Google Glass: OK in the Operating Room or not?

google glass

Dr. Rafael J. Grossmann recently live-streamed a percutaneous endoscopic gastrostomy via Google Glass

Picture the following scenario: You’re mid-surgery and you need some information about the procedure at hand or your patient’s medical history. You could step away from the operating table, consult images on a monitor or access the necessary data on a tablet or PC.

Wouldn’t it be nice if you could simply speak your request and view the results without pausing the procedure or stepping away at all?

That’s the promise of Google Glass, the revolutionary eyewear that’s essentially a wearable computer with a camera, microphone and heads-up display. Put them on and you can not only access and display information with voice commands but you can also take pictures, record video and audio and transmit it all (via Google Hangout) in real-time to anyone with an Internet connection.

And with doctors now testing the technology, it’s worth asking if bringing Google Glass into the OR is a good idea, especially in terms of recording and posting (or streaming) videos.

“It’s a double-edged sword,” says Medical Justice CEO Jeffrey Segal, MD, JD. “It’s a tool like anything else but it does up the ante in terms of risk.”

On the one hand, recording procedures is nothing new and Google Glass can be seen as a newer, cooler tool for training new doctors and demystifying procedures.

“My father helped set up closed-circuit TV broadcasts of operations back in the late 1950s,” says plastic surgeon David B. Reath, MD, of Knoxville, Tenn. “We’ve had the ability to bring [viewers] into the OR for more than 60 years.”

But Reath is less enthusiastic about live-streaming those procedures or otherwise making them available to a larger audience for the simple reason that doing so opens yet another avenue for compromising patient privacy.

“Not everyone has the same stake as the physician does — a staffer with a vendetta or a carelessly posted video can be not only unethical but also illegal,” he says. “Patient privacy is not only a moral issue; it’s a legal one, and that’s going to be a difficult line to walk for some people.”

But even assuming you take appropriate steps to protect patient privacy, risks remain. Consider a scenario where a patient sues you for malpractice and the case ends up in front of a jury, a jury that most likely has little or no experience with the sometimes graphic nature of surgery. Imagine their response when the plaintiff’s attorney shows strategically edited clips from that Glass-enabled video.

“Most people freak out when they see blood,” says Segal. “If you’re just describing a procedure in your operative report — we encountered some bleeding, the bleeding was 350 cc’s, not unreasonable — that has a very different context than a video of blood spurting all over the place.”

Considering that Google Glass is little more than a prototype at this point, there’s no way to accurately predict how using it in the OR will play out. In some cases, it could be a boon, in others a distraction; either way, it promises to present both challenges and opportunities in terms of both providing care and protecting patient privacy.

“Net-net, you take a risk by doing it,” says Segal. “If you’re a confident individual and you’re okay with some element of risk, it’s probably a useful thing. On the other hand, if you’re risk-averse, I wouldn’t be the first one on the block to use it.”

What do you think? Do you think Google Glass belongs in the OR and would you use it if you had the chance?

About Rob Lovitt

Rob Lovitt is a longtime writer and editor who believes every good business has a great story to tell. He has written for dozens of magazines and websites, including NBCnews.com, Expedia.com and the inflight magazines of Alaska, Horizon and Frontier airlines.

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  • Dominic Bray

    No place in the OR in my opinion
    Why would I need the extra hassle and compromise of patient privacy.
    I wear loupes for my cosmetic surgery, having ones vision further obscured when scrubbed can be of no benefit. Glancing at the pre op photos on a high resolution screen in the corner of the OR is no real hardship!

  • Eric M. Joseph, M.D.

    This is the first I’ve heard of Google Glass. Here’s my take: If the main purpose is to access patient information, like CT or MR scans, these are routinely brought to the OR for easy viewing on an x-ray box. Similarly, chart notes may be easily accessed by a circulating nurse.

    I would advise against streaming live video of surgery on the internet, and I’m not sure why any physician would want to.

    Utilizing a small device mounted on surgical loupes to snap a photo, or to selectively video an interesting segment of a procedure would be terrific. Photos or video clips are typically taken by a circulating nurse, and this may result in an improper view or angle, since the sterile field must be respected. Any camera or video-cam mounted on a surgeon’s glasses or operating loupes should only store these images on the surgeons person. Certainly not on the internet.

