MUSC surgeon tests Google Glass for global surgical care, education improvements

Imagine having the ability to transmit real-time surgical instruction from the U.S. to Nepal without a firm proficiency of Nepali, the official language of Nepal. Imagine being briefed on a patient’s condition—CTs, medical history, MRIs—en route to an emergency operation, where time is a competing element. Now, imagine a medical trainee, in the U.S. or Kenya, viewing the previously mentioned surgical events in a classroom as they happen.  Google Glass does all of the above—translates your voice, shares live pictures and videos in real time—with exceptional exactitude.

Go to the Google Glass website and you’ll find a variety of applications for this architectonic—in both technological innovation and design—hardware. The software is even more advanced, and developers, mirthfully called explorers, were given nearly free rein to create world-changing uses and applications for Google’s product.

The growing influence and usefulness of mobile connectivity is shaping the way healthcare professionals do everything, from diagnosing disease to maintaining patient prescription drug adherence. Data from The World Bank show that around 75 percent of the world’s population has access to a cell phone or some form of mobile connectivity. What’s more, it is estimated that only 4.5 billion people own working toilets in the world compared to 6 billion who own cell phones

Joseph Sakran, MD, MPH, Assistant Professor of Surgery at the Medical University of South Carolina (MUSC) and explorer for the Google Glass program, sees this growing connectivity between people and their technology as a way to improve population health by using Google Glass to train better surgeons across the world, thereby enhancing the quality of surgical care in low-resources settings.

“There are many capabilities for new tech but there is a lot of work to be done,” said Sakran. “Especially taking it to resource poor settings—I think we can increase access to care in resource poor settings.”

Most new technologies are not without flaws, though. Google Glass has been subjected to some scrutiny in how its use could encroach on the privacy of others, especially in medicine.

“Clearly, there are some privacy issues that haven’t been ironed out,” stated Sakran. “As Google Glass becomes more prevalent, the legal and privacy issues will work themselves out. But there are real people who can benefit from this hardware’s use”

The benefits of Google Glass, and accompanying high-speed, high-performing software, far outweigh its drawbacks. Sakran is developing projects that encompass domestic and global use for surgical education and increasing access to quality surgical care in rural settings around the world.

For instance, sustaining global interventions is an issue that plagues researchers, philanthropies and non-governmental groups across the globe. “Traditionally, surgeons operate for a few weeks and then they leave,” Sakran remarked. “That sounds great, but where’s the sustainability?”

Sakran’s foremost idea is to relay real-time consultations to healthcare professionals in the field during emergency treatment of an injury. In treating these patients, a clinical officer in Rwanda can “put these glasses on and be 4,000 miles away. They can transmit real time what is going on with the patient.” By doing this, Sakran has the ability to train healthcare workers in responding to road traffic crashes, falls or occupational-related injuries in a judicious and timely manner, where they would otherwise suffer permanent bodily damage or even death.

Seamless wireless fidelity or Wi-Fi access is an issue that could hamper the progress of such a project, but Sakran contends that the mass marketing of Google Glass and other efforts to expand connectivity will remedy access issues.

In fact, Google has developed a project that began June 2013 called “Project Loon”. Project Loon is a nascent, transformational pilot project that floats weather-like balloons into the stratosphere beyond the altitude of airplanes, near the edge of space where “people can connect to [a] balloon network using a special internet antenna attached to their building.” These networks of balloons are “designed to connect people in rural and remote areas, help fill coverage gaps, and bring people back online after disasters.” It’s essentially global Wi-Fi accessible irrespective of location or common signal interference. 

Sakran’s determination to change the outlook of surgical care had its defining moment when he was in high school. A young, hip Sakran, wearing a white shirt and white jeans, was attending a football game with friends when someone opened fire, shooting indiscriminately into the crowd where he stood. He was shot in the neck.

At age 17, Sakran worried less about his wound and more about his parents discovering a pack of cigarettes in his pocket. Blood soaked the white outfit he donned as he was transported to the hospital for emergency surgery. He remembers most of what happened like a lucid dream: sitting upright on the gurney to stymie the bleeding, admiring EMTs apply their training as they—and eventually, surgeons—worked to give him another opportunity to live.  For the next six months, he would have to wear a tracheostomy tube and suffer a permanently paralyzed vocal cord.  

“I realized that I’ve been given a second chance, and now I want to take that opportunity and put it to some good use,” said Sakran. “And while I love taking care of patients and I love teaching residents and I love operating more than anything, I still have significant work ahead of me.”

Sakran knows full well how important it is to adequately train future practitioners. After completing his medical education at Columbia University, he worked side-by-side as a resident with the very surgeons who attended to him after the shooting. “I operated with the surgeons that took care of me,” Sakran said. Training with Google Glass provides a unique opportunity to show students and trainees exactly what a surgeon sees in real-time whether they’re resecting tissues or surveying the anatomic plane.

“As we talk about the training of the next generation, with constraints of the 80 hour work week, you really have to pack in a lot of information and a lot of procedures and unique teaching opportunities in a compact period of time,” said Sakran.

Globalization and the technology revolution have played a large role in public health, economies and politics of developing nations in recent years. While some countries flourish in providing a better quality of life for their residents, an unintended byproduct of this change still persists: poor health outcomes. Sakran takes close care in making sure there are more who benefit from his projects and adjusts for unintended consequences accordingly.  “We have to be very cognizant of the resources we are utilizing,” he chimed.

Sakran’s Google Glass projects abroad are equally applicable in the U.S. To him, borders are disappearing due to the growing interconnectedness of the global community. Translating clinical interventions and research among geographical contexts is now made simpler, especially in places where public health and socioeconomic dynamics are similar.  

“Even in South Carolina, you can go to places where it’s so rural and the resources are limited; it’s almost like a third world country,” exclaimed Sakran.

MUSC is steadily riding the crest on the wave of medical innovation. Just this past year, MUSC has tested a novel procedure to treat hypertension, became the first to test a new generation of stents to treat carotid artery disease, substantially expanded its telemedicine program, and introduced a new laser system to treat cataracts. 

Sakran continued, “I think part of our responsibility as clinicians and individuals is to think outside the box. We can wait for others to do it or we can be leaders in the field. That’s why I came to MUSC, because the delta was large.”