Physicians in the glass house

22. September 2014

Medical hardware and software are part of a lucrative market that has not remained hidden from Google. The group is working on several products such as data glasses for surgeons and a lens that determines blood sugar levels.

Brave New World: For several years Google has been working on the data eyewear Google Glass. It consists among other things of a central processor with RAM, a forward-facing digital camera, a microphone and a bone conduction speaker. Interfaces and sensors are added to this. Data can be faded into the field of view from the Web. Operation of Google Glass is primarily conducted through head movements and words. Those interested can order the miniature computer via the Web. Doctors are now exploring the strengths and weaknesses of this new tool for medical applications.

Google Glass surgically tested inside and out

Already by the end of 2013 a premier event took place: Dutch medical colleagues employed Google Glass during an abdominal operation. They transmitted the action live to the congress “Games for Health Europe” and to YouTube – which made it a bonus for teaching. Yet electronic data glasses can perform considerably more than that. Now Oliver J. Muensterer from New York Medical College has published opinions from the field of paediatric surgery. Together with colleagues Muensterer tested the glasses in “Explorer Version” form for four weeks. The team documented interventions, made phone calls or video conferences, laid down calculations or researched on the web – without leaving the confines of the sterile surgical zone.

All of the testers were satisfied with wearability comfort. Nonetheless, they complained that the battery barely made it through twelve hours. If the surgery day started at seven clock, Google Glass was already limping its way through the afternoon. At full capacity – which includes instances such as during the use of its video functions – after 30 to 40 minutes its energy reserves would already be running dry. Regarding the sound quality, there was also still room for improvement. But that’s not all: while the team was streaming surgical interventions, the data flow stopped temporarily. Whereas developers manage to get various, mostly technical teething matters securely under control, privacy protection remains an Achilles heel: All data lands during the intermediate period on Google servers. What happens there with the information is unclear – not every video conference should in the end be made available to the general public.

Surgeons test augmented reality

Another attempt: surgeons at the University of Alabama in Birmingham, USA, have worked with functions of augmented reality. The platform employed here was VIPAAR (Virtual Interactive Presence in Augmented Reality) in combination with a computer and video glasses. While Brent Ponce at UAB Highlands Hospital in Birmingham inserted total joint prostheses (TEP), his colleague Phani K. Dantuluri from Atlanta supplied advice via virtual means. The two surgeons were able to discuss the case in real time – Dantuluri was ultimately seeing the intervention and even the position of instruments from Ponce’s point of view. Doctors at UAB speak of the opportunity for younger surgeons carrying out complicated procedures to have experienced mentors at their side without them having to be on site.

This gets in the eye: Smart Contact Lenses

Aside from data-eyewear Google has further medical tools in the development pipeline. Together with the Novartis subsidiary Alcon, they are to further develop Smart Lens technologies. Thanks to miniaturised electronics, presbyopia is able to be corrected. Patients with presbyopia require technical assistance because their natural focus no longer works correctly. The researchers are however not satisfied with just that.

New contact lenses determine glucose levels in the tear fluid and send the corresponding data wirelessly to smartphones. An advantage is that the intelligent lens compiles measure readings every second and warns patients via the app long before a critical Diabetes mellitus metabolic situation occurs. Lutz Heinemann of the DDG (German Diabetes Association) task community “Diabetes and Technology” has welcomed the respective plans. He made it clearly known that his association is ready to support Google. In the best case outcome, compliance would be greatly enhanced – he says many patients experience blood samples taken from the fingertip to be extremely unpleasant, meaning they do not keep up with doctors’ recommendations. However before this makes it to market readiness developers need to find their way around some pitfalls. For example, the glucose levels in tear fluid are 50 times lower than those in blood. Changes have a time delay of seven minutes.

Unlimited real-time documentation of illness

Other technologies from Google have already long made their way into the clinic, the key word here being software. For example, Google Maps is also able to be used as an early warning system for doctors and patients. Baxter has on this basis published a map of all TBE risk areas. Researchers at the World Health Organisation use the tool in order to document Ebola outbreaks since 1976. Cards of this type have a big advantage: all people given written authorisation, for example local doctors, are able to register medical cases of illness on site in real time, all without creating an administrative burden. As long as anonymised case reports are involved, data collection is unproblematic. For patient-related information, however, those charged with such responsibilities need to ask themselves how seriously Google takes privacy protection.

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