iPad Use & Value is Related to Hospital’s Infrastructure

The iPad is the new darling of the hospital world.  Depending on who you talk to, it can do almost anything.  Perhaps that is why some groups are jumping into the iPad arena before they are ready.  The adoption of any technology depends heavily on whether an institution has the infrastructure to support it.  Here is an example of one residency program testing the use of an iPad before its hospital had the infrastructure to support it.

The article “Resident Impressions of the Clinical Utility and Educational Value of the iPad” published in the November issue of Journal of Mobile Technology in Medicine tried to determine the value of the iPad during clinical rounds and for education.   The authors from Riverside Methodist Hospital gave 119 residents an iPad to use during the 2011-2012 academic year.  The residents gave their opinions on the clinical utility and educational value of the iPad.  The results were disappointing.  “The iPad received low marks for daily clinical utility (14.7%) and efficiency in documentation (7.8%).  It was most valued for sourcing articles outside the hospital (57.8%) and as a research tool (52%).”  Basically residents did not place a high value on the iPad when used in clinical rounding or as an educational tool.

Yes the residents didn’t find the iPad to be useful during clinical rounding, but that is because the hospital really wasn’t ready for the iPad, or any device, to helpful during rounding.

At the time the article was written, the hospital was still writing orders on a paper based chart.  Moving from paper to the iPad is quite a jump for people and hospital technology.  “All resident groups reported problems with utilization of the iPad for medical documentation/progress notes.” If the hospital is still writing orders on paper based charts perhaps it isn’t the iPad to blame but the fact that the hospital hasn’t adopted writing orders electronically.

In addition to writing orders on a paper based chart, the hospital’s other infrastructure items clearly were not ready for the use of iPads.  Further in the article they discuss connectivity problems and EMR access problems.

Connectivity –  “All resident groups noted problems with iPad login-in and connectivity/WiFi.  During the academic year 98 tickets specific for iPad set-up and connectivity issues were reported to Information Technology services.”  Now the authors do mention that it was 98 tickets out of 182,000 global tickets, but when you only have 119 people using iPad, 98 tickets is not good.  Anybody who has been in a deadzone can relate to the frustration of losing network access. Relying upon a network device for clinical use when you have poor connectivity (or difficult to access WiFi) is like relying on a cell phone service in the mountains after a winter storm.

EMR access – Residents were asked to recommend apps and medical tools for the iPad.  “The single most frequently cited application was Riverside’s electronic medical record.” The method by which they access their EMR makes it cumbersome for somebody with an iPad to access it.  “Our EHR is access via remote desktop, requiring a two-step login process.”  So the device that they wanted them to test its clinical use, does not have easy access to the EMR, a major clinical application.

The authors of this study suggest that residency efficiency “may be less positively impacted by the use of the iPad than previously reported.”  I believe the authors are both right and wrong to make this statement.  The authors clearly listed several hospital wide infrastructure issues creating barriers to online access.  “Though log-in and connectivity issues were noted as a significant problem, technology support was rarely utilized.  Residents often found it faster to use a computer than reporting difficulties.  Additionally, electronic order entry is not available at our hospital.”  Not only do these statements reveal the hospital wasn’t ready for adoption of the iPad or any tablet device, but it reflects their residents’ attitude toward their help desk and the speed at which they need things to work to get information.  I think the authors would have been more accurate if they had stated, residency efficiency may be less positively impacted by the use of the iPad if the hospital is not adequately prepared ahead of time for the use of mobile devices.

To study the use of the iPad in a clinical setting when the clinical setting is clearly not ready, is like testing the use of a car in an area where there are no roads.

I look forward to reading other iPad studies where the hospital is not the barrier and we can better determine whether the iPad (or any other tablet) is of clinical value or not.

Sacred Cows and Heretical Librarians

Last weekend I had the wonderful opportunity to be the keynote speaker for the Midwest MLA Chapter meeting.  It was a great meeting and I learned so much from so many people.  I LOVE Chapter meetings.  Ask me and I will tell you, the Chapter meeting is a great place to share and learn from other in a much more scaled back and doable scale than the large MLA meeting.  That is not to take anything away from MLA, I just think that a Chapter meeting is more intimate.

