title: Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?
abstract: Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation.
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Boehme
authors.affiliation: Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Manser
authors.affiliation: Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: Jannine
authors.initials: J
authors.lastname: Dewar
authors.affiliation: Cambridge Health Alliance, Cambridge, MA, USA.
authors.forename: Amie
authors.initials: A
authors.lastname: Miller
authors.affiliation: Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Siddiqui
authors.affiliation: Harvard Medical School, Boston, MA, USA Cambridge Health Alliance, Cambridge, MA, USA schwaitz@buffalo.edu.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Schwaitzberg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D020811:Biomedical Technology; D000066491:Clinical Decision-Making / Q000379:methods*; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011786:Quality Control; D019114:Remote Consultation / Q000379:methods*; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D014741:Video Recording / Q000295:instrumentation*
keywords: Evidence-based medicine/surgery; biomedical engineering; the business of surgery