Surgical data recording technology has great promise to generate patient safety and quality data that can be utilized to potentially reduce medical errors. Variations of these systems aim to improve surgical technique, develop better training simulation, and promote adverse event investigation similar to the aims of black box technology utilized in other industries. However, many unknowns remain for surgical data recording utilization in operating rooms and clinical settings in the United States. This includes the need to appropriately design systems so they collect meaningful and useful data that can be discussed by surgical team members in an open and safe environment to optimize clinical care processes. In order to better understand the clinical and regulatory environment for surgical data recording systems, we conducted an interdisciplinary review to identify key technology approaches, and assess legal and regulatory implications associated with this potentially disruptive technology. We found technology ranging from audio and visual data, to systems utilizing mobile applications, and kinematic data capture. The data collected present legal questions over ownership of information and privacy, along with regulatory issues at the federal and state levels. The benefits of these data should be balanced with the need to develop appropriate policies and regulations that protect the interests of both clinicians and patients in order to encourage further innovation and better realize the potential of surgical data recording technology to improve clinical decision making and patient safety outcomes.
This paper presents a risk evaluation based approach to the replacement strategy of aged HVDC components. It includes estimation of unavailability of individual HVDC components due to aging failures, calculation of capacity state probabilities of the HVDC system, quantified risk evaluation of the power system containing the HVDC link and benefit/cost analysis for different replacement strategies. The presented approach can be also applied to other system components. The replacement strategy for an aged submarine cable of the HVDC link in a power supply system at British Columbia Transmission Corporation has been analyzed as an example to demonstrate the actual application. The procedure of the analysis has been explained in detail in the example.
Reducing preventable medical errors remains a universal goal, yet implementing effective solutions remains a challenge. The development of surgical data recording technology shows promise to generate robust qualitative and quantitative data in the surgical theater. These data can allow physicians and their teams to capture specific sources of error and implement corrective interventions. Surgical data recording technology encompasses rudimentary data tabulation on notecards, to integrated audio-video systems containing cameras, microphones, and sensors, capturing and synthesizing intraoperative, environmental, and instrumentation information, along with devices tailored to robotic surgical systems. There is growing interest in the implementation of such technology in medical centers, particularly in the United States, Canada, and Europe, but existing medicolegal and regulatory challenges necessitate further research and clinical assessment in order for this technology to facilitate improved surgical patient safety.
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