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David Kerr on Google Glass and big brother medicine

19 Jul, 13 | by BMJ Group

David KerrRecently in the UK, the General Medical Council (GMC) faced a barrage of criticism following the publication of new guidance on the use of social media by doctors. The main point of contention was the recommendation by the GMC that doctors should avoid anonymity on line. This was perceived by critics as an infringement of doctors’ human rights. Unfortunately for the GMC, they are going to have to deal with an even more perplexing problem if the technology behemoth, Google is successful with its latest venture, Google Glass.

Google Glass is essentially a wearable computer in the form of “spectacles” with a computer screen sitting just above one eye—in Google speak this is offers a “glancing experience.” Once switched on the device is activated by nodding and then the choice of function requires the voice command “OK glass.” The technology has a number of features similar to those found on the ubiquitous smartphone including internet access, texting, email facilities, and the ability to take photographs and record video.

Although not available until 2014, Google have launched an early adopter programme. For a mere $1500 around 10,000 “explorers” are now able to buy the device although there has been criticism that the explorers all are young, smart, tech-savvy, and living in the USA. Google is banking on the explorers providing feedback through an online community of “Glass pioneers.” Reminiscent of the bad old days of Big Pharma marketing, the explorers were flown to expensive high-end gatherings in New York, Los Angeles, and San Francisco to be “introduced” to the devices.

From a medical perspective Google Glass could have practical benefits beyond simply undertaking an internet search. For potential patients and their families they could record signs of disease as they happen—for example giving a witness account of a potential seizure, documenting a fluctuating skin rash, or recording perplexing symptoms after starting a new medicine. For people living with chronic medical conditions, such as diabetes, being able to record how they use a new insulin pen device, insulin pump, or glucose sensor would allow for more focused education at subsequent clinic visits. For trainee healthcare professionals their operative or consultations skills could be viewed by their teachers and mentors without the need for expensive audio-visual recording material.

The problem for the GMC and healthcare professionals relates to privacy and who owns the information. When Google glass is recording there is no red light, flash, or whirring noise to show that the device is on. Recently a street arrest in the United States was filmed as it happened by a glass wearer. Although the footage was unremarkable—a minor scuffle followed by two men being handcuffed, the video was viewed more than 230,000 times the same day. The worrying aspect is that no one in the video seemed to be aware that they were being filmed at the time. So what if a patient records the consultation with their doctor and uploads it to the worldwide web for all to see, warts and all? What are the medico-legal implications of one-party recording a medical interaction?

At the moment it is not clear if this type of technology will ever become popular and even if it does would people be interested in using it a healthcare setting? If the answer is yes, then professionals and their regulatory bodies will have to decide fairly quickly whether it is ethical and/or legal to allow patients and their families to bring this into the consulting room? The most likely outcome is prohibition, but that approach does not have an enviable reputation!

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes and Excarbs.com focusing on exercise and insulin. You can follow him on Twitter (@GoDiabetesMD) and Linkedin.

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