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Do You See What I See? Insights from Using Google Glass for Disaster Telemedicine Triage

Published online by Cambridge University Press:  09 January 2015

Mark X. Cicero ,
Barbara Walsh ,
Yauheni Solad ,
Travis Whitfill ,
Geno Paesano ,
Kristin Kim ,
Carl R. Baum  and
David C. Cone
Mark X. Cicero*
Affiliation:
Yale University School of MedicineDepartment of Pediatrics, Section of Pediatric Emergency Medicine, New Haven, Connecticut USA
Barbara Walsh
Affiliation:
University of Massachusetts School of Medicine, Department of Pediatrics, Section of Pediatric Emergency Medicine, Worcester, Massachusetts USA
Yauheni Solad
Affiliation:
Yale University School of MedicineDepartment of Medical Informatics, New Haven, Connecticut USA
Travis Whitfill
Affiliation:
Yale University School of MedicineDepartment of Pediatrics, Section of Pediatric Emergency Medicine, New Haven, Connecticut USA
Geno Paesano
Affiliation:
Yale University School of MedicineDepartment of Pediatrics, Section of Pediatric Emergency Medicine, New Haven, Connecticut USA
Kristin Kim
Affiliation:
Yale University School of MedicineDepartment of Pediatrics, Section of Pediatric Emergency Medicine, New Haven, Connecticut USA
Carl R. Baum
Affiliation:
Yale University School of MedicineDepartment of Pediatrics, Section of Pediatric Emergency Medicine, New Haven, Connecticut USA
David C. Cone
Affiliation:
Yale University School of MedicineDepartment of Emergency Medicine, Section of Emergency Medical Services, New Haven, Connecticut USA
*
Correspondence: Mark X. Cicero, MD Yale University School of Medicine Department of Pediatrics Section of Pediatric Emergency Medicine New Haven, Connecticut USA E-mail mark.cicero@yale.edu
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Abstract

Introduction

Disasters are high-stakes, low-frequency events. Telemedicine may offer a useful adjunct for paramedics performing disaster triage. The objective of this study was to determine the feasibility of telemedicine in disaster triage, and to determine whether telemedicine has an effect on the accuracy of triage or the time needed to perform triage.

Methods

This is a feasibility study in which an intervention team of two paramedics used the mobile device Google Glass (Google Inc; Mountain View, California USA) to communicate with an off-site physician disaster expert. The paramedic team triaged simulated disaster victims at the triennial drill of a commercial airport. The simulated victims had preassigned expected triage levels. The physician had an audio-video interface with the paramedic team and was able to observe the victims remotely. A control team of two paramedics performed disaster triage in the usual fashion. Both teams used the SMART Triage System (TSG Associates LLP; Halifax, England), which assigns patients into Red, Yellow, Green, and Black triage categories. The paramedics were video recorded, and their time required to triage was logged. It was determined whether the intervention team and the control team varied regarding accuracy of triage. Finally, the amount of time the intervention team needed to triage patients when telemedicine was used was compared to when that team did not use telemedicine.

Results

The two teams triaged the same 20 patients. There was no significant difference between the two groups in overall triage accuracy (85.7% for the intervention group vs 75.9% for the control group; P = .39). Two patients were triaged with telemedicine. For the intervention group, there was a significant difference in time to triage patients with telemedicine versus those without telemedicine (35.5 seconds; 95% CI, 72.5-143.5 vs 18.5 seconds; 95% CI, 13.4-23.6; P = .041).

Conclusion

There was no increase in triage accuracy when paramedics evaluating disaster victims used telemedicine, and telemedicine required more time than conventional triage. There are a number of obstacles to available technology that, if overcome, might improve the utility of telemedicine in disaster response.

CiceroMX, WalshB, SoladY, WhitfillT, PaesanoG, KimK, BaumCR, ConeDC. Do You See What I See? Insights from Using Google Glass for Disaster Telemedicine Triage. Prehosp Disaster Med. 2015;30(1):1-5.

Keywords

allied health personneldisasterstechnologytelemedicinetriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 1 , February 2015 , pp. 4 - 8
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2015 

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Footnotes

Conflicts of interest: none

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