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Software systems connect patient data, video and imaging components to surgical teams during the procedure so they can access information when they need it. (Courtesy of LiveData)Operating room visualization equipment has created both opportunity and issues. These challenges range from connecting visualization monitors with sources, to storing and sharing large files.

Managing these elements is especially concerning in relation to:

  • Potential Health Insurance Portability and Accountability Act (HIPAA) violations: Protecting patient information includes making sure images and video stay with the right people. Traditional methods of exchanging these files through encrypted USB drives or printing photos are not secure.These can be lost or stolen, along with all the patient information included, and found by people who will take advantage.
  • Workflow: Imaging systems and video recorders traditionally have their own memory banks, which means if files are not exported and saved, cases can be delayed or content can be lost. Access to files is also an issue, especially in a large healthcare system with isolated servers.

To make this network diagram bigger, click HERE.Suppliers offer basic and customizable solutions to these problems. For instance, during the procedure, video management systems direct images to different screens without having to rearrange equipment. Some of these systems automatically save video and images to a server, share content live outside the OR, such as to a control station or classroom, and save important clips to electronic medical records during the operation.

Following the procedure, basic networks provide a secure repository of images and data. How this information is accessed varies by supplier, but options can include a web-based browser, intranet connection or smartphone app. Some ensure security with requiring HIPAA-approved logins and tracking the file’s chain of custody.

What can surgical teams do to improve implementation?

Laura Holly, director of marketing at Image Stream Medical: “A true image connectivity system requires collaboration between clinical and IT to create a system that works for clinicians. The real challenges are in helping clinicians evolve their workflows to take advantage of this technology.  For example, when clinicians are accustomed to having a physical manifestation of their case - printing out images or copying case files from a USB stick to a hard drive in their office – it can take time to adjust to relying on virtual access wherever they need it – from a browser, a mobile device, or a familiar application like the EMR to their case imagery stored on a secure, central server.  But once they do, they don’t ever want to go back.”

Evan Krachman, product manager and new business development of Sony, added team members also had to be aware of why the systems were installed to feel fully confident using the systems. “The process can vary from different organizations, but still remains crucial to the success of the hospital and the surgical teams,” he said.

What should be expected of video management systems?

Tom Impellizeri, OEM business and product manager at EIZO: “Integrated imaging options mean a wider range of procedures can be performed in one operating suite, such as a hybrid OR. Information from multiple video sources can now be seen on one large, quad HD 4k display monitor, providing more procedural focus, improving the OR’s efficiencies and ensuring staff safety with less cord clutter.”

How do systems influence workflow?

Jake Thiede, marketing manager of Stryker Endoscopy: “Most systems require nurses to take names and patient ID numbers off of schedules and then manually enter them into the image capture devices.  With the proper integration, that information can come to the capture device automatically. This is beneficial because that data is also used to match the images to the right record in the EMR. If it is manually typed and there was one missed keystroke, it won't connect those images to the record.”

“So, when the demographics populate automatically, then the system is tee'd up for the nurse, with the patient and procedure-type in the capture device. Physician settings (can also be stored) for each procedure, and applied according to the information the EMR provides. This saves time typing in patient demographics and the guess-work of perfectly configuring the system to the right colors, brightness, speeds, recording formats, insufflator pressures and other factors.”  

How do systems work with different vendors?

Devon Bream, MPH, FACHE, vice president of global medical sales and marketing at Black Diamond Video: “Beyond the baseline requirement of secure connectivity, the surgical team must ensure that the vendor they select is truly agnostic. Many device manufacturers design and deploy image capture and management systems optimized only for their endoscope tower or imaging magnet, for example. This approach is counterproductive to today’s healthcare information exchange goals.”  

Realistically, how technical should these systems be?

Darko Spoljaric, vice president of Global Marketing at NDS Surgical Imaging: “Companies will tell the surgical teams they have to have the latest visualization system to avoid obsolesce or non-compatibility issues; there is little truth to those claims.”

“HD 1080P and high-resolution analog video sources are still prevalent today in the OR, and will be for the foreseeable future. This is not to dismiss new upcoming technology, such as the much touted 4K video systems.  However, a modern visualization system will be able to handle all major video formats. How large a hybrid OR program is, or wants to become, will also drive the surgical team to prioritize what level of technology they want to invest in, train to and maintain.”

If a facility is evaluating these options, vendors suggest surgical teams ask questions like:

  • What is the OR hoping to accomplish?
  • What training is available?
  • How will this system interact with existing software?
  • What maintenance plans and support can the facility provide staff?
  • Is our IT team prepared to handle a project like this in terms of image storage and budget?

This article was featured in the November/ December 2015 issue of Surgical Products. To see the complete issue, click HERE

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