OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC

Abstract

The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.

Der intelligente HNO-Operationssaal der Zukunft

“…The international research projects on implementation of a "surgical cockpit" include the development of concepts to design a "digital operating theater" where a technique is applied that is adapted to the individual surgeon's needs and that may be used effectively due to compatibility and communication of the single systems [1,3,9,10]. On a national level, an ICCAS project groups called "Modellbasierte Automation und Integration" (MAI, model-based automation and integration) works on the development of a prototypic IT system for administration, control, and monitoring of surgery processes.…”

“…As an example, in the project entitled "Context Aware Medical Assistance" the ICCAS could create a setup that should control the interoperability as well as the working process in the OR. In the context of clinical studies, the standardization process "IEEE 11073 SDC" [3] was conducted that is also applied in the OR.NET (see below). This international standard serves for realization of manufacturerindependent, interoperable networking of patient-near medical devices.…”

“…The system was tested in a total of n = 24 FESS (phantoms) with the result of an appropriate robustness of the implemented processing pipeline [1,19,20]. The principle of modular construction of the technical assistances was also applied in the multicenter project entitled "MoVE" (Modular Validation Environment) based on the standardized device description (IEEE 11073 SDC, service-oriented device connectivity) [3,36,37] in order to verify the transition from the theoretical idea to the clinical routine. This standard solution seems to be suitable for future networking open surgery systems with regard to market introduction [71].…”

“…Thus, the workflow should be optimized which would represent a real benefit for the surgeon and the medical OR staff. Further it is possible to compensate (probable) preoperative additional time efforts due to technical preparations [3,23]. Based on the example of the ICCAS "process navigator", the surgery pathways performed during FESS automatically lead to according postoperative steps (e. g., coding of sub-procedures, images of the surgery site) (▶fig.…”

“…Thus, the discussion about the increasing healthcare expenses becomes more and more important due to the application of robotic procedures, which will have an always higher impact on the technical developments. The current science-based developments give reason to hope that the current implications of modular, open systems leading to increasing networking and communication of the systems do not only improve the surgeon's concentration and assistance, but also result in a reduction of the costs [1,3](▶fig. 2).…”