Unshackling the Physician: Karandeep Singh on Glass & Primary Care

Karandeep Singh, MD gives a Google Glass Demo last April at Boston’s Google headquarters. All photos provided by Jennifer Joe.

On April 23, 2014, the Boston medical community came together at the Boston Google headquarters to learn about the possibilities of wearables and Google Glass. Everyone was buzzing – What is Google Glass? What’s special about it? What does it even do? Can we use it in hospitals?

At the time of the event, Google Glass pilots had been live for some time. The biggest inspiration for the audience was the potential that Glass offered for physicians to actually unshackle from their work stations – a very real possibility for the near future.

In preparation for his keynote and demonstration at the upcoming Pri-Med East Conference, which will be held at the Boston Convention and Exhibition Center on September 11-14, we thought we’d catch up with Dr. Karandeep Singh. He presented his vision of the future of primary care last April, expressing a passion for helping doctors find freedom and joy in their clinics through Glass.

Karandeep Singh, MD, speaks to a full house last April.

Dr. Singh is a Nephrology Fellow at the Brigham and Women’s Hospital (BWH) and a Biomedical Informatics graduate student at Harvard Medical School. He’s also the leader of BWH’s first Google Glass application. Like many doctors, Dr. Singh has expressed frustration about the functionality of today’s Electronic Health Records (EHRs):

The current EHR is designed such that the physician, nurse, and patient all work around it. When a physician steps out of one patient room and enters the next, the traditional EHR doesn’t follow behind. A wearable EHR creates the possibility of a new workflow in which the EHR is an extension of the physician.

Dr. Singh tells us he wants to “reevaluate and redesign the EHR to help clinicians deliver patient-centered care.” The current EHR is designed so that patients and physicians must work around it. EHRs demand information about immunizations and smoking habits, when all a patient really needs is a blood pressure medication refill. EHRs require mammoth monitor screens that sit between doctors and patients. Today’s EHRs even give red flags to correct unknown errors before printing a prescription to give to a patient. Dr. Singh says he envisions a “wearable EHR,” one that is built around the physician’s workflow and needs. This is where Google Glass comes in.

What does this “wearable EHR” look like? Dr. Singh says it will be able to do four time-saving and novel tasks:

Dr. Singh presents at BWH Grand Rounds.

1. Because the system knows where you are in the clinic, it will display content that it intuitively predicts you want.

   • For example, the Wearable EHR has your full docket of 20 or so patients. Depending on the time, list of patient appointments, and room you are in, it will know to display the patient’s most recent vital signs, lab reports, and progress notes.

2. The system will allow physicians to make focused queries that can retrieve information from multiple sources.

   • For example, “fatigue” is a common complaint with a generally standard investigative route. Say you walk into a patient’s room, and the nurse has already recorded the chief complaint as “fatigue.” You will be able to say, “Glass, this patient is here with fatigue.” With just this one query, the Wearable EHR will display the most recent complete blood counts, chemistry panel, thyroid hormone results, any medications the patient is taking associated with fatigue and any current medical conditions associated with fatigue (ie, menstruation and anemia, history of sleep disorder, and allergic rhinitis).

3. The Wearable EHR will be able to link systems.

   • For example, a physician will be able to say, “Glass, start the patient on the medication loratidine 10mg po qdaily for 30 days,” and the system will send the prescription to the patient’s pharmacy and print out or email handouts on how to take loratidine.

4. The Wearable EHR would keep Task Lists for the physician.

   • Dr. Singh tells us he never wants to need to pull a piece of paper out of his pocket again. When seeing patients throughout his day, he will tell Glass the tasks needed for that patient–ie. call the patient’s daughter, order X, Y, and Z. And at the end of day, he can just ask Glass, “What do I need to do for Mr. Smith?”

What will Dr. Singh be demonstrating at the Pri-Med Conference on Saturday, September 13? Watch his demonstration at the Boston Google headquarters for a sneak peak.

Join Stephanie Shine, RN; Dr. Jennifer Joe; Dr. Karandeep Singh; Don Schwartz; Dr. Tristan Gorrindo; and Carlos Rodarte at Pri-Med’s East Conference for a panel on the power of Google Glass in healthcare, September 13th at noon. Register here under “Ticketed Events, Saturday”.