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Are we protecting patient information more than the patient?
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.
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.
“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?
Installing Native Apps in Google Glass: The simple way
One 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…
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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
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CPRGlass The augmented reality APP that can help you save a LIFE
*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.
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
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
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
The CathGlass Project
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?
The Role of Google Glass in Healthcare
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+
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.
Cardiologists, it is time to say goodbye to linear thinking and embrace exponential
Advances in artificial intelligence, robotics, infinite computing, ubiquitous broadband networks, digital manufacturing, nanomaterials, synthetic biology, and many other exponentially growing technologies will enable us to make greater gains in the next two decades than we have in the previous two hundred years.
In order to understand why I say this, one needs to understand the basis of Moore’s law and exponential thinking. What does this mean? It means that the technology created in the past has helped develop the technology of tomorrow in an exponential pace and will continue to do so. Say what? Lets say you were asked the following question “From your current location, where would you be if you took 30 steps?” You would probably be able to say with accuracy your location. Now, if we address this in an exponential concept. Taking 30 steps exponentially (1-2-4-8-16-32-64-128 etc) you would end up 1 billion steps away. Would you have been able to predict this? Likely not since most of us are linear thinkers. This is the foundation of exponential technology. Most people in healthcare are not used to thinking about how technologies that grow at this rate will impact our future and doing so is a key component in making this a better world. If you want more information regarding this, don’t miss the article from Nature “Moore’s law is not just for computers”
Ok… What does any of this have to do with cardiology or the ACC? ACC ’13 marks the third year that The Cardiovascular Education Innovation Forum has been a part of the annual meeting. Despite it’s recent inception, this Forum has been growing linearly (I am trying to change that but there are many obstacles!). This year’s Forum was a little different than prior years. Three fellows, including myself, joined the program committee and helped determine the topics and speakers. Our goal is to mold the Forum into what we know it can become. I have been fortunate enough to be a Singularity University Futuremed alumni in 2011 and 2013. The mission of Singularity University is “How to impact the lives of 1 billion people in 10 years”. Will this happen by placing better drug-eluting or bioabsorbable stents? How about renal artery denervation or TAVR. Change of this magnitude in healthcare will require new strategies and technology along with a different way of thinking. Not just a new design of an existing product. And by the way, I am starting interventional cardiology in June 2013, but then pursuing a biodesign or endovascular/innovation fellowship. I am certain that tech-savy healthcare providers who have embraced technology will lead the revolution in healthcare change.
That is the goal of the cardiovascular innovation forum. To show and motivate every cardiologist to try and impact the life of hundreds at a time. This year the CVIEF invited The Society of Physician entrepreneurs to help and orient cardiologists on the path to materializing our ideas. Venture Capitalists and Angel investors that talked about what type of ideas they are likely to fund, how to approach them, a gameplan to follow.
The 15 Smartphone Apps your Doctor Should be Prescribing
Check the Virtual Magazine at: http://goo.gl/mjfmD
Every time you go to the doctor you will hear the same thing. Lifestyle modifications. Doctors are supposed to encourage you to become healthier, eat better, sleep better and exercise more. Stop smoking etc.
This words or sentences are extremely easy for your doctor to say them, but, difficult to follow, extremely difficult in some cases.
Even doctors, colleagues of mine do not follow them. Yet, they HAVE THE AUDACITY to tell the patient to follow them? BAAAHH Simply ridiculous in my opinion.
Who am I to talk? Well I exercise as much as I can during the week. If time is an issue I will at least take 15 minutes of my day to do an ab workout routine and always, I MEAN ALWAYS eat healthy. I would rather skip a meal than eat junk food. It is no longer a routine but a lifestyle, a lifestyle I chose to adopt many years ago. I want to be in the best shape possible not only for me but for my family. With this apps I will try to help you adopt such a lifestyle. If you have questions, doubts or concerns feel free to shoot me a tweet at @christianassad. I will be more than happy to try and help you succeed!
With this issue I have made a list of 15 apps that either I have used or friends have used to get healthier. The apps are in 3 categories. Healthy Eating , Exercise and Sleep Routine and they are as follows;
Some are free, and some cost 3-4 USD. In any case they are all great and this issue will save you time since there are thousands of applications in this field. This recommendations are based from my personal experience or friends of mine. Hope you enjoy them.
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Healthy Eating
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1) Fooducate
2) Calorie Counter – Myfitnesspal
3) Restaurant Nutrition
4) LoseIt
5) Smoothieselector
6) Whole Food Recipe Maker
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Exercise Better
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1) Runkeeper
2) JEFIT
3) Nike Training Club
4) Nexercise
5) Endomondo
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Sleep Routine
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1) Sleep Bug
2) Sleep Cyle
3) PZIZZ
4) Deep sleep
Electronic Cigarettes, Is it time to Swap the Smoke for Vapor?
Electronic Cigarettes: Swapping the Smoke for Vapor
Often in my cardiology clinic I encounter patients that have tried to quit smoking in multiple occasions always to end up in the same alley.