Some people at the meeting asked if I was going to post my slides from my presentation.  Yes, they are on SlideShare and I have re-posted them here.

These slides don’t have a lot of text.  So I feel there needs to be a bit of outline of what I talked about to give them some context.  So here is a brief summary of what I talked about….
Technology is disruptive.  That doesn’t mean it is bad or good, it just changes everything we do.  It could change things for the good or the bad.  An example of a very disruptive technology is the light bulb.  It completely changed the way we as society do things.  Thinking of more recent technologies, the phone is another disruptive technology.  The telephone changed how we communicated to each other.  The cell phone disrupted things again.  Not only were are we able to communicate with each other over long distances, but we can do it wherever and whenever.  The smartphone just ramped things up even more by making our phones the necessary multi-purpose tool of our lives.  We use it to communicate (text, voice, email, Twitter, Instagram, etc). We use it as our own personal computers to find information online and store/create documents. It is our entertainment center for music, movies, books, online radio and podcasts.  The cell phone (among other technologies) have changed we as a society find and share information.  It is has changed the way people find and share information in libraries.  Think of what future technologies will be like and their impact on libraries.  Think of the latest technology, Google Glass, and library possiblities.
People access library websites through their phone… OR they are bypassing the library website all together and using an app (journal app, library database app, library catalog app, etc.) to find information.  They are accessing all of this information wherever and whenever….in the cafeteria, bathroom, in bed, etc.  This change in society’s behavior requires us to change the way we do things.  We must adapt to the changes in society or we face extinction.  Other professions that are dealing with changes in society as a result of technology: US postal service, newspapers, photo journalists, etc.
My presentation was not a doom and gloom thing.  On the contrary…. I said we needed to look at these disruptive technologies as opportunities.  They provide us the opportunity to shape our own destiny.  They allow us to take our services and resources and put them together in different ways to adapt to the changes.  Think of your resources and services as Legos, each one can be put together in different positions.  If something changes or doesn’t work, change the Lego’s position or swap it out.
Swapping out Lego pieces sounds easy but it may not be as easy as you think.  Libraries need to look at the changes in society and start asking themselves some hard questions.  Are the services/resources we provide for ourselves or for our users.  We do a lot of fooling ourselves that some of our traditional services/resources are for our users when really they are for ourselves.  For example, why are we checking in print journals?  Why do we even have print journals?
We need to look at our sacred cows in our library.  We need to evaluate whether we should keep them or kill them.  We can’t just keep them because we have always kept them.  Cows (in real life and virtual) need to be fed and maintained.  If feeding and maintaining them serves a valid purpose to our users, then we should keep them.  If they don’t, then we need to kill them, or they will eat food and take up space of other resources.  I gave several examples of sacred cows.  The one that everybody seemed to latch on to was my cataloging example.  I asked the question, “Do you need a catalog or would an A-Z list suffice?”  Predictably a few catalogers freaked.  What I tried to convey…
  • If you are at a large academic medical institution or even NLM you need a catalog….BUT do you need to catalog the way you are doing right now? Could you be more agile?  Could you do something slightly different?  We are too entrenched in the way we catalog things.
  • If you are small hospital library with only a few shelves of books, you may not need a catalog.  I know it is crazy to think that, but you may not. Perhaps an A-Z list or *gasp* an Excel sheet posted online will do.  Maybe you could tag your holdings in Library Thing.
  • If you are a small hospital library with more than a few shelves of books, but nowhere near what an academic library has perhaps you need a catalog. But do you need to add anything to the catalog other than what our users care about?  Most users only care about title, author, year, edition, URL, and table of contents.  They don’t care if it is 24 inches tall, illustrated and has 246 pages.  Do you need to catalog using MeSH?
Evaluating these sacred cows may cause us to think some pretty heretical librarian thoughts.  The idea of not cataloging is pretty heretical. don’t get stuck on my catalog example.  One hospital librarian at the conference mentioned they did something pretty heretical, they stopped doing research and providing articles to people who were going back to school. She told them they needed to get their research help and articles from the library of the school they were attending.  She said it was a pretty heretical thought to her staff at the time.
Wikipedia’s definition of heresy: “Heresy is any belief or theory that is strongly at variance with established beliefs or customs.”  Long established customs may not be what we need now as our society changes with technology.  In order to evolve we need to look at our services and question our long established services and see if they are really needed or helping us go forward.  If not, why are we doing them?
In sum we need to look at the sacred cows and start thinking heretical librarian thoughts.  We need to always keep trying and never give up.  Let’s not be afraid of failure, failure just tells us what doesn’t work.  We need to know what doesn’t work, to know what does.

