Infosys: What went wrong?

Bonjour everybody and welcome to another Health Care Bear blog post. Today we shall be looking at the India-led IT Consulting and Services multinational, Infosys. Infosys has been through a tough few years recently, which has gradually pushed it towards the back of the line when it comes to winning Healthcare business. Granted, its strengths lie more in the manufacturing space but without a doubt, it does recognize the growth potential in Healthcare. So today I am going to be looking at a few areas which have hindered Infosys' Healthcare business. If you have any comments then please feel free to leave them below as I'd love to hear what you think. Let's get started...

Constant reorganization: Although not necessarily directly related to Healthcare, the image at the top of this blog post shows that there has been a lot of top-level reorganization within Infosys over the past few years. Whilst it focuses on restructuring its internal workforce to position itself for future growth, it cannot properly focus on winning new business in Healthcare and will suffer from leadership inconsistency. If these recent changes weren't enough, Infosys recently announced that it will be once again restructuring its business from the 1st April 2015. Despite the potential benefits of this restructure such as enhanced flexibility, its clients may once again suffer. At a time when it is looking to renew core existing contracts, this is very inconvenient timing. Such is the desperation of keeping hold of these clients, the CEO himself is even taking charge of around a dozen top customer projects.

Underdeveloped solution portfolio: In the past year, Infosys launched just two healthcare-centric platforms; Clinical Trial Supply Management and Osteoporosis Solutions. Over the same timeframe, Infosys won only two engagements; a contract renewal with the District of Columbia for health information exchange (HIE) and an ERP deal for implementation services with L.A. Care Health Plan. Such lackluster effort for a vertical which it recognizes has growth potential is disconcerting, especially when you see competitors such as Cognizant and IBM make strides through acquisitions and expanded capabilities in strategic areas such as cloud. It can no longer rely on its previous BPO success and must innovate to just keep up.

Startup acquisition strategy: This seems to be a trend among many India-led IT service providers. They are looking to invest in the "next big thing" in order to bolster their innovation credentials and pull away from the pack. According to the Economic Times, Infosys has a $500m fund to invest in startups pursuing disruptive ideas. Due to Infosys falling behind the pack over the past few years, this is a survival strategy. It's reportedly failed acquisition of TriZetto to fellow India-led competitor Cognizant potentially exhibited an appetite for larger acquisitions but due to its investment in other startups, it looks as though it will stick with partnering in Healthcare. Meanwhile, Cognizant's acquisition of TriZetto is enabling it to pull away from the India-led pack and take a high-value-add approach with further onshore presence. Unless Infosys finds a diamond among the coal or invests in an established player, it may stay in limbo and be forced to rely on its network of partnerships to win business in Healthcare.

That's all for today folks! Many thanks for taking the time to read my blog, it's very much appreciated. If you did enjoy it and found it useful then please share it on social media as it would greatly help.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Business Today, Missing Murthy, 17 Feb 2013, http://businesstoday.intoday.in/story/infosys-woes-profit-revenue-growth/1/191782.html
2. Zacks, Infosys (INFY) to Restructure Business: Time to Buy?, 9 Feb 2015, http://www.zacks.com/stock/news/163721/infosys-infy-to-restructure-business-time-to-buy
3. Times of India, Infosys, Wipro set to enter Rs 12,000 crore renewal ring, 6 March 2015, http://timesofindia.indiatimes.com/tech/tech-news/Infosys-Wipro-set-to-enter-Rs-12000-crore-renewal-ring/articleshow/46476526.cms
4. TBR, Infosys PSBQ 4Q14, 2 Feb 2015
5. Economic Times, Why Wipro, TCS, Infosys are wooing retail, healthcare startups and investing in them for survival, 11 Feb 2015, http://articles.economictimes.indiatimes.com/2015-02-11/news/59043865_1_startups-wipro-ceo-tk-kurien-silicon-valley

Track & Trace / Serialization: Beyond Compliance Benefits

Welcome once again to The Health Care Bear blog! This month I've been looking at the Track & Trace / Serialization market in Life Sciences. The most common and potent driver for adoption of T&T / Serialization is undoubtedly for regulatory compliance purposes. However, this is by no means the only benefit of this solution so today I'd like to take you through the various potential benefits of T&T / Serialization. If there are any I've missed then please feel free to comment below...

