Trip Report: The WATCH Society’s Future of Wearable Technology In Healthcare Conference

I just got back from the fantastic Future of Wearable Technology In Healthcare Conference hosted by the International Society of Wearable Technology in Healthcare over July 24-25 in Indianapolis. Their Twitter account is @IntWATCHsociety. Before I get on with the trip report, a bit about myself and Glass.

There were many great presentations at the WATCH conference, on Glass and medical education, HIPAA and privacy issues, real-time video streaming, teaching the autistic, smart belts for pregnancy, managing tech in operating rooms, and so on and so on! However, as is usually the case, this trip report skews toward workflow and workflow-related theme, plus some personal adventures, and the attendees and presenters I actually got to meet. (Including two people who attended because of a post I wrote about the then upcoming WATCH Conference!)

Enough preface!

The day before the conference I drove to Indianapolis. The corn got taller and taller and taller!

In the morning of the conference I used Google Glass’ fantastic turn-by-turn navigation GPS to find the venue.

I, and (Google Glass controlled, via Bluetooth) Mr. RIMP, listened to a most excellent welcome from Paul Szotek MD. He’s behind that pair of LED “eyes” in the upper left. (See the next tweet for a better photo!) Here’s a great write up in the IndyStar about how he got Glass and used it during surgery.

The following is one of my favorite comments, from @PaulSzotekMD, from the entire conference: Glass is a phenomenal platform to force healthcare to choose which data is important! Absolutely spot on. Glass is a culmination of a trend starting with tablets and smartphones. As screen form factors have shrunk, more-and-more intelligence must go into selecting just the right data and options to a smaller-and-smaller screen. My guestimate is that the Glass micro-display, at 640×480, with the smallest recommended font size of 26px, at eight feet away from the viewer, can present less than one percent of the information of a 1600×1200 desktop or laptop computer monitor.

Rafael Grossmann, MD (@ZGJR on Twitter) gave the kickoff keynote, via Google Hangouts. Rafael is such an enthusiastic ambassador for Glass in surgery and healthcare! He really charged up the audience.

I first learned of Dr. Grossman last year, when he was the first person to stream video from Glass during live surgery. It even showed up on the Drudge Report!

Next year’s conference will be in Amsterdam.

The 2015 WATCH Conference chair is Marlies Schijven, MD, PhD (@MarliesSchijven on Twitter). I found the following among tweets from @MarliesSchijven. Most Glass owners have lots of these, photos taken and tweeted during demos. :)

I was delighted to many of my slides from my February slide deck highlighted in one of the presentations.

Certainly, medical education was a big theme at the conference.

One of my prototypes that I wrote last year was even featured!

It’s not really a Snellen Eye Chart. It’s for developers and folks trying Glass on of the first time. The 90px through 26px are standard font sizes for Glass. So the question becomes, when I handover Glass for a two-minute demo: What is the smallest font size you can see? With your glasses? Without? One or the other, about 95 percent can see everything down to the smallest 26px standard font.

A big topic at the conference was Glass integration with EHRs. This was my mockup of realtime patient location and task updating. I did it last summer, but was glad to see it presented here. It fits into the important theme of improving EHR workflow and usability.

You can find the rest of my slides, along with related speaker notes and links to resource materials here.

Back to the WATCH Conference!

Nicolas Terry, Health Law Professor (@nicolasterry on Twitter) made what he conceded many think is a boring subject — HIPAA — into a tolerably interesting subject. (For which I greatly admire his intelligence and good humor!) Here’s his best slide, what do to about Glass at your healthcare organization. Be sure to click on the image and zoom in to better see the individual bullet items.

Up there with @PaulSzotekMD statement (that Glass is a phenomenal platform to force healthcare to choose which data is important!) is this statement from a video shown of Steven Horng, MD speaking about using Glass to access information from his hospital’s EHR. Glass is ultimate unshackling of physician from workstation.

Between these two insights, figuring out what is important “here-and-now” when “here-and-now” keeps changing, and freeing physicians to get back to face-to-face, hands-on patient care, is the greatest potential for Glass to improve patient care.

In fact, the result of the right info and options at the right time in a complicate workflow, and freedom to move around, from problem to problem, solving on the run, will be, as REMEDY’s tagline reads: See More Patients. It’s a pun, of course. To see more is to perceive more. And free physicians from their workstations will allow them to serve more patients.

@PaulSzotekMD described a whole bunch of Glass prototypes he’d help develop with collaborators.

So I asked, what was the relation among the prototypes. Did he imagine using one after another in a workflow? He said absolutely. I hope you can see that I’m not unreasonably to suggest the phrase “wearable workflow” as it might apply to workflow among not just Glass apps, but among these apps and other wearable devices?