Quick & Dirty Way to Make a Library App

Recently I was talking with some medical librarians who mentioned that a lotl their medical students or residents want a library app for their phone or tablets.  These librarians are either solo librarians, librarians with no programming skills, or librarians who are institutions with some restrictive IT policies.  Basically they either don’t have the time, skills or permission to create an app for the library.

But there is a work around to this problem if you/they have an iOS or Android device.  Its a cheat because it isn’t a true app, but it does look like one on the phone’s screen.  Think of it more as a bookmarked page that looks like an app.

Follow these instructions:

Go to the web page you want to make as an “app” and then tap on the square with the arrow at the bottom of the phone screen.

LibraryApp 002

 

Tap “Add to Home Screen”

LibraryApp 001

 

Name it something short and descriptive and then tap Add.  Beware: long names get cut off.

LibraryApp 003

 

It appears as an app on your phone’s screen. Note the picture is of the web page you chose, so if it might be very white or boring looking. But hey it is on the phone.

LibraryApp 004

I don’t have an Android phone so I don’t have screen shots, but my coworker, Kim, gave me the instructions for Android users.

  1. Bookmark the page
  2. Go into Bookmarks menu
  3. Click and hold on the bookmark
  4. Choose “Add Shortcut to Home”

As I mentioned earlier, this isn’t a true app.  But I consider it a quick and dirty way of getting an app like presence on your patron’s devices.

Plagiarism of Medical Text in Medical Apps

In a recent post, Timothy Aungst from iMedicalApps.com sheds more light on the trend of copying established medical textbooks and repurposing it in a medical app that they sell on iTunes.  Aungst cites a recent report in BMJ, where three doctors, “Afroze Khan, Zishan Sheikh, and Shahnawaz Khan face charges of dishonesty in knowingly copying structure, contents, and material from the Doctor’s Guide to Critical Appraisal, by Narinder Gosall and Gurpal Gosall, when developing the app, representing it as their own work and seeking to make a gain from the plagiarised material.” Not only did the doctors plagiarize the text, but according to Aungst and BMJ the doctors also sought to increase their ratings within iTunes by writing reviews of their own apps without disclosing an conflict of interest.

This type of plagiarism is not new. In fact as Aungst states iMedicalApps.com Editor, Tom Lewis, discovered several apps in iTunes that plagiarized other works.  (I wrote a brief post about Tom’s finding while I was on vacation last year.) I can see from Tom’s comment that while he never heard directly from Elsevier regarding the issue, YoDev apps LLC had all of their apps pulled from the App Store.

Copying and re-posting a book online or through bit torrents for free is so 2005.  Welcome to the new world where plagiarizing can make you money. All you have to do is steal the content and sell it in an app.  They are also sneakier than they were in 2005.  They aren’t selling the app under the original book title, they are changing the name and trying to market it as something totally different.   Hmm it seems requiring users to use personal logins to view the PDF is really working to curb copyright violations.

***Update***

According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.

“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”

Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app.  The GMC found that Shahnawaz Khan  no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings.  However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.”  The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”

The Journal App Wars

I have doctors asking about all four journal browsing apps; Docwise, Docphin, Read, and Browzine (click links for reviews on each app. The reviews were either done by me or guest librarians who had access to the app).  A few of the requesting doctors have used one of the above products, but it seems the vast majority of the doctors haven’t used any of the apps and are asking based on word of mouth. 

The four apps are very similar.  To me it is a bit like comparing PubMed vs Ovid Medline, both do the job well but differently.  You also have people who prefer one over the other.  One is free while the other is not. 

