OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability

Abstract

Modern surgical departments are characterized by a high degree of automation supporting complex procedures. It recently became apparent that integrated operating rooms can improve the quality of care, simplify clinical workflows, and mitigate equipment-related incidents and human errors. Particularly using computer assistance based on data from integrated surgical devices is a promising opportunity. However, the lack of manufacturer-independent interoperability often prevents the deployment of collaborative assistive systems. The German flagship project OR.NET has therefore developed, implemented, validated, and standardized concepts for open medical device interoperability. This paper describes the universal OR.NET interoperability concept enabling a safe and dynamic manufacturer-independent interconnection of point-of-care (PoC) medical devices in the operating room and the whole clinic. It is based on a protocol specifically addressing the requirements of device-to-device communication, yet also provides solutions for connecting the clinical information technology (IT) infrastructure. We present the concept of a service-oriented medical device architecture (SOMDA) as well as an introduction to the technical specification implementing the SOMDA paradigm, currently being standardized within the IEEE 11073 service-oriented device connectivity (SDC) series. In addition, the Session concept is introduced as a key enabler for safe device interconnection in highly dynamic ensembles of networked medical devices; and finally, some security aspects of a SOMDA are discussed.

Der künstlich intelligente Operationssaal

“…Diese Integration der unterschiedlichen technischen Geräte im OP wurde im OR.NET-Projekt "Sichere und dynamische Vernetzung in Operationssaal und Klinik" des Bundesministeriums für Bildung und Forschung (BMBF) bearbeitet [9]. Ziel war eine modulare und dynamische Vernetzung von Geräten und Systemeinheiten im Operationssaal zu erreichen und in den Gesamtkontext klinischer IT-Systeme zu integrieren.…”

Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University Hospital

“…12 Pertaining to the requirements, a high-level architecture based on "Integrating the Healthcare Enterprise" (IHE) integration profiles was defined by Pahontu et al 13 Within OR.NET, concepts and mechanisms for both medical device-to-device communication and medical device-to-infrastructure (device to hospital IT infrastructure) communication were developed. The overall service-oriented architecture (SOA) for medical device-todevice communication described in the study of Kasparick et al 14 is based on the Device Profile for Web Services (DPWS) standard, 15 while medical device-to-infrastructure communication is presented in the study of Andersen et al 16 Five demonstration sites with different main purposes were established for presenting and evaluating the concepts and mechanisms, for both medical device-to-device and device-toinfrastructure communications, developed within OR.NET. The following sections describe the objectives of this article, the method used for setting up the demo OR at Heidelberg University Hospital as well as the evaluation method.…”

“…This connector maps HL7 messages to IEEE 11073 SDC. The context manager groups medical devices into different sessions and sets various contexts depending on the context implementation degree supported by medical devices (detailed information on this component can be found in the studies of Kasparick et al 14 and Andersen et al 16 ).…”

“…For example, IHE PCD-01 compliant data directly emerging from Philips patient monitoring system were integrated and displayed within the hospital PDMS COPRA6. For data from Dräger patient monitoring system and anesthesia machine, we implemented an indirect data transmission according to the Device Observation Reporter (DOR) mechanism described in the studies of Kasparick et al 14 and Andersen et al 16 We implemented a component that collects all information of interest from the SDCcompliant device and performs the transformation of this information to IHE PCD-01 messages. By implementing the IHE PCD-01 transaction, we demonstrated a used case for a vendor-independent acquisition and transmission of medical device measurements to the hospital PDMS COPRA6.…”

“…The OR microscope was still able to remotely control the electrosurgical unit even after completion of the session (test scenario 17 in ►Table 3) because the safety context was not implemented at the time of evaluation. Further details about the safety context mechanism can be found in the study of Kasparick et al 14 In this article, we presented implementations of various connection concepts for the OR with hospital IT systems. However, these implementations are not synchronized among each other, as the distribution of the patient and order context was different for each integration scenario.…”