Telemedicine ALSO MAY Cuts Costs and Improve Outcomes in THE ACUTE CARE Management

September 29, 2014 Leave a comment

I just finished reading a very interesting post by Nuviun Digital Health, from September 23rd, 2014. It was entitled “Telemedicine Cuts Costs and Improves Outcomes in Chronic Disease Management”


I recommend reading it, to really get a quick overview of how remote presence medicine, or Telemedicine ( or mobile health, mHealth) is really having an impact in healthcare today. We are not talking so much about “potential”any longer, but about real progress and factual changes in outcomes BECAUSE of the use of this modalities.

As you all know, I’m a big proponent of the smart use and application of technology in Healthcare. I think that as communication technology exponentially evolves, and devices are becoming faster, smaller, less expensive and more user-friendly, they allow us to connect and communicate better in our daily lives. People use video-conference calls more commonly, rather that bringing their phones to their ears to just “hear’ someone, when instead they can “hear and see” the other person.

If this is the case in non-medical settings, it is just intuitive that professional disciplines like medicine, should make use of the same tools to improve the way we care for patients, the way we connect to providers, seek advice and provide expertise.

The device industry is barely waking up, and what we are seeing now is only the “tip of the iceberg”. Wearable devices like Google Glass, Epson Moverio, etc. are only examples of what is there to come, the first steps in the natural evolution of the platform of choice to connect and communicate ( Natural Evolution Up to GoogleGlass )

Early developers, most of whom I had shared views and perspectives with, several months ago, such as Pristine (@PristineIO ), Augmedix (AugmedixINC ) and Droidres (@Droiders ), among others, are the true pioneers and visionaries of how this intuitive way to communicate could improve the interaction between providers-patients and the medical record, hence permitting a more fluid conversation which should allow for better care and outcomes.

It is well accepted that Telemedicine and mHealth have clear roles in the setting of chronic disease. I argue that it has a place as important  in the improvement of acute care issues. Back in 2009, we at EMMC showed that a telemedicine program was well accepted by patients, referring and consulting providers, and that the potential for dollar savings and improved outcomes was real.

( )

Be it in the non-emergent situations, chronic diseases (COPD, HTN, Heart disease or stroke, to name a few) or in the life-threatening conditions and moments, when a provider needs an answer quickly, or when an expert wants to share his or her insights to improve the patient’s care and potentially save a life, the role of wearable HUD (head up displays) telecommunication devices to improve the process of communicating remotely is plainly obvious.

The way I see it, why use a written letter when you can use the phone? Why use a land-line telephone when you can use a smartphone? Why use a smartphone when you can use a video-phone? It just makes sense, despite the demands of proof, evidence, data or ROI.

This is just the beginning. Innovation in Healthcare is happening fast and it is unstoppable. Unstoppable because the current state of our system is unsustainable, due, among other factors, to exorbitant cost, lack of access, deficient communication and connectivity among key players (read provider-provider-patient-regulators-administrators and industry!) and shortage of expertise.

The smart application of technology can help us with this.

Medical Records were not meant to be “Sugarcoated”

September 27, 2014 Leave a comment

Originally posted on Medhacker:

I have spoken recently with several doctors that are changing the way they write their notes and thus relevant patient information. Why? Simple, a great thing is happening, patients are beginning to embrace digital health , learning more about their diseases/conditions and accessing, studying and understanding their medical records.


Here is the kicker…Sometimes in life we hear others addressing personal issues that even though they are true, they are uncomfortable to hear. Some can easily ignore them, others may  feel insulted and/or aggravated. This is extremely important to YOU, yes you who is reading this, since you now  have easy access to your Medical records.

Medical records are not meant to be a story. They were not made to be easy on our ears. They are scientific data used to capture facts. They are the mixture of years of training, medical knowledge, experience, and a patient-doctor relationship.


Why is this important?

View original 231 more words

Categories: Uncategorized

The most important trend in physician communications: Report

September 25, 2014 Leave a comment

Originally posted on ScienceRoll:

MDigitalLife released a report about the most important trend in physician communications. Read their statement and download the report here.

They also shared an interesting insight about my Twitter statistics.


View original

Categories: Uncategorized

Simply, GOOGLE GLASS…in DIGITAL HEALTH, a health sensor & beyond

September 7, 2014 Leave a comment


Once in a while, an electronic wonder comes along that shakes the status quo; a gadget that makes everything change, that rewires our thoughts and ideas and gives us hope for a possible better future, here and now.

