IoT INNOVATIONS

Very few places can make better use of accurate, high-fidelity, real-time information than a hospital operating room (OR). From endoscopic camera video to vital-sign monitoring to electronic medical records (EMRs) containing recent scans—OR staff needs instant access to as much relevant data as possible to make quick, life-saving decisions during surgery. And with today’s technology, integrating all of that on a single display inside the operating room shouldn’t be much of a challenge.

But unfortunately, it is. Technology advancement is limited in hospital ORs by a supplier ecosystem driven by a few large OEMs and their proprietary technologies. Since these manufacturers are responsible for the vast majority of OR equipment today—everything from endoscopic cameras and operating tables to HVAC and lighting systems—they can package highly-integrated, total OR solutions that are expensive and don’t work well with other vendors’ systems.

This vendor lock-in makes adding technology that’s commonplace in other markets resource intensive, time consuming, and cost prohibitive for hospital ORs. As a result, hospital administrators are often forced to upgrade one or two of their ORs at a time through one of the leading vendors or, in many cases, not upgrade any of them at all.

Al Moosa Specialist Hospital, a leading health center in Al-Ahsa, Saudi Arabia, faced a similar compromise when trying to implement new, entry-level, “smart operating room” infrastructure. It looked outside traditional channels for help.

A #SmartOperating room integrates #OR equipment and hospital information systems (HIS) in a single pane of glass to give surgical teams instant access to all the #data they need. iMedtac via @insightdottech

A Smart Operating Room on a Cart

The staff at Al Moosa Specialist Hospital performs operations ranging from neurosurgery and vascular surgery to plastic surgeries and burn surgeries. Its breadth of healthcare services and 12 operating rooms make for a dynamic environment, and delivering high-quality patient care means continually increasing the precision and efficiency of ORs.

A smart operating room enables this by integrating OR equipment and hospital information systems (HIS) in a single pane of glass to give surgical teams instant access to all the data they need. At the same time, information from inside the OR—such as endoscopic camera feeds, video of the OR table, vital signs, etc.—can be relayed to nurses and hospital admins for coordinating post-op care, or to remote physicians who can offer guidance or feedback over the web in real time.

The smart operating room challenge is more of a data-integration challenge than anything. With that in mind, Al Moosa Specialist Hospital turned to medical WORX, a design consultancy and systems integrator that services healthcare customers in the Middle East. It, in turn, selected the iMOR-SDB OR integration system from the Internet of Medical Things technology provider iMedtac as the foundation of its smart OR design (Video 1).

The iMedtac iMOR-SDB ingests video and data from HIS and electronic equipment over APIs, then manages and routes it to displays in the OR, nurses’ stations, or wherever else it’s needed. In addition to data integration and video routing, the system can be used to record safety checks during the operation, display important reminders, stream to remote parties, and even recognize gestures.

Best of all, the software stack is packaged with the Axiomtek mBOX600, a medical-grade box PC built around 8th Generation Intel^® Core^™ processor technology that measures in at just 250 mm x 240 mm x 90 mm. In other words, small enough to be transported from OR to OR on a medical cart.

Critical for the iMOR-SDB are a half-size, 16-lane PCIe Gen 3 slot and a full-size PCIe Mini Card slot on the mBOX600, which are used to support either full HD (1080p) or ultra-HD (4K) video-capture cards. They also provide channels for video, endoscopy/microscope camera feeds, EMR or HIS information, and data from other systems. Multiple USB 3.1s, an HDMI 1.4 port, and dual DisplayPort 1.2 ports allow for quick integration with modern monitors and displays.

The entire stack is compliant with Health Level Seven (HL7) application-layer clinical data transfer, and the Fast Healthcare Interoperability Resources (FHIR) electronic healthcare data exchange standards.

“At Al Moosa Specialist Hospital, it’s on a nursing cart with a monitor; and the PC connects to the MRI, CT scanner, endoscopy machines, and internet to gather data from EMRs,” says Jason Miao, Business Director at iMedtac. “We also have a different module called the iMOR-SDB-CMS, central management system, which provides a standard FHIR- and HL7-compliant protocol that makes it easy for local installers to integrate the platform with HIS systems.”

The Smart Operating Room of the Future

One portable iMOR-SDB was deployed at Al Moosa Specialist Hospital in December of 2022, and it has already been so successful that administrators plan to deploy one in each of the facility’s 11 other operating rooms. These will be installed in a more permanent, wall-mount configuration, and integrate with the hospital’s EMR/HIS infrastructure via the central management system mentioned previously.

But regardless of how it’s installed, the iMOR-SDB is a standalone unit that doesn’t need to be physically integrated with other equipment beyond plugging in a monitor. Compared to the alternative, this saves time, effort, and cost for hospitals looking to operate as efficiently as possible, and to deliver the highest level of care via operating rooms of the future.
 

This article was edited by Christina Cardoza, Associate Editorial Director for insight.tech.