Can Google Glass’ enterprise iteration solve the patient documentation crisis?

[grow_thumb image=”” thumb_width=”200″ /]”Glass is a hands-free device, for hands-on workers.” What a marketing position! Google Glass finally arrives at where it should have started–not a techie toy or a social snooper banned from bars, but a tool for specific work needs that solve specific but important problems. This is not only ‘on trend’, but also the ‘professional case’ is steak on the grill as a powerful way to lend legitimacy to a new product (the classic is Tang ‘orange drink’ going into space in the early ’60s). The recent announcement of Glass Enterprise Edition (EE) marking its emergence from stealth mode was a refreshingly low-key (for Google and parent Alphabet) surprise. Even the revamped look is sturdy and utilitarian in full glass mode (left) or in clip-on (and also serves as eye protection). 

Their on-trend position for healthcare is to reduce the amount of time that doctors spend charting and documenting patients. Augmedix, a Glass partner, built the documentation automation platform for Sutter Health and for Dignity Health that captures the information from the interaction between patient and doctor via a ‘remote scribe’. Jay Kothari, the Glass project lead, quotes data from Dignity that it reduces clinician daily documentation time from 33 percent to less than 10 percent,  The Sutter Health estimate is two hours per day. Out of the gate this is extremely valuable because it improves the clinician-patient face-to-face (and presumably virtual) visit in eye contact, reduces the break in taking notes, and reduces time pressure generated by post-visit review. Netherlands-based swyMed concentrates on facilitating virtual visits, and is testing a home visit pilot with Loyola University Health System practitioners in Maywood, Illinois. Others, like John Nosta, have been continuing to use Glass in business. Our Readers may want to check out these partners as that is how Google is making the Glass available, not directly. SF/Boston-based partner Brain Power wasn’t mentioned in Mr. Kothari’s blog, but their AI/VR applications for brain conditions such as autism and TBI, as well as other uses such as clinical trials and care for older adults. mHealthIntelligence interviewed Augmedix’s CEO Ian Shakil, who notes that Glass still needs improvements in battery life for the hard work of documenting patient visits.

Update: An interesting comment on this via Twitter. The paper is from 2015 but the regulatory and privacy questions around recording patients and information remain. Augmedix does state on its website that it is HIPAA compliant.

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Tracking ER ‘frequent flyers’ community-wide to coordinate care, reduce readmissions

“There are folks who have a life of going from emergency department to emergency department, and that’s how their day is spent,” said Sorrell, an emergency physician and administrator at Sutter Health. “It’s sad and tragic, but that’s what happens.”

Alameda County,  just south of San Francisco, spans both wealth (Berkeley)- and poverty-stricken (Oakland) – parts of California. What it has a lot of as well are ER (ED) ‘frequent flyers’ a/k/a ‘super-users’. Some can’t manage their chronic conditions, while others are looking for a meal, a warm bed, safety or human contact. What is also true is that 1) this is an expensive and largely unnecessary form of medicine and social care, 2) there’s a lot of duplicated resources being utilized which are needed elsewhere and 3) the patients aren’t receiving the right sort of care for a better quality of life.

Since a data sharing program, PreManageED, was implemented on 31 March in four Sutter Health hospitals and two Alameda Health System hospitals, two hospitals found that they shared more than 2,000 patients, with over one-third having 6+ visits to the ER in the past year. But this is more than duplicate procedures, multiple EMS calls and badly coordinated care resulting in Medicare or Medicaid penalties. The Alameda hospitals are also integrating local community clinics and social services organizations into PreManageED so they receive alerts from the hospitals when their patients/clients arrive in the ER. It turns out that many patients are receiving social services from multiple agencies–also duplicated and uncoordinated. There is an example here of a mentally ill patient who visited ERs over 900 times in three years. Over 24 separate people had provided her with medical, emergency and social services–and none of them knew what the other was doing. The Alameda County program is a step to bring these ‘frequent flyers’ down to earth and improve their outcomes. Kaiser Health News

Big data in heart failure detection gets $2 million grant

One part of the US government that hasn’t gone silent is the National Institutes of Health (NIH) which announced yesterday a $2 million research grant to IBM, Sutter Health and Geisinger Health System to jointly develop data analytics tools to help primary care physicians detect heart failure sooner. This will analyze EHR data to determine the patterns that may be indicative of a person at high risk–and investigate more effective early intervention. Big data sets sights on heart disease (HealthcareITNews)