An acute manpower crunch amidst the pandemic has been one of the biggest challenge for healthcare. However, it has also been a driver of innovative ideas and solutions in hospitals […]
An acute manpower crunch amidst the pandemic has been one of the biggest challenge for healthcare. However, it has also been a driver of innovative ideas and solutions in hospitals to improve productivity and efficiency.
In October 2021, Singapore’s Alexandra Hospital (AH) became the first healthcare facility in the Asia-Pacific to leverage smart glasses – the Google Glass – to alleviate manpower demands.
Smart glasses worn by personnel on-site allows clinicians at other locations to get a first-person view of the patient, which cannot be achieved with other devices such as smartphones. Providing livestream video and audio of the situation, the glasses facilitate collaboration amongst the multidisciplinary care team to assess, provide feedback and intervene in real-time; while personnel wearing the Glass can be hands-free to perform clinical procedures conveniently.
The glasses were first piloted by enrolled nurses at AH’s Urgent Care Centre. By wearing the smart glasses, these nurses can triage patients and dispense approved medications under the supervision of a registered nurse (who is located outside the centre). This helped reduce registered nurse manpower required inside the area and cut PPE usage and cost.
“Google Glass has greatly reduced the risk of exposure among healthcare workers by reducing the number of nurses needed to be physically present at the extended screening area and when fronting COVID-19 patients,” explained Dr. Alexander Yip, Clinical Director, Office of Health Innovation and Technology at AH.
He shared that Google Glass has been deployed for 121 patients over the last 4 months, and have shown encouraging results in boosting efficiency.
“We have calculated the time and cost savings in terms of PPEs conserved; number of trips avoided for nurses to walk to and from the area; time spent gowning up and down; as well as increased efficiency in relaying of patient information. Overall, the total estimated cost savings from PPEs are $377.16, while total time savings for nurses are estimated to be 847 minutes or 14 hours.”
The glasses have since been deployed for home-based nursing services, COVID-19 treatment at F1 Pit Building and inpatient virtual rounds, and there are plans to gradually expand its use cases.
“We anticipate savings from manpower to increase and be impactful over time as we continue to deploy and scale Google Glass to other use cases,” Dr. Yip said.
Trials and tests critical before deployment
With the unique demands of healthcare, new technologies and solutions must pass through a set of criteria that measures their suitability in a healthcare setting, said Dr. Koh Tsingyi, Head, Office of Health Innovation at AH.
“The device must be worn on a location where it will least likely get contaminated and must be able to withstand the rigors of patient care activities yet be lightweight, compatible with personal protective equipment, and comply with infection control requirements,” he noted. “Google Glass Enterprise Edition 2 is the most commercially accessible device currently that ticks off all the boxes.”
He shares that prior to adoption of any new product or solution, the hospital team needs to closely evaluate the value and functionalities it would bring.
“The key criteria for adoption of such technology solutions in AH is understanding institutional and user needs, and introducing solutions that can effectively address these gaps in care delivery. The solution should be user-friendly to the various care team members in the healthcare system and possess functionalities which can be adapted to the different clinical settings,” said Dr. Koh.
Subsequently, user engagement sessions should be held to understand their care needs and potential use cases, added Ms Chong Jia Foong, Project Manager, Office of Health Innovation and Technology.
“It is imperative to map out all potential risks and barriers that could surface during the implementation phase and to plan for contingencies to overcome them. Comprehensive internal product testing, simulation and dry-runs of intended use cases in the real-life environment with the users allows us to identify these gaps,” she explained.
Data and findings from these tests would then be used to draw up accurate user manuals, standard workflow, escalation protocols, and evaluation criteria.
One key concern raised during the trials was that of patient data protection and privacy. Following discussions, the project team added in the requirement for patient consent and disabled video recording and photo taking features.
After go-live, regular feedback sessions with users continue to be held to hear from the users regarding any drawbacks or issues they may face. This ensures adjustments and changes can be quickly made.
“For instance, during one of the regular discussions with the nurses, we learnt that the Google Glass battery drained faster when used continuously for video conferencing. Hence, we advised the nurses to charge the Glass regularly especially after a prolonged usage for video conferencing, and to shut down the device completely when not in use to conserve power. Such information is valuable and transferrable to the following pilots to be implemented,” shared Ms Chong.
Dr Yip revealed that AH is co-developing a bespoke solution that will deliver a connected ward ecosystem that can support virtual nursing. For out-of-hospital care, the team is looking at a comprehensive remote patient monitoring solution which includes a patient dashboard, home monitoring devices backed by a data integration platform.
“Alexandra Hospital is committed to driving technology-enabled care transformation to deliver quality healthcare across the care continuum that is safe, efficient, and value-driven while securing manpower sustainability.”