• Comply with regulations: OK, let's get this one out of the way! Regulations are constantly evolving all around the world and in Life Sciences, T&T can help comply with those such as the FDA mandate applicable to Manufacturers, Repackagers, Wholesale Distributors and Dispensers stating that product ownership cannot be accepted without transaction history and statements (either paper or electronic.) Unfortunately, as is this case with this one, they are frequently delayed or changed. Despite the compliance benefits of a T&T solution, the volatile nature of these regulations is pushing customers away from deploying this type of solution globally on an enterprise-wide basis. Regional vendors are making the most of this by concentrating on local regulations only whilst larger, global players face the stigma of being considered out of touch.
• Improve visibility: Serialization gives a client the ability for logistics transparency across the supply chain. Not only will this make reporting more accurate and efficient but it will also eliminate potential unseen issues such as theft. This will also enable the client to detect returns that were not originally sold to the customer to avoid fraudulent claims.
• Protect your brand: Once a client is able to identify and highlight illegal activities such as theft, counterfeiting and diversion; they can then take measures to combat this. In Life Sciences, drug quality is extremely important and so assuring that the intended product makes it all the way to the market without tampering will help protect the brand.
• Provide an integration platform: Deploying a solution which knits together other applications into an overall solution will have long term benefits. Especially given the current reluctance to deploy enterprise wide, global solutions; a serialization solution able to bring in outside components will be valuable when/if the regulatory landscapes in other regions settle down a bit.
• Control your inventory: This solution will enable the client to gain better insight into raw materials ordering. Using analytics in conjunction with T&T/Serialization will maximize storage space and streamline process scheduling.
• Improve workflow processes: The less physical handling is involved, the more productive the supply chain will be and so errors will decrease as the human element is minimized. As well as reducing errors, automation will also speed up the supply chain process considerably.
• Speed up the order-to-cash life cycle: Being able to definitively state where the goods have traveled and exactly when it was delivered and to whom will speed up the time it takes to authorize payment.
• Perfect order fulfillment: Serialization will help perfect order fulfillment by identifying incorrect orders and resolving them before delivery to the customer. This will directly impact a vendor's reputation and improve levels of customer satisfaction.
• Aid the returns process: Through reverse logistics, serialization will also help the recall, return and withdrawal processes as well as shrink/loss recovery. During the same process, the vendor will also be able to pinpoint the location and time where the issue occurred.
• Increase mobility: So your products are making their way through their life cycle, what's stopping you from moving with them? Mobile access to a track and trace solution will enable key members of your workforce to follow the product's journey whilst also on the move and if there is an issue, they are able to keep track of what's going on in real time and correct it on the go.

I'm sure I've only scratched the surface with these benefits so if you have any other suggestions of the potential benefits of a Track-and-Trace / Serialization solution, let me know down in the comment section below.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

The Pros & Cons of Cognizant's acquisition of TriZetto

In late 2014, Cognizant (a leading provider of IT, business consulting, enterprise applications and business process services) acquired TriZetto (a healthcare IT solutions vendor to the payer and provider market) for $2.7bn. This was a major acquisition and will undoubtedly reap a number of positive effects for Cognizant going forward although there are still some concerns. In this blog post, I'm going to lay out the pros and cons that I have seen throughout my research to hopefully get a rounded picture of what the future may hold for Cognizant.

Pros

• This acquisition adds a comprehensive range of innovative and complex software solutions (especially core payer software) and consulting capabilities to Cognizant’s portfolio, enabling it to offer end-to-end solutions in the US healthcare market – one of its key verticals.
• TriZetto reaches almost half of the insured American population through its 245,000 healthcare provider clients as it dominates the core claims marketplace. Cognizant's long standing reputation in services will serve to compliment this position as they look to take advantage of the synergies between the two. This will also create the opportunity to enhance EHRs from claims and EHR data. Finally, Cognizant may seek to expand joint capabilities in care management, population health and PBM-related services.
• This acquisition will put pressure on other India-led outsourcers as Cognizant pushes away from Infosys and Wipro and further towards TCS. Cognizant will also look to move away from the stigma of a low-cost India-led player and start positioning itself as more of a direct threat to global MNCs. It will also be harder for smaller software and IT services providers to compete with the combined size of Cognizant and TriZetto.
• Cognizant will look to cross-sell and up-sell to clients covered by both parties (estimated to be over 30.) This will enable Cognizant to forge deeper relationships, capture greater wallet share and potentially upgrade some clients to strategic clients.

