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.com ,   @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 – https://drive.google.com/file/d/0B3Wg187K2hoHNTZlSXU4Q25zM2g3NkU5UUsyMVItS3NOd3pF/edit?usp=sharing

GoogleGlass in Healthcare, at Doctors2.0 …Breaking barriers and spreading the news

I had the honor to once again participate in the Doctors2.0 conference in Paris this past June (http://www.doctors20.com) .

If you haven’t heard of it, you are missing out a fantastic opportunity to learn, share and connect with an outstanding group of participants, in both sides of the room, from e-patients to e-doctors, from entrepreneurs to medical students, from industry to consumers.

This is a conference like no other, where the mix of attendees makes the core of the event, and gives it a relevance that it is not common to any other gathering.

I had the privilege and the honor to be interviewed by @HospitalPatient, e-patient Michael A. Weiss, to relate my vision and experience as a Surgeon, Innovator, Healthcare Futurist and GoogleGlass Explorer, being the first surgeon to ever use the device, answering his interesting questions and explaining the potential of this amazing technology in Healthcare and Medical Education.

Here is the interview http://youtu.be/mGTrDJbiNp8

GoogleGlass Update. Nooo, Not The Video!!!

My email to Google, earlier today, after learning that the new update removes the video call feature from Glass:

The removal of video feature is really a deadly blow for Glass in Medicine!
The use in Med Ed, Telemedicine, Tele-mentoring, Tele-consulting is Now NOT possible!
I only hope that this is restored in the next update.
There’s a very active, important, growing professional community that has been working around Glass in Healthcare, who depends on this particular characteristic of Glass.
Please reconsider the decision of taking video away, or at least allow some user subgroups to choose whether to update.
Folks like me and several others, from Maine and Boston to San Francisco and Beyond our borders, must have the video option to be able to make Glass an important tool in Healthcare and Medical Education.

Personally, Always trust that Google will do the “right and bright” thing!
Video calls are essential if Glass is to be used as a professional tool (healthcare, technical disciplines, law engine cement, education, etc!)
I trust that Google is working on improving and optimizing a feature that certainly was “less-than-ideal” in the way it was working; at the same time, I wish we could keep using it until a better feature was already available, so that we wouldn’t have to halt our experience and development of Glass in Healthcare.
Also, Google should feel free to ask and “tap” the pool of “expert”, pioneer Explorers, to get our sense, opinion and even, maybe, recommendations before moving forward as Glass evolves!
I think that is one of the main advantages and “cleverness” of the Glass Explorers Program.

Rafael Grossmann, MD, FACS

Questions and Hurdles for GoogleGlass in Medicine

I was recently asked these three questions, by Dr. Jennifer M. Joe, of Mestro.com  and Editor-in-Chief  of  MedtechBoston.com, in regards to the convergence of GoogleGlass and Medicine.

–What will be the top 5 mistakes that physicians/clinicians will have about Google Glass?

–What are the top 5 fields who will benefit from Google Glass? Surgery, Emergency Medicine, Radiology, Dermatology, and Neurology?
–What will be the top 5 biggest hurdles in getting Google Glass into the clinical setting?

Obviously, I’m not able to exactly predict the future, but I feel that my experience of several years as a surgeon and of a few years as an innovator in healthcare and, more recently, as a GoogleGlass Explorer might give me some extra advantage as well as insight to be able to come up with interesting thoughts, arising from EXPERIENCE and INTUITION.

A- What will be the top 5 mistakes-misconceptions that physicians/clinicians will have about Google Glass?

I believe that in the initial phases, as Glass is publicly released, many healthcare providers will purchase it; the interest and curiosity about the device will be  based on the reports of medical peers, GoogleGlass Explorers, after several months of experience with it, along with the spectacular and exciting coverage and spread by the media.

1-I think that one of the most common mistakes that I can foresee, is that most users will assume that the device has connectivity of its own.It does not! It needs a wifi network to connect to, or a smartphone that it can tether to, in order to have internet capabilities.