The biggest difference is that three of the apps show the abstracts and tables of contents to almost every medical journal known to man (I over exaggerate of course).  The full text is provided if the library/institution as a subscription to that journal.  However, there is no clear branding or explannation of what journals the library/instituion owns because Docwise, Docphin, and Read don’t know.   If a doctor views the table of contents for the Journal of Big Toe Science in Docwise, Docphin, or Read  (which is not owned by the library), the doctor is denied the full text.  Last time I checked, there was no clear message as to why they can’t get the full text. Docwise, Docphin, or Read didn’t say soemthing like, “Your library doesn’t subscribe to this journal therefore you can’t access the full text.” Docwise, Docphin, and Read do not know the library/institutions holding or access methods.

Browzine does know what the library/institution owns.  Because the library submits the list (with access methods) to Third Iron (the company that owns Browzine).  Browzine only shows those journals to doctors. There is no guessing as to whether it is available full text to the doctor.  If it is in Browzine, it should be available full text.

Let’s pretend that my hospital library provided proxy access to resources. (Most hospital libraries don’t have proxy servers to provide access to journals or other resources.)  I could have my pick of these apps to provide to my users.  My question for librarians is: Do I list all four apps and let them decide what they want?  I have a very strong feeling (based on 15 years of answering doctor’s library questions) that doctors are going to be complaining about Docwise, Docphin, or  Read not providing the full text.  After all, if the library recommended a product that connects users to the full text, shouldn’t everything be full text?

What do other libraries do?  Do you list all of the apps and let the users decide?  Do you worry that there might be confusion among the apps because they are so similar but slightly different? Do you worry that doctors might feel frustrated when they can’t get the full text? Would doctors even bother ordering the unavailable article (going outside of the app to do this) through the library? 

I appreciate your thoughts and comments. Because sometimes I feel with these journal apps I am being asked to pick between Coke and Pepsi, Ovid and PubMed.  I know the difference between them, but my users don’t. Does it matter?

Get MLA CE for Participating in #medlibs Chat

The #medlibs chat group will be hosting a five week series presented by the University of Massachusetts Medical School Lamar Soutter Library.

Here are the weekly chats:

  1. August 15th: Host: Donna Kafel Topic: e-Science portal
  2. August 22nd: Host: Kevin Read Topic:e-Science thesaurus
  3. August 29th: Host: Andrew Creamer Topic: New England Collaborative Data Management Curriculum
  4. Sept. 5: Host: Sally Gore Topic: Role of the informationist on research teams
  5. Sept. 12: Hosts: Lisa Palmer & Kate Thornhill Topic: Institutional repositoriesand open access

Discussing e-science issues on #medlibs is a great way to learn more about the topic, but the icing on the cake is that these chats have been approved for free (or near free at $5) MLA CE!

While this is a cool opportunity, there are rules for getting the CE. 

  1. No partial CE hours will be awarded.
  2. Participation is measured by at least 3 tweets during each #medlibs chat session as shown by the chat transcript discussion AND/OR a reflective summary paragraph about the chat transcript discussion posted as a comment to each week’s blog post at http://medlibschat.blogspot.com/

In her post Nikki says that MLA pre-approved this e-science series for CE.  If there are costs they would go directly MLA according to their Discussion Group Program.  Nikki has graciously volunteered her time to be the convener for the program, verify participation,  administer evaluations, and issue the CE.

The CE may or may not be free. If it is not free, it will be extremely cheap. It will only cost $5! Whether the CE is free or $5 will be clarified soon by MLA and announced when known.

If there is a fee for the CE, please note the following:

  1. Participation will not be tracked or awarded to those who indicate they will only take it for free if a cost is required.
  2. PayPal will be used to collect funds if there is a cost for CE. The convener (Nikki Dettmar) will email all participants who have indicated they will pay a cost for CE with further instructions.
  3. If there is a cost for CE and you have not paid by the end of the series, no CE will be awarded. There will not be followup/reminder emails.

To learn more about the e-science series go to the #medlibs blog. To register for the CE go to this link.

What a great opportunity. Kudos to Nikki for all of her hard work coordinating this.  Thank you to the weekly hosts.  I have a lot to learn about e-science and I am going to sign up.