Sometimes, it is not really just one device, but many-in-one, with multiple capabilities and features that excite the imagination of the users, explorers, problem-solvers or “wannabes”.

Do you remember the Swiss Army Pocket-knife?  images-7

Let’s take Google Glass, for example; it is basically a wearable, smart-phone-like device, a communications tool. It allows you to make a phone-call (Glass-call, really), send a text message, e-mail and tweet. Taking photos, video (form the users point-of-view) and searching the Internet are also included. A formerly available feature, the video “Hangouts” and live video calls are not possible for now, but will return soon, and, reportedly, with much-improved quality.

All of these capabilities have, for the last year, inflamed the imagination of many people, among many disciplines, in my case, the field of Digital Health, Healthcare and Medical Education.

When I first saw Glass in live action, in the hands (forehead) of one of its inventors, Babak Parviz, at the Singularity University-FutureMed program 2013 ( ), I immediately knew that this device had the potential to change the game, or even better, “creatively destroy” how the game was played.

I applied and got selected to the Google Glass Explorers program, while dreaming about its uses in my field of work; I was able to buy it very early last year, started using it, became amazed with its potential and possibilities, performed the FIRST surgical operation with Glass ever documented, (, and then, suddenly and spontaneously became an advocate for it, sort of an evangelist for the use of the device in Healthcare and Medical Education, as well as an advisor to many start-ups and individuals who saw in this technology a true, exponential breakthrough in the computing device platform. Alongside, gave three TEDx talks related to GoogleGlass in Healthcare and Education (

BUT we have yet to see, much beyond its intuitive applications.

The fact that Glass has a second camera that points towards the wearer’s eye, a forward camera, a microphone, a bone conduction audio transducer, a touchpad, a gyroscope, a GPS, an accelerometer, a gyroscope, a magnetometer, an ambient light and proximity sensor and that it is head-mounted, in contact with the skin of the forehead, gives it incredible leverage to develop as a multi-tasking device in medicine.

Glass can detect you eye movements and hence its ability to translate those movements into commands. Imagine navigating your screen, texting, typing, etc. , just by looking to different directions. It might sound silly, but think of quadriplegics (a person paralyzed from the neck down), and how this feature could open marvelous opportunities for then to functionally reintegrate, back to life.

Some time ago, I tried “The Muse” (@ChooseMuse ) and also became fascinated with it. It is basically a portable, wearable EEG (Electro-encephalogram, to detect, read and display your brain waves). It just works! You put it on, sync it with the app in your smartphone, and it displays an indirect measurement of your brain’s electrical activity. Plain amazing! Just imagine the potential to help you “train” your brain, to learn to focus, relax, meditate, provide biofeedback, etc.  Think PTSD therapy!

And then, I thought, this goes pretty much in the same position, in your forehead were Glass usually sits; how about integrating Google Glass + Muse, and add this incredible feature to the mix?

How about navigating the Glass menu with your brain’s electrical activity? (Think: “OK Glass, take a picture”!). Or train your brain, again with instant feedback, to give commands and navigate a computer screen menu.

Then, a few days ago, I read and article and watched a video, from a group in MIT/Georgia Tech, who is developing the fantastic idea to use the many embedded systems within Glass (the gyroscope, the magnetometer, the accelerometer, etc.), to basically provide accurate measurements of heart frequency and breathing rate (BioGlass). In addition to the obvious uses in medicine and fitness, this functionality could potentially detect your alertness and anger levels, whether you are falling asleep or not paying enough attention.

Now you could be relaxing and slowing your brain’s activity, and getting immediate feedback on your cardiac and respiratory rates…Awesome. A yogi’s dream!

As a surgeon, I also envision its uses in medical care, allowing patients, and providers, the right state of mind to undergo a procedure, to control pain with drug-free anesthesia or analgesia, to perform a procedure in a relaxed state, taking away pain, stress and frustration…

There’s another very clever gadget that allows your forearm muscles’ electric activity to be translated into commands to drive your electronics, and navigate their menus, allowing you to use hand gestures instead of a touch pad or a mouse; it’s called “The Myo”.

For sometime now, I’ve been playing with it and engaging with developers who are kindly sharing their software “spells” and abilities to help me trial and evaluate an integrated Glass-Myo interface.

I can go thru the Glass menu and screens just by moving my hand. Since this device “reads’ the electrical signals at the muscle level, then it potentially can act as an EMG (Electromyogram), and not just read but also evaluate muscular activity (think of the many muscular disorders that could benefit from this); couple this with The Muse, and you come up with a tool to give instant brain feedback related to muscular contraction and movement (Tai-Chi on steroids!), allowing the training, re-training and/or tuning of a particular group of muscles.