2-Another issue, will be related to its inappropriate use regarding privacy regulations and HIPAA.To use this device in the clinical setting (with patients), the device needs, or should be,”cleared” by your institution’s compliance office, but ONLY when there will be transmission of patient’s data through the device, through the internet. If the device is being used during a visit, for instance,  to look up information related to the patient’s condition in the internet, or to help explain a subject to a patient, using a digital resource, or in any way that does not involve patient’s Private Health Information (PHI), there should be no concerns about HIPAA compliance.

3-The device is not fully functional with only voice commands. It does need the “tap or swipe” on the right frame, to navigate certain menus; this makes it unsuitable, at least in an efficient manner,  for use when the user’s hands need to remain sterile.

4- The screen on the device is the equivalent of a 28″ screen seen from approximately 6-8 ft away; despite this, the content display allowance on the screen is in no way the same to what you can fit on an equivalent “non-Glass” display.

5-The battery life of the device is very limited, and if used continuously, the charge would likely not last much more than an hour or two, almost always requiring an additional, external, portable power supply.

B- What are the top 5 fields who will benefit from Google Glass? Surgery, Emergency Medicine, Radiology, Dermatology, and Neurology?

I think that “procedural” specialties (Emergency, Surgery, EMS), as well as those that rely heavily in the direct observation and “inspection” of the patient and the gathering of visual data to make a diagnosis (Radiology, Psychiatry, Neurology) will be the ones that will initially benefit from this type of device. After the device evolves, and eventually presents itself as the next step in the evolution of the computing platform to connect us to the digital realm, any medical specialty will integrate it as part of the routine, just as we now have PC’s, laptops, tablets, etc.

C- What will be the top 5 biggest hurdles in getting Google Glass into the clinical setting?

1-I believe that the protection of Private Health Information (PHI) and compliance with HIPAA are at this point the main obstacles being faced by GoogleGlass incorporation into the clinical setting (at least in the USA). There are developers working on this topic, and also some who have come up with solutions which are currently being tested in different locations.

2-Integration with the Electronic Medical record (EMR) is a feature that must be accomplished, if GoogleGlass is to be useful in the current setting of Healthcare. The device needs to be an extension of the current platforms that we routinely use, running the same EMR software or at least agnostically conversing with it.

3-Cost has to come down for it to be universally adopted as a new platform, likely substituting  the smartphone in  the near future. The price would have to be competitive with the cost of current portable devices.

4-There will have to be a change of “culture”, in the side of both the providers and the patients. This will naturally happen, as it did with the smartphones and tablets.

5- The network infrastructure will have to be enhanced. The bandwidth of current cellular and wifi networks, does not allow an optimal transmission of data.Dedicated networks will have to be developed so that medical users can have priority channels to allow connectivity without delays, flaws or intrusiveness.

I think that for now, these are my few thoughts regarding these very interesting questions; I hope this helps.

Please don’t forget to connect with me via Twitter at @ZGJR, or to visit the blog for further follow up comments or inquiries regarding this topic or the general theme of Innovation Technology in Healthcare.

As always, I’m very interested in spreading this information and my vision for the use of GoogleGlass in Healthcare, as well as conversing about what the future of technology in medicine will be like. Image

Always looking for speaking engagements and platforms.

Best ,

Rafael Grossmann, MD, FACS


OTHER Links, including my three recent TEDx talks about Glass in Healthcare in 2013.
#TEDx on the intuitive #GoogleGlass preventing Med errors and empowering the #EMR
“OK Glass”:Disrupt HC
#TEDx on wearable #GoogleGlass #mHealth “OK Glass: I need a surgeon http://t.co/qHNxy34k4E My Journey from the Amazon to GoogleGlass in 2014GoogleGlass & other Marvels, for Youth – My latest vid at #TEDx Youth@JBMHS, “GoogleGlass and other Marvelshttp://youtu.be/k_d0vfgBYm4
How will #googleglass fit in with #medicine? @ZGJR has answers. Watch his short vlog here: http://t.co/Q6LsAFMeWVhttp://t.co/cYbkDSKzWK