Friday Fun: Why I Chose a Windows Phone

Below is a guest post from my husband about his Windows Phone.  A while back ago I asked him to write a post comparing the different phones he has had.  He the only person I know who has had an iPhone, Blackberry, Android and Windows phone and is not working for CNET or another technology review company.  He has used and lived with each of these phones at some period of time.  He started with the iPhone 3G then moved to the Android.  He had a Blackberry for work and now has a Galaxy S4 for his work phone.  He currently has a Windows Phone as his personal phone. 

He started out writing a big ol’ post comparing all of the platforms but realized lots of people have already done that, so why reinvent the wheel.  It was after some good natured teasing I gave him about his Windows phone that he decided to write his post about his phone. 

So enjoy your Friday Fun guest post and maybe it might get you thinking about a Windows phone.  I have to admit, as much as I tease him, he is right about the Office capabilities being a big plus.

—–
My name is Mike and I am a Windows Phone user. 

Yes, I know.  There are actually some of us out there and believe it or not, we really do like it.  Alot. 

It was a long winding path to get here, over the iOS river and through the Android woods.  I won’t bore you with the details but I have had plenty of exposure to both of the major platforms through personal and work devices.  

 Using Apple products has always felt to me like I’m living in a subdivision with an overzealous homeowners’ assocation.  It’s very clean and everything works but God help me if I want to put up non-sactioned Christmas lights or change the flag on my mailbox.    

 I won’t even mention iTunes.  I’m still seeing a therapist over that.

 When I went to Android it was for the promise of the exact opposite of the iPhone experience.  Open, free, do whatever you want.  It was the Summer of Love all over again.

 But the more time I spent within that user interface, the jarring transitions from one app to another and the inconsistent overall delivery of the experience, it began to feel more and more that I had taken the brown acid and was in for a bad trip: http://www.youtube.com/watch?v=hKoLlKmQSHU

 The app quality and overall safety itself wasn’t exactly what I had in mind either.   Downloading something from the Google app store felt like the smartphone version of the Russian roulette scene from The Deerhunter.

 It was at my moment of greatest smartphone despair that I found myself at an AT&T store and face to face with a Nokia Lumia.  What do I have to lose?  I told my then five year old son to stand still and try and be quiet while I tried something.  While he went and did the total opposite of that I took the phone for a test drive.

I work for a software company so I have used countless numbers of different programs on different platforms over the course of my career.  The Windows Phone UI was one of the simplist, most intuitive I had ever used.  

 Even using one hand and half my brain to try and corral a kid who was going Dennis the Menace inside the store, I effortlessly moved through the interface.  I read (fake) e-mail and text messages, did a quick Google search and was even able to take a photo of my son hiding behind the Samsung Galaxy Note display (thanks to the dedicated camera button on the side).

 The more I used it and the more I read about it, it was like having the best of both worlds.  The live tiles and the Metro (Modern UI) interface gave every app a uniform sameness but yet there was a freedom to change and different ways to view and do things.  It was like the hippies had grown up, moved into the subdivision, and gotten rid of the rules but still kept their lawns mowed at a reasonable height.   

The first time I emailed myself a couple of Word documents and an Excel spreadsheet for a meeting and they opened without so much as a single glitch I almost cried.  

 Even the physical qualities were to my taste.  I like a little heft to my phone, something that doesn’t feel like it will  fly out of my hand as soon as I pull it out of my pocket.  For example, my two year old daughter’s pink barrettes feel sturdier than the Galaxy S4 I use for work.  

 I could go on and on (and maybe I will if the Krafty Librarian gets lazy and needs me to fill up more space).  If you find yourself in the smartphone doldrums like I was, I highly recommend you at least pick one up and give it a try.  

 Or you might just be happier like this:
http://www.youtube.com/watch?v=Z19vR1GldRI

The Doctor’s Instagram

The app Figure 1 has been getting a lot of press recently.  I learned about it a few weeks ago but I am just now getting around to mentioning it here.

Figure 1 is being called the Instagram for doctors.  It is a crowdsourced  images database app.  The crowd happens to be doctors, and the images happen to be medical images.  The app is a collection of medical images submitted by doctors to share, collaborate and learn from.  Doctors are verified using their institutional email address.  The app takes patient privacy very seriously.  It has a face detection program that automatically blocks out the face in a submitted photo and it includes other editing tools to remove other identifying features.  A HIPPA authorization digital consent form is also included.  Patients click the agree button then sign screen/form.

