This first appeared in the December 2012 IT Matters column in DOTmed Business News

Emergency room doctors often make their rounds with a stethoscope draped over their necks, but a project in a New York City hospital is investigating whether they’d like to add another, more modern bit of technology to their repertoire: a heads-up display.

The project, soon to be undertaken at Staten Island University Hospital, aims to see if an image-viewing headset could improve communications between radiologists and ER physicians while giving the latter faster access to images vital to patient care.

“As a radiologist you’re constantly faced with this task of communicating findings of something important in a patient to an ER physician,” Dr. Avez Rizvi, the leader of the project and a radiologist at the hospital, part of the Northshore- LIJ Health System, explained to DOTmed News. “When the hospital is busy and the ER is seeing hundreds of patients and we’re reading hundreds of studies, things can fall through the cracks. (So the question becomes,) how do you communicate the most important findings, like an aortic dissection, to the clinician as quickly as possible?”

“Not like anything else you’ve used”
HUDs should be familiar to science-fiction fans. Viewers of Paul Verhoeven’s 1987 ultraviolent classic “Robocop,” for instance, might remember the cyborg super-cop had a built-in HUD that pointed out whether the people who stumbled into his sight were innocent Detroit civilians or drug-dealing perps.

The HUD project taking off at the Staten Island medical center is different, of course. For starters, the HUD is not cybernetically attached to the eye. Instead, the HUD is a headset, currently in the prototype phase, that the ER physicians would wear during their shifts. Made by the semiconductor company Kopin, the HUD, called Golden-i, delivers information via a single tiny projection screen that rests just below the eye.

That’s an important detail: the HUD’s screen is not a true display. Rather, it’s a mini-projector that beams the image onto the user’s retina. “It’s not like anything else you’ve used,” said Dr. David Hirschorn, an imaging informatics expert also at the Staten Island hospital who has tried out the device and is helping with the project.

Hands-free
Rizvi said he had the idea for introducing HUDs into medicine some time ago, even before he started his residency, as they have some practical advantages over other mobile devices. For instance, because the headset is hands-free, providers don’t have to worry about contamination. “(Doctors) don’t want to carry around an iPad, because there are sterility issues with it,” Rizvi said.

But he had to wait for engineers to come up with a HUD technology that would suit his needs. And he thinks he has found it in the Kopin device. The two-pound product doesn’t need to be touched; it’s controlled by neck movements and voice, the latter powered by Nuance Communications’ speech recognition technology. The Golden-i is not a finished product and does have a few kinks, but Rizvi said the commercial device will have a faster processor and updated software. “Right now, it feels pretty good,” he said. “But at times it might be a little jittery. You can tell the device isn’t 100 percent there.”

Human-to-human
The project is still in the early stages. When DOTmed News spoke with Rizvi, the team had not yet distributed all the headsets, and was still some time away from collecting early data – data which they hope to share in June at the Society of Imaging Informatics in Medicine’s annual meeting. (The team had originally planned on sharing preliminary data at the Radiological Society of North America’s conference in late November, but Superstorm Sandy, which hit Staten Island hard, forced them to delay the study.) Once up and running, Rizvi said they hope to use 10 devices in total, with five deployed in Staten Island and five with their partners at the University of Louisville in Kentucky.

The device itself is also a work-in progress. Unveiled a few years ago, it’s still only a prototype, although a “beta version” is expected to be available as this issue goes to press. Rizvi said a full commercial launch, to be handled by Motorola, could come as soon as first quarter 2013. (As the device has not been released, Rizvi said he didn’t know how much it would cost.)

But the team is working on developing their own software for it, with IT consulting firm Intelligent
Product Solutions providing technical assistance. One challenge is to get
a voice-over-IP system going, so the radiologist and the ER physician could talk through the headset, with the radiologist guiding the ER physician through the images and noting points of clinical interest.

Hirschorn said, if successful, the headset has the potential to be one of those technologies that “increase human-to-human interaction instead of decreasing it.” The larger value-add, he said, would be if doctors could have a use for the device when they’re not looking at their patients’ X-rays or CT scans, such as having electronic medical records always at their fingertips.

Nonetheless, he predicts a positive reception. “There should be high satisfaction,” he said. “The radiologist serves what (the ER doctor) wants up on a little platter.”