Most medical students learn by observing experienced surgeons, but operating theaters are small and confined. Now an app for Google Glass called Surgery Academy wants to let surgeons stream a heads-up view of their process to students anywhere in the world.
Surgery Academy is the brainchild of an Italian iOS developer named Armando Iandolo and his cofounder, former medical student Andrea Madrigali. "We combine the useful with the extremely useful," says Iandolo.
Surgery Academy is currently running an Indiegogo campaign to raise the rather low sum of $6,000. "Clearly, six thousand dollars is peanuts," says Iandolo. "We mainly want to understand how many supporters the project can gather around."
But will it actually work? Can you really train doctors virtually, like you train astronauts or airplane pilots? To find out, I asked the doctor/coders from Modernizing Medicine for their opinion of Surgery Academy’s concept.
"This is a reasonable ancillary educational opportunity for medical students to be used as a supplement to surgical rotations," says rheumatologist Elana M. Oberstein. "In reality, nothing replaces real-life exposure in an operating room."
Her colleague and otolaryngologist David Lehman agrees. "There is value in having the ability to view an operation remotely to have an idea of what a specific operation entails or to gain a different perspective on how other surgeons may perform operations differently. However, merely viewing an operation without physically being in the operative field—touching and manipulating the tissue, and being present as a surgeon responds to the multitude of variables that arise with each unique case and patient—can in no way substitute for hands-on experience, particularly for a medical student or a resident learning a new procedure."
The goal of the project, says Iandolo, is to provide not just a video feed to students, but also real-time information on the patient’s vital signs and health records. It will eventually also include a MOOC for teaching surgery to medical students using the technology.
The development work so far has been on Android only and the Milan-based team is not yet using the Google Mirror API; they are currently using a proprietary REST API. The Mirror API allows you to build web-based services, called Glassware, that interact with Google Glass to define the content seen by users, actions like read aloud, reply by voice, and navigate to and notifications. Iandolo told me that work has already started on retrieving the vital signs information. "And it's amazing!" he adds. They have plans to move entirely to Google’s infrastructure after some initial testing.
Retrieving anonymized electronic health records for a patient on whom a surgery is being performed would require integration with one or more electronic health record systems as well compliance with regulations defined in the HIPAA (Health Insurance Portability and Accountability Act). Some work would also be required to adapt PC-based EHR data to the mobile view required by Glass. "We believe that vendors will adapt their software to provide only the most critical of information to users of Google Glass," says Iandolo.
"The medical institution would have to have Google sign a HIPAA form and make sure the transfer was secure," says Iandolo. "The other solutions would be to encrypt the stream from glasses to the hospital server so Google is monitoring an encrypted stream, or just skip the monitoring of health care feeds perhaps by allowing the hospitals to run their own server."
Surgery Academy would also need to work with Vendor Neutral Archive providers (a standard format and interface for medical images and documents) to get access to medical images which the surgeon may use during an operation. None of these integrations seem to have been tackled yet by Surgery Academy.
While Surgery Academy may be at a very early stage, Google Glass has already gained some champions among surgeons. Orthopedic surgeon Dr. Selene Parekh recently used the technology as he conducted foot and ankle surgery at a medical conference in India. In December last year, the device was worn by plastic surgeon Dr. Anil Shah as he carried out rhinoplasty. Shah sees multiple advantages to using Glass in surgery from reviewing medical images without turning his view from the patient to training students.
Cardiothoracic surgeon Pierre Theodore has also used Google Glass to compare medical scans like CTs and X-ray images with the surgical situation in front of him. "This is not cyberpunk," says Iandolo. "We already have all the technology and the know-how to make it happen."