By now, the early excitement surrounding Google Glass has begun with the usual suspects. Television reports have been run, newspaper articles have been written, a million blogs have been posted. And now that we all have a solid concept in our heads about what Google Glass is, and what it can and can’t do, it’s time for the pioneers to step into the the gold mines to see what can be extracted.
With a vast landscape ahead of them, some developers are heading in the navigation direction, others are going after the geolocation approach, while still others are seeking the gaming route. One Texas-based startup is taking their experience in the medical field and looking to bring Glass into the operating room, revolutionizing healthcare in the process.
While Pristine is technically still in stealth mode, I recently spoke with Kyle Samani, CEO of Pristine.io, about their ambitious plans to make Glass an indispensable device for tomorrow’s healthcare professional.
In addition to Kyle at the helm, the founding team of pristine includes Patrick Kolencherry, CTO, Mark Troutfetter, VP of Engineering, and Arik Yaacob, Sr. Technology Architect. The team is currently developing two distinct applications to run on Glass, both of which center around the surgical process. Their focus is on pre, intra, and post-op solutions for surgeons, nurses and anesthesiologists.
“We’re adding value across four dimensions: patient safety, efficiency (saving money), teaching and training, and convenience for the medical professionals” Kyle says.
When it comes to patient safety, Kyle says that one (potential) use case for Pristine is retrieving data from the EMR (Electronic Medical Record). As we’ve seen with a number of other uses for Glass, it’s an unobtrusive device that’s perfect for accessing text-based data, and freeing up healthcare workers hands could have huge potential.
“If you’re running around all day, using your hands, and you need to access and share information, Glass is going to change how you do your job,” Kyle says. “Studies have shown that smartphones are some of the dirtiest places on earth. Our users will never touch Glass once they put it on.”
Now you wouldn’t think that washing your hands one more time after you’ve accessed some data on your phone would be a big deal, but when you think about how much information healthcare workers need access to on a daily basis, and how many times they have to maintain germ free hands and fingers, the benefits of healthcare and Glass start to add up very quickly.
“Keep in mind, we’re not just talking about doctors. Nurses, phlebotomists, lab technicians, PA’s, LVN’s, CRNA’s, there are so many different job classes of medical professionals in healthcare. And pretty much all of them have that job description: running around all day accessing and sharing information while using their hands.”
Overcoming the obstacles
As with any product development, Kyle and his team have had their fair share of obstacles to overcome. When you add in the fact that Glass isn’t even readily available, and that the company is still in (semi-) stealth mode, you’re looking at a compounded problem to solve.
“The biggest obstacle to further development is simply lack of Glass. In an operating room, you’ve got a surgeon, an anesthesiologist, and three or four nurses. That’s 5 or 6 units right there. I want to test three OR’s at a time,” Kyle says.
As Pristine never touches a patient, it’s not classified as a medical device, thus, there’s no need to seek FDA approval and get mired in red tape. However, the rules and regulations don’t stop at simply being classified as a medical device.
“One of the big ones with FDA certification is around marketing claims. If you’re going to say that your device makes patients five percent safer, you’re opening yourself up to need[ing] FDA approval. So we have to be careful [about] our marketing claims, but otherwise, we’re good to go.”
On the software development front, Kyle is quick to point out that Glass is buggy and undocumented. Coupled with relatively low powered hardware, the Pristine team find themselves constantly coming up with creative solutions to deliver the user experience they’re seeking.
“We’re not using the mirror API, but rather writing native Android applications,” Kyle says.
But why not go the official Google sanctioned route of using the mirror API? Wouldn’t this make development a whole lot easier? The answer is yes, and no, and one that not only Pristine will have to deal with.
It revolves around privacy. That age-old beast that users of the Internet and those that develop for it must grapple with. In the case of healthcare, Google has already had its go around with online health records. While Google Health never took off the way the company had hoped for, one is left wondering if this lack of adoption might have had to do with privacy concerns. And the same might be true for Pristine.
“The mirror API is pretty much unusable for anything healthcare related, because everything gets routed through Google’s own servers. Google told us flat out, ‘We do not want you putting healthcare data on our servers.’” Google knows the privacy advocates will be all over them for it, so they’re discouraging it from the start.”
To circumvent the “might be breached” issue, Pristine is taking the old-school approach and keeping all the data behind the hospital’s firewall. In other words, all of a patient’s data already exists in electronic format on a hospital’s server; Pristine is simply saying that they’re facilitating the transfer of this data from the server to the device, Glass, with no data ever leaving the local network.
“It literally becomes 10 times harder to close the deal and make things happen when the ‘This lives inside your firewall’ and ‘This doesn’t live inside your firewall’ conversations begin,” Kyle says. “We made the decision to install our software locally to avoid exactly this debate.”
In order to comply with HIPAA (Health Insurance Portability and Accountability Act) standards, Pristine is encrypting all data, both at rest and in transit.
Healthcare Professional Adoption and the ‘droid effect
We all know that there’s no need to spend countless hours in pursuit of a pipe dream. If there’s no market for your product, you’re dead on arrival. Not so much for Pristine.
“We have a lot of demand, far more than we can support at this stage. We’ve had 10 hospitals reach out to us, and nine or 10 individual surgeons and anesthesiologists contact us about piloting the apps. I can’t run 10 pilots. I simply don’t have the manpower,” Kyle says.
Pristine is currently in discussion with three of the top medical centers in the world, although Kyle couldn’t confirm which three (he did give me license to speculate, but I’ll leave that up to you), and two large academic medical centers are slated for pilots by the end of September.
So it would appear that the healthcare professionals are on board, but what about the patients?
Kyle and I spoke at length about various wearable display technology devices, including meta-view and Atheer, both of which he sees potential in. However, these are augmented reality devices, displays that by definition obstruct the user’s vision.
“What’s nice about Glass is that it allows you to maintain eye-to-eye contact. You have this thing there, but it really isn’t obtrusive.”
Kyle views the defining characteristic of wearable display technologies as how much of the device blocks the human face.
“I believe that the human eye is what makes the face. If you cover the eye, you go from human to android. There are devices out there like oculus rift that are awesome, but you don’t look like a human when you’re wearing it.”
To this point, Kyle believes that Glass is the best suited to the healthcare industry because it’s a Google product, has already received a massive amount of coverage, and there’s a large swath of the population that has already seen the device, or is at least aware of what it is. Competing wearable display devices are going to have a hard time in this field, as patient awareness is likely to be low and sensitivity high.
Piloting the next versions
Pristine is on track to start their first pilot programs in two medical centers by the end of September, and will begin to receive their first bit of “real world” feedback from healthcare professionals.
And while they’re bound to begin the tuning and fine-tuning stages, Kyle isn’t ruling out completely new ways of serving the healthcare professional community.
“This is a very new device, and we don’t need to pretend that we know everything. Who knows the kinds of ways and things people are going to use it for. I’m sure our customers are going to have all kinds of ideas about new use cases.”
Lead image provided under Creative Commons via JD Lascia
Google Glass image provided under Creative Commons via Giuseppe Costantino
Oculus Rift image provided under Creative Commons via Sergey Galyonkin
Kyle Samani image provide by Patrick Kolencherry of Pristine.io