title: Do you see what I see? Insights from using google glass for disaster telemedicine triage.
abstract: BACKGROUND
  Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage.
  
  
  METHODS
  This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine.
  
  
  RESULTS
  The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P = .39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P = .041).
  
  
  CONCLUSIONS
  There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine, and telemedicine required more time than conventional triage. There are a number of obstacles to available technology that, if overcome, might improve the utility of telemedicine in disaster response.
authors.affiliation: 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA.
authors.forename: Mark X
authors.initials: MX
authors.lastname: Cicero
authors.affiliation: 2University of Massachusetts School of Medicine,Department of Pediatrics,Section of Pediatric Emergency Medicine,Worcester, MassachusettsUSA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Walsh
authors.affiliation: 3Yale University School of MedicineDepartment of Medical Informatics,New Haven, ConnecticutUSA.
authors.forename: Yauheni
authors.initials: Y
authors.lastname: Solad
authors.affiliation: 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA.
authors.forename: Travis
authors.initials: T
authors.lastname: Whitfill
authors.affiliation: 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA.
authors.forename: Geno
authors.initials: G
authors.lastname: Paesano
authors.affiliation: 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kim
authors.affiliation: 1Yale University School of MedicineDepartment of Pediatrics,Section of Pediatric Emergency Medicine,New Haven, ConnecticutUSA.
authors.forename: Carl R
authors.initials: CR
authors.lastname: Baum
authors.affiliation: 4Yale University School of MedicineDepartment of Emergency Medicine,Section of Emergency Medical Services,New Haven, ConnecticutUSA.
authors.forename: David C
authors.initials: DC
authors.lastname: Cone
mesh_terms: D000060:Accidents, Aviation; D003237:Connecticut; D004189:Disaster Planning; D017598:Efficiency, Organizational; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians; D005139:Eyeglasses; D005240:Feasibility Studies; D006801:Humans; D020407:Internet; D013647:Task Performance and Analysis; D014218:Triage / Q000458:organization & administration*; D014741:Video Recording
keywords: HIPAA Health Insurance Portability and Accountability Act; OS operating system; triage