I liked the following quote, from @MarliesSchijven’s presentation, so much I tracked it down its complete context.

“Anthony (Tony) Jones, M.D., is the vice president and chief marketing officer for patient care and clinical informatics at Philips Healthcare. He explains, “The most exciting potential application of Google Glass in healthcare is the ability to allow providers to ‘virtually’ be in two places at once, which will have a significant impact on workflow and patient care.”

For instance, imagine a doctor or nurse is with a patient and he or she is doing a basic procedure that requires both hands. An alarm or alert is triggered in another room.

“Rather than interrupting the current procedure, the provider can use the verbal commands to call up the patient monitoring data that’s triggering the alert, Jones explains. “At that point, the provider can decide whether the alarm can wait or whether it needs immediate action.”

Similarly, bringing some of the basic vital signs info from the monitor directly into the field of vision via Google Glass allows the provider to do the procedure and view the feedback data without taking their eyes off of the patient.

“It sounds simple, but small workflow improvements like this can reduce errors and have a significant impact on patient care,” Jones says.”

The following slide describes a study examining how often and how long, on the average, a resident looked away from the patient to consult a bedside monitor. It doesn’t compare to Glass, but one hopes it could help increase the amount of time patients get the full attention of their care givers. I look forward to more such statistics comparing w/Glass and w/o Glass conditions.

On the morning of the second day of the WATCH Conference, before I even got out of bed, I reflected what I perceived to be the dominate themes of the first day of the conference. This is what I tweeted.

  • Google Glass
  • Medical education
  • HIPAA
  • Live streaming video
  • EHR integration
  • Workflow

One of the highlights of the WATCH Conference was the opportunity to finally meet Brian Norris, who I had only previous known through lots of interaction of Twitter (he’s @Geek_Nurse). He’s a triple threat — clinician, developer, activist — who really cares a lot about the Indianapolis health IT innovation and startup scene. I heard frequent comments of appreciation about Brian from other local Indianapolis-based attendees.

Brian provided particularly valuable insight to anyone hoping to get an app into the Google Glass online app store. Basically, follow instructions! Use Google’s checklists. Conduct a self test. Pay particular attention to branding. Google wants the attention on the app and its functionality, not an implied relationship or partnership with Google. Watch the size and location of your images!

By the way, I went through the Glass UI style guide and combined all their different example screens into a single 640×360 image you can use a the (temporary) background in any glassware you develop. Just turn it on once in a while to see if you’re coloring outside the line, so to speak. :) You can access it directly from your GDK or Mirror API app at http://wareflo.com/glass-gutters-spacing.jpg.

One of the presenters didn’t show up, so I got to take his place! So, off-the-cuff (appropriate for a wearable tech conference) I presented Wearable Workflow, Google Glass, Wearlets and Mr. RIMP. I recorded it and I created a YouTube video from video of Mr. RIMP interacting with Glass, plus photos of his innards and from the conference. I got to talk about “wearable workflow” and “wearlets” (out of which wearable workflows are constructed). #

Many thanks to Brian Norris (@Geek_Nurse on Twitter) for tweeting the following photo of Mr. RIMP (and me).

Mr. RIMP attracted a lot of attention! Lot of folks wanted selfies with him.

I was particularly happy to get this group photo of Matt, a Google Glass Guide, Mr. RIMP trying on Glass, and myself.

John Springer give a great prevention about Glass in the operating room used manage supplies and devices.

By the way, I didn’t realize his Twitter account at the time, it’s @JohnSpriCST. Here’s his Twitter profile: “OR GLASS”!

springer

Divya Dhar of Seratis Health gave an overview of her company, and how Glass could fit into their mobile care coordination platform. From the @SeratisHealth Twitter profile, “Seratis brings doctors and nurses out of the pager era by allowing #healthcare providers to coordinate, track and analyze care across the team.” In particular, I was intrigued by “Seralytics.” Once you support and capture care coordination workflow, the next obvious step it to data mine it, looking for patterns and insights to improve those workflows.

Finally we got to what was, in my mind, the best presentation at the WATCH Conference, Kyle Samani’s Achieving Scalable Commercial Success With Glass In Healthcare (slides). I interviewed Kyle a year ago for my blog about health IT workflow.

PristineIO is developing a sophisticated mobile and distributed workflow management system for Glass, combining video communication, checklists, and just-in-time user guides.

I saw the following point in several other demonstrations, a point with which I very much agree. Glass (and other wearables too, capable of delivering information to wearer and doing something in response to wearer intentions) requires considerable infrastructure and real-time management of information and workflow to be useful in healthcare. I made this very point in last year’s InformationWeek column Google Glass: Autocorrect For Your Life.