As I have said many times before, I think that Google Glass represents the beginning of the natural evolution of the computer (computing) platform.

Technology develops and progresses exponentially.

Google Glass use and applications are only limited by our creativity and imagination, and only the future will tell what’s possible and Beyond.

Stay put and don’t change the channel.

Thanks for reading.


Rafael Grossmann, MD, FACS

Follow in Twitter @ZGJR for more updates and to contact me.



TEDX Talks as a Great Platform to Make Change Happen in Healthcare

A Summary of my TEDx talks, since 2011, related to Innovation Technology in Healthcare, Telemedicine, mHealth, Medical Education, wearables and, of course, Google Glass!
Feel free to share them. Best

TEDxDirigo: iPod + tele + trauma. “An iPod could save a life” or “The 130 Million Sq. Ft. Trauma Room”

TEDxBermuda: “OK Glass: I need a surgeon

TEDxDirigo: “OK Glass”:Disrupt HealthCare Now!

TEDx Youth@JBMHS: “GoogleGlass & other Marvels, Google Glass and Beyond


Categories: Uncategorized

GoogleGlass on Steroids!

August 11, 2014 3 comments


In medicine, when we say that something is “on steroids“, it usually means that it is super-charged, greatly improved and much better (think of how the steroids are usually, Ilegally used to improve athlete’s performance!).

When I thought of writing this post, my mind had been for days revolving around the fact that, despite being an amazing device, with great potential, GoogleGlass is still fairly limited and rough, in order to overly improve the way we do or teach medicine.

There have been several updates to the software, and the Glass we enjoy today is significantly better than the one I got in early June, 2013, a few days before I performed the first ever documented surgery procedure using this incredible gadget. The software runs smoother, the battery lasts longer, the features and menu are improved…Unfortunately, we are still missing the very important ability to live-stream video, since it was “recalled” several months ago ( a move that was necessary, since that feature was really not worth of the Google standard ). Some time ago, I had the chance to speak with the current head of Glass, Ivy Ross, , and she explained the reasoning behind the decision and also mentioned that, in the near future, something better will be brought back-…I can’t wait!). As I have emphasized in the past, this unique characteristic of Glass is really one of the reasons why, right out-of-the-box- this marvelous wonder could potentially revolutionize Healthcare and Medical Education, among many other disciplines.

Over the last year, many” wonder” coders, individuals, start-up companies and Universities have developed “spells” that really allow us to do the” magic” with Glass.We have gone far, but we are still just in the beginning, barely scratching the surface…

I have said it before, GoogleGlass represents the “Natural Evolution” of the computer (hardware ) platform, and its use is only limited by our imagination and creativity; I believe that we have seen a lot of that fantastic creativity in action, but there’s still a lot of ground to cover, a lot of potential to be fulfilled…


One of the features that is still missing, is the ability to integrate a completely “touch-less” control to Glass, enabling the navigation of the menu without a “swipe” or “tap”, without voice, wink or tilting of the head. The more intuitive way to do it, is to use hand “gestures” (moving, pointing, squeezing, etc.) in a virtual field, up in the air in front of our face (and Glass). For someone as myself, for example, for whom hands need to remain absolutely sterile at all times while operating, a virtual menu, which I can navigate without physical contact, would be to be “on Steroids”!

For some time time, I have been collaborating with a few brilliant teams of individuals, who will make this happen. New, and older devices, like the Myo (, LeapMotion (, Kinect ( and incredible interfaces like TedCube ( will augment GoogleGlass in ways that we can only dream of now.

Enabling touch-less commands and navigation of menus, will for sure make this  wearable device run “on steroids”, increasing the performance, our performance, and allowing us to, legally…get the gold we all deserve.





50 People Shaping Our State-THANKS!







I am really humbled and honored to be chosen as one of the “50” in this amazing publication, the July 2014 issue of Maine magazine ( ,   @Themainemag ) , “50 People Shaping Our State”.

As an “imported Mainer”, originally from the tropical latitudes of Venezuela, in South America, I feel that this state has so much more to offer than being a vacation paradise, the “Way Life Should Be”. A true land of opportunity and innovation.

Completely aside of my passion and achievements in Technology Innovation in Healthcare, it is THE TEAM I’m part of, whom really make a difference in regards to maintaining, improving and restoring the Health of our patients and “Shaping our State” for the better. THANKS to them.

MM_July2014_50People.pdf –


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