As doctors, we are supposed to encourage patients to quit smoking every time they come to our clinics and “guide” them to the right pathway. Easier said than done. As a Cardiologist I am amazed and amused to a certain extent when I see my colleagues recommending patients to lose weight, eat healthier, and stop smoking. Yet many of them do contrary to this recommendations. You have to practice what you preach…
Recently a very pleasant man came to my clinic. He had history of heart attack, and sudden cardiac death. Resuscitation was performed and he was lucky enough to come back to the world to his family. After 10 years he continues to smoke. Why? His answer is “I enjoy smoking too much doc, but believe it or not I do not inhale”… Ok.. Thats when I noticed. Winning the Lotto is more feasible than making him quit smoking…
Medical Societies do not recommend the use of E-Cigarettes as a cessation method for smoking. due to its possible harmful effects. FURTHER TRIALS ARE NEEDED. (Dont you just love how we practice medicine). I have spoken with patients who have made the jump by their own will to vaping instead of smoking and have not met one that is dissapointed. They all say the feel better, healthier, with more energy. Biased may be, but I can tell you from a subjective standpoint… They also look healthier.
In summary. I can not tell patients to use or prescribe e-cigarettes, but I can say that they appear to be a far better option than inhaling 4,000 chemicals from smoke…
In the following pages I will go over some information regarding smoking and vaping and different types of electronic cigarettes just to educate people on what is out there. I am by no means an expert on the subject, but hopefully this info can help others as much as it helped me.
Hope You like it ———> Electronic Cigarettes: Swapping the Smoke for Vapor
Real Time Monitoring is about to make sports far more Exciting!
The Future of Sports is about to get a Major Facelift
It was recently announced at Manhattan’s New Museum of Contemporary Art an exciting concept that will change the way we see sports as spectators and how teams manage their performance tactically.
Adidas and Major League Soccer announced a new initiative that will likely turn the MLS into the most technological sports league in the world. The initiative is to make every soccer player to wear small sensor that’ll track their movements and vital signs. This will be sent back to the coaches in real-time for monitoring in their tablet. Now how this information will be used has innumerable applications.
You are probably familiar with the miCoach app for android or iOS in which it monitors your physical activity. Similar apps would be endomondo, run keeper, nikes app etc. The new miCoach system uses a collection of sensors that fit into a small pocket in the player’s shirt. That is not all, additionally there are sensors woven right into the the players uniform and senses heart rate as well as other vitals. If you think that weight could be an issue think again since the data cell itself weighs only 52 grams. Sensors incorporated into the system include; a tri-axis accelerometer, GPS, magnetometer, gyroscope which will be worn by every player in all 19 teams
How does it work?
The data captured by the sensors is then sent by Wi-Fi to the coach’s tablet (in this case it seems it will be iOS iPad)
How can it be used? Well even gambling will change…
The most important use of such technology is player safety in my opinion. Many of us have witnessed players having syncopal episodes (passing out) and even dying in the field. In a vast majority it is due to an underlying problem related to electrical conduction of the heart causing life threatening arrythmias or enlarged hypertrophic heart walls affecting the way the heart pumps and therefore delivering blood properly to the brain and other organs.
This appears to be originally designed for the coach, but as I just mentioned, potential uses include the team’s doctor or healthcare providers. Using this information not only for strategic instruction but medical. If you see a player is having a severe arrhythmia, blood pressure drop, etc then the doctor or even the application itself could let the coach know “GET THIS PLAYER OUT NOW!” If you are the other team and you are able to see how the other team’s endurance is doing, the coach could potentially make appropriate strategic changes. Finally doctors can have a bigger roll in recommending a coach what to do 😉
Think about it in the gambling perspective. Online gambling is even being explored in a social concept now by different game companies one example is Zynga. Everything is becoming social now. Real time monitoring provides more data, more paramaters that could be used for such. Fantasy football is about to get a “steroid” injection.
If you are in america you probably do not care much about soccer (let’s be realistic) so how about football? Monitoring NFL players and having sensors in their helmets which measure temperature, and force of impact? If a force of impact is significant ant there is risk for severe concussion the app will let you know and doctors as coaches will get the player out and seek medical attention.
An #Awesome Twist? How would you feel about knowing this information in real time when you are watching the game?
Think about what the fans would do with this information? How this will affects the social interaction with fantasy football? Will it change how gambling happens? Imagine you are watching a game in which your team is losing. You see your smartphone and you are aware that the mean endurance of your team surpasses significantly that of the other team. It gives you a reason why to stay in your seat and wait for the scoring point doesn’t it? (At the same time you probably will also get an AD from gatorade saying “Improving endurance” or some other nonsense since ads are everywhere)
Have many more ideas and concepts but you would probably not read them all 😉 If you have more post them!
Impact of Emerging Exponential Technologies in the way we practice Medicine
I was asked to give a talk in my University which is The University of Texas Medical Branch, regarding exponential technologies in Medicine. For those who do not know me, I am a cardiologist who is passionate about incorporating technology into medicine. I have no doubt that major changes will be happening in the incoming years in the way we practice as well as how we engage with our patients. Click here for the link to see or download or copy paste http://goo.gl/IwCdB
Before giving the talk I overheard people saying “it is a joke, this is a cardiology meeting, what is he talking about” I also heard others with more positive comments. As one of my slides states “The problem with close minded people is that their mouths are always open”.
Soon after initiating my talk I could see how the audience became captivated with what I had to say. My goal was to open some eyes to the potential of exponential technologies. I wanted to show them technologies that are and will be game changers in our every day practice, and hopefully ignite some light bulbs to stop conventional routine thinking and dream a little…
Hope you like the slides
Update: 3 hours after the upload it became top presentation of the day, 6 hours later top presentation talked about in facebook, and 36 hours later 30,000 views
Contact:
Twitter: @christianassad
E-Mail: christian.assad-kottner at singularityu.org
Christian Assad, MD Interventional Endovascular Cardiology
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