Cons

• The acquisition has brought about a law suit by fellow solutions provider Syntel. Syntel claims that the acquisition terminated a contract it had with TriZetto as well as mishandled information. Syntel is asking for $3.4m in rebates as well as $6.1bn in punitive damages. If this goes through then it will be a very significant blow at a time when Cognizant is onboarding TriZetto, making the transition even more difficult [1].
• Cognizant will need to reduce its partnership network to avoid overlap with the additional capabilities TriZetto brings to the table. For example, both Pegasystems and TriZetto have claims management solutions and so this may lead to Pegasystems being ousted to avoid a clash of interests. Whether this will be a positive or negative in the long run is up for debate but it should be interesting to see how it pans out.
• Some analysts believe that Cognizant may have overpaid for the acquisition as the $2.7bn price tag comes in at almost four times TriZetto's revenues last year. Although Cognizant is confident that this is a positive move going forward, TriZetto hasn't matched Cognizant's growth pace as of late and so it is bargaining on combined market presence rather the sum of two products [2].
• There may be integration problems both geographically and from a business perspective. With Cognizant being very consulting/systems integration/services heavy and TriZetto focusing on software, they may have a few differences in opinion of how to approach the market although it seems as though Cognizant will keep TriZetto as a single entity rather than attempting to merge it into their business. Geographically, Cognizant is primarily based in India whereas only a third of TriZetto's staff are based over there [2]. Although this will give Cognizant a positive local presence, there may be some teething issues.

In my personal opinion, a lot of the concerns are focused on the "now" and how TriZetto will be integrated into Cognizant's organization and strategic plan. Although this may cause some initial problems, if they can work these out then there is an abundance of opportunity to both differentiate itself from competition, improve its current and future client base and expand its software and services portfolio. Whether this will slow down Cognizant's acquisition and geographical expansion strategy is yet to be seen but the future looks bright in my view.

That's all for now folks, as always I'm interested to know your thoughts on this topic so feel free to comment below and finally, if you like my content please subscribe, follow me on Twitter and share on social media.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. CRN, Syntel Sues Cognizant For More Than $6 Billion After TriZetto Acquisition, 13 Jan 2015, http://www.crn.com/news/managed-services/300075362/syntel-sues-cognizant-for-more-than-6-billion-after-trizetto-acquisition.htm
2. Financial Times, Cognizant rejects claim it overpaid for TriZetto, 15 Sep 2014, http://www.ft.com/cms/s/0/56a0d63c-3cec-11e4-a2ab-00144feabdc0.html#axzz3QxY763G9

Healthcare IT Predictions: 2015 and Beyond

Welcome one and all! Thank you for keeping up to date with my blog, it is very much appreciated and I hope you're finding it an interesting read. Today we're going to be talking about predictions in Healthcare IT both in the near term and further into the future.

There's a lot of content out there discussing potential trends and predictions going forward and so I took the time to review a variety of sources and have decided to cover just three trends I believe are the most widely acknowledged and have the potential to have the greatest impact on the Healthcare vertical. As always, I'd love to hear your feedback on the trends I've covered in this blog as well as others you feel are important so leave your comments below.

1) Data-driven digital strategies
Data is at the heart of everything these days. It arrives in droves in various forms from numerous sources and with varying levels of security protecting it, making it a minefield for organizations to manage. A fully encompassing and actionable strategy is essential throughout the data life cycle from storing the data to analyzing it. Not only does Big Data claim to reduce costs of healthcare (by more than $300bn just for the US alone according to McKinsey) [1] but also to improve quality of care by making better decisions based on more accurate data. I personally see data as the foundation for analytics to build upon. Sure, proper data management can streamline operations, cut costs and improve reporting quality but there is a market appetite for analyzing this data to improve decision making and predict what's down the line. Before clients can do so, the data needs to be accurate, secure and managed properly. Analytics based on inaccurate data is not only a waste of time and resources but is also dangerous in a healthcare setting. By no means is this a simple task though. 

