Smart Hospital: How devices communicate in the OR

In a Smart Hospital, all devices are designed to be connected and integrated, thus increasing efficiency and reducing time loss – at least, that is how things are meant to work in theory. In reality, there are still countless vendor-specific point solutions that cannot be integrated. That’s why there is a need for solutions that bridge the gap between the different applications and formats.

In this MEDICA-tradefair.com interview, Auke Meppelink talks about the Digital O.R. by Brainlab, outlines the important aspects for users in integrated ORs and reveals the obstacles that still need to be overcome before OR systems can talk to each other.

What is the Digital O.R. by Brainlab? Where and how can this platform be used?

Auke Meppelink: Our digital surgical products are aimed at increasing efficiency and improving surgical outcomes. It takes a lot of organization - such as coordinating OR personnel, equipment or data from multiple exams - to ensure optimal treatment and care for patients. This also necessitates the use of various technologies such as CT scans, navigation systems, microscopes, and maybe even robots. Our Digital O.R. solution simplifies all operating room processes with the help of intuitive software. It guarantees that all information is centrally managed and promptly available when needed.

To do this, we work closely with physicians from all over the world. This enables us to combine medical knowledge with our expertise in hospital integration while covering the entire surgical workflow at the same time. It all begins when the nurse prepares the surgical schedule, which our software is able to directly send to the OR. Once the physician enters the OR, all screens have already been prepared and are ready - that is, all required information such as patient data, diagnostic imaging, and pre-operative planning are projected onto the preferred screens. This might sound easy but is difficult to do and involves a lot of effort. Hospitals use various archives and systems that contain the relevant information. Generally, these programs and devices do not communicate with each other, while the staff frequently has to work with up to ten different interfaces. We are able to integrate all applications, allowing the information to be instantly visible in our system. We focus on seamless integration with the existing setup and emphasize an easy and intuitive user experience.

What are the added benefits for hospital facilities?

Meppelink: One major added benefit is time savings. The information is more structured and stored centrally in one place. It is thus more quickly available when needed. What's more, our technology reduces the surgical staff's workload, as evidenced by the surgical checklist: instead of manually recording all events and then entering them into the PC after the surgery, the operating room nurse is able to immediately enter all information into the system and save it automatically.

In addition, our solution grants physicians access to comprehensive and detailed information, thus allowing them to make informed decisions during the planning and surgical stages. The clinical relevance of our applications is an important distinguishing feature of Brainlab products. Our Smart Anatomy Viewer, which physicians are able to use online both in the operating room, as well as anywhere in the hospital or at home, automatically extracts the most important information from a patient's image such as a CT or MRI scan for instance. For example, during the resection of a liver tumor, the vessels and the tumor itself are clearly visible and displayed in detail on a CT scan. This assists the physician in choosing how to perform the tumor resection without causing damage to the vessels and other critical structures. Oftentimes, this type of information is hard to discern on an unedited CT scan.

What do users expect from integrated devices at the hospital?

Meppelink: Obviously, the expectation is for the integration to be seamless while allowing easy access to more information and data. In actuality, users frequently prefer easy-to-understand technology that does not make processes more complicated or even longer. That may sound obvious, but it often is not. Technology companies are consistently developing new systems, but they do not always emphasize an added benefit or consider the everyday work of users. Time and again, we see devices with amazing features that ultimately go unused. We always aim to achieve a better outcome for the patient at the OR. When important, medically relevant information is processed in an easy and improved way, and the time it takes for the setup and user settings is reduced, it enables the physician to concentrate on the critical surgical procedures. While great product knowledge training is definitely essential, it is just as important to put intuitive and easy-to-use products on the market.

What are the greatest difficulties as it pertains to integrated hospital equipment?

Meppelink: Not all systems are open and can subsequently be integrated. Time and again we encounter systems that do not have open interfaces. While that is slowly changing, it is frequently still a roadblock.

Does the OR play a special role in the Smart Hospital? If so, what role does it play?

Meppelink: Yes, it definitely plays a special role. If we think of the Smart Hospital as a hospital where the treatment and care processes at all departments and wards are digitally linked and integrated across clinical disciplines and locations, it is clear that the operating room is an extremely critical area. For one, even minor discrepancies or lack of information can result in drastic consequences during a surgical intervention. At the same time, the operating room is a major cost factor for hospitals: studies show that ORs as a whole account for nearly 40 percent of total hospital expenses. Efficiency is increased if there is more available data and less inhomogeneous information.

What trends will shape the development of the Smart Hospital or the Hospital of the Future, respectively?

Meppelink: The Hospital of the Future will predominantly be a digital hospital. This is the only way to facilitate the automation of numerous, chiefly administrative tasks. Imaging procedures will be increasingly done right in the OR - think Hybrid Operating Room – and in the future, information that was collected during the course of the treatment will be processed using big data analytics and artificial intelligence in support of the decision-making process. Efficient and smart data management in the background is the prerequisite for this process.