  • Dr Remus Repta

    “Progress is a nice word but change is its motivator”—JFK
    At first sight (no pun intended) Google Glass seems superfluous in the filed of plastic surgery. Plastic surgery is a fairly low tech field. Marking pen, scalpel, cautery, suture, a handful of metal tools. For google glass to take hold in the ORs of the plastic surgeon there must be a motivator. Potential motivators include access to info, teaching, and marketing. If and when google glass becomes widely utilized in the plastic surgery world it will be for marketing purposes. There will be a great role for teaching since step by step intra-operative video of plastic surgery procedures is an invaluable tool for budding and established plastic surgeons and this perhaps how it’s use will start. When its marketing role is worked out, google glass in the OR of plastic surgery might gain wider traction.

    All the best,

    Dr Remus Repta

  • Dr. Brent Moelleken

    Great idea to have an interactive tool like Google Glass available during patient consultations. A patient with an unusual medical condition, medication interaction, maybe even access a medical record. However plastic surgery demands extreme focus, perfect lighting and uncompromised exposure. No place to be surfing the internet while performing a delicate revisional facelift!

  • Robert F. Centeno M.D.

    Wonderful technology, but probably not going to be a game changer in Aesthetic Plastic Surgery. As others have noted, except for subspecialties like craniofacial surgery, hand surgery and microsurgery, we are pretty low tech. Endoscopes and robots have not taken hold in our specialty because they do not confer any major advantage to the patient or the surgeon. This technology would be very nice intra-operatively where three dimensional imaging and guidance software technology is being used to facilitate surgery or for teaching complex procedures to a medical audience. Privacy issues and medicolegal concerns are the major drawbacks but are not insurmountable if the benefits to the patient were significant. It will be interesting to see how this evolves!

  • Dr. Elisa Burgess

    I love technology but sometimes I think it can be a distractor. It is easy to check websites, emails, and video every few minutes on your phone but that doesn’t mean we should apply that in the operating room. If I were a patient, I would want to have a well prepared and non distracted surgeon to focus on my operation. I would want the surgeon to protect my privacy for personal and legal purposes. Google glass sounds like fun technology but it would not be my best assistant in the operating room for plastic surgery.

    Dr. Elisa Burgess

  • F. Victor Rueckl, M.D.

    While this technology could be great in teaching environments, it’s not going to be of much use in small practices. When I’m in a room with a patient I make sure my cell phone is off – and so is theirs. I need to be focused, and I want that patient engaged. Distractions with gadgets don’t bode well for good patient/doctor interactions. Now having said that, in a teaching capacity, Google Glass could be great!

  • Mark Schusterman

    Personally, I don’t want any distractions while I’m operating. There are no situations that I have encountered doing aesthetic plastic surgery where I would need to look up something on line during an operation. I believe bluetooth ear buds are also a no-no.

  • David B. Reath, MD

    Rob, this is a very balanced and fair treatment of this topic. As I said we have had the ability to bring the public (whomever that might be) into the operating room for over 50 years. So the question is why haven’t we done so? Probably it is because the public shouldn’t have excessive access to this area. Or, possibly because the public doesn’t wan it.
    However, this is an interesting technology and will probably have it’s greatest application in surgical education.

    • Rob Lovitt

      Thanks Dr. Reath. Although I didn’t include it, I also liked your insight that medicine is often like a salmon swimming upstream against the current of oversharing everything. Needless to say, that’s the appropriate direction when patient confidentiality is concerned.

  • George Commons

    I strongly guard every single aspect of patient privacy. This is just another intrusion that would not enhance patient care. A surgeon should never go to the operating room unless he or she has a perfect understanding of the history. Video coverage is very easy and possible in any OR setting and having an attachment on the glasses is not needed. Even more concerning would be if every one in the OR, or at least others that assist had such glasses and even further compromised patient privacy. And then just think, the surgeon could check his latest stock account numbers and possible even send his broker a buy or sell. A joke of course. But surgeon diversion could easily occur with such a TOY. This is a TOY and does not belong in any OR. It certainly will never be allowed at our Plastic Surgery Center Palo Alto, used by 19 different surgeons including the Stanford University Plastic Surgery department. Diversion in the OR cause patient complications. Surgeons must pay attention to the patient and not PLAY with some silly glasses TOY. My Best, Dr Commons

  • Alberto Rancati MD- Argentina

    Sorry to disagree, but I think they will be extremely useful in plasticnsurgery for educational purposes.
    Do not think in senior surgeons, but for juniors, to have the possibility of being/ seeing in the operating room while an experimented surgeon is performing a delicate manouver? This is just the begining I think of a new esucational pardigm. Think in a Surgical Network where all of us can schedule our surgeries and young drs can see them through the web and to talk to the surgeon without travelling!
    The crazy ideas of today can be the standard tomorrow,