IDC is putting heavy emphasis on digital strategies claiming that by 2016, operational inefficiency will become critical at 25% of hospitals, driving them to budget for a data-driven digital strategy [2]. With an increasing focus on performance quality (including measuring and reporting quality), it is vital that the data is accurate, accessible and actionable [3].

Not only will healthcare organizations require the IT know-how to manage this data but they will also need to ensure that all stakeholders such as the lines of business, clinicians, IT vendors and C-level executives are all educated and on the same page as to what roles they will play in this strategy going forward.

2) No excuses for lack of interoperability
Philippe Houssiau, Vice President of Healthcare in the UK for CSC sees that there is no excuse for a lack of interoperability with systems in place across the care continuum and a drive from policy makers [4]. Although we have the technology to solve the interoperability issue, it's by no means a simple task.

The UK's Better Care fund claims that it will save £253m from reduced emergency admissions during 2015-2016. This seems to be widely considered as an unrealistic target, which is made only worse by an expected NHS funding gap of £65bn by 2030. UK healthcare organizations are therefore in the unenviable position of trying to improve the quality of care whilst also having to dramatically cut costs [5] [6].

Regardless of the monetary figure, the operational benefits of making systems interoperable are undeniable. The lack of uptake, the negative feedback and the functional issues of EHRs have primarily been due to lack of interoperability. Not only does this take up valuable time of healthcare practitioners but also encourages the use of quicker workarounds, which subject the organization to unforeseen cyber security threats.

3) Agile, flexible and scalable IT infrastructures
As well as the increasing amount of data, there is also increasing adoption of devices and applications in the healthcare vertical. IDC expects around 70% of healthcare organizations to invest in consumer-facing mobile apps, wearables, remote health monitoring and virtual care by 2018 [1]. As mentioned previously, not only is the amount of data increasing but also the variety of sources too.

Patients are increasingly interacting with healthcare providers virtually and also via mobile devices and applications. What's interesting to note here is that the recent alliance between Apple and IBM is very well placed to take full advantage of this trend as they cover both the consumer side with Apple devices and applications and the enterprise side building on IBM's experience and footprint in the market. But anyway, I digress...

Organizations must prepare themselves for the influx of data by investing in agile, flexible and scalable IT infrastructures to cope with this increase. Naturally, this plays right into the hands of cloud and SaaS providers who are able to scale up and down based on demand. However, the healthcare industry has notoriously been very cautious when adopting the cloud as some CIOs believe that adopting the cloud signifies giving up control and thereby opening the doors to security issues. Although many organizations are still wary of the cloud, which can be seen by the uptake of private cloud in comparison to public, gradually they are starting to become more confident in using it.

I could go on and on but I'll leave it there for now. I'd love to hear what you're seeing in the market, whether you agree or disagree with the trends/predictions mentioned above or any other comments you may have so feel free to comment below.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Tech Republic, Big data will enhance healthcare, but to whose benefit?, Nov 24, 2014, http://www.techrepublic.com/article/big-data-will-enhance-healthcare-but-to-whose-benefit/
2. IDC, FutureScape: Worldwide Healthcare 2015 Predictions, Nov 12, 2014
3. CSC, Why Healthcare Reform Hinges on Data, http://www.csc.com/health_services/publications/91654/116373-why_healthcare_reform_hinges_on_data
4. Ehealth Insider, 15 predictions for 2015, Jan 2, 2015
5. Public Finance, Health Foundation analysis predicts £65bn NHS funding gap, Jan 23, 2015
6. LGC Plus, Unrealistic better care fund targets must be revised, says NHS England, Jan 5, 2015

Wearables and Sensors... For the fit, the ill and frugal

As you may have picked up on by now, I like to criticize a lot. This is not because I'm a particularly negative human being but I believe that businesses need people who question everything so that they can improve their products, strategies and overall confidence about what they are producing. Let's call it "Social Quality Assurance"!

With that being said... Welcome to the first Health Care Bear post of 2015! Hope you all had a wonderful time over the holidays, I assume my present from you got lost in the post right?! Anyway, in keeping with my recent post about Google Glass, I wanted to expand that out into wearables and sensors in the Healthcare market.

