions, including live hangout with ED physicians will be mentioned in a later post.

Example of Eulerian Video Magnification from MIT

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Sources/Bibliography
1) http://www.heart.org/HEARTORG/CPRAndECC/HandsOnlyCPR/LearnMore/Learn-More_UCM_440810_FAQ.jsp
2) http://www.cnn.com/2010/HEALTH/07/28/chest.compressions/index.html
3) Current knowledge of and willingness to perform Hands-Only™ CPR in laypersons. Resuscitation. 2013 Apr 22. pii: S0300-9572(13)00225-6. doi: 10.1016/j.resuscitation.2013.04.014.
4) Field JM, Hazinski MF, Sayre MR, et al. Part 1: Executive Summary:  2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S640-56.
5) MIT algorithm measures your pulse by looking at your face   http://www.wired.co.uk/news/archive/2012-07/25/mit-algorithm

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The CathGlass Project

July 4, 2013 Leave a comment

At the moment, I am  experimenting with helpful ways that glass could help an interventional cardiologist. This is the concept I have designed so far and working on. Any recommendations?
cathglassHOWTO

Categories: Health, TechMed

The Role of Google Glass in Healthcare

June 16, 2013 1 comment

I picked up my google GLASS last week and so far I am very happy with them. Describing them with words would not do them justice. Since many colleagues and friends have been asking about them I decided to make a small video. Please excuse video quality and lack of editing. I am moving and not much time in my hands

The first video shows the unboxing of glass, second one I briefly mention potential uses, and third the official Google Glass tutorial on getting started.

If you have any questions feel free to contact me. Twitter Christianassad and same goes for google+

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Exciting times ahead in Medicine!

1) Glass Unboxing

2) Just some few Examples of Potential Glass uses in Healthcare 

3) The original Google Glass getting started video

 

A post that you might also find helpful comes from Melissa McCormack, Managing Editor of Software Advice’s The Profitable Practice.

Google Glass: Whether or not you’re excited about its use as a consumer device, you have to recognize the potential benefits it can offer the medical community. Software Advice, a company that connects medical software buyers to live expertise, contemplates a few of the potential uses for Glass in health care.

One exciting possibility is the use of Glass in surgery. There are the academic uses of course: a surgeon live-streaming her procedure to a group of medical students, or a surgical resident streaming his procedure to a supervising physician. Compared to current video conferencing technology, Glass would save time in setup and provide an easy and compelling first-person view of the action.

But there are other potential surgical uses as well. For example, a surgeon could video conference with consulting specialists during a procedure – and that feedback could be delivered directly to his plane of vision, rather than the surgeon having to reference a peripheral screen.

Along those same lines, think about surgeries where X-ray, ultrasound, or camera-equipped scopes are used to track positioning of surgical instruments. Those images, too, could be delivered to a surgeon “in eye” instead of him having to move focus from the patient to a screen. Here, Glass facilitates the ideal alignment of the surgeon’s attention with the patient.

To read about other potential uses of Glass in medicine, view the full article here: http://profitable-practice.softwareadvice.com/will-google-glass-change-the-face-of-medicine-0613/   below is a summary she has done of the article but I suggest checking the full article for a more descriptive experience.

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