You don’t have submit any images to benefit from the app according to their site. “First of all, you can still access the images that others are posting so that you can learn from them, use them as a reference for your own practice, or comment on them so that others can learn from you.”

David Ahn at iMedicalApps posted a great review describing the positives and negatives of this novel app.  He notes some of the limitations of the app are the indexing of the images and lack of identifying information.  Ahn discovered upon doing a search for heliotrope rash that the first seven results were “clearly not a heliotrope rash.” As librarians know, indexing images is tricky.  Ahn noted Figure 1  also pulls images from outside medical websites (non-user submitted images) and a link to the website instead of the submitter’s name is listed.  However the outside images have “no captions, markings, or even any clear diagnosis listed.”  Besides the obvious problems with lack of identifying information, Figure 1 displays user submitted images before web scraped images.  As Ahn illustrated with the heliotrope rash, this can cause problems because the correct image (scraped from the web) was buried below the 7 incorrect ones (user submitted ones).

Additionally, I find doctors not only want to see and share images, but they often want to include them in presentations and slides for teaching purposes.  Right now you can only share the images through the app.  Emailing a colleague an image gives them a simple email (below) requiring them to use Figure 1 to see the image.  Making it so Figure 1 images can be used in presentations would make this Instagram like app even more useful to doctors and medical professionals.

 figure1email

This is a very new app. It appears they launched in May 2013, so it isn’t surprising that there is some room for improvement.  I don’t know of any products or apps that are perfect 3 months from their launch.  Yet as of today, it is the 5th most downloaded app in the Medical category of iTunes and according the MedicalApps post, the app is outpacing Landy’s projections.  So, given its popularity I expect to see some improvements relatively soon.

What I found to be interesting was Dr. Landy describing to Ahn his reason for creating this app.

Dr. Landy wondered how he could quickly access a medical image database to assist in identifying new clinical pathologies. This question eventually led him to create Figure 1. Like many physicians, he was not satisfied with the paywalls of private medical image libraries or with Google Images’ lack of medical selectivity.

Furthermore, when it came to sharing medical images with his peers, he found e-mail inefficient, as images would often get drowned out amidst ballooning inboxes. As a result, he helped create Figure 1, a free, crowdsourced medical image sharing resource that is quickly and easily accessible for health care practitioners.

Finding good medical images has always been a booger, and Dr. Landy is right about the frustrations of pay walls.  I would extend it a bit further to say that not only is the paywall part is a barrier to finding medical images, but the siloed nature of these medical image sites is a massive barrier as well.  Even if somebody has paid for these medical image sites, there is no repository or online catalog of all the image packages bought from different companies.  That makes searching for images difficult even if you paid for them.

I am curious to see how Figure 1 evolves and what impact it will have on doctors finding images.  I am also curious to see how/if subscription companies with medical image silos might adapt as a result of apps like Figure 1.

Brief Summary of Google Glass in Medicine

Google is letting several people “play” with Google Glass. I know of two people at my institution who are trying it out.  Since I don’t have Google Glass(es) and I don’t have a real need for them right now other than playing with them and obsessively worrying about breaking them (there is a reason I buy cheap sunglasses).  I thought I would summarize some of things the medical/technical people testing Glass have said. 

John Sharp at eHealth
John works at the Cleveland Clinic.  He had three days with Google Glass and his thoughts are:

  • Voice command takes some getting used to
  • Menu gets some getting used to
  • Nice to be hands free browsing, taking videos/photos -camera quality excellent
  • Possiblity for healthcare – Physicians receive alert on patients lab results via Glass
  • Network access for surfing is currently problematic. Need an available wireless network or an open network that does not require authentication. Alternative is to connect using your phone’s bluetooth (wifi) or  enable your phone as a wireless hotspot (dataplan!)
  • Messages are alerts are short and limited text to fit on tiny screen/glass
  • Permissions/privacy concerns because you don’t know somebody is filming using Glass

John Halamka at Life As a CIO
Chief Information Officer of Beth Israel Deaconess Medical Center briefly describes Google Glass and how it works and lists 5 potential uses.