This blog post was inspired by an article by Penn Medicine[1] in which they discuss the behavioral aspect to wearables and sensors. It's undeniable that there is a lot of hype and ongoing investment but there is a cultural change that must run in parallel to compliment the adoption of these devices. I've listed a few of my thoughts below as to the pros and cons of this technology so sit back and enjoy...

Pros

• Power to the consumer - Being able to own / be in charge of a piece of technology that will ultimately lead to health benefits and financial incentives is empowering and continues the trend of greater consumer engagement. Patients will start taking on more and more responsibility for their own well being as incentives become more enticing and penalties more severe.
• Technology already in the market - Although older generations may need support to get to grips with the technology currently available, the beauty is that pretty much everything we need is already at our disposal. Phone apps are available to track sleep patterns, exercise and dietary information. The Samsung Galaxy S5 even has a heart rate monitor built in. Consumers have more or less everything they need, the business mechanisms just need to be put in place to make use of these. When it comes to devices actually worn by the subject, these are already relatively cheap with some basic heart monitoring watches available under £10. More advanced wearables are still a little pricey but will very quickly start declining in price.
• Telehealth and the virtual world - We're starting to see some primary care visits being carried out remotely and this is set to increase over the coming years. Whether the consumer side of the conversation is at a PC or via a mobile phone, the data captured by the wearables will more than likely be stored on the same device used to contact the practitioner and therefore made available quite easily. Also, as virtual interaction becomes more routine, alerts may be set up to monitor when someone's heart rate drops significantly for example and then a practitioner or ambulance can be called automatically to assess the situation. The possibilities are endless.

Cons

• The "Big Brother" effect - In my humble opinion, this isn't a critical factor but there are a lot of skeptics and conspiracy theorists out there that already believe we are constantly being watched and monitored and that this encroaches on our freedom. If they are worried about CCTV cameras, recording devices in lampposts and phones being hacked; chances are they won't be running out to the shops to buy an electronic device that is on their person 24/7.
• More data... great! - The Healthcare vertical already has a tonne of data that they still don't know what to do with. Yes, data for a specific patient will be able to be analyzed by a practitioner for the purposes of improving the patient's health but in the grander scale of things, how are Healthcare organizations going to cope with this new influx of data on a larger scale when they're not yet at the stage of being confident enough to capture, manage and analyze the data already available to them?
• #Integration - This is a key theme of 2015. So your wearable tracks your heart rate for example, great, then what? That data needs to be stored, shared with Payers/Providers and ultimately analyzed. With so many devices in the market, the data needs to be standardized and made available to those who need it as well as being presented in a simple way so that relevant actions can be made. Case in point, I used to drive a car with a monitor in the engine which would monitor my speed and distance travelled and relay that back to my insurer. The same needs to happen with wearables as well as collating that with other healthcare institutions to analyze the data on a grander scale. There's a lot of work to be done before this is possible.

A final note about who will use these and why... I like to categorize the general public into three categories when talking about this topic: those that need it (the ill), those that want it (the fit) and those that don't really care (the lazy.) Before I carry on, I'd like to note that obviously not all of these will have the funds to buy these devices but for the purposes of this analysis, let's say everyone is on a level playing field. The ill will adopt these devices in conjunction with Healthcare Providers in an attempt to improve their health, simple. The fit will adopt these devices independently in order to maximize their own daily routines, fine. The third category is where it gets interesting; the average Joe doesn't particularly care what their heart rate is, whether or not they're getting the idyllic amount of sleep or how many steps they've taken in a day. What they do care about is money (let's face it, who doesn't?) and so to include this demographic, organizations may have to offer incentives such as lower insurance premiums or rewards for participation in clinical trials.

I could go on but I'll leave it there for now. If you have any other pros or cons then feel free to leave a comment below.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. Penn Medicine, Wearable Tracking Devices Alone Won't Drive Health Behavior Change, According to Penn Researchers, 01/08/2015: http://www.uphs.upenn.edu/news/News_Releases/2015/01/wearables/

Healthcare Data Security Strategies; Proactive or Reactive?