GoogleGlass vs. Healthcare

Hi there. This is the body of an e-mail I recently wrote. After reading it (before it was sent), I thought that in a way, and in very few words, it represented my abbreviated thoughts on how wearable technology (like GoogleGlass) really has an inevitable and imminent role in the healthcare game. Here we go:

What is the central idea, topic, or concept (50 words or less)?
 “Wearable” user platforms (i.e. GoogleGlass) represent the evolution of the hardware interface, connecting humans to the digital realm, and have the potential to revolutionize medical care, changing the current paradigms.
Despite advances in EMR (Electronic Med Records) engagement, data flow is still archaic and inadequate, prone to inaccuracy and promoter of errors, because the input is being done by the human element, the same way we did it when “pen and paper” charts were the norm. 
Intuitive, “human-free” data flow, by an “artificially smart”, deep-learning capable system (imagine “Google Now for Healthcare”) will make the system more efficiently dynamic, more accurate, providing only the pertinent, correct data, when needed, improving care, preventing medical errors and decreasing cost. Let “the data come to us”, rather than us go searching for it.
Such a system would allow the user to input data as well, smoothly, instantaneously, by intuitive means (i.e. voice commands, although not exclusively), again, making it more efficient.
It will Improve Communication and Connectivity between All the elements of this Healthcare Equation, and that will make the ultimate result BETTER.
 Why is this idea timely now? How is this a significant difference from the status quo in health, medicine, or society?
Healthcare is in crisis. The cost and the incidence of medical errors are unacceptable unsustainable, from a financial and, more importantly, a moral societal perspective. The change needs to happen now. We have reached the developmental, technological level and have the means to make this a reality.
What is the impact on health and medicine if this idea is fully embraced? How big and wide-spread is this impact?
The impact is self-explanatory. BETTER Healthcare overall. It would reach all stages of medical care, from prevention to cure and rehabilitation. 
What changes or innovations need to occur in order for this idea to be realized?
We have the technology! We need to boldly change the approach, enact the ideas for the smart use of the tools we have (i.e. GoogleGlass). We need to change the “culture” of healthcare , from corporations, to hospitals to providers…and patients. Preaching loudly about this, like in TEDMED, will spread the news, and the more people see the possibilities, the sooner the changes will be demanded!
I hope you like it. Please provide me with feedback. Thanks
As always, my Best to you.

OK Glass: not a new idea !

It’s really been an evolution. It’s not a new idea.
Recently, while researching for information to complete a few talks I have coming up at different conference venues, I came across a 1962 issue of a magazine that really surprised me and got me thinking.
I’m attaching the original article and some pics for you to enjoy and hopefully be as surprised and excited as I was.

I have said it many times, GoogleGlass represents the natural evolution of the computing device, of the platform connecting the information-the Web to the individual; from the first computers that filled up a room, to the big desktop PC, to the laptop, to the tablet, to the smartphone…down to a wearable device like Glass, so far, the ultimate gadget.

I believe Glass has great potential in Healthcare. When Glass apps are made available, I do believe, I do know, this platform will revolutionize the process of providing care and educating future generations of providers. In the meantime, the device, as it is, still can change the way we work and teach medicine. By allowing us to do a Hangout from “our forehead”, and streaming our point-of-view to an individual or a crowd anywhere, ” show and tell” takes a new meaning, a whole new dimension.

In my last post, I showed both perspectives, the traditional recording of a procedure vs. the actual view of the surgeon performing a thoracostomy.

When I performed the first surgical procedure ever done while wearing GoogleGlass, it was not only very intuitive to use, but also I could appreciate how it would be helpful to enhance communication and connectivity to and from the operating room.

See: 1st time Glass In The OR by R Grossmann MD FACS ! http://t.co/bMR64jVCTQ
&MedEd”OK Glass:Teach me Medicine!” http://t.co/0vYPZcrzKk






In that old article from 1962, the last paragraph actually tells about how such a device could logically help surgeons provide better care, that’s 51 years ago, long way before the Internet was even thought of. A Real Evolution indeed.