“For Glass to be the raging success I believe it will be, many Glassware apps — particularly in healthcare, the industry I call home — will require sophisticated self-adapting and user-customizable filters, priorities and workflows.”

Hub-and-spoke, central coordination and supervision, such as described in an earlier presentation, are all about what organizational psychologists call “span-of-control.” Information technology and machinery is, essentially, making it possible for less trained personnel to deal with more situations, but to subject to realtime quality assurance and immediately available specialized expertise. And it is this middleware layer, of contextually-aware computing combined with flexible workflow automation, which will make this increased span-of-control possible.

I didn’t tweet the slides, but one was a map with pins representing pilots and customers from coast to coast (accompanied by hint there are lots more in the pipeline). Kyle got there early (I think he was one of the first 1500 to receive Glass). Articulated a vision, executed aggressively, pivoted when necessary, all through while writing many blog posts about Glass and health IT along the way, to keep the rest of us up-to-date.

Conclusions

The WATCH Conference was well worth the trip, and bodes well for the future of the International WATCH Society. This “Conclusions” section as just a place for me to collect some thoughts that didn’t make it into the previous, more chronologically, thematically, presented slides, tweets, and interspersed commentary about them.

First of all, its interesting, the “WATCH Society” and “WATCH Conference”. WATCH stands for WeArable TeChnology in Healthcare. Glass is not the only wearable tech. And of course there are smart “watches” but 95-percent of the conference presentations were about Glass. There had been several large wearable conferences the weeks before, one on each coast, and in those conferences, Glass was not nearly as overwhelmingly represented. I think this is a testimonial to the grasp Glass has achieved on the collective imagination of healthcare clinicians and health IT visionaries.

Second of all, the two most impressive uses of Glass I saw, Glass to access EHR info at Beth Israel Deaconess Medical Center and PristineIO’s implementation of hub-and-spoke management of lesser skilled healthcare workers, both involve using Glass in ways Google did not foresee. In the case of Beth Israel, if you watch the video, the Glass app presents info in ways violating Google’s Glass guidelines. In the case of PristineIO, the native Glass Android operating system is being wiped away to make it literally impossible to violate HIPAA. One of the characteristics of transformation technology is that it ends up being used in a lots of ways unforeseen by the inventor of that technology. Twitter is a lot like that, for example, hashtags were invented by users. Now I don’t know if Glass is the Twitter of wearable tech in healthcare, but I think these unpredicted, even advised against, successful uses of Glass are the single best predictor something very interesting is going on.

Third, I don’t like to admit I am wrong. But I predicted last year that Glass would be an even bigger consumer phenomena than vertical phenomena (healthcare, energy, education, security, etc). While I program Glass with in eye toward uses in healthcare, I also love using it out and about. Its turn-by-turn navigation user experience is far superior to dashboard-based GPS. I love to be able to respond to a tweet or email (hands-free!) in almost sub-second response times. But I’ve changed my mind. Glass will be more successful in verticals such as healthcare, first.

Regardless, I am consistently and boundlessly effusive about Glass in person and online (2000+ tweets on the #GoogleGlass hashtag) was still surprised and impressed by the quantity, variety and subtlety of the Glass apps, projects, and envisionings I witnessed at the WATCH Conference. And, echoing what I heard from many people at the conference, WATCH was just the tip of an iceberg. There are many more stealth, under-the-radar, Glass in healthcare software development projects and startups than were presented publicly at the WATCH Conference.

Finally, many thanks and kudos to the doughty and visionary Indianapolitans who threw a great conference about wearable technology in healthcare! One more tweet!


P.S. By the way, I’m giving a keynote about Glass and wearable workflow at a healthcare conference this coming February. There will be a free webinar preview of that keynote September 16 I’ll tweet the registration link when it’s available. Here’s the title and abstract.

Wearable Workflow Needs Health Systems Engineering

“From the original calculator watch to today’s Google Glass and smart clothing accessories, wearable technology seeks to weave (sometimes literally!) information technology into everyday life and work, making it pervasive, intimate, and, metaphorically, friction free. Especially promising are applications in healthcare. These, for example, include patient monitors for the well and unwell and wearable user interfaces to health information systems. However, wearable tech will not succeed unless we get its workflows right. Getting the workflow right requires both means of driving workflow at the point-of-care and -health AND systems for analyzing, creating, and optimizing this workflow. In other words, successful wearable technology in healthcare requires health systems engineering. This presentation provides an overview of wearables and how health systems engineering can help make them a success in healthcare.”

In other words: Wearable Workflow!

P.S.S. Check out my own Google Glass in healthcare prototype!

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