It should come as no shock to anyone reading this that security in the Healthcare industry is a huge issue. With the introduction of flashy new tech comes the burden of making sure that it is not compromised. This is by no means an isolated issue as security is paramount in a variety of other verticals but the sensitive and personal nature of the data held by Healthcare organizations means that breaches receive a lot of media attention. The question is whether it is more effective to guard against incoming attacks or proactively analyze data to prevent future breaches from being as effective.

Before I start, it's important to note that the main cause of Healthcare data breaches occur due to lost or stolen devices (68%) rather than hacking [1]. This issue will progressively worsen due to organizations embracing the mobility trend and so it is much easier (although by no means easy to start with) to protect the data held on these devices rather than the devices themselves. With this being said, a blog post about locking up your devices and keeping a firm eye on them would be pretty short and dull so I'd like to concentrate on hacking and malicious attacks.

Healthcare organizations will continue to invest in defensive measures against cyber crime but it is becoming increasingly important to invest in the analysis of these threats and the prediction of future potential breaches. This will run in parallel to the evolving technologies enabling hackers to maliciously gain access to the organizations data.

With the ever growing popularity of Big Data & Analytics, it is crucial that attacks are not treated as independent events and instead the data and information should be collected until there is a significant mass to analyze previous attacks and prepare for what's to come. This intelligence will then (hopefully) enable the user to identify when the organization is under attack a lot quicker and then respond more efficiently.

I'd like to conclude this blog post by highlighting that although security measures are evolving as are hacking techniques, the biggest variable factor is the user - whether it be due to insufficient training, snooping or a blatant disregard for protocol. There is a vicious cycle whereby as security measures become more sophisticated, they may become less user friendly, prompting users to find easier workarounds which then make the system vulnerable. In my personal opinion, organizations should invest further into training and user friendly interfaces whilst maintaining secure access to data in the background.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. HIT Consultant, 68% of Healthcare Data Breaches Due to Device Loss or Theft, Not Hacking, 11/04/2014: http://hitconsultant.net/2014/11/04/healthcare-data-breaches-device-theft-loss/

Google Glass in Healthcare: Rad or Fad?

There seems to be a lot of hype around Google Glass at the moment and its potential impact in the healthcare sector. It is expected that shipments of the product will increase from half a million units in 2012 to 6.6 million in 2016 [1]. 

As I analyse commentary on this revolutionary product, I get the overwhelming feeling that this is viewed as a step towards innovation rather than innovation itself although this is expected as it's still early days in the product development life cycle and apps are still in production. Regardless of concerns, the numbers seem to be pointing towards widespread adoption and if successful this is an exciting shift towards "The Hospital of the Future".

Philips Healthcare and Accenture have already seen the potential and have collaborated to explore the possibilities in Healthcare [2] as it's clear that Google Glass won't be hitting the catwalk anytime soon and so targeting enterprises is a much more appropriate option.

The Huffington Post recently published a slide deck on 15 ways Google Glass will transform the healthcare industry [3]. I wanted to evaluate each of the points in terms of my views on whether I think they are accurate and practical so without further ado, let's get the ball rolling...

Virtual Dictation
Rating: 5/10
If the aim is to simply record a conversation then yes this would work but audio files are only useful for litigation purposes. The real value comes from transcribing the conversation and if Siri is anything to go by then we are still a way off perfecting this. Once the kinks are perfected however then yes it will be useful.

Telemedicine
Rating: 7/10
So here's the scenario; you're carrying out minor surgery and need the guidance of an expert. You stream what you're viewing to the expert who is on a tablet while the both of you are talking to each other. This has the potential to be very impactful providing variables such as Internet connection don't get in the way. However, in a similar vain to virtual dictation, video conferencing still has a lot of issues. Very rarely have I attended a Google Hangout that hasn't had at least one minor hiccup and when this technology is in a pressurized situation such as a surgery then minor hiccups could risk lives. 

Resident Training
Rating: 10/10
In a safe environment, Google Glass would be a perfect way to show trainees not only what a practitioner sees on a daily basis but also a better visualization of techniques and visa versa, the teacher will be better able to critique.

Augmented Reality
Rating: 5/10
I can only express my personal opinion here as a non-practitioner but if vital signs are constantly in the corner of my eye, this could possibly distract me and also obscure peripheral vision.

