Opportunities and Limitations of Wearable Technology in the Operating Room
Guest commentary from renowned surgeons Dr. Pierre Theodore (UCSF) and Dr. Edward Bender (St. Francis Medical Center).
“Using wearables such as Google Glass at the point of care provides a tantalizing view of what future holds. Work still needs to be done in the short-term in order for the technology to be ready for primetime. Enhancements to speech recognition capabilities and more robust image processing will allow for wearable technology like Google Glass to be viable platform that will ultimately improve patient care.” - Dr. Pierre Theodore, UCSF Medical Center
Wearable technology presents an opportunity to drive value for surgical procedures by allowing the operating room staff to leverage real time audio visual communications to improve patient care. This is not new. Surgeons are accustomed to wearing head mounted cameras connected to standard video recording and transmission devices, but these have been hampered by supporting only one way communication from inside the operating room to an audience outside the operating room. The technology for the reverse trip back to the surgeon has been either ignored or hacked together using separate and cumbersome technologies such as an intercom, an independent AV feed, or even the telephone with sketchy audio quality.
Indeed, surgeons are excited about the possibility of more advanced wearable technologies allowing them to change the way procedures are conducted. Google Glass is the newest and most highly touted of these technological advances. The anticipated benefits include the ability to coordinate care, increase efficiency and provide better patient outcomes by bringing in remote experts on-demand for virtual live-video support.
In testing the Google Glass platform in various operative environments with our medical advisors, we’ve identified the following opportunities and limitations with the current state of the Google Glass technology for on-demand support in the operating room leveraging live video streaming.
Opportunities
Real-time support: Ability for the operative staff to leverage the audio and video communications built into the wearable technology.
Hands free: Ability to obtain real-time support and have both hands free for the task at hand.
Integrates into workflow: No impedance on the clinical workflow in the operating room.
Local visualization: Remote user is able to hear and see exactly what the Glass user is viewing in real-time.
Limitations
Limited battery life: The battery is limited just with basic use. Add live streaming of real-time communications and the battery life is reduced to a half an hour or less.
Ambient noise: Operating rooms are noisy places. Glass has limited audio with a mono and stereo earbuds that do not provide adequate volume in the operative environment.
Small screen: The OR staff can have trouble viewing the Glass screen and may require prescription lenses.
Limited viewpoint: The operating room staff is unable to view the remote user because it is a “personal” video stream seen only by the wearer. This limits the use in certain applications such as inservicing and other activities where the entire surgical team must be synchronized.
High learning curve: Glass is a new interface with different functionality that requires users to learn the hardware and software. We’ve found this to be a relatively high learning curve and not intuitive.
Limited use case: In certain cases, surgeons require the use of loupes to provide magnification to the operative field, and the Glass platform may not be easily adaptable to such situations.
To address some of the limitations, there is the ability to add a battery pack, include custom headphones, add prescription lenses and provide user training. However, these are temporary fixes that are not sustainable for larger scale adoption.
In addition, technology such as Google Glass is still in early beta development under a Google Glass explorer program with commercial release not expected until late 2014. The wearable technology presents an opportunity should the limitations be addressed in future iterations.