Dr. Andrew Laster, a Charlotte rheumatologist, normally wears glasses. But the pair he donned before examining Dianne Hager sported a sleek white bar at the right corner.
When Laster asked Hager to describe the arthritic pain in her joints, a tiny camera in that white bar flashed their words and actions to India, where a trained transcriptionist, Abhishek Pundhir, watched and took notes.
While facing the patient, Laster periodically summarized his findings: “Eight tender joints. No swollen joints.” Pundhir typed the words that would become part of the patient’s electronic medical record.
This three-way conversation was made possible by Google Glass, the technology that famously flopped when rolled out to consumers in 2013.
Initial enthusiasm for the $1,500-per-pair web-streaming glasses quickly gave way to ridicule, and Google stopped selling the product for most consumers early this year. But today, a partner company has found a new market for the technology – health care.
Hundreds of doctors such as Laster, who bought his first Google Glass in 2014, are using the product to save time by delegating much of their note-taking to transcriptionists, also called scribes, on the other side of the camera.
This new market developed in recent years after hospitals and medical offices converted from paper to electronic records. That process frustrated many doctors who were accustomed to writing or dictating their notes and don’t like clicking multiple boxes on computer templates to document patient encounters.
It saves me easily an hour and a half every day. And it frees me up to go in the room, sit down and look the patient in the eye.
Dr. Andrew Laster, Charlotte rheumatologist, on using Google Glass
Augmedix, a San Francisco-based company, came up with the software and support to make Google Glass useful for doctors. It has trained several hundred scribes, in San Francisco and in India, to retrieve medical records for doctors and write notes updating patient records.
Laster is “one of our rock star users,” said Augmedix co-founder Ian Shakil. He predicts the number of doctor-users will be in the thousands next year.
Patients have mostly been accepting. Only five have declined to allow Laster to wear Google Glass during their appointments. Hager, 55, of Union County, readily agreed.
“I’m pretty open to new technology,” Hager said. “It wasn’t like I was getting naked or anything. If it was a gynecology office, it would be a totally different story.”
More time with patients
Augmedix co-founder Shakil, 31, first tried Google Glass in 2012 and, he said, “It blew my mind. I saw incredible opportunities in health care.”
He and Pelu Tran, a friend from Stanford University, founded the company to find and market applications for Google Glass.
In 2014, when Tran was visiting Asheville, Laster invited him to meet in Charlotte. Laster subsequently became the first rheumatologist in the country – and the first doctor in the Southeast – to adopt Google Glass in his practice, Arthritis & Osteoporosis Consultants of the Carolinas.
“I would never go back,” said Laster, 62, a physician in Charlotte for 30 years. “In terms of dictating on the computer, it saves me easily an hour and a half every day. And it frees me up to go in the room, sit down and look the patient in the eye.”
The switch to electronic records was “cumbersome” and “disruptive,” Laster said. “I feel like a huge burden has been lifted.”
Laster said he and his group opted not to hire on-site scribes because it would have required lengthy training to bring them “up to speed in rheumatology.” He added that turnover could be a problem because many scribes work for only two years before going to medical school or other professions.
Anne Mendelson is another of Laster’s patients who agreed to allow him to wear Google Glass during their visits. Her husband, Barry, a retired physician who accompanies his wife to visits, said he’s seen many doctors turn their backs on patients to face their computers.
“It’s not the doctors’ fault,” Barry Mendelson said. “The doctors are trapped. Every doctor that I talk to tells me the same thing. They can’t get out fast enough (because of the) computer nonsense. …
“The advantage of Google Glass is that it gives the doctor the freedom to talk and examine, which is what you’re paying for. … What’s more important than that?”
‘Not for everybody’
Not everyone finds Google Glass so helpful.
Another partner in the rheumatology group, Dr. Ahmed Kashif, tried it but stopped after four weeks, partly because reading type in the small frame gave him headaches.
“I think it’s the concentration – the way you try to use the small muscles of your eye in a certain way,” Kashif said. “I had to squeeze my eye to look at this small window. It was not very practical.”
Kashif, 56, said it was also a little confusing to speak to his patient and also to the scribe. After already going through the difficult conversion to electronic medical records, Kashif said it just seemed like too much.
“I did not have enough patience to make it work for me,” he said. “Definitely it’s not for everybody.”
Neither of Charlotte’s two major hospital systems has adopted Google Glass. Novant Health’s chief medical information officer, Keith Griffin, said he tried it six months ago and found it lacking – with “poor battery life and very limited functionality.”
“In my opinion, it is clearly not ready for prime time,” Griffin said.
‘Money well spent’
Another of Laster’s partners, Dr. Gary Maniloff, uses Google Glass and also says it saves time on record keeping.
“Documentation is one of the hardest things we do,” he said. “We’re good at seeing patients and managing their care, but getting all the required information into the electronic record is demanding and time-consuming.”
At 62, Maniloff said he had been intimidated by electronic records. But Google Glass “is one technology I chose to embrace.” He said the scribe in India is “excellent” and works long hours during India’s nighttime.
In addition to writing notes for patient charts, Laster said his scribe also serves as a “medical Siri,” answering requests for lab results or lists of medications and sharing them through the Google Glass camera.
Many of the scribes employed by Augmedix have been medical students or practicing physicians, Laster said. Even so, he and Maniloff still edit their notes to ensure accuracy. Patient records remain private and are not kept offshore in India, Laster said.
The doctors pay a monthly fee for the Google Glass service, although they said they could not disclose the amount. “It’s not an insignificant cost,” Maniloff said, “but to us it’s money well spent.”