EMS Communications
Rating: 8/10
Streaming images from the field back to the ER will prepare the awaiting doctors and nurses for what to expect. For one way video conferencing, it works well but my only concern is Internet connectivity out in the field, which may make it more of a distraction and hindrance.

Surgical Training
Rating: 10/10
Google Glass seems to be made for training purposes whereby everything the surgeon sees can be streamed to a large monitor as they talk through their actions. As long as these are standard procedures then I don't see any issues with this.

Improved Rounds
Rating: 3/10
The theory here is that medical records can be brought up whilst attending to patients on rounds. Although theoretically this sounds beneficial, it is compromising the human aspect of doctor-patient interactions. Personally, if I'm dealing with a doctor, I want them to be EITHER talking to me OR looking at my records, not both at the same time. Multi-tasking in this environment will fail to improve the end user experience.

Improving The Patient Experience
Rating: 1/10
The article seems to lose focus at this point. It seems to circle back to the telemedicine point, which I've already covered. Therefore, I'm going to rate this on its title; Improving The Patient Experience. I'd like you to picture something in your mind for a moment; imagine you're on a date with someone and you're chatting about your hobbies, your family, your travels etc. Now picture the same scene where your date is wearing Google Glass and already knows everything about you as they're reading up about you at the table therefore negating the requirement for your input. Does it sound awkward to you? It certainly does to me.

Procedure Analysis
Rating: 10/10
This goes back to training, which I've already commented on.

Patient Communications
Rating: 1/10
The article tries to convince the reader that Google Glass will improve alerts for patients. So instead of a pager buzzing to signal that the nurse is required at a patient's bed, Google Glass will flash up in the nurse's vision? Are nurses not busy enough?! Not only does this compromise whatever the nurse is currently working on but I imagine that a lot of nurses won't have the time to have a conversation remotely between visiting other patients and the mounds of paperwork they have on their desks.

Improved Visibility
Rating: 10/10
This (once again) goes back to training for future on-demand videos from different angles. Not much more to be said.

Telemedicine for Acute Patients
Rating: 8/10
This is a similar point to 'EMS Communications' in that Google Glass can help diagnose stroke sufferers quickly and organize the setting to properly receive the patient at the hospital. As previously stated, one way video conferencing will work well with Google Glass providing the Internet connection is reliable.

Patient Care Instruction
Rating: 10/10
Recording instructions that doctors have given so that the patient can re-visit it if unclear works well. It's a more sophisticated way of putting a Dictaphone on the table, making two copies and giving one to the patient. In this case, providing both the doctor and patient talk clearly, it will greatly reduce inaccurate instructions.

Faster Access to Information
Rating: 5/10
Yes, bringing up a patient record will more than likely be faster than accessing it on a tablet or mobile device but once again, I do not buy into the sales pitch that it gives the doctor more time with the patient. If I hold up a tablet to cover half of my face, that does not constitute still spending time with the patient. Once again, multi-tasking in this environment will not put the patient at ease.

Compliance
Rating: 9/10
As previously mentioned, audio recordings will enable a full record of what has been said in the event of a litigation case. Then it's just a case of storing them all and making them secure!

In a Jerry Springer-esque way, I'd like to leave you with my final thoughts. Theoretically, yes Google Glass has a lot of very useful applications and features that will speed up interactions and better inform practitioners. However it runs the risk of compromising the human aspect that a lot of patients require to feel confident about the future of their health. I hope that doctors and nurses will attach a glasses strap onto their Google Glass devices so that when the time comes where a personal one on one interaction is needed, they can put them down and focus.

Best Regards,

Jonathan Cordwell

Research Analyst, Healthcare Strategy

ResearchNetwork, CSC

1. InformationWeek Healthcare, Google Glass Gains Momentum In Healthcare June 18, 2014: http://www.informationweek.com/healthcare/mobile-and-wireless/google-glass-gains-momentum-in-healthcare/d/d-id/1278648
2. Philips, Experience the future of wearable technology - Philips Healthcare: http://www.healthcare.philips.com/main/about/future-of-healthcare/index-video.wpd
3. Huffington Post, How Google Glass Will Transform Healthcare, October 17, 2014: http://www.huffingtonpost.com/vala-afshar/how-google-glass-will-tra_b_6003100.html