“OK Glass, I need a Surgeon…now!” . A Telemedicine Revolution…or Evolution!

Some people have called me a “Telemedicine Innovator”. To me, the fact is that I only try to make the workflow easier, more efficient, intuitive  and, at the end, provide as good or better patient care with New Ideas and the tools already available.

I work at a tertiary care hospital, which means that we get referrals from a vast area, underserved in regards to many medical specialties, including mine, which is General Surgery and Trauma. The surface area that only ONE surgeon covers, at any particular moment,  24/7, is larger in size than the combined area of Ma., Vt. and NH!

More and more ( and this will only get worse!), the demand for specialty medical services increases, much faster than the supply of medical professionals, which actually, in most acute care specialties, trends in the opposite direction.

An added BIG issue, is that the cost of Healthcare is currently unsustainable (and this will also get worse!), with an expected expenditure of approximately 33% of the GDP by 2050.

We have been using telemedicine for several years, in order to improve the access to our system. In prior entries, I have recounted how mobility in telemedicine is an advantage and how using iPodTouch we could connect to several hospitals in our Tele-Health network in more efficient manner, faster and with no added real cost or disadvantage. Since then, we evolved, to be able to use any smartphone device, enabling us to connect agnostically to any device thru the appropriate software (our administration chose a commercial, medical grade application called ClearSea, which so far seems to be working very well).

So, almost every time I’m on duty call, I have been using ClearSea thru my iPhone to connect to a remote tele-trauma device in any of our Tele-health network hospitals. I have been trying to use ore and more frequently, almost replacing the “phone call” , if indicated and if possible.

One big limitation, is the fact when the remote, referring provider tries to “show” me a specific lesion, wound or burn area in a “difficult-to-see” location. Let’s say in a patients back or between the legs, axilla, etc. The fixed wall cameras and even the mobile units (camera on top of a screen in a cart) are almost useless for this purpose.



If we had a device that allowed for a “point-of-view” of the user perspective, with synchronous (live)  streaming conferencing capability , so that we could see exactly what the other person (the referring provider) was seeing, that would be a “game-changing” tool!

Well, nowadays, we have such a device; Google Glass has all of that, and much more (check the GoogleGlass advertisement videos that follow)

Glass really allows for a direct view of what the user is seeing. For instance, when we are trying to show someone, how to perform a procedure, to get the best view, they really have to “peek” behind our shoulder.If we had a head-mounted camera, the view would not we live. Google Glass really solves that problem. There is also a “screen-share” mode , where the Glass view can be shown on a projector or a monitor, so that many people can see the actual streaming, to the minimal detail, from the “surgeon’s eye” ( a medical education dream).

The following are two videos from the last edition of  an “Advanced Trauma Life Support” (ATLS) course that we offer at our institution a few times per year (all the participants gave their permission to be featured, even the “Trauma-Man”, a high tech mannequin that we use for the hands-on session, instead of animal models). The first video shows a traditional recording of the How-To-Do a thoracostomy (chest tube placement). The second video is recorded thru Glass. You are the judge!

So, having GoogleGlass allows the user to share a direct point of view of the actual patient in a way never thought possible before.

I do believe that telemedicine could potentially be revolutionized by the use of this device.

The regulation regarding privacy issues and HIPAA, will have to continue to adapt to the development of new technology.

I’m certain that very soon, the industry will provide Glass specific “apps” that will allow the video-conferencing in a secure, encrypted fashion, just as it happened when mobile telemedicine solutions were initially deployed ( When we started using iPodTouch and then smartphones for teletrauma, Skype was the application of choice because of HIPPA compliance issues. Within a few months ClearSea, Vidyo, Jabber, etc. were all developed and made available to consumers. See TEDxDirigo talk “iPodTeletrauma, the $229 130 million sq. ft. Trauma Room)

As I have written and said before, I think the future will be brighter than we think.

Technology is developing exponentially, but it is the smart application of the available technology that will allow us to provide much better and less expensive patient care, and, at the end, potentially save lives.

So, when a referring provider in a remote area , needs a surgeon NOW, Google Glass will make it happen.