  • Google Glass basics: (He calls it basically an Android cell phone without the cellular transmitter.)
  • Can run Android apps (Krafty thought: Candy Crush andyone?)
  • Videos displayed at half HD resolution
  • Sound uses bone conduction only wearer can hear it (Krafty note: I am very familiar with this method, there is an underwater MP3 player that uses the same technology.)
  • Has motion sensitive accelerometer for gestural commands
  • Right temple is touch pad but also has microphone for voice commands
  • Battery lasts about a day

Potential uses:

  • Meaningful Use Stage 2 for hospitals- Screen shows picture of patient and medication on Glass to nurse who is about to administer the drug to ensure that she has correct patient and medication. (Krafty thought: The movie Terminator is coming to mind and I can imagine the the nurse “scanning the room” and it flashes on patient and does face recognition with ID bracelet confirmation then scans the barcode of the medication and gives a green screen if it is right or red screen if it is wrong. But according to this post facial recognition apps are currently banned.)
  • Clinical documentation – provide real time video of the patient/doctor encounter. 
  • Emergency Department Dashboards – ER doc puts on Google Glass and looks at patient and it does a “tricorder” like scan of patient providing vital signs, triage details, nurse documentation, lab results, etc. John states “At BIDMC, we hope to pilot such an application this year.”  (Krafty thought: Dude  that is the Terminator screen up display that I am thinking of.)
  • Decision Support – Google glass would retrieve the appropriate decision support for the patient in question and visually sees a decision tree that incorporates optimal doses of medications, the EKG of the patient, and vital signs. 
  • Alerts and Reminders – Communication, emails, phone calls, calendar, etc.  

Timothy Aungst and Iltifat Husain at iMedicalApps
I can’t tell from the post whether they tried one out or whether they were just coming up with usage scenarios.  They provides a lot of scenarios (too many to list here) so I just thought I would mention a few that I think stand out. There is also a lively discussion in the comments section.

  • EMS Responder at an accident has Google Glass on and transmits live stream to ER department status of patients and the traumas for each patient enabling the ER to better prepare for the patients upon arrival.
  • A cardiologist in a cath lab overlays the fluoroscopy as they perform a femoral catheterization for a patient with a recent myocardial infarct.
  • A physical therapist can see past sessions with a patient from previous recordings, overlaying their current range of motion, identifying changes as well as progression.
  • Any healthcare professional could walk up to a patient’s bed and instantly see all their vitals such as pulse, BP, O2 Sats, etc.

Dr. Rafael Grossmann @ZGJR Blog
Has several very interesting posts on his current use of Google Glass treatpatients. He is not only using it in medical scenarios but also with real patients.

There are a lot of people in library land writing posts about Google Glass and its potential impact on libraries.  I don’t know of a librarian who has tried them (if there is one let me know) and asside from iMedicalApps I chose to focus on those who have actually tried them.  A future post will look at the potential of Google Glass in libraries.

 

 

#Medlibs Tomorrow: Using Social Media for Consumer Health

Tomorrow I will be moderating the #medlibs chat and we will discuss the use of social media for patient education and consumer health.  72% of adults seek medical information online, and between 26-34% (depending on various reports) of people use social media to find health information.  The thought is the trend will continue to grow.

I will be asking these questions (I’m giving them to you ahead of time so you can think about them):

  • How are librarians using social media to provide consumer health information or patient education?
  • How do you measure the effectiveness of a social media health information campaign?
  • What are some barriers to providing patient education/consumer health information via social media?

#medlibs is a active group with lots of ideas and opinions so I am sure we will have more questions as we discuss things, but this is these are the main ones to get us started.

See you all online Thursday July 11, 2013 at 6pm PST and 9pm EST.

*Disclosure Notice*
I am writing a book chapter on this topic and this #medlibs discussion will help me with it.  I may use some tweets or reference parts of the #medlibs chat in the chapter.  I don’t want to squelch the overall fun chattiness of the group.  If I use anything I will only refer to tweets that are specifically related to the discussion topic and I will make every effort to let you know I am using your tweet.